I. PRACTICAL TIPS ABOUT VACCINES1. FEAR OF SHOTS
• 3 P’s for helping children/infants during vaccinations.- Pharmacological (pain medicine): - topical anesthesiaand sugar water (infants).- Psychological (thoughts and behaviors): - Hold andbreast feed(for infants); Breathing deeply (children) anddistractions.- Physical (Body positions and Activities): Breathedeeply (parent) and distract(infant); hold in lap…1. FEAR OF SHOTS
2. WHO SHOULDN’T GET VACCINE• Any child who has had a severe reaction to a vaccine should notreceive another dose of the same vaccine.• Severe reactions include:- DIFFICULTY BREATHING- HIVES- LOW BLOOD PRESSURE- SHOCK- USUALLY OCCURING IMMEDIATELY AFTER RECEIVEINGTHE VACCINE(SHOT).• Weakened vaccines shouldn’t be given to children withleukemia, lymphoma and other types of cancers or AIDS.• The live, weakened vaccine include MMR and Varicella vaccine.
2. WHO SHOULDN’T GET VACCINE(VACCINE REACTION RATE)
3. VACCINATING CHILDREN WHO LIVE WITHSOMEONE WITH WEAKENED IMMUNITY
• Children living with someone who has weakenedimmunity (such as leukemia, lymphoma and other typesof cancers) can receive all types of vaccines that arerecommended for children.• Children who receive vaccines that contain only a partof a virus or bacterium (hepatitis B, Hib, DTaP) or akilled virus (IPV) are also not contagious.3. VACCINATING CHILDREN WHO LIVE WITHSOMEONE WITH WEAKENED IMMUNITY
4. CHILDREN WHO ARE ILL• Unfortunately, illness is common reason for manychildren to miss vaccines.
4. CHILDREN WHO ARE ILL (CONTD…)• It is safe to give all of the recommended vaccines tochildren with minor illness.Minor illness include:- low grade fever- ear infections, cough, running nose, diarrhoea, orvomiting.• Several studies found that children with minor illnesswere not at greater risk of side effects and had a similarimmune response after immunization as childrenwithout minor illnesses.
5. CHILDREN WITH PREGNANT MOTHERS• Sometimes infants and toddlers are scheduled toreceive vaccines at the same time that their mother ispregnant.• Children who receive live, weakened vaccines(Measles, Mumps and Rubella or Varicella) are notlikely to be contagious.• Therefore, a child whose mother is pregnant mayreceive all the recommended vaccines.
6. CHILDREN WHO ARE BREAST FEEDING• It is unlikely that the antibodies found inbreast milk can interfere with the ability ofvaccines to induce protective immunity ininfants.• Therefore, all infants who are breast-feeding may receive all the recommendedvaccines.
7. CHILDREN WHO TAKE STEROIDS• Steroids are commonly given to children with commondiseases such as Asthma, or poison envy.• Since steroids can weaken the immune system,parents ask whether it is safe to give vaccines at thesame time children are getting steroids.• The answer is Yes or NO.• It is safe for children who received steroidscream or steroids sprays(aerosols) to getvaccines.
7. CHILDREN WHO TAKE STEROIDS (CONTD…)• Vaccines are also safe for children who receivedsteroids for less than 2 weeks. However, children whoreceived high doses(2mg per kg of body weight) ofsteroids per day of prednisone or its equivalent bymouth for more than 2 weeks should not receive like,weakened virus vaccines (specifically, MMR orVaricella)• High Doses of Steroids may decrease child’s ability tofight infection, as well as the ability to build up immunityafter vaccination.
8. CHILDREN WITH ANTIBIOTIC ALLERGIES• Some Children have severe allergies reactions to Antibiotics.• These reactions may include hives, difficulty breathing, lowblood pressure or shock.• None of the vaccines contain antibiotics to which children areusually allergic.• Some vaccines contain trace amounts of antibiotics that areextremely rare cause of allergic reactions and to which mostchildren are never been exposed (Specifically, neomycin,polymixin B, and Streptomycin)• Therefore, Children Allergic to penicillin, amoxicillin,Cephalosporin, or sulfa drugs may receive all recommendedvaccines.
