The hepatitis B vaccine
What are the benefits of the hepatitis B vaccine?
The hepatitis B vaccine (HBV) protects your child against the hepatitis B virus, which can lead to liver damage and even death.
Hepatitis B is generally considered an adult disease because it's known to be transmitted through unsafe sex and shared needles. But many who get it, including children, don't engage in these "high-risk" behaviors. They're either infected at birth or they contract the disease from close contact during childhood with others who are infected.
Hepatitis B is highly infectious. An estimated 800,000 to 1.4 million people in the United States have the virus, and 20 to 30 percent of them acquired the disease in childhood. Many of them never feel sick and don't know they have it, but those who become infected as children are more likely to have long-term health problems such as cirrhosis and liver cancer. About 2,000 to 4,000 Americans die from hepatitis B-related illness every year.
The HBV vaccine was introduced in 1982 and became part of the recommended immunization schedule in the United States in 1991. Since then, the incidence of acute hepatitis B has dropped by over 95 percent in children and adolescents, and over 75 percent overall. The number of new infections per year has declined from an average of 260,000 in the 1980s to about 43,000 in 2007, with the biggest decline among children and adolescents.
What's the recommended schedule?
Recommended number of doses
Three shots.
Recommended ages
• At birth
• Between 1 and 2 months
• Between 6 and 18 months
Women in the United States are screened for hepatitis B during pregnancy. If you test positive, your baby should get an injection of hepatitis B immune globulin (HBIG), which provides short-term protection, within 12 hours of birth.
To track your child's immunizations, use BabyCenter's Immunization Scheduler.
Who shouldn't get the hepatitis B vaccine?
A child who had a life-threatening allergic reaction to a previous dose of hepatitis B vaccine should not be vaccinated again.
Also, if for some reason your child didn't get hepatitis B shots as a baby and you know that she's had a life-threatening allergic reaction to baker's yeast (the kind used in baking bread), she shouldn't receive the hepatitis B vaccine because it's made with that type of yeast.
Are there any precautions I should take?
Children who are moderately to severely ill should probably wait until they recover before getting the hepatitis B vaccine. That way, if they do have any side effects, they'll be better able to tolerate them.
What are the possible side effects?
Some children feel soreness where the shot was given and a few develop a low-grade fever.
Severe allergic reactions are rare but possible with any vaccine. See what our expert says about how to tell whether your baby's having an adverse reaction.
In spite of persistent rumors, as yet no evidence links the hepatitis B vaccine to hair loss, SIDS, or autoimmune disorders such as multiple sclerosis or diabetes.
The DTaP vaccine
What are the benefits of the DTaP vaccine?
The DTaP vaccine protects your child against three diseases: diphtheria, tetanus, and pertussis (whooping cough).
Diptheria
This bacterial infection causes a thick gray coating to develop at the back of the throat that makes it hard to breathe and swallow, and can result in suffocation. If the infection is not treated, toxins produced by the bacteria may affect tissues and organs throughout the body, which can lead to heart failure or paralysis.
Death occurs in up 20 percent of cases in people under age 5 and over age 40. These numbers have changed little in the last 50 years, according to the U.S. Centers for Disease Control (CDC).
Before the vaccine was developed in the 1920s, there were more than 175,000 cases a year on average in the United States. By contrast, since the year 2000, only five cases have been reported. But every year sees outbreaks of diphtheria in Eastern Europe, Russia, Brazil, Nigeria, Indonesia, and the Philippines. So while the risk of getting diphtheria in the United States is low, the disease is only a plane ride away.
Tetanus
Tetanus (also called lockjaw) is a bacterial infection that causes severe and painful muscle spasms, seizures, and paralysis. It's not contagious. The bacteria live in soil and dust and enter the body through a break in the skin. People can get tetanus from any kind of puncture wound, or from other types of injuries (even a tiny scratch) if they're not cleaned and cared for properly. Ten to 20 percent of reported cases end in death.
Since the vaccine came into widespread use in the 1940s, the number of tetanus cases in the United States has fallen from about 500 to about 50 a year.
Pertussis
Pertussis, better known as whooping cough, is a very contagious bacterial infection and one of the most common vaccine-preventable childhood diseases. Whooping cough causes coughing spells so severe that it's hard for children to eat, drink, or breathe. It can lead to pneumonia, seizures, brain damage, and death.
