Questions and Answers about Vaccine Ingredients
Q. What ingredients are in vaccines?
A. All vaccines contain antigens, the active ingredients that
prompt the body to create immune cells that will protect against
a future infection. Antigens come in several forms:
1. Weakened viruses: The measles, mumps, rubella and
chickenpox vaccines contain weakened viruses. Weakened
viruses don’t replicate well enough in the body to cause
disease, but still prompt an immune response.
2. Inactivated (or killed) viruses: The polio, hepatitis
A, influenza and rabies vaccines contain inactivated
viruses, which cannot cause even a mild form of the disease.
Because the body still recognizes the virus, it produces
immune cells to protect itself.
3. Partial viruses: Some vaccines contain just part of
the virus, such as a specific protein, that will prompt an
immune response. The hepatitis B and HPV vaccines are made
this way.
4. Partial bacteria: The Hib, pneumococcal and
meningococcal vaccines are made using part of the sugar
coating (or polysaccharide) of the bacteria. The vaccine
creates immunity against this sugar coating, providing
protection against the bacteria. Bacterial vaccines against
diphtheria, tetanus and pertussis (whooping cough) are made
by inactivating the protein in the bacteria that causes
harm.
Vaccines also contain inactive ingredients, which help make
them safer and more effective. They include:
1. Preservatives to prevent contamination with germs.
2. Adjuvants, including aluminum salts, which help your
body create a better immune response.
3. Additives, including gelatin, albumin, sucrose,
lactose, MSG and glycine, which prevent vaccine
deterioration.
4. Residuals of the vaccine production process. They
include tiny amounts of formaldehyde, antibiotics
(neomycin), egg protein and yeast protein.
Q. Why are these other ingredients in vaccines? Are they
safe?
A. Each additive serves a specific function in a vaccine. These
ingredients have been found to be safe in humans in the
quantities given in vaccines, which is much less than children
are exposed to in their environment, food and water.
1. Aluminum salts – Aluminum salts help your body create
a better immune response to vaccines, making the vaccine
more effective. Without an adjuvant like aluminum, people
could need more shots or face lower immunity. Vaccines are
not the only source of aluminum exposure to infants. Because
aluminum is abundant in the earth’s crust, it is present in
our food, air and water, including breast milk and formula.
The aluminum contained in vaccines is similar to that found
in 33 ounces of infant formula. Aluminum has been used in
vaccines for 75 years and has been found to be safe.
2. Formaldehyde – Small amounts of formaldehyde in some
vaccines sterilize the vaccine fluid to prevent harmful
germs from infecting your child. It is used to detoxify the
tetanus toxin, thus making a toxoid that will produce
immunity without toxicity. Vaccines are not the only
source of formaldehyde your baby is exposed to. Formaldehyde
is also in products like paper towels, mascara and
carpeting, and is a byproduct of human metabolism. All
humans have formaldehyde in their blood stream at levels
higher than that which an infant receives in vaccines. The
amount of formaldehyde in vaccines is safe.
3. Antibiotics – Antibiotics, such as neomycin, are
present in some vaccines to prevent bacterial contamination
during the manufacturing process; the antibiotics are added
to the culture media that is used to grow the viruses. The
trace quantities of antibiotics in vaccines rarely, if ever,
cause allergic reactions.
4. Egg protein – Influenza and yellow fever
vaccines are produced in eggs, so egg proteins are present
in the final product and can cause allergic reaction.
Measles and mumps vaccines are made in chick embryo cells in
culture, not in eggs. The much smaller amount of residual
egg proteins found in the MMR vaccine is not sufficient to
cause allergic reactions.
5. Gelatin – Some vaccines contain gelatin to protect
them against freeze-drying or heat. People with severe
allergies to gelatin should avoid getting gelatin-containing
vaccines.
Q. Do vaccines contain antifreeze?
A: No. A component of antifreeze called polyethylene glycol is
used to inactivate the flu virus in some flu vaccine. It is also
used to purify other vaccines. This chemical is also widely used
in personal care products including skin creams and toothpaste.
Q. Do vaccines contain mercury?
A: Thimerosal, a mercury-based preservative, was removed from
childhood vaccines in 2001. It is still present in some
influenza vaccines. Valid scientific studies have shown there is
no link between thimerosal and autism. Since thimerosal was
removed from childhood vaccines, autism rates have actually
increased, supplying further evidence that thimerosal does not
cause autism. The American Academy of Pediatrics (AAP), the
American Medical Association (AMA), the CDC, and the Institute
of Medicine (IOM) agree that science does not support a link
between thimerosal in vaccines and autism. For the IOM report,
go to
http://www.iom.edu/CMS/3793/4705/4717.aspx
Q. Should vaccines be "greener"?
A. Additives like aluminum are in vaccines in extremely small
amounts, but each is included for a specific reason. We are
exposed to significantly higher levels of these chemicals in our
everyday lives. In vaccines, these ingredients serve to make the
vaccine safer and more effective at preventing disease. Each
vaccine product is extensively tested for efficacy (does it
protect the person from the infection?) and safety. It is
not known if changing the make up of a vaccine would affect the
ability of that vaccine to protect a person.
~AAP
October 2008
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Facts
for Parents About Vaccine Safety
from the American
Academy of Pediatrics
Why are vaccines important?
Immunizations protect children. Vaccine-preventable
diseases can have dangerous consequences, including
seizures, brain damage, blindness and even death.
