Ask a Nurse

Today's ask-a-nurse question is a follow-up on last week's vaccine question:

How do I know my baby isn't getting too large of a dose of a vaccine?

Vaccine doses for infants are different from the doses for children and the doses for adults. It is important to note that it requires at least 10 years of FDA testing before a vaccine can even be licensed. Before they are even in use, vaccines are thoroughly tested for proper dosing, safety, and effectiveness, so you can be certain that the right amount is being given to your child to provide immunity to the disease without causing serious adverse effects.

Once a vaccines is licensed, the Centers for Disease Control and the FDA continue to monitor for safety and effectiveness of the vaccine. Any hint of a problem will lead to an in-depth investigation and appropriate actions will be taken including even revoking the vaccine's license if necessary.

If you have a question you would like Nurse Brittany to answer, e-mail it to healthyhappychildren@gmail.com.

Ask a Nurse

Today's ask-a-nurse question is from Angie in Michigan:

Is there still mercury in vaccines?

In the 1930s thimerosal, an organic compound containing mercury, started being widely used in vaccines and other drug products as a preservative. Although there was never evidence that the small doses of mercury in the preservative caused any harm to patients, in July of 1999 the American Academy of Pediatrics, along with several other public health organizations, began working with vaccine manufacturers to reduce or eliminate the use of thimerosal in vaccines simply as a precautionary measure.

To date, thimerosal has been removed or reduced to trace amounts in all vaccines recommended for children under the age of six. For older children and adults, there are now many vaccines that are available in thimerosal-free formulas.

If you have a question you would like Nurse Brittany to answer, e-mail it to healthyhappychildren@gmail.com.

Ask a Nurse

I've heard of children having bad reactions to vaccines? What are the signs of a reaction? What should I do if I am concerned my child may be having a reaction?

Fortunately it is rare that a child has a reaction to a vaccine, but it does happen. Here are the signs you should look for. Call your pediatrician if your child has any of the following symptoms:
* hives
* difficulty breathing
* a fever greater than 104
* a generalized rash
* extreme irritability

It is important to note that it is common after getting vaccinated for children to experience a little pain, redness, or swelling at the injection site. Children may also develop a slight fever, but these symptoms should go away within a few days. Children's Motrin or Tylenol can help relieve any of these symptoms.

The Statistics Behind Vaccines

If you're like most, you know vaccines are important in keeping our children healthy and disease free, but you may not know exactly what diseases your children are being protected from. So what are the actual statistics on how various vaccines have prevented illness and death? Below are the disease and death rates from the Centers for Disease Control and Prevention since the introduction of various vaccines.


Vaccine: DTaP
Diptheria—In 1920 there were 147,991 reported cases of diptheria causing 13,170 deaths. In 2002, one case was reported in the United States.
Tetanus—Tetanus continues to kill 300,000 newborns and 30,000 birth mothers a year in areas of the world where the immunization is not available.
Pertussis (Whooping Cough)—Before the immunization, there were around 260,000 cases reported each year leading to around 9,000 deaths. Worldwide there were 9,771 cases reported in 2002.

Vaccine: HIb
Haemophilus Influenza type b (bacterial meningitis)—Before the vaccine, HIb killed 600 children a year and infected over 20,000. In 2005 only 34 cases were reported.

Vaccine: PCV
Pneumococcal—Since the vaccine was introduced, disease rates in children have declined 70 to 80 percent.

Vaccine: IPV
Polio—Before the vaccine 13,000 to 20,000 new cases were reported each year. In 2000 no cases were reported.

Vaccine: MMR
Measles—Measles continues to be one of the most infectious diseases in the world, and researchers estimate that if the vaccine were stopped, there could be some 2.7 million deaths worldwide from the disease.
Mumps—Before the vaccine there were an estimated 212,000 cases of mumps annually. In 2002 there were 270 cases reported.
Rubella—Before the vaccine it is estimated that rubella led to 20,000 infants born with severe disability, 2,100 neonate deaths, and 11,250 miscarriages.

Vaccine: Varicella
Varicella (Chickenpox)—Before the vaccine there were around 4 million cases annually, leading to 11,000 children hospitalized and 100 deaths each year. In 2002 there were 9 reported deaths from chickenpox.

Vaccine: HepB
Hepatititis B—In 1982, 22,177 new cases of the disease were reported. In 2002 only 7,996 cases were reported.

Vaccine: Smallpox
Smallpox—The vaccine for smallpox began to be widely used in 1900. At that time there were about 1,000 deaths caused by the disease each year. By 1977 smallpox had been eradicated.

In the News: MMR Vaccine

The question of whether vaccines cause autism has become quite a controversial topic related to children's health. However, the 1998 study that suggested a link between the MMR vaccine and autism was retracted last week, sending an important message to the health care community. The study was retracted after an intense investigation by a medical panel in Great Britain that concluded that one of the study's authors had been dishonest and violated basic research rules and ethics.

In response to the retraction of the study, Tom Skinner, a spokesman for the Centers for Disease Control and Prevention, said, “It builds on the overwhelming body of research by the world’s leading scientists that concludes there is no link between MMR vaccine and autism.”

Richard Horton, editor of the medical journal that retracted the study, added, "I certainly hope that our retraction today will help to reassure parents that there really isn’t anything to be concerned about with the vaccine."

For more information on why the study was retracted, you can read the following articles from the New York Times:

http://www.nytimes.com/2010/02/03/health/research/03lancet.html
http://well.blogs.nytimes.com/2010/02/08/did-the-media-inflame-the-vaccine-autism-link/

Later this week we will post more information on the recommended vaccination schedules for your children so you can keep them healthy and happy.