Guiding Parents on Childhood Vaccinations: Top Vaccines - Master's in Public Health Degree Programs

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Parents have a new baby. It’s amazing. It’s exciting. It’s scary. Parenting decisions come fast, and we want to be prepared. One of the very first decisions parents will have to make is whether to vaccinate their child or not. This decision can come as early as their baby’s first 24 hours in the hospital. Medical professionals have an opportunity to advise considerate parents on this hot topic. Before making a decision, here are some of the top questions they will want to have answered:

What are the top preventable childhood diseases and their vaccines?
How do vaccines work?
Why are children immunized so early?
When are vaccinations scheduled?
Are there harmful ingredients in vaccinations?
What are the side effects and risks?
What are the vaccination requirements for school attendance in the United States
Are there any known alternatives to vaccines?

Top 16 Preventable Childhood Diseases and their Vaccines

1. Hepatitis B

Vaccine: HepB

Hepatitis B is an infection that comes from the HBV virus. Even though children can heal from Hepatitis B infections, some cases become chronic. Having chronic Hepatitis B can lead to liver failure, liver cancer, or cirrhosis. The symptoms of Hepatitis B are:

pain in abdomen
dark urine
fever
pain in joints
little or no appetite
nausea and vomiting
weakness
fatigue
jaundice

Infants and children at a greater risk of developing chronic hepatitis B infections.

2. Diphtheria

Vaccines: DTaP: <7 yrs, TdaP: Adolescent/Adults, Td: Adolescent/Adults

Diphtheria is a very contagious infection in the throat. It blocks the airway and can cause severe breathing problems. It starts with a sore throat and doctors often misdiagnose it as a strep infection. Bacteria causing diphtheria goes into the lining of the respiratory system, destroying healthy tissue. Dead tissue then forms a thick coating in the throat and/or nose. It can cover tissues in the nose, tonsils, voice box, and throat. This can make swallowing and breathing very difficult. The poison can also get into the bloodstream. The heart, nerves, and kidneys can be badly affected. IV antibiotics and an anti-toxin injection are given in the hospital to treat the diphtheria infection. It must be treated immediately. Diphtheria was fatal for about half of the people who got it in the US before the vaccine came out.

3. Tetanus

Vaccines: DTaP: <7 yrs, TdaP: Adolescent/Adults, Td: Adolescent/Adults

Tetanus is not a contagious disease. It comes from spores that are in the environment. It can be found in dirt, manure, dust, etc. Once the spores get into the body through cuts in the skin, they turn into bacteria. Symptoms of tetanus are:

trouble sucking and constant crying in newborns
lockjaw
painful muscle spasms that are usually triggered by noise, light, or touch
rigid facial and abdominal muscles
trouble breathing or swallowing
feeling restless and/or irritable
fast heartbeat and breathing
a headache
seizures
sweating
urinating difficulty
a low fever

Sometimes a ventilator is needed to aid breathing. Broken bones can also occur. About 10 to 20 percent of tetanus infections are fatal, according to the Centers for Disease Control and Prevention (CDC).

4. Acellular Pertussis

Vaccines: DTaP: <7 yrs, TdaP: Adolescent/Adults

Pertussis used to affect 200,000 children a year before the vaccine came out. Pertussis (whooping cough) is an upper respiratory infection. It comes from the Bordetella pertussis bacteria. It is serious and can cause permanent disability or death in infants. There are two stages of Pertussis.Early-stage symptoms include:

runny nose
low-grade fever
light cough
apnea, especially in infants

Usually diagnosing Pertussis is difficult until the late stages. This can be as ling as two weeks later. In this stage, a child will experience rapid coughing followed by a “whoop” sound and vomiting. Coughing fits usually get worse as the illness continues. The coughing during nighttime can be the most severe. The coughing can last for 10 weeks or more. Pertussis is called “100-day cough” in China. About half the infants who get whooping cough will need to be hospitalized. Around 61% of infants will have apnea during the sickness, 23% of them will get pneumonia, and about 1% will experience seizures and death.

