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Answers to immunization FAQs

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There are now 12 potentially deadly diseases that childhood vaccination can protect against, according to the U.S. Centers for Disease Control and Prevention and the American Academy of Pediatrics. Here are their answers to parents FAQs.

Why should I immunize my kids?

Vaccinations can help prevent some of the most deadly diseases in history.

What diseases do vaccines protect against?

There are 12 potentially serious diseases that vaccines protect against: Measles, mumps, rubella (German measles), diphtheria, tetanus (lockjaw), pertussis (whooping cough), Polio, Haemophilus influenzae type b (Hib disease), hepatitis B, varicella (chickenpox), hepatitis A and pneumococcal disease.

Any of them can kill a child.

It’s easy to forget how serious they are because — thanks largely to vaccines — we don’t see them nearly as much as we used to. Measles used to kill thousands of people in the United States every year. In the 1940s and 1950s tens of thousands of children were crippled or killed by polio. As recently as the mid-1980s, 20,000 children a year suffered from meningitis and other serious complications as a result of Hib disease.

These diseases aren’t as common as they used to be, but they haven’t changed. They can still lead to pneumonia, choking, brain damage, heart problems, liver cancer, and blindness in children who are not immune. And they still kill children every year.

How many shots does my child need, and when?

Some children should get their first shot (hepatitis B) before leaving the hospital after birth. Others begin at 2 months of age. You will have to return for more shots several more times before the child starts school. Check the recommended schedule.

How does immunity work?

You get sick when germs invade your body. When measles virus enters your body it gives you measles. Whooping cough bacteria cause whooping cough. And so on.

It is the job of your immune system to protect you from these germs. Here’s how it works:

Germs enter your body and start to reproduce. Your immune system recognizes these germs as invaders from outside your body and responds by making proteins called antibodies.

Antibodies have two jobs. The first is to help destroy the germs that are making you sick. Because the germs have a head start, you will already be sick by the time your immune system has produced enough antibodies to destroy them. But by eliminating the attacking germs, antibodies help you to get well.

Now the antibodies start doing their second job. They remain in your bloodstream, guarding you against future infections. If the same germs ever try to infect you again — even after many years — these antibodies will come to your defense.

Only now they can destroy the germs before they have a chance to make you sick. This process is called immunity. It is why most people get diseases like measles or chickenpox only once, even though they might be exposed many times during their lifetime.

This is a very effective system for preventing disease. The only problem is you have to get sick before you develop immunity.

How do vaccines help?

The idea behind vaccination is to give you immunity to a disease before it has a chance to make you sick.

Vaccines are made from the same germs (or parts of them) that cause disease — measles vaccine is made from measles virus, for instance, and Haemophilus influenzae type B (Hib) vaccine is made from parts of the Hib bacteria. But the germs in vaccines are either killed or weakened to reduce the risk that they will make you sick.

The vaccines containing these weakened or killed germs are introduced into your body, usually by injection. Your immune system reacts to the vaccine the same as it would if it were being invaded by the disease — by making antibodies. The antibodies destroy the vaccine germs just as they would the disease germs.

They stay in your body, giving you immunity. If you are ever exposed to the real disease, the antibodies will be there to protect you.

Why are vaccines given at a certain age?

Vaccines are given at an early age because the diseases they prevent can strike at an early age. For example, up to 60 percent of severe disease caused by Haemophilus influenzae type B occurs in children under 12 months of age. Infants less than 6 months of age are at highest risk for serious complications of pertussis — 72 percent of children under 6 months who get pertussis must be hospitalized, and 84 percent of all deaths from pertussis are among children under 6 months.

Also, some vaccines work best when they are given at certain ages. For example, measles vaccine is not usually given until a child is at least a year old. If it is given earlier than that, it may not work as well.

What if my child misses a shot?

For most vaccines, it is never too late to catch up on missed shots. Children who missed their first shots at 2 months of age can start later. Children who have gotten some of their shots and then fallen behind schedule can catch up without having to start over.

If you have children who were not immunized when they were infants, or who have gotten behind schedule, contact your doctor or the health department clinic. They will help you get your children up-to-date on their immunizations.

