During their early years, children need many different vaccinations to prevent diseases that used to cause serious health problems. The American Academy of Pediatrics, the American Academy of Family Physicians, and the Centers for Disease Control and Prevention (CDC) regularly update the list of recommended vaccinations for children.
Some parents are unsure whether to have their babies and children vaccinated. There are several reasons for this.
In the US, many parents have grown up in a part of the world where most people have been immunized. Smallpox has been eradicated from the world, and other serious illnesses, such as polio, diphtheria, rubella, and measles are now very rare. Because few parents have had these diseases and seen the damage they can do, they may not realize how important it is to prevent them.
Except for smallpox, these illnesses still occur, although much less often than they did before good vaccines were developed. Most are still common in third world countries. There have been outbreaks of mumps among college students recently, and pertussis (whooping cough) case numbers have increased recently.
Vaccines, like any type of treatment, have benefits and risks. The benefits of being immunized almost always far outweigh the risks. When this is not so, vaccines are given mainly to people at especially high risk.
Smallpox is a good case in point. Until about 35 years ago, everyone was given the smallpox vaccine. Because smallpox immunization programs were successful worldwide, the risk of catching smallpox was finally eliminated. Smallpox vaccines are no longer given except to military personnel and a few others who may be exposed in the case of a terrorist attack. Today, so far as we know, the virus exists only in a few research laboratories.
Polio is another example of how immunization practices change as the risk of getting the disease is reduced. From the 1960s until the 1990s, the oral polio vaccine was recommended for everyone. It is easier to administer and less expensive than injectable vaccine, and has been an invaluable tool in the global campaign to eradicate polio. Now, immunization has eliminated the virus from most of the world. It is still a risk only in a few developing countries.
With the risk of disease in the U.S. now this low, it no longer makes sense to give a vaccine that has a real, albeit very rare (less than 1 case per million doses) risk of causing polio in and of itself. The more expensive injectable (killed) vaccine is now the only one given in the U.S. It carries no risk of vaccine-related polio.
Public health experts expect that the polio virus will one day be wiped out. When this happens, polio vaccines may no longer be needed at all.
Many new vaccines have been developed, licensed for use, and added to the routine childhood immunization schedule in recent years. These include: Haemophilus type b (Hib) vaccine, which protects against a severe form of meningitis in children varicella (chickenpox) vaccineMeningococcal vaccine (MCV-4), which protects against another severe form of meningitis, more common in adolescents and young adultspneumococcal vaccine, which protects against pneumonia and meningitis in infantsvaccines for hepatitis A and hepatitis B, which protect against two types of viral infections that cause inflammation of the liverrotavirus vaccine, an oral vaccine for young infants that protects against a severe form of diarrheahuman papillomavirus vaccine, which protects against the sexually transmitted virus responsible for cervical cancer
Scientists are working hard to develop a vaccine for the human immunodeficiency virus or HIV, which causes acquired immune deficiency syndrome, or AIDS. And, as new vaccines are developed, parents may face recommendations for their children.
One problem with new vaccines is that no one can predict all of their possible side effects. One rotavirus vaccine had to be taken off the market because it caused a serious problem with the intestines of a few children who took it.
It also is not known how long their protection will last. The immunity from chickenpox vaccine, for example, has been found to fall off just enough in some people who get it, that a second dose of vaccine is needed.
Sometimes policies have to be modified for other reasons. With measles vaccine, about five percent of people never develop immunity when a first shot is given. Most of them do respond to a second shot. Hence, a two-dose policy for measles vaccination is now in place.
Obviously, all these policy decisions are difficult and change over time. So what should parents do? Are immunizations safe?
Keep these points in mind: The illnesses for which vaccines are recommended are generally serious and often life-threatening.Many of these diseases are still around. People who have not been vaccinated risk getting them.Vaccines have some unavoidable side effects. However, these are often minor and affect a small number of people, especially when compared to the real risk of harm from the natural illnesses they prevent.
As scientists learn more, many new vaccines will become available. It will be more important than ever to seek reliable information about current and new vaccines in order to make informed decisions about vaccination. The current recommendations of the Advisory Committee on Immunization Practices can be reviewed at http://www.cdc.gov/nip/publications/ACIP-list.htm. The complete immunization schedule for children can be seen at http://www.cdc.gov/nip/pdf/child-schedule.pdf.
For more information on vaccine safety see www.vaccinesafety.edu.