Parenting in the Early Years

Immunizations

When babies are born, their immune system that helps them fight off diseases is immature. Some of the immunity is temporary, consisting of antibodies that are passed through the placenta and breast milk.

Immunizations work by stimulating the immune system to recognize and fight off specific infections. To ensure continued protection, it is important to vaccinate according to the recommended immunization schedule.

View the American Academy of Pediatrics' Recommended Immunization Schedule

Beware there are some individuals, including doctors, that have promoted alternative schedules or advised against immunization. These recommendations are not based on current scientific evidence. Delaying or deviating from the recommended schedule puts your child and others in the community at risk.

Be Wise, Immunize

Immunizations protect your child and family from outbreaks of many potentially serious and even life-threatening diseases. As the number of immunized people increases, the occurrence of the diseases decrease and some such as smallpox have even been eliminated. New vaccines are continuously being developed to reduce many of the serious infections that continue to cause problems.

If your child has missed an immunization, it is important to get it immediately. Children in both public and private schools are required by law to be immunized before entering school. Those children who have not received the required immunizations can be prohibited from attending school.

Ask your doctor for an immunization card for each of your children and keep it updated. Your child's vaccinations are entered into a state registry that tracks and monitors when vaccines are due and alerts your physician to any missed vaccines.

Vaccines, like any medicine, are capable of causing serious problems such as severe allergic reactions. People who have HIV, immune disorders, cancer, are currently taking steroids or other immune suppressors, such as cancer treatments or organ transplant medications, need to talk with their doctor about whether they should receive vaccinations.

Explanation of Diseases and Related Vaccinations

Polio

Polio is a virus that can cause meningitis and paralysis. At the time of the polio epidemic there were more than 27,000 people who died or were paralyzed from the disease. The vaccine program has eliminated polio as a disease in this country but it does exist in other parts of the world. That means that an individual infected with polio can get on a plane and bring the infection to the United States in a matter of hours. Until polio is eliminated worldwide, it is important to continue to vaccinate.

Polio Vaccine

The polio vaccine is the inactive form given in a shot called IPV. Children receive three doses the first year and a booster at 4 to 6 years.

Measles

Measles is a highly contagious illness that causes fever, eye irritation, a runny nose and a cough. It can cause pneumonia, brain damage and can even cause fatal outcome in previously healthy children. Measles continues to be a frequent cause of death in underdeveloped countries.

If a non-immunized child is exposed to measles, contact your physician so appropriate measures can be taken.

Mumps

Mumps virus causes fever, headache and painful swelling of the facial glands. It can cause brain inflammation, deafness and swelling of the testes or ovary resulting in sterility.

Rubella (German Measles)

This virus tends to be mild, causing a low-grade fever, rash and joint aches. If women develop rubella while pregnant, it causes severe birth defects or miscarriage.

MMR (Measles, Mumps, Rubella Vaccine)

This is a live vaccine developed from a weakened strain of the measles, mumps and rubella virus. It is given in two doses: the first at 12 to 15 months and the second at 4 to 5 years.

Side effects of the vaccine may be fever, a mild rash, or body achiness which usually occurs seven to 12 days after vaccination. Rarer, more serious reactions include seizure or lowering platelet counts. Several cases of brain damage have occurred after the vaccine but they are so rare that it is unclear if the vaccine caused them. After thorough investigations, scientific studies have found no link between the MMR and autism, though some individuals continue to promote this incorrect theory.

Diphtheria

Diphtheria is a rare bacterial infection of the nose and throat that can be deadly to children and adults. The bacteria produce a toxin that may attack the heart or nervous system.

Tetanus

Tetanus, commonly known as lockjaw, is caused by a common bacteria that lives in the dirt and enters the body through cuts or burns. It causes severe muscle spasms, a locking of the jaw and inability to swallow.

Pertussis 

Pertussis is also known as whooping cough. It causes a frequent violent cough that can last up to 2 to 3 months and can result in pneumonia, seizures and encephalitis. Infected infants require hospitalization and one percent of infected infants die.

DTaP

This is the combination vaccine to protect against diphtheria, tetanus and pertussis. The recommendation is to receive five doses starting at six to eight weeks of age and finishing on entrance to school.

Tdap is a vaccine for adolescents and adults to provide similar protection against diphtheria, pertussis and tetanus. Recommendations are to administer this vaccine on entrance to middle school after the age of 11 and to all previously non-immunized individuals between the ages of 11 and 65.

Common side effects of the vaccine include fever, local swelling, temporary swelling of the whole arm, irritability and sleepiness. One in 1,000,000 has a more severe reaction of high fever above 104°F, seizures, or temporary unresponsiveness.