But, do not postpone your child’s immunizations just because you know she can catch up later.

What will happen if my child doesn’t get these shots?

If your child is never exposed to any of these diseases, nothing will happen.

If your child is exposed to any of these diseases, there is a good chance he will get the disease. What happens then depends on the child and the disease. The child could get mildly ill and have to stay inside for a few days. He could get very sick and have to go to the hospital. At the very worst, he could die.

In addition, he could also spread the disease to other children and adults who are not immune. If there were enough unprotected people in your community, the result could be an epidemic.

What are my child’s chances of being exposed to these diseases?

It’s hard to say. Some of these diseases are very rare in the U.S. today, so the chances of exposure are small. Others are still fairly common. Some are rare in the U.S. but common elsewhere in the world.

Don’t assume your child is completely safe from these diseases, even the rare ones. For instance, a child in the United States has only a tiny chance of catching diphtheria. But several years ago a boy in California did catch diphtheria and he died. He was the only child in his class who hadn’t been vaccinated.

Are shots safe?

Shots 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 child gets her shots.

Symptoms of a more serious reaction include the following:

  • Very high fever
  • Generalized rash
  • Large amount of swelling at the point of injection

If any of these symptoms occur, call your pediatrician right away.

Do shots always work?

Shots work most of the time, but not always. Most childhood immunizations give immunity to at 90 percent to 99 percent of the children who get them.

Should every child be immunized?

No. Sometimes a child should wait before getting certain vaccines, or should not get them at all. Go through this checklist and tell your doctor or nurse if any of these apply to your child on a day when an immunization visit is scheduled.

Is your child sick today?

Does your child have any severe (life-threatening) allergies?

Has your child or a sibling ever had a severe reaction after a vaccination?

Does your child have a weakened immune system (because of diseases such as cancer, or medications such as steroids)?

Has your child gotten a transfusion, or any other blood product, recently?

Has your child ever had convulsions or any kind of nervous system problem?

Does your child not seem to be developing normally?

What about the risks? I have read that immunizations can cause condition ranging from autism to multiple sclerosis.

The CDC stresses that you need to weigh the risks versus the benefits.

Every activity, from riding in a car to getting out of bed in the morning, carries some risk. Sixty Americans are electrocuted each year by household wiring or appliances; over 8,000 die from falls in the home. There is no such thing as a risk-free activity.

So the question is not, “Is immunization risk-free?, but rather “Do the risks of immunization outweigh its benefits?”

The CDC thinks the answer is clear. Immunization “can be credited for saving more lives and preventing more illnesses than any medical treatment,” according to U.S. Surgeon General Dr. David Satcher.

The benefits of immunization are obvious in the plummeting rates of diseases for which there are vaccines.

The risks are either so minor (sore arm) or so rare (seizures) the CDC believes they are far outweighed by the lives saved and illness prevented by immunization.

You can find information about vaccine safety on CDC’s National Immunization Program site and from your health care professional.

Who should you contact if your child has a vaccine-associated injury or side effect?

In the event your child has a vaccine-associated injury, or even if you think a vaccine might have caused a medical problem your child has, you should report the problem to VAERS — the Vaccine Adverse Event Reporting System.

Even if the reactions reported to VAERS turns out not to have been caused by the vaccine, but occurred after the vaccination by chance, it is important to report it. One of the purposes of VAERS is to collect enough data to help researchers identify previously unknown side effects, or to show that some reactions are not caused by vaccines.

You can also report a vaccine reaction to VAERS yourself. The toll-free information line is 1-800-822-7967.

The National Vaccine Injury Compensation Program is a federal program that offers compensation for the care of anyone believed to have been injured by vaccines. For more information, you can call the program toll-free at 1-800-338-2382 or visit its Web site.

Do immunizations hurt?

They may hurt a little and your child may cry for a few minutes. There may be some temporary swelling where your child was injected.

If your child is old enough to understand, explain that immunizations help prevent some very serious illnesses. Comfort and play with your child after the immunization. Acetaminophen can be used to help relieve some of the more common side effects, such as irritability and fever, but always check the dosage with your pediatrician.

Source: Centers for Disease Control and Prevention and the American Academy of Pediatrics