Parents worry about the unvaccinated Measles vaccine can have multiple doses

Try articulating your visions, Aquarius

Dear Amy: I’m about to have my first child. My brother and his partner have a young child. They have chosen not to vaccinate.

While I am not looking to get into a vaccine debate with them, I have some concerns about letting their young child come into close proximity withmy newborn.

We plan to vaccinate our child. Prior to our baby receiving those vaccines, I am uneasy exposing the baby to children who are unvaccinated. I do not want their child around mine, until mine has been vaccinated. But I don’t want to upset them or get into a debate about vaccines with them.

How should I approach this? — Worried New Mother

DearWorried: Your job as a parent is to use your best judgmenttodowhatis best for your family. Your brother and his partner are using their own judgment, and have their own reasons, for denying their child vaccines.

According to my research, including conversations with pediatricians and many reputable sources, your unvaccinated baby is in a high-risk group for vaccine-preventable diseases.

You should be aware of the risks and limit contact with unvaccinated children, possibly until your child is a year old.

“Herd immunity” means that this other unvaccinated child is likely being protected by the vaccinated people surrounding them. (Your choice to vaccinate helps to protect other children fromdisease.)

Assume that you will have to have at least one conversation with these other parents regarding your own choice. Pass along your doctor’s recommendations using neutral language, and say that you will followthe doctor’s advice.

Having this conversation may upset familymembers, but talking is less dangerous than the risk of whooping cough, measles, flu and other diseases.

Readers can send email to askamy@amydickinson.com or letters to “AskAmy” P.O. Box 194, Freeville, NY, 13068.

Dear Dr. Roach: My daughter is 4 years old and has, in the past five days, developed measles. She was vaccinated at 9 months and has been treated with antibiotics, Tylenol and vitamin A supplements. What concerns me is that she is now experiencing seizures, even without a fever. Theyarenot grand mal seizures, but simple ones. They havemeworried. What can I do?— G.A.

Measles remains a serious disease in many parts of the world, with 90,000 deaths reported in 2016.

Vitamin A supplements may be of value in those who are deficient, and Tylenol can help keep the fever down, reducing the risk of febrile seizures. The antiviral drug ribavirin sometimes is used, though without clear evidence of effectiveness. Otherwise, there are no effective antibiotics or other treatments for measles.

When seizures occur in a child with measles in absence of fever, it can indicate a complication called encephalitis — inflammation of the brain. Children also may experience nausea and vomiting, and they usually have a headache. Confusion and sleepiness are other common symptoms. The diagnosis can be confirmed by an evaluation of the fluid around the brain.

Confirmed encephalitis with measles is treated with steroids. This reduces the risk of permanent brain damage. Even so, 25 percent of children may be left with some impairment, including epilepsy.

Unfortunately, vaccination at 9 months is not adequate protection. Children’s immune systemsmaynot be able to fully respond to the vaccine so early. Children are recommended to have the measles vaccine at 12-15 months and again at 4 to 6 years in the United States. In countries where risk of measles mortality remains high, children are vaccinated at 9 months, then again at 15-18 months. During an outbreak, a dose may be given as early as 6 months old.

Write toDr. Roach at ToYourGoodHealth @med.cornell.edu.

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