5. Haemophilus influenzae type b4

Vaccine: Hib

Hib mostly infects children under 5 years old. It is spread through droplets in the air. There are several types of harmful diseases caused by H. influenza. These are:

Pneumonia: lung infection
Bacteremia: blood infection
Epiglottitis: Inflamed epiglottis
Cellulitis: Bacterial skin infection
Infectious Arthritis: Infection in the joints
Meningitis: This infection can be very serious. It kills about 3 to 6% of the children who get it. It causes brain damage or hearing loss in about 5% of children.

6. Polio

Vaccine: Inactivated poliovirus (IPV:<18 yrs)

guide to childhood vaccinations Polio is considered eradicated in the United States. Before the vaccine came out, just about 60,000 cases of polio were reported and more than 3,000 deaths. Polio affects children in so many different ways. 95% of polio cases are asymptomatic, which is great news. The remaining 5% of cases are symptomatic and present in these three ways:

Abortive polio This form causes a mild upper respiratory infection, diarrhea, a sore throat, and fevers. The child may never be diagnosed with polio.
Nonparalytic polio This type is more serious. A child will suffer a stiff neck and light sensitivity, but these symptoms go away after about 10 days.
paralytic polio This is the most harmful form of polio. It is severe and debilitating. It paralyzes the child and can be deadly.

7. Pneumococcal

Vaccines: Pneumococcal conjugate (PCV13) and Pneumococcal polysaccharide (PPSV23)

Pneumococcal is a disease that has several different manifestations:

Pneumococcal pneumonia: Pneumonia is a lung infection. Symptoms are:

fever
chills
chest pain
cough
rapid breath and difficulty breathing

Bacteremia is a secondary complication of pneumococcal pneumonia. It is a blood infection. This is a very serious complication. It can cause lung and heart problems.

Pneumococcal meningitis: Infected tissue covering the brain and spinal cord. The symptoms:

stiff neck
fever
headache
light-sensitivity of the eyes
confusion.

Babies may experience losing their appetite, having a hard time drinking, being lethargic, and vomiting. It is life-threatening. Most cases occur in children under 18 months old. Even though most make a full recovery, about 25% will suffer from permanent, severe, and disabling after-effects. About 15% of people will die from it.

Pneumococcal sepsis: Sepsis is an overactive response from the immune system when it senses an infection. It sends toxins throughout the body that can cause organ failure and death.

8. Rotavirus (RV)

Vaccines: RV1 (2-dose series), RV5 (3-dose series)

Rotavirus is a very contagious disease that most children will get. The symptoms are:

severe diarrhea
vomiting
fever
abdominal pain

Diarrhea and vomiting last between 3-8 days. The biggest complication of the Rotavirus is dehydration. Infants and children usually land in the hospital to receive IV fluids.

9. Influenza

Vaccines: Live, Intranasal(LAIV) and Inactivated (IIV)

Influenza, which is the flu, is a virus that attacks one’s respiratory system. It is very contagious. According to the CDC symptoms are:

fevers
headaches
loss of appetite
muscle aches
dizziness
fatigue
cough
runny nose
sore throat
nausea and vomiting
ear pain
diarrhea
weakness
chills

Secondary infection from the flu is pneumonia. This is dangerous for infants and children. Dehydration from the flu virus is also a concern for infants and children. Some will be hospitalized and given IV care to treat the dehydration.

10. Measles

Vaccines: MMR and MMRV

Measles is a virus that is highly contagious. 500,000 cases of measles were reported each year in the United States before the vaccine was invented. Measles is generally not life-threatening but it used to kill around 500 people yearly. It was also responsible for 4000 cases of encephalitis every year. The measles shows up as a rash all over the skin. There are flu symptoms and fevers that are very high. The measles infection usually lasts for several weeks.

11. Mumps

Vaccines: MMR and MMRV

Mumps is a virus. It attacks the parotid salivary glands. They become very swollen and painful. Symptoms of the mumps are:

painful chewing and swallowing
fevers
headaches
muscle aches
weakness
fatigue
loss of appetite

Usually, mumps isn’t fatal but there are cases when it is. There are some serious side effects. Post-puberty boys can experience swollen testicles. Encephalitis is another risk of mumps and can be deadly. The membranes and fluid around the brain and spinal cord along with the pancreas can swell also. Mumps can be the cause of hearing loss, miscarriages, and heart problems.

