"Pokey" in the thigh or arm?

My daughter knows vaccinations as "pokeys" and so we introduced that term to my toddler son, who was due for his measles-mumps-rubella (MMR) and varicella (chicken pox) vaccines on last Friday. He accepted the two shots in each thigh with some discontent, but was easily distracted from his pain. He has really thick thighs at close to 32 pounds. One might wonder, shouldn't he have gotten them in his arm because of the size of his thighs? Well, the MMR and varicella vaccines are given in the fat tissue (subcutaneous injection) just below the skin, so it was fine for my son. This also explains the lack of injection site reactions (redness, hardness, or warmth) that I noticed with the other vaccines that he has received. Of note, most of the routine childhood vaccines are given into the muscle area on the side of the thigh (anterolateral) or arm (deltoid muscle). Whether it is given in the arm or leg depends on the age of the child and the muscle mass available in the arm vs. leg. The routine childhood vaccines that are given subcutaneously are MMR, varicella, and inactivated polio. When he is due for his diptheria-tetanus-pertussis vaccination at his next visit, it will be an intramuscular injection that will go into his deltoid muscle. In the meantime, I'll be watching out for the rash and fever in the next couple of weeks.

FDA continues to review asthma meds

The FDA continues to review clinical trial data to assess the possible association of mood and behavioral adverse effects related to medicines that affect the leukotriene pathway (montelukast [Singulair], zafirlukast [Accolate], and zileuton [Zyflo]). These medicines may also be used for allergic rhinitis and to prevent exercise-induced asthma. No conclusion has been reached, yet, but this update to the March release informs us that it may take another 9 months.

These medicines are effective in controlling your child's asthma. Please do not stop your child's medicine, but do speak to the pharmacist or doctor if there are any concerns. Monitor your child for any changes in behavior and mood that are untypical, including suicide thinking and behavior. Remember that the evaluation is ongoing, so there is nothing to panic about.