Gail Carlson.PhD.
Health Education Specialist
University of Missouri Extension
Copyright/Access Information
Even in the best of times, balancing all the demands of parenting
can be tricky for parents. When a child becomes ill, the parent's
world gets turned upside down. It is impossible for parents to
keep their children healthy all the time. Infectious diseases
are sometimes easily spread by other people, by animals, and even
through airborne droplets that contain disease-causing bacteria
and viruses. Young children, especially those under the age of
two, are more likely to get sick just because their immune systems
are not fully developed.
Nevertheless, there are some things that parents can do to help
strengthen their children's immune systems and reduce their risk
of becoming ill. Children who eat right, get enough rest, and
participate in regular exercise are better able to fight off disease.
Proper hand washing by children and adults and keeping our homes
and living environments clean can also help reduce our exposure
to disease- causing bacteria and viruses.
However, some very serious infectious diseases can only be prevented by getting children immunized.
Within recent history, large numbers of children were killed
by diseases like small pox, polio, diphtheria, whooping cough
and tetanus. Many others were left permanently disabled because
of
measles, rubella, and Hib (Hemophilus influenza). Today, vaccines
are available to prevent these communicable diseases. Immunization
(the use of vaccines) is based on a simple principle. Many infectious
diseases can only be contracted once during a lifetime. In the
process of recovering from a particular disease, the body produces
a permanent defense response against the organism which causes
that disease. Immunization artificially triggers this defense
response so that a person can become immune without actually getting
the disease.
All immunizations carry with them the possibility of side effects.
No immunization is 100 percent safe or 100 percent effective.
However, in comparison to the risks associated with contracting
the disease, the risks from the vaccines are minimal. Vaccines
are administered in small dosages at specified times in early
childhood in order to reduce the risk of side effects and provide
maximum protection. In most cases, once the vaccine series has
been completed it provides the child a lifetime of immunity from
that disease.
Except for the oral polio vaccine, vaccines are given by injection.
Reactions to vaccines are typically mild but may include headaches,
mild fever, and some redness and muscle soreness at the site of
the injection. Generally, the symptoms last for only a day or
two. A mild rash, which can last 5 to 10 days, may develop after
a child receives the measles vaccine.
Severe reactions to immunization can occur, but they are rare.
As a precaution, vaccinations are often delayed if the child is
running a fever. If a child has ever had convulsions, has had
a previous reaction to vaccines, or has a weakened immune system,
the parent should inform the health care provider before any vaccinations
are given.
With the exception of small pox, which has been almost eradicated,
the viruses and bacteria that cause infectious diseases such as
hepatitis B, diphtheria, polio, and measles still exist in our
environment. In order to prevent outbreaks of such diseases, it
is important that we maintain high vaccination levels among our
children. Experience has shown that when there are large numbers
of unimmunized children in an area, these diseases can spread
very quickly.
The major measles outbreak that recently occurred in this country
is a good illustration. The number of reported measles cases were
relatively low between 1981 and 1988. We became complacent and
failed to have our children properly immunized. As a result, between
1989 and
1991, we saw a major increase in reported measles cases. In this
three year period (1989-1991) 55,000 measles cases were reported.
This outbreak resulted in 11,000 hospitalizations and 130 deaths.
Failure to vaccinate preschool-aged children was identified as
one of the major causes of the outbreak. Not having children immunized
contributes to the outbreaks of many of these infectious illnesses
and children who are not immunized are the most susceptible.
In Missouri, children are routinely vaccinated against nine diseases
- diphtheria, hemophilus influenza B (Hib), hepatitis B, measles,
mumps, pertussis, polio, rubella and tetanus. It is also recommended
that children be screened for tuberculosis at regular intervals
- at about one and five years of age and again when the child
enters high school and college. Tuberculosis is a contagious disease
and in recent years there has been an increase in the number of
reported cases. While
technically not an immunization, TB screening can help identify
those who have come in contact with the virus causing this disease,
so that treatment can be provided.
Over 90% of Missouri's children entering school are protected,
or current on their immunizations. Since age-appropriate immunization
is also a requirement for participation in child care and preschool
programs, most preschool-age children are also appropriately immunized.
The greatest number of under-immunized children are those aged
two and younger. It is also this group that is most susceptible
because their immune systems are not fully developed.
For children, disease is an abstract concept and since the
viruses and bacteria that cause disease can't be seen, they don't
exist. On the other hand, the pain associated with a vaccination
is vivid and immediate. Children reactions to this experience
can differ greatly depending on their individual personalities.
Some will react quickly and loudly and then just seem to forget
about it. Others will brood and fuss about it for days. Allow
your children to deal with their feelings about the experience
and help prepare them for these experiences which are a necessary
part of life at this age. The majority of the vaccinations are
given when your child is an infant and toddler. It is going to
be difficult to prepare a child this young ahead of time. But
you can reassure your child afterward and give them any extra
love and attention they might need.
By the time your preschooler is ready for boosters, you can take
a more active role in preparing them for their immunizations.
Talk to your child. Read stories about going to the doctor for
a shot. Be honest if you child asks if they are going to get shots.
Let children who have recently been to a doctor talk about their
experiences or encourage them to act out their feelings with a
doll or other toys. Children need opportunities to vent their
feelings. But, try to be positive and reassure them that doctors
are for healing and helping.
Our children will be faced with many unpleasant life experiences.
We can use immunization experiences, which may be unpleasant but
necessary, to begin teaching our children some coping skills for
dealing with unpleasant experiences. We can also prepare ourselves
for this experience. If you are having your own negative feelings
about having their children immunized, just remind yourself that
your child deserves a healthy life. By have them immunized you
are giving them that chance.
(As set forth by the Advisory Committee on Immunization Practices,
The American Academy of Pediatrics, and the American Academy of
Family Physicians. January 1996.)
Newborn - Hepatitis B-1
2 months - Hepatitis B-2, DPT (diphtheria, pertussis, tetanus),
OPV (oral polio virus), Hib (hemophilus influenza type B)
4 months - DPT, OPV, Hib
6 months - Hepatitis B-3, DPT, Hib
15 months - MMR (Measles, Mumps, Rubella), Hib, VZV (chickenpox)
18 months - DPT and OPV
4-6 years - DT P or DTaP (diphtheria tetanus), MMR*, and
OPV
11-12 years - Hepatitis B-3, T(d), MMR*, VZV (age 11-12)
Every 10 years Immunization - T(d) (adult tetanus, diptheria)
*A second dose of the MMR vaccine is needed at 4-6 years or
11-12 years depending on state school immunization requirements.
Pantell, R. H. Fries, J.F. and Vickery D.M. "Taking Care
of Your Child." Reading, Massachusetts: Addison-Wesley Publishing
Company, Inc. 1990.
Shelov, S.P., Editor in Chief. "Caring for Your Baby and
Young Child: Birth to Age 5." New York: Bantam Books, 1991
U.S. Department of Health and Human Services. "General Recommendations
on Immunization." Atlanta, Georgia: Centers for Disease Control
and Prevention, 1/28/94, 43 (RR-1)