Answering Your Questions

You have questions. We have answers.

As parents, determining how best to protect our children can be overwhelming and confusing because of the volume of information available on the internet about vaccines. Even the bad information can look and sound credible and science‑based.

What and who should parents believe?

The answers below to some of the most frequent questions parents ask about vaccines are based only on credible medical research and science from the most trusted and respected physicians, research and public health organizations across the globe. The answers also draw attention to some of the “bad science” about vaccines that has confused and alarmed so many parents, even after those studies were exposed as fraudulent and untrue.

The good news is that while many parents have questions about vaccines, most do choose to protect their child through vaccination and discuss questions with their child’s health care provider.

Read the Most Commonly Asked Questions.

Vaccines today

The diseases we vaccinate against have declined, but they haven’t disappeared. Recent outbreaks of mumps on college campuses, Hepatitis A in Michigan and around the country, measles at Disneyland and whooping cough (pertussis) cases in Michigan in 2014 show that vaccine-preventable diseases can easily make a comeback. See our News section for more recent examples. All vaccine-preventable diseases can make people very sick; some can kill.

Other countries don’t have the same access to vaccines as we do in the United States. Vaccine-preventable diseases are only a plane-ride away, and if we stop vaccinating, vaccine-preventable diseases can and will return. This is why we still vaccinate against diseases we no longer see in our country. If the majority of our country stopped vaccinating, one infected traveler from another country could potentially spark an outbreak.

Fourteen diseases that cause serious medical problems can be prevented by age two through routine childhood vaccines:

Diphtheria

  • Caused by bacteria.
  • Spread from person to person through the air by coughing, sneezing, or just breathing.
  • Causes sore throat, fever, and chills.
  • If not properly diagnosed and treated, it can produce a toxin that can cause heart failure or paralysis.
  • About 1 person in 10 infected with diphtheria dies.
  • Prior to vaccination (through the 1920s), about 150,000 people got diphtheria each year, and about 15,000 died.
  • Can be prevented with the DTaP (Diphtheria, Tetanus, and Pertussis) vaccine, administered at 2 months, 4 months, 6 months, 15 through 18 months, and 4 through 6 years of age.

Hepatitis A

  • Caused by hepatitis A virus.
  • Found mostly in bowel movements and spread by personal contact or through contaminated food or water.
  • Causes liver disease – muscle and stomach pain, diarrhea or vomiting, loss of appetite, fatigue, yellow skin or eyes (jaundice).
  • Children younger than about 6 years old might not have any symptoms.
  • About 100 people die each year from liver failure caused by hepatitis A.
  • Can be prevented with the Hepatitis A (HepA) vaccine, administered at ages 12 through 23 months and again 6 to 18 months after the first dose.

Hepatitis B

  • Caused by hepatitis B virus.
  • Spread through contact with blood or other body fluids.
  • Causes liver disease – muscle and stomach pain, diarrhea or vomiting, loss of appetite, fatigue, yellow skin or eyes (jaundice).
  • Some people recover and others become “chronically infected,” which can lead to liver disease or liver cancer.
  • Chronically infected people can infect others through, for example, unprotected sex or sharing needles.
  • Babies of chronically infected mothers are usually infected at birth.
  • About 3,000 to 5,000 people die each year from hepatitis B.
  • Can be prevented with the Hepatitis B (HepB) vaccine, administered at birth, with a second dose at 1 through 2 months of age and the final dose at 6 through 18 months.

Haemophilus influenzae type b (Hib)

  • Caused by bacteria.
  • Spread from person to person through the air by coughing, sneezing, or just breathing.
  • If Hib bacteria enter the bloodstream they can cause meningitis, pneumonia, arthritis, and other serious medical problems.
  • Before vaccine, Hib was the leading cause of bacterial meningitis in children younger than 5 (about 1 out of every 200 children in that age group). One child in 4 suffered permanent brain damage, and 1 in 20 died.
  • Can be prevented with the Hib (Haemophilus influenzae type b) vaccine, administered at 2 months, 4 months, 6 months and 12 through 15 months of age.

