At 10:21 AM 7/1/98 -0400, wrote:
>
>I agree with you. I dont feel the numbers of VAAP necessitated the
change in
>the schedule and until recently I talked to parents about both
IPV/OPV but had
>added my editorial comments that I thought the OPV was fine.
>Now I am leaning towards IPV at 2, 4 mos, mostly because I am worried
about
>what legalities of recommending the OPV
>Maureen CPNP
>
I think the legal risk in the all OPV schedule remains really low as long
as it's still considered an acceptable option by the AAP
and
you've explained the different schedules to the family and documented
their acceptance of the minuscule OPV risks. Remember, you're
talking about risks in the one-out-of-million(s) range, so even a
provider who continues all OPV and doesn't ask about household contacts
or isn't on the lookout for immune deficiency will still be
highly
unlikely to encounter VAPP in their career.
Michael Sachs, M.D.
General Pediatrician