12. Rubella

Vaccines: MMR and MMRV

Rubella is caused by a virus. There are some cases when Rubella is asymptomatic. When it’s not, symptoms range from:

mild fever
headaches
runny nose
pink eye
cough
swollen glands

Serious symptoms are:

arthritis
brain infection
and bleeding problems

Rubella is the most harmful to unborn babies. If a mother gets Rubella when she is pregnant, she can have an early miscarriage or a stillbirth. If the baby survives, there is a chance of lifelong complications. These complications are heart problems, hearing or eyesight loss, learning disabilities, and liver or spleen damage.

13. Varicella (Chickenpox)

Vaccines: MMRV and VAR

Varicella or chickenpox is a virus that is very contagious. Symptoms include an itchy blister rash, fevers, fatigue, loss of appetite, and headaches. Complications of chickenpox are:

bacterial infections of skin/soft tissues
pneumonia
infection/inflammation of the brain
bleeding problems
sepsis
dehydration.

Most children will recover with no problem, but there are deadly cases. The greatest risk patients are newborns born to mothers who had chickenpox during the pregnancy, patients with leukemia, children on medications that suppress the immune system, and anyone with immune system problems.

14. Hepatitis A

Vaccine: HepA

Hepatitis A is a virus that is caught by coming in contact with fecal matter. It is contagious and children get it at daycares oftentimes. Usually, the younger children have fewer symptoms when they have Hep A than the older ones. Some have no symptoms at all. Older kids will have fevers, nausea, vomiting, loss of appetite, and fatigue. They will have jaundice and pain where the liver is. There aren’t any medications that can heal the virus. Resting, drinking fluids, and eating a well-balanced diet can aid in the healing process.

15. Human Papillomavirus (HPV)

Vaccine: HPV – Gardasil-9

HPV, or human papillomavirus, causes warts. There are over 100 varieties of human papillomavirus. Depending on the type of HPV infection dictates where warts develop on the body. Warts can be on the feet, neck, and face. Some types of genital HPV can cause cancer of the lower part of the uterus that connects to the vagina (the cervix). A lot of times, your body will kill the HPV before warts form. If they do develop, it will depend on which type of HPV the infection is and where they will infect the body. HPV can cause cervical cancer, but it’s only a very slight risk.

16. Meningococcal Disease

Vaccines: Meningococcal ACWY VIS and Serogroup B Meningococcal (MenB) VIS

Meningococcal disease is contagious through contact with another person’s saliva and happens over an extended period of time. Even though it isn’t a highly contagious disease, it is contagious and very serious. The two most common types of meningococcal infections are meningitis and septicemia. Both of these are very serious and can kill a person within hours. The symptoms, at first are fevers, headaches, nausea, and vomiting. They get worse very quickly. As the illness progresses, the symptoms are light sensitivity, confusion, and a stiff neck. In young children, doctors look at the child’s reflexes for signs of meningitis. They don’t display the same symptoms as the older kids but their reflexes are indicators of the infection.

Meningococcal Septicemia occurs when the bacteria enter the bloodstream and multiplies, damaging the walls of the blood vessels. This causes bleeding internal bleeding. Symptoms are:

fevers
fatigue
vomiting
chills
cold hands and feet
terrible pain (muscles, joints, chest, or abdomen)
rapid breathing
diarrhea
dark purple rash

Meningococcal disease is very serious and can kill in a few short hours. Getting an early diagnosis and treatment right away is key. 10 to 15% of people infected with the meningococcal disease will die even with the IV antibiotics. 11 to 19% of people who survive will have long-term disabilities. A couple of disabilities include brain damage and loss of limbs.

childhood vaccine guide

Vaccine Information

How do vaccines work for a child’s immune system?

A child’s immune system works to fight infections. When it comes in contact with an illness, its white blood cells activate and begin making proteins called antibodies. These antibodies find the virus or bacteria and create a counter agent to fight it. After the immune system gets rid of the illness, oftentimes there are antibodies left over that prevent the same illness to reoccur.

Sometimes children’s immune systems aren’t strong enough to fight certain kinds of illnesses. Vaccinations were created to give the body the idea that these diseases need to be fought. There are live vaccines and inactivated ones.

