I. Practical Tips About Vaccines

II. Common Concerns about Vaccines

VACCINES

VACCINES

I. PRACTICAL TIPS ABOUT VACCINES 1. FEAR OF SHOTS

• 3 P’s for helping children/infants during vaccinations.- Pharmacological (pain medicine): - topical anesthesia and sugar water (infants).- Psychological (thoughts and behaviors): - Hold and breast feed(for infants); Breathing deeply (children) and distractions.- Physical (Body positions and Activities): Breathe deeply (parent) and distract(infant); hold in lap…

1. FEAR OF SHOTS

2. WHO SHOULDN’T GET VACCINE

• Any child who has had a severe reaction to a vaccine should not receive another dose of the same vaccine.

• Severe reactions include:- DIFFICULTY BREATHING- HIVES- LOW BLOOD PRESSURE- SHOCK - USUALLY OCCURING IMMEDIATELY AFTER RECEIVEING THE VACCINE(SHOT).

• Weakened vaccines shouldn’t be given to children with leukemia, lymphoma and other types of cancers or AIDS.

• The live, weakened vaccine include MMR and Varicella vaccine.

2. WHO SHOULDN’T GET VACCINE(VACCINE REACTION RATE)

3. VACCINATING CHILDREN WHO LIVE WITH SOMEONE WITH WEAKENED IMMUNITY

• Children living with someone who has weakened immunity (such as leukemia, lymphoma and other types of cancers) can receive all types of vaccines that are recommended for children.

• Children who receive vaccines that contain only a part of a virus or bacterium (hepatitis B, Hib, DTaP) or a killed virus (IPV) are also not contagious.

3. VACCINATING CHILDREN WHO LIVE WITH SOMEONE WITH WEAKENED IMMUNITY

4. CHILDREN WHO ARE ILL• Unfortunately, illness is common reason for many

children to miss vaccines.

4. CHILDREN WHO ARE ILL (CONTD…)

• It is safe to give all of the recommended vaccines to children with minor illness.Minor illness include:- low grade fever- ear infections, cough, running nose, diarrhoea, or vomiting.

• Several studies found that children with minor illness were not at greater risk of side effects and had a similar immune response after immunization as children without minor illnesses.

5. VACCINATING CHILDREN WITH PREGNANT MOTHERS

5. CHILDREN WITH PREGNANT MOTHERS

• Sometimes infants and toddlers are scheduled to receive vaccines at the same time that their mother is pregnant.

• Children who receive live, weakened vaccines (Measles, Mumps and Rubella or Varicella) are not likely to be contagious.

• Therefore, a child whose mother is pregnant may receive all the recommended vaccines.

6. CHILDREN WHO ARE BREAST FEEDING

• It is unlikely that the antibodies found in breast milk can interfere with the ability of vaccines to induce protective immunity in infants.

• Therefore, all infants who are breast-feeding may receive all the recommended vaccines.

7. CHILDREN WHO TAKE STEROIDS

• Steroids are commonly given to children with common diseases such as Asthma, or poison envy.

• Since steroids can weaken the immune system, parents ask whether it is safe to give vaccines at the same time children are getting steroids.

• The answer is Yes or NO.

• It is safe for children who received steroids cream or steroids sprays(aerosols) to get vaccines.

7. CHILDREN WHO TAKE STEROIDS (CONTD…)

• Vaccines are also safe for children who received steroids for less than 2 weeks. However, children who received high doses(2mg per kg of body weight) of steroids per day of prednisone or its equivalent by mouth for more than 2 weeks should not receive like, weakened virus vaccines (specifically, MMR or Varicella)

• High Doses of Steroids may decrease child’s ability to fight infection, as well as the ability to build up immunity after vaccination.

8. CHILDREN WITH ANTIBIOTIC ALLERGIES

• Some Children have severe allergies reactions to Antibiotics.

• These reactions may include hives, difficulty breathing, low blood pressure or shock.

• None of the vaccines contain antibiotics to which children are usually allergic.

• Some vaccines contain trace amounts of antibiotics that are extremely rare cause of allergic reactions and to which most children are never been exposed (Specifically, neomycin, polymixin B, and Streptomycin)

• Therefore, Children Allergic to penicillin, amoxicillin, Cephalosporin, or sulfa drugs may receive all recommended vaccines.

9. CHILDREN WITH EGG ALLERGIES • Some children are highly allergic to proteins in eggs.

• Allergic reactions includes Hives, difficulty breathing and shock.