Before the vaccine was introduced in the 1940s, about 147,000 U.S. children came down with whooping cough every year. The number of cases in the United States dropped to a historic low of 1,010 in 1976 but then rose again, with more than 25,000 reported in 2005 as adolescents who had been vaccinated as babies lost their immunity and more babies went unvaccinated.
To counter this trend, an additional shot called the Tdap is now recommended at age 11 or 12. And one Tdap shot is also recommended, now, for adults who didn't have one during adolescence. Getting yourself vaccinated helps to protect your infant and other infants you're around.
Whooping cough remains a serious health problem among children in other parts of the world.
What's the recommended schedule?
Recommended number of doses
Six shots between birth and age 12; one in adulthood.
Recommended ages
- At 2 months
- At 4 months
- At 6 months
- Between 15 and 18 months
- Between 4 and 6 years old
- A booster shot at 11 or 12 years of age (called the Tdap)
- For adults: a Tdap (for adults who've never had one) or Td booster every ten years
To track your child's immunizations, use BabyCenter's Immunization Scheduler.
Who shouldn't get the DTaP vaccine?
- Children younger than 6 weeks old
- A child who has had a severe reaction to a previous DTaP shot, including difficulty breathing, hives, fainting, high fever, seizure, or nonstop crying for three or more hours. If this happened to your child, consult your doctor before she receives another dose of the vaccine.
- Talk to your child's doctor about other possible situations in which your child shouldn't get the vaccine. If the pertussis part of the shot causes a reaction, a DT (diptheria tetanus) shot may be appropriate.
Are there any precautions I should take?
According to the CDC, keeping fever under control is especially important for children who have had any type of seizure. The agency recommends that children who have had a seizure take an aspirin-free pain reliever at the time of the shot is given and for the next 24 hours. (Acetaminophen only for babies younger than 6 months; acetaminophen or ibuprofen for kids 6 months and older.) Check with your doctor to be sure.
Children who are moderately to severely ill at the time the vaccine is scheduled should probably wait until they recover before getting the shot. That way, if they do have any side effects, they'll be better able to tolerate them.
What are the possible side effects?
Most potential side effects are associated with the pertussis part of the vaccine. Neither the diptheria nor the tetanus vaccine is known to cause any serious side effects.
Relatively common side effects - usually occurring after the fourth and fifth doses of the vaccine - include mild fever, and redness, swelling, and soreness. If you notice these, you can ask the doctor whether it's okay to give your child acetaminophen or ibuprofen (for age 6 months and older) to ease discomfort. Fussiness, tiredness, and (more rarely) vomiting can also occur.
Severe allergic reactions are rare but possible with any vaccine. See what our expert says about how to tell whether your baby's having an adverse reaction.
The Hib vaccine
What are the benefits of the Hib vaccine?
The Hib vaccine protects your child from the Haemophilus influenzae type b bacteria, which can cause epiglottitis (severe swelling in the throat that makes it hard to breathe), a serious form of pneumonia, and a disease called bacterial meningitis.
Meningitis is an infection of the membrane covering the brain and spinal cord that can lead to lasting brain damage and deafness in young children, and can sometimes be fatal. Haemophilus influenzae can also cause serious joint and skin infections as well as other less common infections.
Before the Hib vaccine was approved for young children in the late 1980s, Hib was the leading cause of bacterial meningitis in U.S. children under 5. About 20,000 children in the United States under 5 years old got severe Hib disease each year and nearly 1,000 people died. Hib meningitis causes death in 1 out of 20 children and permanent brain damage in 10 to 30 percent of those who survive.
Thanks to the vaccine, the number of cases in kids under 5 had dropped to 259 by 2003 — a decline of more than 98 percent. The cases that still occur are mostly in children who haven't gotten all their shots or are too young to have been immunized.
What's the recommended schedule?
Recommended number of doses
Three or four doses.
Recommended ages
• At 2 months
• At 4 months
• At 6 months (not needed if the PedvaxHIB or ComVax brand of vaccine was given at 2 and 4 months)
• Between 12 and 15 months
It's especially important for kids to get this vaccine on schedule, because the diseases it protects against tend to strike children between the ages of 2 months and 2 years.
To track your child's immunizations, use BabyCenter's Immunization Scheduler.
Who shouldn't get the Hib vaccine?
