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home  > health and wellness

Health and Wellness Articles on Families on-the-go Magazine
March / April 2007

More Vaccines on the Recommended Schedule

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  We are accepting new patients please call to get to know the doctor 526-PEDS

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