Tag: live vaccines

Who Is at Risk If You Don’t Vaccinate Your Kids?

Passive immunity doesn't last until 12 months, when infants get their first dose of the MMR vaccine, so they are at risk for disease.
Passive immunity doesn’t last until 12 months, when infants get their first dose of the MMR vaccine, so they are at risk for disease. Photo by Jamie Beverly (CC BY-SA 2.0)

Whenever there is a discussion about folks who intentionally choose to not vaccinate themselves or their kids, one of their arguments invariably is ‘why are you so worried if you and your kids are vaccinated?”

Here is an example:

“My argument is simple. If you are vaccinated, you should not have to fear an outbreak of any preventable disease. That’s what the vaccine is supposed to prevent, right? Therefore, why should anyone butt into someone else’s business and tell them they should vaccinate? If one and one’s dependents are vaccinated, why should they have to worry about my personal decision to not vaccinate?”

I personally don’t believe in vaccines

As most people understand, the argument is far from simple.

Who Is at Risk If You Don’t Vaccinate Your Kids?

There are many people who are at risk from those who are unvaccinated, including those who:

  • are too young to be vaccinated or fully vaccinated – remember, with the latest immunization schedule, kids don’t typically get their first MMR until age 12 months and their second until they are 4 to 6 years old
  • can’t be fully vaccinated and have a true medical exemption – this includes children and adults with some immune system problems, vaccine allergies, or other contraindications to getting one or more vaccines
  • were vaccinated, but later developed an immune system problem and their immunity has worn off – might include children with cancer, AIDS, those receiving immunosuppressive therapy after a transplant, or a condition that requires immunosuppressive doses of steroids, etc.
  • were vaccinated, but their vaccine didn’t work or has begun to wear off (waning immunity) – vaccines work well, but no vaccine is 100% effective

These are the children and adults that can be, and should be, protected by herd immunity. At least they can be when most folks are vaccinated.

“We want to create a ‘protective cocoon’ of immunized persons surrounding patients with primary immunodeficiency diseases so that they have less chance of being exposed to a potentially serious infection like influenza.”

Medical Advisory Committee of the Immune Deficiency Foundation

So while some folks who are against vaccines try to scare others about shedding, those who take care of kids with immune system problems and their families go out of the way to get everyone around them vaccinated so their kids aren’t at risk of getting a vaccine-preventable disease!

“…the increased risk of disease in the pediatric population, in part because of increasing rates of vaccine refusal and in some circumstances more rapid loss of immunity, increases potential exposure of immunodeficient children.”

Medical Advisory Committee of the Immune Deficiency Foundation

Tragically, not everyone has gotten the message, and we continue to see and hear about kids who are too young to be vaccinated or who couldn’t be vaccinated get exposed to those who got sick because they simply chose to not get vaccinated.

What to Know About Risks from the Unvaccinated

Intentionally unvaccinated children and adults put others at risk for vaccine-preventable diseases.

More Information on Risks from the Unvaccinated

Rabies Vaccines

Rabies is a little different than most vaccine-preventable disease.

While we do have a rabies vaccine, in fact, one of the first vaccines when it was developed in 1885 by Louis Pasteur, it is typically given after you have been exposed to the rabies virus. Most other vaccines are routinely given before you are ever exposed to the diseases they prevent.

And the rabies vaccine has changed a lot since Pasteur’s day.

Instead of getting daily shots for 14-21 days, the rabies vaccine is now given when you are exposed, with human rabies immune globulin (HRIG), with further doses of vaccine on days 3, 7, and 14.

Do you need a rabies vaccine after getting bit by an animal?

It depends on the animal and whether or not the animal can be quarantined (confined and observed for rabies symptoms for 10 days).

And while any mammal can get rabies, the ones that are most worrisome are:

  • raccoons, skunks, bats, foxes, and coyotes
  • cats, dogs, and ferrets
  • livestock, cattle, horses

Most importantly, note that “Recent data suggest that transmission of rabies virus can occur from minor, seemingly unimportant, or unrecognized bites from bats.”

The CDC states that “Small rodents like squirrels, hamsters, guinea pigs, gerbils, chipmunks, rats, and mice) and lagomorphs including rabbits and hares are almost never found to be infected with rabies and have not been known to transmit rabies to humans.”

