On November 6, the California Department of Public Health (CDHP) announced
the first report of an influenza-associated death in a person under the
age of one year for the current flu season. In reporting the infant’s
death in Stanislaus County, the CDHP noted, in part, “Young children
less than a year of age are at increased risk of severe influenza. It
is especially troubling when a baby too young to be vaccinated (under
age 6 months) passes away. Preventing the spread of this often deadly
disease is why getting vaccinated is so important.”
The Centers for Disease Control and Prevention (CDC) recommends a yearly
flu vaccine for anyone 6 months of age and older as the first and most
important step in protecting against flu viruses. Because children younger
than 6 months are too young to be vaccinated, the people who care for
them should be vaccinated instead. The flu shot given during pregnancy
has been shown to protect both the mother and her baby (up to 6 months
old) from flu.
“Parents need to protect their children from serious, potentially
life-threatening illnesses, including the flu,” says Dr. Bhaskari
Peela, a pediatrician with Washington Township Medical Foundation. “One
way you can do that is to make sure your children’s vaccinations
are current. Making sure children and teens are up-to-date on vaccinations
for diseases also will protect the health of infants who are not yet old
enough to be vaccinated.”
Because young children’s immune systems are not as well developed
as an adult’s, they are particularly vulnerable to bacterial and
viral infections. Flu vaccines are recommended every year because the
type of flu virus in circulation changes every year. Other vaccines provide
long-term, perhaps even lifetime protection against a variety of illnesses.
“Most vaccines are given during the first two years of life,”
says Dr. Peela. “Many of these vaccines are given at ages 2 months,
4 months and 6 months to build up children’s immunity. Other immunizations
are recommended at 15 months, 4 years and at age 10 to 11 before middle
school. Certain ‘booster’ shots are recommended throughout
life. For example, the Tdap booster shot that protects against tetanus,
diphtheria and pertussis – also called whooping cough – is
important for pregnant moms and any other people who are in contact with
infants who are not vaccinated.”
Thanks to vaccines, a number of diseases are becoming very rare in the
United States. In December 2014, however, a large outbreak of measles
started in California when at least 40 people who visited or worked at
Disneyland in Orange County contracted measles. The outbreak also spread
to at least half a dozen other states.
“Since that outbreak of measles last year, I have seen parents become
more willing to vaccinate their children, which is a positive change,”
Dr. Peela observes.
“Some people questioned the safety of vaccines, and some parents
voiced concern that a baby’s immune system cannot handle multiple
vaccines at once, but studies have shown there is no evidence for either
of those claims,” she explains. “I am really impressed by
the fact that parents are becoming better informed about the importance
of vaccination. We will work with parents to address any concerns they
have about vaccine safety and scheduling, but we do follow the guidelines
from the CDC and the American Academy of Pediatrics (AAP) to make sure
kids get their vaccines at the right time.”
The AAP recommends vaccines for:
- Measles, mumps, rubella (MMR)
- Diphtheria, tetanus and pertussis (DTaP), with a booster vaccine called
Tdap at ages 10 to 12
- Haemophilus influenza type B (Hib)
- Hepatitis A
- Hepatitis B
- Chickenpox (varicella)
- Pneumococcal disease
- Meningococcal disease
- Rotavirus infections
- Influenza, for all children age 6 months and older
The AAP added the rotavirus to its recommendations in 2006, noting that
rotavirus is a major cause of stomach and intestinal infections in the
U.S., infecting four out of five children in the first three to five years of life.
The AAP also recommends vaccination against human papillomavirus (HPV)
for both girls and boys, generally at 11 to 12 years of age. HPV infection
can lead to possible cervical cancer, and the vaccine protects against
several strains of HPV that cause cervical cancer.
“This year, the HPV vaccine now contains more strains of the virus,
for additional protection,” notes Dr. Peela. “In addition
to helping prevent cervical cancer, the HPV vaccine also can help both
boys and girls prevent getting throat cancer later in life. If you have
concerns about the HPV vaccine, or the age your child should receive the
vaccine, you should consult your doctor.”
In California, various vaccinations are required for children attending
public school. Many private schools also require proof of vaccination.
Some children currently are allowed by California law to skip immunizations
if a parent submits a “personal beliefs exemption” or a medical
exemption at enrollment. Parents who want to opt out of the vaccines required
to attend public schools also must submit a signed statement that they
have received information from a health care professional regarding the
benefits and risks of vaccinations.
Dr. Peela emphasizes that the protection provided by childhood vaccines
far outweighs the very small risks of any serious reactions to the vaccines.
The potentially serious complications of some vaccine-preventable diseases include:
- Measles – Measles can lead to ear infections, pneumonia and encephalitis
(an inflammation of the brain that can cause convulsions, deafness, mental
retardation or even death).
- Mumps – Serious complications can include meningitis (inflammation
of the cover of the brain and spinal cord) or encephalitis.
- Diphtheria – If not treated promptly, diphtheria can produce a toxin
(poison) that spreads through the body causing serious complications such
as heart failure or paralysis.
- Tetanus (“lockjaw”) – Like diphtheria, tetanus can produce
a toxin that spreads through the body, causing muscle spasms in the neck,
arms, legs and stomach.
- Pertussis (“whooping cough”) – Violent coughing spells
can go for weeks, causing difficulty with eating, drinking or breathing
and leading to major complications such as pneumonia, convulsions and
encephalopathy (a brain disorder).
- Polio – Polio attacks the nervous system. Symptoms can range from
flu-like symptoms to total paralysis. Before the polio vaccine became
available in 1955, polio killed tens of thousands and left many more paralyzed.
The U.S. has not had a reported case of polio since 1979, but Afghanistan,
Pakistan and Nigeria still have frequent outbreaks. The greatest risk
factor for polio is not being vaccinated.
- Hepatitis A and Hepatitis B – Both of these viruses cause liver disease,
which may lead to cirrhosis (scarring of the liver) or liver cancer.
- Rubella (German Measles) – Generally a mild disease that causes a
fever, swollen glands in the back of the neck and a rash on the face and
neck, rubella presents the greatest risk to unborn babies. If a woman
gets rubella early in pregnancy, there is an 80 percent chance the baby
will be born deaf or blind, with a damaged heart or brain.
“Most kids have no reaction to their vaccinations other than minor
soreness at the injection site,” Dr. Peela says. “Sometimes
a child may experience a low-grade fever, a mild rash around the injection
site or a slight sense of fatigue or tiredness. The dangers associated
with not being vaccinated are far more serious than those fairly common
If you need help finding a physician for your child, visit www.whhs.com
and click on the tab for “Find My Physician.”
For a complete schedule of vaccines recommended by the CDC, visit www.cdc.gov/vaccines.
For recommendations from the American Academy of Pediatricians, visit
www.aap.org and click on the link for “Information for Parents.”
For information on immunizations from the California Department of Public
Health, visit www.cdhp.gov and click on the link for “Healthy Living”
under the tab for “Health Information.”