Something else that we have put a  lot of consideration into is vaccinations for William. The US and Canada have very similar immunization schedules that start at 2 months of age. The first few shots (DTaP, Hib, IPV, Men-C, and RV) are given in 3 parts at 2, 4, and 6 months of age. The pneumococcal vaccine is given in 4 parts starting at 2 months. Since we will be leaving when William is only 5 months old, he will not be able to finish any of the series that we would start here. We have realized that we only have 3 options:

1. The boys and I will stay an extra month so that he can finish his first sets shots
2. We will leave when he is 5 months old, as originally planned, and have 1 month to figure out how to obtain the last shots he needs in Japan at an expat clinic.
3. We will not do any of his vaccinations in Canada, and begin him on the Japanese schedule once we arrive.

I really don't want to wait an extra month in Canada since that will actually be 2 months after Dustin leaves. Since our house will be sold by then, I will have to stay the extra time with my in-laws and spend every waking moment making sure that Theo does not break the multitude of knicknacks and tear their house to pieces.

I also don't relish the thought of running around trying to find Canadian vaccinations in Japan with only a one month time limit. I have read that getting imported shots at an expat clinic is super expensive, since it would not be covered by Japanese healthcare. I have no idea how expensive though, because every forum and website I have read fails to mention exactly how much they paid.

I have been reading up on the Japanese immunization schedule in the past month. There are a few differences from the Canadian schedule, the most important being the use of a non-attenuated or live polio vaccine (OPV), they do not immunize for mumps, and they immunize for tuberculosis (BCG). At first I thought it was a bit sketchy that they used the live polio vaccine compared with the inactive polio vaccine (IPV) that we use in the west. The live vaccine can actually cause someone to contract polio and there have been multiple cases of vaccine associated polio paralysis. After reading about it a bit more though, I realized that the US and Canada used the same OPV until the 1990's and only then switched to IPV. I guess if virtually everyone I know, including myself, got the live vaccine, and no one I know has contracted polio, I shouldn't worry about William. They also do not vaccinate for mumps like we do in the west. Mumps does not really affect young children too badly, but it can cause infertility if adolescent males contract it. So we can worry about that one in the future.

Japanese BCG vaccine
The last notable difference with their immunization schedule is that they vaccinate for tuberculosis instead of just testing for it with a mantoux like we do in Canada. The BCG vaccine uses a creepy looking 9 needled puncher device, leaves a scar, and makes you test positive on a mantoux. The scar isn't a big deal, I am sure William wouldn't be upset about an interesting arm scar, but testing positive for TB when you don't have it is annoying. My dad tests positive on a mantoux and has had to always have chest x-rays instead.

After thinking about our options and talking with our pediatrician, we have decided to hold off on starting any vaccinations in Canada and start him off the Japanese way. Hypothetically, he will be protected by my immunity anyway. I suppose that I will need to get my hands on  a Mother and Child Health Handbook (boshi kenko techo) when I get to Japan.

 We have not thought about this issue with Theo too much. At three years old he only needs two shots sometime between the ages of 4 and 6. We can always get them while visiting back home at some point in the next 3 years.


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