Live vaccines are made up of a weakened version of the bacteria or virus. Dead forms of the organism are another way to make a vaccine. The organisms were killed but preserved to keep their ability to provide immunity or protection. Another kind of vaccine is one that was designed by inactivating the toxin made by the bacteria. When the vaccine is given, the body’s immune system detects this weakened or dead germ and reacts just as it would when a real infection happens. It begins making antibodies against the vaccine material. These antibodies stay in the body and will react if a real infectious organism attacks. Every day a child is exposed to 2000-6000 antigens. The number of antigens used in childhood vaccines is very small in comparison with the ones they come in contact with each day.

Why are children immunized so early?

Even though babies receive antibodies through the placenta in the last couple of months of the pregnancy, their immune systems are not fully developed until around six months old. Besides, mothers will not give diphtheria, whooping cough, polio, tetanus, hepatitis B, or Hib antibodies to their babies. These diseases can be harmful or deadly to an infant. Immunizations usually start when the baby turns two months old, as their antibodies from birth are declining. Medical studies have shown for over decades when an infant is the most likely to be susceptible to the diseases and also when the infant will have the best immune response to the vaccine.

What is the vaccine schedule?

There is a common timeline for vaccine administration. Generally, there is a guideline that pediatricians follow for each vaccine. Here is the list:

Hepatitis B vaccine: This vaccine is given to most newborns before they are discharged from the hospital. The second dose is given at age 1 to 2 months, followed by the third dose at age 6 to 18 months.
Rotavirus vaccine: There are two ways to give this. It is given in two or three doses. The first way is at ages 2 months, 4 months, and 6 months. The second way is at ages 2 months and 4 months.
Haemophilus influenzae type b (Hib) vaccine: Depending on the vaccine used, three or four doses of the Hib vaccine are given. One way is at age 2 months, 4 months, and 12 to 15 months. The other way is at age 2 months, 4 months, 6 months, and 12 to 15 months.
Poliovirus vaccine: A dose and three boosters of the vaccine are given: at ages 2 months, 4 months, 6 to 18 months, and 4 to 6 years.
Diphtheria, tetanus, and acellular pertussis vaccine: Before age 7, children are given the DTaP. Five doses of DTaP are given at ages 2 months, 4 months, 6 months, 15 to 18 months, and 4 to 6 years. One dose of Tdap is recommended at age 11 to 12 years.
Pneumococcal vaccine: 2 months, 4 months, 6 months, and 12 to 15 months.
Meningococcal vaccine: Two doses are given at age 11 to 12 years and 16 years
Influenza vaccine: Annually. Most people only need one dose. Children who are 6 months to 8 years old are given two doses at least 4 weeks apart if they are receiving the influenza vaccine for the first time.
Measles-mumps-rubella (MMR) vaccine: Two doses. Ages 12 to 15 months and 4 to 6 years.
Varicella vaccine: Two doses are given at ages 12 to 15 months and 4 to 6 years.
Hepatitis A vaccine: Two doses of the hepatitis A vaccine are given. The first dose is given between ages 12 to 23 months. The second dose is given 6 to 18 months later. If children over age 23 months have not been vaccinated, they can be given the hepatitis A vaccine later.
Human papillomavirus (HPV) vaccine: The human papillomavirus vaccine is given to adolescents in 2 or 3 doses. The number of doses depends on how old the person is when they first receive it. If the first dose is given at age 9 to 14 years, 2 doses are given, separated by at least 5 months. If the first dose was given at 15 years or older, 3 doses are given. The second dose needs to be given no sooner than1 month after the first, and the third dose is given after 5 months after the first dose. Routine vaccination is recommended at age 11 to 12 years.

Are there harmful ingredients in vaccinations?

There are parental concerns with certain ingredients used in vaccines. These are the main ingredients causing concern:

