It’s that time of year when we think about immunizations. That’s because every January the American Academy of Pediatrics (AAP) and the Centers for Disease Control (CDC) issue an updated immunization schedule. The online version is on the CDC’s web site. There are three schedules: one for birth to 6, one for 7 to 18 and a “catch-up” schedule for kids who start late or have interruptions for whatever reason.
Immunization is an evolving science, and new vaccines are created all the time. Once we start getting experience with them, it’s not unusual to change the timing or number of doses. And sometimes vaccines get taken off the schedule, either because there’s a newer and better version, or (rarely) because of problems.
This year, there are only a few changes:
• The vaccine against H1N1 influenza was formally added for children 6 months and older (since it was developed after last January, it didn’t make it onto last year’s schedule)
• A booster dose of meningococcal vaccine is recommended for children at high risk of meningococcal disease (such as those without a spleen, or who have certain problems with their immune system). If your child has already received meningococcal vaccine, check with your doctor about if and when another dose is needed.
• Whenever possible, doctors are encouraged to use combination vaccines (such as Pentacel, which combines DTaP, IPV and HIB). They work as well as giving vaccines separately, and most kids would agree that the fewer shots, the better!
• There is a new vaccine against rotavirus, called Rotarix. It’s given in two doses, unlike the three doses of Rotateq. Both are effective. The choice will likely be based on availability and insurance coverage—if you have an infant less than 2 months old (which is when the first dose of either is given), check with your doctor.
• There are two changes related to immunization against human papilloma virus, or HPV:
First, there’s a new version, Cervarix, that protects against cervical cancer, but not genital warts or vulvar or vaginal cancers. It’s given in the same dose schedule as the existing version, Gardasil.
Second, doctors are encouraged to consider giving Gardasil to boys, to prevent genital warts and help decrease the spread of HPV (which is a sexually transmitted disease). It’s not an official recommendation at this point, just a suggestion. Talk it over with your doctor. You can visit the CDC site for more information on HPV vaccination.
As you look at the schedules and think about how the changes do or don’t affect your children, it’s a nice opportunity to stop and appreciate just how much of a difference immunization has made in the lives of children everywhere.
There’s been a 75 percent drop in deaths from measles worldwide—and the Americas are measles-free. According to a report from the United Nations and the World Bank, immunization saves 2.5 million children every year. And if all countries could fully immunize 90 percent of their children under 5, it would save two million more every year. That’s a lot of children.
It’s easy to get complacent, though, especially when we don’t see illnesses like measles anymore. Even chicken pox, which each year killed 100 children and hospitalized 10,000 before the vaccine was introduced in 1995, has become relatively rare. When you hardly see illnesses, it’s easy to think that vaccinating against them isn’t important. And indeed there is a “herd immunity” that helps protect unvaccinated children: if enough of the children around them are vaccinated, they are less likely to be exposed to vaccine-preventable illnesses.
But counting on herd immunity isn’t a good idea. First of all, every year there are cases of measles and other vaccine-preventable illnesses, many among children who come from other countries—and every year, they infect unvaccinated children. Second, if everybody starts counting on herd immunity instead of vaccinating, soon there won’t be any herd immunity—and the diseases, which used to kill or disable thousands of children, will come back.
So take a moment this January to learn more about immunization. The CDC’s web site is a great resource, full of information about specific vaccinations as well as the risks and benefits of immunization in general. Talk to your doctor. When it comes to your child’s health, the more you know, the better.