• Children younger than 6 weeks old
• Any child who has had a serious allergic reaction to a previous dose
Are there any precautions I should take?
Children who are moderately to severely ill should probably wait until they recover before getting the Hib vaccine. That way, if they do have any side effects, they'll be better able to tolerate them.
What are the possible side effects?
Up to 30 percent of children have some redness, warmth, or swelling at the site of the injection. Fever and irritability happen infrequently. These symptoms may show up within a day of vaccination and can last two to three days.
Severe allergic reactions are rare but possible with any vaccine. See what our expert says about how to tell whether your baby's having an adverse reaction.
The polio vaccine
What are the benefits of the polio vaccine?
The polio vaccine protects your child against the poliovirus. Before a vaccine was introduced in 1954, more than 20,000 cases of polio were reported annually in the United States, and about 1,000 people died each year.
Not everyone who's infected with polio gets sick (up to 95 percent have no symptoms), and many who do get sick have only mild symptoms such as cough, fever, and stomach pain, or a stiff neck and headache. But about 1 in 200 people who get polio become paralyzed.
Polio caused by the wild virus was thought to have been eliminated from the Western hemisphere, because there hadn't been a case in the United States since 1979 or in the Americas since 1991. Then, in 2005, four children in Minnesota were diagnosed with the disease. The children were Amish (the Amish routinely decline to have their children vaccinated). None of the children were paralyzed as a result of the infection.
Outbreaks of polio continue in Africa and Asia, and global travel is common enough that a traveler could easily bring polio back to this country.
Is the vaccine given orally or in a shot?
Your child should receive the IPV, or inactivated polio vaccine, which is given by injection, for all four doses. Until 2000, the government had recommended that the third and fourth dose be the OPV, or oral polio vaccine, which is made from a live, weakened version of the virus. The OPV was considered somewhat more effective than the IPV.
Unfortunately, it had a very rare but dangerous side effect: About one in 2.4 million people who received the OPV contracted polio. Deciding that the risk of giving this vaccine was too great, the U.S. government took it off the schedule. The IPV given today has been enhanced to protect children from polio just as effectively as the OPV.
What's the recommended schedule?
Recommended number of doses
Four doses.
Recommended ages
• At 2 months
• At 4 months
• Between 6 and 18 months
• Between 4 and 6 years old
To track your child's immunizations, use BabyCenter's Immunization Scheduler.
Who shouldn't get the polio vaccine?
A child who has ever had a life-threatening allergic reaction to the antibiotics neomycin, streptomycin, or polymyxin B, or had a severe reaction to a previous dose of vaccine, should not get the polio shot.
Are there any precautions I should take?
Children who are moderately to severely ill should probably wait until they recover before getting the polio vaccine.
What are the possible side effects or risks of an adverse reaction?
Many children are a little sore at the site of the injection. No serious side effects from the IPV have been reported.
Severe allergic reactions are rare but possible with any vaccine. See what our expert says about how to tell whether your baby's having an adverse reaction.
The pneumococcal vaccine
What are the benefits of the pneumococcal vaccine?
This vaccine, also called Prevnar, protects against pneumococcal (pronounced new-m'COCKL) infections, which mostly strike children under age 5 and can lead to some of the worst childhood diseases. Kids under 2 years old are most at risk.
Before the vaccine was available, pneumococcal infection caused more than 700 cases of meningitis, 13,000 blood infections, and 5 million ear infections in children under 5 every year, according to the U.S. Centers for Disease Control and Prevention (CDC). The infection is caused by pneumococcus bacteria, also known as Streptococcus pneumoniae. These bugs live in the mucous lining of the nose and in the back of the throat, and when plentiful enough can cause an infection in the respiratory tract, middle ear, or sinus cavities.
Pneumococcal bacteria are spread by close contact and through coughing and sneezing. Diseases such as meningitis and pneumonia can crop up within days of infection. Symptoms of pneumococcal pneumonia usually include fever and chills with shaking or trembling, as well as chest pain, coughing, shortness of breath, rapid breathing, rapid heart rate, fatigue, and weakness. Nausea, vomiting, and headaches are also associated with pneumococcal pneumonia, but are less common.
Though antibiotics such as penicillin can kill the offending bacteria, up to 40 percent of the strains may be resistant to antibiotics. So experts highly recommend the vaccine, which is effective in up to 90 percent of people who get it. The vaccine can even prevent some of the most serious ear infections among children.
