General Information on Vaccines
Pediatric HealthCare has a new vaccine policy effective Nov 1st, 2019.
Click here to open the full policy statement.
THE CHILDHOOD IMMUNIZATION SCHEDULE: WHY IS IT LIKE THAT?
Q: Who decides what immunizations children need ?
A: Each year, top disease experts and doctors who care for children work together to decide
what to recommend that will best protect U.S. children from diseases. The schedule is
evaluated each year based on the most recent scientific data available. Changes are
announced in January, if needed. The schedule is approved by the American Academy of
Pediatrics, the Centers for Disease Control and Prevention, and the American Academy of
Family Physicians.
Q: How are the timing and spacing of the shots determined?
A: Each vaccine dose is scheduled using 2 factors. First, it is scheduled for the age when the
body's immune system will work the best. Second, it is balanced with the need to provide
protection to infants and children at the earliest possible age.
Q: Why are there so many doses?
A: Researchers are always studying how well vaccines work. For many vaccines three or four
doses are needed to fully protect your child. The doses need to be spaced out a certain
amount to work the best.
Q: Why is the schedule "one size fits all"? Aren't there some children who
shouldn't receive some vaccines?
A: Your child's health and safety are very important to your child's doctor. The schedule is
considered the ideal schedule for healthy children but there may be exceptions. For example,
your child might not receive certain vaccines if she has allergies to an ingredient in the
vaccine, or if she has a weakened immune system due to illness, a chronic condition, or
another medical treatment. Sometimes a shot needs to be delayed for a short time, and
sometimes not given at all.
Your pediatrician stays updated about new exceptions to the immunization schedule. This is
one reason your child's complete medical history is taken at the pediatrician's office, and why
it is important for your child's health care providers to be familiar with your child's medical
history.
Q: Why can't the shots be spread out over a longer period of time? There are 25
shots recommended in the first 15 months of life; why not spread these out over 2 or 3
years?
A: First, you would not want your child to go unprotected that long. Babies are hospitalized
and die more often from some diseases, so it is important to vaccinate them as soon as it is
safe. Second, the recommended schedule is designed to work best with a child's immune
system at certain ages and at specific times. There is no research to show that a child would
be equally protected against diseases with a very different schedule. Also, there is no
scientific reason why spreading out the shots would be safer. But we do know that any
length of time without immunizations is a time without protection.
Q: I've seen another schedule in a magazine that allows the shots to be spread out.
It was developed by a pediatrician. Why can't I follow that schedule? My child would
still get his immunizations in time for school.
A: There is no scientific basis for such a schedule. No one knows how well it would work to
protect your child from diseases. And if many parents in any community decided to follow
such a schedule, diseases will be able to spread much more quickly. Also, people who are too
sick or too young to receive vaccines are placed at risk when they are around unvaccinated
children.
For example, following one alternative schedule would leave children without full polio
protection until age 4. Yet it would take only one case of polio to be brought into the U.S.
for the disease to take hold again in this country. This schedule also delays the measles
vaccine until age 3. We have already seen outbreaks of measles in some parts of the country
because children were not immunized. This is a highly infectious disease that can cause
serious harm--even death. The reason we recommend vaccines when we do is because young
children are more vulnerable to these diseases.
Pediatricians want parents to have reliable, complete, and science-based information, so that
they can make the best decision for their child about vaccination.
Q: Isn't it possible that my child has natural immunity to one or more diseases? If
he does, can't he skip the shot?
A: Tests that check for immunity to certain diseases do not work well in young children.
Q: Isn't it overwhelming to a child's immune system to give so many shots in one
visit?
A: Infants and children are exposed to many germs every day just by playing, eating, and
breathing. Their immune systems fight those germs, also called antigens, to keep the body
healthy. The amount of antigens that children fight every day (2,000-6,000) is much more
than the antigens in any combination of vaccines on the current schedule (150 for the whole
schedule). So children's immune systems are not overwhelmed by vaccines.
