Immunizations: What You Need To Know

At birth, infants have protection against certain diseases because antibodies have passed through the placenta from the mother to the unborn child. After birth, breastfed babies get the continued benefits of additional antibodies in breast milk. But in both cases, the protection is only temporary.

Immunization (vaccination) is a way of creating immunity to certain diseases by using small amounts of a killed or weakened microorganism that causes the particular disease.

Microorganisms can be viruses, such as the measles virus, or they can be bacteria, such as pneumococcus. Vaccines stimulate the immune system to react as if there were a real infection it fends off the infection and remembers the organism so that it can fight it quickly should it enter the body later.

Some parents may hesitate to have their kids vaccinated because they’re worried that the children will have serious reactions or may get the illness the vaccine is supposed to prevent. Because the components of vaccines are weakened or killed and in some cases, only parts of the microorganism are used they’re unlikely to cause any serious illness. Some vaccines may cause mild reactions, such as soreness where the shot was given or fever, but serious reactions are rare.

The risks of vaccinations are small compared with the health risks associated with the diseases they’re intended to prevent.

By making sure that your child gets immunized on time, you can provide the best available defense against many dangerous childhood diseases. Immunizations protect children against:

  • hepatitis B
  • polio
  • measles
  • mumps
  • rubella (German measles)
  • pertussis (whooping cough)
  • diphtheria
  • tetanus (lockjaw)
  • Haemophilus influenzae type B
  • chickenpox.

All of these immunizations need to be given before children are 2 years old in order for them to be protected during their most vulnerable period.

Are your child’s immunizations up-to-date?

Remember to keep track of your child’s immunizations — it’s the only way you can be sure your child is up-to-date. Also, check with your pediatrician or health clinic at each visit to find out if your child needs any booster shots or if any new vaccines have been recommended since this schedule was prepared.

If you don’t have a pediatrician, call your local health department. Public health clinics usually have supplies of vaccine and may give shots free.

Types of Vaccines

Four different types of vaccines are currently available:

Attenuated (weakened) live viruses are used in some vaccines such as in the measles, mumps, and rubella (MMR) vaccine.

Killed (inactivated) viruses or bacteria are used in some vaccines, such as in IPV.

Toxoid vaccines contain a toxin produced by the bacterium. For example, the diphtheria and tetanus vaccines are toxoid vaccines.

Biosynthetic vaccines (such as Hib) contain synthetic substances.

 Your Child’s Immunizations

The following vaccinations and schedules are recommended by the American Academy of Pediatrics (AAP). Please note that some variations are acceptable and that changes in recommendations frequently occur as new vaccines are developed. Many of these vaccines are available as combinations to reduce the number of shots a child receives. Your doctor will determine the best vaccinations and schedule for your child.

Recommended Vaccinations:

  • Hepatitis B
  • Pneumococcal conjugate vaccine (PCV)
  • DTaP (diphtheria, tetanus, acellular pertussis)
  • Hib (meningitis)
  • IPV (polio)
  • Influenza
  • MMR (measles, mumps, rubella)
  • Varicella (chickenpox)
  • MCV4 (bacterial meningitis)
  • Hepatitis A

 

Hepatitis B

Hepatitis B virus (HBV) affects the liver. Those who are infected can become lifelong carriers of the virus and may develop long-term problems such as cirrhosis (liver disease) or cancer of the liver.

Immnization Schedule

Hepatitis B vaccine usually is given as a series of three injections. The first shot is given to infants shortly after birth. If the mother of a newborn carries the hepatitis B virus in her blood, the infant needs to receive the first shot within 12 hours after birth, along with another shot (HBIG) to immediately provide protection against the virus. If a newborn’s mother shows no evidence of HBV in her blood, the infant may receive the hepatitis B vaccine any time prior to leaving the hospital. It may also be delayed until the 4- or 8-week visit to the child’s doctor.

If the first dose is given shortly after birth, the second shot is given at 1 to 4 months and the third at 6 to 18 months. For infants who don’t receive the first shot until 4 to 8 weeks, the second shot is given at 3 to 4 months and the third at 6 to 18 months. In either case, the second and third shots are usually given in conjunction with other routine childhood immunizations.

Why the Vaccine Is Recommended

The hepatitis B vaccine usually creates long-term immunity. Infants who receive the HBV series should be protected from hepatitis B infection not only throughout their childhood but also into the adult years. Eliminating the risk of infection also decreases risk for cirrhosis of the liver, chronic liver disease, and liver cancer. Young adults and adolescents should also receive the vaccine if they did not as infants.

