While I am very pro-vaccine and empathize with the author of the article I have to say the obvious here. If I had a child in the same boat I would really, really have to re-think the need for daycare. I would consider many things before exposing my immunocompromised child to a multitude of infectious agents (only a small fraction of which are preventable through vaccination). Work at home, quit your job for a while, hire an in home provider. All these things and I'm sure many other creative responses are better than "congregate with sniffling, coughing, puking toddlers".

In other words there are bigger fish to fry here then getting everyone vaccinated... which I support but in reality will never, ever happen.

Hm. What if they need both incomes--this can't be an inexpensive disease. And they might need the child to be covered by both spouses' insurance too--it's pretty easy to start hitting up against a million dollar lifetime limit in a case like this, which means that insurance simply stops paying.

Having both parents work might be just as important to this child's survival as the medical treatments he receives because they can pay for them.

Really? What if the child is covered under his mother's health plan? If they try and switch him, his cancer will more than likely fall under the "pre-existing" condition clause of any new health plan- and suddenly, he's not covered under any insurance. Chemotherapy, radiation, and just walking through the door of an oncologist's office are incredibly expensive.

Maybe she HAS to work to cover the medical bills. Did you ever consider that?

No I didn't ever think of these things... thanks so much for bringing up the obvious! My only point is why stop at vaccine preventable illness... for an immunocompromised chilld (or adult for that matter) ANY infection can be problematic so why risk it in daycare.

Thre pt's condition can and would be covered through public insurance (ie public aid). There are many, many children who unfortunately have terrible illness and DO NOT have private insurance. Believe me they DO get medical care. Keeping benefits and exposing a child to something that might kill them seems illogical to me. Really? YES REALLY?

They get public aid if their parents are very, very poor, and qualify for Medicaid.

janna1g:

They get public aid if their parents are very, very poor, and qualify for Medicaid.

That's absolutely right. There are income limits to these public aid programs. Even if the family were able to qualify, it takes months to verify paperwork and get through the red tape. If and when the approvals are completed, the child may have to switch doctors or travel much further to a doctor or hospital. It's not as simple as quitting a job one day and signing up for public assistance the next. Really.

It happens everyday and could happen here! Not ideal but it really is the lesser of two evils... why the concern regarding vaccine-preventable-daycare-sp­read germs and not the other much more common variety that would be just as dangerous to a immunocompromised child?? It makes NO SENSE to be up in arms about measles for example when a common viral infection could be just as life threatening?

The choice is the parents to devise an alternative to daycare if she truly is worried about infection for her child. Worrying about one set and ignoring the much more common "others" makes for an illogical argument.

In other words, independent of the other kids in her daycare getting vaccinated... her child WILL get ill from the other kids... not if but when. REALLY!

fourleaf:

No I didn't ever think of these things... thanks so much for bringing up the obvious! My only point is why stop at vaccine preventable illness... for an immunocompromised chilld (or adult for that matter) ANY infection can be problematic so why risk it in daycare.

If the child's immune system is compromised, there is a risk in taking that child out in public anywhere. Daycare isn't the only place that kids pick up infections.

fourleaf:

Thre pt's condition can and would be covered through public insurance (ie public aid). There are many, many children who unfortunately have terrible illness and DO NOT have private insurance. Believe me they DO get medical care. Keeping benefits and exposing a child to something that might kill them seems illogical to me.

I believe ( and please correct me if I am wrong) that there is a waiting period/ qualifying period for MedicAid, which can be six months. Kind of a long time for a child with cancer to be without health care coverage, especially if Mom just quit her job. Assuming daycare is ~$12-24K per year. I'm pretty sure that wouldn't cover one week of chemo in the hospital.

She hired in-home care . . . did you read the article?

Nope... didn't read the article LOL! And if she has hired in home daycare then that's exactly what I said that ONE of her options was in my initial post. Why write the very personal article about daycare... her problem is solved. She has done what I suggested initially.Also yes it is a risk to attend anything in public and if the pt's white blood cell count were so low that is SHE SHOULD AVOID PUBLIC PLACES WITH HER CHILD. If the child were a severly premature infant I would say the same thing!

My only point which you really have not addressed is why the uproar over a small fraction of potential infections and not all of them. A truly concerned mom would AVOID DAYCARE IN THIS SITUATION AT ALL COSTS!

fourleaf:

A truly concerned mom would AVOID DAYCARE IN THIS SITUATION AT ALL COSTS!

Thanks for teaching us all what truly concerned moms would do. I'm sure that someone who hasn't had to live through the agony of having a child with leukemia knows what's best for this particular family and their situation.

And what qualifications do you have to state your opinion?! Oh yeah I forgot ... any one can voice their opinion... rather than attack ME you really should try to refute the initial argument which you have failed to do.

In addition, I happen to have expertise in this field as I am a Pediatrician and see a variety of ill and healthy kids ALL DAY! I stick to my original premise that all illness is particularly worrisome for this pt (not just vaccine preventable illness). My recommendation to any parent in this situation is to avoid daycare.

You may disagree but you will not convince me that in this situation daycare is warranted... no matter how ill-informed or nasty you are!

I completely agree: why would a mother put an immunocompromised child in day care? It's NOT because she has no other options. She does. In the end she went and hired an in-home babysitter. The real reason is, and I'm quoting the mother now, that the daycare would have been a "magical place for him." What is THAT about? Really? Day care is very rarely the best option for any child, but for a parent to put an immunocompromised child into day care is just hard to believe. Studies show day care children get far more colds and other viruses than children who are not in day care. While there may be cases where day care truly is the only option, I doubt there are many cases. It's most often the most CONVENIENT place for the mother to put a child. It certainly was that in this case. The mother could, and eventually did, find another option. It was just slightly harder. Finally, there is no Medicaid waiting period, at least not in our state. I'm a medical biller and we sign people up for Medicaid retroactively all the time.

A comment about Medicaid eligibility. My son was diagnosed as an infant with a "catastrophic medical condition". We were approved to receive Medicaid for him though we would not have qualified under strictly income guidelines. Childhood cancers may qualify for this exception as well.

fourleaf,

I took issue with your suggestion to quit her job. If that were the best solution, I'm sure she would have done it and we wouldn't be reading her article about daycare.

I took further issue with you suggesting that because this woman considered daycare for her child, she was not a "truly concerned parent". You have no basis to claim this woman isn't concerned for her child.

In my experience, public aid ( and no, I am not an expert in all states, nor have I claimed to be) often comes with red tape and paperwork delays which might make dependence upon it problematic. This is another reason why, as stated, I'd be concerned about relying on it for my child.

No, I am not a health care worker, and I have never claimed to be one. I don't think that Slate requires posters to the Fray to have medical degrees. I think pretty much "reading the article" qualifies me to post here, even if my opinion is different than yours.

Who I am is a normal, everyday person fortunate enough to volunteer at an amazing organization which is dedicated to making kids with cancer feel like "normal" kids. My "expertise" is limited to seeing families who cannot afford a vacation come here and finally, finally, have the "normal" experience of taking the kids to theme parks and play at the pool. I don't blame this woman for wanting to find a "magical" place for her son, where he could be around other kids his age and enjoy the same things the other kids do. I don't believe that she deserves the implication that you made that she doesn't care for her son, or isn't truly concerned.

I'm sorry you feel that I'm nasty. I will certainly steer clear of your posts in the future.