Back to school: Vaccines for children

3 Sep

The Seattle Times Editorial Board wrote in Editorial: The heavy cost of anti-vaccination free-riders:

LAST weekend, a teenager in King County whose parents intentionally avoided mandatory vaccinations was diagnosed with measles. Public-health officials in King County and in Portland, Ore., where the teen had recently attended a tennis tournament, scrambled to issue detailed itineraries of potential contamination.
Lucky for them, and for the rest of us, school hadn’t started. But imagine the anger of a parent of a particularly vulnerable child — an infant, or a child with a compromised immune system — learning his or her kid is now at risk because another parent was gambling with a preventable, highly transmittable illness.
In epidemiology, it’s known as the free-rider phenomenon. Non-immunization is a risk some parents apparently think they can afford only because most other parents wisely choose to immunize their kids. http://seattletimes.com/html/editorials/2021724027_editvaccination01xml.html
Too many children are not receiving the appropriate vaccines. See, Vaccination Coverage Among Children in Kindergarten — United States, 2012–13 School Year http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6230a3.htm?s_cid=mm6230a3_w

There are many myths regarding vaccination of children.

Dina Fine Maron wrote in the Daily Beast article, 6 Top Vaccine Myths:

To sort through the onslaught of information and misinformation about childhood immunizations, we asked Austin, Texas-based pediatrician Ari Brown, coauthor of “Baby 411: Clear Answers and Smart Advice for your Baby’s First Year,” to debunk some of the most common vaccination myths.

Myth 1: It’s not necessary to vaccinate kids against diseases that have been largely eradicated in the United States.

Reality: Although some diseases like polio and diphtheria aren’t often seen in America (in large part because of the success of the vaccination efforts), they can be quite common in other parts of the world. The Centers for Disease Control and Prevention warns that travelers can unknowingly bring these diseases into the United States, and if we were not protected by vaccinations, these diseases could quickly spread throughout the population. At the same time, the relatively few cases currently in the U.S. could very quickly become tens or hundreds of thousands of cases without the protection we get from vaccines. Brown warns that these diseases haven’t disappeared, “they are merely smoldering under the surface.”
Most parents do follow government recommendations: U.S. national immunization rates are high, ranging from 85 percent to 93 percent, depending on the vaccine, according to the CDC. But according to a 2006 study in the Journal of the American Medical Association, the 20 states that allow personal-belief opt outs in addition to religious exemptions saw exemptions grow by 61 percent, to 2.54 percent between 1991 and 2004.
Brown is concerned that parents who opt out or stagger the vaccine schedule can end up having to deal with confusing follow-up care, which could produce an increase in disease outbreaks like last summer’s measles epidemic. A 2008 study in the American Journal of Epidemiology reported that when there are more exemptions, children are at an increased risk of contracting and transmitting vaccine-preventable diseases.
For more on the pros and cons of staggering or skipping vaccinations, visit MSN’s guide or read this U.S. News and World Report piece. For information on vaccine safety, check out the CDC’s information page. To search for your state’s vaccine requirements, see the National Network for Immunization Information.

Myth 2: Mercury is still in kids’ vaccines.

Reality: At the center of this issue is a preservative called thimerosal (a compound containing mercury) that once was a common component in many vaccines because it allowed manufacturers to make drugs more cheaply and in multidose formulations. But public concern, new innovations and FDA recommendations led to its removal from almost all children’s vaccines manufactured after 2001. (More thimerosal background can be found at the FDA’s Web site) Since flu vaccines are not just for children, manufacturers still put thimerosal in some flu-shot formulations. You can ask your pediatrician for the thimerosal-free version, says Brown.
If your child does not have asthma and is at least 2 years old, Brown recommends the FluMist nasal-spray vaccination over the flu shot. “It seems to have better immune protection and it could help your child avoid another shot,” she says. (Caveat: the spray does contain a live version of the virus, which can result in a slight increase in flulike symptoms).

Myth 3: Childhood vaccines cause autism.

Reality: There is no scientific evidence that this link exists. Groups of experts, including the American Academy of Pediatrics and the Institute of Medicine (IOM), agree that vaccines are not responsible for the growing number of children now recognized to have autism.
Earlier this month, the law supported scientists’ conclusions in this arena with three rulings from a section of the U.S. Court of Federal Claims, which stated that vaccines were not the likely cause of autism in three unrelated children. The U.S. Department of Health and Human Services said in an online statement following the ruling, “The medical and scientific communities have carefully and thoroughly reviewed the evidence concerning the vaccine-autism theory and have found no association between vaccines and autism.” Noting the volume of scientific evidence disproving this link, an executive member of one of the nation’s foremost autism advocacy groups, Autism Speaks, recently stepped down from her position because she disagrees with the group’s continued position that there is a connection between the vaccines and autism.
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Myth 4: Getting too many vaccines can overwhelm the immune system and cause adverse reactions or even serious illness.

