Recommended Childhood Vaccines - 2007

We live in an age when many serious diseases have been eliminated from parts of the world, particularly the more developed countries. Many medical discoveries and social changes have contributed to this success, including antibiotics, good sanitation, and regulations to ensure clean food and water. In addition to these improvements, we have seen the development of vaccines that protect us against infectious diseases that have caused millions of illnesses and deaths.

Immunization is one of the most significant public health achievements of the 20th century. Vaccines have eradicated smallpox, eliminated wild poliovirus in the US and significantly reduced the number of cases of measles, diphtheria, rubella, pertussis and other diseases.

Vaccines offer safe and effective protection from infectious diseases. By staying up-to-date on the recommended vaccines, individuals can protect themselves, their families and friends and their communities from serious, life-threatening infections.

Recommended vaccinations begin soon after birth and continue throughout life. Being aware of the vaccines that are recommended for infants, children, adolescents, adults of all ages and seniors, and making sure that we receive these immunizations, are critical to protecting ourselves and our communities from disease.

Because children are particularly vulnerable to infection, most vaccines are given during the first five to six years of life. Other immunizations are recommended during adolescent or adult years and, for certain vaccines, booster immunization are recommended throughout life. Vaccines against certain diseases that may be encountered when traveling outside of the US are recommended for travelers to specific regions of the world.

Because most people make sure their families are immunized, many serious diseases are at an all-time low in the United States. But even though coverage has improved, some areas of under-immunized children still exist, leaving the potential for disease outbreaks. In addition, some vaccine-preventable infectious diseases are still common in other countries. If we stop vaccinating in the US, these diseases could easily return.

How Do Vaccines Work?
When we're exposed to disease germs, we produce substances called antibodies to fight them off. Usually, the antibodies destroy the invaders and the illness is prevented. Vaccines are made from the same germs (or parts of them) that cause disease, but the germs in vaccines are either killed or weakened so they won't make us sick.

The vaccine causes us to produce antibodies against that particular illness just as it would if the real disease was attacking. The antibodies usually stay in our immune system for a lifetime and protect us from getting sick with the same disease again. This protection is called immunity.

Most childhood vaccines give immunity to 90% to 99% of the children who get them. But occasionally a child will not respond to certain vaccines. This is another reason why it's important for all children to be vaccinated. Children who haven't responded to vaccination have to depend on the immunity of others around them for protection.

RECOMMENDED 2007 CHILDHOOD IMMUNIZATION SCHEDULE

The following diseases are prevented by routine shots given to children ages 0-6 years. These diseases can cause serious health issues including pneumonia, brain damage, severe eye problems, and paralysis. In almost all cases, vaccines will prevent them.

DtaP vaccine protects against diphtheria, pertussis (whooping cough) and tetanus. These three vaccines are combined in a single shot.

Diphtheria is a serious infection of the throat, mouth, and nose, which can lead to suffocation, pneumonia, heart failure, and paralysis.

Tetanus is caused by germs in dirt and rusty metal that get into the body through a cut. Tetanus attacks the jaw muscles first, often causing lockjaw. It can also affect the muscles used to breathe. It causes death in 3 out of 10 people who get it. Pertussis (whooping cough) causes a bad cough that sounds like a "whoop." The severe coughing can interfere with eating, drinking and breathing. The illness can be life-threatening, especially in children younger than 1.

When to get it: Shot is given at 2 months, 4 months, 6 months, and 15-18 months, with a booster given between the ages of 4 and 6 years. Under some circumstances, adolescents should receive a different formulation, called Tdap. After that, everyone should get a tetanus/diphtheria (Td) booster every 10 years throughout life.

Possible side effects: Fever, soreness where shot is given or irritability. In rare cases, the shot can cause very high fever and convulsions.

Hepatitis A vaccine protects against a serious liver disease caused by the hepatitis A virus (HAV). HAV is found in the stool of persons with hepatitis A. It is usually spread by close personal contact and sometimes by eating food or drinking water containing HAV.

When to get it: Hepatitis A vaccine is given in two doses, both between 12-23 months of age. The two doses in the series should be administered at least 6 months apart.

Possible side effects: Up to 1 out of 6 children have soreness where the shot was given, while 1 out of 25 get a headache. About 1 out of 12 children have a loss of appetite and some get tired. If these problems occur, they usually last 1 or 2 days. Very rarely, some people have a serious allergic reaction within a few minutes to a few hours of the shot.

Hepatitis B vaccine protects against a serious liver disease caused by the hepatitis B virus. It can cause lifelong liver problems or death. About 128,000 people become infected with hepatitis B virus each year. There's no cure for "hep B," but this simple immunization can prevent it.

When to get it: For babies, three shots are given before 18 months of age. Older children, adolescents, and adults who didn't get the shot when they were babies can get the first shot any time, a second shot 1-2 months later, and a third shot 4-6 months after the first shot.

Possible side effects: Soreness where the shot is given, or fever.

Hib vaccine protects against Haemophilus influenzae type b, an infection that can seriously harm a child's brain, blood, bones, throat, and the area around the heart.

When to get it: Shot is given at 2 months, 4 months, 6 months, and 12-15 months.