Possible Risks

Serious problems associated with receiving the HBV vaccine are rare. Problems that do occur tend to be minor, such as fever or redness or tenderness at the injection site.

When to Delay or Avoid Immunization
  • if your child is currently sick, although simple colds or other minor illnesses should not prevent immunization
  • if a severe allergic reaction (called anaphylaxis) occurred after a previous injection of the HBV vaccine
Caring for Your Child After Immunization

The vaccine may cause mild fever, and soreness and redness in the area where the shot was given. Pain and fever may be treated with acetaminophen or ibuprofen. Check with your child’s doctor about the appropriate dose.

When to Call the Doctor
  • if you’re not sure of the recommended schedule for the hepatitis B vaccine
  • if you have concerns about your own HBV carrier state
  • if moderate or serious adverse effects appear after your child has received an HBV injection

 

Pneumococcal Vaccine (PCV)

The pneumococcal conjugate vaccine (PCV) protects against pneumococcal infections. The bacterium is the leading cause of serious infections, including pneumonia, blood infections, and bacterial meningitis.

Children under 2 years old are most susceptible to serious pneumococcal infections. The pneumococcus bacterium is spread through person-to-person contact. The vaccine not only prevents the infection in children who receive it, it also helps stop its spread.

Immunization Schedule

PCV immunizations are given as a series of four injections starting at 2 months of age and following at 4 months, 6 months, and 12 to 15 months. Children who miss the first dose or may have missed subsequent doses due to vaccine shortage should still receive the vaccine, and your child’s doctor can give you a modified schedule for immunization.

Why the Vaccine Is Recommended

The most serious infections affect children younger than 2 years old, and the vaccine will protect them when they’re at greatest risk.

PCV also is recommended for kids between 2 and 5 years of age who are at high risk for serious pneumococcal infections because they have:

  • sickle cell anemia
  • a damaged spleen or no spleen
  • HIV/AIDS
  • cochlear implants
  • a disease that affects the immune system, such as diabetes or cancer
  • to receive medications that affect the immune system, such as steroids or chemotherapy

In addition, these high-risk children may also receive the pneumococcal polysaccharide vaccine (PPV) in addition to the PCV when they’re older than 24 months.

The PCV vaccine should be considered for all other 2- to -5-year-olds, especially those who are under 3 years of age; are of Alaska Native, American Indian, or African American descent; or who attend group child-care centers.

Possible Risks

Children who receive the PCV vaccine may have redness, tenderness, or swelling where the shot was given. A child may also have a fever after receiving the shot.

When to Delay or Avoid Immunization
  • if your child is currently sick, although simple colds or other minor illnesses should not prevent immunization
  • if your child has had a severe allergic reaction to a previous dose of the vaccine
Caring for Your Child After Immunization

The vaccine may cause mild fever, and soreness and redness in the area where the shot was given. Pain and fever may be treated with acetaminophen or ibuprofen. Check with your child’s doctor about the appropriate dose.

When to Call the Doctor

  • if your child missed a dose in the series
  • if a severe allergic reaction or high fever occurs after immunization

 

DTaP

The DTaP vaccine protects against:

  • diphtheria, a serious infection of the throat that can block the airway and cause severe breathing difficulty
  • tetanus (lockjaw), a nerve disease, which can occur at any age, caused by toxin-producing bacteria contaminating a wound
  • pertussis (whooping cough), a respiratory illness with cold symptoms that progress to severe coughing (the whooping sound occurs when the child breathes in deeply after a severe coughing bout); serious complications of pertussis can occur in children under 1 year of age, and those under 6 months old are especially susceptible
Immunization Schedule

DTaP immunizations are given as a series of five injections and are usually administered at ages 2 months, 4 months, 6 months, 15 to 18 months, and 4 to 6 years (before starting school). After the initial series of immunizations, a vaccine called Tdap (the booster shot) should be given at ages 11 to 12. Then, Td (tetanus and diphtheria) boosters are recommended every 10 years.

Why the Vaccine Is Recommended

Use of the DTaP vaccine has virtually eliminated diphtheria and tetanus in childhood and has markedly reduced the number of pertussis cases.

