Chickenpox vaccine - to exclude or not?

**Fitrix** · 19-05-2015, 08:41 AM

One of my parents put this on me last night. She is taking her child to get him the chickenpox vaccine this morning. This is because she is trying to get pregnant and doesn't want to any risk to her potential pregnancy...... However, we have a child in our setting who has a one month old new baby brother - with quite severe reflux and therefore very underweight and a bit poorly.
After 10 seconds googling (mum said she had no idea if he'd be contagious or not after) it transpires that he will indeed be contagious for 6 weeks.
So where the hell do I stand? Should I accept him back later today? If mum of newborn isn't happy for her child to be exposed to the child who has been vaccinated who is accountable here? Do I have to miss out on earnings because of the choices one mum has made? Do I not allow her child to attend yet still charge?

Any advice appreciated!

**tess1981** · 19-05-2015, 09:09 AM

Can't offer advice as this is a new situation to me but you really are stuck between a rock and a hard place.
I hope someone knows the answer could you ring ofsted or a gp or nhs direct

**shortstuff** · 19-05-2015, 09:42 AM

sorry I have no advice either. I would hate to be put in this position though. I would be having a firm word with mum that is getting the vaccine. She should have done the research, or maybe she did and didnt want to admit she knew it made LO contagious?

**loocyloo** · 19-05-2015, 09:47 AM

I would phone gp ... as if every child who had vaccine had to be excluded for 6 weeks ... That's impossible. Ask what the likelihood of someone catching pox from a child who has had vaccine ... as usually only contagious a couple of days before and then till scabbed.

However, with the mindee with poorly baby sibling I don't know! Would they always be there at the same time? Babies usually have immunity to things from mother, so may be fine. It might be that babies mum needs to talk to her dr.

Good luck in a tricky situation.
I think I would see what dr said re vaccinated child and if has to be excluded then mum still pays as you are available to work.
I also don't accept children the day they are vaccinated in case of reactions.

**Mouse** · 19-05-2015, 10:36 AM

I would speak to a GP, or NHS direct help line, although I'm pretty sure they would tell you the chance of someone else catching chicken pox from a vaccinated child is extremely unlikely. It is a live vaccine like MMR, but you wouldn't exclude for that.

If they do suggest you exclude the child, it will be up to the vaccinated child's parent to keep them away and pay your fees as per your contract.

How would the mum of the newborn know that the other child has had a chicken pox vaccine? Due to confidentiality you shouldn't tell them. I understand the sibling you mind could be exposed, but they would actually be at a greater risk of catching chickenpox from a child who has the illness rather than from the child who has been vaccinated.

I would (and do) accept children back after they have been vaccinated, but on the understanding that if they appear to be unwell from it or suffering a reaction, parents need to collect them immediately.

**Fitrix** · 19-05-2015, 12:05 PM

Originally Posted by Mouse

How would the mum of the newborn know that the other child has had a chicken pox vaccine? Due to confidentiality you shouldn't tell them. I understand the sibling you mind could be exposed, but they would actually be at a greater risk of catching chickenpox from a child who has the illness rather than from the child who has been vaccinated.

You see I disagree (and this will prob start a whole other debate!!) but this is where I ignore confidentiality and employ common sense and decency. If I know a child in my setting carries a risk then I feel an obligation to inform mums who enter my setting who by the nature of our business are often trying to conceive, are newly pregnant or have vulnerable children - newly born or not yet born they have the right to protect.

The nhs advise is to keep lo away from risk groups for 6 weeks. The mum disagrees but will go along with what I say. Rock and a hard place indeed!

**loocyloo** · 19-05-2015, 12:14 PM

Can you wiggle days so that the vaccinated child doesn't attend the same day as child with poorly baby sibling?
Just wondering if possible as thinking mum of poorly sibling may be home on maternity leave?

However. Just because mum has had own child vaccinated doesn't mean she won't come into contact with chicken pox! Both of my own children apparently got it 'out of thin air' as has a recent mindee!
And I do know the risks. I had a miscarriage at 8 weeks, the exact same time a small child I cared for full time came out with chicken pox. Again ... came from nowhere and drs said it may or may not have been a factor. ( in that I went on to have other miscarriages ... probably not)

Also edited to say, that in this instance I would be telling mum of vaccinated child that I needed to tell mother of poorly babe if her (vacinated) child attended.

