To Immunize or Not to Immunize - Part 1

Immunizations have been a hot topic in Colorado lately due to pending state legislation (Colorado House Bill 1288) that would tighten the rules for how parents exercise the "personal belief" exemption from immunizing their children. 

When it comes to vaccinations, our family is all in.  We fully immunized our oldest son according to the standard schedule from the American Academy of Pediatrics and he has never had so much as a fever from a vaccine.  He has also been a really healthy kid, in general and does not have MCADD.  We felt that immunizations for our MCADD kid were even more important and he has also been fully immunized according to schedule.  Since entering our parenting years, my husband and I have been regular recipients of annual flu shots and also have gone in for the whooping cough booster shots (tdap).


I was curious whether there was any specific guidance on immunizations for children with fatty acid oxidation disorders and was pleased to find a study in the Journal Pediatrics from 2006.  The basic outcome of the study for MCADD patients was that "because patients with these disorders can become extremely ill with infections in general, but particularly with those that are associated with nausea and vomiting, it is obvious that these children should not be permitted to confront wild-type infections.  Immunizations are an essential part of the health care maintenance of this patient population."

In addition, the study asserted that "contraindications against immunizations were not found in the available infectious disease and metabolic disease databases for inborn errors of metabolism. However, there are some inborn errors with associated impaired immune functions or tendency for rapid decompensation that may require caution and close follow-up after administration of immunizations. The purpose of these follow-up evaluations is to not only monitor for metabolic decompensation but also assess for suboptimal immune responses to the vaccinations that could potentially leave these patients susceptible to major vaccine-preventable diseases."  In other words, definitely immunize, but always observe your child closely after immunizations.

Although there definitely needs to be more research to ensure that our kids are actually getting appropriate immunity from vaccinations, I take comfort in the meantime knowing that my kiddo has some degree of immunity from a vaccine.  That comfort definitely outweighs the unknown of what he might encounter from the actual virus he could contract without that immunity. I know when a vaccine is administered and what side effects to watch for.  We carefully monitor him after immunizations to make sure that he is eating and drinking well and that his system isn't stressed by fever or illness, so it is definitely a far more controlled situation than him catching a random infectious disease, which I think we can all agree that we dread!!