Possible Risks

The vaccine frequently causes mild side effects: fever, mild crankiness, tiredness, loss of appetite, and tenderness, redness, or swelling in the area where the shot was given. Rarely, seizures can occur following DTaP. Most of these side effects result from the pertussis component of the vaccine. Severe complications caused by DTaP immunization are rare. Most kids have little or no problem.

When to Delay or Avoid Immunization
  • if your child is currently sick, although simple colds or other minor illnesses should not prevent immunization
  • if your child has an uncontrolled seizure disorder or certain neurologic diseases or seems not to be developing normally ? the pertussis component of the vaccine may not be given, and your child may receive a DT (diphtheria and tetanus) vaccine instead

If your child experienced any of the following after an earlier DTaP, consult with your doctor before your child receives another injection of the vaccine:

  • seizures within 3 to 7 days after injection
  • worsening of seizures
  • an allergic reaction after receiving the vaccine, such as mouth, throat, or facial swelling
  • difficulty breathing
  • temperature of 105? Fahrenheit (40.5? Celsius) or higher during the first 2 days after injection
  • shock or collapse during the first 2 days after injection
  • persistent, uncontrolled crying that lasts for more than 3 hours during the first 2 days after injection
Caring for Your Child After Immunization

Your child may experience fever, soreness, and some swelling and redness in the area where the shot was given. Pain and fever may be treated with acetaminophen or ibuprofen. Check with your child’s doctor about the appropriate dose. Some doctors recommend a dose just before the immunization.

A warm, damp cloth or a heating pad also may help reduce soreness. Moving or using the limb that has received the injection often reduces the soreness.

When to Call the Doctor
  • if you aren’t sure whether the vaccine should be postponed or avoided. Children who have had certain problems with the DTaP vaccine usually can safely receive the DT vaccine.
  • if complications or severe symptoms develop after immunization, including seizures, fever above 105 Fahrenheit (40.5 Celsius), difficulty breathing or other signs of allergy, shock or collapse, or uncontrolled crying for more than 3 hours

 

Hib

Haemophilus influenzae type b bacteria were the leading cause of meningitis in children until the Hib vaccine became available.

Immunization Schedule

The Hib vaccine is given by injection at ages 2 months, 4 months, and 6 months (however, some of the Hib vaccines do not require a dose at 6 months). A booster dose is given at 12 to 15 months.

Why the Vaccine Is Recommended

Long-term protection from Haemophilus influenzae type b occurs in more than 90% of infants receiving three doses of the vaccine. Those immunized have protection against meningitis, pneumonia, pericarditis (an infection of the membrane covering the heart), and infections of the blood, bones, and joints caused by the bacteria.

Possible Risks

Minor problems, such as redness, swelling, or tenderness where the shot was given, may occur.

When to Delay or Avoid Immunization
  • if your child is currently sick, although simple colds or other minor illnesses should not prevent immunization
  • if severe allergic reaction occurs after an injection of the Hib vaccine, further Hib immunizations may not be given to your child
Caring for Your Child After Immunization
  • The vaccine may cause mild soreness and redness in the area where the shot was given.
  • Pain may be treated with acetaminophen or ibuprofen. Check with your child’s doctor about the appropriate dose.
When to Call the Doctor
  • if you aren’t sure whether the vaccine should be postponed or avoided
  • if moderate or serious adverse reactions appear after the Hib injection

 

IPV

Polio is a viral infection that can result in permanent paralysis.

Immunization Schedule

The inactivated poliovirus vaccine (IPV) is usually given at ages 2 months, 4 months, 6 to 18 months, and 4 to 6 years before entering school.

Until recently, the oral poliovirus vaccine (OPV) was given in the United States. Updated recommendations by the Advisory Committee on Immunization Practices now call for IPV injections. This change eliminates the previous small risk of developing polio after receiving the live oral polio vaccine.

Why the Vaccine Is Recommended

Protection against polio occurs in more than 95% of children immunized.

Possible Risks

Side effects include fever and redness or soreness at the site of injection.

When to Delay or Avoid Immunization

IPV should not be given to kids with severe allergy to neomycin, streptomycin, or polymyxin B.

Caring for Your Child After Immunization

IPV may cause mild fever, and soreness and redness at the site of the injection for several days. Pain and fever may be treated with acetaminophen or ibuprofen. Check with your child’s doctor about the appropriate dose.

When to Call the Doctor
  • if you aren’t sure whether the vaccine should be postponed or avoided
  • if moderate or severe adverse reactions occur after the immunization

 

Influenza

Influenza, commonly known as he flu, is a highly contagious viral infection of the respiratory tract.

