question and answer
January 2000
DONATO GUGLIOTTA, MD, of Trenton, ON, inquires: "Are two vaccinations (bilateral) in one sitting generally less traumatic to a four- to six-year-old child than giving them in separate visits?"
My comments are purely anecdotal, since I haven't found a study that specifically addresses your question. Opinion in this matter depends on one's perspective. In my office, nurses administer routine immunizations. They seem less than thrilled about giving two vaccines at the same time. It makes sense -- two shots in one visit will invariably seem worse than just one, both to the vaccinee and the vaccinator. But it's less clear whether two separate visits, each with one injection, is actually less stressful in the end. In contrast to my nurses (and some patients), I'd rather give two vaccines at the same visit when the immunization schedule calls for it. My reasons are twofold. First, I'd rather my patients get their immunity as soon as possible. Postponing vaccination means extending the risk period for acquiring natural disease -- and requires an extra return visit to my office. Secondly, some families may not be reliable at coming in for routine scheduled health maintenance visits. In these situations, I'd rather properly immunize the child while I have the chance. Still, I'm not fanatical about dual immunization. If the child, parent, nurse or physician appear about to decompensate at the prospect of a second vaccine, postpone it. NS
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