What's the recommended schedule?
Recommended number of doses
Four doses.
Recommended ages
• At 2 months
• At 4 months
• At 6 months
• Between 12 and 15 months
To track your child's immunizations, use BabyCenter's Immunization Scheduler.
Are there any precautions I should take?
Mildly ill children can be vaccinated. But if your child has a high fever or a severe illness, such as pneumonia, wait until his health improves before taking him in for the vaccine. He'll be better able to handle the immunization when he's healthy.
What are the possible side effects?
About a quarter of vaccinated children have redness, discomfort, or swelling at the site of the injection. Up to a third develop a fever of over 100.4 degrees. One in 50 has a higher fever of over 102.2 degrees.
Severe allergic reactions are rare but possible with any vaccine. See what our expert says about how to tell whether your baby's having an adverse reaction.
The rotavirus vaccine
What are the benefits of the rotavirus vaccine?
It protects against rotavirus, the most common cause of diarrhea in babies and young children in the United States and around the world. The severe diarrhea caused by this virus is often accompanied by fever, vomiting, and dehydration. It's extremely contagious, and spreads easily through ordinary person-to-person contact.
Good hygiene and sanitation don't effectively stop rotavirus disease, so immunization is your best defense. The vaccine protects 98 percent of kids from severe diarrhea and 74 percent from getting rotavirus diarrhea at all.
According to the U.S. Centers for Disease Control (CDC), rotavirus infects almost all children in the United States by age 5. (Adults can contract it, too, but the illness tends to be mild.) In the United States alone, it triggers more than 400,000 doctor visits and 200,000 emergency room visits, 55,000 to 70,000 hospitalizations, and 20 to 60 deaths among kids under age 5.
In February 2006 the U.S. Food and Drug Administration (FDA) approved a new version of the vaccine, and the CDC's Advisory Committee on Immunization Practices now recommends that all children get it.
How is the new vaccine different from the old one?
The new vaccine, RotaTeq, replaces Rotashield, which was taken off the market in 1999 after being linked to incidents of bowel obstruction in some infants. RotaTeq is a live, oral vaccine, and is the only approved rotavirus vaccine on the market.
RotaTeq is manufactured using a very different process than the earlier vaccine and was widely tested before winning approval. According to the CDC, these tests demonstrated not only the safety of the new vaccine, but its effectiveness, too: The CDC says it will prevent about 74 percent of all rotavirus cases, 98 percent of severe cases, and 98 percent of hospitalizations.
What's the recommended schedule?
Recommended number of doses
Two or three doses before the age of 8 months.
Note: Unlike most vaccines, the rotavirus vaccine is given by mouth rather than as an injection.
Recommended ages
• At 2 months
• At 4 months
• At 6 months (not needed if the Rotarix brand of vaccine was given at 2 and 4 months)
The U.S Centers for Disease Control (CDC) advises against starting the vaccine series in babies over 14 weeks and 6 days old. If your baby hasn't gotten a first dose by then, talk to your doctor about whether it makes sense to try to catch up.
The vaccine isn't recommended for babies once they turn 8 months old, because there's not enough evidence to show how well it works in older babies and some evidence that they're more likely to suffer adverse reactions, like fever.
To track your child's immunizations, use BabyCenter's Immunization Scheduler.
Who should not get the rotavirus vaccine?
A child younger than 6 weeks old.
A child who has had an allergic reaction to a previous rotavirus vaccine, is allergic to one of the components of the vaccine, or has had a bowel obstruction.
Are there any precautions I should take?
A child with a mild illness can probably be vaccinated. But you'll probably want to delay it if your child's moderately or severely ill. Either way, let your doctor know that your child is sick.
The rotavirus vaccine should be used with caution in infants with compromised immune systems or a history of a chronic gastrointestinal illness, as the safety and effectiveness of the vaccine for these children haven't been determined.
Because the vaccine contains a live virus that could potentially infect others, take extra care in disposing of diapers and washing your hands for a week after the first dose. There's no evidence the virus is shed in the later doses.
What are the possible side effects?
In tests of the vaccine, some babies had a few more minor symptoms — including diarrhea, vomiting, ear infection, and runny nose — than those who received a placebo. No serious side effects have been associated with the vaccine.
Severe allergic reactions are rare but possible with any vaccine. See what our expert says about how to tell whether your baby's having an adverse reaction.
