Category: Immunization Schedules

Do Your Kids Need a Mumps Booster Shot?

Traditionally, kids get vaccines to protect them against mumps when they are 12 to 15 months old (1st dose of MMR) and again before starting kindergarten (2nd dose of MMR).

Do Your Kids Need a Mumps Booster Shot?

Routine use of the mumps vaccine, which was first licensed in 1967, has helped to greatly reduce the incidence of mumps cases from pre-vaccine era levels.

Outbreaks of mumps the last few years have led to calls for a third dose of MMR in some situations though.

mumps-booster — During an outbreak, universities make sure students are up-to-date with their MMR vaccines.

Does that mean that your kids will need a third dose of the MMR vaccine?

Probably not.

“Persons previously vaccinated with 2 doses of a mumps virus–containing vaccine who are identified by public health authorities as being part of a group or population at increased risk for acquiring mumps because of an outbreak should receive a third dose of a mumps virus–containing vaccine to improve protection against mumps disease and related complications.”

Recommendation of the Advisory Committee on Immunization Practices for Use of a Third Dose of Mumps Virus–Containing Vaccine in Persons at Increased Risk for Mumps During an Outbreak

Is there a mumps outbreak in your area?

While that is the main reason to get a third dose of MMR, simply being near an outbreak still doesn’t mean an extra vaccine is necessary.

“In the setting of an identified mumps outbreak, public health authorities should define target groups at increased risk for mumps during the outbreak, determine whether vaccination of at-risk persons is indicated, and provide recommendations for vaccination to health care providers.”

Recommendation of the Advisory Committee on Immunization Practices for Use of a Third Dose of Mumps Virus–Containing Vaccine in Persons at Increased Risk for Mumps During an Outbreak

Your local or state health department will decide which folks need a third dose of MMR in an outbreak situation.

“Persons at increased risk for acquiring mumps are those who are more likely to have prolonged or intense exposure to droplets or saliva from a person infected with mumps, such as through close contact or sharing of drinks or utensils.”

Recommendation of the Advisory Committee on Immunization Practices for Use of a Third Dose of Mumps Virus–Containing Vaccine in Persons at Increased Risk for Mumps During an Outbreak

Why not just give everyone a third dose of MMR?

The issue with the mumps vaccine is waning immunity, so it isn’t known how long an extra dose would last, and that’s why at this time, the only recommendation is to give an extra dose during outbreaks.

If you are still unsure about needing a third dose of MMR, ask your pediatrician, school health clinic, or local health department, especially if you have heard about local mumps cases.

What to Know About the Mumps Booster Shot

A third dose of MMR is recommended for some people at high risk to get mumps in an outbreak situation.

Immunization Schedules from Other Countries

The latest immunization schedule from the CDC and AAP.

Why does the United States give so many more vaccines than other countries?

The easy answer might be that we want to protect kids from more vaccine-preventable diseases. Of course, it is much more complicated than that.

But why does it matter?

It still matters because Jenny McCarthy has pushed the idea that we have an ‘autism epidemic‘ in the United States because “other countries give their kids one-third as many shots as we do.”

And some folks still believe her.

They also believe anti-vaccine myths and misinformation linking giving more vaccines to having higher infant mortality rates.

Immunization Schedules from Other Countries

Which vaccines a country routinely gives often depends on the risk a diseases poses to the people that live there. For example, some countries routinely give the BCG and Japanese encephalitis vaccines, but only give the hepatitis B vaccine in high risk situations.

And while many folks still push the myth that the United States gives many more vaccines than other developed countries, you just have to look at their immunization schedules to see that it isn’t true.

Remember that in the United States, children typically get:

36 doses of 10 vaccines before starting kindergarten that protect them against 14 vaccine-preventable diseases
at least three or four more vaccines as a preteen and teen, including a Tdap booster and vaccines to protect against HPV and meningococcal disease, plus they continue to get a yearly flu vaccine

So by age 18, that equals about 57 dosages of 14 different vaccines to protect them against 16 different vaccine-preventable diseases. While that sounds like a lot, keep in mind that 33% of those immunizations are just from your child’s yearly flu vaccine.

Immunization Schedules from Europe

How do immunization schedules from European countries differ from the United States?

Austria's immunization schedule for 2017 includes all of the same vaccines as the US schedule. — Austria’s immunization schedule for 2017 includes all of the same vaccines as the US schedule, plus the vaccine for Japanese encephalitis (if high risk).

Surprisingly, they don’t differ by that much, despite what you may have heard or read.

And in many European countries, even if you don’t get more vaccines overall, you do get more dosages at an earlier age, often with two dosages of MMR and the chicken pox vaccine by the time your child is 15 to 24 months old.

The latest immunization schedule from Germany.

