May 1, 2020 National Infant Immunization Week - The Importance of Continuing with Timely Vaccinations

Meg Fisher, MD, Medical Director, Unterberg Children’s Hospital, Chair, Department of Pediatrics, Monmouth Medical Center

National Infant Immunization Week (NIIW) is an annual event that highlights the importance of immunizations to protect infants from 14 serious, and potentially deadly, vaccine-preventable diseases. This year NIIW takes place from April 25 through May 2. Vaccines can be a confusing topic for parents, but especially now during the COVID-19 crisis where they might be hesitant to bring children into the doctor’s office. Despite the circumstances, it remains vitally important to continue with regularly scheduled and routine immunizations.

Why is it essential for parents to get their infants immunized?

It is important for children to get protected from infectious diseases for which we have vaccines. Slowing or stopping vaccines increases the risk of vaccine-preventable diseases. During the last 3 months of pregnancy, a mother’s protective antibodies cross from her blood to her baby. So when a baby is born at full term, the baby is protected from whatever diseases the mother was protected against. But that protection doesn’t last. Each month, half of the protection from mother’s antibodies goes away. By 6 months, a baby is no longer protected against these infectious diseases. Therefore, getting your infant immunized within the first six months is vital. The infant will build up his or her own antibodies at the same time the maternal antibodies are going way so the child will stay protected.

How do vaccines work?

It depends on the vaccine, but vaccines help develop immunity by imitating an infection. This type of infection, however, almost never causes illness, but it does allow the immune system to produce antibodies. Once the imitation infection goes away, the body is left with a memory of how to fight that disease in the future.

What is the recommended immunization schedule for infants?

• At birth:
  • The Hepatitis B vaccine is given
    • The Hepatitis B virus can damage the liver and if a baby becomes infected right after birth or soon after, they are likely to have chronic infection and more likely to develop cirrhosis of the liver and liver failure or liver cancer
• At two months:
  • The Rotavirus (RV) vaccine should be given
    • It is the only vaccine given by mouth.
    • This protects against rotavirus, which can lead to diarrhea, fever and vomiting, which can result in dehydration
    • Before we had this vaccine, rotavirus was the most common reason infants were hospitalized
  • The DTaP vaccine is given
    • This protects against diphtheria, tetanus and pertussis.
    • Diphtheria isn’t really around anymore but the bacteria are out there; it affects the throat and can result in swelling of the neck as well as damage to the heart and nerves
    • Tetanus causes lockjaw (severe muscle spasms that can interfere with breathing)
    • Pertussis is whopping cough, which is most severe during infancy. Whopping cough in an infant can cause damage to brain. The cough from pertussis lasts for months. The mother gets vaccinated during pregnancy against whopping cough and the child should also get vaccinated.
  • The Haemophilus influenza type b (Hib) vaccine is given
    • The Hib bacteria can infect the brain, middle ear, and airway and can affect the lungs, heart, skin and joints
    • This was a serious issue until a vaccine was created in the late 1980s
    • If children aren’t immunized, they can catch it because the bacteria haven’t gone away
  • The Pneumococcal vaccine (PCV13) is given to protect against Streptococcus pneumoniae
    • Like Hib, Streptococcus pneumoniae causes infection of the brain, middle ear, heart, lungs, and joints
    • Streptococcus pneumoniae causes infection in all ages
    • Immunizing children not only protects them but also protects their parents and grandparents because immunized children don’t carry the bacteria in their nose and throat and thus, can’t give it to others.
  • The polio vaccine is given (IPV vaccine)
    • Although polio has been eliminated from most of the world, it’s still present in some countries and could come back to the United States
    • Polio can cause paralysis
• Starting at 6 months and yearly
  • The influenza vaccine should be given for the flu
    • A flu vaccine is necessary every year because the flu strain changes from year to year
• At 12 months:
  • The measles, mumps, rubella (MMR) vaccine should be given
    • Measles causes fever, cough, pink eye, rash, and can infect the lungs and brain
    • Mumps causes fever and swelling of the glands in the neck and can cause meningitis
    • Rubella is a mild fever illness but dangerous for developing babies, in whom it can damage the heart, brain and eyes
  • The Varicella vaccine should be given to protect against the chickenpox
    • Chickenpox can be severe and more than just an unpleasant rash
    • It can also involve the brain covering and can affect brain function and the lungs
    • Preventing chickenpox is important because if you don’t get chickenpox you can’t get shingles as an older adult. The chickenpox virus stays within a person and can reactivate years later, causing shingles. Shingles is a painful rash that burns and itches; the pain can last for months to years.
• Anywhere from 12 months to two years old:
  • The Hepatitis A vaccine should be given
    • Hep A causes infection of liver

Is it safe to get several vaccines at one time?

Not only is it safe, but it is the best thing to do. Multiple vaccines don’t overwhelm a child’s immune system and it means not as many visits to the doctor’s office.

Why is it important to stick to your vaccine schedule?

• The schedule recommended by the Centers for Disease Control and Prevention is safe and effective at protecting your child and carefully designed to provide protection at just the right time.
• Young babies are at the highest risk for serious disease complications, thus delaying vaccines could leave your child vulnerable to disease when they’re most likely to have serious complications.
• It’s best to vaccinate before your child is exposed to dangerous diseases. It can take weeks for a vaccine to help your baby make protective disease fighting antibodies and some vaccines require multiple doses to provide the best protection. If you wait until you think your child could be exposed to a serious illness, like when they start daycare or during an outbreak, there may not be enough time for the vaccine to work.
• Every vaccine on the schedule is important. Children won’t have the best protection from serious diseases until they get all the recommended doses of each vaccine.
• Children who are not vaccinated on schedule are not only at risk of getting sick themselves, but they can also spread illness to others who aren’t protected, like newborns or those who are immunocompromised.

How safe are vaccines?

All vaccines in use have been developed with extraordinary testing for safety. Before it can be licensed, the vaccine goes through extensive testing in animals and then in people and it must be shown to be safe and effective. Once the vaccine is licensed, it’s monitored at the federal level. The Vaccine Adverse Events Reporting System allows any physician or parent or patient to report side effects or adverse events following immunizations. The Vaccine Safety Datalink is a very large database that contains information from many large health groups. The information does not include names or birthdates, but it includes which vaccines were given and what happened later. This is used to monitor the safety of all vaccines. When there are reports of side effects, the database can be searched to see if the side effect was more common in people who received the vaccine. If a safety problem is detected, the vaccine recommendations are changed.

Are there side effects to vaccines for infants?

Every medicine has side effects. For vaccines the side effects include pain at injection site and sometimes fever.

What if my child needs to receive their vaccinations right now but I’m feeling hesitant to take them to the doctor’s office because of COVID-19?

Parents should be reassured that pediatricians are taking all the necessary precautions in their offices to make it safe for children and adults to visit. They are scheduling well visits and sick visits at different times. Patients and parents are being screened before coming into the office. Pediatricians are being very careful, but if you have any concerns, talk to your pediatrician ahead of time. Please be sure to get your child immunized. There’s no need for your child to get sick from bacteria and diseases that are preventable.

For a referral to an RWJBarnabas Health pediatrician, call 888-724-7123.