Immunization Schedule

These groups, who are at increased risk of flu-related complications, should receive the flu shot every year:

  • children 6 to 59 months old
  • any child or adult with chronic medical conditions, such as asthma, cystic fibrosis, diabetes, sickle cell anemia, and HIV/AIDS
  • children ? from 6 months to 18 years ? on long-term aspirin therapy
  • anyone age 65 and older
  • women who will be pregnant during the flu season
  • anyone who lives or works with infants under 6 months old
  • residents of long-term care facilities, such as nursing homes
  • health-care personnel who have direct contact with patients
  • out-of-home caregivers and household contacts of anyone in any of these high-risk groups

In the past, there have been times when there were vaccine shortages and delays. So talk with your doctor about availability.

For kids younger than 9 who are getting a flu shot for the first time, it’s given in two separate shots a month apart. It can take about 2 weeks after the shot is given for the body to build up protection to the flu.

Another non-shot option called the nasal mist vaccine came on the market in 2003 and is now approved for use in healthy 5- to 49-year-olds. But this nasal mist isn’t for everyone, and can’t be used by high-risk children and adults or pregnant women.

Why the Vaccine Is Recommended

The flu vaccine reduces the average person’s chances of catching the flu by up to 80% during the season. Getting the shot before the flu season is in full force gives the body a chance to build up immunity to, or protection from, the virus.

The shot usually becomes available between September and mid-November. Although you can get a flu shot well into flu season, it’s best to try to get it earlier rather than later, if your doctor thinks it’s necessary. However, even as late as January there are still 2 to 3 months left in the flu season, so it’s still a good idea to get protection.

Even if you or your child got the vaccine last year, that won’t protect you from getting the flu this year, because the protection wears off and flu viruses constantly change. That’s why the vaccine is updated each year to include the most current strains of the virus.

Possible Risks

Given as one injection in the upper arm, the flu shot contains killed flu viruses that will not cause someone to get the flu, but will cause the body to fight off infection by the live flu virus. Getting a shot of the killed virus offers protection against that particular type of live flu virus if someone comes into contact with it.

Some of the most common side effects from the flu shot are soreness, redness, or swelling at the site of the injection. A low-grade fever and aches are also possible. Because the nasal spray flu vaccine is made from live viruses, it may cause mild flu-like symptoms, including runny nose, headache, vomiting, muscle aches, and fever. Very rarely, the flu vaccine can cause serious side effects such as a severe allergic reaction.

When to Delay or Avoid Immunization

People who should not get the flu shot include:

  • infants under 6 months old
  • anyone who’s severely allergic to eggs and egg products because the ingredients for flu shots are grown inside eggs. Tell the doctor if your child is allergic before he or she gets a flu shot.
  • anyone who’s ever had a severe reaction to a flu vaccination
  • anyone who’s had Guillain-Barr? syndrome (GBS, a rare medical condition that affects the nerves) within 6 weeks of getting a flu shot
  • anyone with a fever
Caring for Your Child After Immunization

Pain and fever may be treated with acetaminophen or ibuprofen. Check with your child’s doctor about the appropriate dose. Some doctors recommend a dose just before the immunization. A warm, damp cloth or a heating pad also may help minimize soreness. Moving or using the limb that has received the injection often reduces the soreness as well.

When to Call the Doctor
  • if you aren’t sure if the vaccine should be postponed or avoided
  • if there are problems after the immunization

 

MMR (measles, mumps, rubella)

The MMR vaccine protects against measles, mumps, and rubella (German measles). MMR vaccinations are given by injection in two doses. The first is administered at age 12 to 15 months; the second generally is given prior to school entry at age 4 to 6 years.

Why the Vaccine Is Recommended

Measles, mumps, and rubella are infections that can lead to significant illness. More than 95% of children receiving MMR will be protected from the three diseases throughout their lives.

Possible Risks

Serious problems are rare. Potential mild to moderate adverse effects include rash, fever, swollen cheeks, febrile seizures, and mild joint pain.

When to Delay or Avoid Immunization
  • if your child is currently sick, although simple colds or other minor illnesses should not prevent immunization
  • if your child has an allergy to eggs, gelatin, or to the antibiotic neomycin that has required medical treatment
  • if your child has received gamma globulin
  • if your child has immune system problems related to cancer, leukemia, or lymphoma
  • if your child is taking prednisone, steroids, or immunosuppressive drugs
  • if your child is undergoing chemotherapy or radiation therapy
Caring for Your Child After Immunization

If a rash develops without other symptoms, no treatment is necessary and it should resolve within several days. Pain and fever may be treated with acetaminophen or ibuprofen. Check with your child’s doctor about the appropriate dose.

