2011 Recommended Immunizations for Children from Birth Through 6 Years Old

Vaccine-Preventable Diseases and the Vaccines that Prevent Them

Six Common Misconceptions about Immunization

This list of six common misconceptions was originally written by the Centers for Disease Control and Prevention in the United States primarily for use by practitioners giving vaccinations to children in their practices.

An edited version is reproduced here as useful information for health-care workers giving vaccination as well as concerned parents. In this modern age of communication, health-care workers will encounter patients who have reservations about getting vaccinations for themselves or their children. There can be many reasons for fear of or opposition to vaccination. Some people have religious or philosophic objections. Some see mandatory vaccination as interference by the government into what they believe should be a personal choice. Others are concerned about the safety or efficacy of vaccines, or may believe that vaccine-preventable diseases do not pose a serious health risk.

All health-care workers giving vaccines have a responsibility to listen to and try to understand a patient's concerns, fears, and beliefs about vaccination and to take them into consideration when offering vaccines. These efforts will not only help to strengthen the bond of trust between staff and patient but will also help determine which, if any, arguments might be most effective in persuading these patients to accept vaccination.
These pages address six common misconceptions about vaccination that are often cited by concerned parents as reasons to question the wisdom of having their children vaccinated. If staff can respond with accurate rebuttals perhaps we can not only ease parents' minds on these specific issues but discourage them from accepting other anti-vaccine "facts" at face value. The goal of health care providers is not to browbeat parents into vaccinating, but to make sure they have accurate information with which to make an informed decision.

Misconceptions

• "Diseases had already begun to disappear before vaccines were introduced, because of better hygiene and sanitation".
• "The majority of people who get disease have been vaccinated".
• "There are "hot lots" of vaccine that have been associated with more adverse events and deaths than others. Parents should find the numbers of these lots and not allow their children to receive vaccines from them".
• "Vaccines cause many harmful side effects, illnessses, and even death - not to mention possible long-term effects we don't even know about".
• "Vaccine-preventable diseases have been virtually eliminated from my country, so there is no need for my child to be vaccinated".
• "Giving a child multiple vaccinations for different diseases at the same time increases the risk of harmful side effects and can overload the immune system".

1. "Diseases had already begun to disappear before vaccines were introduced, because of better hygiene and sanitation."

Statements like this are very common in anti-vaccine literature, the intent apparently being to suggest that vaccines are not needed. Improved socioeconomic conditions have undoubtedly had an indirect impact on disease. Better nutrition, not to mention the development of antibiotics and other treatments, have increased survival rates among the sick; less crowded living conditions have reduced disease transmission; and lower birth rates have decreased the number of susceptible household contacts. But looking at the actual incidence of disease over the years can leave little doubt of the significant direct impact vaccines have had, even in modern times.
For example, there have been periodic peaks and valleys throughout the years, but the real, permanent drop in measles incidence coincided with the licensure and wide use of measles vaccine beginning in 1963.
Other vaccine-preventable diseases show a roughly similar pattern in incidence, with all except hepatitis B showing a significant drop in cases corresponding with the advent of vaccine use. (The incidence of hepatitis B has not dropped as much because infants vaccinated in routine programs will not be at high risk of disease until they are at least teenagers. Therefore a 15-year lag can be expected between the start of routine infant vaccination and a significant drop in disease incidence.) Haemophilus influenzae type b (Hib) vaccine is another good example, because Hib disease was prevalent until the early- to mid- 1990s, when conjugate vaccines that can be used for infants were finally developed. (The polysaccharide vaccine previously available could not be used for infants, in whom most cases of the disease were occurring.)

Recommended Immunization Schedule for Persons Aged 7 - 18 Years— 2011

This schedule includes recommendations in effect as of December 21, 2010. Any dose not administered at the recommended age should be administered at a subsequent visit, when indicated and feasible. The use of a combination vaccine generally is preferred over separate injections of its equivalent component vaccines.
Considerations should include provider assessment, patient preference, and the potential for adverse events. 

1. Tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap).
(Minimum age: 10 years for Boostrix and 11 years for Adacel))
• Persons aged 11 through 18 years who have not received Tdap should receive a dose followed by Td booster doses every 10 years thereafter.
• Persons aged 7 through 10 years who are not fully immunized against pertussis (including those never vaccinated or with unknown pertussis vaccination status) should receive a single dose of Tdap. Refer to the catch-up schedule if additional doses of tetanus and diphtheria toxoid–containing vaccine are needed.
• Tdap can be administered regardless of the interval since the last tetanus and diphtheria toxoid–containing vaccine.

Breakthrough Meningitis Vaccine Developed for Africa at Affordable Price

          A new conjugate vaccine against meningococcus A costing only $0.5 (£0.3; €0.4) a dose that has been developed for use in Africa is about to be introduced for the first time in a national vaccination programme in Burkina Faso, researchers announced.

• The campaign to vaccinate all children and young adults from the ages of 1 to 29 years with the vaccine, MenAfriVac, will begin in Burkina Faso on 6 December. Niger and Mali will follow with similar vaccination campaigns.

Countries in the so called meningitis belt in sub-Saharan Africa—from Senegal in the west to Somalia in the east—have had regular epidemics of meningococcal meningitis for the past century. Almost all of the major outbreaks are caused by group A Neisseria menigitidis.

Sources:

http://www.who.int/mediacentre/factsheets/fs141/en/

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001633

http://www.doctorswithoutborders.org