Category: Vaccine Education

Recommendations for Reporting About Vaccines

Historically, the media has played a huge role in pushing vaccine misinformation and scaring parents away from vaccinating and protecting their kids.

“The media created the MMR hoax, and they maintained it diligently for 10 years.”

Dr. Ben Goldacre Bad Science

Even before Andy Wakefield and his MMR hoax, the media helped fuel pertussis outbreaks by pushing the flawed research of John Wilson, which led to lawsuits against DPT vaccines and a big drop in vaccination rates.

None of it was true and the lawsuits failed, but the consequence was still that many unvaccinated kids died.

Bob Sears appeared on Fox & Friends in 2010 for the segment "Vaccines: A Bad Combination?"
Bob Sears appearing on Fox & Friends in 2010 for the segment “Vaccines: A Bad Combination?” is a great example of false balance.

Many others in the media have done a great job in promoting myths and fake controversies about vaccines and have used false balance in their interviews and articles to scare parents.

Fortunately, things have gotten better over the years.

Important Points for Reporting About Vaccines

Still, despite what some folks might think, health journalists aren’t going to get in trouble for reporting about vaccines.

They are going to hear about it if they do a bad job though.

“…it is important to recognise that the balance of media reporting does not necessarily reflect the balance of the argument among the involved professionals – by this is meant that equal weighting might be given by the media (and thus the lay community) to those for and against the vaccine although opponents of vaccination might be a very small number, as for example happened with both pertussis and MMR.”

David Baxter on Opposition to Vaccination and Immunisation the UK Experience – from Smallpox to MMR

Remember, the way that health journalists cover vaccines and vaccine-preventable diseases can influence the behavior of people, either helping them understand that vaccines are safe and necessary, putting them on-the-fence about vaccines, or scarring them away from getting vaccinated and protected.

So be careful when reporting about vaccines, as it gives you the opportunity to correct many of myths that scare people, while educating folks about the topic you are covering.

You should also:

Are you ready to cover your next story about vaccines or the next measles outbreak?

What to Know About Reporting on Vaccines

The way that health journalists cover vaccines and vaccine-preventable disease outbreaks can influence the behavior of people, either helping them understand that vaccines are safe and necessary, putting them on-the-fence about vaccines, or scarring them away from getting vaccinated and protected.

More on Reporting about Vaccines

Vaccines and Hemophilia

Kids with hemophilia bleed.

The Medical and Scientific Advisory Council of the National Hemophilia Foundation recommends "that patients with bleeding disorders continue to follow the American Academy of Pediatrics’ and CDC’s vaccine recommendation route and schedule for their age."
The Medical and Scientific Advisory Council of the National Hemophilia Foundation recommends “that patients with bleeding disorders continue to follow the American Academy of Pediatrics’ and CDC’s vaccine recommendation route and schedule for their age.”

They bleed into their joints, into their skin (hematoma), and from their mouth and gums. They can bleed after surgery and even after getting their vaccinations.

Vaccines and Hemophilia

Having hemophilia is certainly not a contraindication to getting vaccinated though.

“Your child should get regular immunizations with necessary precautions to prevent bleeding from the injection sites.”

Hemophilia FAQs

There are some precautions that are recommended before giving vaccines to a child with hemophilia, including:

  • using a 23-gauge or smaller caliber fine-gauge needle – consider a 25- or 27-gauge needle
  • when possible, giving the vaccine SQ instead of IM – for example, although the IPV (polio), hepatitis A, and hepatitis B vaccines are usually given IM, studies have shown that they can be given SQ to kids with hemophilia
  • applying firm pressure, without rubbing, after the vaccine is given for at least two minutes and up to 5 to 10 minutes
  • giving acetaminophen for pain relief, if necessary, instead of ibuprofen
  • warning about the risk of a hematoma developing at the injection site

Most importantly, if the child with hemophilia is already getting routine prophylaxis to prevent bleeding, schedule their vaccines around the same time to decrease the risk of bleeding.

Your child’s hematologist will likely give you specific instructions to provide to your pediatrician regarding immunization precautions.

