By the time a baby is 2 years old, she
may have had more than 20 vaccine injections. After a few more shots as a
preteen, your child will be protected from 16 major diseases. Here's what you
need to know about the process.
When we get a virus, we produce
antibodies to fight it and give us immunity from another attack. Vaccines do the
same thing, but the antibodies are made from weakened or killed viruses (or
bacteria) that stimulate the antibody formation without the illness. Once an
entire population is immunized, a disease could be virtually wiped out. (After
the polio vaccine was developed in the 1950s, the death and paralyzation rates
fell to zero in the U.S. and most of the developed world.)
But it's not a foolproof plan. In 2003,
33 children and six adult caregivers in New York got whooping cough; by February
of 2004, another 34 cases were reported. Health officials traced the outbreak's
origin to four children in two families whose parents chose not to have them
During an outbreak, even a child who has
been inoculated can get sick because in about 5 percent of cases, a vaccine
doesn't fully "take." The best protection for all kids, then, is universal
immunization whenever possible.
HepB protects against
hepatitis B, a viral illness passed from mother to newborn. Most hospitals give
it before discharge, often within hours of birth. In rare circumstances, it can
be delayed, but only with a physician's order and a copy of the mother's lab
report showing that she's not a carrier. An exception: Preemies under 4.4 pounds
should wait until the one-month checkup, unless the mother is a HepB carrier
(they should get all their other vaccines on schedule at their actual age, not
their gestational age).
1 month: HepB
If your baby got the
HepB vaccine (see above for what Hep B protects against) at birth, he'll now get
a booster shot; if not, he'll get his first one. In any case, he must get his
first shot by 2 months and the second one by 4 months.
2 months: DTaP, Hib, IPV, PCV, RotaTeq
DTaP protects against three bacterial diseases: diphtheria;
tetanus, which causes lockjaw; and pertussis (whooping cough). Hib protects
against Haemophilus influenzae type b, a cause of bacterial meningitis and
IPV protects against polio, a viral illness that
causes paralysis and can be fatal.
PCV protects against
pneumococcal bacterial infections, which can cause deafness, pneumonia, and
RotaTeq protects against rotavirus, a viral
disease that causes severe diarrhea.
Your child can get one
vaccine -- Pediarix -- in place of HepB, DTaP, and IPV, but there is a higher
risk of a mild fever. Pediarix is given at 2, 4, and 6 months.
4 months: Boosters for DTaP, Hib, IPV, PCV, RotaTeq
(See above for explanations of the diseases these vaccines
6 months: Boosters for HepB, IPV, and RotaTeq, and often for
DTaP, Hib, and PCV
(See above for explanations of
the diseases these vaccines protect against.)
shots, available in October, aren't mandatory but are recommended for kids 6
months to 5 years old. Ask for a thimerosol-free children's vaccine (regular
ones still contain the mercury preservative). Skip the shot entirely if your
child is allergic to eggs, which is what's used to make flu vaccines.
12 months: Boosters for Hib and PCV (any time up to 15
months); varicella, MMR (both up to 15 months), and HepA.
(See above for explanations of the diseases that the Hib and
PCV vaccines protect against.)
Varicella protects against
MMR protects against three viral illnesses:
measles, which can cause pneumonia; mumps, which can lead to deafness; and
rubella, a.k.a. German measles, which is especially dangerous if a pregnant
woman is exposed to it because it can cause miscarriage or birth defects.
HepA protects against hepatitis A, a viral illness spread by
hand-to-mouth contact that affects the liver and can cause jaundice, severe
stomach pain, and diarrhea.
You can ask for the ProQuad
vaccine, which combines MMR with varicella, so there's one less shot.
15 months: Booster for DTaP (up to 18 months)
(See above for an explanation of the diseases that the DTaP
vaccine protects against.)
18 months: Possible boosters for HepB, DTaP, IPV; booster for
(See above for explanations of the diseases
these vaccines protect against.)
