Immunizations And Your Child

All new parents must choose whether or not to immunize their infant or child against common childhood illnesses. We at Suburban Pediatric Associates feel strongly that vaccination is an important step toward keeping your child healthy. Following are some things to keep in mind when weighing the factors involved in making this important decision.

Risks vs Benefits of Vaccination

You many wonder why you need to have your child immunized when many of the diseases we immunize against have essentially been wiped out of our communities. This success is due in large part to our efforts to have widespread immunization for our children in this country. Even a slight decline in the immunization rates could allow for a comeback of many infectious diseases. Many of these illnesses still occur around the world and exposure is only a plane trip away.

Most parents don’t know of anyone who has suffered serious illness or death from these dreadful childhood infections and may therefore not feel the strong need to have their child immunized against them. In 1999, when rates of immunization were lower, there was a measles outbreak in the United States, and one out of every 500 people who developed the disease died. Whooping cough made a resurgence as little as two years ago in our area.

Safety is a primary reason parents are hesitant to vaccinate. Vaccines are safe, and researchers are constantly looking for ways to make sure that vaccines are as safe as possible. For example, there was a concern about the pertussis part of the DTP vaccine at one time, but the older version of the vaccine is no longer used and has been replaced by a newer DTaP vaccine. This vaccine contains only the segment of the pertussis bacteria required for immunity as opposed to the whole cells of the bacteria used previously.

From time to time adjustments in immunization recommendations are necessary to increase effectiveness and safety. One example is the oral polio vaccine. it was associated with a rare complication where a few children actually developed polio after being immunized. Now we only use the inactivated polio vaccine (IPV), which carries absolutely no risk of causing polio itself. The evidence could not be clearer — your child is at much greater risk from the infectious diseases themselves than from the vaccines.

If you think that you will not immunize your child to avoid the risks of the vaccine, remember that choosing not to immunize your child is a risk in itself. Your child can contract one of these illnesses and suffer subsequent problems. Your child could transmit the disease to others, including those who may be particularly vulnerable, like young infants or relatives with immune problems (many cancer patients, for example, can’t be immunized). And if an outbreak of one of these illnesses should occur, your child would need to stay out of school, even if they were not sick, because they would be a high risk of developing the illness.

Understanding Vaccines

It is important for you as a parent to understand what you are vaccinating your child against. Following is a summary of the illness and corresponding vaccines that are a part of the normal vaccination schedule for your child.

Diphtheria, Tetanus, and Pertussis Vaccines. Diphtheria causes a thick covering in the back of the throat. It can lead to breathing problems, paralysis, heart failure, and even death. Tetanus (lockjaw) is a serious disease that causes painful tightening of the muscles, usually all over the body. It can lead to "locking" of the jaw so the victim cannot open his mouth or swallow. Tetanus leads to death in about 1 in 10 cases. Pertussis, also known as whooping cough, is a highly contagious respiratory disease. It is caused by the bacterium Bordetella pertussis. Pertussis is known for uncontrollable, violent coughing which often makes it hard to breathe. After fits of many coughs, someone with pertussis often needs to take deep breaths which result in a "whooping" sound. Pertussis most commonly affects infants and young children and can be fatal, especially in babies less than 1 year of age.

Hepatitis A is a liver disease caused by the hepatitis A virus (HAV). Hepatitis A can affect anyone. Vaccines are available for long-term prevention of HAV infection in persons 1 year of age and older. Good personal hygiene and proper sanitation can also help prevent the spread of hepatitis A. For children, the first dose should be given at 12-23 months of age. Children who are not vaccinated by 2 years of age can be vaccinated at later visits. Two doses of the vaccine are needed for lasting protection. These doses should be given at least 6 months apart.

Hepatitis B is a serious disease caused by a virus that attacks the liver. The virus, which is called hepatitis B virus (HBV), can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. All children should get their first dose of hepatitis B vaccine at birth and should have completed the vaccine series by 6 through 18 months of age. The series consists of three separate vaccines. Children and adolescents through 18 years of age who did not get the vaccine when they were younger should also be vaccinated.

HIB (Haemophilus influenzae type b) vaccine prevents meningitis (an infection of the covering of the brain and spinal cord), pneumonia (lung infection), epiglottitis (a severe throat infection), and other serious infections caused by a type of bacteria called Haemophilus influenzae type b. It is recommended for all children under 5 years old in the US, and it is usually given to infants starting at 2 months old. The Hib vaccine can be combined with other vaccines.

Measles, Mumps and Rubella (MMR). Measles is the most deadly of all childhood rash/fever illnesses. The disease spreads very easily, so it is important to protect against infection. Mumps is a viral illness with symptoms including fevers, headaches, muscle aches, fatigue, loss of appetite and parotitis (swollen and sender salivary glands under the ears). Outbreaks of mumps still occur in the United States. Rubella is another viral illness characterized by a rash. it is often called “German measles.” This illness can be particularly harmful to pregnant women. Two doses of this vaccine are needed for complete protection. Children should be given the first dose of MMR vaccine at 12 to 15 months of age. The second dose can be given 4 weeks later, but is usually given before the start of kindergarten at 4 to 6 years of age.

Pneumococcal conjugate vaccine. PCV13 or Prevnar 13® is currently recommended for all children under 5 years of age. This provides protection against the bacteria Streptococcus pneumoniae, which can cause many illnesses including bacteremia (bloodstream infection), and meningitis (infection of the membranes surrounding the brain and spinal cord), and may also provide protection against middle ear infections.

Polio is an infectious disease caused by a virus that lives in the throat and intestinal tract. It is most often spread through person-to-person contact with the feces of an infected person and may also be spread through oral/nasal secretions. Most people infected with the polio virus have no symptoms, however for the less than 1% who develop paralysis it may result in permanent disability and even death. Inactivated Polio Vaccine (IPV), used in the U.S. since 2000, is given as an injection in the leg or arm, depending on age. Polio vaccine may be given at the same time as other vaccines. Most people should get polio vaccine when they are children. Children get 4 doses of IPV, at these ages: 2 months, 4 months, 6-18 months, and booster dose at 4-6 years. Oral Polio Vaccine (OPV) has not been used in the United States since 2000 but is still used in many parts of the world.

Varicella vaccine or the chickenpox vaccine is the best way to prevent chickenpox. Vaccination not only protects vaccinated persons, it also reduces the risk for exposure in the community for persons unable to be vaccinated because of illness or other conditions, including those who may be at greater risk for severe disease. While no vaccine is 100% effective in preventing disease, the chickenpox vaccine is very effective: about 8 to 9 of every 10 people who are vaccinated are completely protected from chickenpox. In addition, the vaccine almost always prevents against severe disease. If a vaccinated person does get chickenpox, it is usually a very mild case lasting only a few days and involving fewer skin lesions (usually less than 50), mild or no fever, and few other symptoms.