When to Call the Doctor
  • if you aren’t sure if the vaccine should be postponed or avoided
  • if there are problems after the immunization

 

Varicella (chickenpox)

The varicella vaccine protects against chickenpox (varicella), a common and very contagious childhood viral illness.

Immunization Schedule

The varicella vaccine is given by injection between the ages of 12 and 18 months. Older children who have not had chickenpox may also receive the vaccine. Kids 13 years or older who have not had either chickenpox or the vaccine would need two vaccine doses at least 1 month apart.

Why the Vaccine Is Recommended

The varicella vaccine prevents severe illness in 95% of children who are immunized. It’s up to 85% effective in preventing mild illness. Vaccinated kids who do get chickenpox generally have a mild case.

Possible Risks

Serious reactions are extremely rare. Possible mild effects are tenderness and redness where the shot was given, fever, fatigue, and a varicella-like illness. A rash can occur where the shot was given or elsewhere on the body up to 1 month after the injection. It may last for several days but will disappear on its own without treatment.

When to Delay or Avoid Immunization
  • if your child is ill with anything more serious than a cold, immunization should be delayed
  • if your child has an allergy to gelatin or to the antibiotic neomycin that has required medical treatment
  • if your child has received gamma globulin
  • if your child has immune system problems related to cancer, leukemia, or lymphoma; is taking prednisone, steroids, or immunosuppressive drugs; or is undergoing chemotherapy or radiation therapy
Caring for Your Child After Immunization

Pain and fever may be treated with acetaminophen or ibuprofen. Check with your child’s doctor about the appropriate dose.

When to Call the Doctor
  • if you aren’t sure if the vaccine should be postponed or avoided
  • if there are problems after the immunization

 

MCV4 (Menactra)

The meningitis vaccine protects against meningococcal disease, a serious bacterial infection that can lead to bacterial meningitis.

The vaccine is recommended for kids at age 11 or 12 years, at age 15 years if not previously vaccinated (before entering high school), and for older teens who are entering college and will be living in a dormitory setting.

Why the Vaccine Is Recommended

Bacterial meningitis, an inflammation of the membrane that protects the brain and spinal cord, is a rare but highly contagious disease that can spread rapidly among kids who are in close quarters. It can be life-threatening if it’s not promptly treated.

Possible Risks

Some of the most common side effects are swelling, redness, and pain at the site of the injection, along with headache, fever, fatigue, and a rash.  The FDA is currently investigating several cases of Guillain-Barre Syndrome that have occurred within 6 weeks of MCV4 vaccination.  At this time, CDC and FDA cannot determine with certainty whether Menactra does increase the risk of GBS in persons who receive the vaccine and, if so, to what degree (the current data suggests an estimated possible increase of approximately 1.25 GBS cases for every million vaccinnees, but this estimate has many uncertainties).

When to Delay or Avoid Immunization
  • if your child tends to have allergic reactions to the DTaP vaccine or to latex
  • if your child is currently sick, although simple colds or other minor illnesses should not prevent immunization
Caring for Your Child After Immunization

Your child may experience fever, soreness, and some swelling and redness in the area where the shot was given. Pain and fever may be treated with acetaminophen or ibuprofen. Check with your child’s doctor about the appropriate dose. Some doctors recommend a dose just before the immunization.

A warm, damp cloth or a heating pad also may help reduce soreness. Moving or using the limb that has received the injection often reduces the soreness.

When to Call the Doctor
  • if you aren’t sure if the vaccine should be postponed or avoided
  • if there are problems after the immunization

 

Hepatitis A

The hepatitis A virus (HAV) causes fever, nausea, vomiting, and jaundice, and can lead to community-wide epidemics. Child care centers are a common site of outbreaks.

The vaccine is recommended for children over 1 year of age, followed by a second dose 6 months later. The vaccine is also recommended for older kids and adults who are at high risk for the disease, including those who are traveling to locations where there are high rates of HAV.

Why the Vaccine Is Recommended

Vaccination against HAV can help stop epidemics from developing in the community. Some infected children do not have any symptoms, and can spread the virus to others. The more young children who are vaccinated against HAV, the more limited the spread of disease will be in a community.

