What You Need to Know About Fall 2011 Vaccines

Many Oklahoma parents were surprised this year when they went to register their children for school to discover that some changes had been made to the state’s immunization requirements. Other parents may still be wondering exactly what their child received in what our pediatrician affectionately refers to as the “kindergarten special.” Immunization requirements can be confusing, and at times, controversial. An understanding of the requirements and the diseases they prevent is key in helping parents make informed choices about vaccinations.

An Immunization Primer

When it comes to vaccinations, everyone has an opinion. According to the recommended schedule, immunizations begin at birth, and continue at various intervals through adolescence. In addition, there are some vaccines that are recommended, but not required. The following immunizations are on the recommended schedule:

  • Hepatitis B. Hepatitis B is a viral inflammatory infection of the liver, which is spread by the exposure to bodily fluids. According to the World Health Organization, approximately 25 percent of the world’s population has been infected with Hep B. The synthetic form of the vaccine was introduced on the market in 1986, and is now routinely administered during the first 12 months of life, though the series can be given at any age. Schedule: three doses, with the first injection usually administered to newborns prior to leaving the hospital. Dose two follows a month later, and the third six months after the first.
  • •DTaP. DTaP is the acronym used for the collective immunizations preventing diphtheria, tetanus, and pertussis (whooping cough). This vaccine is indicated for children ages two months to six years and is often confused with Tdap. Schedule: five doses, typically given at two, four, six, and 15-18 months of age, with a booster between four and six years old.
  • Tdap. Similar to DTaP, Tdap protects against tetanus, diphtheria, and pertussis, and is given to adolescents or adults as a booster. Schedule: single dose given around 11-12 years old.
  • •Hib. Hib refers to the Haemophilus influenzae type B vaccination. This bacterium is the primary cause of childhood meningitis, and the vaccine has been used routinely in the United States since the early 1980s. Schedule: three or four doses; CDC recommends four doses, given at two, four, six, and 15-18 months of age.
  • Polio. Polio is an acute viral infectious disease. If the virus enters the central nervous system, it can lead to muscle weakness and various types of paralysis, depending on the nerves involved. The injectable vaccine was perfected and introduced in 1955, at the height of the polio epidemic, and while the disease has not been fully eradicated, cases are rare and are generally limited to less industrialized nations. Schedule: four doses, given at two, four, and six-18 months, with a booster given at about four to six years of age.
  • Pneumococcal Conjugate. Children under two are routinely administered PCV13, which covers 13 strains of Streptococcus pneumoniae, including pneumonia and meningitis. Schedule for children under two: Four doses, given at two, four, six and 12-15 months. The pneumonia vaccine can be given at any age, but those over the age of two receive the PPSV injection, which covers 23 strains of the bacteria. Schedule for those over age two: single dose.
  • Rotavirus. Protects against rotaviruses, which are the leading cause of diarrhea and vomiting among infants and young children. The vaccine is a fairly new addition to the list of recommended immunizations, and has been routinely used since 2009. The good news is that this product is generally administrated orally. Schedule: three doses, given at two, four, and six months of age.
  • MMR. MMR refers to the vaccine which protects against measles, mumps, and rubella (German measles). MMR has been the source of speculation and controversy, as it is believed by many to correlate closely with the onset of symptoms of autism spectrum disorders. The MMR vaccine tends to have a higher rate of adverse reactions, with approximately 10 percent of children developing fever, malaise, and/or a rash up to three weeks after the first dose. Approximately five percent will develop temporary joint pain. Schedule: two doses, given at 12-15 months and four-six years of age.
  • Hepatitis A. Protects against Hep A, an acute infectious disease of the liver, usually transmitted through contaminated food or beverages. Schedule: two doses, given six months apart. Typically started at 12-23 months of age.
  • Varicella. Protects against the virus commonly known as chicken pox. Schedule: two doses, typically given at 12-15 months and four-six years of age.
  • MCV4. Protects against meningococcus, which causes meningitis and septicemia.(Currently optional) Schedule: single dose, usually given at 11-12 years of age.
  • HPV. This optional vaccine is used to protect against Human Pappilomavirus, a sexually transmitted virus that causes approximately 70 percent of cases of cervical cancer in women and 90 percent of cases of genital warts in both genders. Schedule: three doses, with the second dose given two months after the first, and the final dose six months after the initial. The vaccine can be administered anytime prior to the onset of sexual activity to individuals nine years and older.
  • Influenza. This optional seasonal vaccine is highly variable, and is offered either as an inactivated injectable form or a live vaccine nasal spray. The vaccine protects against Flu types A and B, as well as H1N1. While mild side effects may occur with the injectable flu vaccine, it is not possible to develop the flu from the inactivated vaccine. Side effects from the injection are usually limited to soreness at the injection site, and in some cases, mild fever or body aches. Users of the nasal spray, a live vaccine, may experience fever, sore throat, body aches, headache, and nasal congestion. Flu vaccines reduce the number of hospitalizations due to complications of influenza by 70 percent. If those who have been vaccinated happen to contract the flu, they usually experience a milder case, with a shorter duration. Schedule: annually, ideally given in the fall. The vaccine takes about two weeks after administration to reach its full effectiveness.