• Both Measles and Mumps vaccines are made in cells originally derived from chick eggs. However, not enough chick proteins are contained in the final vaccine preparations to cause problems.

• Recent studies have shown that even children with severe egg allergies can receive Measles – Mumps Vaccines without difficulty.

• Children with severe egg allergies should not, however receive either the Influenza or Yellow fever vaccines.

10. PREMATURE BABIES• Most premature infants, including those with low birth

weights, can be immunized at the usual chronological age.

• The only exception to this rule is the Hepatitis B vaccine. Premature infants (children born within 36 weeks’ gestation with a birth weight of less than 4.4 pounds) whose mothers are not infected with the Hepatitis B virus should receive the vaccine at two months of age rather than at birth.

• Those premature infants whose mothers are infected with the Hepatitis B should receive vaccine at birth, independent of body weight.

10. PREMATURE BABIES (CONTD…)

11. GIVING VACCINES SIMULTANEOUSLY• Because children receive 11 vaccines routinely, some

children could receive 4-5 vaccines during a single visit to the doctor.

• Some manufacturers are working for combined vaccines.

• All routinely recommended vaccines can be given simultaneously, there is no evidence that giving one vaccine significantly interferes with the immunity caused by another. Nor is there evidence that any of the vaccines increases the rate of side effects of another. Different vaccines should, however, be given at the same sites of the body.

12. MISSED VACCINES

• A missed vaccine doesn’t mean that the series must be started all over again/. If a dose of DTaP, IPV, HiB, or hepatitis B is missed, the series of immunizations can be continued after the missing dose(s) is given.

13. VACCINATING CHILDREN ADOPTED FROM OTHER COUNTRIES

• Children vaccinated in other countries should be immunized according to the same schedule as that required for children in the current country. However, a written record of immunization should be provided as evidence that a child has been vaccinated ether in this country or elsewhere.

13. VACCINATING CHILDREN ADOPTED FROM OTHER COUNTRIES

• The majority of vaccines made in other parts of the world, including developing countries, are produced with adequate quality control standards and are of reliable potency.

II. COMMON CONCERNS ABOUT VACCINES1. VACCINES DON’T WORK

• best example of the impact of vaccines: -the vaccine that prevents meningitis caused by the bacterium Haemophilus influenzae type b (Hib).

• After, the introduction of Hib vaccine, the incidence of Hib memingitis declined to fewer than 50 cases per year from 15,000 cases (during 1990).

• A Dramatic reduction in the incidence of diseases such as measles, mumps, German measles, polio, diphtheria, tetanus, and pertussis occurred within several years of the introduction of vaccines against them.

VACCINES WORK• VACCINES NOT ONLY WORK, BUT THEY WORK PHENOMENALLY WELL.

2. VACCINES AREN’T NECESSARY

• In some ways, vaccines are victims of their own success.

• Most young parents have never seen a case of some diseases. So they question the continued need for vaccines.

• Vaccines should be given for 3 reasons:- prevent some highly prevalent diseases within the country (polio)- Prevent some diseases still present in the environment (measles)- Prevent some diseases which have been virtually eliminated in the country but may b prevalent in other areas of the world (disease might be acquired during international travel)

3. VACCINES ARE NOT SAFE

• in some cases, a person’s immune system will not generate an adequate response. As a result, he or she will not be effectively protected after immunization.

• That said, the effectiveness of most vaccines is high. The inactivated polio vaccine offers 99% effectiveness after three doses. The varicella (chickenpox) vaccine is between 85% and 90% effective in preventing all varicella infections, but 100% effective in preventing moderate and severe chicken pox.

3. VACCINES ARE NOT SAFE (CONTD…)

• Almost all vaccines can cause pain, redness, or tenderness at the site of injection. And some vaccines cause more severe side effects.Example: Pertussis vaccine can cause persistent, inconsolable crying or high fever.Although none of the severe symptoms results in permanent damage, they can be quite frightening to parents.

• Vaccines are brought in use (licensed) only after successful trial on a number of cases.

• Information about the side effects of vaccines are on Vaccine Safety Datalink (VSD)

4. INFANTS ARE TOO YOUNG TO BE VACCINATED• Children are immunized in the first few months of life because

several vaccine-preventable diseases infect them when they are very young.Eg: Pertussis, Hib meningitis, Hepatitis B, and so on.