Because of the success of the national immunization
program, many young parents today have never seen a case
of one of these illnesses, but measles, meningitis,
chickenpox, pertussis and other diseases exist in the
world and would re-emerge here if immunization rates
fell. For example, recent outbreaks of measles in the
U.S. were traced to unvaccinated children who became
infected while traveling in Europe. Likewise, it would
only take one case of polio from another country to
bring the disease back to the U.S. if children are not
protected by vaccination.
Are vaccines safe?
Yes. Today’s vaccines are safer than any in history.
Vaccines contain antigens, which are either live but
very weakened viruses, inactivated viruses, or small
parts of bacteria or viruses that prompt the body to
produce protective antibodies without causing the
disease.
Even though children receive more vaccines now, the
total number of antigens is less because today’s
vaccines are more refined than older versions. At a very
young age, children’s immune systems are equipped to
respond to many antigens at the same time, including
those in vaccines as well as the ones they encounter in
their daily activities such as eating, breathing and
playing.
In addition to antigens, vaccines contain ingredients to
prevent contamination and improve effectiveness. These
ingredients have been found to be safe in humans in the
quantities given in vaccines, which is much less than
children are exposed to in their environment, food and
water. Valid scientific studies have shown there is no
link between autism and thimerosal, a mercury-based
preservative once used in several vaccines (and still
used in some flu vaccine). However, since thimerosal was
removed from childhood vaccines in 2001, autism rates
have actually increased, supplying further evidence that
thimerosal does not cause autism.
Before a vaccine is licensed, it is studied in thousands
of children and in combination with other vaccines.
After licensure, the federal government continues to
monitor a vaccine’s safety. This continuous monitoring
ensures researchers will uncover any rare side effects,
even if they affect only a small number of children. For
example, a rotavirus vaccine was withdrawn in 1999 after
it was linked to intestinal blockages in about 100
children. This vaccine was replaced by a new and safer
product. Today’s recommended vaccines have been shown to
be safe and effective for millions of children.
Can I delay or skip vaccines?
It is not a good idea to skip or delay vaccines, as this
will leave your child vulnerable to diseases for a
longer time. Children are most vulnerable to
complications from disease in their early years of life,
when vaccines provide protection, and some
vaccines produce a better immune response at particular
ages.
Parents should follow the schedule provided by the U.S.
Centers for Disease Control and Prevention, the American
Academy of Pediatrics and the American Academy of Family
Physicians, which is designed by experts to ensure
maximum protection and safety for children at various
ages. This schedule allows for some flexibility to delay
certain shots when advised by a child’s pediatrician due
to illness, certain chronic conditions or other medical
reasons. Parents should discuss any concerns with their
child’s pediatrician.
More information is available at
http://www.aap.org/advocacy/releases/autismparentfacts.htm
and
www.cdc.gov/vaccines.
June 2008
Learn More
At:
http://vaccinateyourbaby.org
Vaccinate
Your Baby is an awareness campaign that was
launched by
Every Child By Two, an organization
devoted to raising awareness of the critical
need for timely immunization and to foster a
systematic way to immunize all of America's
children by age two. The site was launched
in August of 2008, and features news and
information for parents who wish to learn
the truth about immunization and how best to
protect their children from
vaccine-preventable diseases.
About Every
Child By Two
Every Child
By Two (ECBT) was founded by former First
Lady Rosalynn Carter and former First Lady
of Arkansas Betty Bumpers in 1991 as a
result of the measles epidemic that killed
nearly 150 people. Carter and Bumpers have
been working on immunizations since their
husbands were governors in the early 70's
and have been credited with the passage of
laws mandating school-age vaccination
requirements in every state. The goals of
ECBT are to raise awareness of the critical
need for timely immunizations and to foster
a systematic way to immunize all of
America's children by age two. To forward
its agenda, ECBT enlists the support of
elected officials and their spouses,
concerned community leaders, and
representatives of many national
organizations.
ECBT works
with immunization partners nationwide to
educate those who effect policy decisions
regarding immunizations and to seek funding
for state immunization programs who are
responsible for the delivery of vaccines to
the uninsured and underinsured children of
this nation. The cofounders and staff of
ECBT travel throughout the nation to
highlight the need for continued vigilance
to ensure that the 12,000 babies born every
day receive life saving vaccines in a timely
manner.
ECBT works in
conjunction with the Centers for Disease
Control and Prevention to conduct
educational programs for healthcare
providers. Much of our efforts focus on
ensuring that electronic immunization
registries are fully developed and
implemented throughout our country. This
electronic medical record helps physicians
ensure that their patients receive all their
vaccines on time and help parents keep track
of their children's vaccines.
ECBT
spearheaded efforts to attain a Presidential
directive to ensure that children who
receive benefits from the Supplemental
Nutrition Program for Women, Infants and
Children (WIC) are screened at each
certification visit to ensure they are up to
date on vaccines.
Every Child
By Two has assisted in the development of
programs and coalitions throughout the
nation that seek to increase immunization
coverage rates. We are well respected for
our ability to mobilize grassroots
campaigns, affect state and federal public
policy, and execute programs that have
lasting positive effects on the nation's
public health system
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Vaccine Information
Sheets
These information sheets provide valuable information about
vaccines benefits and risks and are provided by the
Centers for Disease Control.
http://www.cdc.gov/vaccines/pubs/vis/default.htm
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Prevention from diseases outweighs MMR side effects
By JOHN LAWRENCE KIELY
Thursday, October 09, 2008
I’m in a hospital bed, gasping for breath. Through the clear
plastic of an oxygen tent, I see my Mom. Her face is red and
she’s crying and crying. I feel hot. Every few hours a nurse
opens the oxygen tent and gives me a shot. It hurts.