Possible side effects: Soreness where the shot is given, fever.

Influenza vaccine protects against "the flu," which attacks the respiratory system (nose, throat and lungs). Young children are at increased risk of complications and hospitalizations from the influenza virus.

When to get it: Healthy children aged 6 to 59 months (4 years, 11 months), as well as people who have close contact with these children, should receive annual influenza vaccine.

Possible side effects: Soreness, redness or swelling where the shot is given; fever or aches.

Meningococcal vaccine protects against meningitis, an infection of the fluid in the spinal cord and surrounding the brain. Meningitis is usually caused by a viral or bacterial infection; viral meningitis is generally less severe and resolves without specific treatment, while bacterial meningitis can be quite severe and can result in brain damage, hearing loss, or learning disability. Vaccines can prevent several of the most common types of bacterial meningitis.

When to get it: Meningococcal vaccine should be administered to all children at age 11-12 years and to unvaccinated adolescents at high school entry (age 15 years). All college freshmen living in dormitories should also be vaccinated. For prevention of invasive meningococcal disease, vaccination is recommended for children in certain high-risk groups who are older than age 2.

Possible side effects: Generally mild, such as redness or pain where the shot was given. Fever is possible but not common.

MMR vaccine protects against measles, mumps, and German measles (rubella). These three vaccines are combined in a single shot.

Measles: is easy to catch and causes a rash, high fever, and cough. Measles can also cause hearing loss, convulsions, brain damage, and death.

Mumps: makes the saliva glands under the jaws swell and hurt. It also usually causes fever and headache, and can have serious complications. It is even more painful for teen-age boys, whose testicles may swell. Rubella: (German measles) is mild in children but can damage the unborn baby if a woman gets it while she is pregnant.

When to get i: One shot is given at 12-15 months and another is usually given at 4-6 years. Women who do not know if they are immune to rubella can be tested to see if they are. If they have no immunity they should get the rubella vaccine more than three months before they plan to get pregnant. Possible side effects: Pain where the shot is given and a rash. The shot can also cause swollen glands or mild joint pain, but these are rare.

Pneumococcal vaccine protects against invasive pneumococcal diseases, which can cause brain damage and death.

When to get it: Shot is given at 2 months, 4 months, 6 months, and 12 to 15 months.

Possible side effects: Soreness where the shot is given, mild fever.

Polio vaccine protects against polio, a virus that can cause paralysis and death. There are two kinds of polio vaccines: the inactivated polio virus (IPV), which is the shot recommended in the United States today, and a live, oral polio virus (OPV). OPV causes polio in a few people and experts believe that using OPV is no longer worth the slight risk, except in limited cases. IPV does not cause polio.

When to get it: Shot is usually given at 2 months, 4 months, 6-18 months, and at 4-6 years.

Possible side effects: Soreness where the shot is given.

Rotavirus vaccine protects against one of the most common causes of gastroenteritis (sometimes called "stomach flu") in infants and young children. Rotavirus disease is very contagious; nearly every child in the US has been infected with rotavirus by age 5. A child may develop rotavirus disease more than once because there are many different rotavirus types.

When to get it: Infants should receive 3 doses - one at age 2 months, one at age 4 months, and one at age 6 months.

Possible side effects: Children are slightly (1%-3%) more likely to have mild, temporary diarrhea or vomiting within 7 days after getting a dose of rotavirus.

Varicella (chickenpox) vaccine protects against chickenpox, which is usually a mild disease that causes an itchy rash and fever. But some children experience serious complications.

When to get it: Two doses are given - the first shot at age 12 to 15 months and the second shot at 4-6 years of age.

Possible side effects: Pain where the shot is given, rash or fever.

Scheduling the Vaccines
For most of these vaccines, the first shots should be given when children are still babies. Children can be vaccinated at the doctor's office or at the local health department. Ask the doctor to give you a list of the shots each child has received. Keep this list so that you have records (children will need these to start most schools) and so you'll know when and if your child needs more shots.

There are vaccinations for other diseases, such as hepatitis A and influenza, that are given to adults and children if they are at risk of getting those diseases or they are likely to have serious complications if they get them.

If your children have gotten behind in the schedule, it's not too late. Most of these shots can be given at any age, and a child who has gotten behind does not have to start over. The shots already given will still count, and the child will still develop immunity. Contact your doctor or health department clinic for details about getting back on schedule.

Vaccine Safety
Vaccines are very safe, but they are not perfect. Like any other medicine they can occasionally cause reactions. Usually these are mild, like a sore arm or a slight fever. Serious reactions are rare, but they can happen. Your doctor or nurse can discuss the risks with you before your children receive their shots. The important thing to remember is that getting the diseases is much more dangerous than getting the shots.

Be sure to tell your doctor if anyone in your immediate family has ever had a bad reaction to a vaccine, and ask if there are any conditions under which vaccination is not recommended. After immunization, children may be fussy due to pain, fever or other mild reactions to the vaccine. In almost all instances, the following tips will resolve any problems.

If a child has pain:
Give acetaminophen (such as Tylenol). Do not give aspirin - it can have serious side effects in some cases.

If a child has a fever: