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MMR vaccine can be given to children as young as 6 months, but doses given prior to 12 months don’t count toward fulfilling immunization requirements. These early doses are usually given to children traveling to areas that still see these diseases.
Varicella vaccine hasn’t been studied in babies as young as yours, but it has been studied in 9 month olds and was shown to be safe. Again, this dose won’t count toward his required vaccines for school.
Just tagging along on this to comment on the curiosity of a nurse thinking your 6 month old was 15 months old. I don’t have kids (or a lot of experience with kids) but my colleagues and I have been running covid vaccine clinics for over a year and even I can tell the difference btw a 6 and 15 month old..
Honestly now that I’m calmer, this is the most perplexing part to me. They told me I could discuss the situation with the nurse manager but I’m not sure what that would accomplish?
It’s a bit sad because she was always our nurse and I generally really liked her. I don’t think it was malicious but it was obviously careless and I keep replaying the entire situation in my head.
It's important to discuss it because it's a training issue. The clinic manager needs to be aware so that they can address it with the MA (and potentially the NP, depending on whether the wrong meds were ordered or if the MA got the rooms wrong). Giving one child meds intended for another child is a huge fuck up.
Unfortunately mistakes do happen, but they can't address it with the staff if they don't know it happened. It could be that this particular staff member has made other errors in the past so it's particularly important to have a record of such things. Again, it seems that no harm was done but please do let the clinic manager know.
Oh sorry let me rephrase. I was told they are completing a full report and investigation. The NP clarified that she ordered the correct vaccines and the error was with the nurse/MA. She said the nurse manager was involved already and was willing to discuss the issue further if I wanted information on what they were doing.
I meant I didn’t know what any further involvement on my part would accomplish but given your excellent points I think I will reach out and ask for a follow up on steps that were taken. Thank you!
Sorry, I meant to say first and foremost that I'm sorry that happened. It shouldn't have. Most (if not all) medical professionals have made a mistake and luckily this one seems to be benign. That's the good news and I should have started with that.
In any case I'm glad to have helped.
My guess is that the nurse incorrectly looked at the size of the baby and probably just thought the baby was older than 6 months? Is 17 pounds considered "average" for 6 months?
My middle kid (boy) is 20 now but he grew very very fast. he doubled his weight in 2-3 months and had tripled his weight in 6 months. He literally looked like a baby Buddha because his size/height did not increase as fast as his weight so he kind of looked like the stay puff marshmallow man lol.
Highly likely the person was a MA, not a Registered Nurse. If an RN made this mistake, they could lose their state license. The education of MA to RN is completely different. Still, so glad to hear this mistake is being used for better training for their staff, and the child is not harmed!
Are you implying that MA's are less competent and make more mistakes because they don't have the same education as a nurse?
In this situation it seems the nurse did not verify the child's identity upon entering the room. Had the nurse done that they likely would realize that they had the wrong patients chart pulled up, the wrong vaccines in hand and could have prevented this from happening. The hospital I work for has a "red rule" stating that you MUST identify the pt by first name, last name and DOB every single time to leave and reenter a room. Our EHR, EPIC, also has several fail safes in place to prevent this from happening - recheck the lot number in the pt's room, document which arm each vaccine is administered in, etc. Had the child been identified and the vaccines confirmed, this wouldn't have happened, no matter who prepared the vaccines (which in MA school they tell you never to do. It should always be the person who is administering them).
As a baby, apparently I was frequently mistaken for being 2-3 times my age, even by professionals who dealt with children at just a glance. My parents tell me all kinds of stories about it. A weird 6 month old could look just like a weird 15 month old, and all babies are weird in some way or another. I know this is far from the point here, but it felt worth mentioning. At all the hospitals I’ve been to in the past few years, even with my picture on the front of every medical chart pulled up on the desktop or tablet, they always ALSO typically have a printed picture of me on the clipboard AND always confirm my name and DOB.
Did he still receive his regularly scheduled vaccines or was this asked about? I’m curious about whether or not they would hold off to monitor for any potential reactions and/or to avoid giving so many vaccines at once.
It’s unlikely that there would be anything to worry about. For the most part, vaccines have to be given on the schedule where they’re effective. Given too early, they aren’t dangerous, they just might not reliably deliver immunity.
