Category: Vaccine Education

Immunization Quiz

Think that you have done enough research about vaccines and are ready to take our immunization quiz?

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Good try, but you might want to do a little more research about vaccines.

#1 You might need a tetanus shot if…

Any contaminated puncture wounds, whether from a rusty nail, bite, or scratch, may require a tetanus shot and TIG if your immunizations aren’t current.

#2 DTaP stands for…

DTaP stands for Diphtheria, Tetanus and acellular Pertussis.

#3 If you miss one or more of your child’s sets of shots, you will usually need to…

In general, you do not need to restart the entire series of a vaccine if you miss one or more doses. You should schedule a visit as soon as possible to get caught up though.

#4 If your child has a possible side effect after getting his vaccines, you can report it to…

You or your Pediatrician can report possible vaccine side effects to VAERS, the Vaccine Adverse Event Reporting System.

#5 Prevnar is a vaccine that protects against infections with the Streptococcus pneumoniae bacteria, which commonly causes…

The Streptococcus pneumoniae bacteria can commonly cause meningitis, blood infections, pneumonia and ear infections.

#6 In general, vaccines are…

Vaccines are neither 100% safe nor 100% effective, but they do offer the ‘highest degree of protection with the lowest rate of untoward effects’ and the benefits of getting vaccinated is thought by most professionals to outweigh the risks.

#7 Heather Whitestone, who was crowned Miss America in 1994, was deaf because of…

Newspapers reported that Heather Whitestone, who won the Miss America pageant in 1994, had a reaction to the DPT shot. In reality, her deafness was a result of a Hib infection.

#8 If you want to protect your healthy 6 year old against the flu, you can get him a flu vaccine in a…

Flumist, a nasal spray flu vaccine, can be given to healthy children who are at least 2 years old, so this child could either get a regular flu shot or the nasal spray.

#9 Which of the following vaccines usually aren’t given until your child’s first birthday?

The first MMR vaccine usually isn’t given until a child is 12-15 months of age, although it can be given as early as 6 months if they will be traveling to a high risk area or during an outbreak, with the dose repeated at 12 months. The first DTaP is given at 2 months and the influenza vaccine (flu shot) can be given to infants over age 6 months. The Td or tetanus vaccine is not given until a child is at least 7 years old.

#10 At what age can children begin getting yearly flu shots?

#11 You can get a flu vaccine if you are…

In general, you can get a flu shot if you are breastfeeding or pregnant. People with severe egg allergies should talk to their doctor before getting a flu shot, but they can still usually be vaccinated. There is no association between milk allergies and the flu shot.

#12 MMR stands for…

MMR is a combination of the Measles, Mumps and Rubella vaccines.

#13 Before going to college, students, especially those that will be living in a dorm should consider getting…

College students, particularly those who live in dormitories, have a slightly increased risk of getting meningococcal disease and should get a meningococcal vaccine (Menactra or Menveo). A menB vaccine is also now available.

#14 There are vaccines to prevent your child from getting infected with the…

There is currently no hepatitis C vaccine, but children and adults can get vaccinated with both the hepatitis A and hepatitis B vaccines.

#15 In the United States, the oral polio vaccine is…

The oral polio or Sabin vaccine is no longer given to children in the United States because in a few people (about one in 2.4 million), it can cause polio. The oral polio vaccine is actually better at keeping the disease from spreading to other people though and is still used in many parts of the world.

#16 There are vaccines that can protect people against…

There are vaccines to protect against smallpox and anthrax, however there are no vaccines against SARS or the West Nile virus. The vaccine against Lyme Disease is no longer available. We do have a Rotavirus vaccine.

#17 You have lost your 5 year olds shot records and he is about to start school. You may have to…

Since Hib and Prevnar are usually only given to children under age 5, you would not have to repeat all of his shots. You will have to repeat some of them though (DTaP (4doses), IPV (3doses), hepatitis A (2 doses), hepatitis B (3 doses), MMR (2 doses), Chickenpox (2 doses)) if you do not test his immunity or titer testing does not prove that he is immune.