For Information on Rabies Vaccines:

FluMist

FluMist, the live, attenuated influenza vaccine (LAIV) that is given intranasally, instead of like a traditional flu shot, was first approved by the FDA in 2003.

At that time, it could be given to healthy, nonpregnant persons aged 5 to 49 years.

The age indication was lowered to include healthy kids between the ages of 2 to 4 years in 2007, in time for the 2007-08 flu season.

Other changes to FluMist over the years include that:

  • the dose was lowered from 0.5ml to 0.2ml in 2007
  • FluMist stopped being shipped frozen in 2007, instead being shipped at a higher 35°F to 46°F
  • Flu Quadrivalent was approved in 2012, but didn’t become available until the 2013-14 flu season
  • MedImmune, the makers of FluMist, begin to investigate reports of “lower than expected effectiveness” during the 2013-14 flu season and “possible problems with thermostability” are fixed
  • for the 2014-15 flu season, FluMist became the preferred flu vaccine for children between the ages of 2 to 8 years
  • the preferential recommendation for FluMist was removed the next year, for the 2015-16 flu season, when either inactivated flu shots or FluMist were recommended

And of course, for the 2016-17 flu season, the ACIP and AAP recommended that FluMist not be used at all.

About 14 million doses of FluMist would have been available in the United States during the 2016-17 flu season. Although a small percentage of the 171 to 176 million total doses of available flu vaccine, FluMist has been very popular with pediatricians, parents and especially children, as it helps avoid a shot.

Based on data from observational studies showing lower than expected effectiveness of FluMist Quadrivalent from 2013 through 2016, on June 22, 2016, the Advisory Committee on Immunization Practices (ACIP), an advisory committee to the Centers for Disease Control and Prevention (CDC), voted to recommend that FluMist Quadrivalent should not be used during the 2016-2017 influenza season.

There are “discordant results among” studies though and experts aren’t sure why.

If You Need More FluMist Information:

References:
  • MMWR. Notice to Readers: Expansion of Use of Live Attenuated Influenza Vaccine (FluMist®) to Children Aged 2–4 Years and Other FluMist Changes for the 2007–08 Influenza Season. November 23, 2007 / 56(46);1217-1219
  • MMWR. Recommendations of the Advisory Committee on Immunization Practices — United States, 2016–17 Influenza Season. August 26, 2016 / 65(5);1–54.

Vaccines in Pregnancy

Can children get vaccinated when their mother is pregnant?

Yes.

The CDC states that “pregnancy of recipient’s mother or other close or household contact” is not a contraindication to getting vaccinated, even for live vaccines like MMR or Varivax.

What about pregnant women? Are vaccines safe or necessary for them?

While they shouldn’t get live vaccines, like MMR, Varivax, Flumist, or the yellow fever vaccine, or the HPV vaccine, it is safe and necessary for pregnant women to get most other vaccines.

In fact, all pregnant women should get:

Getting vaccinated during pregnancy helps protect newborn babies and infants against the flu and pertussis (whooping cough).

For more information:

Shingles Vaccine

The varicella zoster virus causes chicken pox.

When chicken pox becomes reactivated, people get shingles or herpes zoster. A painful rash that can last for several weeks, shingles can be prevented with Zostavax, the shingles vaccine. Licensed in 2006, it has been recommended that all seniors who are at least 60 years old get the shingles vaccine.

For more information:

Polio Vaccines

The first polio vaccines were licensed in the 1950s and ’60s by Jonas Salk and Albert Sabin.

Together, they have helped us get to the point where we are close to eradicating polio. We are not quite there yet.

Today, in the United States, after thirty years of using the live, oral polio vaccine, we are once again using polio shots because of the risk of VAPP. Infants get their first doses at two and four months and a third dose in the primary series between six and 18 months. A booster dose is give between four to six years.

For more information:

Updated April 26, 2017

Yellow Fever Vaccines

Although the first yellow fever vaccine was developed in 1935, a yellow fever vaccine wasn’t licensed in the United States until 1953.

It was mosquito control more than the yellow fever vaccine that helped control yellow fever in the United States though.

Unfortunately, yellow continues to be  a big problem in many parts of the world and a yellow fever vaccine is required before travel to certain countries.

For more information: