Need Advice... Mom Doesn't Want Son to Have Hep B Immunizations

[Unregistered]

I have a new daycare boy who is 12 months old. He just started about a week ago. The mom was having a hard time finding his immunization record because of a move and so she just gave to me today. I was stressing out because I've never let anyone start up in the daycare without me having the immunization record on file.

Anyway - she bring to me today and I realize that her son has never had any Hepatitis B shots. I asked her about it at pick up today and she said that her and her husband decided that they didn't want to get that particular shot for their son because in her words "he could only get Hepatitis B from sex or drug use". I was a little shocked and didn't know how to respond right then. I told her that the immunizations need to be up to date before he even began here. She quickly changed the subject & then another parent came to the door so the conversation got cut short.

I have never had this happen. I live in California by the way. So I'm wondering what to do in this situation... Is there a waiver she could sign so she doesn't have to get those shots for him so he can continue to come here? Will I get in trouble from Licensing if he doesn't have those done? Should I tell her he can't come back till they get it - even though they don't want to? Is it dangerous for him to be in daycare without that shot?

On a side note... this boy is VERY difficult and so I am not really worried about them not sticking around. I also don't want to waive my policies and rules that I've always had regarding all shots being up to date before care even starts. I don't know why I let that slide.

Any advice would be very appreciated!

[MotherNature]

I don't know what your licensing demands, but we won't do hepB with our new baby either. We do other vax, but Hep B is only transmitted through tainted needles or sex. By the time the kid is old enough for those -generally- the vax has worn off anyway. You can do boosters when older and sexually active. The reason they do them at birth is in case the mother has an STD, which is obnoxious. I understand that hospitals want to protect themselves, but one would hope mothers would be honest if they did, instead of just assuming you have an STD & inoculating your baby automatically w/ an unnecessary vaccination.

[Lil'DinoEggs]

I am not in California, but my regs require all shots. If it were me and I was inspected, I would get like a yellow tag saying it has to be done in 30 days or something like that as long as the child is updated on everything else.

Again, my regs state if a parent wants to get an exemption, they need to start filling out paperwork with the health department and moves upwards to get approval. I don't know the whole process as only one parent has ever asked me for an exemption. I believe exemptions are granted to children with a known allergy to an ingredient, religious and cultural reasons. But it takes more than "Hey, I don't want my kid to have it"

[Evansmom]

You should look up the requirements in your state. In some states there is a waiver a parent can sign to have their child be exempt from one or all vaccines for reasons of conscience or religion. So in TX you can sign a waiver even I you just don't want your kid to have vaccines. There doesn't have to be a medical reason here.

We slow vax so I know about it, at least here in TX.

[snbauser]

It's been a while since I was licensed in CA and I'm sure one of the other ladies will post when they see this. BUT when I was there, they could sign on the blue form that the schools used to waive the shots and you could have that on file. But you also have to have some type of notification to your families that you may or may not have a child in care that is not fully immunized and you have to do it in a way that you don't violate their privacy. My licensor at the time told me the easiest way to do it was if you were comfortable taking kids without immunizations to update your policies that says at any point in time you may or may not have children in care that are not fully immunized.

[MamaBearCanada]

I don't know what your licensing demands, but we won't do hepB with our new baby either. We do other vax, but Hep B is only transmitted through tainted needles or sex. By the time the kid is old enough for those -generally- the vax has worn off anyway. You can do boosters when older and sexually active. The reason they do them at birth is in case the mother has an STD, which is obnoxious. I understand that hospitals want to protect themselves, but one would hope mothers would be honest if they did, instead of just assuming you have an STD & inoculating your baby automatically w/ an unnecessary vaccination.

This is misinformation and misleading. While these are probably the most common methods of transmission Hep B is spread through blood and infected body fluids. Sharing, even unintentionally, nail clippers, toothbrushes, razors, earrings can be a risk. A bite that breaks the skin is a risk. Children with lesions are a risk and at risk. Also, people often don't know that they are infected with Hep B and thus it would not be disclosed by an undiagnosed mother.

http://www.hepb.org/hepb/transmission.html

http://www.who.int/mediacentre/factsheets/fs204/en/

Hep B transmission in daycare

http://www.ncbi.nlm.nih.gov/m/pubmed/9489202/

[Unregistered]

I have a new daycare boy who is 12 months old. He just started about a week ago. The mom was having a hard time finding his immunization record because of a move and so she just gave to me today. I was stressing out because I've never let anyone start up in the daycare without me having the immunization record on file.

Anyway - she bring to me today and I realize that her son has never had any Hepatitis B shots. I asked her about it at pick up today and she said that her and her husband decided that they didn't want to get that particular shot for their son because in her words "he could only get Hepatitis B from sex or drug use". I was a little shocked and didn't know how to respond right then. I told her that the immunizations need to be up to date before he even began here. She quickly changed the subject & then another parent came to the door so the conversation got cut short.

I have never had this happen. I live in California by the way. So I'm wondering what to do in this situation... Is there a waiver she could sign so she doesn't have to get those shots for him so he can continue to come here? Will I get in trouble from Licensing if he doesn't have those done? Should I tell her he can't come back till they get it - even though they don't want to? Is it dangerous for him to be in daycare without that shot?

