Grandparents and your child’s health

This morning, let’s have a chat for all the Nanas, Grannies, Grams, Grandmas, Babas, Glam-mas, Maimeó, Pops, Grandads, Daideo, Grandpas and Gramps:

“I just came across a post where a 55 year old grand mother contacted measles and then passed them onto her baby grand daughter . My question is , do adults need to get booster injections for childhood diseases ? My husband had measles when he was 4 then got a really bad dose of it when he was 40. We have a grand daughter who is 1 , should we be getting boosters too?”

This is a great question, and there is a lot going on in it. I am going to focus on 2 areas: Grandparent vaccines and Rubella (also called German Measles) [it is nearly impossible to get measles twice; German measles are often to blame]. I want to fully explain this, so pour yourself a cup of coffee. I’m going to break this into 2 posts: Grandparent vaccines and Rubella.

Grandparent vaccines are actually a question doctors are starting to hear more and more around the world. Why? There are 2 important reasons for this: Grandparents are the generation that remember the impact of no vaccines. Depending on their age or where they grew up, it is likely they saw the direct and devastating effects of whooping cough, polio, measles, and mumps in their family or childhood friends. Vaccines have an entirely different meaning for many grandparents than they do for today’s younger mammy. Many diseases, thankfully, have become more of an abstract idea than a reality.

Why else? We’ve talked alot about herd immunity and protecting the vulnerable. That is, our communities are protected when 90% of vaccine-eligible people are vaccinated. When numbers drop below that, the diseases can re-enter our communities. We have talked alot about how that includes your young infant, but also includes aging adults. Grandparents are worried about their own health. Why? Vaccine effect not only wanes as we age, but the ability of the immune system to mount a response to any disease also gets weaker as we age. As we age, many grandparents are also on medication for many conditions that can impair their ability to mount an immune response. Remember, vaccines themselves don’t fight a disease. They train your own immune system to recognize a disease. If your immune system is ill or doesn’t work, vaccines can’t work as well for you. This is why we all care so much about vaccines: protecting a community.

Because vaccination levels have dropped due to anti-vaxx movement, this is a new area to explore for doctors and public health specialists. Public vaccination programs until recently had successfully protected this population (Measles, for example, was nearly eradicated in 2000)

So, what vaccines can grandparents get to protect their young grandchildren? I am going to state from the outset that Ireland does not currently have official recommendations for grandparent vaccinations, and you might have to do a little chatting with your GP. Globally, here are the vaccines that many doctors are recommending grandparents consider discussing with their GP.

1) Flu Vaccine! For yourself and your family. Actually, everyone. And always anyone caring for young children should be flu vaccinated. Your GP should be on board with that one.
2) Whooping cough to protect newborns, especially. [Usually given as a combo injection with diphtheria and tetanus.] This one is a really good idea. We have an outbreak here, and US CDC is now recommending this one for grandparents of new infants, ideally given 2 weeks before due date. Irish recommendations are more vague: “Any adult who wishes to reduce their risk of [whoopign cough] infection to themselves or to young babies may get the vaccine.”
3) Pneumococcus – recommended for anyone age 65 and over anyway.
4) MMR booster – not routinely recommended yet, but increasingly popular among many grandparents internationally in response to outbreaks. There is no harm in this, and only lots of potential benefit!
5) Shingles vaccine – Yes, there is a vaccine against the hell that is shingles. It is available in Ireland. It has not been added to the routine immunisation schedule yet. But you can protect your grandchild and yourself with the vaccine. You will have to discuss the cost with your GP.

Last things about grandparents: Docs love grandparents. They can have a really important role in overall family health. We always think of the obvious:
support to new mothers, emotional health and development of their grandchildren. It also works both ways: grandparents who spend time with their grandchildren are healthier. [And as I write this in clinic this morning, a very special Nana is taking Baby C. and pre-schooler T. to the playground this morning.]

Lastly, docs also know that grandparents may be among our best community health allies. Quote from a recent paper on community health: “grandparents’ memory and knowledge of preventable childhood infectious diseases could be harnessed as a public health measure to counteract the current, ill-informed, negative attention on paediatric vaccines.” [10.1016/j.vaccine.2018.10.017]