Reality: Children’s immune systems are capable of combating far more antigens (weak or killed viruses) than they encounter via immunizations. In fact, the jury is still out on if there’s an actual limit on how many the body can handle—though one study puts the number around a theoretical 10,000 vaccines in one day.(Visit the American Academy of Pediatrics’ site or the Network for Immunization Information for more information)
Currently, “There is even less of a burden on the immune system [via vaccines] today than 40 years ago,” says Edgar Marcuse, a professor of pediatrics at the University of Washington who works on immunization policy and vaccines. He points to the whooping-cough vaccine as an example where there are far fewer antigens in the shot than the earlier version administered decades ago. Brown says she supports following the recommended schedule for vaccinations, which outlines getting as many as five shots in one day at a couple check-ups. (The CDC’s recommended vaccination schedule can be found here.) “I have kids, and I wouldn’t recommend doing anything for my patients that I wouldn’t do for my own kids,” she says.
The CDC reports that most vaccine adverse events are minor and temporary, such as a sore arm or mild fever and “so few deaths can plausibly be attributed to vaccines that it is hard to assess the risk statistically.” Of all deaths reported to the Health and Human Services’ Vaccine Adverse Events Reporting site between 1990 and 1992, only one is believed to be even possibly associated with a vaccine. The Vaccine Safety Datalink Project, an initiative of the CDC and eight health-care organizations, looks for patterns in these reports and determines if a vaccine is causing a side effect or if symptoms are largely coincidental.
If you have concerns about following the recommended vaccination, schedule don’t wait until a check-up. Set up a consultation appointment with your pediatrician, or even outline a strategy for care with your doctor during your pregnancy.

Myth 5: It’s better to let my kid get chickenpox “naturally.”

Reality: Before the chickenpox vaccine was licensed in 1995, parents sometimes brought their child to a party or playground hoping that their child might brush up against a pox-laden kid to get their dose of chickenpox over since cases were usually less severe for children than adults. But pediatricians say severe complications are possible with chickenpox—including bacterial infections that could result in a child’s hospitalization or death. (More information on the chickenpox vaccine is available at the CDC’s Web site.)
Now that there’s a vaccine for chickenpox, more than 45 states require the shots (unless your child already had the chicken pox or can prove natural immunity). Two shots usually guarantees your child a way out of being bedecked in calamine lotion for two feverish weeks, but some individuals do still come down with a milder form of the pox. Most pediatricians recommend getting the shot.

Myth 6: The flu shot causes the flu.

Reality: The flu shot does not contain a live virus, so your child can’t get the flu from this shot. But, after the shot, it’s not uncommon to feel a bit achy while the immune system mounts its response. Remember that for two weeks following the shot, your child can still get the flu, so be sure to help your child avoid that feverish kid next door.
http://www.thedailybeast.com/newsweek/2009/02/22/six-top-vaccine-myths.html

Here is information from the 6 Top Vaccine Myths regarding vaccination schedules:

For Health Care Professionals
Birth-18 Years and Catch-up
• View combined schedules (birth-18 years and catch-up)
http://www.cdc.gov/mmwr/preview/mmwrhtml/su6201a2.htm
• Print combined schedules (including intro, summary of changes, references…) [355 KB, 7 pages]
http://www.cdc.gov/vaccines/schedules/downloads/child/mmwr-0-18yrs-catchup-schedule.pdf
• Print combined schedules in color (chart in landscape format) [202 KB, 5 pages] also in black & white [348 KB, 5 pages]
http://www.cdc.gov/vaccines/schedules/downloads/child/mmwr-0-18yrs-catchup-schedule.pdf
• Print full MMWR supplement (birth-18 years, catch-up, adult, adult medical and other indications, adult contraindications and precautions) [1MB, 21 pages]
http://www.cdc.gov/mmwr/pdf/wk/mm62e0128.pdf
• Order free copies from CDC
http://wwwn.cdc.gov/pubs/ncird.aspx#schedules

For Everyone
Easy-to-read Schedules for All Ages
Easy-to-read formats to print, tools to download, and ways to prepare for your office visit.
• Infants and Children (birth through 6 years old)Find easy-to-read formats to print, create an instant schedule for your child, determine missed or skipped vaccines, and prepare for your office visit…
http://www.cdc.gov/vaccines/schedules/easy-to-read/child.html
• Preteens & Teens (7 through 18 years old)Print this friendly schedule, take a quick quiz, fill out the screening form before your child’s doctor visit, or download a tool to determine vaccines needed…
http://www.cdc.gov/vaccines/schedules/easy-to-read/preteen-teen.html
• Adults (19 years and older)Print the easy-to-read adult schedule, take the quiz, or download a tool to
• determine vaccines needed…
http://www.cdc.gov/vaccines/schedules/easy-to-read/adult.html
http://www.cdc.gov/vaccines/schedules/

Here is information from the American Academy of Pediatrics regarding vaccination. http://www2.aap.org/immunization/ Parents must consult their doctors about vaccinations.

Related:

3rd World America: Tropical diseases in poor neighborhoods
https://drwilda.com/2012/08/20/3rd-world-america-tropical-diseases-in-poor-neighborhoods/

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One Response to “Back to school: Vaccines for children”

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  1. 10 Medical Myths | The Crazy World We Live In - September 14, 2013

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