Nationally, 20 percent of children under two years of age are not fully immunized for basic childhood diseases. Yet preschool children are the most susceptible to dangerous diseases like whooping cough, hepatitis and meningitis. Children should, in fact, receive most of their vaccinations during their first two years of life, starting at birth.
Vaccines have virtually eliminated many childhood scourges. Ironically, thanks to this great success, many people have become complacent about their children’s inoculations because they don’t remember how devastating these diseases used to be. A 1993 Gallup poll showed that nearly half of parents do not realize that polio is a contagious disease, or that measles can cause mental retardation, or that tetanus can lead to fatal paralysis. Even though 95 percent of children in the United States are immunized by the time they enter school-a requirement in all 50 states-toddlers and infants are not getting the protection they need. The truth is, without vaccines these diseases still pose a threat.
A vaccine is a preparation containing the weakened or killed microorganisms that cause a specific disease. When these substances are injected or taken orally, the body stimulates the immune system to produce the necessary defenses against a particular disease. Occasionally, because of the organisms introduced into the body, adverse reactions to vaccines may occur, but they are usually mild. Serious reactions are rare. In fact, the American Academy of Pediatrics (AAP) asserts that the risk a child faces if he or she gets one of these dangerous childhood diseases are far greater than the risk of complications from a vaccine.
According to the American Academy of Pediatrics, your child needs all of the following vaccinations to stay healthy. The Academy also recommends a specific schedule for when children should get their shots.
- MMR. Protects against measles, mumps and rubella (German measles).
- OPV. The Oral Polio Virus vaccine protects against polio.
- DTP. Protects against diphtheria, tetanus (lockjaw) and pertussis (whooping cough).
- Hib. Protects against Haemophilus influenza type b, a major cause of spinal meningitis.
- HVB. Protects against hepatitis B, which causes liver disease.
In addition, a vaccine against Chicken Pox has recently been approved by the Food and Drug Administration. AAP now recommends that a single dose of the varicella vaccine be given to babies between 12 and 18 months of age. The Academy also advises it be given to all children, adolescents and young adults who have not already been infected. This recommendation is not without controversy, however.
The immunization schedule below tells you at what age your child should get each of the recommended vaccines.
|4 Months||X||X||X (4)|
|6 Months||X||X (4)|
|12-15 Months||X||X (4)|
|4-6 Years||X (5)||X|
|11-12 Years||X (6)||X (7)|
|14-16 Years||X (7)||X|
(1) = The HbOC-DTP combination vaccine may be substituted for separate Hib and DPT vaccines.
(2) = Children in close contact with immunosuppressed individuals should receive inactivated polio vaccine.
(3) = Infants of mothers who tested seropositive fof Hepatitis B Surface Antigen should receive Hepatitis B Immune Globulin at or shortly after the first dose. These infants will also require a second Hepatitis B vaccine dose at 1 month and a third at 6 months of age.
(4) = Depends on which Hib vaccine was given previously.
(5) = For the fourth and fifth dose, the Acellular Pertussis (DTAP) vaccine may be substituted for the DTP.
(6) = Except where public health authorities require otherwise.
(7) = Where resources permit, the HBV series of three immunizations should be given to previously unimmunized preadolescents or adolescents.
Source: American Academy of Pediatrics, 1994
The best choice is a pediatrician who sees your child regularly. This way you will be assured that accurate records will be kept of what vaccinations your child has received and when. A community health center or local public or children’s health clinic can vaccinate your child as well, but then it is up to you to make sure your child is getting all the vaccines he or she needs at the proper time.
If you cannot afford vaccines for your child, community health centers, medical school clinics, children’s clinics, public health clinics, and some pediatricians’ offices, will vaccinate your child for free or at a very low cost. To find the location of one in your area, call your county’s Department of Health.
Our thanks to Jerome A. Paulson, M.D., Associate Professor of Health Care Sciences and Pediatrics, George Washington University, Washington, DC, for reviewing this article.
In 1995, the Food & Drug Administration approved the first vaccine in the U.S. to prevent chicken pox (varicella), and the American Academy of Pediatrics (AAP) quickly released recommendations for its use. But should your child get it?
The AAP suggests that children, adolescents and young adults who have not had the chicken pox get vaccinated. A single dose can be given to young children between 12 and 18 months old at the same time they receive their first measles, mumps and rubella (MMR) immunization. It is still not clear whether a booster shot will be needed. The Academy cites the “serious complications and deaths that result from chicken pox, the cost to families and society in terms of lost work days, and the efficiency and safety of the new varicella vaccine,” as reasons for their guidelines.
Despite this glowing endorsement, the vaccine is not without controversy. It was actually developed over 13 years ago to protect high-risk children, such as those with AIDS and leukemia, from severe and potentially fatal complications. However, opponents challenge the wisdom of mass immunization since chickenpox is only a minor illness in healthy kids. Not only do experts worry about unknown long-term effects, they’re also concerned that the vaccine may only be effective for a limited time, perhaps ten years. If that’s true, chicken pox would shift from being a childhood disease to one of adulthood when it poses serious risks such as pneumonia and inflammation of the brain. Similar problems have already occurred in some people given the measles vaccine. Furthermore, there is a question of whether this live, though weakened, strain of the chicken pox virus may be reactivated later in life and cause a painful outbreak of shingles.