If these symptoms occur, the vaccine series will not be continued. There is controversial evidence that the old form of the pertussis vaccine, no longer being used, was responsible for rare instances of permanent brain damage. Despite these possible side effects, most experts in pediatrics feel the benefit of the vaccine far outweighs the risk.

TD

Td is the adult diphtheria and tetanus shot which is advised every 10 years, or after five years if a dirty wound occurs.

Newer forms of these vaccines now are combined with other immunizations reducing the total number of shots that need to be administered.

Haemophilus Influenza B

Haemophilus Influenza B is a bacterium that causes severe illness in children, usually under the age of 5. It can cause meningitis (an infection of the coverings of the brain), pneumonia, joint infections and a life-threatening throat infection called epiglottitis.

Before this vaccine was introduced, 20,000 children in the United States were infected each year and around 1,000 of them died. Because some people are deciding not to vaccinate their children there has been a recent increase in the number of cases of life threatening disease seen.

HIB Immunization

There are several forms of the vaccine available. The primary series starts at two months and is either two or three shots. With Pedvax, a six-month dose is not needed. There is a booster vaccine administered between 12 and 18 months.

There are few side effects of this vaccine. Most common is redness and swelling at the site of the injection. More generalized symptoms may occur when this vaccine is given in combination with the DTaP.

Hepatitis B

Hepatitis B is a serious disease that can cause liver inflammation, loss of appetite, fever, rash and swelling of the joints. Long-term effects of the virus can be destruction of the liver, liver cancer or death.

Each year 150,000 people develop hepatitis B and about 5,000 people die from it.

Hepatitis B is contracted by exposure to infected body fluids, including blood, semen, vaginal secretions and saliva. Infants who are infected have the highest risk of developing chronic liver disease and may die from their infection.

Hepatitis B Vaccine

This is a three or four dose vaccine. It is recommended to begin the series in the nursery and complete it over the first year of life. The vaccine is one of the safest. A low-grade fever or pain at the injection site may occur.

Hepatitis A

Hepatitis A is a serious but usually self limiting liver disease, though it can be fatal. It causes fevers, nausea, weakness and jaundice. The disease is spread by contact with an already infected person or through contaminated food or water. It typically takes six to eight weeks to recover but can take up to nine months.

Hepatitis A Vaccine

Hepatitis A Vaccine is recommended for all children 12-23 months, those at high risk and for individuals that are traveling or living in countries with a high incidence of Hepatitis A. It is two-part vaccine with the second dose being given at least six months after the first. The vaccine may cause soreness at the site of vaccination, fatigue or headache for one or two days. There are rare more serious allergic reactions.

Chicken Pox (Varicella)

Chickenpox is a common childhood disease characterized by fever, fatigue and a blister-like rash. It can be very serious and may cause pneumonia or encephalitis, which is an inflammation of the brain. Chickenpox is the major setup for a life-threatening bacterial infection called "Invasive Strep," which can develop in a matter of hours.

Varivax

This chickenpox vaccine is recommended for children at 12 months of age and a second dose is recommended between the age of 4-6 or to any individual over 5 who has only received a single dose. If an individual is over 13 when receiving the vaccine, the schedule is two doses spaced 4 to 8 weeks apart. As of April 2006, the use of chickenpox vaccine had reduced the deaths from chickenpox by 88 percent.

Side effects of the vaccine include soreness at the site of the shot, fever, and a mild rash up to one month after the vaccine. Rare, more serious reactions include seizures, pneumonia and possibly encephalitis.

Pneumococcal

Pneumococcal diseases are infections caused by the bacteria Streptococcus pneumonia. Until the vaccine was started, Streptococcus pneumonia was the most common bacteria that infected the coverings around the brain called meningitis, and invaded the bloodstream of children. It continues to be the most common cause of ear and sinus infections.

Pneumococcal Vaccine

This vaccine is given in a four-dose series starting at two months and finishing at 12 to 18 months. If the vaccine is started after seven months of age, the schedule is changed.

This vaccine is recommended for all children under two and higher risk children, including those in daycare, Native American, Native Alaskan, African American and children with chronic illnesses.

Side effects include local reaction. A fever of up to 102 degrees is common after the second dose. As with any medicine, other very rare serious reactions can occur.

The current vaccine has been very successful in lowering the number of serious pneumococcal infections but protects against only seven strains that most commonly cause disease. Strains not covered by the vaccine are starting to be more frequent causes of infections. Experts are currently working on a vaccine to cover more types of pneumococcal infections.

