Let’s face it. Our children are our lives and our future, and whether dealing with our community or our families, we must as parents do everything to assure our children safe passage from birth through childhood into adulthood.  We teach and raise our children to trust us as parents, that we will protect and love them. That’s why we’re all so fortunate to be living now, not fifty or more years ago, when  science and our understanding of the immune system has helped develop vaccinations (see Table 1) protecting us each day against crippling and even life threatening infectious diseases. As a full time pediatrician before the development of  the hemophilus and pneumococcal vaccines,  I remember caring for very sick children with meningitis or bacteremia (bacteria in the blood) which caused serious injury and rarely claimed a child’s life.  Just a few hours or days earlier of life-sustaining treatment in the hospital with antibiotics made the difference for that child and the family. And however gratifying it was to cure the child of infection, the risks of delaying treatment and possible complications were too high. Is there a better way to assure safe passage for our children, and prevent serious infectious diseases from reaching our homes, schools and communities? Up-to-date information, parental awareness, along with childhood and adult vaccinations may very well be one of the answers, and the benefits far outweigh the risks of non-vaccination.

Parents are concerned with and ask basically the same good questions: 1) why are so many vaccinations needed; 2) can’t so many vaccinations be harmful and hurt my young child’s immune system;  3) aren’t there problems and side effects with some or all of these vaccinations? Let’s address each question. First, vaccinations are given throughout life, but most are given during the first 3 years (Table 1), when viral and bacterial infections have the greatest chance of hurting our children and their immature, developing immune systems. The immune system is a complex network of antibodies and cells designed to fight viral, bacterial and fungal infections. By the time a child is three years of age, 23 vaccinations will have been given to protect against 11 different infectious diseases. Our children are at the greatest risk from: diptheria, pertussis (whooping cough), tetanus, polio, hepatitis, hemophilus influenza (causes meningitis, bacteremia, sinusitis and ear infections), pneumococcus (causes bacteremia, pneumonia, sinusitis, ear infections) and varicella (causes chicken pox and later shingles). These vaccinations “boost” the young, immature immune system and help recognize and fight off serious infections that threaten our infants, toddlers and children. Since the introduction of  the pneumococcal and hemophilus vaccines, serious pneumococcal disease has dropped 37% and hemophilus disease over 90%!

Second, science and technology have developed more “immunogenic” vaccinations. This means that vaccines contain only those proteins that the immune system recognizes as “foreign”, recruiting cells and producing antibodies to seek and destroy the invading infection. In 1960, five vaccines contained over 3000 proteins, mostly due to the whole cell pertussis vaccine, and most proteins were not immunogenic. Today, the same vaccines have only 125 immunogenic proteins and are equally effective! And yet, if all the vaccinations were given at one time, we would predict that only 0.01% (1/10,000) of the immune system would be used up. Thus, the vaccinations are more immunogenic without unnecessary proteins and better able to prevent these diseases, without “exhausting” an immature immune system. The infant, toddler or child therefore is thus at much less risk for vaccine side effects, complications, and very capable of fighting off new viral or bacterial infections.

Finally, vaccines can have side effects, but technology has tried keeping pace and avoiding these problems. The whole cell pertussis vaccine in use up to 3 years ago caused high fevers, irritability and rarely seizures, but the new pertussis acellular vaccine has fewer side effects. Allergic reactions to vaccines are very low; in one study, only case report per 450,000 doses was noted, and only one case of a life-threatening reaction per 8 million doses occurred. The oral polio vaccine has been replaced with the injectable vaccine to improve immunogenicity and reduce side effects. The new varicella vaccine rarely causes high fever or irritability, significantly reduces new cases of chicken pox and uncomfortable, painful cases of shingles, and for every $1.00 spent on the vaccine, $5.00 is saved in medical costs. Chicken pox as disease, however, can cause bacterial skin infections, nervous system and kidney diseases. 

Parents thus should feel free to question their providers about vaccinations, new developments, side effects and risks. Information on-line can be obtained by checking www.nih.gov, www.aaaai.org, and www.acaai.org. 

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