It’s
1959. I’m in second grade. I’d caught the measles, just like
my brothers and sisters and friends. Except unlike them, my
measles didn’t go away. It got worse and turned into
something I’d never heard of: pneumonia. I spent a month in
the hospital, survived, and spent a few more months
recovering at home. But more than four million children got
measles in the United States in that year and 385 died.
Most Americans don’t remember those days. Why? Because
four years after I got sick, the Centers for Disease Control
and Prevention began a mass measles immunization program. By
2000, the number of reported cases of measles had decreased
to 86 and the number of deaths to one.
So it is distressing to see that this year measles is on
the upswing.
As of July, there were 131 measles cases reported to
CDC, the highest number since any comparable period
since 1996. Most pediatricians and public health officials
believe that’s because fewer parents are bringing their
young children in to get vaccinated.
And why is that? Because since 1998 the idea that the
measles-mumps-rubella (MMR) vaccine causes autism has scared
them away.
This is not just shameful. It’s scandalous. The entire
phenomenon was spawned by a few studies by one research team
with results that nobody else has been able to replicate and
publish in the peer-reviewed medical literature.
Meanwhile, more than 20 epidemiologic studies have
reported no association between the MMR vaccine and autism
spectrum disorders, including one published last month.
Meanwhile, allowing your child to skip the vaccine may be
a risky decision. Measles is not just a charming appearance
of red spots on a two-year old’s stomach.
Recent reviews from Health Canada and Canada’s National
Advisory Committee on Immunization compared the effects of
measles to the side effects of the MMR vaccine.
Along with the pneumonia I had as a kid (1 to 6 percent
of measles cases), the risks of measles include severe
encephalitis (one per 1,000 cases) — about a third of which
result in mental retardation. They also include one to 10
deaths for every 10,000 measles cases. Another risk is
subacute sclerosing panencephalitis, a rare fatal illness
(one per 100,000 measles cases) caused by an ongoing measles
virus infection of the brain, in which symptoms of brain
damage usually begin seven to 10 years after infection.
And the side effects of MMR? Fever, malaise, a mild rash,
swollen glands and a stiff neck in about 5 percent of the
patients, febrile seizures in about three out of 10,000, and
temporary low platelet count in about three per 100,000
patients. About one in 1 million have an easily treated
anaphylactic reaction. And no deaths. Not one.
Because of the relationship of the measles virus to
encephalitis, vaccine safety experts have had an ongoing
concern that the MMR vaccine might be a rare cause of this
disease. Fortunately, all studies with controls have found
no association between the MMR vaccine and encephalitis.
In the scientific community, the controversy over whether
the MMR vaccine causes autism essentially ended by 2001.
Much to their credit, local and state public health
officials have consistently been editorializing in local
newspapers throughout the country about the safety of
vaccines and their importance for child health.
But despite the evidence, federal public health officials
have remained almost completely silent on this issue.
Meanwhile, the modern anti-vaccination movement, which
has become a hobby of upper-middle-class activists and
Hollywood celebrities with no time to learn the basic tenets
of epidemiologic methods (or even of the scientific
process), has used pseudoscience and misinformation to gain
far too much influence on our public discourse on child
health.
It’s time for Washington to step forward. No other
collection of agencies has the power to get the public’s
attention.
It’s time for them to speak, run public service ads,
alert reporters and aggressively rebut the spurious idea
about MMR.
My mother wasn’t wrong to be crying, back in 1959. The
risks of measles are real. Americans were right to be elated
when the measles vaccine became available.
The MMR vaccine doesn’t hurt kids. Letting them go
without it will.
• John Kiely, a retired research epidemiologist
for the
CDC’s National Center for Health Statistics, is American
editor of the medical journal Paediatric and Perinatal
Epidemiology.
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Increase in Hib
Cases--
Parents Urged to Make Sure Infants and Children Under
Five Are Vaccinated
Minnesota has seen an
increase in Haemophilus influenza type B (Hib)
cases in children younger than 3 years of age. In 2008,
there were 5 confirmed cases of Hib, including one
death. This serious disease has been uncommon since
routine use of Hib vaccine began over 15 years ago.
Before widespread use of the vaccine, Hib disease struck
over 20,000 children per year in the U.S. Although Hib
bacteria normally circulate in the community, the
current conditions are jeopardizing the cushion of
protection high immunization coverage provides, making
babies even more vulnerable.
The children affected were either mostly un-immunized or partially
immunized.
“This is a terrible reminder to us that we can’t let our guard
down,” stated Dr. Anne Schuchat, Director of the CDC’s
National Center for Immunization and Respiratory
Diseases. “Bacteria and viruses are still out there, and
if there is an opportunity, serious disease can come
back.”
Because high immunization coverage provides what’s commonly called
“herd immunity,” parents may forget that
vaccine-preventable diseases are still circulating. CDC
urges parents of children under age 5 to check their
children’s immunization records, or to call their
children’s doctor, nurse, or clinic to see if their
children are fully protected with Hib vaccine as age
appropriate. Hib vaccine is safe and highly effective.
