Dr. Mona's Mom Blog

Does my child really need vaccines?

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Childhood vaccines are an important part of keeping our kids healthy from harmful illnesses. This blog post will go over the schedule including a break-down of each vaccine, the illness it prevents against, and why it is recommended.

Why are there so many vaccines?

Vaccines are created to protect children from illnesses that can cause hospitalization, complications, or death. The U.S. has an extensive vaccination program to help reduce the spread of these illnesses and the subsequent complications they can cause in kids. In this blog, I go over all major vaccines given under the age of one.

Why is spacing not recommended?

The reason why spacing is not routinely recommended is that it’s not studied for efficacy. Vaccine schedules are created with immunity in mind, so the spacing is such to provide maximum immunity in a safe way to a child. Spacing has no research to support that it would be as effective in providing immunity, hence why it’s not recommended.

Theoretically, spacing it a week or two is probably fine, but it’s preferred to go by the schedule and it’s what I recommend to my patients and what we did for our son as well. If you choose to vaccinate and want an adjusted schedule, speak to your child’s clinician on options. But, do consider vaccinations!

Hepatitis B

  • When is it routinely given: 3-4 doses (Some Hep B vaccines are given in combination with other vaccines). Birth, 1-2 months of life, and 6 months of life.
  • How Hepatitis B is transmitted: Contact with blood or bodily fluids (sexual contact). Can be transmitted from mom to baby. Can be transmitted through bites in childcare settings.
  • Disease symptoms: Virus causing fever, headache, weakness, vomiting, jaundice (yellowing of eyes and skin), and/or joint pain.
  • Possible complications of Hepatitis B infection: Chronic liver infection, liver failure, liver cancer.
  • Side effects of vaccination: Common side effects are soreness, redness, or swelling at the site of injection. Side effects are short lived. In babies, we do not see any fever with this vaccine or side effects including babies given this within 24 hours after birth.
  • Why I recommend it: Hepatitis B has been seen to be transmitted from mother to baby. The complications if baby gets this virus are severe, so vaccines help to eliminate this risk. Babies born to Hep-B positive moms automatically get this vaccine plus a special medicine, but it is recommended to all babies regardless of maternal Hep B status given complications of Hep B. Parents often ask if they can wait until their child is older to get this vaccine as the chances of blood contact is low and sexual contact. The reality is, this is a safe vaccine to be given in infancy so there is little need to wait and the vaccination schedule provides them life-long protection.

Rotavirus

  • When is it routinely given: 3 doses (2 months, 4 months, 6 months). There are some brands (Rotarix) that are a two-dose series. Your child should receive this vaccine before 15 weeks and if they don’t, they have aged out of it.
  • How Rotavirus is transmitted: Through mouth or contact with bodily secretions. Very commonly transmitted in daycare settings.
  • Disease symptoms: Virus that causes diarrhea, fever, vomiting, and potential dehydration.
  • Possible complications of Rotavirus infection: The rotavirus vaccine was created due to increased incidence of hospitalizations due to rotavirus infection. Infants and newborns were admitted for IV fluids related to dehydration secondary to rotavirus infection.
  • Side effects of vaccination: Common side effects are irritability after vaccination and a short-term diarrhea or vomiting episode after vaccination. This can last anywhere from 2-5 days and typically resolves without intervention.
  • In rare circumstances, intussusception can happen after the rotavirus vaccine. This is a type of bowel blockage that is treated in a hospital and could require surgery. It happens naturally in some infants every year in the United States, and usually there is no known reason for it. There is also a small risk of intussusception from rotavirus vaccination, usually within a week after the first or second vaccine dose. This additional risk is estimated to range from about 1 in 20,000 US infants to 1 in 100,000 US infants who get rotavirus vaccine.
  • Why I recommend it: Rotavirus can lead to severe dehydration. Many parents ask if they can forego if they don’t plan on putting their child into childcare and they have no siblings in childcare. This is the only situation where I consider foregoing the vaccine. However, the benefits also outweigh the risk for me for this vaccine and I recommend it to all families.

Dtap (Diptheria, Tetatnus, Pertussis)

  • When is it routinely given: 5 doses (2 months, 4 months, 6 months, 15-18 months, and 4-6 years). This vaccine is a combination vaccine and cannot be broken down further.

Diptheria

  • How Diphteria is transmitted: air, direct contact
  • Disease symptoms: Bacteria that causes sore throat, mild fever, weakness, and swollen glands in neck.
  • Possible complications of Diphteria infection: Swelling of the heart muscle, heart failure, paralysis, and/or coma.

Tetanus

  • How tetanus is transmitted: exposure through cuts in the skin, stepping on a rusty item that causes skin to break.
  • Disease symptoms: Bacteria that causes stiffness in neck and abdominal muscles, difficulty swallowing, muscle spasms, and fever
  • Possible complications of Tetanus infection: Broken bones, breathing difficulty, and/or death

Pertussis

  • How pertussis is transmitted: air, direct contact
  • Disease symptoms: Bacteria that causes severe cough, runny nose, and a pause in breathing in infants (apnea)
  • Possible complications of pertussis infection: Pneumonia, hospitalization due to apneas, and/or death.
  • Side effects of Dtap vaccination: Common side effects include soreness or swelling where the shot was given, fever, irritability, and/or vomiting. These symptoms last 1-3 days if they happen at all.
  • Small increased risk of febrile seizures when the flu shot is given during the same visit as the Dtap vaccine. This is not a life-threatening condition and does not cause long-term problems for the child.
  • Why I recommend it: Diptheria is almost eradicated in the US thanks to vaccination programs and continuing to vaccinate will ensure that this stays that way. Tetanus can be a life-threatening illness, so the vaccine is highly recommended. Pertussis (whooping cough) can be very harmful to infants leading to hospitalization or death so vaccines will help reduce that chance. Remember, that babies who have received one dose of the Dtap vaccine are not 100% protected against these infections as it takes boosters to obtain full immunity, which is why it’s important the primary caretakers are vaccinated against pertussis (Tdap).

HIB (HAEMOPHILUS INFLEUNZA B)

  • When is it routinely given: 4 doses (2 months, 4 months, 6 months, and 12-18 months).
  • How Hib is transmitted: air, direct contact
  • Disease symptoms: Bacteria that may cause a blood infection or meningitis. In some kids, they can be asymptomatic. Can also cause ear infections.
  • Possible complications of Hib infection: This can potentially cause meningitis (inflammation of the brain and spinal column), bloodstream infections, pneumonia, arthritis, and neurological impairment such as hearing loss.
  • Side effects of vaccination: Common side effects are irritability after vaccination, fever, or redness at the site of infection which should resolve within 2 days.
  • Why I recommend it: Hib can lead to severe complications that I have seen in clinical practice. A healthy child who now needs physical therapy and has hearing loss due to a Hib infection. The benefits of vaccination outweigh any risk (as with all vaccines we recommend).

PCV13 (Pneumococcal Vaccine)

  • When is it routinely given: 4 doses (2 months, 4 months, 6 months, and 12-18 months).
  • How is this illness transmitted: Air, direct contact
  • Disease symptoms: Bacteria that may cause no symptoms, pneumonia, or ear infections.
  • Possible complications of PCV13 infection: A bacterial infection in the blood, meningitis (infection/inflammation of the brain and spinal cord), severe ear infections, and/or death.
  • Side effects of vaccination: Common side effects are irritability, fever, or soreness at the site of infection which resolves in 1-2 days.
  • Children who get this vaccine at the same time as the flu vaccine may have an increased risk of a febrile seizure, which does NOT cause any permanent or long-term seizure condition.
  • Why I recommend it: Due to this vaccine, we have seen a large decrease in ear infections in children. Pneumococcal vaccination with at least one shot can help protect 8 in 10 babies from invasive disease of this bacteria.

IPV (Inactivated Polio Vaccine)

  • When is it routinely given: 4 doses (2 months, 4 months, 6 months, and 4-6 years).
  • How is this illness transmitted: Air, direct contact, through the mouth
  • Disease symptoms: Virus that may cause no symptoms, sore throat, fever, or headache.
  • Possible complications of Polio infection: Paralysis from the waist down and/or death.
  • Side effects of vaccination: Common side effects are irritability, fever, or soreness at the site of infection which resolves in 1-2 days.
  • Why I recommend it: The first polio vaccine was available in 1955 and thanks to vaccination efforts, we have not seen polio in the U.S. in our lifetimes. However, this illness still exists in other countries. Vaccination efforts assure that polio doesn’t return and cause devastating complications.

MMR

  • This vaccine is a combination vaccine and cannot be broken down further.
  • When is it routinely given: 2 doses (12-15 months and 4-6 years).

MEASLES

  • How Measles is transmitted: air, direct contact
  • Disease symptoms: Virus that causes rash, fever, cough, runny nose, pink eye
  • Possible complications of Measles infection: Encephalitis (brain inflammation and swelling), pneumonia, and/or death.

MUMPS

  • How mumps is transmitted: air, direct contact
  • Disease symptoms: Virus that causes swollen salivary glands under the neck and jaw, fever, headache, fatigue, and/or muscle pain
  • Possible complications of Mumps infection: Meningitis (infection of the lining of the brain and spinal cord), encephalitis (brain swelling), inflammation of testicles or ovaries, and/or deafness.