9. CHILDREN WITH EGG ALLERGIES• Some children are highly allergic to proteins in eggs.• Allergic reactions includes Hives, difficulty breathing and shock.• Both Measles and Mumps vaccines are made in cells originallyderived from chick eggs. However, not enough chick proteinsare contained in the final vaccine preparations to causeproblems.• Recent studies have shown that even children with severe eggallergies can receive Measles – Mumps Vaccines withoutdifficulty.• Children with severe egg allergies should not, however receiveeither the Influenza or Yellow fever vaccines.
10. PREMATURE BABIES• Most premature infants, including those with low birthweights, can be immunized at the usual chronologicalage.
• The only exception to this rule is the Hepatitis Bvaccine. Premature infants (children born within 36weeks’ gestation with a birth weight of less than 4.4pounds) whose mothers are not infected with theHepatitis B virus should receive the vaccine at twomonths of age rather than at birth.• Those premature infants whose mothers are infectedwith the Hepatitis B should receive vaccine at birth,independent of body weight.10. PREMATURE BABIES (CONTD…)
11. GIVING VACCINES SIMULTANEOUSLY• Because children receive 11 vaccines routinely, somechildren could receive 4-5 vaccines during a single visitto the doctor.• Some manufacturers are working for combinedvaccines.• All routinely recommended vaccines can be givensimultaneously, there is no evidence that giving onevaccine significantly interferes with the immunitycaused by another. Nor is there evidence that any ofthe vaccines increases the rate of side effects ofanother. Different vaccines should, however, be givenat the same sites of the body.
12. MISSED VACCINES• A missed vaccine doesn’t mean that the seriesmust be started all over again/. If a dose ofDTaP, IPV, HiB, or hepatitis B is missed, theseries of immunizations can be continued afterthe missing dose(s) is given.
13. VACCINATING CHILDREN ADOPTED FROMOTHER COUNTRIES• Children vaccinated in other countries should beimmunized according to the same schedule as thatrequired for children in the current country. However, awritten record of immunization should be provided asevidence that a child has been vaccinated ether inthis country or elsewhere.
13. VACCINATING CHILDREN ADOPTED FROMOTHER COUNTRIES• The majority of vaccines made in other parts of the world,including developing countries, are produced with adequatequality control standards and are of reliable potency.
II. COMMON CONCERNS ABOUT VACCINES1. VACCINES DON’T WORK• best example of the impact of vaccines: -the vaccine that prevents meningitis caused by the bacteriumHaemophilus influenzae type b (Hib).• After, the introduction of Hib vaccine, the incidence of Hibmemingitis declined to fewer than 50 cases per year from15,000 cases (during 1990).• A Dramatic reduction in the incidence of diseases such asmeasles, mumps, German measles, polio, diphtheria, tetanus,and pertussis occurred within several years of the introductionof vaccines against them.
VACCINES WORK• VACCINES NOT ONLY WORK, BUT THEY WORK PHENOMENALLY WELL.
2. VACCINES AREN’T NECESSARY• In some ways, vaccines are victims of their own success.• Most young parents have never seen a case of some diseases.So they question the continued need for vaccines.• Vaccines should be given for 3 reasons:- prevent some highly prevalent diseases within the country(polio)- Prevent some diseases still present in the environment(measles)- Prevent some diseases which have been virtually eliminated inthe country but may b prevalent in other areas of the world(disease might be acquired during international travel)
3. VACCINES ARE NOT SAFE• in some cases, a person’s immune system will notgenerate an adequate response. As a result, he or shewill not be effectively protected after immunization.• That said, the effectiveness of most vaccines is high.The inactivated polio vaccine offers 99% effectivenessafter three doses. The varicella (chickenpox) vaccine isbetween 85% and 90% effective in preventing allvaricella infections, but 100% effective in preventingmoderate and severe chicken pox.
3. VACCINES ARE NOT SAFE (CONTD…)• Almost all vaccines can cause pain, redness, or tenderness atthe site of injection. And some vaccines cause more severe sideeffects.Example: Pertussis vaccine can cause persistent, inconsolablecrying or high fever.Although none of the severe symptoms results in permanentdamage, they can be quite frightening to parents.• Vaccines are brought in use (licensed) only after successful trialon a number of cases.• Information about the side effects of vaccines are on VaccineSafety Datalink (VSD)
4. INFANTS ARE TOO YOUNG TO BEVACCINATED• Children are immunized in the first few months of life becauseseveral vaccine-preventable diseases infect them when they arevery young.Eg: Pertussis, Hib meningitis, Hepatitis B, and so on.