The entire country has been in a Hib vaccine shortage since
December, 2007. This shortage is expected to last into
mid-2009. There are adequate vaccine supplies to provide
protective Hib primary series vaccination for all the
children who need them. However, vaccine supply is
complicated to manage during a shortage, so not all
medical offices or clinics will have vaccine available
on any given day.
With the currently available vaccine, babies should receive three
doses of available Sanofi Hib vaccine: one each at 2, 4,
and 6 months of age. Due to the shortage, the booster
dose normally received at age 12-15 months can be safely
deferred, except for children at high risk, such
as those children with sickle-cell disease, leukemia,
HIV and other immune system problems, no spleen, or
American Indian/Alaska Native children. Older children
who did not receive the Hib vaccine during infancy can
be protected with fewer doses. Parents should check with
their child’s healthcare provider.
CDC has initiated enhanced surveillance to look for Hib disease in
children across the country. To date, CDC has not
identified any additional clusters of Hib disease
outside of Minnesota, but it continues to work with the
states to follow up on any suspected cases and urges
providers to report cases to their health departments.
Parents can look at immunization schedules or find out more
information by visiting:
http://www.cdc.gov/vaccines, or calling
1-800-CDC-INFO.
This document can be
found on the CDC website at:
http://www.cdc.gov/vaccines/vpd-vac/hib/downloads/increase-hib-cases-508.doc
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PARENTAL VACCINE REFUSAL RESULTS IN INCREASED PERTUSSIS
CASES
Over
the past 40 years, childhood immunization has eliminated
or reduced many vaccine-preventable diseases, including
polio, diphtheria, measles, mumps and rubella. In the
study, “Parental Refusal of Pertussis Vaccination Is
Associated With an Increased Risk of Pertussis Infection
in Children,” researchers identified 156 confirmed cases
of pertussis (whooping cough), and 595 control subjects.
Children of parents who refused pertussis immunization
were at 23 times the risk for infection compared to
vaccinated children. Herd immunity does not appear to
completely protect unvaccinated children from pertussis,
which highlights the need to develop an effective way to
explain the risks and benefits of this and all
immunizations to parents.
~AAP
(june 2009)
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NEW IMMUNIZATION ALLIANCE ISSUES NATIONAL CALL TO ACTION
For
Immediate Release - AAP
CHICAGO
(Sept. 18, 2008) — Concerns about keeping immunization rates at
adequate levels have prompted the nation’s leading medical and
advocacy groups to join together to raise the public’s
confidence in vaccines. The Immunization Alliance calls on
policymakers, public health agencies, physicians, and the public
to work together to preserve the health of the nation’s children
through immunization. The Alliance, which is made up of
medical, public health and parent organizations, met recently to
discuss the increase in questions from parents about the value
of, and need for, today’s childhood vaccines.
“We do not
want to become a nation of people who are vulnerable to diseases
that are deadly or that can have serious complications,
especially if those diseases can be prevented,” said Renee
Jenkins, MD, FAAP, president of the American Academy of
Pediatrics. “The groups in this Alliance have made a commitment
to pool our resources and expertise, and to ask the government
to help avert what could become a national emergency. We want to
impress upon the public the possible consequences—safety,
medical, personal, and economic issues—of having a population
that is not adequately protected against measles, whooping
cough, meningitis, and many other diseases.”
Dr. Jenkins
stressed that our current vaccines, and those that may be
developed in the future, provide an important safety net to
protect against these consequences.
The Alliance
has stated its commitment to ensure adequate levels of
immunization in the United States, and has jointly endorsed a
Call to Action (see below) to enlist health professionals, the
public, the media and the government in supporting immunizations
and their importance to the public’s health. Included are
requests for a public information campaign by the government; a
commitment to ongoing research to ensure the continued safety,
efficacy and development of vaccines; balanced reporting by the
media; continued efforts from doctors in working with parents;
and confidence from parents themselves.
Although the
Centers for Disease Control and Prevention (CDC) announced that
2007 immunization rates were adequate, recent data show that
approximately one-fourth of toddlers are not properly immunized.
Recent outbreaks of measles in several cities, the worst in a
decade, are just one example of how the decision not to
vaccinate can affect individual children and the public’s
health. Most cases have been among the unvaccinated.
The Alliance
says many young parents have never seen these diseases, so they
question the need for the vaccines. Pediatricians are hearing
from parents who fear that their children are receiving too many
vaccines, and recent inaccurate media reports have helped to
fuel their concerns. The group emphasizes that if children are
not immunized, there could be epidemics of many diseases that
cause loss of life, or in many cases, severe loss of quality of
life due to mental retardation, blindness, amputation and other
serious consequences.
“If
immunization levels decline, epidemics are not out of the
question,” said Georges C. Benjamin, MD, FACP, FACEP (E),
executive director of the American Public Health Association.
According to the Alliance, if a single disease reaches epidemic
levels, communities and families will suffer in terms of demands
on our health care system, lost productivity and wages, missed
school time, and serious health effects.
“Children
are particularly vulnerable,” said Dr. Jenkins, which is why
experts have recommended that specific vaccines be given during
infancy and early childhood. “Childhood vaccines are vital to
growing up healthy,” she said.
Trish
Parnell, Executive Director of Parents of Kids with Infectious
Diseases (PKIDs), added, “When you have seen your child fighting
for his life because there is no magical treatment for his
disease, you wish with all of your heart that he had been
vaccinated. My daughter was not vaccinated against hepatitis B
and she consequently became infected with this horrible
disease. Our story is just one of thousands told to PKIDs over
the years – we wish we never had to hear another.”