There is another form of pneumococcal vaccine that covers 23 strains of pneumococcal infections and is recommended for certain high risk groups of patients over the age of two including those with immunodeficiency, individuals without a spleen, individuals with certain chronic heart, kidney, lung diseases or cancer. Your doctor will advise you if your child needs this vaccine. If you think your child may be a candidate, be sure to raise this question.

Rotavirus Infection

Rotavirus infection causes vomiting and diarrhea. This infection can result in severe
dehydration and accounts for up to 50 percent of the children that are hospitalized for diarrhea. Four out of five children will become infected with rotavirus by time they are 5 years old.

Rotavirus Vaccine (Rotateq)

The oral vaccine is administered in three doses with at least four weeks between doses, with the first dose started by 12 weeks of age the final dose administered by eight months (32 weeks).

Side effects most commonly include diarrhea, vomiting, and fever.

Meningococcal Infection

This is a very aggressive bacterial infection that is the most common cause of bacterial meningitis. It can also cause shock and bleeding that can result in severe injury including loss of limbs, as well as cause neurologic damage. Up to 15 percent of individuals that are infected die. At risk for this infections are infants through young adults. This infection can attack healthy individuals. At higher risk are those living in more crowded housing such as college dorms and army barracks.

Meningococcal MCV4 (Menactra)

This is a meningococcal vaccine to protect against 75 percent of the types of meningococcal that cause infection. The recommendation is to vaccinate when a person turns 11-12 years old, with a booster at age 16-18. If a person receives his or her first dose at age 16, they do not need a booster. Studies are being conducted to determine if the vaccine is protective in infants.

Common side effects of the vaccine include fever and soreness at the site of the vaccine. A question was raised about the possible association with a rare occurring neurologic disorder (Guillain-Barre) which causes progressive weakness. The most recent information demonstrates at most a slight increase of risk, if any, over the general population. 

Influenza

Is a common winter viral infection characterized by sudden onset of fevers, headache, achiness, sore throat, congestion and cough. More severe complications which can lead to hospitalization and death include pneumonia, encephalitis (brain inflammation), and heart tissue inflammation called myocarditis.

Influenza Vaccine 

This includes both the inactive type and the live virus. The vaccine is adjusted each year to cover the most anticipated strains. The recommendation is to vaccinate the individuals at highest risk for complications, which include children ages 6 months to 18 years, care givers of children 0-59 months, as well as all individuals with underlying diseases such as asthma, diabetes, cancer, heart disease, and metabolic disease.

Side effects of the vaccines are typically sore arm, fever or achiness. Rare, more serious neurologic complications have been reported.

Individuals with severe egg allergies should not receive the vaccine.

The use of live virus vaccine is not indicated under two years of age. Your doctor can review with you if you are a candidate for the live virus influenza vaccine.

Human Papilloma Virus (HPV)

HPV is a common virus infecting 20 million men and women in the US. The infection is spread through sexual contact and causes cervical cancer, precancerous cervical changes and genital warts. Cervical cancer is the second most common cause of female death from cancer, causing about 4,000 deaths per year in the United States.

HPV Vaccine (Gardasil)

This vaccine, if received before exposure to the HPV virus, is very effective in preventing papilloma infection and reducing the risk of cervical cancer in girls; oral, anal and rectal cancer in boys; and genital warts in both sexes. There are many strains of the papilloma virus and the vaccine covers the most common strains that cause cancer and warts. It only works if received before exposure to the virus. It is recommended to give the vaccine at ages 11-12 up to age 26, but can be started as young as 9 years old. It is a three-shot series with two months between the first and second shot and four months between the second and third shot.

Tuberculosis (TB)

This is a severe infection primarily associated with pneumonia, although it can cause other complications including meningitis, kidney disease, and infection of the bones or joints. This disease is contracted through exposure to another infected individual. Unfortunately, the frequency of tuberculosis is on the rise.

There are now strains of tuberculosis that are resistant to the usual drugs used to cure TB.

Reducing the number of people infected with tuberculosis requires testing individuals at high risk for contracting tuberculosis.

The following individuals are at risk and should be tested:

  • Infants and children exposed to individuals with active TB
  • Individuals with medical risks such as diabetes or persons on chemotherapy
  • Individuals living in housing projects
  • Individuals exposed to institutionalized persons such as nursing home patients or prisoners
  • Drug users
  • Individuals infected with HIV
  • Individuals born in countries with a high incidence of TB or exposure to such individuals
  • Health care employees

The Tuberculin test, or Mantoux (PPD), is not a vaccine. These are tests to detect if you have been exposed to tuberculosis and need medication.