IMMUNIZATION TOPICS

What are diphtheria, tetanus, and pertussis?

Diphtheria is a bacteria that releases a toxin or poison that can cause a thick coating in the nose, throat, and airway. This coating can obstruct breathing leading to suffocation, inflammation of the heart muscle leading to heart failure, and paralysis.

Tetanus is a bacteria that contaminates skin wounds and releases a toxin that can cause muscle spasm, especially of the jaw ('lock jaw'), and paralysis.

Pertussis is a bacteria that leads to paroxysmal coughing spells, difficulty breathing, or periods of absent breathing. In infants, these periods of paroxysmal coughing and lack of breathing can be life threatening. Older children can have coughing followed by the characteristic inspiratory whoop ('whooping cough').

What are the diphtheria (D) and tetanus (T) vaccines?

The vaccines consist of toxoids, or inactivated toxins. The toxoid causes an immune response that creates an antibody against the toxin.

If a child is exposed to the bacteria after receiving the vaccine, his immune system will protect his body against the toxin.

What are the pertussis (P) and acellular pertussis (aP) vaccines?

The old vaccine for pertussis contained killed pertussis cells that triggered the body to make antibodies against them. This was an effective vaccine but may have been related to undesirable side effects including high fever, local soreness and irritability in a small number of children. Although there has been some controversy regarding the possibility of the old pertussis vaccine (P) causing epilepsy (a long term seizure disorder) or encephalopathy, no medical study has been able to prove a relationship between the old vaccine and long-term side effects.

The new acellular pertussis vaccine (aP) is made from pertussis toxoid (inactivated toxin) and a limited number of surface proteins from the pertussis bacteria. Previous vaccines had been made from the whole pertussis bacteria cell. The new vaccine still enables the body to mount an immune response and create protective antibodies, however, there is a lower incidence of high fevers and other side effects following injections of the acellular vaccine (aP) compared to the old vaccine (P).

What are the side effects of the DTaP vaccine?

The most common side effects of the DTaP vaccine, similar to any injected vaccine, are pain, irritation, mild redness at the injection site, and a mild fever. These symptoms may lead to prolonged crying.

More severe reactions are exceedingly rare.

Of the more severe reactions to the old vaccine (DTP), high fever was the most common, occurring 0.3% of the time (or in 3 in 1000 patients). The occurrence of high fever following the new DTaP vaccine is even lower. There are no known long-term effects from this type of fever.

It is not possible to develop diptheria, tetanus, or pertussis by receiving the vaccine.

What is the vaccination schedule for the DTaP vaccine?

Newborn dosing schedule:

• Dose #1 at 2 months
• Dose #2 at 4 months
• Dose #3 at 6 months
• Dose #4 at 15-18 months
• Dose #5 between 4-6 years, before entering school

Older children who have never been vaccinated against DTP should be vaccinated. Call our office for an appointment.

Who should NOT receive the DTaP vaccine?

Anyone with a previous episode of anaphylaxis immediately following the DTP or DTaP vaccine or encephalopathy within 7 days of giving the vaccine.

Others who may wish to discuss postponing administration of the vaccine include those with a history of seizures, any neurological disorder, and the following reactions after receiving a previous vaccine: a seizure, persistant crying for more than three hours, a fever greater than 104.9 degrees Farenheit (40.5 degrees Celsius), and a collapse or shock-like state.

These adverse reactions to the DTaP vaccine are rare, and the risk of getting the diseases and suffering the consequences are higher than the risk of receiving the vaccine. This vaccine has saved many lives and much pain and suffering.

Warning signs- Call our office for advice if:

Your child is less than 6 months old and has a temperature greater than 100.4 degrees F, Call Our Office Now.

Your child is older than 6 months and has a temperature greater than 102.5 degrees F, Call Our Office Now.

Your child develops any signs of an allergic reaction including hives, rash, or difficulty breathing, Call Our Office Now.

You have any questions or concerns, or are unsure whether your child's symptoms are worrisome, Call Our Office Now.

What is Haemophilus influenzae type b (Hib)?

Hib is a bacteria that can cause serious infections in childood such as otitis media (middle ear infection), meningitis, pneumonia, and epiglotitis, a sudden severe swelling above the larynx or voice box.

Serious Hib infections are much less common today than in the past because of good immunization rates with the Hib vaccine.