Some vaccines, like hepatitis A and chicken pox aren’t routine in every European country, like Iceland and Sweden, but many countries give vaccines that we don’t, like BCG and MenC. And even Iceland and Sweden have recently added the HPV vaccine to their schedule and Sweden may soon add the rotavirus vaccine too.

Immunization Schedules from Other Countries

Many countries, in addition to those in Europe, have vaccine schedules that are very similar to the one that is used in the United States.

The 2017 Immunization Schedule for South Korea includes all of the US vaccines, plus BCG and Japanese encephalitis vaccines.

Just look at the immunization schedules for Australia, Canada, Israel, South Korea, or Taiwan, etc.

What about Japan? They must give fewer vaccines than we do in the United States, right? After all, aren’t they the country that banned the use of the HPV vaccine?

Although that myth is still pushed by many anti-vaccine websites, the HPV vaccine is not banned in Japan. It was removed as a vaccine that is actively recommended in 2013, but it still available and is still on the Japanese immunization schedule.

The 2016 routine and voluntary immunization schedule in Japan.

All of our other vaccines are also on the Japanese immunization schedule. In addition, they give infants the BCG and Japanese encephalitis vaccines.

What to Know About Immunization Schedules from Other Countries

Many countries use a similar immunization schedule and give the same types of vaccines as we do in the United States.

Catch-Up Immunization Schedules

It is surprisingly easy to get behind on your child’s immunizations, even if you are trying to stay on schedule.

How do you miss a shot?

Your child could have been sick when they were supposed to get their vaccines, your pediatrician might have been out of one or more vaccines, or you might have simply missed one of your child’s well checkups.

Catching Up On Vaccines

A catch-up immunization schedule — A catch-up vaccination schedule program can help you figure out when to get the vaccines your child has missed.

If your child gets behind and misses one or more vaccines, be sure to get caught up as soon as possible.

If your child needs to get caught up quickly, like to start daycare or school, to travel out of the country, or because of a disease outbreak in your area, you can even use an accelerated immunization schedule, using minimum intervals between doses.

Depending on your child’s age, you might even be able to skip a few doses or vaccines.

For example, with rotavirus vaccines, vaccination should not be started if an infant is already 15 weeks old and the final dose must be given by 8 months of age.

And if your child gets their first dose of Hib after they are 15 months old, they don’t need any more doses. And they wouldn’t need any doses at all if they are already 5 years old.

Prevnar, IPV, and DTaP might also need to given on an alternative schedule when given on a catch-up schedule.

Specifically, your child might be able to skip:

the fifth dose of the DTaP vaccine, if the fourth dose was given at age 4 years or older.
the fourth dose of the IPV vaccine, if the third dose was given at age 4 years or older.
one or more doses of Prevnar, depending on when the other doses were given

Is this a good way to get out of getting some doses or vaccines?

Of course not. In addition to missing out on those vaccines, your child is missing out on the protection from those vaccines.

“Combination vaccines can be used for children who have fallen behind. Combination vaccines may be used when any of the components are indicated and none are contraindicated. The minimum interval between doses is the greatest interval between any of the individual antigens.”

Immunization Action Coalition on Combination Vaccines

Using combination vaccines, like Pediarix, Pentacel, Kinrix, Quadracel, and ProQuad, etc., can make getting caught up easier too.

For More Information on Catch-Up Immunization Schedules

Vaccines in Special Situations

800px-infant_with_cochlear_implant — Children with a cochlear implant need the Pneumovax 23 vaccine.

In addition to getting routine vaccines, there are some special situations in which kids need extra vaccines or extra dosages of vaccines.

Traveling out of the country and being pregnant are almost certainly the most common special situation when it comes to vaccines.

Vaccines for High Risk Conditions

Other special situations include children with high risk conditions, such as:

complement component deficiencies – Menveo (infants), MenB
chronic heart disease – PPSV23
chronic lung disease (not including asthma) – PPSV23
diabetes mellitus – PPSV23
CSF leaks – PPSV23
cochlear implants – PPSV23
chronic liver disease – PPSV23
cigarette smoking – PPSV23
sickle cell disease – PPSV23
congenital or acquired asplenia – Menveo (infants), PPSV23, MenB
congenital or acquired immunodeficiencies – PPSV23
HIV infection – PPSV23
chronic renal failure – PPSV23
nephrotic syndrome – PPSV23
leukemia – PPSV23
lymphoma – PPSV23
hodgkin disease – PPSV23
iatrogenic immunosuppression – PPSV23
solid organ transplant – PPSV23
multiple myeloma – PPSV23

In general, the 23-valent pneumococcal polysaccharide vaccine, PPSV23 or Pneumovax 23, should be given when a high risk child is at least 2 years old and at least 4 weeks after their last dose of Prevnar 13. Some will need an additional booster dose of Pneumovax 23 after five years.

Remember, most children routinely get 4 doses of Prevnar 13 when they are 2, 4, 6, and 12-15 months old.

And while most kids just get one dose of PPSV23, others, especially those with any type of immunosuppression, get a repeat dose every five years.

Getting Revaccinated

Are there ever situations when kids need to get revaccinated?

While it might be hard to believe, there are more than a few reasons that kids get revaccinated.

The most obvious is when kids lose their vaccine records, although checking vaccine titers might help avoid repeating some or all of your child’s vaccines.

Children who have had a hematopoietic cell transplant (HCT) should routinely get revaccinated:

starting with inactivated vaccines six months after the transplant, including a 3-dose regiment of Prevnar 13, followed by PPSV23, a 3-dose regiment of Hib, and a yearly flu shot and other inactivated vaccines
continuing with a dose of MMR 24 months after the transplant if they are immunocompetent and possibly the chicken pox vaccine

Children who are adopted in a foreign country also often need to repeat all or most of their vaccines. Again, titers can often be done to avoid repeating doses.

Other Special Situations

Other special situations in which your child might need to get vaccinated off the standard immunization schedule might include:

missing one or more vaccines and needing to catch-up
getting exposed to rabies (cats, dogs, raccoons, skunks, bats, foxes, and coyotes)
having a wound that is not considered clean and minor (usually “wounds contaminated with dirt, feces, soil, and saliva; puncture wounds; avulsions; and wounds resulting from missiles, crushing, burns, and frostbite”) if it has been more than five years since their last dose of tetanus vaccine (or a clean and minor wound and it has been more than 10 years)
getting exposed to chicken pox (or shingles) or measles and not being fully vaccinated (two doses of the chicken pox and two doses of the MMR vaccines) or naturally immune, as a vaccine within 72 hours may decrease their risk of getting sick

Do your kids have a medical condition that might put them at high risk for a vaccine-preventable disease?

Do they need a vaccine that other kids don’t routinely get?

For More Information on Vaccines in Special Situations

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Translating Foreign Language Immunization Schedules

It can be hard to enough to read an immunization schedule if you don’t have a medical degree, what with all of the acronyms and all.

DTaP, MMR, and lot numbers, etc.

But what if the immunization schedule is in a foreign language?

foreign-language-immunization-schedules — A Chinese to English immunization record to help make translating records easier.

How much luck will you have reading it then?

Fortunately, there is help for English speakers who get an immunization schedule in Spanish, French, Chinese, or Arabic, etc. And you don’t need your own translator.

Check out the resources below.

Immunization Schedules

Each year, since 1995, the Advisory Committee on Immunization Practices (ACIP) of the CDC has reviewed the recommended immunization schedule, and it has then been approved by ACIP, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists.

Before 1995, in 1994, 1989, and 1983, an immunization was simply published as part of the ACIP’s general recommendations.

Looking for an alternative to the ACIP immunization schedule?

According to the American Academy of Pediatrics:

No alternative vaccine schedules have been evaluated and found to provide better safety or efficacy than the recommended schedule, supported by the Advisory Committee on Immunization Practices of the CDC and the Committee on Infectious Diseases of the AAP (the committee that produces the Red Book).

Pediatricians who routinely recommend limiting the numbers of vaccines administered at a single visit such that vaccines are administered late are providing care that deviates from the standard evidence-based schedule recommended by these bodies.

Again, there are no alternative immunization schedules.

For more information:

Vaccines for Adults

Adults need to get vaccines, just like kids. Of course, they don’t get as many vaccines as kids, since many adults are either already immune or are no longer at risk to many vaccine-preventable diseases.

Adults do get:

a yearly flu vaccine
a single dose of Tdap (if they haven’t had it before and during each pregnancy) and a Td shot every ten years
the pneumococcal vaccines once they are 65 years old
the shingles vaccine once they are 60 years old

They can also get most other vaccines, except Rotavirus and DTaP (they get Tdap instead), that they need because they lack immunity. Although it is not on the immunization schedule, adults can get the polio vaccine if necessary.

Another question that comes up concerning adult vaccines is why so adults and children get the same vaccines. In other words, are vaccines calibrated taking into account a child’s weight and age?

Donald Trump often says that he is against vaccines because we give “one massive dose for a child,” going on to say that they should get smaller dosages in a more spread out schedule. Some others agree, claiming that infants shouldn’t get the same dose of vaccine as an adult.

But do they?

Not always. There are pediatric versions of the influenza, hepatitis A, hepatitis B, and DTaP (vs Tdap) vaccines.

It doesn’t necessarily matter though. Unlike medications you take, like Tylenol or an antibiotic, vaccines don’t go through your whole body to work, so your size doesn’t matter.

For more information on why this isn’t a real issue:

VAXOPEDIA

Do Your Kids Need a Mumps Booster Shot?