**Maza** · 19-05-2015, 12:31 PM

Originally Posted by Fitrix

You see I disagree (and this will prob start a whole other debate!!) but this is where I ignore confidentiality and employ common sense and decency. If I know a child in my setting carries a risk then I feel an obligation to inform mums who enter my setting who by the nature of our business are often trying to conceive, are newly pregnant or have vulnerable children - newly born or not yet born they have the right to protect.

The nhs advise is to keep lo away from risk groups for 6 weeks. The mum disagrees but will go along with what I say. Rock and a hard place indeed!

Gosh, what a horrible predicament to be in. So is the mum going to pay you for the six weeks? It's all such a grey area isn't it?

**Fitrix** · 19-05-2015, 01:01 PM

No I can't really justify excluding on a minimal risk. Both kids in question are currently full time but the LO with the newborn sibling is about to dramatically reduce days as mum is on maternity leave of course. So risk is lessened a bit there. I will avoid toddler groups etc for a few weeks until the worst has passed. Mum thinks Im overreacting by keeping her LO away from groups who risk is so minimal. I guess risk to her potential pregnancy is more important than risk to some poor pregnant woman who has to trail round toddler groups?!

However - it is ultimately down to the other mum (who I have informed) and the advice her GP gives her. If she's not happy about the two kids being in proximity then I will exclude on the days her LO attends. And charge!

**alwaysright** · 21-05-2015, 03:19 PM

Originally Posted by Fitrix

You see I disagree (and this will prob start a whole other debate!!) but this is where I ignore confidentiality and employ common sense and decency. If I know a child in my setting carries a risk then I feel an obligation to inform mums who enter my setting who by the nature of our business are often trying to conceive, are newly pregnant or have vulnerable children - newly born or not yet born they have the right to protect.

The nhs advise is to keep lo away from risk groups for 6 weeks. The mum disagrees but will go along with what I say. Rock and a hard place indeed!

i agree with you, if a child here has an infectious disease i inform the other parents but i dont say joe bloggs has chicken pox i just say another child here has chicken pox, but most of the time before i do i will say to joe bloggs parents, i will have to tell the other parents. always been fine

**alwaysright** · 21-05-2015, 03:22 PM

does she have a definate appt to get the vaccine or just trying to get gp to give it? i didnt think the chicken pox vaccine was available in this country even if you pay for it

**Mouse** · 21-05-2015, 03:28 PM

Originally Posted by alwaysright

i agree with you, if a child here has an infectious disease i inform the other parents but i dont say joe bloggs has chicken pox i just say another child here has chicken pox, but most of the time before i do i will say to joe bloggs parents, i will have to tell the other parents. always been fine

But the child doesn't have an infectious disease. They have possibly been exposed to chicken pox, but they could be exposed wherever they go.

If one of my mindees has chicken pox I tell parents that a child in the setting has it (like you do). More often than not they can figure out who it is anyway!

But if a mindee had been to visit family (for example) and one of the relatives had chicken pox (so exposing mindee to it), I wouldn't tell all the other parents.

**Fitrix** · 21-05-2015, 06:26 PM

Thanks to everyone who gave advice/support. Docs had run out of the vaccine anyway! Mum has booked LO in for it in a weeks time. As the other mum of the newborn is ok about it I have agreed to have LO but will not be taking him out to toddler groups/places of risk to others for 3 weeks (usual incubation period so I figure a good precaution). Mum thinks I'm overreacting and is cross I won't be taking him out to those places but there are plenty of other beneficial things to do outdoors and away from people so that's the way it's going to be.

**LilMisConfused** · 23-05-2015, 07:44 AM

Probably not really your concern but if she is wanting not to catch it because she wants to get pregnant then shouldn't she be the one getting the vaccine - not the child?! Giving the child the vaccine doesn't really make a difference as to whether she will catch it, but vaccinating herself would mean she is then immune!

**alex__17** · 23-05-2015, 07:42 PM

And surely she'll be at risk of catching it off her 'contagious ' child after vaccination?

To be fair I know 2 of my mindees siblings have had chicken pox vaccine, they had it months apart, eldest didn't pass it to younger one and younger one had it at some point while in my care, I had no idea they could be contagious and I doubt mum did either as she keeps them off if ill etc, none of my other mindees or my son caught it.

Doesn't really help your situation but it may be that if you'd not googled or she'd not told you you would have been none the wiser, and they're probably more likely to catch it off another out and about incubating it