Healthy child


Doctors urge preschoolers get all vaccines :::::::::::::::::::::::::::::::::

Susan Dodge

Nearly one in five American toddlers is not getting the vaccines he or she needs to prevent life-threatening childhood diseases, according to the Centers for Disease Control and Prevention.

The children who lack these required immunizations are not just at risk themselves; they are putting other children-their playmates at home or at the daycare center-at risk for illness.

Only 76 percent of children 19 to 35 months old in daycare have been immunized and just 73 percent of children who had never been in daycare have had their shots, according to a new study based on the federal National Immunization Survey. The study appears in the American Journal of Preventive Medicine.

Of the preschoolers who were lacking vaccinations, more than 90 percent were missing more than one dose.

Illinois' vaccination regulations for children in daycare centers really don't work because there is no enforcement muscle behind them, says Carol Stanwyck, one of the researchers who analyzed the immunization survey.

"Some monitor only licensed centers, while others include family childcare programs as well," she says.

There is better enforcement for kids in elementary school because state laws require students to have their vaccinations before enrolling in school. More than 95 percent of kindergartners and first-graders have their required vaccines.

While some parents may not realize that vaccinations need to begin in infancy, it is important that babies be vaccinated because they are especially vulnerable to infections.

"By the time children are 2 years old, they can be protected from more than 11 preventable diseases," says Steve Berman, a pediatrician and president of the American Academy of Pediatrics, in a recent news release. "Several immunizations can often be given at one visit. Parents should check with their pediatrician or health department to see what is needed to keep their child's immunization record current."

Vaccines for infants and toddlers are given at specific times and are based on their vulnerability to disease as well as their ability to tolerate the immunization. If a shot is given too early, for example, it might not be effective. But if it's given too late, it could put a child's health in danger.

The academy and the CDC recommend the following vaccines be given to infants and toddlers up to age 2 over five visits:

• Four doses of DTaP, which includes vaccines against diphtheria, tetanus and pertussis (whooping cough). This is very important given the recent outbreak of whooping cough. (See Chicago Parent's August edition,

• Four doses of the Hib vaccine, which prevents Haemophilus influenza B, a major cause of bacterial meningitis.

• Four doses of pneumococcal vaccine, which prevents bacterial meningitis and blood infections. (Since there is a shortage of the pneumococcal vaccine, the CDC recommends suspending the fourth dose except for children considered to be at extreme risk.)

• Three doses of hepatitis B vaccine.

• Three doses of polio vaccine.

• One dose of MMR vaccine, which prevents measles, mumps and rubella (German measles).

• One dose of varicella (chickenpox) vaccine.

And the latest recommendation from the American Academy of Pediatrics is that infants 6 to 23 months get two doses of flu vaccine spaced one month apart. The CDC is planning to stockpile the flu vaccine this year in the hope of preventing another shortage.

A new vaccine called Pediarix is being developed that would combine five shots in one, including vaccines against diphtheria, tetanus, pertussis, hepatitis B and polio.

Until that receives federal regulatory approval and is available, children should receive about 80 percent of all required vaccines by age 2 and should complete the full schedule by ages 4 to 6 with booster shots. Typical side effects from vaccines are a mild fever or a rash.

Some parents are concerned that infants today receive too many vaccines, resulting in weakened immune systems. But vaccines actually protect an infant's immune system by providing protection against life-threatening diseases.

We also forget how devastating the diseases are that the vaccines fight. Before the immunization against measles, the disease killed about 3,000 children a year and hospitalized another 48,000, according to Berman.

It's important for parents to keep a record of their child's vaccines along with an overall health record, especially in this time of rotating health care providers. For general immunization questions, parents can contact the CDC's immunization hotline at (800) 232-2522 (English) or (800) 232-0233 (Spanish).

Or visit the American Academy of Pediatrics Childhood Immunization Support Program at



Susan Dodge is Ben's mother and a writer living in northwest Indiana.

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