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Fever | Ear Infections | Strep Throat | Antibiotics | Vaccines

VACCINES

Nothing stirs the passions of parents and doctors more than a discussion of vaccines.  As mothers took to the streets in 1950 for the March of Dimes campaign to eliminate poliomyelitis, new vaccines emerged to target some of civilization’s greatest scourges. One by one, diphtheria, tetanus, whooping cough, measles, German measles, mumps, and polio were dealt lethal or near-lethal blows.  In the years since 1950, infant mortality in the U.S. has fallen from 29/1000 live births to 7/1000, a drop largely attributed to vaccines. Today, the recommended childhood immunizations protect against 16 potentially deadly infections (see below).

What are vaccines and how do they work?

Vaccines mimic real infections, “tricking” the body into making antibodies (protective proteins) that are directed against the real germ. Those antibodies then circulate in the body and can produce long-term, often lifetime immunity – a potent mobile force guarding against germ invasions.

Vaccines may be composed of infectious germs that have been weakened, killed germs, or parts of a germ. Some vaccines are given into your child’s muscle, others are given just under the skin, one is given by mouth; one is given into the nose. Many vaccines are given in combination products that protect against more than one disease and minimize the number of shots your child needs.

Who decides which vaccines should be given to kids?

Ultimately, the decision about immunizing your kids must be made by you and your child’s doctor. National guidelines are provided by the Centers for Diseases Control and Prevention (CDC), developed in close cooperation with the American Academy of Pediatrics and the American Academy of Family Physicians. The scientifically-based recommendations of these respected organizations form the basis for the strict immunization requirements that schools and many day care centers enforce as a prerequisite for attendance.

What diseases are we protecting against?

A very brief overview of the 16 infections that today’s recommended childhood immunizations protect against follows below. For each of the vaccines that have been in use long enough to compare with years past, the occurrence rate of the infections targeted by the vaccine has dropped by 95-100% since the vaccines were introduced.

Diphtheria. A severe bacterial infection of the throat that can block breathing and have severe heart and brain effects. One-fifth of infected patients die.
Hemophilus influenza type B. Formerly the most common cause of bacterial meningitis in the U.S, as well as a leading cause of pneumonia, severe blood infections, and infections of joints, skin, voice box, ears, and heart.
Hepatitis A. This is the form of viral hepatitis that causes restaurant and other food and water-associated outbreaks. Occurs frequently in day care centers.
Hepatitis B. A cause of severe viral liver disease, including chronic (long-term) hepatitis and liver cancer. Twenty-30% of cases occur during childhood – many at birth, transmitted from mothers to babies. 
Influenza. Behaves like a “high octane common cold”, with sudden onset of fever, chills, muscle aches, fatigue, and headache, followed by runny nose, cough, and sore throat.
Measles. This potentially severe viral rash disease required hospitalization of as many as 20% of all those infected, with complications such as pneumonia, brain inflammation, dehydration, and ear infections.
Mumps. A virus infection that causes swelling of the glands in the cheeks. In severe cases, mumps also can cause deafness and inflammation of the testes and the brain.
Neisseria meningitidis.An important cause of bacterial meningitis and severe blood infection, many cases occur in kids younger than 2 years and in adolescents; college dormitory outbreaks are well known. Very high death rate.
Papillomavirus. These viruses are the most common sexually-transmitted infection in the U.S.; they cause genital warts and, more importantly, most cases of cervical cancer and dysplasia.
Pertussis. Begins as a mild upper respiratory tract bacterial infection, but progresses in stages to a severe “whooping cough” that can cause death due to exhaustion and oxygen deprivation in young babies.
Poliomyelitis. A virus infection of the spinal cord that can cause paralysis, limb withering, and breathing failure.
Rotavirus. The leading cause of “stomach flu” around the world. There are more than 2.5 million infections in the U.S. each year, resulting in 500,000 ER and physician office visits, 50,000-70,000 hospitalizations and several dozen deaths.
Rubella (German measles). Another formerly common rash disease. When pregnantwomen pass the virus onto their unborn babies, up to 90% develop severe brain and other birth defects.
Streptococcus pneumoniae. A major cause of bacterial blood infection, meningitis, pneumonia and ear infections in children.
Tetanus. Also known as “lockjaw”, this is due to bacteria producing a toxin that paralyzes muscles throughout the body. Occurs with dirty wounds.
Varicella (Chickenpox). This viral rash illness can sometimes be severe. Prior to vaccine use, 4 million cases of chickenpox occurred in the U.S. each year, resulting in 11,000 hospitalizations and more than 100 deaths.

Are vaccines safe?

The simple answer to this question is “yes, vaccines are safe”. But as anyone who has read the headlines for the past several years, specific questions about vaccine safety do arise and raise concern for parents. The complete answers to those questions are too lengthy to reproduce here, but can be found in Germ Proof Your Kids – The Complete Guide to Protecting (without Overprotecting) Your Family from Infections.

Copyright 2007, Dr. Harley A. Rotbart.

Guidelines for Parents from the new book, Germ Proof Your Kids – The Complete Guide to Protecting (without Overprotecting) Your Family from Infections (ASM Press, 2008).

Read Dr. Rotbart’s GERMBlog for frequent updates on important germ issues for your kids