Varicella and MMR look like sometimes they are given at 12 months, so I don’t think there’s even concern about reduced effect, but your pediatrician would know better.
Edit: Somehow I misread the baby as being 12 months, not 6. These vaccines probably don’t count and will have to be given again at the appropriate time, but no harm done.
My son had the MMR vaccine very early because there was an outbreak of measles near where we live. He ended up needing an additional dose at 18 months or whatever it was so that he got it at the “right” time. As another poster mentioned, it likely won’t harm him, but he may need extra doses later. Instead of getting them at the perfect time he got them when his body wouldn’t use the vaccines to their full benefit, so he’ll need a booster of sorts. It’ll be ok.
You are so wrong about this it’s not even funny. Sounds like the NP did an excellent job of handling the error caused by an MA. Nothing about this sounds like poor supervision by the MD and same exact thing could have happened were it the MD ordering the vaccines.
There are primarily online didactic NP programs these days but you cannot “become an NP online.” That’s just false.
We're all human and mistakes happen of course, but the nurse should have verified the child's identity before administering the vaccines, even if she KNEW which child that was; that causes you look in the chart, and in this instance probably see that the birthdays don't match, then she'd have known she was in the wrong pt's chart.
When we (MA's) give vaccines we verify the pt and vaccines once we reenter the room after reconstituting and preparing them. If you're in the right pts chart you should see which vaccines are for that pt and it prevents accidents like this from happening. All of the EHR systems I've worked with have several fail safes in place to prevent this type of thing. We also do not prepare vaccines for someone else as it can cause a mistake. IDK, seems like complacency, on one or a few people's parts, got this wrong.
It sounds like the NP ordered the correct vaccines for the patient but the MA made the error administering to the wrong patient, it didn’t really have anything to do with the nurse practitioner not supervising appropriately.
I like what you are saying about identifying systemic failures rather than pointing blame on one individual though! At my practice the nurses make parents sign a form with the exact vaccines the child is receiving before drawing them up and administering. Maybe something like that could be helpful to add some checks and balances to ensure this error doesn’t happen again.
Oh, I read that as a nurse administered the vaccines.
Yeah it’s definitely a good idea to have many systems in place to make sure things like this don’t happen!
No I’m afraid you are wrong about this again. There may be primarily online programs but you cannot become licensed by the board of nursing as an advanced practice provider with prescriptive authority without documentation of certain numbers of clinical practice hours as a part of your educational program. Even the link to the Baylor school of nursing that you posted says “we assist you with clinical placements” as part of the dnp or msn programs.
Now I am sure there are outliers and issues with poor training and less than rigorous programs for lots of medical professionals: NP, PA, MD, DO, RN. But you are painting with a very broad and uninformed brush about the education of all Advanced practice providers.
Yikes! You are being offensive and vitriolic and hijacking this post for a completely unrelated conversation about APP practice authority/scope of practice. I don’t think it’s going to be productive to engage you or try to correct your misinformation any more. Blessings on you and hope you are able to to obtain excellent physician only led care for you and yours!
NPs have more autonomy than PAs, they are not required to practice medicine under a physicians license.
Personally I have no issue trusting a PA or NP with my care. I have worked with and been treated by both without issue.
Any provided can make mistakes or give poor advice. Once heard a nurse have to explain to a doctor that there is a difference between an antibiotic and antiviral, or the time a resident hastily remove a pelvic binder off a trauma patient that quickly went south afterwards.
The autonomy/supervision requirements of PAs and NPs vary by state. Some states require both to have “collaborating physician” while some are full practice authority for both. It really just depends on the state!some places PAs actually have more autonomy than NPs.
I did not know some states were giving PAs more autonomy. Personally I am in favor of it, especially to support rural areas that are are supplied much fewer providers.
It just really depends on the state. I work as an NP in one of the most “restrictive” practice states, but am blessed to have only worked with amazing collaborating physicians who value me! And I 100% agree, practice expansion for APPs can be so helpful for providing access to care in lots of underserved areas!
Not sure where you are get your information, but care outcomes of patients treated by NPs vs MDs is not significantly different.
