vaccination question

[Philosykos 0]

O.k., so today I went to a doctor to get my vaccinations updated. The doctor said since my last tetanus immunization was only 4 years ago, I should NOT get the combined tetanus-diphteria-pertussis vaccine (Tdap), because there should be a gap of five years (she got this from her vaccination information booklet regarding the Tdap vaccine). So she gave me the simple Td (just tetanus-diphteria).

Back home, I do more research, and realize that I should have gotten the Tdap, to have pertussis immunization. Pertussis vaccine ONLY exists in combination. Now I wonder if I will be required to do the Tdap even though I JUST received a Td vaccine, and despite the fact that I read everywhere (even on the site of the vaccine's maker) that it is not recommended when you have received a Td vaccine less than five years ago...

Does anybody know what they do in this kind of situation? And how harmful would it be to get another Td vaccine within a short period of time, when usually a gap of five years is recommended? Anybody been in that situation?

I am so mad at that doctor, and even more at myself for letting her talk me out of getting the Tdap! Not to mention I feel totally gross because I am having a reaction to the vaccine (flu-like symtoms, I've had that before after shots).

[Ed+Cindy 1]

O.k., so today I went to a doctor to get my vaccinations updated. The doctor said since my last tetanus immunization was only 4 years ago, I should NOT get the combined tetanus-diphteria-pertussis vaccine (Tdap), because there should be a gap of five years (she got this from her vaccination information booklet regarding the Tdap vaccine). So she gave me the simple Td (just tetanus-diphteria).

Back home, I do more research, and realize that I should have gotten the Tdap, to have pertussis immunization. Pertussis vaccine ONLY exists in combination. Now I wonder if I will be required to do the Tdap even though I JUST received a Td vaccine, and despite the fact that I read everywhere (even on the site of the vaccine's maker) that it is not recommended when you have received a Td vaccine less than five years ago...

Does anybody know what they do in this kind of situation? And how harmful would it be to get another Td vaccine within a short period of time, when usually a gap of five years is recommended? Anybody been in that situation?

I am so mad at that doctor, and even more at myself for letting her talk me out of getting the Tdap! Not to mention I feel totally gross because I am having a reaction to the vaccine (flu-like symtoms, I've had that before after shots).

We're in this situation too.

My fiance had the TDP 3 years ago. K-1 (AOS) requires TDaP (acelluar pertussis, not plain pertussis). This is the only vaccine she will need, because of the pertussis being different.

Maybe it is available as a single vaccine in the US?

I know in New Zealand, it is only in a combined vaccine.

Tell the doc your story and if it really isn't recommended, there is a place the doc can check that states he does not recommend it. Up to him though.

[Philosykos 0]

Thanks for your response, Ed. I will talk to the doctor, of course, and we'll see. I still have a bit of time till the medical, since we are still waiting for NOA2.

I am surprised that they would make your fiancée have another pertussis shot just because she didn't have the newer formulation (acellular). I thought the difference between the old and the new formulation was simply that the new has less side effects.

Edited April 1, 2009 by Philosykos

[Ed+Cindy 1]

I am surprised that they would make your fiancée have another pertussis shot just because she didn't have the newer formulation (acellular). I thought the difference between the old and the new formulation was simply that the new has less side effects.

Maybe they won't make her have it. She hasn't been to the medical yet. (we're waiting for NOA2 as well).

FYI: Info on the medical exams from CDC:

http://www.cdc.gov/ncidod/dq/panel.htm

Edited April 1, 2009 by Ed+Cindy

[Chrito 8]

My doctor called vaccination experts from a nearby university about that matter. The single pertussis shot is not available anymore in the whole wide world...

[Philosykos 0]

My doctor called vaccination experts from a nearby university about that matter. The single pertussis shot is not available anymore in the whole wide world...

I know... Isn't that stupid? Anyway, I have researched the problem quite extensively since yesterday (being off work due to vaccine reaction has given me lots of time... ), and have come up with these results regarding the safety of administering the Tdap shortly after a Td shot:

A study published in 2006 came to the conclusion that it can be done as early as 18 months after a Td shot without a significantly increased risk:

http://www.ncbi.nlm.nih.gov/pubmed/1651137...Pubmed_RVDocSum

A study published in 2009 concluded that it is safe to administer Tdap as early as 1 month after a Td shot:

http://www.ncbi.nlm.nih.gov/pubmed/1901137...Pubmed_RVDocSum

From these and other sources, I gather that the main concern is that the tetanus component of the vaccine, if given at too short intervals, may cause a local (i.e. skin) reaction at the injection site. Personally, I am more concerned about systemic side effects, especially given that my reaction to yesterday's Td shot was less than favorable (slight fever, body aches, nausea). Ultimately, however, what worries me is the thought of more serious or possibly long-term effects. There don't seem to be any data regarding such a risk.

Anyhow, I will see what the consulate doctor recommends. I do hope to get pregnant in the near future, so I am actually interested in getting the pertussis vaccine. I just wish I had gotten it yesterday instead of listening to that doctor's unsound reasoning about how I couldn't get Tdap because of my relatively recent tetanus shot, yet Td was o.k.!

Edited April 2, 2009 by Philosykos

[Chrito 8]

Same here, I wanted to get the shot because of getting pregnant next year. Talked to my Gyn and she said it doesn't matter whether to have the shot or not.

After talking to my doctor she gave me the Tdap, my next Td shot was due in 2011, so I've been on the safe side. If I weren't she wouldn't have done it, she would have gotten me a letter from the vaccination experts containing that the risks are way to high. And I didn't want to take the risk to get a stiff muscle which can't be reversed plus an allergic reaction to all upcoming tetanus and diphtheria shots. (just google covaxis, that was my vaccine)

Anyhow, pertussis vaccination work only in 85%, one of my younger relatives got it a couple of years ago although he was fully vaccinated

I read that the panel physicians can grant a waiver if it is not medically appropriate to have a vaccination

[Philosykos 0]

Where did you get the information on the high risk of irreversible muscle stiffening, and later allergic reactions? Please post a link. I would like to see the basis for that. I want to be aware of the risks, but I am also aware that there is a lot of anti-vaccination propaganda out there that doesn't usually have much evidence to support it.

That said, I would also rather not get another shot at this point, and I hope that the consular doctor will sign a waiver. What letter would your doctor have given you? From which vaccination experts? I might want to get something like that as well. Thanks!

Same here, I wanted to get the shot because of getting pregnant next year. Talked to my Gyn and she said it doesn't matter whether to have the shot or not.

After talking to my doctor she gave me the Tdap, my next Td shot was due in 2011, so I've been on the safe side. If I weren't she wouldn't have done it, she would have gotten me a letter from the vaccination experts containing that the risks are way to high. And I didn't want to take the risk to get a stiff muscle which can't be reversed plus an allergic reaction to all upcoming tetanus and diphtheria shots. (just google covaxis, that was my vaccine)

Anyhow, pertussis vaccination work only in 85%, one of my younger relatives got it a couple of years ago although he was fully vaccinated

I read that the panel physicians can grant a waiver if it is not medically appropriate to have a vaccination

Edited April 2, 2009 by Philosykos

[Chrito 8]

Where did you get the information on the high risk of irreversible muscle stiffening, and later allergic reactions? Please post a link. I would like to see the basis for that. I want to be aware of the risks, but I am also aware that there is a lot of anti-vaccination propaganda out there that doesn't usually have much evidence to support it.

That said, I would also rather not get another shot at this point, and I hope that the consular doctor will sign a waiver. What letter would your doctor have given you? From which vaccination experts? I might want to get something like that as well. Thanks!

That's what my doctor told me after talking with an other doctor and calling the university. But since I was on the safe side with the new vaccine we didn't talk about that anymore. I was just glad I refused to be given a single tetanus shot after a minor accident and some stitches last year. Because if I had that tetanus shot she wouldn't have given me the combined one.

I'm not at all against vaccinations, but you always have to know what's going on.

I would say not to worry about that topic anymore, just wait and see what the panel physician has to say. That's why I'm going to the medical well ahead before the interview (May 14), I think right after Easter, in order to get everything squared away by the time of the interview.