If your child hasn't had
her HepB, DTaP, or IPV boosters yet, she'll get them now. After a booster of
HepA, your baby is home free until kindergarten.
4-6 years: Boosters for DTaP and IPV (even if your child got
Pediarix), MMR (even if your child got ProQuad), and varicella
(See above for explanations of the diseases these vaccines
11-12 years: MCV4, Tdap; girls will be offered a three-dose
series of HPV
MCV4 protects against meningitis, a
rare infection that can be fatal.
Tdap is the booster for
adolescents (and adults) against diphtheria; tetanus, which causes lockjaw; and
pertussis (whooping cough).
HPV protects against human
papilloma-virus later in life, a sexually transmitted disease and the main cause
of cervical cancer.
Note: The Centers for Disease Control and Prevention
updates vaccine recommendations based on new data. For the most recent
information on recommended vaccines, go to the CDC's website
Who shouldn't be vaccinated
* Children with moderate or severe
illness -- a high fever, vomiting -- should wait until they're well before
getting shots. If it's just a cold, cough, mild fever, or even mild diarrhea,
though, go ahead and get the immunizations.
* Kids who've ever had a severe reaction
-- hives, low blood pressure, difficulty breathing, or shock -- to a shot
should not be given that particular vaccine again. But stay on schedule with
* Children with a weakened immune system
due to cancer or AIDS should not be given MMR or varicella, which are made from
live viruses. Talk to your doctor.
* Any child on long-term, high-dose
steroids should not receive the live vaccines. But they're fine if your child
takes inhaled steroids or uses oral steroids on a short-term basis.
"I nurse my babies right
after their shots while we're still in the doctor's office. It comforts them
Ann Dominick, Homewood, AL
* Children allergic to gelatin or to the
antibiotics neomycin, polymixin B, and streptomycin should receive alternative
vaccines. Talk to your doctor.
The odds of your child becoming ill from
not being vaccinated are much higher than the odds of her having a serious
reaction to a shot. Over the years, concerns have been raised linking vaccines
to SIDS, autism, and other problems, but no links have been substantiated. The
Autism: Until 1999, several vaccines contained tiny
amounts of the mercury derivative thimerosol as a preservative. Some researchers
hypothesize that thimerosol may contribute to autism rates by damaging the
developing brain, and, as part of a campaign to reduce all mercury exposure,
vaccine makers voluntarily stopped using it. (It's still in some flu vaccines,
but thimerosol-free versions are available.) Since then, repeated studies have
failed to find a link between the preservative and any form of neurological
damage, including autism.
SIDS: The suspicion that there's a link between sudden
infant death syndrome (SIDS) and the hepatitis B vaccine has never been proven.
In fact, SIDS rates have actually plummeted since the vaccine was first
recommended for newborns in 1991 (though experts argue that may have more to do
with babies being put on their backs to sleep).
Allergic reactions: Most vaccines produce no side
effects, or very minor ones, like soreness at the injection site or a low-grade
fever. But some do contain ingredients that kids could be allergic to, such as
gelatin. Still, the risks are very small. The MMR vaccine, for example, has been
linked to one death per 2 million doses.
How to take
the ouch out of shots
An appropriate dose of acetaminophen or
ibuprofen about an hour before the appointment can help lessen the pain. But
there are effective ways to soothe your child without medication:
Blow soap bubbles. Your child's eyes will follow them
instead of the syringe. Even better: Let her blow them herself (kids can do it
as early as age 3). She'll have to breathe deeply to do so, which automatically
relaxes the body.
Work your magic. Simple stuff like "Peekaboo!"; "Which
hand has the red ball?"; and "Look how I can stretch my thumb!" can be great
Sing or read together. Humming along to a favorite tune
or soothing lullaby can go a long way toward taking her mind off the shot. Or
read a book with interesting pictures -- preferably something upbeat that never
fails to garner giggles.
Making sure your child is up to date on
vaccines is one of the most important things you can do to keep her healthy.
Shots aren't the most fun part of a checkup, but with the right distractions and
soothers your child will get through them just fine.