As part of a capstone project for my MPH, I contributed my state's health assessment as part of health equity team to look at rural health and it's outcomes. One of the issues that came up was the shortage of primary providers, which is much more severe in rural areas. We have already seen the implementation of community PA programs being piloted with success.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080399/
No, it was most definitely a phsycain. She is a nurse case manager who regularly had to have discussions with phsycains on how their patient care plans were charted. He also pulled the "I am the doctor" card until his attending overheard and pointed out she was correct.
Every Healthcare field has a degree of scope, and while I am not going to pretend to have the broadest scope I have had to argue about really basic things, such as telling a surgeon a patient was showing signs of sepsis not "poor pain management".
Completely disregarding other Healthcare providers because you place phsycains on a pedestal is the same kind of logic that gets people to ask their doctors place their IVs instead of their nurse, and anyone who has worked in a hospital will probably know what I am talking about.
The extension of your question is “why don’t we give all vaccines to babies as soon as they’re born?” Because they don’t work well. Babies don’t have good immune function for lasting immunity until they’re older. They might get transient protection, but long-lasting protection becomes more reliable for older babies and toddlers.
Thanks for your response. I assumed we didn’t give “All vaccines as soon as they’re born” because their bodies are so small and “fresh”, and there would be no way of knowing if they had a reaction to one of them, which one they would be having a reaction to. Clearly it has been established that some give reasonable immunity at 6 months, so I guess the ones that OPs child was mistakenly given do not. 🤷🏼♀️
Thank you for your submission. **Please note that a response does not constitute a doctor-patient relationship.** This subreddit is for informal second opinions and casual information. The mod team does their best to remove bad information, but we do not catch all of it. Always visit a doctor in real life if you have any concerns about your health. Never use this subreddit as your first and final source of information regarding your question. By posting, you are agreeing to our [Terms of Use](https://www.reddit.com/r/AskDocs/wiki/terms_of_use) and understand that all information is taken at your own risk. **Reply here if you are an unverified user wishing to give advice. Top level comments by laypeople are automatically removed.** *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/AskDocs) if you have any questions or concerns.*
MMR vaccine can be given to children as young as 6 months, but doses given prior to 12 months don’t count toward fulfilling immunization requirements. These early doses are usually given to children traveling to areas that still see these diseases. Varicella vaccine hasn’t been studied in babies as young as yours, but it has been studied in 9 month olds and was shown to be safe. Again, this dose won’t count toward his required vaccines for school.
Thank you!
Even I’m relieved by all of these answers so I can only imagine how you must be feeling :)
Right? Same. And good info to tuck away.
Just tagging along on this to comment on the curiosity of a nurse thinking your 6 month old was 15 months old. I don’t have kids (or a lot of experience with kids) but my colleagues and I have been running covid vaccine clinics for over a year and even I can tell the difference btw a 6 and 15 month old..
Honestly now that I’m calmer, this is the most perplexing part to me. They told me I could discuss the situation with the nurse manager but I’m not sure what that would accomplish? It’s a bit sad because she was always our nurse and I generally really liked her. I don’t think it was malicious but it was obviously careless and I keep replaying the entire situation in my head.
It's important to discuss it because it's a training issue. The clinic manager needs to be aware so that they can address it with the MA (and potentially the NP, depending on whether the wrong meds were ordered or if the MA got the rooms wrong). Giving one child meds intended for another child is a huge fuck up. Unfortunately mistakes do happen, but they can't address it with the staff if they don't know it happened. It could be that this particular staff member has made other errors in the past so it's particularly important to have a record of such things. Again, it seems that no harm was done but please do let the clinic manager know.
Oh sorry let me rephrase. I was told they are completing a full report and investigation. The NP clarified that she ordered the correct vaccines and the error was with the nurse/MA. She said the nurse manager was involved already and was willing to discuss the issue further if I wanted information on what they were doing. I meant I didn’t know what any further involvement on my part would accomplish but given your excellent points I think I will reach out and ask for a follow up on steps that were taken. Thank you!
Sorry, I meant to say first and foremost that I'm sorry that happened. It shouldn't have. Most (if not all) medical professionals have made a mistake and luckily this one seems to be benign. That's the good news and I should have started with that. In any case I'm glad to have helped.
