Immunizations

It can be heart-wrenching to watch your baby get an immunization shot (and it's certainly no fun for the little patient) but immunizations are one of the most important parts of your child's well-baby check-ups, protecting him or her from some of the most dangerous childhood diseases.

Immunizations have saved countless lives and millions of dollars in treatment and hospitalization costs. Vaccines are now available for 15 life-threatening diseases, including diphtheria, measles, mumps, and pertussis (whooping cough), making them virtually obsolete. Before immunizations were implemented, hundreds of thousands of U.S. children were infected each year and thousands died from these diseases. Today, in under-immunized populations of the world, 600,000 children still die each year from whooping cough alone.

Even though these diseases have been effectively wiped out in the U.S., children still need to be immunized because a new outbreak can erupt as easily as an infected person walking off an airplane. A measles outbreak in the U.S. between 1989 and 1991 sickened thousands and killed hundreds of children.

The American Academy of Pediatrics and the Centers for Disease Control recommend that your child receive seven different vaccines during the first 18 months - many of them are given more than once. Recommended immunizations include:

Hepatits B (HBV) - Given at birth or shortly after, then again between 1 and 4 months, and again between 6 and 18 months. Hepatitis B can cause liver damage, liver cancer, and death.

DTaP - Administered at 2, 4, and 6 months; again between 15 and 18 months; and then again between 4 and 6 years old. This protects against diphtheria, tetanus, and pertussis. Diphtheria can cause paralysis, breathing and heart problems, and death. Tetanus (also called lockjaw) can cause muscle spasms, breathing and heart problems, and death. Pertussis causes very long spells of coughing that make it hard to eat, drink, or even breathe, and can lead to lung problems, seizures, brain damage, and death.

Hib - Given at 2, 4, and 6 months, and then again between 12 and 15 months. This immunization protects against Haemophilus influenza type B, which can lead to meningitis, pneumonia, and epiglottitis (a dangerous infection of the flap of tissue that closes off the larynx when you swallow).

Polio (IPV) - Given at 2 and 4 months, again between 6 and 18 months, and a fourth shot between 4 and 6 years old. Polio causes high fever and may progress to meningitis and cause paralysis or death.

MMR - Given between 12 and 15 months, and again between 4 and 6 years old, to protect against measles, mumps, and rubella (German measles). Measles causes a high fever, rash, and cold-like symptoms. It can lead to hearing loss, pneumonia, brain damage, and death. Mumps cause headache, fever, swelling of the glands of the jaw and neck, and swelling in the testicles of adolescent and adult males. It can lead to hearing loss, meningitis, and brain damage. Rubella causes fever and rash on the face and neck.

Varicella - Administered between 12 and 18 months to protect against varicella, or chicken pox. Varicella is extremely contagious and causes a rash and fever. It can lead to serious complications including inflammation of the brain, pneumonia, and rarely, a flesh-eating bacterial infection or death.

Pneumococcal - Given at 2, 4, and 6 months and then again between 12 and 15 months to protect against pneumococcal disease, which can lead to meningitis, pneumonia, and ear infections and can result in permanent brain damage and even death.

Selected states, regions, and certain high-risk groups also should receive vaccination against hepatitis A. Consult your local public health authority to find out if you need this vaccination. The two doses required in the series should be administered at least six months apart and children and adolescents in these populations who have not been immunized against hepatitis A can begin the immunization series at any time. An influenza vaccine is also recommended annually for children between 6 and 23 months.

There are some potential risks and side effects associated with vaccinations, although they are minor compared to the benefits. Some vaccines may cause your child to develop a low-grade fever (less than 102 degrees F), and a rash or soreness at the injection site. In rare cases, your child may have an allergic reaction to the vaccine (usually within a few minutes or a few hours after the shot is administered), characterized by difficulty breathing, wheezing, hives, dizziness, fainting, an erratic heartbeat, and weakness. In very rare cases, a vaccination may cause a high fever or seizure within a few days of the shot. Seek medical treatment immediately if your child displays any of these symptoms.

Despite the overwhelming benefits of immunizations, many children in the U.S. are still not vaccinated against many diseases. To encourage universal immunization, Congress passed the Omnibus Budget Reconciliation Act in 1993, which created the Vaccines for Children (VFC) program. The VFC program provides vaccines to children of families who may not otherwise be able to afford them, at little to no cost. Children who are eligible:

• Are 18 years old or younger;

• Are eligible for Medicaid;

• Are Native American or Alaskan Native;

• Have no health insurance; or

• Have health insurance, but it does not cover immunizations. In these cases, children must go to a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) for immunizations.

Your child can receive free vaccines through the VFC program at private doctor's offices, public and private clinics, hospitals, and select schools in some states. To find out about immunizations and the VFC program in your state, visit the State Immunization Program Website. To view the American Academy of Pediatrics' (AAP) current immunization schedule (.pdf), click here.