The flu shot for children
What are the benefits of the flu shot for young children?
Children under 5 years old are at high risk for serious flu-related complications like pneumonia. Every year in the United States more than 20,000 children under age 5 are hospitalized because of the flu.
Kids under 2 who come down with the flu — even if they don't have any other health issues — are the most likely to need hospitalization. And kids between 2 and 4 who get the flu are more likely than older children to have to see a doctor, be taken to an urgent care center, or end up in an emergency room.
To protect children from the flu and its possible complications, the Centers for Disease Control and Prevention (CDC) recommends a yearly flu shot for kids 6 months to 18 years of age.
The CDC also recommends a yearly flu shot for household contacts and caregivers of children under age 5. This includes anyone who lives with children under 5, such as parents and older brothers and sisters, as well as daycare providers, babysitters, and other caregivers.
The flu vaccine is especially important for kids who:
• Have diabetes, a suppressed immune system, or sickle-cell anemia
• Have chronic heart, kidney, or lung disease (including asthma)
• Have any condition that can compromise their respiratory function
• Are on long-term aspirin therapy for diseases such as juvenile rheumatoid arthritis (Aspirin puts children at risk for Reye's syndrome if they come down with a virus.)
• Live in a household with very young children or with adults who have a compromised immune system, diabetes, severe anemia, or certain diseases of the heart, lungs, or kidneys
What exactly is the flu?
Influenza, commonly referred to as the flu, is caused by a virus that infects the respiratory system, including the nose, throat, and lungs. It's highly contagious, and because it has a one- to four-day incubation period, people often spread the virus before they show any symptoms.
The flu usually causes aches and pains, extreme fatigue, chills and sweats, and a loss of appetite. While flu symptoms such as a runny nose, cough, sore throat, and headache initially resemble those of a cold, flu hits much harder and is likely to be accompanied by a fever of 101 degrees Fahrenheit or higher.
Children with the flu are likely to develop higher fevers than adults. They may also have nausea, vomiting, and diarrhea. In general, though, influenza doesn't affect the stomach and intestines: What people refer to as "stomach flu" — bouts of diarrhea, nausea, and vomiting — is actually not influenza but gastroenteritis.
Most cases of the flu occur during the winter months — although, according to the CDC, flu season can begin as early as October and last as late as May.
Why does the vaccine change from year to year?
Every year, scientists devise a new vaccine about nine months in advance in response to the viruses in circulation at the time and which strains scientists predict will be predominant for the next flu season. Each vaccine protects against three different strains of flu virus.
Won't my vaccinated child still be vulnerable to other strains of flu virus not included in the vaccine?
Fortunately, the flu vaccine provides some protection against other strains of flu. So even if your child unexpectedly becomes infected with one that's not included in the vaccine, he'll probably have a milder case.
What's the recommended schedule?
The CDC recommends an annual flu shot for children from 6 months to 18 years of age.
The first time a child receives the vaccine, he'll get two shots about a month apart, to build immunity. The first one is usually administered in October.
After the first time, the shot is given once a year, preferably in October or November, to give children time to develop immunity before flu season gets into full swing.
Healthy children age 2 and older who have no history of recurrent wheezing or asthma can get a nasal spray version of the flu vaccine. Because the nasal spray vaccine contains a weakened live virus, it's not recommended for people who have contact with anyone who has a compromised immune system, including pregnant women and babies younger than 6 months.
Who shouldn't get a flu shot?
If you have any questions about whether your child should receive the vaccine, talk with his doctor. In general, your child won't receive the flu vaccine if he:
• Is under 6 months of age
• Is severely allergic to eggs (If you think your child might be allergic to eggs, talk to his doctor, as the vaccine is grown in chicken eggs and may contain traces of egg protein.)
• Has had a severe reaction to a flu shot in the past
• Has a moderate or severe illness with a fever
What about thimerosal?
Thimerosal, a preservative that contains mercury, has been removed from all routine childhood immunizations except flu shots — some of which still contain it. The CDC found no evidence that the preservative is harmful, but had it removed as a precautionary measure on the recommendation of the American Academy of Pediatrics and the Public Health Service.
If you're concerned, ask your child's healthcare provider whether the vaccine being offered contains thimerosal. Thimerosal-free vaccines are manufactured and have been earmarked for children ages 6 months to 23 months, but you'll need to check with your provider to see whether one is available that would be appropriate for your child.
