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Understanding about the diseases and the vaccines will help parents decide on the right course of action to take. One of the greatest advances of the 20th century was the development of immunizations, which help to protect children from life-threatening infectious diseases. The search for measures that prevent illness and subsequent hospitalization has continued into the 21st century. What drives the development of new immunizations? A variety of factors push pharmaceutical manufacturers to research and develop new vaccines. Modern society expects the continuous advancement of medical care, and medical companies respond, knowing that profits will soar with a successful product. From the pediatrician’s perspective, immunizations help to keep children healthy. Yes, there are side effects to any intervention, but the risk-benefit ratio must be considered. From the parent’s perspective, this can become a difficult decision for those who already have concerns about the increasing number of immunizations available to their children. Making the right decision is a challenge and cannot be underestimated. Understanding about the diseases and the vaccines will help parents decide on the right course of action to take. The newer vaccines and those on the horizon can fight diarrhea and vomiting, whooping cough, genital warts and cervical cancer and promote the continued prevention of chicken pox in adolescents and adults. Acellular Pertussis Booster Vaccination for Adolescents (combined with tetanus and diphtheria) The number of cases of pertussis, commonly known as whooping cough, continues to increase in teenagers and adults. We used to think that some vaccines gave a person lifelong immunity to certain diseases. This does not seem to be case with the pertussis vaccine. Since the disease in teenagers and adults tends to be relatively mild (a persistent cough can last for more than three weeks), why re-immunize? Because up to 7.5% of adolescents and nearly 5% of adults require hospitalization. In addition, contagious adults put vulnerable or partially immunized children at risk. Studies show that up to 75% of infant pertussis cases were transmitted from adults. A new booster for teenagers that contains tetanus, as well as acellular pertussis, has been developed. It is recommended to be given to children ages 12 and older. Stop vomiting and diarrhea Rotavirus is the most common viral illness that causes vomiting and diarrhea. Globally, rotavirus causes 114 million cases, 24 million outpatient visits and more than 600,000 deaths a year. It causes 5% of all deaths in children under age 5. In the U.S., four out of five children will develop rotavirus disease in the first five years. One in seven will require an emergency or office visit, one in 78 will require hospitalization and one in 200,000 will die from the disease. A new oral vaccine may reduce, over a five-year period, the number of cases by 1 million, hospitalizations by 34,000, nearly 100,000 emergency department visits and more than 200,000 physician visits. A rotavirus vaccine was approved and used in 1998 and was effective, but side effects noted one year after its release forced its removal from the market. This vaccine was about 50% effective. The newer vaccine, Rotateq, is the only vaccine approved in the U.S. for rotavirus gastroenteritis. It is more effective than the previous vaccine, decreasing all cases by 74% – and severe cases by 98% – without prohibitive side effects. This new oral vaccine is recommended by the Centers for Disease Control to be given at 2, 4 and 6 months. Preventing Chicken Pox - the Combination Measles, Mumps, Rubella, and Varicella Vaccine (MMRV) In late 2005, the FDA approved a new combination vaccine for measles, mumps, rubella (MMR) and varicella (chicken pox) to be administered to children between 12 months and 12 years of age. This vaccine was developed to decrease the number of injections in the routine immunization schedule. The MMR portion of the vaccine, when given separately, yielded 93% coverage, but only 87.5% for separate varicella portion. The new combination vaccine continues be as effective as the separate vaccines. In addition, health officials may recommend that the combination vaccine be administered as the booster vaccine between ages 4 and 5, enhancing the varicella immunity. On the horizon One of the vaccines that you will be hearing more about in the future is designed to prevent human papillomavirus-related disease. The HPV virus, a sexually transmitted disease, is associated with cervical cancer and genital warts. Approximately 20 million people in the U.S. are infected with HPV. Different types of the virus are associated with different grades of cervical cancer. This vaccine may be approved within a year. Specific recommendations are not available at this time. General information For information and recommendations on vaccines, talk to your physician and visit www.aap.org, www.cdc.gov or www.immunizationinfo.org. Dr. Clyde Wesp is a pediatrician with Southern Orange County Pediatric Associates – with offices in Lake Forest, Laguna Hills, Rancho Santa Margarita, Ladera Ranch and San Clemente (Talega) – and is affiliated with Saddleback Memorial Medical Center, Mission Hospital and Children’s Hospital of Orange County. He is a member of the American Academy of Pediatrics and the MemorialCare Physician Society. If you have any questions or comments for Dr. Wesp, you can e-mail him at askdrwesp@netscape.net |
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