Kittner_20130815_1786Back-to-school season is in full swing. This is a great time to make sure that children are up to date with their immunizations.  The Centers for Disease Control and the American Academy of Pediatrics agree that immunization is one of the best ways to prevent children from becoming ill – and so do we at The University of Vermont Children’s Hospital at the University of Vermont Medical Center.

Before immunizations became routine, each year thousands of children in the United States became seriously ill with diseases such as polio, measles, meningitis, and whooping cough.  With the advent of successful immunization programs, many of these illnesses are now quite rare. For instance, polio has been eradicated from the US and meningitis, a devastating infection of the fluid that surrounds the brain, is much less common that it used to be. However, the organisms that cause these diseases are lurking and unimmunized individuals are still at risk for illness.

Rise of Measles

The number of cases of measles, which had been officially eradicated in the United States 15 years ago, is surging. Large outbreaks have been reported in different areas of the country. There have even been cases of measles occurring recently in New England. In almost all instances, an unimmunized child becomes infected – often while traveling – and then spreads the infection to other unimmunized children. The disease is extremely contagious, so much so that nine of ten unimmunized people exposed to measles will develop the disease. Fortunately the vaccine is more than 95 percent effective at preventing disease. 

Rise of Whooping Cough

Whooping cough is also making resurgence in the United States. Thousands of cases have been reported in the United States and in the past few years, Vermont has had some of the worst outbreaks. Whooping cough is also very catchy. People with whooping cough generally cough for many weeks and infants, usually too young to be immunized, do extremely poorly with the disease. Although the whooping cough vaccine is not as effective as the measles vaccine, unimmunized people are ten times more likely to develop the disease after exposure than those who are immunized.

Addressing Vaccine Safety Concerns

Vermont, similar to many states, allows parents to defer immunizing their children based on philosophical objections.  Most parents who opt not to immunize their children do so because of vaccine safety concerns.

  • The first issue to address is whether the vaccine is harmless. All activities, including bouncing on a bed, eating a piece of meat, and showering in a bathtub are associated with some adverse events. Vaccines are no different. Vaccines do cause redness and pain at the injection site. Some children will develop a fever following vaccination. However, serious complications following vaccination are incredibly rare-about one in a million. News reports and individual anecdotal reports seem to highlight observations of bad events that occur in children about the time of a vaccination. However, these are observations and may not be related to the vaccine at all.
  • The second issue is whether vaccines prevent harm. Many, many national and international studies have shown that in millions of children vaccines are safe and help prevent severe disease.  Overwhelmingly, the data shows that the benefits of the vaccine far outweigh the risks.

A complication of more parents choosing not to immunize their children is that fewer children in schools and day care centers are fully immunized making it easier for a disease to gain a foothold in a population.  Parents always want the best for their children. They want them to succeed in school, on the athletic fields, and in all their endeavors. So, let’s make sure they have the right number of vaccinations.

No matter how parents feel about vaccination, it is important to talk to your health care provider about the topic. For more information on school entry requirements and currently recommended vaccines visit: http://healthvermont.gov/hc/imm/schoolentry.aspx#manual

William Raszka, MD, is a pediatric infectious disease specialist at the University of Vermont Children’s Hospital at the University of Vermont Medical Center and a professor at the Larner College of Medicine at UVM. 

Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital at the University of Vermont Medical Center and chair of the Department of Pediatrics at the Larner College of Medicine at UVM. 

 

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