What are the possible side effects?
The most common side effect of the flu shot in children and adults is soreness at the vaccination site. Children, particularly those who haven't been exposed to the flu virus, may develop a fever and feel achy and tired. These symptoms can last for up to two days.
Symptoms such as fever, chills, and muscle aches occur in less than 1 percent of people receiving the flu shot (usually those receiving it for the first time) — a rate that's no higher than in people receiving a placebo injection.
In children, the side effects from the nasal spray vaccine can include runny nose, wheezing, headache, vomiting, muscle aches, and fever.
Severe allergic reactions are rare but possible with any vaccine. See what our expert says about how to tell whether your child is having an adverse reaction.
The MMR vaccine
What are the benefits of the MMR vaccine?
The MMR vaccine protects your child against three viruses: measles, mumps, and rubella (German measles).
Many parents now choose the MMRV vaccine instead of the MMR. MMRV is the same as MMR, except that it includes protection against the varicella virus, which causes chicken pox.
Measles
Measles is a highly contagious illness that was once almost universal in children. Its main symptoms are a rash, fever, runny nose, cough, and eye irritation.
Possible complications of measles include ear infections, diarrhea, pneumonia, seizures, encephalitis, brain damage, and death.
Before a measles vaccine was licensed in 1964, more than 500,000 cases of measles were reported on average in the United States annually, with about 48,000 hospitalizations and 450 deaths from the disease. After the introduction of the vaccine, the number of measles cases went down 99.9 percent to about 50 cases a year, mostly originating outside the country.
These days, measles has been virtually wiped out in the United States, although a small outbreak is occasionally imported — usually from Europe or Asia — to an unvaccinated population (a group that refuses vaccines, for example) or to people who have received only one dose of the MMR vaccine. In 2005 there were 66 confirmed cases, and 34 of those occurred in a single outbreak in Indiana that was traced to an unvaccinated traveler who had acquired the disease in Romania.
Mumps
Mumps is a viral infection that typically causes a fever, headache, and inflammation of the glands under the jaw.
Mumps can lead to meningitis, encephalitis, and (rarely) deafness. It can also cause painful swelling of the testicles or ovaries. Twenty to 50 percent of males infected with mumps after puberty develop orchitis, an inflammation of one or both testicles. In rare cases, orchitis can lead to sterility.
The current strain of the mumps vaccine has been used worldwide since being approved in the United States in 1967. Before a vaccine was available, the United States had an average of about 150,000 cases every year. In 2003 the number had dropped to 231 — a 99.9 percent decrease in the number of cases. In 2006, however, 6,000 cases were reported to the Centers for Disease Control and Prevention (CDC) during a multistate outbreak.
Rubella, or German measles
Rubella, also called German measles, is characterized by a pinkish red rash that starts on the face, a mild fever, and swollen lymph nodes. It's possible, however, to have rubella without any symptoms.
Rubella is a mild illness that runs its course in about three days, but if a woman gets it during pregnancy, it can cause miscarriage or birth defects in her baby, including deafness, eye problems, heart defects, and mental retardation.
The first rubella vaccines were licensed in 1969. During an epidemic in 1964-1965, 12.5 million cases of rubella were reported in the United States and 20,000 infants were born blind, deaf, or mentally retarded as a result. Today, rubella has been virtually eliminated in the United States, with only a handful of cases reported each year.
What's the recommended schedule?
Recommended number of doses
Two doses.
Recommended ages
• Between 12 and 15 months
• Between 4 and 6 years old — although the second dose can be given at any time as long as it's at least 28 days after the first.
To track your child's immunizations, use BabyCenter's Immunization Scheduler.
Who shouldn't get the MMR vaccine?
A child who has ever had a life-threatening allergic reaction to gelatin (yes, the stuff found in Jell-O), the antibiotic neomycin, or a previous dose of the MMR vaccine.
Check with your doctor about your child receiving the MMR vaccine if he:
• is taking steroids
• has a disease that affects his immune system, like HIV/AIDS or leukemia
• has cancer
• has a blood disorder or has recently received a blood transfusion
Because the measles vaccine is made by growing the virus in the cells of chicken embryos, children with egg allergies used to be advised not to get the MMR vaccine. However, studies have found that even children with severe egg allergies can receive this vaccine without a greater risk of side effects.
