A Guide to Vaccines & Advocacy: Our Story

Updated: Dec 3, 2020

Despite my training as a pediatric nurse, one of the biggest decisions my husband and I faced as new parents was to vaccinate or not to vaccinate. In this post we will discuss vaccinations, but the over arching theme is parental confidence and advocacy. Let us get into the story that led me to write this post and create the Parental Advocacy Form (linked below).


Leading up to our little one’s (LO) two-month appointment I was dreading the moment it was time to discuss vaccinations. Working in a free-standing pediatric hospital, I see how the parents of unvaccinated children are looked at and I did not want to be on the wrong side of the whispers. On one hand, I did not want our decision to not vaccinate to negatively affect our daughter’s medical care but on the other hand my husband and I had serious concerns about vaccinations. Regardless of our uncertainty, at the end of a great appointment the moment came when our doctor said, “the nurse will be in shortly to give {LO} her two-month shots.” I must have let out a large enough sigh our pediatrician knew something was on my mind. Not only did I have to defend my hesitancy over vaccines, but I had to do it with my husband on video call barely able to hear let alone chime in because of COVID restrictions.


As I opened my mouth, I found all my carefully thought out reasons went out the door and in came the nervous rambling. For the first time, I understood how it felt to be a parent, being told what is best for your child despite not really having your questions answered. In the end, we opted for an alternative vaccination schedule. It was a done deal, our LO received her shot, screamed that painfully piercing scream, and gave us the straightest baby face for the next three days. At work, one of my favorite things to tell parents who were uncertain about their child’s medical care was “get involved with the discussion, ultimately you know your child best.” I left feeling like I was not her biggest advocate.


As LO started to feel better, so did I, until I called the pediatrician to schedule her next vaccine. The scheduling nurse informed me that she was due for 3 more shots. It was made clear that my husband and I were on a different page then her doctor. Our hesitancy on vaccines caused the pediatrician to order every single vaccine as a separate shot instead of keeping certain ones as a combination shot resulting in more pokes. I was upset but understood how it could be have been an easy misunderstanding after our discussion. Our vaccine story is still developing… with the four-month shots (and the resource below) we will get it right.


Now that you know our story, we will address common vaccination fears, solutions to help make vaccinating easier for your family, and a free resource to help you advocate for your child during doctor visits.


Common Vaccination Fears

Importance & Efficacy

First, we will talk about the importance of vaccines and how they work. Your child was born with an immune system that can recognize germs entering their body as foreign invaders and in defense, produces proteins called antibodies to fight them. The first time your child is infected (or introduced as with vaccines) with a virus or bacteria, the immune system produces antibodies designed to fight it. The immune system is unable to work fast enough to prevent the germs from causing disease, leading to your baby getting sick. However, the immune system remembers that germ. If it ever enters the body again, even after many years, the immune system will be able to produce the necessary antibodies fast enough to fight the illness a second time. This protection is called immunity.


Vaccines help develop immunity by imitating an infection which causes the immune system to produce T-lymphocytes (a type of defensive white blood cell) and antibodies triggering an immune response. Once the imitation infection disappears, your body is left with a supply of memory T-lymphocytes and antibodies strengthening immunity and disease prevention.

Vaccines contain the same antigens (or parts of antigens) that cause diseases in an inactive or weakened state so that they do not cause disease but are strong enough to make the immune system produce antibodies. For this reason, vaccinations are a safer substitute for your child’s first exposure to a disease. You child can develop immunity without suffering from the actual diseases that vaccines are designed to prevent.


Ingredients & Safety

The ingredients and safety of vaccines are what was a cause of concern for our family. Debate surrounding vaccine ingredients and safety is due to the suggestion there is a relationship between thimerosal, which contains mercury, and autism & Sudden Infant Death (SIDS). There is evidence and countless research on both sides of the argument. Now I do not believe that vaccines CAUSE autism or SIDS, however, I was still concerned about putting these toxic ingredients into my precious new baby. Being pro anything natural, my hesitation to vaccination was regarding how her body, specifically her brain, would handle and flush out the toxins.


According to the Centers for Disease Control (CDC), each ingredient in the vaccines either provides immunity, acts as a preservative, or is used in the production of the vaccine. Below is a table from the CDC detailing the types of ingredients, examples of the type, the purpose, and the most common source of the ingredient.

* Thimerosal has a different form of mercury (ethylmercury) than the kind that causes mercury poisoning (methylmercury). It’s safe to use ethylmercury in vaccines because it’s processed differently in the body and it’s less likely to build up in the body — and because it’s used in tiny amounts. Even so, most vaccines do not have any thimerosal in them. Learn more about thimerosal, mercury, and vaccine safety.


^ Because influenza and yellow fever vaccines are both made in eggs, egg proteins are present in the final products. However, there are two new flu vaccines now available for people with egg allergies. People who have severe egg allergies should be vaccinated in a medical setting and be supervised by a health care professional who can recognize and manage severe allergic conditions.


†Formaldehyde is diluted during the vaccine manufacturing process, but residual quantities of formaldehyde may be found in some current vaccines. The amount of formaldehyde present in some vaccines is so small compared to the concentration that occurs naturally in the body that it does not pose a safety concern.


Taken from https://www.cdc.gov/vaccines/vac-gen/additives.htm


Side Effects

Side effects of vaccines are usually mild such as a low-grade fever, swelling, pain and redness at the injection site. More serious reactions are rare, but if you have concerns you can always wait in the doctor’s office a few extra minutes to be sure. After her vaccinations, LO is usually just a little fussy for three days or so, nothing a few extra cuddles couldn’t handle.


Common Solutions to Vaccination Fears

Alternative Vaccine Schedule

Some pediatricians will allow you to do an alternative vaccine schedule, meaning you can space out the shots if your LO receives them by the appropriate age. It is important to know the American Academy of Pediatrics and the CDC do not support alternative schedules, however, a lot of parents decide this option is best for their children. Our family ultimately decided this was the route we would take with our LO's vaccinations. Some say this method is potentially more traumatizing since you are spacing out the pokes. For us, we decided spacing out the potential harmful ingredients giving her body time to clear them out, was more important since she usually gets over the pain of the poke quickly and sometimes doesn’t react to it at all.


More Than One Poke at a Time

Another option is to have two nurses administer two shots at once, one in each thigh. Some believe this method reduces the trauma because the pain from the shots occurs once instead of consecutively. In my practice as a bedside nurse, a few parents have requested this method and I’m not quite sure I can confirm this reduces trauma but the babies didn’t seem to be in any extra amount of pain (let’s face it, shots hurt either way).


Pain Reducers

Pediatric offices almost always have some type of pain reducer you can request. At the hospital, I have worked with lidocaine cream to help numb the area and a little tool that vibrates and is meant to block the pain. Our pediatrician’s office has a little pad with multiple prick points meant to stimulate the prick in multiple locations, so the one large prick of the shot hurts less. We chose not to use this tool because, frankly, it looked like it had been used on too many different patients and we were told it works best for older children. Nursing Trade Secret- ask your nurse to administer the shot after the cleaning alcohol is completely dry, this significantly reduces pain!


Advocacy

Now back around to the real reason I wrote this post. Like I said earlier, the vaccine discussion was a point of worry for my family. Due to our apprehension, our baby ended up with more pokes than she needed to have which means more pain, more visits to the doctor’s office, and more exposure to the ingredients we were worried about. I went in so sure we would be able to refuse the vaccines, because we're the parents and we say no. But I found out that was not the case. I regret not being more organized in my thoughts and feelings and better equipped to articulate why I did not feel my LO should be vaccinated so young.


For this reason, I have created a form you can fill out prior to going to appointments with information such as milestones your baby has met, current medications, current feeding schedule and any questions you may have. There is also a section for you to take notes during your visit to ensure you and the medical team are all on the same page. Stating your opinion on your child’s development, medical care, and asking all questions are all equally important. You must be your child’s advocate!


You can download the Infant Check-up Log and take it with you to appointments as long as you feel it is necessary.



Infant Check-up Log (1)
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PDF • 46KB

C. Hughes, The Impactful Nurse



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