Possible Risks

Side effects are usually mild fever, and tenderness, swelling, and redness at the site of the injection.

When to Delay or Avoid Immunization
  • if your child is currently sick, although simple colds or other minor illnesses should not prevent immunization
  • if your child had an allergic reaction to the first dose of hepatitis A vaccine
Caring for Your Child After Immunization

Your child may experience fever, soreness, and some swelling and redness in the area where the shot was given. Pain and fever may be treated with acetaminophen or ibuprofen. Check with your child’s doctor about the appropriate dose.

When to Call the Doctor
  • if you aren’t sure if the vaccine should be postponed or avoided
  • if there are problems after the immunization

 

Immunizations for Travel

Specific information about which immunizations are required by travelers to each country worldwide is available directly from the Centers for Disease Control and Prevention (CDC). Ask your doctor for more information.

Depending on the type and length of travel, some vaccines may be recommended. Most immunizations should be given at least 1 month before travel. Take your child’s immunization records with you when you travel internationally.

Helping Your Child Through Vaccine Injections

Sometimes it’s hard to tell who dreads immunizations more parents or kids. Here are some tips to help make the procedure easier for everyone:

Tell older kids what’s going to happen and that the shot helps to keep them healthy.

Tell younger kids that it’s OK to cry, but also encourage them to be brave.

Try to be calm yourself. Your child can pick up on your concerns.

Distraction at the moment of the injection is helpful. Try having kids count, sing a song with you, or look away (perhaps at a picture on the wall). You may want to have a joke or funny comment ready.

Offer praise after the injection is over.

Plan something fun for after the appointment. A trip to the park or playground can make the overall immunization experience less unpleasant.

As uneasy as getting vaccinated may make both you and your child, remember that immunizations are one of the best means of protection against contagious diseases.

 

Commonly Asked Questions About Immunizations

Since the start of widespread vaccinations in the United States, the number of cases of some formerly common childhood illnesses like measles and diphtheria have declined dramatically. Immunizations have protected millions of children from potentially deadly diseases and saved thousands of lives. In fact, certain diseases crop up so rarely now that parents sometimes ask if vaccines are even necessary anymore.

This is just one common misconception about immunizations. The truth is, most diseases that can be prevented by vaccines still exist in the world, even in the United States, although they occur rarely. The reality is that vaccinations still play a crucial role in keeping children healthy.

Unfortunately, misinformation about vaccines could make some parents decide not to immunize their children, putting them and others at a greater risk for illness. To better understand the benefits and risks of vaccines, here are a few common questions.

What do immunizations do?

Vaccines work by preparing your child’s body to fight illness. Each immunization (given through a shot your child receives) contains either a dead or a weakened germ, or parts of it, that cause a particular disease.

Your child’s body practices fighting the disease by making antibodies that recognize specific parts of that germ. This permanent or long-standing response means that if your child is ever exposed to the actual disease, the antibodies are already in place and his or her body knows how to combat it, so your child doesn’t get sick. This is called immunity.

Will my child’s immune system be weaker by relying on a vaccine?

No, the immune system makes antibodies against a germ, like the chickenpox virus, whether it encounters it naturally or is exposed to it through a vaccine.

Will the immunization give my child the very disease it’s supposed to prevent?

This is one of parents’ most common concerns about vaccines. However, it’s impossible to get the disease from any vaccine made with dead (killed) bacteria or viruses or just part of the bacteria or virus.

Only those immunizations made from weakened (also called attenuated) live viruses – like the chickenpox (varicella) or measles-mumps-rubella (MMR) vaccine – could possibly make a child develop a mild form of the disease, but it’s almost always much less severe than the illness that occurs when a person is infected with the disease-causing virus itself.

The risk of disease from vaccination is extremely small. One live virus vaccine that’s no longer used in the United States is the oral polio vaccine (OPV). The success of the polio vaccination program has made it possible to replace the live virus vaccine with a killed virus form known as the inactivated polio vaccine (IPV). This change has completely eliminated the possibility of polio disease being caused by immunization in the United States.

Why should I have my child immunized if all the other children in school are immunized?

It is true that a single child’s chance of catching a disease is low if everyone else is immunized. Yet if one person thinks about skipping vaccines, chances are that other people are thinking the same thing. And each child who isn’t immunized gives these highly contagious diseases one more chance to spread.