What are the possible side effects?
Mild reactions are fairly common. One in 6 children gets a low fever, and 1 in 20 develops a mild rash. In rare cases, a child has swelling in the glands of his neck or cheeks. If these problems occur, they usually do so seven to 12 days after getting the shot. A child is more likely to have these symptoms after the first dose.
Moderate reactions are less common. About 1 in 3,000 children has a seizure caused by high fever. Though these febrile seizures may seem scary, they're almost always harmless for the child. About 1 child in 30,000 will have a temporarily low platelet count, which may cause bleeding problems.
Severe allergic reactions are rare but possible with any vaccine. See what our expert says about how to tell whether your baby's having an adverse reaction.
I've heard that there's a link between the MMR vaccine and autism. Is that true?
This has been a topic of recent studies and heated debate. The CDC says there's no scientific evidence to link the MMR vaccine with autism. For more information about the CDC stance on this topic, read about the organization's research and answers to concerns.
The chicken pox vaccine
What are the benefits of the chicken pox vaccine?
It may seem unnecessary, because childhood chicken pox (also known as varicella) is usually a relatively mild illness. And some parents think it's better to let their kids be exposed to chicken pox so they'll have the illness (and the resulting immunity) naturally.
But most experts now recommend the chicken pox vaccine, and many schools and daycare centers require it. Here's why:
1) Chicken pox is no party. If your child gets it, he's likely to develop a rash of itchy, painful blisters accompanied by fever and fatigue. If the blisters get infected, he may need antibiotics. They may also leave permanent scars, possibly on his face. If he's going to daycare or school when he gets chicken pox, he'll have to stay home for eight or nine days.
2) Chicken pox can be serious and even deadly. Before the vaccine came along, an average of 10,600 hospitalizations and 100 to 150 deaths caused by chicken pox occurred annually in the United States. Most of the severe complications and deaths occurred in previously healthy people.
3) The vaccine will protect your child from the worst of this illness. While the vaccine isn't 100 percent effective (about 15 percent of vaccinated children still get chicken pox), vaccinated children who come down with it will have only very mild symptoms. That usually means fewer than 50 blisters, no fever, and less sick time.
4) The vaccine can help protect your child against a related disease called shingles. About 10 percent of adults who have chicken pox earlier in life get this rash of extremely painful and disfiguring blisters that can be inches across.
Shingles appears when the chicken pox virus, which lives forever in the central nervous system, "reawakens" and becomes active again. People who have been vaccinated against chicken pox may still get shingles but will have a much less severe case than those who had the disease itself.
For all these reasons, both the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) have put the chicken pox vaccine on the schedule of recommended immunizations.
What's the recommended schedule?
Recommended number of doses
Two shots at least three months apart.
Recommended ages
• Between 12 and 15 months
• Between 4 and 6 years
To track your child's immunizations, use BabyCenter's Immunization Scheduler.
Who shouldn't get the chicken pox vaccine?
A child who has ever had a severe allergic reaction to gelatin (yes, the stuff that's in Jell-O) or the antibiotic neomycin. If he has a severe allergic reaction to his first vaccination, he shouldn't receive a second.
If your child has cancer or any disease that affects his immune system, has recently had a blood transfusion, or is taking high doses of oral steroids (for asthma or poison ivy, for instance), his doctor will carefully evaluate whether receiving the vaccine is a good idea.
Is the chicken pox vaccine a live vaccine?
Varicella is a live-attenuated vaccine, which means it's a live virus that's been weakened so that it won't cause the disease. Instead, the virus will replicate in the cells of the body and cause it to produce an immune response, which should protect against a real chicken pox infection.
What are the possible side effects?
About 20 percent of children will have some soreness at the site of the injection. About 10 percent will have a low-grade fever. About 4 percent will have a mild rash (around ten chicken pox—like blisters).
Fewer than one in a thousand will have a seizure caused by high fever. Though these febrile seizures may seem scary, they're almost always harmless for the child. But you should call your doctor right away if your child has one.
Severe allergic reactions are rare but possible with any vaccine. See what our expert says about how to tell whether your baby's having an adverse reaction.
The hepatitis A vaccine
What are the benefits of the hepatitis A vaccine?
