NEWBORN CRIB SHEET: VACCINES

by Lorel Kane

HISTORY & CONTROVERSY

The idea of vaccinating against infectious deadly diseases dates back to the 18th century with the first vaccine against small pox. By the 20th century small pox had been eliminated around the world, thanks to the power and protection of vaccination.
Measles is all but gone in the United States, according to the Centers for Disease Control and Prevention, with the only reported cases resulting from contact to the infection in other countries where the disease is still circulating.

“Vaccines are victims of their own success. Because they are so successful, people forget how bad these diseases were,” said Dr. C. Mary Healy, from Texas Children’s Hospital. Dr. Healy is the Director of Vaccinology and Maternal Immunization for the Center for Vaccine Awareness and Research at Texas Children’s Hospital. She says a recent resurgence of pertussis, or whooping cough, is a very real reminder to everyone of the benefit of vaccines.

PERTUSSIS OUTBREAKS

In 2010, the Texas Department of State Health services received reports on 2,848 cases of pertussis, 91 just in Harris County. Nationwide the number of reported cases of pertussis soared to 27,500, the most cases reported since 1959, according to the CDC. Twenty-six children died in 2010 as a result of Pertussis and most of them were under one year old.

Dr. Healy says what has become apparent since the 1980s is that the pertussis vaccine wears off after five to ten years and children entering adolescence have become susceptible again.

In 2005 a booster vaccine for tetanus, diphtheria and pertussis, called Tdap became available and is now recommended both for adolescents and adults.

Since infants are not completely protected against pertussis until they are six months old and have had their first three shots, the CDC recommends a strategy called “Cocooning.” The idea is to vaccinate everyone in close contact to babies, so they provide a layer of protection. Close contacts include parents, grandparents, siblings, other close relatives, care-givers and health care providers. “Studies have shown that over 75% of infants who get pertussis get it from someone who lives in the household,” according to Dr. Healy. And that person may not even know he or she has the disease because if the person is older the symptoms are milder and typically don’t include that very identifiable whooping sound young children have when they get it.

VACCINES & DISEASES

Pertussis is just one of 14 serious or potentially deadly diseases which vaccines can prevent in young children.

They are: Chickenpox, Diphtheria, Hib (Heamophilus influenza type b – a serious bacterial disease), Hepatitis A, Hepatitis B, Flu, Measles, Mumps, Polio, Pneumococcus, Rotavirus, Rubella, and Tetanus.

Here is a list of the vaccines and the diseases they protect against, followed by the schedule recommended by the CDC, The American Academy of Pediatrics and the American Academy of Family Physicians.

HepB: Hepatitis B
DTaP: Diphtheria, tetanus and pertussis
PCV: Pneumococcal Disease
Hib: Haemophilus influenza type b
IPV: Polio
RV: Rotavirus
Flu: Influenza (strains change year to year)
MMR: Measles, Mumps, Rubella
HepA: Hepatitis A
Varicella: Chicken Pox
MCV4: Meningococcal meningitis
HPV: Human papilloma virus

CDC RECOMMENDED VACCINE SCHEDULE

Birth: HepB
1 Month: HepB
2 Months: HepB, RV, DTaP, Hib, PCV, IPV
4 Months: RV, DTaP, Hib, PCV, IPV
6 Months: RV, DTaP, Hib, PCV, IPV, Flu (Children should begin getting the flu vaccine at six months old. Since the strains of the flu virus change from year to year the vaccine changes, too, so children should receive the new flu vaccine every year.)
12 Months: HepB, Hib, PCV, IPV, MMR, Varicella, HepA (first dose – minimum age 12 months; second dose 6-12 months later)
15 Months: HepB, Hib, PCV, IPV, MMR, Varicella,
18 Months: HepB, DtaP
4-6 Years: MMR (child may get 2nd dose before age 4, provided iat least four weeks have elapsed since the first dose), Varicella (child may get 2nd before age 4, if at least 3 months have elapsed since the first dose)
11-12 years: HPV (3 doses); MCV (first dose at 11 or 12 years, booster at 16 years. Children who get the first dose between 13-15 years old will need a one-time booster between 16-18 years old.
(source: Centers for Disease Control and Prevention).

ALTERNATIVE VACCINE SCHEDULE

Some vaccines series provide immunity for a lifetime, others need a booster later in childhood and even into adulthood, like the vaccine that protects against tetanus.
Dr. Healy says the vaccination schedule was designed to protect infants as soon as possible. Yet, many parents are concerned when, or even if, to vaccinate their children.
California pediatrician Dr. Robert W. Sears has written a book to address some of those concerns, The Vaccine Book: Making the Right Decision for Your Child. In it he offers an alternative schedule, which he calls “Selective Vaccination,” for parents who want to delay or decline certain vaccines, however he says that approach “runs contrary to the thinking of most doctors.”

Dr. Healy says those are issues that parents should discuss with their own pediatricians before making a decision. She says that parents should realize that the vaccine schedule was carefully designed to protect infants as soon as possible and she adds that she would not advise any parent to opt out of any vaccine. “If you see one baby suffering from pertussis, struggling to breathe while on a ventilator and you saw what that child and their family go through you would realize how wonderful vaccines are and how important it is that everyone get their recommended shot.”