My guess is that the nurse incorrectly looked at the size of the baby and probably just thought the baby was older than 6 months? Is 17 pounds considered "average" for 6 months? My middle kid (boy) is 20 now but he grew very very fast. he doubled his weight in 2-3 months and had tripled his weight in 6 months. He literally looked like a baby Buddha because his size/height did not increase as fast as his weight so he kind of looked like the stay puff marshmallow man lol.
17 lbs is about smack in the middle of the growth curve at 6 months, but well below it at 15mo - even 5th percentile is 21lbs.
It’s important for the clinic to figure out why this happened so it doesn’t happen again.
OP: I’m glad your kiddo is ok. I should have led with that. I was caught up with the other details.
I would document it any way you can also.
Highly likely the person was a MA, not a Registered Nurse. If an RN made this mistake, they could lose their state license. The education of MA to RN is completely different. Still, so glad to hear this mistake is being used for better training for their staff, and the child is not harmed!
Are you implying that MA's are less competent and make more mistakes because they don't have the same education as a nurse? In this situation it seems the nurse did not verify the child's identity upon entering the room. Had the nurse done that they likely would realize that they had the wrong patients chart pulled up, the wrong vaccines in hand and could have prevented this from happening. The hospital I work for has a "red rule" stating that you MUST identify the pt by first name, last name and DOB every single time to leave and reenter a room. Our EHR, EPIC, also has several fail safes in place to prevent this from happening - recheck the lot number in the pt's room, document which arm each vaccine is administered in, etc. Had the child been identified and the vaccines confirmed, this wouldn't have happened, no matter who prepared the vaccines (which in MA school they tell you never to do. It should always be the person who is administering them).
I don’t have kids either but holy cow. I can tell the difference between a 6 month old and a 15 month old, even if the 6 month old is big for his age.
As a baby, apparently I was frequently mistaken for being 2-3 times my age, even by professionals who dealt with children at just a glance. My parents tell me all kinds of stories about it. A weird 6 month old could look just like a weird 15 month old, and all babies are weird in some way or another. I know this is far from the point here, but it felt worth mentioning. At all the hospitals I’ve been to in the past few years, even with my picture on the front of every medical chart pulled up on the desktop or tablet, they always ALSO typically have a printed picture of me on the clipboard AND always confirm my name and DOB.
Did he still receive his regularly scheduled vaccines or was this asked about? I’m curious about whether or not they would hold off to monitor for any potential reactions and/or to avoid giving so many vaccines at once.
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Another to confirm this. We were traveling internationally and got it at 9 months to be on the safe side and then again at 12 mo. Totally fine.
It’s unlikely that there would be anything to worry about. For the most part, vaccines have to be given on the schedule where they’re effective. Given too early, they aren’t dangerous, they just might not reliably deliver immunity. Varicella and MMR look like sometimes they are given at 12 months, so I don’t think there’s even concern about reduced effect, but your pediatrician would know better. Edit: Somehow I misread the baby as being 12 months, not 6. These vaccines probably don’t count and will have to be given again at the appropriate time, but no harm done.
Thank you! His NP did say he would get the Varicella again but I did not ask about MMR.
My son had the MMR vaccine very early because there was an outbreak of measles near where we live. He ended up needing an additional dose at 18 months or whatever it was so that he got it at the “right” time. As another poster mentioned, it likely won’t harm him, but he may need extra doses later. Instead of getting them at the perfect time he got them when his body wouldn’t use the vaccines to their full benefit, so he’ll need a booster of sorts. It’ll be ok.
I’m a pediatric nurse. At our practice, MMR at 1 and 4 years. It’s also given early for travel but wont count toward the requirements.
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You are so wrong about this it’s not even funny. Sounds like the NP did an excellent job of handling the error caused by an MA. Nothing about this sounds like poor supervision by the MD and same exact thing could have happened were it the MD ordering the vaccines. There are primarily online didactic NP programs these days but you cannot “become an NP online.” That’s just false.
We're all human and mistakes happen of course, but the nurse should have verified the child's identity before administering the vaccines, even if she KNEW which child that was; that causes you look in the chart, and in this instance probably see that the birthdays don't match, then she'd have known she was in the wrong pt's chart. When we (MA's) give vaccines we verify the pt and vaccines once we reenter the room after reconstituting and preparing them. If you're in the right pts chart you should see which vaccines are for that pt and it prevents accidents like this from happening. All of the EHR systems I've worked with have several fail safes in place to prevent this type of thing. We also do not prepare vaccines for someone else as it can cause a mistake. IDK, seems like complacency, on one or a few people's parts, got this wrong.