The Alliance
also emphasizes that adolescents and adults should receive
immunizations and vaccine boosters according to recommendations
from the CDC, the American Academy of Family Physicians, the
American Academy of Pediatrics, the American College of
Physicians, the American Medical Association, and the American
College of Obstetricians and Gynecologists in order to protect
themselves and to do their part to keep infectious diseases at
bay in their communities.
Ardis Hoven,
MD, infectious disease specialist and Board member of the
American Medical Association, said, “Vaccines are one of the
best public health accomplishments of all time and have proven
time and time again their ability to keep horrific diseases at
bay. Because of vaccines, many diseases have been eliminated in
the United States, but are still active in other countries and
could rebound here. The ongoing measles outbreaks in several
states are testimony that those who forgo vaccinations are
vulnerable to infection from imported disease, and can pose a
significant health risk for their communities.”
More
information about the importance of vaccines is available from
the individual organizations listed on the Call to Action, or
from the CDC at
www.cdc.gov
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Vaccine
Prevented Illnesses (Photos)
This child
with MEASLES, displays the
characteristic red, blotchy pattern on his face and body during
the third day of the rash. Immunization has decreased the
incidence of measles in the U.S. by 99 percent, though outbreaks
in 2008 have resulted from non-immunized people acquiring the
infection while traveling abroad. Measles is highly contagious.
Measles typically results in rash, fever and cough.
Complications can include ear infection, croup, diarrhea and,
rarely, encephalitis and death.
Photo source: U.S. Centers for
Disease Control and Prevention
One of the most infectious diseases in
the world; if measles vaccinations were stopped, it is estimated
that 2.7 million people would die worldwide.
How it spreads: Coughing, sneezing,
talking.
A patient
displays swelling due to MUMPS,
a
disease that is characterized by swelling of the salivary
glands. Prior to the vaccine that was introduced in 1967, an
estimated 100,000 to 200,000 cases of mumps occurred in the U.S.
each year.
Photo source: U.S. Centers for Disease Control and Prevention.
Before the vaccine, mumps was a major
cause of deafness and brain damage in children.
How it spreads: Coughing,
sneezing, talking.
A young boy
displays the characteristic rash indicative of
RUBELLA, otherwise known as German
measles. Rubella is a respiratory viral infection characterized
by mild respiratory symptoms and low-grade fever, followed by a
rash lasting about 3 days. In children, the illness may not be
diagnosed since the rash may be mild and mimic other conditions.
Rubella vaccination is particularly important for non-immune
women who may become pregnant because of the risk for serious
birth defects if they acquire the disease during pregnancy.
Birth defects include deafness, cataracts, heart defects, mental
retardation, and liver and spleen damage (at least a 20% chance
of damage to the fetus if a woman is infected early in
pregnancy).
Photo source: U.S. Centers for Disease Control and Prevention
During 1964 and 1965, before the
vaccine, of the 20,000 infants born with rubella syndrome,
11,600 were deaf, 3580 were blind, and 1800 were mentally
retarded.
How it spreads: Coughing or
sneezing.
This child with
DIPHTHERIA presented with a characteristic swollen
neck, sometimes referred to as “bull neck”.
Photo source: U.S. Centers for Disease Control and Prevention
Before the vaccine, diphtheria caused as
many as 15,520 deaths in children during one year.
How it spreads: Direct contact
with an infected person.
It can lead to breathing problems, heart
failure, and death.
A
preschool-aged boy displays the severe muscle contraction of
TETANUS, a disease caused by
bacteria in a dirt-contaminated wound. Deep-puncture wounds pose
the biggest risk.
Photo source: U.S. Centers for Disease Control and Prevention
Without a vaccine, persons of all ages
in the US could get this deadly disease.
How it spreads: Lives in the soil
and enters the body through cuts and puncture wounds.
Tetanus is NOT contagious from person to person.
It can lead to stiffness of the jaw, so
the victim can't open his mouth or swallow. It leads to
death in about 1 case out of 5.
A
preschool-aged boy with PERTUSSIS
(whooping cough) produced thick, respiratory secretions
during a severe coughing spell. Pertussis is most severe when it
occurs in the first six months of life.
Photo source: AAP Red Book Online Visual Library
Before the vaccine, between 150,000 and
260,000 cases of pertussis and up to 9000 deaths were reported
each year.
How it spreads: Coughing and
sneezing, highly contagious.
It can lead to pneumonia, seizures
(jerking and staring spells), brain damage and death.
According to a CDC study, parents and
siblings are important contributors to the spread of pertussis
infection to infants and young children.
Adults who have not had a tetanus
booster in the last five years should ask their physician about
receiving this important vaccine.
Child has swollen face due to
HIB (Haemophilus influenzae
type b) infection.
Photo source: U.S. Centers for Disease Control and Prevention.
Before the vaccine, Hib meningitis
killed 600 children each year and left many survivors with
deafness, seizures or mental retardation.
How it spreads: Contact with an
infected person; enters through the nose and throat.
It can lead to meningitis; pneumonia;
infections of the blood, joints, bones and covering of the
heart; brain damage; deafness; and death.
Made of
stainless steel, this Emerson Respirator, also known as an "iron
lung," was used by POLIO patients
whose ability to breathe was stopped by the crippling viral
disease. This iron lung was donated to the CDC's Global Health
Odyssey by the family of polio patient Barton Hebert of
Covington, La., who had used the device from the late 1950s
until his death in 2003. Iron lungs encase the chest cavity in
an air-tight chamber. The chamber is used to create a negative
pressure around the body, causing air to rush into the lungs.