On a side note... this boy is VERY difficult and so I am not really worried about them not sticking around. I also don't want to waive my policies and rules that I've always had regarding all shots being up to date before care even starts. I don't know why I let that slide.

Any advice would be very appreciated!

Not in CA, but I am in another state where ANY immunization is exempt and they can get an exemption card signed by themselves and physician for ANY reason. HEP B series is a great shot to have because you can get it in many ways, so she's not correct in saying it's "only" transmitted the way she described, however, it's her choice to either get or not get and I would never make it a requirement that she has her kid immunized, only that she gives me a legal exemption card showing that she has opted out.

I would probably also explain that by not having the vaccine, her child is more susceptable to illness than without it, just so she understands fully the risks. I am sure her Ped's dr probably explained it at some point as well, but it doesn't hurt to hear it from you and this either solidifies that she's comfortable with her decision or may prompt her to ask more questions to the Ped's dr, neither of which is a bad thing, from the sounds of it.

[Michael]

Pushing post back up.

[TwinKristi]

Oh how I love these posts...

First, the chances of her son getting Hep B from your daycare, unless you have Hep B, is slim to none. Our Ped told us back when my 8yr old was a baby that no, infants and children really don't need these vaccines but it's when they're teens or adults and make risky choices that they'll need it and what person making risky choices is going to even know about Hep B or come to their dr to get the series of vaccines. She called it "targeting a captive audience" and that it's for when they're adults more than anything. Unless either parent works in the medical field many parents are avoiding hep B. Myself included. My son has only had a handful of vaccines that our Ped (not the same as above) have agreed would benefit our son the most. Pneumococcal, HIB and we started DTAP.

Bottom line, in CA you can have them sign the back of the blue card to cover yourself. You can also have their Ped write a letter explaining their reasons for excluding Hep B. If "your" rules state they must be fully immunized than that's your rule and you would either need to term them or have them get the vaccine. I don't exclude for anything like that. If they're not up to date they sign the back of the blue card, have a doctor's note and I'm covered. No one has yet but that's my plan if someone does. But of all vaccines Hep B is really not one to worry about.

[TwinKristi]

people who frequently require blood or blood products, dialysis patients, recipients of solid organ transplantations;
people interned in prisons;
injecting drug users;
household and sexual contacts of people with chronic HBV infection;
people with multiple sexual partners, as well as health-care workers and others who may be exposed to blood and blood products through their work; and

These are the people at the "highest risk" for this. So she's not far off on her assumption. Healthcare workers who are exposed to those who are highest risk are included.

[MotherNature]

This is misinformation and misleading. While these are probably the most common methods of transmission Hep B is spread through blood and infected body fluids. Sharing, even unintentionally, nail clippers, toothbrushes, razors, earrings can be a risk. A bite that breaks the skin is a risk. Children with lesions are a risk and at risk. Also, people often don't know that they are infected with Hep B and thus it would not be disclosed by an undiagnosed mother.

Yes, you're right. I said sex because I didn't type out bodily fluids.. since those are the most common vectors. Toothbrushes, etc..transmit bodily fluids. I should have been clearer on my explanation and intent. My husband is very pro-vax, & I am more of a delay them but get them person. I'm certainly not an anti-vaxer. The only one I really question is this hepB one. Thank you for the info. I will look through it. All of my other kids have gotten it automatically, but I really do question the need for it since I know we don't have hepB. Will look at the info though on transmission in a daycare setting-very helpful. Thanks!

[Unregistered]

Thanks for all your advice. So on the back of the blue immunization record, where I keep track of his shots, the space on the back has a space for the parent to sign for an exemption for Tuberculosis... but it doesn't have a space saying signing for any other vaccine exemption. Is there a separate form in California that I would have to have her sign?

[Unregistered]

Nevermind... I just found the section

[Unregistered]

One more thing... I really appreciate all of your help with this...

My policy states that each child's immunization records MUST be completely up to date for all vaccines before coming to the daycare. He kinda slid thru the cracks (my fault on that). So now I am trying to decide if I either:

1) Let her slide and have her sign the waiver on the back of the blue card
2) Stick to my policies and say he needs to get the shots up to date or can't come to the daycare.

I've never had this situation before. I also noticed that he hasn't had his MMR yet... but he is only 12 months old so he still has some time. I don't want to force her to get shots for her kid that she doesn't want to, but I also don't want to break my policies for a new family.

[MarinaVanessa]

Bottom line, in CA you can have them sign the back of the blue card to cover yourself. You can also have their Ped write a letter explaining their reasons for excluding Hep B. If "your" rules state they must be fully immunized than that's your rule and you would either need to term them or have them get the vaccine. I don't exclude for anything like that. If they're not up to date they sign the back of the blue card, have a doctor's note and I'm covered. No one has yet but that's my plan if someone does. But of all vaccines Hep B is really not one to worry about.

Yes this. As a requirement of licensing you should have a blue immunization card filled out for all children. On the back of it is a Personal Beliefs Afidavit that the parents can sign. You fill out the immunization parts that their child does get and in the HepB portion just write in "refuse" or something and the signed back portion will cover you when licencing comes knocking.