#18 If a women is pregnant, which shots should her kids not receive?

A pregnant household member, including the child’s mother, is not a contraindication to administration of any vaccine.

#19 Waning immunity is an issue for which of the following vaccines?

Vaccine-induced immunity to pertussis is thought to last for just a few years following the last dose. Measles and chickenpox immunity is long lasting.

#20 Your child should not get a vaccine if…

In general, vaccines do not need to be delayed for mild illnesses, with or without fever, such as a cold or if your child is taking antibiotics. Having had a severe allergic reaction to a vaccine is usually a contraindication or reason not to get another one.

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Why Do We Combine Vaccines?

Do you know why they combine multiple vaccines into a single shot?

Have you ever wondered why we combine vaccines? It's not a conspiracy...
It’s not a conspiracy…

Not surprisingly, your answer likely says a lot about what you think about vaccines

Why Do We Combine Vaccines?

Combination vaccines aren’t new.

The DPT vaccine was one of the first vaccines to be combined and that was way back in 1948. Before that, protection against diphtheria, tetanus, and pertussis came from three separate injections.

Want your child to get single antigen vaccines instead of a combo because you think they are getting too much in a combination vaccine? Keep in mind that the original DTP vaccine contained 3,002 antigens in each dose. And now, they get about 650 antigens from all of the vaccines they get during their whole childhood!

Which combination vaccine came next?

No, it wasn’t MMR.

How many antigens did kids get with this old schedule?

When the first polio vaccines came out, kids got three separate vaccines against the three strains of polio. They were later combined into the single polio vaccines.

And to reduce the number of injections even further, from 1959 to 1968, Quadrigen, a DTP/Polio combination was available!

And then came the MMR combination vaccine in 1971, combining protection against measles, mumps, and rubella into one shot.

Are you starting to see why we combine vaccines?

It helps reduce the number of injections that a child receives at one visit.

It has nothing to do with trying to hide any proof of a vaccine injury, after all, most parents still get their kids the same vaccines, whether or not they are combined.

Is it to save money?

In general, combination vaccines are about the same price as individual vaccines. Some are a little more and some are a little less.

It is typically easier to order, store, and administer a combination vaccine than each of the individual vaccines separately though, which can save moey. Using combination vaccines may also help to reduce errors.

Still, combining vaccines has never been about anything more than reducing the number of shots that kids have to get to be protected.

“So, at a doctor’s visit, your child may only get two or three shots to protect him from five diseases, instead of five individual shots. Fewer shots may mean less pain for your child and less stress for you.”

CDC on Combination Vaccines

Combination vaccines allow kids today to get 10 vaccines to protect them against 14 vaccine preventable diseases, but as few as 23 individual shots by age five years.

“Combination vaccines were associated with improved completion and compliance and should be encouraged among children who are undervaccinated or who received single-antigen vaccines only.”

Kurosky et al on Effect of combination vaccines on completion and compliance of childhood vaccinations in the United States

And it helps to keep vaccination rates up!

More on Combination Vaccines

Understanding the Vaccine Injury Table

The Vaccine Injury Table was created by the National Childhood Vaccine Injury Act of 1986.

“The Table makes it easier for some people to get compensation. The Table lists and explains injuries/conditions that are presumed to be caused by vaccines. It also lists time periods in which the first symptom of these injuries/conditions must occur after receiving the vaccine. If the first symptom of these injuries/conditions occurs within the listed time periods, it is presumed that the vaccine was the cause of the injury or condition unless another cause is found.”

What You Need to Know about the National Vaccine Injury Compensation Program

A table injury is an illness, disability, injury or condition covered by the National Vaccine Injury Compensation Program.

“For example, if you received the tetanus vaccine and had a severe allergic reaction (anaphylaxis) within 4 hours after receiving the vaccine, then it is presumed that the tetanus vaccine caused the injury if no other cause is found.”

