Vaccinations

Newborn Care Vaccines / Vaccinations Information
By Loraine Stern M.D.

The best thing since clean water to ensure your children’s health is vaccinations. The diseases that they protect your child from are deadly and are still around.

There are many newborn vaccines given in the first year:

Newborn VaccinesHepatitis B
Diphtheria
Tetanus
Whooping cough
Pneumoccoccus (a bacteria that causes pneumonia and meningitis)
HIB, a bacteria that causes meningitis, bone and joint infections and a life threatening throat infection called epiglottitis among others
Polio
Rotavirus (a stomach virus that puts children under 2 in the hospital with dehydration and can kill)
MMR – Measles, Mumps and Rubella
The first hepatitis B shot is given shortly after birth in some but not all hospitals.

Some parents worry that there are so many immunizations but this is far from the limit that children can handle. In fact, every day infants are exposed to new material that their immune systems recognize and react to.

When vaccines are delayed or refused, these diseases come back. Measles, for example, is a vaccine that some parents are refusing because of the mistaken idea that it might cause autism. An unimmunized child in Indiana gave measles to 30 people, 3 of whom were hospitalized, one in the intensive care unit.

When going in for your newborn’s vaccines, hold your infant, comfort her while she is getting the shots and cuddle her immediately after. Realize that you are doing the best possible thing for your child. Newborn Vaccines will be discussed in further detail on the newborn video.

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Schedule of Immunizations
The American Academy of Pediatrics recommends the following schedule for vaccines. If you miss or are late with one, you do not have to start over but just resume the schedule. However, we do not recommend delaying any of them.

In the hospital: Hepatitis B (not in all hospitals)
2 Months: DTaP, Polio, HIB, Hep B, Prevnar, Rotavirus (Rotateq or Rotarix)
4 Months: DTaP, Polio, HIB, 
Prevnar, Rotavirus (Rotateq or Rotarix), Hep B (If not given in hospital)
6 Months: DTaP, Prevnar, Rotavirus (Rotateq), HIB
9 Months: Hepititis B
12 Months: MMR, Chickenpox, Prevnar
15 Months: DTaP/HIB, Prevnar (if not given before)
18 Months: Polio, Prevnar (if not given before)
2 Years: Hepatitis A
3 Years: Hepatitis A
4-6 Years: Booster DTaP, Polio, MMR, Chickenpox, TB, Hemoglobin, (can be split over 2 years)
After age 6: Yearly checkups with Tetanus Booster at age 10, Meningococcal at 11-12, HPV vaccine for girls after 11-12

Every fall, all family members should have a flu vaccine.


Vaccines and Tylenol
By Michael Schoenwetter, MD

Many families worry when their babies receive vaccines. Some of the concerns are the pain and possible side effects from the shots. I break down normal vaccine reactions into two main types. The first is a local reaction: mild redness and/or swelling at the injection site. This very common, normal reaction will usually subside in the first day or so. Applying a cool compress may be helpful to reduce the inflammation. Severe swelling or redness that is spreading is not normal and should be seen by your doctor. The second normal vaccine reaction, which is usually more concerning to the family, is a more systemic reaction. This is when the baby’s immune system is “turned on” from the vaccination and the baby might feel cranky and/or develop a fever for the first 24-48 hours after the shots. This is a normal, expected side effect that does not happen every time, but is not worrisome or unexpected. If the fever persists, is very high, or the baby seems extremely irritable or lethargic, your doctor should be notified.

Frequently, parents try to prevent the fever and crankiness by pre-medicating their babies with Tylenol (acetaminophen). In the past, this practice was not discouraged. In fact, the CDC’s advisory panel says it is reasonable to pre-medicate children at high risk for developing seizures, which can be triggered by fevers. However, a recently published study showed slightly lower protective antibody levels from vaccines in infants who were pre-medicated with Tylenol versus infants who did not receive Tylenol. The effect of the decreased levels might be small, as the vast majority of the pre-medicated infants did achieve protective antibody levels after their booster doses. Even so, the evidence in the study does point to stopping the practice of pre-medicating to try to prevent this reaction. Of importance, there is no evidence that the same decrease of antibody levels occurs when a fever reaction is treated by Tylenol. In summary, not pre-medicating with Tylenol, but giving it if fever develops might give the best benefit of immunization.

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