Tag: combination vaccines

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

Should Parents Be Concerned About Combination Vaccines and Febrile Seizures?

Anti-vaccine folks have parents worried about everything and anything having to do with vaccines these days.

Unlike most of the ideas that anti-vaxxers push, febrile seizures really can occur after vaccines. Fortunately, they aren’t something to be worried about.

Should Parents Be Concerned About Combination Vaccines and Febrile Seizures?

While febrile seizures can be scary, it is important to know that without other risk factors, kids who develop febrile seizures after a vaccine are at the same small risk for developing epilepsy as other kids.

And know that vaccines aren’t the only cause of febrile seizures. Vaccine-preventable diseases can cause both febrile seizures and more serious non-febrile seizures.

What about the extra risk of febrile seizures following combination vaccines?

“Studies have shown a small increased risk for febrile seizures during the 5 to 12 days after a child has received their first vaccination with the measles, mumps, rubella (MMR) vaccine. The risk is slightly higher with the measles, mumps, rubella, varicella (MMRV) combination vaccine, but the risk is still small. Studies have not shown an increased risk for febrile seizures after the separate varicella (chickenpox) vaccine.”

Childhood Vaccines and Febrile Seizures

The small extra risk of febrile seizures for the measles, mumps, rubella, varicella (MMRV) combination vaccine vs the separate MMR and chicken pox vaccines is just for the first dose of these vaccines, so pediatricians and parents might choose to give the separate vaccines instead. And only use this combination vaccine for the second dose.

Are any other combination vaccines a concern for febrile seizures?

Nope, even though some anti-vaccine sites push that idea and that vaccines can cause epilepsy.

Parents will likely be reassured by one of the studies that anti-vaccine folks like to cite, which states that “vaccination with DTaP-IPV-Hib was not associated with an increased risk of epilepsy.”

We do know that there is a small increased risk for febrile seizures when the influenza vaccine is given at the same time as either the Prevnar13 vaccine or the DTaP vaccine, although “the risk of febrile seizure with any combination of these vaccines is small and CDC’s Advisory Committee on Immunization Practices (ACIP) does not recommend getting any of these vaccines on separate days.”

Is the risk really small though?

After all, an article by Sheri A Marino talks about a 6-fold extra risk in some cases.

Isn’t that a lot?

“Does this mean we should stop giving these vaccines together or stop giving them at all? We say, emphatically, no. With the results of this study, we can accurately calculate the risks and benefits of this practice. The risk is 1 febrile seizure per pediatric practice every 5 to 10 years. Febrile seizures, although frightening to parents, rarely have any long-term sequelae. The benefits of giving these vaccines simultaneously include decreased office visits associated with painful vaccines, decreased episodes of vaccine-associated fussiness, and, most important, the assurance that children will be fully immunized and protected from infections that carry real morbidity and mortality. It is well established that the vaccines we miss when we fail to give all the vaccines we can (simultaneously at each health care visit) may never be administered to some children, thus leaving them at risk for the diseases the vaccines prevent. It goes without saying that influenza, diphtheria, tetanus, pertussis, and pneumococcal infections may result in serious illness. These infections also have the potential to cause fevers and febrile seizures. Without vaccines to prevent these illnesses, pediatricians would see many more than 1 case of most of these infections each decade. In fact, they would see children in their practices with both febrile seizures and life-threatening infections. The risk from these diseases far outweighs the risk from the vaccines.”

Sawyer et al on Vaccines and Febrile Seizures: Quantifying the Risk

Because the risk of febrile seizures is so small, it remains small even with any extra risk.

What’s more concerning? The risks of following anti-vaccine propaganda and leaving your kids unvaccinated and unprotected.

Vaccines are safe, with few risks, and necessary.

More on Vaccines and Febrile Seizures

Are the Tdap and DTaP Vaccines the Same Thing?

You have probably already figured out the Tdap and DTaP aren’t the same vaccine, after all, if they were, why would they have different names, right?

Are the Tdap and DTaP Vaccines the Same Thing?

I bet you don’t know the difference between the two vaccines though.

Yes, they both are both combination vaccines that protect against diphtheria, tetanus, and pertussis.

The difference is that one (DTaP) is used as the primary series for infants and younger children (age 6 years and under) and the other (Tdap) is given to older children (age 7 years and above), teens, and adults.

Okay, that’s not the only difference.

The DTaP vaccine actually contains more diphtheria and pertussis antigens than Tdap, which is why it has the capital “D” and “P” in its name. The amount of tetanus toxoid antigens are about the same in both vaccines.

So Tdap contains the same amount of tetanus toxoid, plus a reduced amount of diphtheria and acellular pertussis antigens, as compared to DTaP.

While you would think that older children and adults would get the vaccine with the higher amount of antigens, since they are bigger, that’s not how this works. Vaccines typically start working at the injection site, so body size isn’t a key factor in determining the amount of ingredients.

As a booster dose of vaccine, the lower amount of antigens works just fine and helps reduce the risk of side effects from repeated doses that you might get with higher antigen counts.

More on Tdap vs DTaP

Does Pentacel Contain Mercury?

Thimerosal was taken out of most childhood vaccines in 2001, only remaining in muti-dose vials of flu vaccines, which could easily be avoided, as a good supply of thimersosal-free flu vaccine has been available for many years.

“Thimerosal is a mercury-based preservative that has been used for decades in the United States in multi-dose vials (vials containing more than one dose) of medicines and vaccines. There is no evidence of harm caused by the low doses of thimerosal in vaccines, except for minor reactions like redness and swelling at the injection site. However, in July 1999, the Public Health Service agencies, the American Academy of Pediatrics, and vaccine manufacturers agreed that thimerosal should be reduced or eliminated in vaccines as a precautionary measure.”

CDC on Thimerosal in Vaccines

For some reason, that hasn’t kept some parents from still being concerned about mercury in vaccines.

Does Pentacel Contain Mercury?

Pentacel is vaccine that combines the diphtheria and tetanus toxoids and acellular pertussis adsorbed, inactivated poliovirus and Haemophilus b conjugate (tetanus toxoid conjugate) vaccines (DTaP-IPV/Hib) into one shot.

Pentacel is mercury free.
Like most other vaccines on the childhood immunization schedule, Pentacel is mercury free.

It is routinely given to children as a four dose series, when they are 2, 4, 6, and 15 to 18 months old.

Like most other vaccines given to children, Pentacel is thimerosal-free.

It does not contain mercury.

More on Mercury in Vaccines