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August 2008
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Child vaccines: The shots that kids need
The diseases prevented by the 12 childhood vaccines in the table below are bad ones. They can leave you blind, deaf, or paralyzed. They can cause painful infections of the bones, lungs, or skin. They can inflame the brain, turn healthy cells cancerous, or scar the heart. In some cases, they can kill.

Routine vaccination, however, has all but eliminated many of those diseases. For example, in 2006 there were only 55 reported cases of measles in the U.S., and none of diphtheria or polio. In comparison, before vaccination became common some 500,000 people in the U.S. developed measles each year, 176,000 contracted diphtheria, and 16,000 came down with polio.

Experts hope that current recommendations for the flu and meningitis vaccines, as well as new vaccines against viruses that contribute to certain other common childhood diseases and even cervical cancer, will prove equally successful. And they caution that failure to vaccinate could lead to a resurgence of some previously controlled diseases. Indeed, recent outbreaks of the mumps and pertussis (whooping cough) may have stemmed in part from declining immunity because of inadequate vaccination. In many cases, vaccination rates for more recently recommended vaccines remain low.

But there's little reason for the average person to avoid being vaccinated, because the potential benefit of vaccination greatly outweighs the potential risks. Those risks include the vaccine-specific side effects described in the table below, as well as minor reactions such as mild fever or pain at the injection site, severe but rare allergic reactions, and fainting. (Because of that last risk, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices now recommends that kids stay in the doctor's office for 15 minutes after getting vaccinated.) See the CDC's vaccination schedule for children ages birth to 6 years old.

CHILDHOOD VACCINES
Vaccine Year introduced Severe consequences of natural disease Moderate or severe vaccine side effects (%) Vaccine efficacy (%)
Chicken pox (varicella) 1995 Skin infections, shingles (painful nerve inflammation that develops in adults who had disease as children), encephalitis (brain inflammation) Rare 70 to 90
DTaP, Tdap  (for diphtheria, tetanus, and pertussis) 1991 Diphtheria: Paralysis, heart failure, death
Tetanus: Weakened bones, pneumonia, death
Pertussis: Impaired breathing, pneumonia, seizures, death
Prolonged crying (1 to 9/8000), fever of 104° F or higher (1/3000), convulsions (1/14,000) Diphtheria: 95
Tetanus: >99
Pertussis: 80 to 85
H influenzae B (childhood) 1985 Skin or bone infections, meningitis (inflammation of the lining of brain and spinal cord), pneumonia, systemic blood infection Rare 95 to 100
Hepatitis A 1995 Impaired liver function, death Rare 94 to 100
Hepatitis B 1981 Impaired liver function, death Rare 80 to 100
HPV (Human papillomavirus) 2006 Genital warts, cervical cancer Appear rare >99
Influenza, injected (inactivated vaccine), inhaled nasal spray (live vaccine) Shots, 1945; inhaled, 2003 Pneumonia, death Injection: Rare Nasal spray: nasal congestion (20 to 75/100), headache (2 to 46/100), vomiting (3 to 13/100) 87 to 90
MMR (for measles, mumps, and rubella) 1967 Measels: Pneumonia, encephalitis, seizures, death
Mumps: Inflamed testicles (in postpubertal males), deafness
Rubella: Blindness and deafness as well as heart defects and retardation in children born to infected mothers
Fever of 103° F or higher (5 to 15/100 doses), seizure (1/3,000) Measels: 95
Mumps: 95
Rubella: 95
Meningitis 1974 Permanent neurological impairment, loss of limb, death Fever over 100° F (3 to 5/100); headache, vomiting, diarrhea, seizures (3 to 4/100); Guillain-Barre syndrome, or temporary paralysis (rare) >/= 85
Pneumococcal (childhood) 2000 Pneumonia, systemic blood infection, meningitis Fever over 100.4° F (15-24/100 doses) 90
Polio (paralytic) 1955 Respiratory failure, post-polio syndrome, paralysis, death Vaccine-induced polio (oral vaccine only: 1/2.4 million doses) >/= 99
Rotavirus 2006 Fever, vomiting, dehydration, death Appear rare 74 to 98

 In general, the more serious the problem, the less common it is.
 After one dose. Reduces severity of symptoms in children who do get disease.
 Tdap approved in 2005 for use as a booster for adolescents age 10 to18 (and adults) who have already received full course of DTaP.
 Against infection from four strains of HPV responsible for about 70 percent of cervical cancers and 90 percent of genital warts.
 Inhaled vaccine approved only for children ages 2 and older.
 Inhaled vaccine has also been associated with 27 percent reduction in risk of ear infections.
 
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