5. IT’S BETTER TO BE NATURALLY INFECTEDTHAN IMMUNIZED• ―Natural‖ infection almost always causes better immunity thanVaccination (only the Hib, pneumococcal, and tetanus vaccines r betterat inducing immunity than natural infection.• Natural infection causes immunity after just ONE infection, vaccinesusually cause immunity only after several doses are given over anumber of years (example: DPT, Hepatitis B, etc are given at leastthree times) But,• Natural infection from polio virus can cause paralysis, Mentalretardation from Natural Hib infection, Liver failure from Hepatitis B andso on.• THE BENEFITS OF VACCINE-ACQUIRED IMMUNITYEXTRAORDINARILY OUTWEIGH THE SERIOUS RISKSOF NATURAL INFECTION.
• Infants and young children commonly encounter and managemany challenges to their immune system at the same time.• 20 years ago children received 5 shots by two year of age andas many as 2 shots at one time, now we have 11 routinelyrecommended vaccines, children receive as many as 20 shotsby 2 yrs of age and five shots at a single visit. Many parents areconcerned abt whether children can handle these vaccines.• But vaccines are just a small part of what babies or childrenencounter everyday6. CHILDREN GET TOO MANY SHOTS
7. VACCINES WEAKEN THE IMMUNE SYSTEM• Natural infection with certain viruses (wild type) canindeed weaken the immune system. For example:Children infected with measles are more susceptible tobacterial infections of the bloodstream (sepsis)• But vaccines are different. The vaccine are themselvesso disabled that they cannot weaken the immunesystem.
8. VACCINES ―USE UP‖ THE IMMUNE SYSTEM• Dr. Meh Cohm and Dr. Rodney Langman theorized that, ―the no.of MOS to which a body can respond depends on the no. ofcells in the blood that can make antibodies sufficient torecognize all the relevant parts of the MOS.Using this theory, it stood to reason that the no. of MOS towhich one response depends on one’s size. Elephant canproduce immunity to abt 100 times more MOS than humans.• Although adult humans could make more antibodies to moreorganisms than infants, scientists estimated that even younginfants could respond to abt 100,000 different orgns at one time.Therefor, 11 vaccines use only abt 0.01 percent of the immunitythat is available.
9. SOME VACCINES CONTAIN OTHERINFECTIOUS AGENTS THAT MAY DAMAGE MYCHILD• Vaccines that are made with killed versions of pathogens—or with only a partof the pathogen—are not able to cause illness. When a person receivesthese vaccines, it is nearly impossible for him or her to become ill with thedisease• It is important to note that attenuated vaccines can cause serious problemsfor individuals with weakened immune systems, such as cancer patients.These individuals may receive a killed form of the vaccine if one is available.If not, their doctors may recommend against vaccination. In such cases,individuals rely on herd immunity for protection.• live, attenuated vaccines generate longer-lasting immunity than killedvaccines. Thus, killed vaccines are more likely to require boosters tomaintain immunity. Killed vaccines, however, also tend to be more stable forstorage purposes, and can’t cause illness.
10. VACCINES CAUSE AUTISMS• This possibility was publicized after a 1998 paper by a Britishphysician who claimed to have found evidence that the MMR(measles, mumps and rubella) vaccine was linked to autism.• The potential link has been thoroughly explored; study afterstudy has found no such link, and the original 1998 study hasbeen formally withdrawn by the Lancet, which had originallypublished it.• It’s likely that this misconception persists because of thecoincidence of timing between early childhood vaccinations andthe first appearance of symptoms of autism.
11. A MERCURY CONTAINING PRESERVATIVE(THIMEROSOL) CONTAINED IN MANYVACCINES HARMS CHILDREN.• The preservative, thimerosal ( Thiosalicylic acid + Mercury),which is used in some vaccines. The mercury contained inthimerosol is an organic form called Ethylmercury.• Preservative protect vaccines from bacterial contamination,however multidose vials can be contaminated and lead to mildor fatal infections. Mercury in high amount can cause damage tothe nervous system and kidney. Hence, IOM recommends DTaP,Hib, and Hepatitis B vaccines free from thimerosol to be used inUSA.• Studies have shown that low level thimerosol, in vaccines doesnot cause neurological problems or autism.
