Things you need to know about children's immunizations
Why are vaccines given to children when they are so young? Why can't I just wait until my child is school age?
The majority of vaccines we recommend for young children are the ones that protect against serious, potentially fatal diseases that infants are most susceptible to. Their immune systems are still developing and may need help fighting serious infection. If we wait to immunize until school age, we may return to an era when infant mortality was very high and many children never reached school age.
What are the legal requirements for immunizing children? How do I find out about the state regulations where I live?
Each state has its own requirements for immunization that must be met when your child enters school. You may need to have proof � in the form of an immunization record obtained from your health care provider � 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 the use of such medical resources.
Is immunity from a vaccine as strong as immunity from being naturally infected? If so, why are boosters necessary?
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 can include permanent disability and even death.
There are some vaccines, such as tetanus and pertussis, in which the immunity is not lifelong. Booster shots are necessary to raise (boost) immunity during high-risk ages and also to maintain as large a portion of the vaccine-protected population as possible � establishing a "herd immunity" that helps prevent the spread of the disease. In addition, some people may fail to build immunity to the first doses of a vaccine but respond to later doses.
Why are some vaccines administered in combination? Isn't that a lot for my child's immune system to handle at one time?
Every day, children survive constant exposure to many different germs. A child's normal immune system can handle the introduction of several weakened 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.
There is also a practical side to this approach. Some of the vaccines have been combined to limit the numbers of shots, thereby the number of office visits, and in turn any trauma your child might experience. Also consider what is being prevented compared with the potential consequence of disease when a vaccine is avoided or delayed. All the diseases for which we have vaccines warrant being prevented, and sooner rather than later.
Are there times when my child should not be vaccinated?
There are very few circumstances in which immunization should be postponed or avoided. One would be when a child has had a serious life-threatening reaction to a particular vaccine such that further doses of that vaccine should not be given. The common cold or an ear infection is not a reason to avoid or defer a vaccine. A serious illness in a child may be reason to wait until recovery before receiving certain vaccines.
How do I catch up on the immunization schedule if, say, I've had to cancel a doctor visit or missed an appointment?
Your physician has access to catch-up immunization schedules that address this problem. It usually is not necessary to redo any doses to resume the schedule.
Is it OK to not vaccinate my child with a particular vaccine if I have safety concerns? What about half doses?
In general, it is not advisable to skip any recommended vaccines. This can leave your child vulnerable to a potentially serious disease that could otherwise be avoided. Half doses are not recommended because they are little different from not vaccinating at all. You are the final arbiter in deciding what vaccines your child gets. You would serve your child well to discuss such concerns with the child's physician.
What is the best way for me to reassure my child while a vaccine is being administered?
Parents' fears can be perceived by the child. If you feel it is wise and right to vaccinate, preparing your child for a brief discomfort � the shot � in exchange for a bad disease will go a long way. Holding your child and talking with him or her during the shot giving also helps. In cases of greater fear, some physicians use relaxation techniques or hypnosis for needle-fearing children.
Do vaccines have any side effects?
Vaccine side effects come in two general categories: the common and not serious, and the rare but serious. In the first category, it is not unusual to have a low-grade fever and soreness at the injection site for some but not all vaccines. In very rare circumstances, there can be a serious allergic reaction (anaphylaxis) or neurologic side effects. Although the latter gets a lot of attention in the press, its occurrence is fortunately rare.
What do I do if I think my child is having a serious reaction to a vaccine?
As with all medications, vaccines do carry some risk. Fortunately, as I've said, serious reactions are extremely rare. If one does occur, contact your physician immediately or go to an emergency facility. Such reactions are also reportable to the federal government under the Vaccine Adverse Event Reporting System (VAERS)