This actually happened between 1989 and 1991 when an epidemic of measles broke out in the United States. Lapsing rates of immunization among preschoolers led to a sharp jump in the number of cases of measles, as well as the number of deaths and children with permanent brain damage. Similar outbreaks of pertussis (whooping cough) struck Japan and the United Kingdom in the 1970s after immunization rates declined.

Although vaccination rates are fairly high in the United States, there’s no reliable way of knowing if everyone your child comes into contact with has been vaccinated, particularly now that so many people travel to and from other countries. As the 1999 outbreak of encephalitis from West Nile virus in New York illustrated, a disease can hop halfway around the world very quickly because of international travel. So, the best way to protect your child is through immunization.

Why should I subject my child to a painful shot if vaccines aren’t 100% effective?

Few things in medicine work 100% of the time, but vaccines are one of the most effective weapons we have against disease – they work in 85% to 99% of cases. They greatly reduce your child’s risk of serious illness (particularly when more and more people use them) and give diseases fewer chances to take hold in a population.

It can be difficult to watch your child get a shot, but the short-term pain is nothing compared to suffering through a potentially deadly bout of diphtheria, pertussis, or measles.

Why do kids who are healthy, active, and eating well need to be immunized?

Vaccinations are intended to help keep healthy children healthy. Because vaccines work by protecting the body before disease strikes, if you wait until your child gets sick, it will be too late for the vaccine to work. The best time to immunize children is when they’re healthy.

Will immunizations cause a bad reaction in my child?

The most common reactions to vaccines are minor and include:

  • redness and swelling where the shot was given
  • fever
  • rash

Although in rare cases immunizations can trigger seizures or severe allergic reactions, the risk of these is much lower than that of catching the disease if a child is not immunized. Every year, millions of children are safely vaccinated, and almost all of them experience no significant side effects.

Meanwhile, research continually improves the safety of immunizations. The American Academy of Pediatrics (AAP) now advises doctors to use a diphtheria, tetanus, and pertussis vaccine that includes only specific parts of the pertussis cell instead of the entire killed cell. This vaccine, called DTaP has been associated with even fewer side effects like high temperatures and seizures.

Do immunizations or thimerosal cause autism?

Numerous studies have found no link between vaccines and autism (a developmental disorder that’s characterized by mild to severe impairment of communication and social interaction skills). Likewise, a groundbreaking 2004 report from the Institute of Medicine (IOM) found that thimerosal (an organic mercury compound that’s been used as a preservative in vaccines since the 1930s) does not cause autism either. Still, many parents have opted not to have their children immunized, putting them at great risk of contracting deadly diseases.

The measles-mumps-rubella (MMR) vaccine, especially, has come under fire over the years, despite many scientific reports indicating that there’s no clear evidence linking the vaccine to autism.

In 2004, a long-disputed 1998 study that suggested a possible link between autism and the MMR vaccine was retracted. Even before the 1998 study was retracted, not only had other studies found no link, but the controversial 1998 study was rejected by all major health organizations including the AAP, the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO).

There’s also no reason to believe that thimerosal is linked to autism, according to the 2004 IOM report. Nevertheless, in an effort to reduce childhood exposure to mercury and other heavy metals, thimerosal began being removed from kids’ vaccines in 1999. Now, vaccines for infants and young children contain no or very little thimerosal. And recent studies have not shown any cognitive and behavioral problem for babies who may have received these thimerosal-containing vaccines.

So what could explain the increased rates of autism in recent years? For one thing, there’s a broader definition of autism that can be applied to more children who show varying degrees of symptoms. A greater awareness of the condition among health professionals has also led to more diagnoses.

And although the number of children diagnosed with autism may be increasing, the rates of MMR vaccination are not. In London, diagnosis of autistic disorders has been on the rise since 1979 but rates of MMR vaccination haven’t increased since routine MMR vaccination began in 1988.

In addition, the average age of diagnosis of autism has been found to be the same in both children who have and who have not received the MMR vaccine. What many researchers are discovering is that subtle symptoms of autism are often present before a child’s first birthday – sometimes even in early infancy – but often go unnoticed until the symptoms are more obvious to parents.  So the bottom line is that, although we unfortunately still don’t know what causes autism, strong research indicates that vaccines are not a cause.

Wasn’t there a problem with the rotavirus vaccine?