12. THE HEPATITIS B VACCINE CAUSESSUDDEN INFANT DEATH SYNDROME (SIDS)• Every year in the USA thousands of infants die of SIDS. TheHepatitis B vaccine is now routinely recommended for infants asa series of three vaccines. Therefore, some infants who get thehepatitis B will invariably die from SIDS – Some will die fromSIDS soon after the vaccine is given. But it doesn’t mean thatchild who get Hepatitis B vaccine are more likely to die fromSIDS.• The cases of SIDS has decreased after the American Academyof Pediatrics recommended ―Back to Sleep‖ for infants, ie,parents were asked to let infants on their back instead of facedown. The result was a dramatic decline in SIDS and provedthat SIDS was not related to vaccines.
13. PHARMACEUTICAL COMPANIESOCCASIONALLY MANUFACTURE LOTS OFVACCINES THAT CAUSE HIGH RATES OFADVERSE EVENTS (―HOT LOTS‖)• Individual lots of vaccines that have usually highrates of side effects have never been identified(in USA).• Hence, specific lots of vaccines have never beenwithdrawn from use as ―hot lots‖
14. VACCINE PREVENTED DISEASES OCCURMORE OFTEN IN VACCINATED PEOPLE THANIN NON-VACCINATED PEOPLE.• On its face, this statement seems to be actually true.However, it is important to understand why?• Lets study a situation,- 100 students live in a dormitory of a college…• It is reported that unvaccinated people have 35 timesmore chance of getting Measles than Vaccinated.
15. WHY CAN’T WE ERADICATE OTHERDISEASES, AS WE DID WITH SMALLPOX?• In theory, nearly any infectious disease for which an effectivevaccine exists should be eradicable.• With sufficient vaccination levels and coordination betweenpublic health organizations, a disease can be prevented fromgaining a foothold anywhere; eventually, without anyone toinfect, it must die off.• A notable exception is tetanus, which is infectious but notcontagious: it’s caused by a bacterium commonly found inanimal feces, among other places. Thus, tetanus could not beeradicated without completely removing the Clostridiumtetani bacterium from the planet.
15. WHY CAN’T WE ERADICATE OTHERDISEASES, AS WE DID WITHSMALLPOX?(CONTD…)• Smallpox is unusual, however, in the set of characteristics that made itsusceptible to eradication. Unlike many other infectious diseases, smallpoxhas no animal reservoir.• Another obstacle to eradication for many infectious diseases is visibility.People with smallpox were highly visible: the smallpox rash was easilyrecognizable, so that new cases could be detected quickly. Vaccinationefforts could be focused based on the location of the cases and potentialexposure to other individuals.• Polio, by contrast, causes no visible symptoms in about 90% of the people itinfects. As a result, tracking the spread of the polio virus is extremely difficult,which makes it a difficult eradication target.
• Perhaps most importantly, smallpox patients generally did not reach theirhighest level of infectivity (that is, their ability to infect others) until after theappearance of the smallpox rash. As a result, quick action to quarantineinfected individuals upon the eruption of the rash usually left enough time tovaccinate anyone who had already been exposed, and prevent additionalexposures.• Many infectious diseases do not allow for this kind of reaction time. Measlespatients, for example, can become infectious up to four days before theappearance of the measles rash. As a result, they can pass the virus on tomany, many other people before anyone even knows that they are infected.• Many people still think eradication is possible for certain diseases. Efforts areongoing to eradicate several diseases, such as polio and Guinea wormdisease (Dracontiasis)15. WHY CAN’T WE ERADICATE OTHERDISEASES, AS WE DID WITHSMALLPOX?(CONTD…)
16. WHAT IS HERD IMMUNITY? IS IT REAL? DOESIT WORK?• Herd immunity, also known as community immunity, refers to theprotection offered to everyone in a community by highvaccination rates. With enough people immunized against agiven disease, it’s difficult for the disease to gain a foothold inthe community.• This offers some protection to those who are unable to receivevaccinations—including newborns and individuals with chronicillnesses—by reducing the likelihood of an outbreak that couldexpose them to the disease.
17. The hepatitis vaccine causes arthritis, multiple sclerosis, andlong term (chronic) neurological disorder.18. Vaccines causes Diabetes.19. The DPT vaccine causes a disease that looks like ―shakenbaby‖ syndrome.20. The polio Vaccine is the cause of AIDS.21. The polio vaccine is contaminated with a virus that causescancer.22. Vaccines may contain the agent that causes ―Mad Cow‖disease.II. OTHER COMMON CONCERNS ABOUT VACCINES