The symptoms of Hib infection depend on where the infection is located.

What is the Hib vaccine?

The Hib vaccine is given to children to help their immune systems develop a response to the Hib bacteria.

The vaccine against Hib is a man-made version of the capsular sugars on the surface of the Hib bacteria and is injected into muscle.

If a child is exposed to the bacteria after receiving the vaccine, her immune system will recognize and attack the bacteria.

What are the side effects of the Hib vaccine?

The most common side effects of the Hib vaccine, similar to any injected vaccine, is pain, irritation, mild redness at the injection site, and a mild fever. These symptoms may cause prolonged crying.

More severe reactions are exceedingly rare.

It is not possible to become infected with Hib by receiving the vaccine.

Who should NOT receive the Hib vaccine?

Anyone with previous episodes of anaphylaxis immediately following the Hib vaccine.

What is the vaccination schedule for the Hib vaccine?

Newborn dosing schedule:

• Dose #1 at 2 months
• Dose #2 at 4 months
• Dose #3 at 6 months
• Dose #4 between 12-15 months

Children under 5 who have never been vaccinated against Hib should still receive the vaccinations. Call our office for an appointment.

Warning signs- Call our office for advice if:

Your child is less than 6 months old and has a temperature greater than 100.4 degrees F, call our office now.

Your child is older than 6 months and has a temperature greater than 102.5 degrees F, call our office now.

Your child develops any signs of an allergic reaction including hives, rash, or difficulty breathing, call our office now.

You have any questions or concerns, or are unsure whether your child's symptoms are worrisome, call our office now.

What is Hepatitis B?

Hepatitis B is a viral infection of the liver. The virus is spread by sexual contact and exposure to infectious blood or blood products.

Hepatitis B can either cause a chronic, low-level inflammation of the liver or a sudden, very severe infection of the liver possibly leading to liver failure and death.

Symptoms of hepatitis B include abdominal pain, yellow eyes and skin, fatigue, and nausea.

What is the hepatitis B vaccine?

The hepatitis B vaccine is given to help the immune system develop a response to the hepatitis B virus.

The vaccine against hepatitis B is a recombinant (man-made) version of the capsular surface proteins of the hepatitis B virus and is injected into muscle.

If a person is exposed to the virus after receiving the vaccine, his immune system will recognize and attack the virus.

It is not possible to become infected with hepatitis B by receiving the vaccine.

What are the side effects of the hepatitis B vaccine?

The most common side effects of the hepatitis B vaccine, similar to any injected vaccine, are pain, irritation, mild redness at the injection site, and a mild fever. These symptoms may cause prolonged crying in infants.

More severe reactions are exceedingly rare.

What about the thimerosal/mercury preservative in the hepatitis B vaccine?

The hepatitis B vaccine has been reformulated and no longer contains the thimerosal preservative.

The level of the preservative in the previous formulation was a very small amount and has not been shown to lead to any side effects.

Who should NOT receive the hepatitis B vaccine?

Anyone with a previous episode of anaphylaxis immediately following the hepatitis B vaccine.

What is the vaccination schedule for the hepatitis B vaccine?

Newborns of mothers with hepatitis B disease:

• Dose #1 within 12 hours of birth, given with hepatitis B immune globulin
• Dose #2 at 1-2 months
• Dose #3 at 6-9 months

Newborns of mothers proven to be free of hepatitis B disease:

• Dose #1 from birth to 2 months
• Dose #2 at 1-4 months
• Dose #3 at 6-18 months

Older children who have never been vaccinated against hepatitis B or have not completed the full series dosing schedule:

• Dose #1 at any time
• Dose #2 at least one month after the first dose
• Dose #3 at least four months after the second dose

Warning signs- Call our office for advice if:

Your child is less than 6 months old and has a temperature greater than 100.4 degrees F, Call Our Office Now.

Your child is older than 6 months and has a temperature greater than 102.5 degrees F, Call Our Office Now.

Your child develops any signs of an allergic reaction including hives, rash, or difficulty breathing, Call Our Office Now.

You have any questions or concerns, or are unsure whether your child's symptom's are worrisome, Call Our Office Now.

What are measles, mumps, and rubella?

Measles is a virus that causes a rash, cough, and fever. Measles can lead to ear infections, pneumonia, diarrhea, seizures, brain damage, and even death. Measles is uncommon in the U.S. because of high vaccination rates, but the infection reappeared briefly around 1990 when immunization rates were lower.