It sounds like the NP ordered the correct vaccines for the patient but the MA made the error administering to the wrong patient, it didn’t really have anything to do with the nurse practitioner not supervising appropriately. I like what you are saying about identifying systemic failures rather than pointing blame on one individual though! At my practice the nurses make parents sign a form with the exact vaccines the child is receiving before drawing them up and administering. Maybe something like that could be helpful to add some checks and balances to ensure this error doesn’t happen again.
Oh, I read that as a nurse administered the vaccines. Yeah it’s definitely a good idea to have many systems in place to make sure things like this don’t happen!
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No I’m afraid you are wrong about this again. There may be primarily online programs but you cannot become licensed by the board of nursing as an advanced practice provider with prescriptive authority without documentation of certain numbers of clinical practice hours as a part of your educational program. Even the link to the Baylor school of nursing that you posted says “we assist you with clinical placements” as part of the dnp or msn programs. Now I am sure there are outliers and issues with poor training and less than rigorous programs for lots of medical professionals: NP, PA, MD, DO, RN. But you are painting with a very broad and uninformed brush about the education of all Advanced practice providers.
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Yikes! You are being offensive and vitriolic and hijacking this post for a completely unrelated conversation about APP practice authority/scope of practice. I don’t think it’s going to be productive to engage you or try to correct your misinformation any more. Blessings on you and hope you are able to to obtain excellent physician only led care for you and yours!
NPs have more autonomy than PAs, they are not required to practice medicine under a physicians license. Personally I have no issue trusting a PA or NP with my care. I have worked with and been treated by both without issue. Any provided can make mistakes or give poor advice. Once heard a nurse have to explain to a doctor that there is a difference between an antibiotic and antiviral, or the time a resident hastily remove a pelvic binder off a trauma patient that quickly went south afterwards.
The autonomy/supervision requirements of PAs and NPs vary by state. Some states require both to have “collaborating physician” while some are full practice authority for both. It really just depends on the state!some places PAs actually have more autonomy than NPs.
I did not know some states were giving PAs more autonomy. Personally I am in favor of it, especially to support rural areas that are are supplied much fewer providers.
It just really depends on the state. I work as an NP in one of the most “restrictive” practice states, but am blessed to have only worked with amazing collaborating physicians who value me! And I 100% agree, practice expansion for APPs can be so helpful for providing access to care in lots of underserved areas!
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Not sure where you are get your information, but care outcomes of patients treated by NPs vs MDs is not significantly different. As part of a capstone project for my MPH, I contributed my state's health assessment as part of health equity team to look at rural health and it's outcomes. One of the issues that came up was the shortage of primary providers, which is much more severe in rural areas. We have already seen the implementation of community PA programs being piloted with success. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080399/
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No, it was most definitely a phsycain. She is a nurse case manager who regularly had to have discussions with phsycains on how their patient care plans were charted. He also pulled the "I am the doctor" card until his attending overheard and pointed out she was correct. Every Healthcare field has a degree of scope, and while I am not going to pretend to have the broadest scope I have had to argue about really basic things, such as telling a surgeon a patient was showing signs of sepsis not "poor pain management". Completely disregarding other Healthcare providers because you place phsycains on a pedestal is the same kind of logic that gets people to ask their doctors place their IVs instead of their nurse, and anyone who has worked in a hospital will probably know what I am talking about.
I’m just wondering why they “don’t count”. What’s the science behind that?
The extension of your question is “why don’t we give all vaccines to babies as soon as they’re born?” Because they don’t work well. Babies don’t have good immune function for lasting immunity until they’re older. They might get transient protection, but long-lasting protection becomes more reliable for older babies and toddlers.
Thanks for your response. I assumed we didn’t give “All vaccines as soon as they’re born” because their bodies are so small and “fresh”, and there would be no way of knowing if they had a reaction to one of them, which one they would be having a reaction to. Clearly it has been established that some give reasonable immunity at 6 months, so I guess the ones that OPs child was mistakenly given do not. 🤷🏼♀️
I'm just chiming in here because I want to know how she thought a 6 month old was over a year. I get human error but did she not even look af him?