RUBELLA

  • How mumps is transmitted: air, direct contact
  • Disease symptoms: Virus that causes swollen salivary glands under the neck and jaw, fever, headache, fatigue, and/or muscle pain
  • Possible complications of Mumps infection: Meningitis (infection of the lining of the brain and spinal cord), encephalitis (brain swelling), inflammation of testicles or ovaries, and/or deafness.
  • Side effects of MMR vaccination: Common side effects include soreness or swelling where the shot was given, fever, and/or irritability. Symptoms typically resolve within 1-2 days. Occasionally, we do notice a rash on the body 7-10 days after the vaccine which self-resolves.
  • In rare instances, fever seizures have been reported or low platelet counts. These children have made full recoveries.
  • The MMR vaccine does NOT cause autism, which has been debunked time and time again.
  • Why I recommend it: Rubella is largely irradicated due to vaccine efforts, but mumps and measles persist. Both of these are viruses that potentially can be harmful for some children leading to long-term complications. The benefit of vaccination greatly outweighs the risk. Having seen the rare but serious complications of measles, I will always recommend vaccination.

Varicella (chicken pox)

  • When is it routinely given: 2 doses (12-15 months and 4-6 years old). There are some formulations that are combined with the MMR vaccine to be called MMRV which is also safe.
  • How is this illness transmitted: Air, direct contact
  • Disease symptoms: Virus that causes rash, fatigue, headache, and/or fever.
  • Possible complications of chicken pox infection: Infected blisters, bleeding disorders, pneumonia, encephalitis, and/or vestibular neuritis (hearing impairment).
  • Side effects of vaccination: Common side effects are irritability, fever, or soreness at the site of infection which resolves in 1-2 days.
  • Why I recommend it: Chickenpox is highly contagious. Before the vaccine was available, about 4 million people got chickenpox each year in the US, 10,500 were hospitalized, and about 100-150 died. Chicken pox can also lead to shingles and hearing loss, and thus the vaccine is highly beneficial.

Hepatitis A

  • When is it routinely given: 2 doses (12-23 months and 6 months after the initial dose).
  • How is this illness transmitted: Direct contact, contaminated food or water.
  • Disease symptoms: Virus that may cause no symptoms, fever, stomach pain, loss of appetite, jaundice (yellowing of the skin and/or eyes), dark urine.
  • Possible complications of Hepatitis A infection: Liver failure, joint pain, kidney or pancreatic disorders.
  • Side effects of vaccination: Common side effects are irritability, fever, or soreness at the site of infection which resolves in 1-2 days.
  • Why I recommend it: There have been Hepatitis A outbreaks in communities in the U.S. Hepatitis A is more of a concern in contaminated food and water supplies which rarely does happen in the U.S, but it can and it has. This vaccine is very important to consider before any international travel where adventurous eating (roadside booths) may happen.

INFLUENZA (FLU)

  • When is it routinely given: After 6 months of age. If your child is under 9 years old and it’s their FIRST time receiving the flu vaccine, they need two doses 4 weeks apart. Every year after that, they will just need one dose. Kids 9 years +, just need one dose every year.
  • How is this illness transmitted: Air, direct contact.
  • Disease symptoms: Virus that causes fever, body aches, sore throat, cough, extreme fatigue, and/or vomiting and diarrhea,
  • Possible complications of flu infection: Pneumonia (infection in the lung).
  • Side effects of vaccination: Common side effects are irritability, fever, or soreness at the site of infection which resolves in 1-2 days.
  • Why I recommend it: The flu leads to the hospitalization of almost 26,000 kids every year with deaths as well. The 2019-2020 season (pre-pandemic) reported 188 deaths. Although many kids can fight off this infection, for many healthy kids it can lead to hospitalization and complications which is why it’s best to consider getting the vaccine.

What should you expect after vaccines?

Commonly, children may cry during the vaccine; but they will calm down after. Pre-medication with pain-medicine is not needed and can actually reduce the efficacy of vaccination. Give acetaminophen or ibuprofen (age appropriate), only if cranky beyond baseline. No need to medicate if not necessary. Fever alone is also not a reason to medicate, but if they have a fever and are cranky then medication is appropriate. Fever can last as long as 48 hours post-vaccination, but if it lingers longer; speak to your child’s clinician. If you child has redness or swelling at the site of injection, you can use a cool compress on the area. If it persists, your child is in pain, or it’s spreading, seek medical attention.

What other resources are there regarding vaccines?

Vaccines are tested for safety and efficacy and are monitored throughout the year for continued safety. I fully support vaccines and encourage you to consider them for your child as well. Make sure to visit reputable websites for vaccine education and information, such as the CDC website and the AAP website.

Download my free PDF resource on vaccines here.

P.S. – For more vaccine related education, listen to The PedsDocTalk podcast: Episode 31: The Lowdown on vaccines with two pediatrician moms and Episode 32: Busting vaccine myths with science.

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All information presented on this blog, my Instagram, and my podcast is for educational purposes and should not be taken as personal medical advice. These platforms are to educate and should not replace the medical judgment of a licensed healthcare provider who is evaluating a patient.

It is the responsibility of the guardian to seek appropriate medical attention when they are concerned about their child.

All opinions are my own and do not reflect the opinions of my employer or hospitals I may be affiliated with.