Q: There are no shots given at 9 months, other than maybe flu vaccine or catch-up
vaccines. Why not give some at that visit instead of at 6 months or 12 months?
A: Waiting until 9 months would leave the child unprotected from some diseases, but 9
months is too early for some of the 12-18 month vaccines. For example, it is too early for
the live measles, mumps, rubella and varicella vaccines, since some infants might have a bit
of protection left from their mother during the pregnancy, and that protection could make
the vaccine less effective.
VACCINE SAFETY: THE FACTS
Why vaccinate? Vaccines save lives and protect against the spread of disease. If you decide not to immunize your child, you put your child at risk. Your child could catch a disease that is dangerous or deadly. Getting vaccinated is much better than getting the disease.
Your pediatrician knows that you care about your child's health and safety. That's why you need to get all the scientific facts from a medical professional you can trust before making any decisions based on stories you may have seen or heard on TV, the Internet, or from other parents. Your pediatrician cares about your child too and wants you to know that €¦
Vaccines work. They have kept children healthy and have saved millions of lives for more than 50 years. Most childhood vaccines are 90% to 99% effective in preventing disease. And if a vaccinated child does get the disease, the symptoms are usually less serious than in a child who hasn't been vaccinated. There may be mild side effects, like swelling where the shot was given, but they do not last long. And it is rare for side effects to be serious.
Vaccines are safe. All vaccines must be tested by the Food and Drug Administration (FDA). The FDA will not let a vaccine be given unless it has been proven to be safe and to work well in children. The data get reviewed again by the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics, and the American Academy of Family Physicians before a vaccine is officially recommended to be given to children. Also, the FDA monitors where and how vaccines are made. The places where vaccines are made must be licensed. They are regularly inspected and each vaccine lot is safety-tested.
Vaccines are necessary. Your pediatrician believes that your children should receive all recommended childhood vaccines. In the United States vaccines have protected children and continue to protect children from many diseases. However, in many parts of the world many vaccine-preventable diseases are still common. Since diseases may be brought into the United States by Americans who travel abroad or from people visiting areas with current disease outbreaks it's important that your children are vaccinated.
Also, children with certain health problems may not be able to get some vaccines or may need to get them later. Since each child is different, your child's doctor will know what is best for your child. You should get information about each vaccine at the doctor's office. Ask your child's doctor if you don't understand what you've read.
Vaccines are studied. To make sure the vaccine continues to be safe, the FDA and the CDC created the Vaccine Adverse Event Reporting System (VAERS). All doctors must report serious side effects of vaccines to VAERS so they can be studied. Parents can also file reports with VAERS. For more information about VAERS, visit www.vaers.hhs.gov or call the toll-free VAERS information line at 800/822-7967.
Based on VAERS reports, vaccine safety professionals continuously look for any problem with a vaccine, study the problem, and decide what to do. And if there is a problem, changes are made as soon as possible. For example,
- If a vaccine is no longer safe, it is no longer given.
- If there are new side effects, safety alerts are sent out to your health care providers.
Another way the CDC checks vaccine safety is by studying information about side effects collected from 8 large insurance companies. The Vaccine Safety Datalink (VSD) helps identify if there are any serious problems or safety issues from the records of thousands of children.
In the rare case that a child has serious side effects to a vaccine, parents can contact the National Vaccine Injury Compensation Program (VICP) at 800/338-2382 or www.hrsa.gov/vaccinecompensation. This federal program was created to help pay for the care of people who have been harmed.
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Resources American Academy of Pediatrics Food and Drug Administration |
Centers for Disease Control and Prevention National Network for Immunization Information |
QUESTIONS AND ANSWERES ABOUT VACCINE INGREDIENTS
Q: What ingredients are in vaccines?
A: All vaccines contain antigens. Antigens make vaccines work. They prompt the body to
create the immune response needed to protect against infection. Antigens come in several
forms. The form used in a vaccine is chosen because studies show it is the best way to
protect against a particular infection.
