What is the recommended vaccine schedule?

Our clinic follows the standard immunization schedule endorsed by the Centers for Disease Control, American Academy of Pediatrics and American Academy of Family Practice. These are available at  AAP Immunization page.

We strongly recommend that your child receive vaccines according to the recommended schedule in order to provide your child with the strongest protections against these diseases at the earliest possible age. “Alternative” immunization schedules are non-standard have no basis in science and leave your child vulnerable to serious diseases for an extended period of time.

Diphtheria, tetanus, and pertussis (DTaP) vaccine

Whooping cough is a very dangerous disease, especially for infants. The risk of suffering and death caused by whooping cough is far greater than the possible side effects of the vaccine. A child who has not been immunized against pertussis has a chance of 1 in 3000 of getting whooping cough. In contrast, a child who got the vaccine has a chance of 1 in 2 million of having an serious adverse effect from the vaccine. The risk of children getting pertussis increases if fewer children in the community are immunized. A booster is recommend after age 11. Beginning in 2005 the booster (previously only containing tetanus and diphtheria) now contains a reduced dose of pertussis antigen to protect teenagers and those around them from whooping cough. Parents of young children should also make sure that they are vaccinated with this new booster, especially if a baby is on the way!

Measles, mumps, and rubella (MMR) vaccine

Measles continues to be a serious disease in other countries and easily imported into our country. Children should have the first shot when they are 12 to 15 months old and the second when they are 4 to 6 years old. These diseases are nearly gone from the U.S. However, they will come back if children are not fully vaccinated.

Haemophilus influenzae type b (Hib) vaccine

Haemophilus influenzae is a type of bacteria that causes several life-threatening diseases in young children (such as meningitis, epiglottitis, and pneumonia). Before the vaccine was available, over 10,000 children in the U.S. developed haemophilus meningitis each year. About 500 of them died and 3800 became mentally retarded, blind, or deaf, or got cerebral palsy as a result of the disease. Because of the vaccine, haemophilus influenzae type B is now uncommon in the U.S. The Hib vaccine does not protect against respiratory flu (influenza) and meningitis caused by viruses.

Hepatitis B vaccine (Hep B)

Vaccination against hepatitis B prevents this type of hepatitis and the severe liver damage that can occur 20 or 30 years after a person is first infected. More than 5000 adults die each year in the U.S. from hepatitis-related liver cancer or cirrhosis. The younger the age when the infection occurs, the greater the risk of serious problems.

Polio vaccine

The polio vaccine protects children from this now rare but crippling disease. The inactivated polio vaccine (IPV) is now recommended for all polio doses.

Chickenpox (Varicella) vaccine

The chickenpox vaccine is usually given between the ages of 12 and 18 months, but it can be given to older children if they have not had the vaccine or the disease yet. Children age 13 or older should get 2 doses at least 4 weeks apart.

This vaccine is 70% to 90% effective in preventing chickenpox. If vaccinated children get chickenpox, they have a much milder form of the disease. By being vaccinated, you can reduce the chance of missed work and school, skin infections, medical costs, and getting shingles later in life.

Pneumococcal (PCV13) vaccine

Pneumococcal infections are serious bacterial infections that may cause pneumonia, bloodstream infections, and meningitis. The PCV13 vaccine protects against the 7 types of pneumococcal bacteria that cause most of these serious diseases. The vaccine also prevents a small percentage of ear infections caused by pneumococci.

Routine use of PCV13 is recommended for all infants and toddlers less than 2 years old. Some children (up to age 5) who have a serious illness may benefit from the vaccine.

Rotavirus

The newest vaccine in the schedule is the rotavirus oral vaccine. Rotavirus is a viral cause of severe vomiting and diarrhea. It is not the only cause of viral “stomach flu” but it is the most severe. The use of the vaccine will reduce infections caused by rotavirus that often result in hospitalization and prolonged illness.

This is recommended for infants only. There is no catch-up recommended.

Hepatitis A vaccine (HAV)

The hepatitis A vaccine is recommended for children and adolescents in selected states and regions, and for certain people at high-risk. Talk to your health care provider or local public health department for more information.

Influenza vaccine

Healthy children age 6 to 23 months are recommended to get the influenza vaccine because they are at a greater risk of getting severely ill or needing to go to the hospital because of the flu. The influenza vaccine is also recommended each year for children ages 6 months and older if they have certain medical risk factors. The vaccine can also be given to anyone wanting immunity. Talk to your health care provider for more information.

Meningococcal vaccine (MCV4)

Meningococcal bacteriacauses “purple spots” on the skin, severe blood infections and meningitis. Vaccine has been available since 2005 that protects against 4 types of this bacteria. It is recommended beginning at 11 years old with a booster in the 16 to 18 year age group.

Human Papilloma Virus (HPV)

The latest addition to the schedule is a vaccine for the prevention of cervical cancer. The majority of cervical cancers are linked to infection by human papilloma virus. This is a sexually transmitted infection. The vaccine is a three dose series recommended for middle schoolers beginning at age 11. The initial recommendation was for girls only but in 2010 the recommendation was expanded to include boys. If the vaccine is given prior to the initiation of sexual activity it is very effective in preventing the majority of cervical cancers and genital warts.

Other vaccinations required for international travel

There are many additional vaccines that are recommended for travel to certain countries that are not part of the routine vaccination schedule. An excellent resource is the CDC travel information.

Vaccine controversies

The physicians of Childhood Health Associates are all strong believers in the benefits of vaccination in the prevention of serious infectious diseases.

Thimerisol (mercury containing preservative)

In 2000 the FDA reviewed all pharmaceuticals to evaluate for possible mercury exposures and calculated that with all vaccines currently recommended the possible exposure could exceed a level set for safety. An additional concern was also the potential increase in mercury in the environment from disposal of vaccine containers. No direct links with any diseases or developmental problems have ever been discovered; however, the decision was made to promptly reformulate vaccines to NOT contain that preservative any longer. All vaccines used by Childhood Health Associates, except for some forms of the influenza vaccine for older children, are free of thimerasol and have been so since 1998. However, long-term population studies continue to show no relationship between the old thimerosol-containing vaccines and any increase in neuro-developmental problems.

MMR and Autism

Dr. Andrew Wakefield published an article in 1998 about a small series of patients he had studied. His researched purported to show a higher level of measles antibodies in the intestinal tract of children with autism and theorized a causal link between MMR and autism. Since then the journal that published the article (the Lancet) as well as all authors (except for Dr. Wakefield himself) on the original article have retracted the article as poor science and frankly fraudulent. Dr. Wakefield’s license to practice medicine in the UK has been revoked. Multiple studies since then looking at large populations of children have not found any association between MMR vaccine and autism. These are done by looking at changes in vaccination rates (either increase or decrease) and compare to changes in rates of autism. The Institute of Medicine as well as numerous medical organizations have reviewed all available studies and not found any link between MMR (or any other) vaccine and autism.

Further Information

What shots does my child need for school in Oregon?

Shots required are the same as recommended on the shot schedule for kids entering kindergarten. The newest vaccines including meningococcal and HPV are not yet required for school participation.

Where can I get more information about vaccinations?

In the office we are required to make available information sheets about all the vaccines given in the clinic. These can be viewed fromimmunize.org which has multiple languages available.

Other online resources include: