$Unique_ID{PAR00007}
$Pretitle{}
$Title{Medical Advice:  Immunizations}
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$Author{
Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{Immunization Immunizations vaccine vaccines immunized DTP Diphtheria
Tetanus Whooping cough PERTUSSIS POLIO poliomyelitis MMR Measles Mumps
Rubella SMALLPOX Hemophilus influenzae pneumococcal infection meningococcal
infections chicken pox typhoid typhus yellow fever influenza}
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Your Child:  A Medical Guide


Immunizations


     Despite the availability of vaccines that effectively protect children
against diseases that used to be killers, surveys repeatedly indicate that
almost 50 percent of American children are inadequately protected against
these diseases.
     The seven potentially devastating diseases against which all children can
and should be properly immunized are diphtheria, tetanus, pertussis (whooping
cough), polio, measles, mumps, and rubella (German measles).
     There are two reasons why so many children go unprotected against these
diseases.  First, many parents believe that polio, diphtheria, and whooping
cough no longer exist.  Second, people don't realize how dangerous these and
the other four diseases are.  Children die or are permanently disabled each
year as a result of these preventable diseases.  The statistics prove that
children are in danger from these diseases, and without immunization your
child is also at risk.
     Doctors use two types of immunization:
     Active immunization is achieved by injecting a weakened or killed virus
or bacterium into the body.  This stimulates the body's natural defense
system.  The body produces substances known as antibodies, which are
tailor-made to fight invading organisms.  The antibodies, which are carried in
the bloodstream, remain in the body for years, sometimes a lifetime, to
protect it against that particular disease.
     Passive immunization involves injecting ready-made antibodies--usually
extracted from the blood of animals in which immunity has been induced for the
sole purpose of producing a vaccine.  Passive immunization is only temporary
but serves to protect a person who may already be infected until the body has
time to create its own antibodies.
     The following sections explain how you can protect your child against
these diseases. (Refer to the articles on each of these diseases for full
information on the symptoms, diagnosis, and treatment.)

DIPHTHERIA, TETANUS, AND WHOOPING COUGH (PERTUSSIS)

     To be protected against these three diseases, infants must receive three
injections of the combined diphtheria-tetanus-pertussis (DTP) vaccine by the
age of six months.  The first injection is given at two months, followed by
two more administered every other month.  The child must receive a booster
shot of DTP vaccine at age 18 months and another booster shot at age four to
six years.  Thereafter, a booster of diphtheria-tetanus vaccine is necessary
every ten years for life.

     Diphtheria

     Diphtheria is a bacterial disease that is frequently fatal.  It causes
infection of the nose, throat, tonsils, and lymph nodes of the neck.  The
bacterium responsible can produce a toxin (poison) that causes heart damage
and paralysis.  Cases of diphtheria are reported in every state every year.
For every case reported, there are many carriers of the disease.  (A carrier
is a person who harbors the organisms that cause a disease without getting
sick himself or herself and who can transmit the disease to other persons.)
     Before the diphtheria vaccine came into general use 40 years ago, 80
percent of adult Americans were immune to diphtheria because they had had some
form of the illness in childhood.  This situation no longer exists, so adults
should receive booster shots of diphtheria vaccine every ten years.  Serious
reactions to the diphtheria vaccine are rare.

     Tetanus

     Tetanus, or lockjaw, is a serious disease of the nervous system that is
caused by a bacterium that can enter the body through a wound--even a minor
wound like a scratch or an insect bite.  Cases of tetanus are reported every
year.
     The vaccine is thoroughly safe and effective.  However, its protection
weakens over the years, and booster shots are necessary.  Medical opinion
differs as to how often boosters should be given.  The American Academy of
Pediatrics states that after receiving a booster at the age of four to six
years, a person should receive a booster every ten years for life.  The
American College of Surgeons believes that boosters are necessary every five
years to ensure protection from tetanus that results from the type of minor
wound that is unlikely to be treated by a doctor.
     As a general rule, if your child receives a relatively clean wound, such
as one from a kitchen utensil, you should be sure that he has had a booster
within the past ten years; but if he receives a "dirty" wound (for example, a
wound from a nail or any wound that happens outdoors), you should check to see
that he has received a booster within the past five years.  Adults should
receive boosters at least every ten years.

     Whooping cough

     Whooping cough is more common than many parents (and doctors) realize.
It is a highly contagious infection of the respiratory tract, which gets its
name from the severe, strangling cough that develops as the disease
progresses.
     Whooping cough vaccine is the most uncertain of the three components of
the DTP vaccine, because it does not give complete immunity.  There have been
extremely rare instances of brain damage following its use, but in some of
these cases the damage was caused by faulty administration of the vaccine
rather than by the vaccine itself.  The vaccine may also cause a brief
reaction of fever.  For these reasons, routine boosters are not recommended
after the child receives a booster at the age of four to six years.  However,
the mortality rate among infants under age one who contract whooping cough and
the possibility of complications in older children are high enough to exceed
by far the minimal risk of the vaccine.
     In England, serious reactions to the vaccine were sufficiently frequent
at one point to persuade the medical profession to suspend its use.  However,
because of the increasing incidence of whooping cough and its severe
complications, immunization has now been reinstituted in England.

POLIO

     Polio, also known as poliomyelitis and infantile paralysis, is an
infection of the spinal cord that can, in 1 to 2 percent of cases, lead to
paralysis or death.
     Outbreaks of polio still occur in this country, and infants should
receive two or three doses of the Sabin vaccine, which provides protection
against all three types of polio.  The first dose should be given at two
months, with the second and third doses separated by intervals of six weeks to
two months.  This vaccine is given by mouth, not as an injection.  A booster
series should be given at the age of one-and-a-half to two years, and again at
four to six years.  Children who were not immunized in infancy should receive
a total of three or four doses, depending on their ages.  The Sabin vaccine is
undoubtedly safe for children.
     Adults who are not immune and who plan to travel to a country where polio
is uncontrolled should also be immunized.  In fact, all adults should be
immunized against this disease.  Some medical authorities believe that the
risk of an adult being exposed to polio within the United States is minimal,
and therefore adult immunization is unnecessary.  However, too many cases of
polio have occurred in adults over the age of 30 to make this argument
acceptable.
     Because the Sabin vaccine is a "live" vaccine (meaning that it contains
live organisms), it does carry a slight risk of polio for adults.  However,
the Salk vaccine (a dead vaccine, prepared from inactivated organisms) does
not.  Adults who are not immune should receive an initial series of Salk
vaccine to acquire temporary immunity, followed by a full series of Sabin
vaccine for permanent protection.

MEASLES, MUMPS, AND RUBELLA

     The live measles-mumps-rubella (MMR) combination vaccine should be given
to children at the age of 15 months.  It confers long-term (probably lifelong)
immunity against all three diseases.

     Measles

     Measles is a contagious viral disease that affects mainly the respiratory
system, the eyes, and the skin.  It is considered dangerous mainly because its
complications can include pneumonia (inflammation of the lungs), encephalitis
(inflammation of the brain), and ear infections.  Because most children are
now vaccinated against it, measles is seldom seen today.  The risk of a child
contracting encephalitis from the vaccine is less than one in a million, and
pneumonia and ear infections are never seen as a consequence of immunization.

     Mumps

     Mumps is a contagious viral disease that causes swelling of the parotid
glands, which are the salivary glands beneath the ear.  Mumps can be painful
and uncomfortable, but seldom has long-term complications.  The most serious
complication of mumps is encephalitis (inflammation of the brain), which can
be followed by hearing loss or deafness.  The mumps vaccine, which is included
in the MMR vaccine, is harmless to the child and is 95 percent effective in
preventing the disease.

     Rubella

     Rubella, or German measles, is a contagious viral disease that produces
mild, cold-like symptoms and a short-lived rash.  The disease is not usually
dangerous except when it is contracted by a pregnant woman.  In the first
three to four months of a pregnancy, rubella can affect the unborn child and
cause serious, lifelong problems.  Now that the vaccine is available and
routinely given to young children, rubella is fairly uncommon.  The last major
outbreak was in 1964-1965.  Nevertheless, a pregnant woman should take care to
avoid exposure to the disease, and a child who contracts rubella should be
kept away from anyone who is or might be pregnant.  Very rarely, the rubella
vaccine causes transient (temporary) arthritis in older children.

SMALLPOX

     Vaccination against smallpox, a highly contagious disease that used to
occur in epidemics, is no longer practiced in the United States.  According to
the World Health Organization, smallpox has been eradicated from the entire
world.

OTHER VACCINES

     A vaccine is now available to protect against Hemophilus influenzae virus
infection.  It is recommended that all children in day care receive this
vaccine when they are 18 months old and that all other children receive it
when they are about two years old.
     A vaccine against pneumococcal infection is available for use in children
in certain high-risk groups.  A vaccine against meningococcal infection is
still in the experimental stage and is used only in specific cases.
     A vaccine to prevent chicken pox has recently been developed but is not
available for general use.
     Vaccines against typhoid, typhus, yellow fever, and influenza are
presently available.  None of these is yet recommended for children unless a
child will be at special risk.  Consult your doctor if you are in doubt.

RELATED TOPICS:  Diphtheria; Influenza; Measles; Meningitis; Mumps; Pneumonia;
Polio; Rubella; Tetanus; Whooping cough