Wednesday, June 8, 2011

Keeping Track of Your Child's Vaccinations

One of the topics that come up often on the boards is shoddy book-keeping of the doctor's office, posts like

"My child is two years old and I am sure we had done all first year vaccines, but now we got called back for XYZ shots"

"I got a letter from the State saying that my child is not up to date, but s/he is"

"my child got his/her 4th DTaP at 12 rather than at 15 months and now we have to go back for a 5th, because the 4th doesn't count" *

"my child got his/her MMR too early and now it doesn't count" *

All of these are real life examples (2 from Dr. Bob's old board, 1 from Babycenter) and they illustrate one thing very clearly:

You have to keep a record of the vaccines your child get!

Now in an ideal world, your pediatrician hands you a vaccination schedule on your first well visit, including all info on the first vaccines, so you can read up ahead of time. S/he'll discuss with you whether you have any questions before the first shots and each time your baby is vaccinated, the little sticker on the vaccine vial that has vaccine name and lot number goes into a booklet like this:

that you get to keep. I have encountered such "best practice" with our second child - our first had 3 cards, one for each country she got vaccinated in, until we combined them into one. It is surprising, however, how often parents do not automatically get vaccination records to take him with them.

However, you need such records, so if you move or change doctors, you have proof of which vaccinations your child has had. These "Yellow Cards" exist world wide (the upper picture is an Ugandan one filched off the web, my daughter has one from California, my son one from Germany), they have been around for a really really long time - I have one, my original one is white though and I recently found my mum's and grandma's (proper record keeping during WWI and WWII, although mainly for smallpox).

It is even more important to keep your records if you are on an "alternative" schedule (for any reason - the European schedule my daughter had been vaccinated on for her first 9 months was very much "alternative" to what was recommended/required in the US).

As soon as your child is born, you can make up a vaccination schedule for him/her - the CDC has a handy tool, or find your country's National schedule and do it by hand. If you want to diverge from what is recommended, highlight this on the schedule. Take the schedule in to your doctor's appointment to double check you have done it right. Ask for the yellow card and then keep track of all shots. Also make sure that all vaccines are actually available in the combination that you want to give them - there are still parents out there who want to give monovalent measles, mumps and rubella, but they are no longer made by Merck - there are also periodic shortages in vaccines (in recent years for example the monovalent hib).

It needs a little planning, but it is very valuable, and, ultimately, your responsibility.

* that is actually a topic for another post


  1. I bet yours does not have yellow fever (second figure on page)!

    Yes, I still have both of my white and yellow vaccine records (the picture is from the older white version). As a college student I freaked out the doctor giving student volunteers the 1976 swine flu vaccines by making him fill in this record. I don't think he had ever met a student who had been vaccinated for typhoid, typhus and yellow fever.

    But, alas! I have not added much to it since. I have been with the same family medicine practice for almost thirty years, and they have all the records. I really need to have them update my kids' records (the ones who live at home get annual flu shots!). A nurse redid all three of them a while ago since they were kind of a mess, it was not a problem since the practice had given them all their vaccines.

    I really don't move around as much as you, nor as much as I used to. So it is not a priority. Though if we do travel, I can get a good record from our primary health provider.

    (By the way, being overly enthusiastic about being on time for vaccines, my oldest got his four year old DT, not DTP due to history of seizures, a day or so before his 4th birthday. This freaked out the school district vaccine compliance software that insisted it be on or after the birthday. So the very kind nurse just entered the date on the district computer system to be on his 4th birthday. She was just happy to have parents get their kids vaccinated, since she had to deal with the non-compliant and had stories of parents sending feverish kids to school with a bottle of Tylenol!).

    1. they do now, Chris (have the YF and typhoid vaccines ;) ).

    2. Ah, I see there is a trip to tropical climes. Good luck and have fun. It should be very interesting and educational.

      Still be wary of the mosquitoes, because dengue is called break bone fever for a reason (I have had it).

    3. Yikes! We were slathered in mosquito repellent and it was, in many senses of the word, the trip of a life time!

  2. In the state of WA, vaccines are now tracked by a state computer registry called "child profile", well as at the doctors office. There is also still a physical card for the parents to carry. The computer tracking system has helped prevent loss of records as patients transfer doctors and has made it easier for parents to obtain duplicates.

  3. Thanks Moderation, that is interesting. I assume that parents might object to this kind of centralized record out of generic "Big Brother" concerns?

  4. Chris - no, no yellow fever, but typhoid ;)

  5. Cath,

    I wanted to ask about this while the now defunct Dr. Bob's vax forum was running....anyway, we were never given a "yellow" master vax card for my little one.

    I have my own records in a little book from our first ped. Is that sufficient for record keeping?

  6. Amber - that is perfectly fine. I would let it get stamped and signed at each shot visit, just so that you have an "official" record, colour and layout really don't matter, as long as the info is there.

    Hope you are well :)

  7. Good reminder Cath!

    I have the NM vax "passport" and have the nurse fill in the shot each time my dd has one. NM also has a centalized system, but it is voluntary at this point and my midwife advised against it (over fears that at some point the state could use the info to turn you over to child services for bad parenting).

    My personal vax records are just a copied 8.5x11 sheet of paper from my file. The NM "passport" idea was totally foreign to me.

    I'm asuming that the record would have to be "verified" by the dr's office to be acceptable to most places. Am I right?

  8. Hi Middle Roader -

    I think you would have a much easier time regarding state and school requirements if your own records were stamped/signed.

  9. I agree you should take charge of keeping your own records, moving states, changing insurance can all propose an issue. There are websites popping up, such as that will help you take control of your own records. Keeping record on paper is fine, but if you can store them online and gain access to them whenever and wherever you may be, that is definitely a bonus! Plus, heaven forbid if you have a fire or other natural disaster, your information is safe.

  10. In Australia, all childhood vaccines are registered by medicare, and if your kid is up to date at age 5, you get money from the government AND they get to go to school. Its awesome!