What to Know About Vaccines and Hemophilia

Kids with hemophilia should get all of their vaccines on schedule, but precautions should be taken to decrease the chance of bleeding after getting an immunization.

More About Vaccines and Hemophilia

What Shots Do You Need to Be Around a Newborn?

We often focus on what vaccines a baby will need once they are born, but it is also important that folks around your new baby get vaccinated too.

What Shots Do You Need to Be Around a Newborn?

To protect their new baby, many parents institute a no visit policy for friends and family members who don't get vaccinated.
To protect their new baby, many parents institute a no visit policy for friends and family members who don’t get vaccinated.

Of course, all of your vaccines should be up-to-date, especially if you plan to be around young kids. That’s how we maintain herd immunity levels of protection for those who can’t be vaccinated and protected, including newborns who are too young to be vaccinated.

In addition to routine vaccines, it is especially important that teens and adults who are going to be around a newborn or younger infant have:

  • a dose of Tdap – now routinely given to kids when they are 11 to 12 years old and to women during each pregnancy (to protect newborns against pertussis), others should get a dose if they have never had one. There are currently no recommendations for a booster dose.
  • a flu shot – is it flu season? Then anyone who is going to be around your baby should have had a flu shot. And for the purposes of keeping a newborn safe from the flu, you can assume that flu season extends from September through May, or anytime that flu shots are still available.

That’s it?

Only two shots?

Yes, only two shots assuming you are either immune or are up-to-date on your other vaccines. If you have been delaying or skipping any vaccines, then you might need an MMR, the chicken pox vaccine, and whatever else you are missing.

Other Precautions Around a New Baby

Unfortunately, there are many risks to a new baby that aren’t vaccine preventable.

Just because everyone is vaccinated and protected, that doesn’t mean that you should have a party welcoming your baby home and invite everyone in the neighborhood. Besides the flu, we get concerned about other cold and flu-like viruses, especially RSV.

That means to protect them, you should keep your baby away from:

  • large crowds, or even small crowds for that matter – in general, the more people that your baby is exposed to, the higher the chance that they will catch something
  • people who are sick
  • cigarette smoke – second hand smoke increases the risk of infections, like RSV

And make sure everyone, even if they don’t seem sick, washes their hands well before handling your baby.

“Parents or relatives with cold sores should be especially careful not to kiss babies—their immune systems are not well developed until after about 6 months old.”

AAP on Cold Sores in Children: About the Herpes Simplex Virus

Because you can sometimes be contagious even if you don’t have an active cold sore (fever blister), some parents don’t let anyone kiss their baby. Most of this fear comes after news reports of babies getting severe or life-threatening herpes infections after a probable kiss from a family member or friend.

When Can I Take My Newborn Out in Public?

When can you take your baby out in public? Most people try to wait until they are at least two months old.

Is that because that’s when they are protected with their two month shots?

Not really, as your baby won’t really be protected until they complete the primary series of infant vaccinations at six months.

Two months is a good general rule though, because by that age, if your baby gets a cold virus and a fever, it won’t necessarily mean a big work-up and a lot of testing. Before about six weeks, babies routinely get a lot of testing to figure out why they have a fever (the septic workup), even if it might be caused by a virus. That’s because younger infants are at risk for sepsis, UTI’s, and meningitis and they often have few signs when they are sick.

Keep in mind that going out in public is much different from going out. You can go for a walk with your baby at almost any time, as long as they are protected from the sun, bugs, and wind, etc., as long as there aren’t people around.

What to Know About Protecting Newborn Babies

Protect your baby by making sure everyone around them is vaccinated and protected, especially with a dose of Tdap and the flu vaccine.

More on Protecting Newborn Babies

Answers To Frequently Asked Questions About Immunizations

Have questions about your child’s immunizations?

We probably have the answers.

Answers To Frequently Asked Questions About Immunizations

Not surprisingly, many parents have the same questions about immunizations and they want answers to reassure themselves that they are doing the right thing for their kids by getting them vaccinated and protected.

Still have questions?

