More
Vaccines on the Recommended Schedule
By: Dr. Bhumi
Upadhyay, Northeast Pediatrics
Immunizations are an important part of
pediatric care and the recommended schedule is constantly
changing. We are all familiar with tetanus, pertussis, polio, MMR,
chicken pox, etc. vaccines, but new ones are being added to the
schedule- Pertussis boosters, meningococcal, rotavirus, and the
HPV vaccine. How will our children handle all this vaccines?
Should we worry about too many vaccines or are we protecting our
children? We will discuss the benefits of each of these new
vaccines.
Pertussis, also known as the whooping
cough, is the only vaccine preventable disease, which is on the
rise in the US. This is due to the waning immunity from the
previously immunized people. Although, it is a mild illness in
the adults, it can be a life threatening condition for infants,
causing hospitalizations and deaths. A pertussis booster is
recommend at the 11-12 year old visit and every 10 years
thereafter. It is in combination with the tetanus booster.
Protecting our adolescents and adults will protect our little
infants who are not immunized or only partially immunized. The
infants are still vulnerable until their third dose of DTaP at 6
months old.
Meningococcal meningitis has two peak
incidences in the pediatric population-one in infants < 1 years
old and again in the adolescents. Incidence is higher in infants
but mortality is higher in adolescents. About 75% of the
meningococcal meningitis is caused by 4 strains. Therefore, the
quadrivalent vaccine can greatly decrease the incidence. It is
now a recommended vaccine in our adolescent population either at
the 11-12 year old visit or thereafter. Students living in
dormitories are at a greater risk of meningitis and should be
given the vaccine prior to going to college if not caught up
earlier.
Rotavirus is the horrible “stomach
flu”, which we all have encountered in some way. It causes
vomiting and diarrhea and fever in all age groups. Our infants
are at greatest risk of dehydration and hospitalization. Four in
every 5 children less than 5 years old will have the rotavirus.
One in 7 will have a doctor’s visit, and 1 in 70 will be
hospitalized and 1 in 200.000 will result in death every year. It
is transmitted person to person via fecal oral transmission. A
child can have over 100 billion virus particles in one gram of
stool during the illness. It is highly contagious and can cause
10-20 diarrhea stools a day. The vaccine covers 5 strains of the
rotavirus, which are known to cause 96% of all rotavirus
illnesses. The vaccine appears to decrease severe illness by 98%
and overall incidence by 74%. This vaccine is approved as 3 doses
at 2, 4, and 6 months of age.
There are over 100 types of human
papillomaviruses (HPV). Most of them cause the common warts.
However, about 30 types affect the genital areas and may have no
symptoms. It is sexually transmitted and fairly common. There are
more than 6 million new cases a year in the US and 80% of women
will have genital HPV by the time they are 50. HPV causes genital
warts but more importantly it can cause abnormal cervical cells
that lead to cervical cancer. Since the HPV virus can go
asymptomatic, it may not get treated and may cause the precancer
cells to develop. The HPV vaccine covers four strains of HPV so
it will not prevent about 30% of the cervical cancers and about
10% of the genital warts. It will not treat already acquired HPV.
Therefore, it is recommended to be given prior to the person being
sexually active. It is recommended at the 11-12 year old visit
for the girls and is a series of three injections.
Many new vaccines are introduced and
approved. Please talk to your doctor about these vaccines and
other changes in the vaccine schedule that is not covered here.
Dr. Bhumi
Upadhyay, a Board Certified Pediatrician and active member of the
American Academy of Pediatrics, graduated from the University of
Miami six year Honors Program in Medicine. If you have questions
about this article or your child email Dr. Bhumi at
drbhumi@northeastkids.com. We are accepting new patients
please call to get to know the doctor 526-PEDS
back to top
|