Photo source: U.S. Centers for Disease Control and Prevention
This child
is displaying a deformity of her right leg due to
POLIO.
Photo source: U.S. Centers for Disease Control and Prevention
Before the vaccine, 13,000 to 20,000
cases of paralytic polio were reported each year in the US; many
children were left on crutches, in braces, in wheelchairs, an on
iron lungs.
How it spreads: Transmitted by
person-to-person contact with contaminated water. Some
people experience no symptoms at all but are carriers who can
spread the disease to others.
It can lead to paralysis; or death (by
paralyzing breathing muscles).
A teenage
girl is pictured with VARICELLA
(chickenpox) lesions in various stages. Chickenpox tends
to be more severe in adolescents and adults than in young
children.
Photo source: AAP Red Book Online Visual Library
This
10-year-old, unvaccinated boy developed
VARICELLA (chickenpox) with hemorrhagic lesions.
Photo source: AAP Red Book Online Visual Library
Before the vaccine, an estimated 4
million people got chickenpox, causing 11,000 hospitalizations
and 100 deaths each year.
How it spreads: Coughing,
sneezing, or contact with chickenpox sores; usually occurs in
children younger than 10 years of age.
HEPATITIS B
(no available photo)
Approximately 25% of children who
develop lifelong hepatitis B infection die of related liver
disease as adults.
How it spreads: Direct contact
with infected blood; via blood transfusions, other body fluids
and sexual transmission. It can also be contracted through
tatooing and body piercing. A pregnant woman who is
infected can also infect her baby.
It can lead to liver damage; liver
cancer and death.
PNEUMOCOCCUS
(no available photo)
Before the vaccine, about 188 of every
100,000 children younger than 2 years of age developed invasive
pneumococcal disease.
How it spreads: Coughing and
sneezing.
It can lead to meningitis; blood
infections, ear infections, pneumonia, deafness, brain damage
and death.
ROTAVIRUS
(no available photo)
Signs and symptoms include: severe
diarrhea, vomiting and fever.
How it spreads: Contact with other
children who are infected.
It can lead to dehydration,
hospitalization (up to about 70,000 per year), and death.
4 month old female with gangrene of hands
due to MENINGOCOCCEMIA
In 2004, an estimated 125 deaths due to
meningococcal disease occurred in the US. Infants younger
than 12 months of age have the highest rates of disease.
How it spreads: Contact with
infected individual through throat (coughing and kissing).
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Vaccine Risks/Precautions
Vaccines can cause side effects, like any other medicine.
Mostly these are mild "local" reactions such as tenderness,
redness or swelling where the shot is given, or a mild fever.
They happen in up to 1 child out of 4 with most childhood
vaccines. They appear soon after the shot is given and go
away within a day or two.
More severe reactions can also occur, but this happens much less
often. Some of these reactions are so uncommon that
experts can't tell whether they are caused by the vaccine or
not.
Among the most serious reactions to vaccines are severe allergic
reactions to a substance in a vaccine. These reactions
happen very rarely-less than once in a million shots. They
usually happen very soon after the shot is given. Doctor's
office or clinic staff are trained to deal with them.
The risk of any vaccine causing serious harm, or death, is
extremely small. Getting a disease is much more
likely to harms a child than getting a vaccine.
Other Reactions:
Dtap vaccine -
-
Mild problems - Fussiness ( 1 in 3), tiredness or
poor appetite (1 in 10); vomiting (1 in 50); swelling at the
site for 1 to 7 days (1 in 30)-usually after the 4th or 5th
dose.
-
Moderate problems - Seizure (1 in 14,000); non-stop
crying for 3 hours or more (up to 1 in 1,000); fever over
105 degrees F (1 in 16,000).
-
Serious problems - Long term seizures, coma, lowered
consciousness, and permanent brain damaged have been
reported very rarely after Dtap vaccine. They are so
rare we can't be sure they are caused from the vaccine.
Polio vaccine / Hepatitis B vaccine / Hib vaccine -
Pneumococcal vaccine -
Rotavirus vaccine -
Precautions:
If your
child is sick on the date vaccinations are schedule, your
provider may want to put them off until she recovers.
A child with a mild cold or a low fever can usually be
vaccinated that day. But for a more serious illness, it
may be better to wait.
Some
children should not get certain vaccines. Talk with your
provider if your child had a serious reaction after a previous
dose of a vaccine, or has any life-threatening allergies.
(These reactions and allergies are rare.)
Talk to your provider before getting Dtap vaccine if your
child had any of these reactions to a previous dose of DTaP:
-
a
brain or nervous system disease within 7 days
-
non-stop crying for 3 or more hours
-
a
seizure or collapse
-
a
fever over 105 degrees F
Talk to you provider before getting Polio vaccine if your
child had any of these reactions to a previous dose of Polio:
Talk
to you provider before getting Hepatitis B vaccine if
your child had any of these reactions to a previous dose of
Hepatitis B:
Talk
to you provider before getting Rotavirus vaccine if your
child had any of these reactions to a previous dose of
Rotavirus:
-
a
weakened immune system
-
ongoing digestive problems
-
recently gotten a blood transfusion or other blood product
-
ever had intussusception (an uncommon type of intestinal
obstruction)
**For
more information about vaccines, ask your healthcare provider,
contact your local or state health department or contact the
Centers for Disease Control and Prevention (CDC) at
1-800-232-4636. You can also visit the CDC website at
www.cdc.gov/vaccines.