Rotavirus is one of the most common causes of diarrhea in young children. In 1999, a rotavirus vaccine was taken off the market because it was linked to an increased risk for intussusception, a type of bowel obstruction, in young infants. However, the U.S. Food and Drug Administration (FDA) recently approved a new, different rotavirus vaccine called RotaTeq, which has been studied in more than 70,000 children, and has not been found to have this increased risk. The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC) has recommended that it be included on the regular immunization schedule. This rotavirus vaccine will be given to infants as a liquid by mouth during regular vaccination times at age 2 months, 4 months, and 6 months. RotaTeq has been found to prevent approximately 75% of cases of rotavirus infection and 98% of severe cases. Your child’s doctor will have the most current information.

Do immunizations cause sudden infant death syndrome (SIDS), multiple sclerosis, or other problems?

There are concerns, many of which circulate on the Internet, linking some vaccines to multiple sclerosis, SIDS, and other problems. To date, several studies have failed to show any connection between immunizations and these conditions. The number of SIDS cases has actually fallen by almost 50% in recent years, whereas the number of vaccines administered yearly continues to rise.

Why does my child need to be immunized if the disease has been eliminated?

Many diseases have been eliminated because people immunized their children.  That’s proof alone that immunizations work.  But diseases that are rare or nonexistent in the United States, like measles and polio, still exist in other parts of the world. Doctors continue to vaccinate against them because it’s easy to come into contact with illnesses through travel. That includes anyone who may not be properly immunized who’s coming into the United States, as well as Americans traveling overseas.

If immunization rates fell, a disease introduced by someone visiting from another country could cause serious damage in an unprotected population. In 1994, polio was brought to Canada from India, but it didn’t spread because so many people had been immunized. It’s only safe to stop vaccinations for a particular disease when that disease has been eradicated worldwide, as in the case of smallpox.

How long does immunity last after getting a vaccine?

A few vaccines, like the one for measles or the series for hepatitis B, may make you immune for your entire life. Others, like tetanus, last for many years but require periodic shots (boosters) for continued protection against the disease.

The pertussis vaccine also does not give lifelong immunity, and that may be one reason why there are still outbreaks of the disease. And although pertussis isn’t a serious problem for older kids and adults, it can be spread to infants and young children who may develop whooping cough. Because of this, adolescents now receive a pertussis boosters along with the tetanus and diphtheria booster (Tdap) – an important step in controlling this infection.

It’s important to keep a record of your child’s shots so you’ll know when he or she is due for a booster. It’s also a good idea to get the flu vaccine each year – if it isn’t in short supply. Even if you or your child may have gotten the vaccine last year, that won’t protect either of you from getting the flu this year because the protection wears off and flu viruses constantly change. That’s why the vaccine is updated each year to include the most current strains of the virus.

The flu vaccine reduces the average person’s chances of catching the flu by up to 80% during the season. But because the flu vaccine doesn’t prevent infection with all of the viruses that can cause flu-like symptoms, getting the vaccine isn’t a guarantee that you or your child won’t get sick during the season. But even if someone who’s gotten the shot gets the flu, symptoms will usually be fewer and milder.

Are vaccines continuously studied and improved because they’re unsafe?

The Food and Drug Administration’s Center for Biologics Evaluation and Research is the government agency responsible for regulating vaccines in the United States. Working in conjunction with the CDC and the National Institutes of Health (NIH), they continuously research and monitor vaccine safety and effectiveness.

New vaccines are licensed only after thorough laboratory studies and clinical trials are conducted, and safety monitoring continues even after a vaccine has been approved. There have been – and will continue to be – improvements (such as those that have already been made to the DTaP and polio vaccine, for example) that will minimize potential side effects and ensure the best possible safety standards.

Where can I go to get affordable immunizations for my child?

Clearly, vaccines are one of the best tools we have to keep children healthy, but the effectiveness of immunization programs depends on availability. You can receive inexpensive or free vaccines through many local public health clinics and community health centers, and campaigns to vaccinate children often hold free vaccination days.

A program called Vaccines for Children covers Medicaid-eligible, uninsured, Alaskan and Native American populations, and some underinsured children for routine immunizations up to 18 years of age. The vaccines are provided by the government and administered in the doctor’s office. However, the doctor’s visit itself is not covered (unless the child has insurance, including Medicaid). But some public health clinics may cover both the visit and the immunizations.

Where can I obtain more information on immunizations?

The Vaccine Adverse Events Reporting System

The Centers for Disease Control

Medline Plus

 

(Adapted from American Academy of Pediatrics)

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