Mumps is a virus that causes fever, headache, and swollen salivary glands around the jaw. Swelling of the testicles can also occur in post-pubertal boys, causing pain but usually not leading to sterility.

Rubella, also known as the German Measles, is a virus that causes a rash, swollen lymph nodes (usually in the neck), and slight fever. If rubella is passed on to a developing fetus, it can cause severe damage to the brain, eyes, and ears of the fetus. There was an outbreak of rubella in the New York area in 1998 from poor immunization rates.

What is the measles, mumps, rubella (MMR) vaccine?

The vaccine for all three components is a combination of live, weakened viruses that is injected under the skin. The body kills the weakened virus and makes antibodies that protect against future infections. If a child is exposed to these viruses after receiving the vaccine, her immune system will recognize and attack the viruses.

A person with normal immune function should not develop measles, mumps, or rubella from the vaccine.

What are the side effects of the MMR vaccine?

The most common side effects of the MMR vaccine, as with any injected vaccine, are pain, irritation, mild redness at the injection site, and a mild fever. These symptoms may cause prolonged crying.

There is a 15 percent chance of a fever and/or rash that develops 7-12 days after vaccination. Both the fever and rash will go away naturally.

Who should NOT receive the MMR vaccine?

Anyone with a previous episode of anaphylaxis immediately following the MMR vaccine or the antibiotic neomycin.

Anyone who received immunoglobin (IG) in the last 3-9 months (for example, IVIG, HBIG, RSVIG or Respigam, TIG, RIG, VZIG, or red cell and platelet transfusions). If your child received any of these products in the last year, let us know at your next visit.

Anyone with a recent history of cancer or use of anti-cancer drugs.

Anyone using immunosuppressive drugs such as corticosteriods or other medications following an organ transplant.

Anyone who is possibly pregnant or may become pregnant in the next three months.

Other reasons which may warrant postponing administration of the vaccine include any history of seizures in the child or any history of low platelets.

What is the vaccination schedule for the MMR vaccine?

Newborn dosing schedule:

• Dose #1 at 12-15 months
• Dose #2 at 4-6 years

Older children who have never been vaccinated against MMR should be vaccinated. Call our office for an appointment.

Warning signs- Call our office for advice if:

Your child is less than 6 months old and has a temperature greater than 100.4 degrees F, Call Our Office Now.

Your child is older than 6 months and has a temperature greater than 102.5 degrees F, Call Our Office Now.

Your child develops any signs of an allergic reaction including hives, rash, or difficulty breathing after receiving the vaccination, Call Our Office Now.

You have any questions or concerns, or are unsure whether your child's symptoms are worrisome, Call Our Office Now.

What is Streptococcus pneumoniae (pneumococcus), and why should my child be immunized?

Streptococcus pneumoniae is a bacteria that can cause serious infections such as meningitis and pneumonia. The bacteria is also one of the several causes of otitis media (middle ear infection).

The pneumococcal vaccine has the potential to reduce the number of these infections in children -- it can reduce more than 1/2 of all cases of bacterial meningitis, 1/3 of all cases of pneumonia, 1/4 of chronic ear infections, and as much as 7% of all ear infections. The number of children needing insertion of ear tubes to treat multiple ear infections fell by 20%.

The vaccine will not prevent more ear infections because many are caused by viruses, other bacteria, and strains of pneumococcus not covered by the vaccine.

The symptoms of pneumococcal infection depend on the body system or organ where the infection is located.

What is the pneumococcal conjugate vaccine (PCV7)?

The pneumococcal conjugate vaccine is given to children to help their immune systems develop a protective response to the pneumococcus bacteria

The vaccine against pneumococcus is a man-made version of naturally occurring capsular or surface sugars of the pneumococcus bacteria that is injected into muscle. The vaccine is made by attaching this material to a protein used for decades in the DPT vaccine

If a child is exposed to the bacteria after receiving the vaccine, her immune system will recognize and attack the bacteria.

What are the side effects of the pneumococcal vaccine?

The most common side effects of the pneumococcal vaccine, similar to any injected vaccine, are pain, irritation, redness at the injection site, and a mild fever. These symptoms may cause irritability in infants.

More severe reactions are exceedingly rare.

It is not possible to become infected with pneumococcus by receiving the vaccine.

Who should not receive the pneumococcal vaccine?

Anyone with previous episodes of anaphylaxis immediately following the pneumococcal vaccine.

What is the vaccination schedule for the pneumococcal conjugate vaccine?

Newborn dosing schedule:

• Dose #1 at two months
• Dose #2 at four months
• Dose #3 at six months
• Dose #4 between 12-15 months

Many children less than five who have never been vaccinated against pneumococcus should still receive the vaccine. These children include African Americans; Native Americans; Alaska Natives; those with sickle cell anemia, HIV, and chronic diseases; and those who are immunocompromised. The CDC also recommends that the vaccine should be considered for other children 24 to 59 months, with priority given to children in group child care, children who are socially or economically disadvantaged, and children with frequent or recurrent ear infections. Call our office for further information or an appointment.

Warning signs -- call our office for advice if:

If your child is less than six months old and has a temperature greater than 100.4 degrees Fahrenheit, Call Our Office Now.

If your child is older than six months and has a temperature greater than 102.5 degrees Fahrenheit, Call Our Office Now.

If your child develops any signs of an allergic reaction including hives, rash, or difficulty breathing, Call Our Office Now.

If you have any questions or concerns, or are unsure if your child's symptoms are worrisome, Call Our Office Now.

What is polio?

Polio is a virus which can cause severe paralysis.

The polio virus is passed from the stool of an infected person to the mouth of another person. This can happen even in "sanitary" conditions.

What is the polio vaccine?

Polio vaccine is available in two forms, both of which are effective.

• A weakened form of the virus taken by mouth (OPV)
• An inactivated or killed form of the virus injected under the skin (IPV)

If a child is exposed to the virus after receiving the vaccine, his immune system will recognize and attack the virus.

What are the side effects of OPV?

There is a 1 in 1.5 million risk of developing the disease after taking the first dose of the live-virus vaccine. The risk is much lower for later doses because of the protection gained from the first dose, but the risk still exists.

Children with poor immune function have a higher risk of getting polio from OPV.

Since live, weakened virus can be passed through the stool, others may be at the 1 in 1.5 million risk of getting polio if they have never been vaccinated or have weak immune systems.

Because of the possibility of developing polio after receiving the oral vaccine, it is currently recommended that children receive all four doses by injection.

What are the side effects of IPV?

The most common side effects of the IPV vaccine, similar to any injected vaccine, are pain, irritation, mild redness at the injection site, and a mild fever. These symptoms may cause irritability in infants.

More severe reactions are exceedingly rare.

Who should NOT receive the OPV vaccine?

The current recommendation is that children should not receive the oral vaccine because of the risk of getting polio from the dose. If you still decide to give you child the oral vaccine, please consider the following restrictions:

Anyone with a previous episode of anaphylaxis immediately following the vaccine or use of the following antibiotics: streptomycin, polymyxin B, and neomycin.

Anyone with a history of cancer or use of anti-cancer drugs.

Anyone using immunosuppressive drugs such as corticosteriods or other medications following an organ transplant.

Anyone with a history of human immunodeficiency virus (HIV) infection.

Anyone with close contact with other children or adults who have immune system problems as above.

Anyone who is or plans on becoming pregnant in the next three months.

Who should NOT receive the IPV vaccine?

Anyone with a previous episode of anaphylaxis immediately following the vaccine or use of the following antibiotics: streptomycin, polymyxin B, and neomycin.

What is the vaccination schedule for the polio vaccine?

The American Academy of Pediatrics and the CDC recommend that children be vaccinated with only IPV unless there are other risk factors involved.

Newborn dosing schedule:

• Dose #1 at 2 months
• Dose #2 at 4 months
• Dose #3 at 12-18 months
• Dose #4 at 4-6 years

Older children who have never been vaccinated against polio should be vaccinated. Call our office for an appointment.

Warning signs- Call our office for advice if:

Your child is less than 6 months old and has a temperature greater than 100.4 degrees F, Call Our Office Now.

Your child is older than 6 months and has a temperature greater than 102.5 degrees F, Call Our Office Now.

Your child develops any signs of an allergic reaction including hives, rash, or difficulty breathing, Call Our Office Now .

You have any questions or concerns, or are unsure whether your child's symptoms are worrisome, Call Our Office Now.