Thimerosal (ethylmercury): This is only used in the influenza vaccine. It is a preservative that helps prevent dangerous bacterial or fungal contamination. Children used to get three vaccines that contained more mercury in them than the EPA recommended limit. This led to questioning whether the thimerosal in vaccines could be linked to autism or other conditions. Scientific study has shown that ethylmercury is not linked to autism, however, currently no vaccines except for the influenza vaccine use it.
Formaldehyde: Formaldehyde is used to inactivate viruses and detoxify toxins. This assures that the patient will not get sick after an injection. According to The U.S. EPA, International Agency for Cancer Research and the National Toxicology Program formaldehyde is classified as a carcinogen. Several studies show that long-term formaldehyde exposure can lead to certain types of cancer. The amount of formaldehyde in vaccines is very small and is mostly diluted down to minimal amounts during the manufacturing process. The FDA claims that there is 50 to 70 times more formaldehyde already in an average newborn’s body than in a single dose of a vaccine. Current science shows that the formaldehyde used in vaccines is harmless. The highest amount of formaldehyde present in any vaccine is .02 mg per dose.
Aluminum: This is put into vaccines to make them, strengthening the immune system response allowing them to be more effective. Children receive fewer doses because of it. Evidence that long exposure to high levels of aluminum can cause brain and bone disease is concerning to parents. According to doctors, breastfed infants naturally ingest around 7 milligrams of aluminum in their diet throughout the first six months of their lives. This is about 3.5 milligrams greater than the 4.4 milligrams of aluminum in the standard immunizations in the first 6 months of life. The amount of aluminum is so small that it doesn’t cause any noticeable rise in the base amount found in the blood, even right after injection.

What are the side effects and risks?

Common side effects of any vaccine can include:

Injection site reactions (pain, swelling, and redness)
Mild fever
Shivering
Fatigue
Swollen glands
Headache
Muscle and joint pain
Irritability
Swollen eyes

More serious side effects include:

Difficulty breathing
Wheezing
Rapid heartbeat
Severe shoulder pain and reduced range of motion in the arm where a shot was given can happen
Brief fainting spells
Clammy skin
Anxiety or a feeling of dread
Confusion
Pain and stiffness of the joints
Low platelet count
High fever

Rare serious reactions to vaccines can include:

Seizures Some children are more prone to seizures when experiencing a high fever. The seizure usually lasts approximately 20 seconds and very rarely more than 2 minutes.
Intussusception (relates to rotavirus) A bowel obstruction. This risk is very low while occurring in a baby in the first 1 to 7 days after receiving the first dose. Likewise, there is a very small risk that It could also happen after the second dose as well. Babies may cry a lot, look pale, be very irritable, and pull their legs up to their stomachs because of pain.
Anaphylaxis This is a severe allergic reaction. It happens suddenly, usually within 15 minutes, but it can occur hours after getting the vaccine. Early signs of anaphylaxis include:
- redness and/or itching of the skin
- swelling (hives)
- breathing difficulties
- a sense of distress

What are the vaccine requirements for school attendance in the United States?

With the exception of a few states, most schools require:

HepB
DTaP
IPV
MMR
Varicella

The Hepatitis A vaccine is required in about ¼ of the states and Hib, PCV, and Flu vaccines are rarely required.

Are there any known alternatives to vaccines?

There is a method that has been used for over 200 years, developed from an Australian doctor named Dr. Isaac Golden, called Homeoprophylaxis. It is controversial, and you won’t hear the majority of physicians say that this is a suitable alternative. HP (Homeoprophylaxis) is administered on tiny sugar pellets. They are given one illness at a time and without adjuvants, preservatives, antibiotics, animal viruses, GMOs or excipients. It contains only the amount of the disease. HP produces a similar response to our own immune systems but in a much milder way. A child may get a very brief runny nose or more tired. According to the teaching of Dr. Golden, the side effects of this method are less.

HP Is made when the substance is diluted from natural diseases, an animal, mineral or vegetable source. It is diluted, taking away any molecules, and therefore harmless. Proponents of HP claim that it is this stimulation to the immune system that helps it to recognize disease in the environment and effectively produce an immune response in the most natural way.

Fast facts

There is a new flu vaccine created each year because the pathogens change with the changing strains of the flu. Each year researchers design one that will likely circulate through the upcoming flu season.
Three states, Mississippi, West Virginia, and California do not allow religious or personal exemptions to vaccines.
A vaccine only has to introduce enough of disease to attack the lymph system for the body to create an immunity.
A vaccination record is a good way to keep a child’s vaccines on schedule. If the child moves to a different provider, this will assure that they don’t get immunized again. This should be started when an infant gets their first vaccines.
If a child has an adverse reaction to any vaccine, it should be reported to VAERS (Vaccine Adverse Event Reporting System). Report what happened, the date, and the time.

MPH Staff

This concludes our feature on the top 16 vaccines.