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Vaccinations: What Parents Need to Know

Vaccine facts to help you set your kids' immunization schedule

By the time your baby is 18 months old, he’s already had about 16 shots and 3 oral vaccinations to protect him from more than a dozen serious illnesses. He’ll need two to four more shots before Kindergarten, three more by age 11, two more before college and a flu vaccine every year. There can be confusion — and oftentimes misinformation — concerning immunizations, making it difficult for parents to separate fact from fiction. Here’s what you need to know.

Follow the vaccination schedule

Though you may want to shield your kids from the pain the shots will cause or believe spacing them out is a good idea, following your doctor’s guidelines is crucial to keeping your child — and others — safe.

CDC Vaccine Guidelines

Infant to age 6

7 to 18 years

“You have to play by the rules if you want the maximum effectiveness,” insists Gary Emmett, MD, director of hospital pediatrics at Thomas Jefferson University/Nemours in Philadelphia. For example, if you give a 12-month-old varicella (the chicken pox vaccine) and MMR (measles, mumps, and rubella) as two separate immunizations on the same date, they are extremely effective and have a low rate of side effects. But if you combine MMR and varicella in one vaccine, there is a much higher rate of side effects. And if you give each one “two or three weeks apart,” explains Dr. Emmett, “they don’t work as well.”

PreK immunizations

Delaware, New Jersey and Pennsylvania all require incoming Kindergarten students to be immunized before school begins.

“Enforcing the immunization guidelines helps to maintain a healthier population and protects children, their siblings, families, school staff members and other students who may have some immunocompromised conditions,” says Pat Guilday, lead nurse for the Brandywine School District in Wilmington, DE.

Families may refuse to have their kids vaccinated for religious reasons, by signing an affidavit. Those students are still placed in class with their peers but can cause problems for both themselves and their classmates.“When we have a scare of an outbreak, children who haven’t been immunized have to miss school,” says Guilday. “Those children can also introduce a disease back into the community.”

The herd effect

“All immunizations work not because one person gets it, but because everyone gets it,” says Dr. Emmett. “Measles is the most infectious disease in the Western world. You can get measles because you sat in a chair that someone with measles sat in four hours before you. There aren’t many diseases like that. To get it out of the population you have to have about 95 percent of the population immunized. So saying you’re going to take a chance with your child by not getting the vaccine is actually taking a chance with everybody’s child.”

Vaccinations and autism

There is no link between vaccines and autism, insists Dr. Emmett. It’s been widely posited that thimerosal, a preservative previously used in many childhood vaccines, could lead to autism spectrum disorders (ASDs). In 2001, thimerosal was removed or reduced to trace amounts in every childhood vaccine except one type of influenza vaccine, according to the Centers for Disease Control. No scientific link has been found that vaccines cause ASDs.

Choose the best flu vaccine

Flu vaccines, recommended at 6 months and then given once a year thereafter, are available in live nasal and dead injectable forms. For kids younger than 2, only the injectable vaccine is approved. Between a child’s 2nd and 9th birthdays, the nasal delivery is more effective and generally recommended, says Dr. Emmett. After age 9, it’s personal preference whether your child prefers a nasal spray or shot.

The importance of the HPV vaccine

Girls and boys should be given the HPV vaccine at 11 or 12 years old, before kids become sexually active — a must in order for the shot to be effective against HPV germs. Administered as a series of three shots over six months, it protects girls against cervical and other cancers and boys against rectal and throat cancers. “Lots of parents can’t deal with the shots because that implies their children will have sex,” says Dr. Emmett, but “it doesn’t have any correlation.”

Before a shot

Before letting your child know that a shot is due at an upcoming doctor’s appointment, consider the individual’s age and temperament. “Some kids really want to know ahead of time so they can prepare themselves, while other kids just worry about it,” says Athena Zuppa, MD, associate professor of anesthesiology and critical care at the Hospital of the University of Pennsylvania and the Children's Hospital of Philadelphia

As a mom of three, Dr. Zuppa doesn’t make a big deal about her three kids’ immunizations.  “We make the shot as invasive as the doctor looking in the ear,” says the Medford, NJ resident. “They [know they’ll] get their belly checked, their eyes checked and they may or may not get a shot.”

If your child is nervous about getting a vaccine, it’s helpful to hold her, squeeze her hand or rub her back or leg to take the emphasis off of the place where the shot is administered.

Dr. Zuppa believes that kids have trouble with long-term reward, so explaining to them that they need a shot to make sure they don’t get sick a few years down the road means very little, at least to younger kids. They better understand the immediate gratification of getting the lollipop or sticker that the doctor gives out.

Terri Akman is a contributing writer to MetroKids.

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