Daycare with unvaxxed kids?

July 30, 2016 4:46 AM

I'm looking for help figuring out how big of a risk this poses.

Daycare is very limited in our area. We found a spot that would be fairly convenient but the provider's own children are on a delayed vaccination schedule due to a bad initial reaction to vaccines. Our baby is on the regular schedule but is still young enough to only have had the first set of vaccines (2 months). There haven't been outbreaks of measles in the area but vaccination rates are not as high as I would like, so heard immunity may be limited.

I'm talking to my doctor but I think to some extent this is going to come down to my tolerance for risk. If we don't get into this daycare we are going to be paying out the nose for a nanny, which we can afford but will not work quite as well for us. If anyone can point me to statistics about how dangerous it might actually be, or share how you made a similar decision, that would be very helpful.

posted by anonymous to Health & Fitness (23 answers total)

I wouldn't risk it. Kids are dirty- they'll touch and put everything in their mouths. They don't wash their hands, they don't cover their faces when they cough. Consequently, they get sick alllll the time, especially in a setting like daycare. Your child is young enough to die from pertussis, the flu, or measles. While it's unlikely, I think I would take every possible precaution and find another care arrangement. It's great that your provider has their children on a delayed schedule and not opted out entirely- maybe you send your baby after they've completed them?

According to the CDC, you'd have to worry more about pertussis or the flu than measles, as measles deaths are rare in comparison, but pertussis is very dangerous in infants, especially under 3 months of age.
posted by serenity_now at 5:28 AM on July 30, 2016 [9 favorites]

I wouldn't do it. You don't have any control over who the provider's children come into contact with, or what they bring home from vacations, shopping trips, etc.
posted by roomthreeseventeen at 5:52 AM on July 30, 2016 [1 favorite]

I think I would be okay with this after my child received pertussis vaccines, because as mentioned above, that and flu are the biggest risks. But overall, I'm raising my eyebrows at the provider's explanation to you. What was the bad reaction the child had? And both child had it? Did he/she tell you when her children will be vaccinated? I'm questioning if provider's anti-vax in general, but lied to you about it. In that case, I would be worried about this provider just not being truthful and particularly that provider's lying about a really important topic.
posted by areaperson at 6:04 AM on July 30, 2016 [22 favorites]

Also wanted to add: I agree with above posters, that in a perfect world, I would send my kids only to a daycare with all vaccinated kids and providers. But in reality, I live in an area with a pretty high rate of anti-vaxxers. Our pre-school has a 18% non-vax rate for instance, and that was better than many. In most daycare situations, I wouldn't even know if the kids are vaccinated and I certainly wouldn't know which kids weren't vaccinated. So I think if you have to use daycare, this is unfortunately a risk you have to take and the best you can do is vaccinate your kids.
posted by areaperson at 6:14 AM on July 30, 2016 [2 favorites]

Delayed vaccination is different than unvaccinated. Do you know what vaccines her kids have had?
posted by annathea at 8:08 AM on July 30, 2016 [6 favorites]

Your vaccinated child(ren) are not at risk from unvaccinated (or delayed-vax) children. Unvaccinated and delayed-vax children are more at risk from vaxxed kids due to vaccine shedding (you can do some googling on that subject), and still the risk is relatively small.

My own kids are 100% not vaxxed (note: people who do not vax are not necessarily "anti" vax) due to a documented medical history of adverse vaccine reactions within our family.

People who don't vaccinate do not take this decision lightly. We are like anyone else; we want the best for our kids and we want our kids to be healthy, just as you do. In our case we spoke to multiple doctors about our situation to get their opinions, read a lot, and went to lectures on the subject.

We take all normal health precautions that anyone would take with their kids; healthy foods, limit sugar, extra vitamins in the winter, avoiding indoor playspaces during cold and flu season, lots of handwashing.

We send both of our kids to a daycare /preschool that goes 6wks-TK and has over 100 students total. My kids have never been more than mildly sick with the usual colds and runny noses. And they got sick from school, they didn't bring it to school. It's common to hear from non-vaccinating families that they rarely see illness in their children.

So, I said all of that in order to say this; if I were you I wouldn't hesitate at all to send your kids to this daycare. Just practice and teach all of the normal health precautions that you would no matter where they go to daycare and your kiddos should be just fine.

(My personal advice to parents is to recognize that cold and flu season (and that encompasses other illnesses too) goes hand-in-hand with "Sugar Season" - Halloween, Thanksgiving, Christmas, Valentines Day. Too much refined sugar can suppress the immune system. Limiting sugar and learning to make good choices about healthy foods will help our kids stay healthy their whole lives.)
posted by vignettist at 8:52 AM on July 30, 2016 [3 favorites]

If she doesn't vaccinate her children then she isn't going to be requiring it of her other clients. It will only take one bad moment to wipe out most of the daycare. Don't do it.
posted by myselfasme at 8:59 AM on July 30, 2016 [5 favorites]

I can share my thinking with the caveat that I've lost a baby to medical system failure, and almost lost my elder son to appendicitis, and my younger son developed cataracts, so I've experienced a lot of medical issues with my kids.