Rotavirus vaccines are associated with a very small risk of intussusception, but that is not a good reason to miss the benefits of this vaccine.
Like most pediatricians, my kids are vaccinated and protected. Photo by Vincent Iannelli, MD

With so much misinformation out there scaring folks about vaccines, that’s not surprising.

Just keep in mind that every anti-vaccine talking point and myth they push has an easy answer, even as folks continue to move the goalposts in search of new arguments against vaccines.

Yesterday it was mercury. Today it’s aluminum. Tomorrow it will be something else, while they continue to use vaccine scare videos to make you think that vaccines aren’t safe.

Parents who do their research understand that the real threat to their kids isn’t vaccines, it is the anti-vaccine experts that continue to push propaganda about vaccines.

What to Know About Answers To Frequently Asked Questions About Immunizations

The most basic answers to your questions about vaccines are that while vaccines aren’t perfect, they are safe and necessary and they do work well to protect us from vaccine-preventable disease.

More on Frequently Asked Questions About Immunizations

How to Claim a Vaccine Exemption

Don’t want to get your kids vaccinated?

You might be surprised to know that no one is out there trying to force you into vaccinating them.

Want to enroll your kids in daycare, preschool, school, or college?

Then they will need to be vaccinated.

How to Claim a Vaccine Exemption

Of course, depending on where you live, you could get a vaccine exemption and leave your kids unvaccinated and unprotected.

Does your child qualify for a medical exemption? All states allow kids to claim medical exemptions to getting vaccinated. True medical exemptions are rare though, as you can see from the rates in states that actually require screening and approval of medical vaccine exemptions.

Are you a Christian Scientist? In 47 states, laws allow religious exemptions to vaccinations. Ironically, these exemptions are often abused, as you don’t actually need to belong to a religion that is against vaccines to claim a religious exemption to vaccinations.

“When you are challenged by the viewpoint of a denomination, pastor, publication, or atheist authority: You do not worship any pastor, church, religious publication, or denomination. Your pastor’s personal view on vaccines is irrelevant to your stance because pastors do not learn about the biblical implications of vaccinating during seminary and your pastor isn’t God. (Though if you have a pastor willing to go to bat for you, use him.)”

Megan on How To Get a Vaccine Religious Exemption Like a Boss

It is not even a secret that parents abuse the religious vaccine exemption, claiming them even when they don’t have a sincere religious belief against getting vaccinated.

And in 20 states, it is even easier to claim a vaccine exemption. These are the states that allow philosophical or personal belief vaccine exemptions, in which you can typically just say that you are against vaccinating and protecting your kids “for reasons of conscience.”

Vaccine exemptions are too easy to get in some states, but even with an exemption, your child will still be excluded if there is an outbreak.
Vaccine exemptions are too easy to get in some states, but even with an exemption, your child will still be excluded if there is an outbreak.

What reasons? You don’t usually have to go into much detail…

Why Parents Abuse Vaccine Exemptions

It is not hard to understand why some parents abuse vaccine exemptions.

They abuse vaccine exemptions because they can.

In many states, it is easy to abuse vaccine exemptions because medical exemptions aren’t verified and approved and it is often easier and more convenient to get an exemption than to get vaccinated. Believe it or not, some doctors will even sell you a medical exemption for your child. Also, parents are made to feel so scared by anti-vaccine propaganda that they think that they need to get an exemption.

“Permitting personal belief exemptions and easily granting exemptions are associated with higher and increasing nonmedical US exemption rates. State policies granting personal belief exemptions and states that easily grant exemptions are associated with increased pertussis incidence.”

Omer et al on Nonmedical exemptions to school immunization requirements: secular trends and association of state policies with pertussis incidence.

But just because you can claim an easy exemption in a state without strong vaccine exemption laws doesn’t mean that you should.

While there are no benefits to delaying or skipping vaccines, there are plenty of risks. And the risks aren’t just to your unvaccinated child. We continue to see and hear about kids who are too young to be vaccinated or who couldn’t be vaccinated getting caught up in outbreaks caused by others who simply chose to not get vaccinated.

