KIDS' STUFF
UNDERSTANDING CHILDHOOD VACCINES
AUTHOR Wendy C. Daly MD, FAAP
The information in this article was obtained from the “Red Book” Report of the Committee on Infectious Diseases from the American
Academy of Pediatrics, as well as the CDC and WHO websites.
I
had chickenpox at age three along with my
two younger siblings. At age five, the pain I
experienced with mumps was excruciating.
When I was eight, my (then) three siblings
and I were confined to rest in a dark room
because we all had measles. At some point
in my childhood, I was given a smallpox
vaccine that left a scab the size of a June Bug
on my left deltoid. When I was 10, I lined up with my classmates to
receive my first dose of the oral polio vaccine, which was given on a
sugar cube administered by the school nurse. My parents and their
contemporaries never thought to question any vaccine.
Smallpox was eradicated globally in 1977. Poliomyelitis was
eliminated from the US in 1991. Measles was eliminated in 2000 and
Congenital Rubella Syndrome was eliminated in 2004. Elimination
does not mean the absence of cases. It is defined as the absence
of disease transmission for a 12-month period following the last
infectious case report. In 2004, there were only 37 cases of measles
reported in the U.S. As of June 20, 2019, 1,077 cases of measles have
been reported in 28 states.
In 1998, The Lancet published a paper by British physician An-
drew Wakefield, which proposed a link between the measles vaccine
and autism. His research was ultimately discredited, he admitted
he lied, and he lost his license to practice in the UK for authoring
a fraudulent research paper. Unfortunately, this article spurred a
climate of distrust of all vaccines. This climate is continually fueled
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LOUISVILLE MEDICINE
by celebrity support and misinformation on all forms of social media.
Discoveries in immunology, molecular biology and medical ge-
netics have given rise to newer and safer vaccines. There are literally
hundreds of government agencies and private organizations that
monitor vaccine safety and development. Vaccine recommendations
have changed, as does everything in life. Companies that develop
vaccines must meet stringent guidelines in manufacturing, delivery
and storage. The number of vaccines may have risen over the past
few years, but changes in research and development have actually
decreased the number of antigens required to induce immunity.
Therefore, only a small amount of the child’s immune system is
needed for an effective response to a vaccine. Vaccine trials require
the simultaneous administration of new vaccines with current ones
to ensure the safety and effectiveness of vaccine combinations.
Before licensing a vaccine, the FDA also thoroughly investigates
all vaccine ingredients including the antigen, the stabilizers that
protect the vaccine integrity, preservatives that prevent the growth
of bacteria and fungi, and any residual components left over from
the manufacturing process. Some parents request vaccines to be
separated. At present, most vaccines are given in a single-dosed
syringe containing 0.5 cc of diluent. If the components of a combi-
nation vaccine are separated, such as Pentacel (DTaP-HiB-Polio)
or Pediarix (DTaP-Hep B-Polio), the infant receives 1.5 cc, or three
times the amount of the components that some parents are trying
to avoid. In addition, older vaccines were developed using different
technology and may have to be drawn up from a multidose vial.