What You Need to Know about the National Vaccine Injury Compensation Program

To quality as a table injury, the illness, disability, injury or condition has to occur within a specific “time period for first symptom or manifestation of onset or of significant aggravation after vaccine administration.”

Understanding the Vaccine Injury Table

So if there is a Vaccine Injury Table, then that proves that vaccine injuries are real, right?

The Vaccine Injury Table is easier to understand if you actually look at the table.
The Vaccine Injury Table is easier to understand if you actually look at the table.

Wait, does anyone dispute that vaccine injuries are real?

No one says that vaccines are 100% safe, so yes, of course, it is known that they have risks and cause adverse effects. While most of these adverse effects are usually mild, they can rarely be severe or even life threatening.

The idea the vaccine injuries are common is what is misunderstood and misrepresented by anti-vaccine folks.

It's no joke, studies have shown fewer side effects after the second dose of MMR!
It’s no joke, studies have shown fewer side effects after the second dose of MMR!

Consider the above post by Bob Sears

Yes chronic arthritis after a rubella containing vaccine is a table injury, but it is very rare. Arthritis after the rubella vaccine is typically mild and temporary, lasting just a few days.

While rubella containing vaccines can cause arthritis, they do not cause lifelong rheumatoid arthritis. So even if you were to be one of the very rare people who developed chronic arthritis after a rubella containing vaccine, a table injury, it would still not be the same thing as rheumatoid arthritis.

“The association between rubella vaccination and chronic arthritis is less clear. Most recently published research, has shown no increased risk of chronic arthropathies among women receiving RA27/3 rubella vaccine and do not support the conclusion of the IOM (Slater et al., 1995; Frenkel et al., 1996; Ray et al., 1997). These studies have included a large retrospective cohort analysis which showed no evidence of any increased risk of new onset chronic arthropathies and a double-blind historical cohort study. One randomised placebo-controlled, double-blind study of rubella vaccination in sero-negative women demonstrated that the frequency of chronic (recurrent) arthralgia or arthritis was marginally increased (1.58 [1.01-2.45], p = 0.042) (Tingle et al., 1997). In 2011, the United States Institute of Medicine (IOM) reviewed available research and concluded that the evidence is inadequate to accept or reject a causal relationship between MMR vaccine and chronic arthralgia in women.”

Information Sheet Observed Rate of Vaccine Reactions Measles, Mumps and Rubella Vaccines

And it wouldn’t even be clear if your chronic arthritis was caused by the vaccine!

“The Table lists and explains injuries and/or conditions that are presumed to be caused by vaccines unless another cause is proven.”

What You Need to Know about the National Vaccine Injury Compensation Program

To be added to the Vaccine Injury Table, there only has to be scientific evidence that a condition could be caused by a vaccine.

“Where there is credible scientific and medical evidence both to support and to reject a proposed change (addition or deletion) to the Table, the change should, whenever possible, be made to the benefit of petitioners.”

Guiding Principles for Recommending Changes to the Vaccine Injury Table

That makes sense, as the NVICP is a “is a no-fault alternative to the traditional legal system for resolving vaccine injury petitions” for VICP-covered vaccines.

Vaccines Covered by the Vaccine Injury Table

Most routinely used vaccines are covered by the Vaccine Injury Table, including vaccines that protect against:

  • diphtheria, tetanus, and pertussis – DTaP, Tdap, Td
  • measles, mumps, and rubella – MMR, ProQuad
  • chickenpox – Varivax, ProQuad
  • polio – IPV, OPV
  • hepatitis B
  • hepatitis A
  • Hib
  • rotavirus
  • pneumococcal disease – Prevnar
  • influenza – seasonal flu vaccines
  • meningococcal disease – MCV4, MenB
  • human papillomavirus – HPV4, HPV9

In fact, “any new vaccine recommended by the Centers for Disease Control and Prevention for routine administration to children, after publication by the Secretary of a notice of coverage” is automatically included, at least for Shoulder Injury Related to Vaccine Administration and vasovagal syncope.

