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Immunization Schedule

The availability of effective and safer vaccines and new recommendations from the American Academy of Pediatrics continue to necessitate changes in our immunization schedule. The following is a schedule applicable to most children. In some cases, such as minor illnesses, certain vaccines may be postponed. Most of the immunizations are given in the first year of life.

The Vaccines

Pediarix is a combined vaccine that contains DTaP, IPV and Hepatitis B.

• DTaP - protects against three diseases. Diphtheria causes a thick coating in the nose and throat, closing the airway and leading to breathing problems and sometimes death. It can also cause heart failure. Tetanus (lock jaw) causes painful muscle spasms throughout the body, particularly stiffness around the jaw which can prevent breathing and can be fatal. Pertussis (whooping cough) causes severe coughing spells which can interfere with eating, drinking, and breathing. The disease can lead to pneumonia, seizures, brain damage, and death. The DTaP (acellular DTP) is a new vaccine that has fewer side effects than the older DTP.
• IPV- protects against polio, a sometimes fatal disease which can cause permanent muscle damage and paralysis. The previously used oral form of polio vaccine,OPV, is no longer used. OPV carries a very small risk (about 5 cases a year in the US when it was used) of causing polio disease. IPV, the injection form of the vaccine, carries no risk of causing the disease and is the only form available in the US presently.
• Hepatitis B - Protects against Hepatitis B, a liver disease which can lead to cirrhosis of the liver, liver failure, and liver cancer.
  

HIB - Protects against H. influenza B, a bacterium which causes meningitis, pneumonia, joint infections, and epiglottitis (a disease in which the airway closes preventing breathing).

Prevnar - Protects against serious infections caused by the pneumococcus bacteria. Pneumococcus has become a common cause of highly morbid bacterial meningitis in infants and young children (prior to the routine use of HIB vaccine, HIB was the most common cause of meningitis in this age group). Pneumococcus is also a frequent cause of pneumonia, sinusitis, and middle ear infection.

Proquad is a combination vaccine containing MMR and Varivax that can be used at 5 years. At 15 months, the two must be given separately.

• MMR - Protects against three diseases. Measles causes a rash and can lead to pneumonia, encephalitis, and brain damage. Mumps causes painful swelling of the glands that produces saliva. It can lead to meningitis, encephalitis, deafness, paralysis of facial muscles, pancreatitis, and damage to the reproductive system after puberty. Rubella (German measles) causes a rash and joint pain. In pregnant women rubella can result in miscarriage, stillbirth, or blindness, deafness, or mental retardation in the baby.

• Varivax - Protects against varicella-zoster (chicken pox). Although a usually uncomplicated and self-limiting disease in children, chicken pox can cause pneumonia, joint pain, liver inflammation, or encephalitis. Occasionally the skin lesion can be the entry point for serious bacterial infection. The Center for Disease Control (CDC) reports between 4,000 and 9,000 hospitalizations and between 100 and 125 deaths annually in the U.S. as a result of chickenpox.
  

Rotavirus - protects against a virus that causes severe diarrhea, mostly in babies and young children. It is often accompanied by vomiting and high fever. This is an oral vaccine only given to infants.

TdaP - Tetanus and Purtussis booster now recommended at age 12 and every 10 years after throughout life.

Menactra - protects against Meningococcal disease which is a serious bacterial illness. It is the leading cause of bacterial meningitis in children 2-18 years old in the U.S. Meningitis is an infection of the brain and spinal cord coverings. Meningococcal disease can also cause blood infections.

HPV - protects against Human Papillomavirus. Certain types of HPV can cause cervical and genital cancer. This a 3 dose series that begins in early adolescence.

There are several other vaccines that may be indicated in special situations (international travel, dormitory dwelling) which your doctor may recommend in addition to the standard schedule listed above.Note: Prevnar is the only vaccine currently not required for entry into daycare or school. However, in accordance with recommendation from the American Academy of Pediatrics, we do recommend this vaccine.

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