CHERUBS Medical Expert Series: CDH & Vaccinations (Oct 1-7, 2013)

[christinastembler]

Chris, RSV Shots, with what information can a parent approach an Insurance Company to better the possibility of Qualification after 2nd year of life?

[ChrisBarry]

Hi Dawn,
Actually albuterol is a bronchodilator, not a steroid, and it is fine to give immunizations with albuterol. Also, for children on inhaled steroids like Pulmicort, Flovent, etc, it is perfectly fine and recommended for them to receive immunizations on schedule.

Chris, what about the cherubs who are on long-term steroids like Albuterol?

[ChrisBarry]

Excellent question. Getting RSV vaccines covered by insurance can be difficult, especially as the children get older. The vaccine is extremely expensive, and has to be given monthly during the RSV season. I recommend talking with your child's pediatrician's office to see if they have a RSV vaccine coordinator who can help work with the insurance and vaccine companies. Best of luck!

Chris, RSV Shots, with what information can a parent approach an Insurance Company to better the possibility of Qualification after 2nd year of life?

[HeidiForney]

As the parent of a very complex CDH kiddo (16+ yrs old, who lost a large portion of intestine both small and large as an infant due to NEC) we were told that he is not allowed to have any live vaccines. I asked at his most recent appt and that is still the case, per his surgeon. When Sean was a baby he also suggested it would be prudent to consider doing just one vaccine at a time rather than doing them as typical babies, several per visit, even if that meant delaying some of the vaccines a little bit. What are your thoughts on this?

[ChrisBarry]

Hi there,
I would do as your surgeon recommended. In general, we recommend getting vaccines done per the recommended schedule. Many vaccines have a range of ages during which they may be given. In a complex case like your son, sometimes variations to the schedule are permitted.

As the parent of a very complex CDH kiddo (16+ yrs old, who lost a large portion of intestine both small and large as an infant due to NEC) we were told that he is not allowed to have any live vaccines. I asked at his most recent appt and that is still the case, per his surgeon. When Sean was a baby he also suggested it would be prudent to consider doing just one vaccine at a time rather than doing them as typical babies, several per visit, even if that meant delaying some of the vaccines a little bit. What are your thoughts on this?

[jcrawford]

as the parent of a now adult 22 yearold surviour what about the guardisil shot for girls does she need it or not

[ShellyMoore]

With the large amounts of blood products some of our Cherubs sometimes need (especially during ECMO) and the frequent in & out of the hospital, are Hepatitis A and B vaccines warranted & if so when?

Shelly

[ChrisBarry]

Hi,
The HPV vaccine is recommended for females from ages 11-26, so your daughter is in that age range. Gardasil is also indicated for males up to age 21.

as the parent of a now adult 22 yearold surviour what about the guardisil shot for girls does she need it or not

[ChrisBarry]

Good question. Especially for children who are exposed to blood products, and even those who aren't, Hepatitis B vaccine is definitely recommended. Hep B is a 3-dose series that can be started as soon as the child is born. Hepatitis A is spread through food and fecal to oral contact. It is also recommended to get the Hep A 2-dose series after age 1 year.

With the large amounts of blood products some of our Cherubs sometimes need (especially during ECMO) and the frequent in & out of the hospital, are Hepatitis A and B vaccines warranted & if so when?

Shelly

[ChrisBarry]

Here is a link to the CDC's recommended vaccines for adults. Figure 2 "Recommended vaccinations indicated for adults based on medical and other indications" has a column for "Chronic Lung Disease", which would apply to many Cherubs.

http://www.cdc.gov/mmwr/preview/mmwrhtml/su6201a3.htm