“I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.”

Dr. Bob Sears in The Vaccine Book

Not surprisingly, websites and organizations that give advice on getting kids easy vaccine exemptions never mention these risks. They also overstate the risks of vaccines and don’t mention the benefits of getting vaccinated.

Vaccines are safe and necessary. Unless your child has a true medical contraindication to getting one or more vaccines, do a little more research before getting a non-medical exemption.

What to Know About Claiming a Vaccine Exemption

While it is typically not hard to claim a vaccine exemption for your child, since vaccines are safe and necessary, be sure you understand the risks of delaying or skipping any vaccines if your child doesn’t need a true medical exemption.

More on Claiming a Vaccine Exemption

 

Immunization Requirements to Start School and Daycare

If you are following the latest immunization schedule and your kids are up-to-date on all of their vaccines, then they will likely be ready to start daycare, kindergarten, high-school, or college.

There aren’t usually any extra vaccines that they will need to start school.

Of course, if you have skipped or delayed any vaccines, then they might have to catch up on some immunizations before starting school.

Another situation where you might need to do some catching up is if you move, and instead of following the CDC schedule, you were just getting the minimum number of vaccines that were required to attend school where you used to live. For example, your kids could have been all set to start kindergarten in Arkansas, but if you suddenly moved to Texas, they might need a second MMR, a booster dose of Varivax, and two doses of hepatitis A vaccine, as none of those are required in Arkansas.

Immunization Requirements to Start Daycare and Preschool

Daycare rules in Idaho give parents a month to stay on schedule with all of the CDC immunization requirements.
Daycare rules in Idaho give parents a month to stay on schedule with all of the CDC immunization requirements.

Since many new parents have to go back to work when their baby is only about two to six weeks old, they won’t have time to get their first set of vaccines at two months.

That won’t keep them out of daycare, but delaying too much longer, usually more than a month, probably will.

To start daycare or preschool, infants and toddlers need to get most of the vaccines on the CDC immunization schedule. This includes DTaP, hepatitis B, Hib, Prevnar, and IPV (polio), and then once they are 12 months old, booster doses of the primary series of vaccines and the MMR, Varivax (chickenpox), and hepatitis A vaccines.

The only vaccine that is missing from many state mandates is the rotavirus vaccine. And that simply has to do with the strict timing requirements of when you need to start (before 15 weeks of age) and finish this vaccine (by 8 months).

Some states do require rotavirus though, and simply state that kids must follow “age appropriate dosing.” That way, if they are too old, they just don’t need to get it.

Immunization Requirements to Start Kindergarten

In addition to most of the vaccines they needed to start daycare or preschool, to start kindergarten, kids need their 4 to 6 year old boosters:

  • the fifth dose of DTaP to protect them against diphtheria, tetanus, and pertussis
  • the fourth dose of IPV to protect them against polio
  • the second dose of MMR to protect them against measles, mumps, and rubella
  • the second dose of Varivax to protect them against chicken pox

If using combination vaccines, these four immunizations can be combined into just two shots – Proquad (MMR + Varivax) and either Kinrix or Quadracel (DTaP + IPV), which your preschooler will appreciate to help reduce the pain from getting these shots.

If your kids were missing any vaccines, they will also need to get caught up on those before starting school.

Immunization Requirements to Start Middle School

Preteens and teens get a few vaccines when they start middle school when they are around 11 to 12 years old, including:

  • a dose of Tdap to protect them against diphtheria, tetanus, and pertussis
  • a dose of Menactra or Menveo to protect them against meningoccocal disease

Although not required by most schools, the HPV vaccine is also usually given around this time.

Immunization Requirements to Start College

And then, before going off to college, at around age 16 years, kids will usually need:

They can also get the MenB vaccine, although it isn’t yet required for all students. This vaccine (Bexsero or Trumenba) has a “permissive” recommendation, in that parents are told they can get it if they want their kids to avoid meningococcal B disease, but it is not required yet.

What about a third dose of MMR?

