It may seem hard to believe, but in just a few weeks the kids are heading back to school. As you check the school supplies list, making sure they're ready for that big day, you'll want to check their vaccination record as well. This year, new requirements might have them baring their arms for better health.
What's new for this school year?
The Pneumococcal Conjugate Vaccine (PCV) is now required for children attending licensed daycare. This vaccine helps prevent pneumonia, meningitis, and ear infections caused by the pneumococci bacteria. A pertussis booster (Tdap) has been added for children in grades 6, 9 and 12 to help prevent whooping cough. Other students will be required to obtain the booster next year. A chicken pox booster (Varicella) is required for children entering kindergarten, grade 6 and grade 12. Again, other students will be required to receive the booster next year.
These new shots are in addition to those children should already have by the time they enter kindergarten like diphtheria, tetanus and pertussis; measles, mumps and rubella; chicken pox and hepatitis B.
So why the changes?
In 2004, Wisconsin had the fifth highest rate of pertussis in the country. Statistically, 2 in 100 adolescents with pertussis are hospitalized or have complications. While people may not have heard of them recently, these diseases are still out there. Vaccines not only protect your children, in some cases they help build a base of immunity in the community to protect others, too.
"Take chicken pox for instance," says St. Mary's pediatric hospitalist Heather Rainwater. "It causes itchy skin irritations in most children. But if you're pregnant with chicken pox it can be devastating or fatal to the fetus. Keeping kids healthy helps pregnant moms stay healthy, too."
Why vaccinate at all? Aren't these diseases all gone?
The CDC says immunization is one of the most important public health inventions since safe drinking water. It has saved millions of lives and prevented hundreds of millions of cases of disease. Polio has been declared eradicated from the globe thanks to vaccinations. Just 40 years ago, it was the feared paralyzer of children. The same can be said for a host of other diseases. Diphtheria used to be one of the most dreaded of childhood diseases, killing more than 10,000 Americans each year. After we started vaccinating children in the 1930s and 1940s, the disease began to disappear. Today, most doctors will never see a single case of diphtheria, much less have a child die from it.
"Immunizations protect children against diseases that many people aren't even familiar with anymore because the immunizations have been so effective," explains Larry Elfman, MD, pediatrician at the Dean West Clinic in Madison.
"Just because these diseases aren't seen anymore, doesn't mean we should stop vaccinating," advises Dr. Heather Rainwater. "We've had a measles, mumps and pertussis outbreak recently so they're not as uncommon as you might think. If we were to stop vaccinating now, those diseases would start to show up again in at-risk populations."
As it is, vaccinations aren't 100 percent effective. However, because enough people in the community receive the shots, it helps reduce the odds dramatically of an illness becoming widespread in a particular region.
"If not enough get vaccinated it leaves a reservoir of people who can pass it," says Dr. Rainwater.
The flu, for example, mutates each year. So it's important for kids to have a flu shot each year so they're protected from the latest strain. Some skip the shot for fear of getting sick.
"There's no reason to be scared of this particular shot at all," says Dr. Rainwater. "The flu vaccine is a killed virus so there's absolutely no way to get flu from the flu shot - it's just not possible. But you may get sick after getting one because you are going to go in a room with others to get your injection, and it will be during the winter in flu season. It's possible to pick up the flu in the waiting room. So some people will catch the flu within a few days of getting the flu shot - but that's because of exposure before - and not the shot itself."
What about shots and autism?
Another reason some avoid shots - or have their children exempted from them - is an alleged risk of autism. Some believe a mercury-based preservative could be to blame. But doctors say there's no reason to be afraid.
"Until 1998 or so, vaccines contained a mercury-based preservative and there were concerns it might be linked to autism," says Dr. Rainwater. "They never proved an association, but to make sure people keep getting immunized, manufacturers took the mercury preservative out of all but some flu shots."
Dr. Rainwater says if families have any concerns, rather than avoiding the vaccinations altogether, the most important thing they can do is have a conversation about it with their doctor.
"If a family comes in and they're resistant, we talk about their concerns. If they will articulate their concern, we can talk it through," she says.
What about other recommended but not mandatory shots?
One important shot that's been getting a lot of attention lately is the vaccine for the human papillomavirus or HPV. HPV is a sexually transmitted disease making it a difficult topic for families. But doctors say it's an important shot for teen girls to receive.
"It's the first vaccine to prevent a cancer," says Dr. Rainwater. "It's safe and effective. I can't think of any reason not to get it."
Falling into the same category of recommended but not mandatory is the meningococcal shot. Dr. Rainwater says this should be given to anyone who will be living in close quarters, like kids moving into a dormitory. It's a rapidly progressing disease and when contracted, is about 25 percent fatal.
The bottom line.
Even though we haven't heard much about them, diseases like diphtheria, pertussis and measles are still out there. Vaccines are one powerful tool we have against them. Currently, there are vaccinations for 14 such diseases. While it's true, you only get these diseases once, and the risk of contraction is low; with a vaccination your risk of contracting is near zero.
Vaccinations protect not just you and your family, but also the elderly, pregnant mothers and young children. Sometimes children do not pick up 100 percent immunity from a particular vaccination or are unable, due to allergies or other issues, to get the shot at all. If we all become vaccinated we help prevent those individuals from getting sick, too.
How do Vaccines Work?
When germs enter our bodies, our defense system recognizes them as intruders. Our bodies produce proteins (called antibodies) to attack the germs. Usually the germs are able to reproduce faster than the antibodies can get rid of them. But eventually, the antibodies build-up and the germ is eliminated. Each germ requires a unique antibody to get rid of it. Once the body has fought a particular germ, those antibodies remain in the blood, for future protection.
A vaccine tricks the body into thinking it's being invaded by a particular germ. Antibodies are made without an actual germ to fight. But, if that germ tries to invade in the future, the antibodies are already there to fight it.
According to the CDC, in 1962, the year before measles vaccine was introduced, almost 500,000 cases of measles were reported in the United States, and many more cases went unreported. By 1972, there were about 32,000 cases per year and by 1982, fewer than 2,000 annually. As of the end of 2005, there have been only 405 total cases in this century.
Is it Possible to Vaccinate Kids Too Much?
Some parents worry about whether they're overworking their child's immune system by getting several different shots at the same time. This topic has been studied extensively and doctors say there is no evidence this will cause any issues.