Immunizations are a very important tool in preventing serious childhood diseases. In many states, immunizations are required prior to school admission. It is imperative that you keep an immunization record for each of your children. This record should be completely up-to-date and always available. It is a good idea for parents to keep this information with them. It is your responsibility to always keep up with your child’s immunization records because this may be very important at the time of accident or illness.
DTP (Diphtheria, Tetanus, and Pertussis) vaccine has been administered to healthy children in the U.S. for more than 40 years. It is a killed cell vaccine (components from the bacteria are used to make the product). The vaccine is given at 2, 4, 6, 15 to 18 months, and at 4 to 5 years of age. Potential minor side effects occur in about 1/3 of children, and consist of low grade (less than 102 degree) fever, local soreness or swelling at the injection site, or irritability. These are self limited, beginning within hours of the immunization and lasting less than a day. A small knot at the site may persist for several weeks before resolving. Tylenol or other brand of acetaminophen (see dosing guide) may be used to minimize these symptoms. Rarely, (about one chance in 3,000), a more severe reaction may occur, such as a high (more than 105 degree) fever, convulsion, or an extreme weak, pale appearance. These problems are also temporary, but are frightening and your child’s physician should be notified immediately if these occur. DTP has also been associated with a very rare risk of long term injury. However, when compared to the hazard of death or damage from the disease Pertussis, normal healthy children are felt to be far safer with the vaccine despite the above risks. A new approved vaccine is the DTaP – (Diphtheria, tetanus, and acellular pertussis) vaccines are efficacious when administered to infants as the primary series (i.e., doses 1-3). In addition, local reactions, fever, and other systemic events occur substantially less often after diphtheria, tetanus, and acellular pertussis (DTaP) administration than after administration of whole-cell diphtheria, tetanus, and pertussis (DTP). Therefore, diphtheria, tetanus, and acellular pertussis (DTaP) vaccines are recommended for all five doses in the vaccination schedule. For children who have started the vaccination series with one, two, three, or four doses of whole-cell diphtheria, tetanus, and pertussis (DTP); diphtheria, tetanus, and acellular pertussis (DTaP) is also recommended for all remaining doses in the schedule. During the period of transition from use of whole-cell diphtheria, tetanus, and pertussis (DTP) to diphtheria, tetanus, and acellular pertussis (DTaP), whole-cell diphtheria, tetanus, and pertussis (DTP) is an acceptable alternative to diphtheria, tetanus, and acellular pertussis (DTaP) for any of the five doses.
Polio vaccines have been routinely administered to U.S. children since the 1950’s, and they have produced the elimination of paralytic polio in our country. The vaccine in use is the Inactivated Polio Vaccine, and this is given at 2 and 4 months of age followed by booster doses at 12-18 months and 4-5 years.
“MMR (measles, mumps, rubella)”
The MMR is also a live virus vaccine, and it is given by injection at 12-15 months of age, with a booster dose at age 4-6 years. Severe side effects are extremely rare, but children can occasionally develop a measle-like rash and/or low grade fever from 1-2 weeks after the immunization. This reaction is typically brief and self limited, and requires nothing more than acetaminophen for treatment. The same precautions as those for oral polio vaccine also apply to the MMR since both are live vaccines. Also, children highly allergic to egg might possibly react to MMR. Let your doctor know about possible egg allergy prior to immunization.
“HIB (Hemophilus influenza type B vaccine)”
This immunization prevents serious infections due to the H flu bacterial germ, the most common cause of spinal meningitis in childhood. The HIB vaccine has been routinely given to all children for about a decade, and is now combined in the same shot with DTP vaccine. This vaccine is extremely well tolerated.
This vaccine is given to protect your child against the Hepatitis B virus, which can cause problems with the liver. This vaccine is given as a series of three doses, with the first right after birth, the second dose 1-2 months after and the last 6 months later. This is also a vaccine with a very safe track record.
Chickenpox vaccine is the newest addition to the routine childhood immunization series. This is a live virus vaccine (similar to MMR) and is recommended for every child older than age one who has not had chickenpox. It is given as a shot and consists of a single dose to younger children, or a two dose regimen if the child is 13 years or older. Side effects are few and consist of occasional soreness at the site of injection, mild flu-like symptoms, or rarely, a few chickenpox spots. The same precautions should be observed as for the polio vaccine.
Prevnar is a pneumococcal vaccine, which helps prevent childhood diseases caused by the bacterium Streptococcus Pneumoniae. These infections are the most common invasive bacterial infections in children. Prevnar is recommended for use in all children 23 months of age and younger and for children ages 24-59 months who are at high risk of invasive pneumococcal infection. Since the immunization schedule depends on when your child receives their first dose, see your physician for their recommendations.
“TB Skin Test”
This is not an immunization, but is a test that is done to determine whether your child has been infected with tuberculosis, a chronic and severe lung disease. It is sometimes a part of routine health visits at 12-15 months of age, and is definitely indicated if a family member has the disease.
Tetanus (lock jaw) is a disease which is caused by a bacteria which can grow in contaminated wounds. The bacteria can produce a toxin or poison which causes serious muscular spasms. Dirty wounds (those contaminated with dirt, feces, soil and/or saliva), or deep puncture wounds are particularly tetanus prone. Universal immunization with tetanus vaccines has virtually wiped out tetanus in the United States. Children who suffer more serious wounds should have particular attention paid to their immunization status. If your child has had three or more DTP vaccine doses within the past 5 years, then he/she does not require tetanus immunization after a dirty wound. If 5 or more years have elapsed since the last immunization to tetanus, then a booster will be required at the time of the injury. Children and adults should receive a tetanus immunization at least every ten years even if no wounds have occurred.