Antigen forms include:
- Weakened live viruses. They are too weak to cause disease but can still prompt an
immune response. Measles, mumps, rubella, rotavirus, chickenpox, and one type of
influenza vaccine contain weakened live viruses.
- Inactivated (or killed) viruses. These viruses cannot cause even a mild form of the
disease, but the body still recognizes the virus and creates an immune response to
protect itself. The polio, hepatitis A, influenza and rabies vaccines contain inactivated
viruses.
- Partial viruses. These are made up of the specific part of the dead virus that will
prompt a protective immune response. Some vaccines are made this way including
the hepatitis B and HPV vaccine.
- Partial bacteria. These vaccines work in two ways. First, the Hib, pneumococcal
and meningococcal vaccines are made using part of the sugar coating (or
polysaccharide) of the bacteria. The vaccine creates immunity against this sugar
coating, providing protection against the bacteria. Second, vaccines against
diphtheria, tetanus and pertussis (whooping cough) are made by inactivating the
protein in the bacteria that causes harm.
Vaccines also contain other ingredients, which help make them safer and more
effective. They include:
- Preservatives. They keep the vials from getting contaminated with germs.
- Adjuvants. They help the body create a better immune response. These are
aluminum salts.
- Additives. They help the vaccine stay effective while being stored. Additives include
gelatin, albumin, sucrose, lactose, MSG and glycine.
- Residuals of the vaccine production process. Some ingredients are needed to
make the vaccine. Although these ingredients are removed, tiny (residual) amounts
are left in the final product. Depending on how the vaccine is made, it may include
tiny amounts of antibiotics (neomycin), egg protein or yeast protein.
Q: Why are these other ingredients in vaccines? Are they safe?
A: Each ingredient has a specific function in a vaccine. These ingredients have been studied
and are safe for humans in the amount used in vaccines. This amount is much less than
children encounter in their environment, food and water.
- Aluminum salts. Aluminum salts help your body create a better immune response
to vaccines. Aluminum salts are necessary to make some of the vaccines we use more
effective. Without an adjuvant like aluminum, people could need more doses of
shots to be protected. Everyone is exposed to aluminum because there is much
aluminum in the earth's crust. It's present in our food, air and water, including breast
milk and formula. The amount of aluminum in vaccines is similar to that found in 33
ounces of infant formula. Aluminum has been used and studied in vaccines for 75
years and is safe.
- Formaldehyde. Formaldehyde is used to detoxify diphtheria and tetanus toxins or
to inactivate a virus. The tiny amount which may be left in these vaccines is safe.
Vaccines are not the only source of formaldehyde your baby is exposed to.
Formaldehyde is also in products like paper towels, mascara and carpeting. Our
bodies normally have formaldehyde in the blood stream and at levels higher than in
vaccines.
- Antibiotics. Antibiotics, such as neomycin, are present in some vaccines to prevent
bacterial contamination when the vaccine is made. Trace amounts of antibiotics in
vaccines rarely, if ever, cause allergic reactions.
- Egg protein. Influenza and yellow fever vaccines are produced in eggs, so egg
proteins are present in the final product and can cause allergic reaction. Measles and
mumps vaccines are made in chick embryo cells in culture, not in eggs. The much
smaller amount of remaining egg proteins found in the MMR (measles, mumps,
rubella) vaccine does not usually cause a reaction in egg allergic children.
- Gelatin. Some vaccines contain gelatin to protect them against freeze-drying or heat.
People with severe allergies to gelatin should avoid getting gelatin-containing
vaccines.
Q: Do vaccines contain antifreeze?
A: No. Antifreeze is typically made of ethylene glycol, which is unsafe. Polyethylene glycol (a
chemical used in antifreeze and personal care products like skin creams and toothpaste) is
used in vaccines and is safe. It is used to inactivate the influenza virus in some influenza
vaccines. It is also used to purify other vaccines.
Q: Do vaccines contain mercury?