The biggest risk is probably pertussis and it can be fatal in babies so I would not use that daycare until after at the least the first effective shot, period, end of story.

For measles etc., I think you and the baby's other parent need to really think about how you would feel if your child got it. Would you feel like wow, this sucks. Or would you feel like you were Guilty Forever. As someone who didn't listen to her gut in labour and has lived with that actually fatal consequence, it actually -really- helps me that I was in what was supposed to be a really great L&d practice. But for my husband, he wouldn't actually need that sense.

The other thing is will you be constantly on edge at every news story about measles.

Whatever you decide, you are doing a great job. Illnesses do come and we still put a lot of moral weight on them like the aforementioned sugar thing (my kids have had years they caught lots of colds and it wasn't sugar or hygiene, I would call it luck.) in this case I think the risks are probably much more about being stressed out, and I don't mean that blithely.
posted by warriorqueen at 9:18 AM on July 30, 2016 [9 favorites]

Oh one more thing: if you had to stay home for 2+ weeks would your finances completely fall apart? Because that's a more likely consequence than horrific issues.
posted by warriorqueen at 9:19 AM on July 30, 2016 [3 favorites]

I would and did go to great lengths when my children were young to minimize their exposure to unvaccinated children. so I would definitely be looking for other options if I were you. That said, unless you are lucky enough to find a care provider that requires vaccination, then you might have to deal with unvaccinated children wherever you go. Ask about the vaccination rates when you're interviewing other providers and you should be able to find some that require vaccination or that have a low percentage of unvaccinated children.

For me, I would seriously question the judgement of a provider who doesn't fully believe in vaccination, whether her own children were vaccinated or not. I take vaccination seriously enough that I think not vaccinating is a safety risk akin allowing my children to be in a household where guns are improperly stored. I would never allow my children into a house like that, one where the I could not trust the parents to attend to my children's basic safety, just as I wouldn't let me children play or be cared for in the home where the parents don't vaccinate.
posted by scantee at 10:26 AM on July 30, 2016 [4 favorites]

Nanny vs. Daycare: What's Best for Your Kid?

Day care babies: More infections now, fewer later

Day Care Kids Get Sick More Often, But Grow Up to Be Stronger in School, Study Shows

Studies Outside the U.S. Show Unvaccinated Children Healthier than Vaccinated Children

The perils and pitfalls of doing a “vaccinated versus unvaccinated” study

I am a conservative parent. If you can afford a nanny, I would go with a nanny until at least a year of age, having nothing to do with vax status at all. But I did my best to find you actual studies that didn't seem strongly biased in either direction. Good studies are pretty hard to come by. There are lots of ways a study can be biased or just garbage data from the get go.

The general consensus from stuff I read looking for good studies for you is that the first year in daycare or school ends up being the sickest year, regardless of age of the child. I would be more comfortable having a sickly toddler than a sickly infant.

I recently saw an article about long term health effects of babies exposed to a significant one time pollution event. (http://www.huffingtonpost.com/the-conversation-us/what-causes-asthma-clues_b_11198490.html) I am a big believer in the idea that negative health events very early in life can have serious long term consequences and it can be hard to trace back or quantify, so this article fits with that idea.

But, you know, all humans are prone to framing data through the lens of their existing beliefs. If I believed something else, perhaps I would not have read the article at all, much less knew how to find it again.

Best.
posted by Michele in California at 11:01 AM on July 30, 2016

The answer to this question will vary greatly depending on what part of the world or what part of the US you are in. Vaccination rates and disease incidence rates vary geographically.
posted by bq at 3:36 PM on July 30, 2016 [3 favorites]

fyi op, The link between sugar in immune system suppression in practice is unclear, and far from settled science. I would be extremely reluctant to pin my hopes on sugar vs things like pertussis and the flu.
posted by smoke at 5:22 PM on July 30, 2016 [7 favorites]

Once your child is fully vaccinated than this day care provider sounds fine, but until that's the case, I vote for a nanny. A delayed vaccination schedule is not a red flag, but it is important information and your 2-month old is vulnerable until his/her vaccinations are complete. Thank the day care provider for her candor and ask if you can contact her when your baby is ready to transition into day care.
posted by katemcd at 5:46 PM on July 30, 2016

Smoke, since you called me out I'll just clarify for the record that I do not believe that "limiting refined sugar" is an acceptable alternative to safe and effective vaccines. My addendum was written in the spirit of sharing sensible advice with a new parent.