Practical Advice

Edmond pharmacist Lee Lavender is co-owner of Hospital Discount Pharmacy, a provider for the state’s Vaccines for Children program. “The pharmacists here are certified through a program at Texas Tech University, and we hold immunization permits from the Oklahoma State Board of Pharmacy.” During the summer, they vaccinate around 200 children each month. “The rest of the year, we do anywhere from 20-50 immunizations a month.” They pharmacy also offers flu vaccines in the fall.
Many parents were surprised to discover that incoming seventh-graders were required to have the Tdap vaccine for enrollment. “The incidence of whooping cough has been increasing in the United States, especially for teens and babies younger than six months, so that requirement is new for this year.” In addition, Lavender and her staff encourage flu vaccines for adults and children who are over six months of age.
The best advice when making decisions about vaccinating your child is simply to get good information. Talk to your pediatrician, do your research, and remember—many people have very passionate opinions about immunizations, whether they’re for or against. Ultimately, parents have to decide what’s best for their child and their family after weighing the risks and benefits.
For more information from the Oklahoma State Department of Health, visit their website at www.ok.gov/health.

Other Back-to-School Health Concerns

Some illnesses just seem inevitable when kids go back to school. What infections should parents be concerned about? KidsHealth.org says these are the top five illnesses parents should look out for:

  1. Pinkeye. Also known as conjunctivitis, pinkeye is very contagious. Prevent spreading by washing hands often with warm water and soap, not touching eyes and sharing eye drops, makeup, pillowcases, washcloths and towels.
  2. Strep throat. Spreads through close contact, unwashed hands and sneezing or coughing. Prevent spreading by not sharing food, drinks, napkins or towels and teaching kids to sneeze or cough into a shirtsleeve, not their hands.
  3. Head lice. Anyone can get this infection; it’s not a sign of poor hygiene and lice do not spread disease. Parents should discourage sharing combs, brushes, hats and helmets with others to help prevent the spread of lice.
  4. Molluscum Contagiosum. This skin rash is common among kids up to age 12, yet many parents are not familiar with it. It spreads easily, most commonly through direct skin-to-skin contact, but kids can get it by touching objects with the virus on them such as toys, clothing, towels and bedding. Wash hands with soap and warm water and avoid sharing towels or other personal items to prevent spreading.
  5. Walking pneumonia: The leading pneumonia in school-age kids and young adults, spread through person-to-person contact or sneezing and coughing. It usually develops gradually and can be successfully treated with antibiotics. Encourage kids to wash their hands thoroughly and frequently to prevent spreading.

Shannon Fields is a freelance writer from Edmond and a Certified Pharmacy Technician at Innovative Pharmacy Solutions.

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