A: Thimerosal, a mercury-based preservative, was removed from most childhood vaccines in
2001. It is still present in some influenza vaccines. Thimerosal is still used in the manufacture
of some vaccines to prevent contamination. The thimerosal is removed at the end of the
manufacturing process. In some cases, a tiny amount of thimerosal remains. The remaining
amount is so small, that it is not possible for it to have any effect. Valid scientific studies
have shown there is no link between thimerosal and autism. In fact, autism rates have
actually increased since thimerosal was removed from childhood vaccines. The American
Academy of Pediatrics (AAP), the American Medical Association (AMA), the CDC, and the
Institute of Medicine (IOM) agree that science does not support a link between thimerosal in
vaccines and autism. For the IOM report, go to
http://www.iom.edu/CMS/3793/4705/4717.aspx.
Q: Should vaccines be "greener"?
A: The amount of each additive used in vaccines is very small. In fact, we are exposed to
much higher levels of these chemicals in our everyday lives. In vaccines, these ingredients are
used to make the vaccine safer and more effective. Each vaccine is tested many times to
make sure it is safe and works. Taking ingredients out might affect the ability of the vaccine
to protect a child.
The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
Copyright © American Academy of Pediatrics, October 2008
WHY DOES MY CHILD NEED TO BE IMMUNIZED?
Immunizations have helped children stay healthy for more than 50 years. They are safe and they work. In fact, serious side effects are no more common than those from other types of medication.
Vaccinations have reduced the number of infections from vaccine-preventable diseases by more than 90%! Yet many parents still question their safety because of misinformation they've received. That's why it's important to turn to a reliable and trusted source, including your pediatrician, for information.
The following are answers to common questions parents have about immunizations.
Q: Why are some of these vaccines still needed if the diseases are not as common anymore?
A: Because of vaccines, many of these diseases
are not as common as they once were. However, the bacteria and viruses that cause them still exist.
For example, before the Hib vaccine was developed
in the 1980s, there were about 20,000 cases of Hib disease in the United States a year.
Today there are fewer than 100 cases a year. However, the bacteria that causes Hib disease still exists. That is why children
need the vaccine to be protected.
In the United States vaccines protect children from many diseases. However, in many parts of the world vaccine- preventable diseases are still common. Because diseases may be brought into the United States by Americans who travel abroad or from people visiting areas with current disease outbreaks, it's important that your child is vaccinated.
Q: Do vaccines even work? It seems like most of the people who get these diseases have been vaccinated.
A: Yes. Vaccines work very well. Millions of children have been protected against serious illnesses because they were immunized. Most childhood vaccines are 90% to 99% effective in preventing disease. When a large majority of children have been vaccinated, it is expected that most who get the disease will have been vaccinated. And if a vaccinated child does get the disease, the symptoms are usually milder with less serious side effects or complications than in a child who hasn't been vaccinated.
Q: "What side effects will my child have after getting a vaccine? Are they serious?"
A: There may be mild side effects, like swelling, redness, and tenderness where the shot was given, but they do not last long. Your child may also have a slight fever and be fussy for a short time afterward. It is rare for side effects to be serious. However, call your pediatrician right away if your child has
- A very high fever (>103 °F) and is younger than 3 months
- Hives or black-and-blue areas at places where the injection was not given
- A seizure
You should also call your pediatrician if you have any other concerns.
Q: "Should some children not be immunized?"
A: Children with certain health problems may need to avoid some vaccines or get them later. In most cases, children with cancer, those taking oral or injected steroids for lung or kidney conditions, or those who have problems with their immune systems should not get vaccines that are made with live viruses. To protect these children it is very important for others to be vaccinated. For children with a recent history of seizures, the pertussis part of the DTaP vaccine may need to be delayed. However, a child with a minor illness such as low-grade fever (<100.4 °F), an ear infection, cough, a runny nose, or mild diarrhea can safely be immunized.
Last Updated 6/9/2010
Source Immunizations: What You Need to Know (Copyright © 2003 American Academy of Pediatrics, Updated 1/10)