**The
National Vaccine Injury Compensation Program is a federal
program to help pay for the care of anyone who has a serious
reaction to a vaccine. Contact number is 1-800-338-2382
or their website at www.hrsa.gov/vaccinecompensation.
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Pertussis
Vaccine Recommended
At
a recent infectious disease conference, Scott Halperin, M.D., presented
information showing the incidence of pertussis in particular populations is
increasing. Pre-school children used to have the highest incidence of the
disease but that has now shifted to the adolescent and adult population.
The greatest burden of the disease is occurring in 10-19 year olds. The
new guidelines strongly recommend that adults up to age 65 years receive the new
adult vaccine for pertussis, Tdap. (Boostrix or Adacel). The vaccine is
the only way to eventually eliminate the disease.
Usually,
adolescents acquire pertussis from the community and household contacts and
adults acquire it from their school-age children and can then transmit the
illness to their young infants who are at the highest risk of morbidity and
mortality. Symptoms in adults predominantly are cough, sleep disturbance,
cough with vomiting and whooping. The average duration of the disease is 8
weeks.
In
the past, adolescents and adults were not vaccinated against pertussis because
the older vaccine caused serious side effects when given to older children and
adults. The new vaccine (Boostrix or Adacel) is safe and effective against
whooping cough for these age groups. The Advisory Committee on
Immunization Practices recommends all adolescents 12 years and older should
receive a single dose of Tdap (Boostrix or Adacel) instead of Td. If the
patient already received Td, they can still receive Tdap after a five year
interval.
~Infectious
Diseases in Childhood, February 2006
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Hepatitis
A vaccine recommended
The
American Academy of Pediatrics has issued a recommendation for universal
administration of Hepatitis A vaccine to all infants 12 to 23 months of age,
with a second dose six months later. This is only a recommendation and not
a required vaccine at this time.
Hepatitis
A is a serious liver disease caused by the hepatitis virus. Hepatitis A
virus is found in the stool of affected people. It is usually spread by
close personal contact and sometimes by eating food or drinking water containing
the virus. About 70% of children younger than 6 years of age often have
the virus without showing symptoms. This allows them to easily spread the
disease. The older you are the more likely you are to have serious
consequences from the disease.
The
symptoms may be a mild "flu like" illness, jaundice (yellow skin or
eyes) or severe stomach pains and diarrhea. A person with hepatitis A can
easily pass the disease to others within the same household.
Since
the Hepatitis A vaccine is recommended, Comprehensive Pediatrics has integrated
this vaccine into the immunization schedule. See immunization schedule
above, updated February 2009.
Hepatitis A is now being offered to
all age groups. You should check with
your medical insurance carrier regarding coverage.
In addition, on February 25,
ACIP (Advisory Committee on Immunization Practices) updated its
guidance by recommending hepatitis A vaccination for all
previously unvaccinated persons who anticipate close personal
contact (e.g., household contact or regular babysitting) with an
international adoptee from a country of high or intermediate
endemicity during the first 60 days following arrival of the
adoptee in the United States. The first dose of the 2-dose
hepatitis A vaccine series should be administered as soon as
adoption is planned, ideally 2 or more weeks before the arrival
of the adoptee.
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Take
the "ouch" out of shots
A new study suggests that
too much consoling and commiserating with your child
before immunizations may end up doing more harm than
good.
According to pediatrician
Neil L. Schechter, M.D., director of the pain relief
program at Connecticut Children's Medical Center, the
more overly sympathetic parents were, the more likely
their children were to complain of pain. He
suggests taking a "matter of fact, supportive,
nonapologetic approach" by explaining what's going
to happen and why he/she is getting the injection.
A sense of humor goes a
long way, and distraction techniques can also be very
helpful.
Additional Comfort Measures:
Before
shots:
• Bring your
child’s immunization record.
• Read vaccine information statements.
• Ask any questions.
• Bring along a favorite toy or blanket.
• Stay calm; your baby picks up your feelings.
During shots,
distract and comfort by:
• Touching
soothingly and talking softly.
• Making eye contact as you smile at your baby.
After shots,
comfort by:
• Holding,
cuddling, caressing, or breastfeeding.
• Talking lovingly and soothingly.
• Asking your doctor for advice on using a non-aspirin pain
reliever when you get home.
At home:
• Mark your
calendar for your next appointment.
• Review vaccine information statements for possible
reactions.
• A cool wet cloth can reduce redness, soreness, and/or
swelling where the shot was given.
• Observe your child for the next few days. You might see a
small rash or notice a fever. If your child has any reaction
that concerns you, call your doctor or seek medical
attention.
• To reduce pain or fever, your doctor may recommend you
give your child a non-aspirin pain reliever.
• Also try giving your child a sponge bath with lukewarm
water to reduce fever.
• Give your child plenty of fluids. It is normal if he/she
eats less than usual for the next 24 hours.
~California Dept. of Health
Studies
have shown that some parents are reluctant to have their
children immunized because they fear their children will
experience significant pain during and after the
injections. The authors of the study, “Analgesic
Properties of Oral Sucrose During Routine Immunizations
at 2 and 4 Months of Age,” examined how the use of an
oral sucrose (sugar) solution may help reduce pain
response for children ages two to four months. One
hundred infants receiving routine immunizations received
either a controlled amount of oral sucrose or a placebo.