While an extra dose of the MMR vaccine is now being given in some situations, it is mainly if your child is at high risk because of a current mumps outbreak. A mumps booster shot is not currently recommended just because your child is going off to college.

What to Know About Immunization Requirements for Incoming Students

If you have been following the latest immunization schedule and your kids are up-to-date on all of their vaccines, then they will likely be ready to start daycare, kindergarten, high-school, and college without needing any extra vaccines.

More on Immunization Requirements for Incoming Students

 

Your Baby’s First Vaccines

Your baby’s first vaccines are very important.

While they don’t provide instant protection, they do start your baby on the path to eventually getting protected from 16 different vaccine-preventable diseases.

Your Baby’s First Vaccines

Rotavirus vaccines are associated with a very small risk of intussusception, but that is not a good reason to miss the benefits of this vaccine.
The rotavirus vaccine will be among your baby’s first vaccines. Photo by Vincent Iannelli, MD

After the birth dose of the hepatitis B vaccine, your baby’s first vaccines when you visit your pediatrician for their two month check up will include:

  • DTaP – diptheria – tetanus – pertussis
  • IPV – polio
  • Hepatitis B
  • Hib – haemophilus influenzae type b
  • Prevnar 13 – pneumococcal disease
  • Rotavirus

Sound like too many? Those vaccines work to protect your baby against eight vaccine-preventable diseases!

And it doesn’t mean that your baby has to get six shots.

The rotavirus vaccine is oral – your baby drinks it.

And many of the other vaccines can be given as a combination vaccine, either Pediarix (combines DTaP-IPV-HepB) or Pentacel (combines DTaP-IPV-Hib), to reduce the number of individual shots your baby needs to get even more.

While that still means multiple injections, there are things you can do to minimize the pain during and after the vaccines, from breastfeeding and holding your baby to simply trying to get them distracted.

Your Baby’s Next Vaccines

After their first vaccines at two months, your baby will complete their primary series of vaccines with repeated dosages of the same vaccines at four and six months.

Why do we need to repeat the same vaccines?

Because that’s often what it takes to help us build up an immune response to a vaccine, especially at this age.

These first vaccines prime the immune system, which when followed by a later booster vaccine, provide good protection against each disease.

start your baby on the path to eventually getting protected from 16 different vaccine-preventable diseases.
Ari Brown, MD explains why you shouldn’t delay or skip your child’s vaccines.

And the requirement of multiple dosages of a vaccine is a small price to pay to be able to skip the symptoms and risk of more serious consequences that come from getting a natural infection and natural immunity.

Did your baby have a reaction to their first set of vaccines?

While some fever, pain, and fussiness is not unexpected, be sure to tell your health care provider if your baby had a reaction that you think was more severe, like a high fever or non-stop crying for several hours.

Can you expect a reaction to your baby’s second set of shots if they had a reaction to the first? Probably not. Side effects, even those that are serious, rarely happen again, even when the same vaccines are given.

Your Baby’s Vaccines

While you certainly shouldn’t skip or delay any of these vaccines, you should know that:

  • the routine age for starting these vaccines is at two months, but
  • if necessary, they can be given as early as when a baby is six weeks old.
  • the routine interval between dosages of the primary series of these vaccines is two months, but
  • if necessary (usually as part of a catch-up schedule), these vaccines can be usually be given as soon as four weeks apart, although the third dose in the series of DTaP, IPV, and Hepatitis B vaccines shouldn’t be given any sooner than at age six months.
  • infants who will be traveling out of the United States should get an early MMR vaccine – as early as six months of age

And if your baby is at least six months old during flu season, then they will also need two doses of the flu shot given one month apart. The minimum age to get a flu shot is six months, and kids get two doses during their first year of getting vaccinated against the flu to help the vaccine work better.

Learn more about if you are on the fence. Your baby needs to be vaccinated and protected.

What to Know About Your Baby’s First Vaccines

Your baby’s first vaccines are safe and necessary to start them on a path to eventually getting protected from 16 different vaccine-preventable diseases.

More on Your Baby’s First Vaccines

Updated February 7, 2018