HOW SAFE ARE VACCINES?

Vaccines are very safe, but like any medication they can cause reactions. The vast majority of reactions that may occur in your child are mild, such as a sore arm where the shot is given or a slight fever. Serious reactions are very uncommon. Some are caused by the vaccine, but others are too rare to know whether they are caused by the vaccine or would have occurred anyway. Occasionally a child with allergies, such as to eggs, may have a severe allergy to part of a vaccine. While there is a very small risk (around one in a million) that a vaccine will trigger an allergic reaction, make sure your child's doctor knows about any allergies the child has had in the past.

Your doctor will discuss the risks with you before each immunization for your child, and will give you a Vaccine Information Statement (VIS), which describes the vaccine's benefits and risks. You can also review the information about precautions and side effects of individual vaccines (see links to vaccines at left).

The important thing is that having your child immunized is generally much safer than leaving her open to the diseases the vaccines can prevent. Once thousands of children in the U.S. died each year from diseases that vaccines now can prevent. Two of the greatest success stories of vaccines are the worldwide elimination of smallpox disease and the eradication of polio in the U.S.

There is a lot of incorrect or misleading information about the safety of vaccines, so it is important for you to know that the source of any information about vaccines is a trusted one. Discuss any concerns you have with your child's doctor.


DO VACCINES ALWAYS WORK?

Most vaccinations that children receive provide immunity about 90 to 100 percent of the time. Occasionally, a child does not respond to certain vaccines, for reasons that aren't entirely understood. This is one reason why it is important for all children to be immunized. A child who does not respond to a vaccine has to depend on the immunity of others around him.


WHY SHOULD I HAVE MY CHILD IMMUNIZED?

Immunizing your child not only helps to keep her from getting serious illnesses, but it also helps to protect the health of the community. Some children are too young to get certain vaccinations, such as the measles vaccine, which should not be given to children younger than 1 year. Other children cannot be vaccinated for medical reasons, such as children with leukemia or another type of cancer. It also helps to give protection to some people who do not make an adequate immune response to vaccination or those who have just received a vaccine, but whose bodies have not yet developed immunity.


WHY ARE VACCINES GIVEN AT SUCH AN EARLY AGE?

The diseases vaccines prevent can occur at a very young age. Some diseases are far more serious or common among infants or young children. For example, children under 1 year old are the most affected by severe diseases such as bacterial meningitis caused by Streptococcus pneumoniae or Haemophilus influenzae type b bacteria. Of the children under 6 months of age who get pertussis, 72 percent must be hospitalized, and 84 percent of all deaths from pertussis are among children younger than 6 months.


What should I do to ease the pain and fear of vaccination?

Many children fear getting routine vaccinations and other shots, and studies have shown that several strategies can reduce that fear. Depending on the age of the child, many of these techniques can be used alone or in combination. Counting, listening to music, blowing soap bubbles, watching a video tape, or reading or telling a story can distract the child from the shot and anticipated pain. Getting the parent involved can reduce the parent's concern, which may improve the child's coping skills.


What if my child misses a dose of vaccine?

Talk to your child's doctor about a catch-up schedule. If immunizations have been delayed, your child can continue the series regardless of the time between doses. Vaccinations do not have to be repeated if there is a longer-than-recommended interval between doses.


What are preservatives and why are they added to vaccines?

Although the major ingredient of any vaccine is a killed or weakened form of the bacteria or virus that the vaccine is designed to prevent, some vaccines (mainly ones that come in vials that might be used several times) contain preservatives to prevent bacterial growth. Thimerosal is a preservative that contains a very small amount of mercury and was used for many decades in some vaccines.

In recent years, there has been concern about a possible connection between the amount of thimerosal given to children and developmental disorders such as autism, Attention Deficit Hyperactivity Disorder (ADHD), and delays in speech and language development. But there is not sufficient research evidence to support any such link.

However, because of concerns about the total amount of mercury that a child would be exposed to, given the total number of vaccines in the recommended childhood immunization schedule, thimerosal has been removed from or reduced in those products. Some inactivated flu vaccines still contain this preservative, so you may want to ask your doctor about using a flu vaccine that is thimerosal-free.


What should you do if your child has a reaction?

Most children do not have reactions to vaccines or if they do, the reactions are usually minor, local reactions (pain, swelling, or redness at the injection site) or a mild fever. These go away within a day or two and don't normally require any special treatment. If your child shows symptoms of an allergic reaction (difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat, or dizziness) after getting vaccinations, or if he or she shows other unusual symptoms such as a high fever or behavioral changes, call a doctor or get the child emergency medical care right away.

Tell your doctor what happened, the date and time it happened, and when the vaccination was given.

If your child had a severe (life-threatening) allergic reaction to a dose of a vaccine, it is very likely he should not get another dose of that specific vaccine. If the severe allergic reaction was thought to be caused by an ingredient in the vaccine, he very likely should not get any other vaccine that contains that specific ingredient. Discuss with your child's doctor which vaccines can be given safely to your child if he had a serious allergic reaction to any vaccine.


Reporting Adverse Reactions

If your child has a serious vaccine-associated reaction, or even if you think a medical problem your child has might have been caused by a vaccine, report the problem. It is especially important to report any problem that happened after vaccination and resulted in hospitalization, disability, or death. The Vaccine Adverse Event Reporting System (VAERS) collects and reviews reports of suspected vaccine injuries. Generally, the doctor fills out a VAERS report and sends it to the program, but a parent can also file. You can get more information about VAERS from the toll-free information line at 800-822-7967, or go to the Web site at www.vaers.hhs.gov.

VAERS cannot prove that a vaccine caused a problem or provide medical advice, but it does provide important information to the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC). Those agencies monitor the safety of the vaccine as it is given to millions of children and adults of various backgrounds and medical conditions. If it is reported a vaccine might be causing a problem, the CDC and FDA will investigate further to make sure that the benefits of using the vaccine continue to exceed the risks.


Should I keep a record of my child's vaccinations?

It is important for parents to maintain complete records of all vaccinations that their child has received. Some doctors keep these records, but often only for a few years. Families move, travel, and change health providers so a complete record often is not available from one source. Ask your doctor for an immunization record form. Have the form updated with the date and doctor's signature each time your child is vaccinated.

Parents can create an online computer record of their children's shots by using an Immunization Information Systems (IIS), also known as Immunization Registries. An IIS is useful for making sure that your child gets all of her immunizations on schedule, and for maintaining good records that you and your child's doctor can use, even when you move. State laws require that information in the IIS be kept confidential. To find your IIS, go to www.cdc.gov/vaccines/programs/iis/default.htm.


What vaccinations does my child need?

Because vaccines work best when they are given at certain ages, the CDC has developed a schedule. This schedule is reviewed and updated each year to determine which childhood immunizations are necessary and when they should be given. Your child's doctor will use those recommendations to determine the best time for your child to be vaccinated. In some cases, such as with preterm (premature) infants or children with a serious illness, your child's doctor may make changes to this schedule.


Travel

Your child may need additional vaccines if he will be traveling overseas. If you plan to travel, be sure to talk with your child's doctor when you begin to make travel plans so that these immunizations can be given before you leave.

If you have any questions or concerns about immunizations and your child, you should always talk to your child's doctor. For additional information about immunizations, visit the CDC's Web site, at www.cdc.gov.