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Wednesday, March 26, 2008

Childhood immunizations: First line of defense against illnesses

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Immunizations are one of the best ways to protect children from a multitude of serious diseases. Children in the United States routinely get vaccines that protect them from more than a dozen diseases. Some vaccines are given in combination with others. Most vaccines require multiple doses given at various intervals.

For the sake of your child's health, take the time to understand the benefits and risks of vaccines. Jay Hoecker, M.D., a pediatrician at Mayo Clinic, Rochester, Minn., responds to questions and concerns you might have about your child's immunizations.

Why are vaccines given to children when they're so young? Why can't you just wait until your child is school-age?

The majority of vaccines protect against serious, potentially fatal diseases that are most likely to occur when children are very young. And the immune systems of infants are still developing and may need help fighting serious infection. If we wait until the child is older, we may return to an era of high infant mortality — and many children may never reach school age.

What are the legal requirements for immunizing children? How do you find out about your own state's regulations?

Each state has its own immunization requirements that must be met before your child can enter school. You may need proof — such as an immunization record obtained from your doctor's office — at the time of school registration. Your local school system can inform you about relevant state laws. Most states have religious-exception clauses if your faith prohibits immunization.

Is the immunity you get from a vaccine as strong as the immunity you get from being naturally infected?

For most vaccine-preventable diseases, immunity from the vaccine is as strong as immunity following the natural disease. Furthermore, vaccines can be administered without risk of the serious effects of disease, which might include permanent disability and even death.

Why are booster shots necessary?

Some vaccines, such as tetanus and pertussis, don't provide lifelong immunity. Booster shots are necessary to raise (boost) immunity in high-risk age groups. The practice of administering regular booster shots also keeps as large a portion of the population as possible vaccine-protected. Such vaccine protection establishes "herd"immunity. This refers to how an individual has a lowered risk of catching a disease, not specifically because he or she has been immunized, but because so many others have been immunized that there are few people left who can spread the disease.

Why are some vaccines administered in combination? Isn't that a lot for your child's immune system to handle at one time?

Every day, children survive constant exposure to many different germs. A child's immune system can handle the introduction of several weakened or killed disease strains in a vaccine at the same time. Only vaccines that have proved safe, after years of research and testing, are given in combination.

Are there times when your child should not be vaccinated?

Few circumstances require that immunizations be postponed or avoided. If your child has a serious illness, it may be important to wait until he or she has recovered before receiving certain vaccines. The common cold or an ear infection isn't a reason to avoid or defer immunization. If a child developed a life-threatening reaction to a particular vaccine, further doses of that vaccine would not be given.

How do you catch up on the immunization schedule if you've had to cancel a doctor visit or have missed an appointment?

Your doctor is familiar with catch-up immunization schedules that address this problem. It usually isn't necessary to repeat earlier doses to resume the schedule.

Is it OK not to vaccinate your child with a particular vaccine if you have safety concerns?

In general, it's not advisable to skip any recommended vaccines. This can leave your child vulnerable to a potentially serious disease that could otherwise be avoided. You have a responsibility to ensure the extent of your child's vaccine-built immunity. If you have reservations about particular immunizations for your child, discuss your concerns with your child's doctor.

What's the best way to comfort your child while a vaccine is being administered?

Your child may be able to perceive any fears that you have, so try to stay calm and relaxed. Hold your child and talk with him or her during the shot.

To minimize discomfort, you can give your child acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) before or after a shot. Follow the label instructions for the correct dose. You can also use an ice pack on the injection site to reduce redness and swelling.

Do vaccines have any side effects?

Vaccine side effects may be different for each particular immunization, but they fall into two general categories: Common but not serious and rare but serious.

Common side effects include:

* Low-grade fever
* Soreness at the injection site

In rare circumstances, a child may experience:

* Serious allergic reactions (anaphylaxis)
* Neurological side effects

However, for healthy children, the benefits of vaccine protection far outweigh these rare risks of vaccination.

What do you do if you think your child is having a serious reaction to a vaccine?

Fortunately, serious reactions are extremely rare. But if you're concerned that your child might be having a reaction related to an immunization, contact your doctor immediately or go to an emergency room.

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August 01, 2006

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