This vaccine protects your child against the hepatitis A virus, which causes a liver disease. The long-term physical consequences of hepatitis A are far less serious than those of hepatitis B or C. Still, a bout of hepatitis A is no fun, and the worst cases can cause liver damage and even death.
Hepatitis A is the most common type of hepatitis in the United States, with the highest rates among children ages 5 to 14. Disease rates vary from year to year, and many of those infected show no symptoms — so it's hard to know how many people are infected each year. Before the vaccine came along, the number of reported cases was up to 35,000 per year, but experts believe that after adjusting for underreported and asymptomatic cases, the number could be closer to 180,000.
The hepatitis A virus is carried in feces and may be transmitted by unwashed hands, so it can easily spread in daycare centers and other places where children play together. For example, a caregiver may help an infected child use the bathroom, forget to wash her hands, and then transmit the virus by touching her own mouth or another child's mouth.
Hepatitis A also is transmitted through contaminated food and water. The virus is very hardy and can survive for a long time on exposed surfaces, in raw foods, and in sewage.
The virus may cause symptoms such as fever, fatigue, nausea, vomiting, abdominal pain, dark urine, and sometimes jaundice, but it doesn't always cause symptoms, particularly in children. There's no treatment for the illness, but most children recover on their own within two months. About 15 percent of those infected have ongoing or relapsing symptoms for six to nine months. Three to five in a thousand cases of hepatitis A are fatal.
For all these reasons, the vaccine is now part of the recommended vaccine schedule in the United States. (Before 2006, the vaccine was recommended only in 11 states with significantly higher rates of infection.)
What's the recommended schedule?
Recommended number of doses
Two shots, at least six months apart.
Recommended ages
Between the first and second birthday (ages 12 to 23 months).
If your child is 2 or older, ask your doctor whether a vaccination is in order. Young children who aren't fully vaccinated by 23 months can still be vaccinated. And vaccinations are recommended for older kids in certain high-risk groups, too.
To track your child's immunizations, use BabyCenter's Immunization Scheduler.
Who should not get the hepatitis A vaccine?
A child who has a severe allergic reaction to the vaccine after the first shot should not receive another. Neither should any child who is hypersensitive to alum, a metal used in many vaccines to ensure a better immune response, or to 2-phenoxyethanol, a preservative that protects the vaccine vial from contamination.
Are there any precautions I should take?
This vaccine is so mild that doctors can give it to your child even if he's slightly under the weather. But if your child is suffering from a moderate to severe illness, wait until he's feeling better.
What are the possible side effects?
About 15 percent of children feel sore at the site of the injection. A few experience a headache, fatigue, or loss of appetite.
Severe allergic reactions are rare but possible with any vaccine. See what our expert says about how to tell whether your toddler's having an adverse reaction.
The meningococcal vaccine
The U.S. Centers for Disease Control (CDC) recommends that all children receive a single dose of the meningococcal vaccine (MCV4) at their routine, preadolescent doctor's visit (11 to 12 years of age). It's also recommended for certain high-risk children ages 2 to 10.
This vaccine protects against meningococcal disease. Before the vaccine came along, meningococcal disease was the leading cause of bacterial
meningitis (an infection of fluid around the brain and spinal cord) in children in the United States.
About 2,600 people in the United States get meningococcal disease each year, and 1 in 10 people dies from it. The disease can also cause loss of limbs, deafness, mental retardation, stroke, and other serious problems.
According to the CDC, the vaccine protects about 90 percent of those who are immunized. For more details, visit the
vaccine information sheet on the CDC website.
The human papillomavirus (HPV) vaccine
In 2007, the U.S. Centers for Disease Control (CDC) added to its immunization schedule a new vaccine that prevents human papillomavirus (HPV). The vaccine, recommended for girls ages 11 to 12, is given in three doses. It's highly effective at preventing HPV infections, including the two types that cause most cervical cancers.
HPV is the most common sexually transmitted disease in the United States today, with about 20 million people now infected. It's most common in people in their late teens and early 20s. And it's the leading cause of cervical cancer.
The American Cancer Society estimates that in 2009 in the United States, about 11,270 new cases of invasive cervical cancer will be diagnosed and about 4,070 women will die from it.
You'll find detailed information about the vaccine on the CDC's Human Papillomavirus (HPV) Infection page.
See our article on human papillomavirus (HPV) during pregnancy.
To track your child's immunizations, use BabyCenter's Immunization Scheduler.