The group receiving oral sucrose had lower pain scores
than those in the placebo group. In fact, over the
course of 9 minutes, the oral sucrose group had an
average of 78 percent lower pain scores than the control
group. The authors conclude that oral sucrose is an
inexpensive, short-acting, non-sedating,
easily-administered method of reducing pain for infants
undergoing minor invasive procedures.
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Chickenpox
vaccine (Varivax) will be
required for all children entering kindergarten in 2006.
In
2006-2007 any new student to an
Ohio
school will be required to be vaccinated. Children
who have had the disease are exempt from these requirements.
The
CDC and the Advisory Committee on Immunization Practices (ACIP) voted to
recommend a second dose of varicella vaccine for children four to six years of
age. They also recommend that children, adolescents and adults who only received
one dose should receive a second dose. This second dose will provide
increased protection against varicella disease compared to one dose.
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Menactra
(Meningococcal vaccine)
is
now available
for children ages 11-12 years, teens entering high school
(15 years old), and college freshmen.
Meningococcal
disease is a serious bacterial infection. It
can cause swelling of the brain and spinal cord.
The bacteria are spread through air droplets (coughing, sneezing) and by
direct contact with an infected person (kissing, sharing drinking glasses).
Adolescents and young adults are at increased risk for contracting the
disease. Social behaviors in this
age group often involve close personal contact-kissing, smoking, sharing water
bottles, and crowded situations.
Since
the vaccine is new, only the above age groups will receive the vaccine at the
present time to avoid a shortage. As
the supply of the vaccine increases, all adolescents will be vaccinated.
Your
child will be able to receive the vaccine at their well check up. College
bound seniors who have had a physical but did not receive the vaccine should
call to schedule an appointment.
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Travel
Health Web Sites
If
you plan to travel in the states or out of the country, here are a few sites to
check before you leave for travel recommendations and required vaccines.
CDC
Traveler's Health Web Site: www.cdc.gov/travel/destinat.htm
U.S.
State Department: http://travel.state.gov/travel/travel_1744.html
WHO
Global Health Atlas (communicable disease): www.who.int/globalatlas
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Web
resources on immunization, thimerosal, autism
http://www.cdc.gov/nip/vacsafe/concerns/thimerosal/default.htm#facts
-Provides information on mercury and vaccines.
http://www.cdc.gov/ncbddd/dd/aic/about/default.htm
- Provides information about autism.
http://www.vaccineinformation.org/thimerosal.asp
- Thimerosal related resources for parents and patients.
http://www.nap.edu/catalog/10997.html
- "Immunization Safety Review: Vaccines and Autism", a May 2004
report prepared by the Institute of Medicine (available as a free pdf download,
link through "Sign in to download" and follow the instructions.
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Thimerosal
and Vaccines
Is
it safe? Thimerosal is used in some vaccines and other medicines,
including contact lens solutions, throat and nose sprays. It stops
bacteria and fungi from getting into vaccines, especially open multi-dose
vaccine containers. Thimerosal has a small amount of organic mercury in
it. Some parents and others worry about a link between neurologic
disorders and vaccines that use thimerosal. No scientific data has
shown a link between thimerosal and any childhood disorder. No one has
shown that small amounts of thimerosal in vaccines causes harm, except for minor
side effects like swelling and redness at the vaccination site.
In
1999, the Public Health Service and the AAP recommended that thimerosal be taken
out of vaccines as a precaution. There is no evidence that thimerosal in
vaccines is harmful, but children are exposed to different forms of mercury in
the environment, such as in some fish. We can't always remove the mercury
from the environment, but we can control the mercury used in vaccines. So,
by taking thimerosal out of vaccines, we lessen the amount of mercury a child is
exposed to early in life. Since 2001, all routinely recommended children's
vaccines being made in the US (except some influenza and Td vaccines) contain no
thimerosal or only trace amounts.
Many
childhood vaccines never used thimerosal: measles/mumps/rubella (MMR),
polio (IPV), varicella/chicken pox, some Haemophilus influenzae type b (Hib),
and some diptheria/tetanus/pertussis (Dtap). Some vaccines are only
available with thimerosal, such as meningococcal vaccine, but they are NOT
recommended for very young children.
For
additional information about thimerosal in vaccines, visit www.cispimmunize.org
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Low
Cost Immunization Clinics
Offered by the Cuyahoga County Board of Health:
SJWS Community
Outreach Center 29160 Center Ridge Rd. Suite L
Fridays, 9:00 a.m.
- 3:30 p.m., 1st Wednesday of every month
4:30 - 7:00 p.m.
Call for an
appointment: 440-201-2041
Offered by the
Consortium for Healthy and Immunized Communities.
Clinic locations:
1. Middleburg
Hts. Clinic
17951 Jefferson Park Rd.
216-443-5660
2. Parma
Health Education Ctr 7300 State Road
216-443-5660
3. Brookside
Center
3784 Pearl Road
216-664-4257
4. McCafferty
Health Center
4242 Lorain Ave.
216-664-4257
5. Lakewood
Immunization Clinic 14532 Lake Ave.
216-529-7690
6. St. John
Westshore
29000 Center Ridge Rd.
440-443-5660
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City/County
Immunization Clinics
Click on a link below to find out addresses, phone numbers and
appointment times for immunization clinics in your area.
Cleveland Health
Department
Cuyahoga
County Health Department
Lakewood Health
Department
Lorain County Health
Department
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