Immunize My Children: Should I or Shouldn't I?
By Chris Watson, MD
Immunizations are an important part of staying well. Some of the greatest advances in medicine include vaccinations to prevent polio, measles, mumps, chickenpox, tetanus, influenza, hepatitis, rotavirus, haemophilus, diphtheria, pneumonia, meningitis, and pertussis. We are fortunate to be able to benefit from the great work of medical scientists by immunizing our children and ourselves.
At Avista Family Medicine – Erie, I promote the immunizations recommended by the Center for Disease Control's (CDC) Advisory Committee on Immunization Practices (ACIP). This is a government sponsored committee of experts in the field of immunization that reviews immunizations approved by the Food and Drug Administration (FDA) as safe and effective. Specialty societies from internal medicine, pediatrics, obstetrics, and family medicine normally align their recommendations with ACIP.
Benefits: The major benefits are reduction in risk of getting the diseases that the immunizations target. Since diseases like polio, diphtheria, and tetanus are rare, it is easy to forget the disability and death that they cause. Occasionally, we hear of outbreaks of rubella, measles, pertussis, chickenpox, and meningitis in the news. This is usually related to incomplete immunization of the population at risk.
We now live in a global community, and need to realize that because of travel we share the risks of diseases present all over the world. In 2011, cases of measles in the USA are already higher than the total year for every year since 1996. One third of these cases were traced directly to travel from other countries. A surprising fact is that one half of those imported cases of measles came from the European Union countries, and a large portion of those were from France. One might think that a modern, "civilized" country wouldn't be a source of disease like measles for the USA, but it is.
The human papilloma virus (HPV) vaccine is special in its ability to prevent most cases of cervical cancer. It is recommended (3 shots total) starting at age 11. Pneumonia (PPSV) vaccination can prevent many cases of pneumonia and its related complications. This vaccine is recommended for smokers, people with lung disease (asthma, COPD, emphysema), others with chronic diseases (diabetes, heart disease, kidney failure, cirrhosis, or immune deficiency), and in everyone over age 65. Shingles is a painful condition caused by varicella-zoster, the same virus that causes chickenpox. It can be prevented by immunization at age 60 with Zostavax.
Risks: The typical side effects include pain and soreness at the site of injection that lasts for a day or two. Each injection has its own set of less common side effects, such as headache, body aches, fever or irritability. One concern raised by some parents is the possible connection between specific immunizations, or mercury- based preservatives, and conditions like autism. A great deal of good scientific research goes into making sure that every immunization is safe to give to our children, and continuous information is gathered to make sure we learn and improve our efforts. To date, the cause of autism is unknown and no good study shows a scientific causal link between any immunization or preservative and autism. In addition, none of the current immunization products contains mercury-based preservatives.
In my opinion, the risks of not immunizing far outweigh the risks of getting immunizations for your family at the scheduled time. For children this starts at birth with hepatitis B and continues at most well child visits through the first two years of life. Likewise, adolescents and adults have additional immunizations that are recommended routinely. If you have questions, feel free to ask at your appointment.
You can review the recommended schedule at the following websites:
http://www.cdc.gov/vaccines/spec-grps/infants/downloads/parent-ver-sch-0-6yrs.pdf
http://www.cdc.gov/vaccines/who/teens/downloads/parent-version-schedule-7-18yrs.pdf
http://www.immunize.org/catg.d/p4030.pdf
Website resources to provide further information about immunization:
http://familydoctor.org/familydoctor/en/health-tools/immunization-schedules.html
http://www.mayoclinic.com/health/vaccines/CC00014
http://www.cdc.gov/vaccines/recs/acip/