New vaccines are also covered if they are already “under a category of vaccines covered by the VICP.”

Immunizations given to pregnant women are also covered.

A few others, including vaccines that protect against pandemic flu, smallpox, and anthrax are covered by the Countermeasures Injury Compensation Program (CICP).

Vaccines Not Covered by the Vaccine Injury Table

What about vaccines that aren’t routine?

Other vaccines that are used in special situations, including vaccines that protect against rabies, yellow fever, Japanese encephalitis, cholera, and typhoid aren’t listed in the Vaccine Injury Table and aren’t covered by the National Vaccine Injury Compensation Program.

Have you seen any TV ads for lawsuits against the shingles vaccine, which isn't in the vaccine injury table.
Have you seen any TV ads for lawsuits against the first shingles vaccine?

Shingles vaccines and the older pneumococcal vaccine, Pneumovax, aren’t covered either.

And since they are not covered by the National Vaccine Injury Compensation Program, there are no restrictions on lawsuits against the manufacturers of these vaccines or the health providers who administer them.

So much for the idea that you can’t sue a vaccine manufacturer or that vaccine manufacturers have no liability for vaccines…

Why weren’t these vaccines covered?

Remember, the NVICP and Vaccine Injury Table were created by the National Childhood Vaccine Injury Act of 1986. The vaccines that aren’t covered are not on the routine childhood immunization schedule.

“There are no age restrictions on who may receive compensation in the VICP. Petitions may be filed on behalf of infants, children and adolescents, or by adults receiving VICP-covered vaccines.”

National Vaccine Injury Compensation Program Frequently Asked Questions

Still, since many of the covered vaccines can be given to adults, they are included, even if some of the vaccines adults routinely get aren’t covered.

Will they ever be covered?

“They found a low liability burden for these vaccines, that serious adverse events were rare, and that no consensus existed among stakeholders. After considering the staff report, NVAC chose, in 1996, not to advise the Department of Health and Human Services to include adult vaccines in VICP.”

Loyd-Puryear et al on Should the vaccine injury compensation program be expanded to cover adults?

Adding more adult vaccines to the Vaccine Injury Compensation Program (VICP) is something that has been looked at in the past, but it wasn’t thought to be necessary.

What to Know About the Vaccine Injury Table

The Vaccine Injury Table is a list of conditions set up to make it easier for people to get compensated from the National Vaccine Injury Compensation Program.

More on Understanding the Vaccine Injury Table

Immunization Advisory Groups

Who makes recommendations regarding immunizations?

Your pediatrician?

The CDC?

Merck?

“The most influential body making vaccine recommendations in the USA is the Advisory Committee on Immunization Practices (ACIP).”

Vaccinology – An Essential Guide

In the United States, those recommendations are made by the Advisory Committee on Immunization Practices (ACIP), a group of medical and public health experts who provide advice and guidance to the Director of the CDC.

Immunization Advisory Groups

Again, ACIP is just for the United States though.

Many countries have their own Immunization Advisory Groups
Many countries have their own Immunization Advisory Groups

In other countries, there is:

Altogether, at least 99 countries have their own National Immunization Technical Advisory Groups!

“Immunization Technical Advisory Groups (ITAGs) are expert advisory committees that provide recommendations to guide a country’s national immunization programs and policies. They consist of independent experts with the technical capacity to evaluate new and existing immunization interventions. The premise of these groups is to facilitate a systematic, transparent process for developing immunization policies by making evidence-based technical recommendations to the national government. Their role is primarily technical and advisory and is intended to bring increased scientific rigour and credibility to the complex process of making immunization policies, free of political or personal interests.”

Bryson et al on A global look at national Immunization Technical Advisory Groups

These National Immunization Technical Advisory Groups help countries to tailor immunization schedules and vaccination programs to local needs, while also considering the vaccine policies of the WHO and other experts.

More on Immunization Advisory Groups