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One of the most exciting parts of healthcare is the constant push for new products and services. However, technology and innovation can be a double-edged sword. Decreasing mortality does not come without a cost. One of the most “cost-effective” innovations in healthcare is the development of immunizations. Many lives have been saved with the HIB, Pertussis and Tetanus vaccines while severe disease complications are often avoided. As is well publicized, immunizations can have side effects that are known and some that are not discovered until millions of doses have been administered, casting unnecessary doubt on the entire industry. Major pharmaceutical companies constantly produce new information on current and future vaccines. For example, there is hope for a cure for Lyme Disease and HIV. Two newer vaccines are showing great results and one has just hit the market that can prevent deadly meningococcal disease. [1] Hepatitis A Vaccine Hepatitis A is a common cause of hepatitis, infection and inflammation of the liver caused by the hepatitis A virus (HAV). Often Hepatitis A goes unnoticed in children. However, in adults it can cause jaundice (a yellow color to the skin), abdominal pain, nausea and loss of appetite. Hepatitis A is transmitted easily from person to person and sometimes can be spread through food or drinking water. People who travel outside of the United States are at higher risk of contracting the disease. However, there are areas, especially in parts of California with a high immigrant population, where the HAV is prevalent. The hepatitis A vaccine has been available for nearly 10 years. However, widespread use has only been since the turn of the century. The vaccine is an inactivated virus vaccine and has no capability of giving the disease to anyone who receives it. The Centers for Disease Control recommends the vaccine to children older than 2 traveling to countries other than the U.S., Canada, Western Europe, Japan, New Zealand and Australia. The vaccination is also recommended for all children over 2 years of age in states or communities that have a high average annual rate of HAV infection. The most common side effect is a sore arm. Since 1995, more than 7 million doses have been given with no reports of serious side effects. Ask your doctor if you are at risk for contact with the HAV and if you are a candidate for the vaccine. [2]Meningococcal Conjugate Vaccine Infection with the Meningococcal bacteria is a rare but very serious and deadly disease that strikes between 1,500 and 3,400 Americans every year. The bacteria can cause meningitis (infection around the brain) and/or bacteremia, infection in blood, or septicemia. This disease is deadly with a mortality rate between 10-20%. In addition, if a patient survives, there are often serious complications of the disease including loss of limbs or brain injury. The highest rates of disease are in infants but there is a secondary rise between the ages of 15 and 25. There has been a vaccine available for years but the duration of immunity was limited to 3-4 years. Therefore, the vaccine was administered to college students and those living in dormitories where close contact cannot be avoided. However, a new vaccine recently licensed in the USA, Menactra, is a conjugate vaccine and has the potential to offer equal if not better protection for a longer period of time. Conjugate vaccines are vaccines attached to carrier proteins and tend to produce longer and better immunity. It is expected that the new vaccine will last longer than the previous vaccine. The new vaccine, as was the old, offers protection to certain strains. Type B causes many cases of meningococcal disease in the infant and is not covered by the vaccines. The Advisory Committee on Immunization Practices (ACIP) to the Centers for Disease Control recommends routine vaccination of young adolescents at age 11-12. For those who have not previously received the vaccine, immunization is recommended before high school or college entry. [3]Pneumococcal Conjugate Vaccine Pneumococcal infection causes severe disease in children under 5 years of age, causing meningitis (infection around the brain and spinal cord), septicemia (blood infection, and nearly 5 million ear infections per year. Children under 2 years of age are the highest risk for infection and serious disease. The pneumococcal conjugate vaccine, Prevnar, has been available for nearly five years and long-term studies have shown that the 7-strain vaccine can decrease ear infections overall by 6.5% and those caused by the seven types in the vaccine by 57%. In addition, the need for ear tube placement also is decreased. The vaccine has had about a 97% effectiveness rate in preventing serious pneumococcal disease in healthy children who received all four vaccine doses and a 94% rate for health children who received two doses. Up to now, no serious reaction has been associated with the vaccine. New vaccines are always on the horizon and parents need to be aware of the vaccines as well as the diseases they prevent. When giving your child any medication or foreign substance, there is always the chance of allergic reactions and potential side effects. As a parent, you always have the ultimate say and responsibility for the care of your child. Look at both sides of the equation weighing risks and benefits to any treatment. Ask your doctor to discuss the scientific information available. Seek out RELIABLE information and beware of information that is opinion or conjecture. Someone’s own experience is not a scientific study! Dr. Clyde Wesp is a pediatrician with Southern Orange County Pediatric Associates with offices in Lake Forest, Laguna Hills, Rancho Santa Margarita and Ladera Ranch 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 Memorial Care Physician Society. If you have any questions or comments for Dr. Wesp you can email him at askdrwesp@netscape.net. |
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