5. IT’S BETTER TO BE NATURALLY INFECTED THAN IMMUNIZED• “Natural” infection almost always causes better immunity than

Vaccination (only the Hib, pneumococcal, and tetanus vaccines r better at inducing immunity than natural infection.

• Natural infection causes immunity after just ONE infection, vaccines usually cause immunity only after several doses are given over a number of years (example: DPT, Hepatitis B, etc are given at least three times) But,

• Natural infection from polio virus can cause paralysis, Mental retardation from Natural Hib infection, Liver failure from Hepatitis B and so on.

• THE BENEFITS OF VACCINE-ACQUIRED IMMUNITY EXTRAORDINARILY OUTWEIGH THE SERIOUS RISKS OF NATURAL INFECTION.

6. CHILDREN GET TOO MANY SHOTS

• Infants and young children commonly encounter and manage many challenges to their immune system at the same time.

• 20 years ago children received 5 shots by two year of age and as many as 2 shots at one time, now we have 11 routinely recommended vaccines, children receive as many as 20 shots by 2 yrs of age and five shots at a single visit. Many parents are concerned abt whether children can handle these vaccines.

• But vaccines are just a small part of what babies or children encounter everyday

6. CHILDREN GET TOO MANY SHOTS

7. VACCINES WEAKEN THE IMMUNE SYSTEM

• Natural infection with certain viruses (wild type) can indeed weaken the immune system. For example: Children infected with measles are more susceptible to bacterial infections of the bloodstream (sepsis)

• But vaccines are different. The vaccine are themselves so disabled that they cannot weaken the immune system.

8. VACCINES “USE UP” THE IMMUNE SYSTEM

• Dr. Meh Cohm and Dr. Rodney Langman theorized that, “the no. of MOS to which a body can respond depends on the no. of cells in the blood that can make antibodies sufficient to recognize all the relevant parts of the MOS.Using this theory, it stood to reason that the no. of MOS to which one response depends on one’s size. Elephant can produce immunity to abt 100 times more MOS than humans.

• Although adult humans could make more antibodies to more organisms than infants, scientists estimated that even young infants could respond to abt 100,000 different orgns at one time. Therefor, 11 vaccines use only abt 0.01 percent of the immunity that is available.

9. SOME VACCINES CONTAIN OTHER INFECTIOUS AGENTS THAT MAY DAMAGE MY CHILD• Vaccines that are made with killed versions of pathogens—or with only a part

of the pathogen—are not able to cause illness. When a person receives these vaccines, it is nearly impossible for him or her to become ill with the disease

• It is important to note that attenuated vaccines can cause serious problems for individuals with weakened immune systems, such as cancer patients. These individuals may receive a killed form of the vaccine if one is available. If not, their doctors may recommend against vaccination. In such cases, individuals rely on herd immunity for protection.

• live, attenuated vaccines generate longer-lasting immunity than killed vaccines. Thus, killed vaccines are more likely to require boosters to maintain immunity. Killed vaccines, however, also tend to be more stable for storage purposes, and can’t cause illness.

10. VACCINES CAUSE AUTISMS

10. VACCINES CAUSE AUTISMS

10. VACCINES CAUSE AUTISMS

• This possibility was publicized after a 1998 paper by a British physician who claimed to have found evidence that the MMR (measles, mumps and rubella) vaccine was linked to autism.

• The potential link has been thoroughly explored; study after study has found no such link, and the original 1998 study has been formally withdrawn by the Lancet, which had originally published it.

• It’s likely that this misconception persists because of the coincidence of timing between early childhood vaccinations and the first appearance of symptoms of autism.

11. A MERCURY CONTAINING PRESERVATIVE (THIMEROSOL) CONTAINED IN MANY VACCINES HARMS CHILDREN.• The preservative, thimerosal ( Thiosalicylic acid + Mercury), which

is used in some vaccines. The mercury contained in thimerosol is an organic form called Ethylmercury.

• Preservative protect vaccines from bacterial contamination, however multidose vials can be contaminated and lead to mild or fatal infections. Mercury in high amount can cause damage to the nervous system and kidney. Hence, IOM recommends DTaP, Hib, and Hepatitis B vaccines free from thimerosol to be used in USA.

• Studies have shown that low level thimerosol, in vaccines does not cause neurological problems or autism.

12. THE HEPATITIS B VACCINE CAUSES SUDDEN INFANT DEATH SYNDROME (SIDS)

• Every year in the USA thousands of infants die of SIDS. The Hepatitis B vaccine is now routinely recommended for infants as a series of three vaccines. Therefore, some infants who get the hepatitis B will invariably die from SIDS – Some will die from SIDS soon after the vaccine is given. But it doesn’t mean that child who get Hepatitis B vaccine are more likely to die from SIDS.

• The cases of SIDS has decreased after the American Academy of Pediatrics recommended “Back to Sleep” for infants, ie, parents were asked to let infants on their back instead of face down. The result was a dramatic decline in SIDS and proved that SIDS was not related to vaccines.

13. PHARMACEUTICAL COMPANIES OCCASIONALLY MANUFACTURE LOTS OF VACCINES THAT CAUSE HIGH RATES OF ADVERSE EVENTS (“HOT LOTS”)

• Individual lots of vaccines that have usually high rates of side effects have never been identified (in USA).

• Hence, specific lots of vaccines have never been withdrawn from use as “hot lots”

14. VACCINE PREVENTED DISEASES OCCUR MORE OFTEN IN VACCINATED PEOPLE THAN IN NON-VACCINATED PEOPLE.

• On its face, this statement seems to be actually true. However, it is important to understand why?

• Lets study a situation, - 100 students live in a dormitory of a college…

• It is reported that unvaccinated people have 35 times more chance of getting Measles than Vaccinated.

15. WHY CAN’T WE ERADICATE OTHER DISEASES, AS WE DID WITH SMALLPOX?• In theory, nearly any infectious disease for which an effective

vaccine exists should be eradicable.

• With sufficient vaccination levels and coordination between public health organizations, a disease can be prevented from gaining a foothold anywhere; eventually, without anyone to infect, it must die off.

• A notable exception is tetanus, which is infectious but not contagious: it’s caused by a bacterium commonly found in animal feces, among other places. Thus, tetanus could not be eradicated without completely removing the Clostridium tetani bacterium from the planet.

15. WHY CAN’T WE ERADICATE OTHER DISEASES, AS WE DID WITH SMALLPOX?(CONTD…)• Smallpox is unusual, however, in the set of characteristics that made it

susceptible to eradication. Unlike many other infectious diseases, smallpox has no animal reservoir.

• Another obstacle to eradication for many infectious diseases is visibility. People with smallpox were highly visible: the smallpox rash was easily recognizable, so that new cases could be detected quickly. Vaccination efforts could be focused based on the location of the cases and potential exposure to other individuals.

• Polio, by contrast, causes no visible symptoms in about 90% of the people it infects. As a result, tracking the spread of the polio virus is extremely difficult, which makes it a difficult eradication target.

• Perhaps most importantly, smallpox patients generally did not reach their highest level of infectivity (that is, their ability to infect others) until after the appearance of the smallpox rash. As a result, quick action to quarantine infected individuals upon the eruption of the rash usually left enough time to vaccinate anyone who had already been exposed, and prevent additional exposures.

• Many infectious diseases do not allow for this kind of reaction time. Measles patients, for example, can become infectious up to four days before the appearance of the measles rash. As a result, they can pass the virus on to many, many other people before anyone even knows that they are infected.

• Many people still think eradication is possible for certain diseases. Efforts are ongoing to eradicate several diseases, such as polio and Guinea worm disease (Dracontiasis)

15. WHY CAN’T WE ERADICATE OTHER DISEASES, AS WE DID WITH SMALLPOX?(CONTD…)

16. WHAT IS HERD IMMUNITY? IS IT REAL? DOES IT WORK?

• Herd immunity, also known as community immunity, refers to the protection offered to everyone in a community by high vaccination rates. With enough people immunized against a given disease, it’s difficult for the disease to gain a foothold in the community.

• This offers some protection to those who are unable to receive vaccinations—including newborns and individuals with chronic illnesses—by reducing the likelihood of an outbreak that could expose them to the disease.

HERD IMMUNITY

17. The hepatitis vaccine causes arthritis, multiple sclerosis, and long term (chronic) neurological disorder.

18. Vaccines causes Diabetes.

19. The DPT vaccine causes a disease that looks like “shaken baby” syndrome.

20. The polio Vaccine is the cause of AIDS.

21. The polio vaccine is contaminated with a virus that causes cancer.

22. Vaccines may contain the agent that causes “Mad Cow” disease.

II. OTHER COMMON CONCERNS ABOUT VACCINES

THANK YOU…!!!