Immunizations are an important part of your baby’s health care because they protect him from potentially harmful diseases. Some babies, however, have reactions to the vaccines. The symptoms include pain and redness at the injection site, fever, and irritability. Occasionally, a baby will break out in a rash 6 to 12 days after receiving the measles vaccine. To reduce the fever or pain, give your child a nonaspirin medication, such as acetaminophen, as ordered by your pediatrician. Be sure to call the doctor if your child has a severe reaction.
Table 10.1 presents a recommended schedule for immunizations. The schedule for the Hib (Haemophilus influenzae type b) vaccine against meningitis depends upon which vaccine is used. Doctors now recommend that all infants be immunized for hepatitis B. If your baby was not given the vaccine in the hospital, he should receive three doses by 18 months of age.
Table 10.1. Immunization Schedule
The polio vaccine comes in two types—oral and injectable. The oral vaccine is made from a weakened form of the live polio virus. It is the most common one administered to infants. The benefit of the live vaccine is that it is easy to administer and is excreted in the bowel movements. Because of this, it is also excellent for providing a booster to adults who have been immunized. The disadvantage of the oral vaccine is that it is the cause of the eight to ten cases of polio that occur in the Western hemisphere each year. There has not been a case of polio from a wild virus (not vaccine related) since 1979. In addition, persons whose immune systems are compromised or suppressed, AIDS victims, and persons receiving chemotherapy can contract the disease after receiving an oral dose or following exposure to the excreted virus.
The injectable polio vaccine is made from a killed virus and is therefore slightly less effective. In addition, it requires an injection, which makes it more expensive.
To reduce the annual number of polio cases, the CDC has recommended that the first two doses of polio vaccine be given by injection using the inactivated virus and that the following two doses be given orally using the live virus. If your child or a family member is immunocompromised, the injectable form of the vaccine should be used.
Chickenpox (varicella) is a common, usually mild, childhood disease that, once contracted, provides lifelong immunity. The most common side effects are itching and a mild fever. Serious complications are extremely rare and include pneumonitis, encephalitis, kidney problems, and bacterial superinfections of the lungs, bones, and skin.19 Because the disease is easily transmitted, infected children are isolated for approximately 1 week during an outbreak to reduce the spread of the disease.
The advantage of receiving the chickenpox vaccine (varivax) is that it prevents a child from getting chickenpox. This eliminates the aggravation of missing a week of school or daycare for the child, and possibly a week or more of work for the parent (parents with more than one child may miss more than 1 week of work). Some experts are questioning the benefit of giving the vaccine to all children. They state that the main benefit is an economic one for parents who work, since chickenpox is more of an annoyance than a danger to children. Plus, it is unknown how long the immunity to the disease will be with the vaccine.
If a person over the age of 13 contracts chickenpox, the risk of serious complications is greater. It is rarely just a mild disease in adults. The vaccine may require one or more boosters, and compliance to a booster schedule becomes more difficult as children mature. It is recommended that children over the age of 13 who have not had the disease naturally and adults who have never contracted the disease receive two doses of the vaccine. The vaccine is not recommended for immunosuppressed children or adults.