OP, as you can surmise from the wide range of answers here, your best bet is to do your research on both sides of the issue and make the choice that is appropriate for your own family.
posted by vignettist at 6:14 PM on July 30, 2016

If your baby is 2 months now, s/he won't be old enough to get flu vaccine (6 months) until midwinter. That's also the point when s/he will have received the full primary series of DTaP vaccine, which includes pertussis protection. You might consider using a nanny until then.

Even as someone who's totally on board with the importance of vaccines, I would say the risk of your child becoming seriously ill or dying because of this day care is very small. But really I agree with scantec that I'd be uncomfortable with this day care provider's judgment. The story about "bad vaccine reaction means delayed schedule in all the kids" is not usually something that comes from a legitimate medical doctor's advice. It is either something she made up or some non-doctor told her. If she thinks she can outsmart the CDC on the issue of vaccines, what child care health and safety regulations is she likely to view as unjustified and unnecessary to follow?

Your state health department should be able to tell you how many cases of pertussis there were in your state over the past few years, which may help you assess the risk of starting day care before the primary series is complete. Keep in mind that flu vaccine has less protective power than other vaccines, so a vaccinated child does have something to worry about from those unvaccinated against flu.
posted by lakeroon at 6:35 PM on July 30, 2016 [5 favorites]

Children on a delayed vaccine schedule are unlikely to be vaccinated for rotavirus. I know this because my daughter is on the Sears schedule and we started late at 4 months, missing the window for rotavirus entirely. And we both just got rotavirus. It sucked. The rotavirus vaccine is not 100% effective, so that's something to be aware of in a daycare setting, especially.
posted by PhoBWanKenobi at 7:33 PM on July 30, 2016 [2 favorites]

Anti-vaxxers always have "reasons" for not vaccinating. You could ask for more detail about the delayed schedule, and about their general policies on unvaccinated children and whether any of the other children there are unvaccinated, but in the absence of strong evidence to the contrary I'd assume that "my kids are on a delayed vaccination schedule" is code for "we are an anti-vaxxer-friendly childcare service" and would stay the hell away.
posted by A Thousand Baited Hooks at 5:22 AM on July 31, 2016 [3 favorites]

I'd be extremely concerned about this daycare and a child of this age.

Can you tell us why you think this particular daycare is so much better than hiring a nanny?
A good nanny is above gold if you can afford her/him, especially in the first 18 months.
posted by BlueHorse at 4:17 PM on July 31, 2016

Nannies are more expensive than daycares.
posted by bq at 6:16 PM on July 31, 2016

My nieces go to a primary school with a tolerance of anti-vaxxers, as such the vaccination rate is relatively low (in comparison to other inner city schools in my city). 80% of the children got the measles late last year during an outbreak including a vast majority of kids who had been vaccinated, it surprised me to learn even vaccinated kids can be affected. The school closed for 2 weeks and all the families had to go into quarantine mode. We didn't see the family for a whole month and my brother & wife had to juggle their time off work & use up their annual leave to take care of the kids, what a conundrum for the whole community it was.

I wouldn't risk it with infants & the risk of whooping cough, that's deadly serious stuff.
posted by Under the Sea at 4:29 AM on August 1, 2016

Your vaccinated child(ren) are not at risk from unvaccinated (or delayed-vax) children.

That's incorrect, because vaccines are unfortunately not 100% effective.

Thus vaccinated children can still catch vaccine preventable illnesses in some cases, which is why herd immunity is important, and unvaccinated or delayed-vaxx kids are not providing that herd immunity.
posted by treehorn+bunny at 11:10 PM on August 1, 2016 [6 favorites]

I wouldn't do it.

There are not really two equally valid sides to the vaccination issue. There's supported medical science, and there's dangerous defiance of it. (Note that "supported medical science" includes people who legitimately have a REAL reason they can't be vaccinated.) Delayed schedules are very often vaxx-suspicious in nature, a la Dr. Sears.

And yes, some people definitely say their kids are on a delayed scheduled, to cover up for the fact that the kids are not getting any shots. Lurk in some anti-vaxx communities if you want to see the amount of lying people will engage in, to cover up to the outside world that they aren't vaccinating at all.

And people are mostly emphasizing pertussis in this thread, but measles is a big deal, too. My father was amazingly, horribly, deathly ill when he had measles as a child. My grandmother described it as one of the most traumatic experiences of her life. Not to mention the very small, but very real, SSPE risk. HiB is another concern. Chickenpox isn't even worth the risk, speaking as someone who had shingles at 27.

There are always some people who don't become immune after a vaccination, and I can see no reason to borrow trouble on that front when you don't have to. It's not about isolating your kid. It's not about assuming you can perfectly protect them from all exposure to vaxx-preventable disease, when we live in a world where people are merrily bringing them all back. It's about cutting risk the best you can.

Get the nanny.
posted by Coatlicue at 2:51 PM on August 2, 2016 [2 favorites]