Influenza (flu)

  • Caused by influenza virus.
  • Spread from person to person through the air by coughing, sneezing, or just breathing.
  • The flu is a serious upper respiratory disease (different than the common cold or a stomach virus). Even healthy people can get the flu and it can be very serious.
  • Causes fever, sore throat, cough, headache, chills and muscle aches.
  • Can lead to sinus infections, pneumonia, and inflammation of the heart.
  • Hospitalization rates are high among children, especially babies under 1 year old.
  • Flu causes more deaths each year than any other vaccine-preventable disease – mostly among the elderly, but it can also kill children and young adults.
  • Can be prevented with the Influenza (flu) vaccine, administered every year starting when your child is 6 months old. Some children 6 months through 8 years of age may need 2 doses for the best protection.

Measles

  • Caused by measles virus.
  • Extremely contagious (which means a person who has the disease can easily spread it to other people).
  • Spread from person to person through the air by coughing, sneezing, or just breathing.
  • Causes a rash all over the body, runny nose, fever, and cough.
  • About 1 child in 10 also gets an ear infection, up to 1 in 20 gets pneumonia, 1 in 1,000 gets encephalitis (inflammation of the brain).
  • Before vaccine, almost all children got measles – about 48,000 were hospitalized each year, 7,000 had seizures, about 1,000 suffered permanent brain damage, and about 450 died.
  • Measles still kills about a half million people a year around the world.
  • About 1 person in 1,000 who gets measles will die.
  • Can be prevented with the MMR (Measles, Mumps, and Rubella) vaccine, administered at 12 through 15 months and 4 through 6 years of age. Infants 6 months to 11 months old should have 1 dose of MMR shot before traveling abroad.

Mumps

  • Caused by mumps virus.
  • Used to be a very common childhood disease.
  • Spread from person to person through the air by coughing, sneezing, or just breathing.
  • Usually a relatively mild disease – causes fever, headache, and inflammation of salivary glands.
  • Mumps can lead to meningitis (about 1 child in 10), encephalitis (inflammation of the brain) or deafness (about 1 in 20,000) or death (about 1 in 10,000).
  • Can be prevented with the MMR (Measles, Mumps, and Rubella) vaccine, administered at 12 through 15 months and 4 through 6 years of age. Infants 6 months to 11 months old should have 1 dose of MMR shot before traveling abroad.

Pertussis (whooping cough)

  • Caused by bacteria.
  • Spread from person to person through the air by coughing, sneezing, or just breathing.
  • Can look like a common cold at first.
  • After one or two weeks, it can cause violent coughing spells that can interfere with eating, drinking, or even breathing.
  • Can lead to pneumonia, seizures, brain infection and death.
  • Can be prevented with the DTaP (Diphtheria, Tetanus, and Pertussis) vaccine, administered at 2 months, 4 months, 6 months, 15 through 18 months, and 4 through 6 years of age.

Pneumococcal Disease

  • Caused by bacteria.
  • Most common in winter and early spring.
  • Spread from person to person through the air by coughing, sneezing, or just breathing.
  • After Hib disease began to decline, pneumococcal disease became the most common cause of bacterial meningitis in children under 5.
  • Can lead to ear infections, blood infections, and death.
  • At higher risk are African Americans, some Native American tribes, children with sickle cell disease or with HIV infection and children without a working spleen.
  • Can be prevented with the PCV13 (pneumococcal) vaccine, administered at 2 months, 4 months, 6 months and between 12 and 15 months of age.

Polio

  • Caused by polio virus.
  • Enters the body through the mouth.
  • Can cause paralysis, leaving a person unable to walk or even breathe.
  • About 1,200 polio victims in the United States were forced to live in 700-pound “iron lungs,” a large machine that allowed them to breathe. Several of these people, first confined to an iron lung in the 1950s, still live in them today.
  • Polio caused panic in the 1950s before vaccine – about 20,000 people were paralyzed each year.
  • Can be prevented with the Polio vaccine, administered at 2 months, 4 months, 6 through 18 months and 4 through 6 years of age.

Rotavirus

  • Caused by a virus.
  • Enters the body through the mouth.
  • Causes diarrhea and vomiting in young children – sometimes so severe it can lead to dehydration.
  • Before vaccine, rotavirus caused more than 400,000 doctor visits, 200,000 emergency room visits, up to 70,000 hospitalizations, and 20 to 60 deaths each year.
  • Can be prevented with the Rotavirus (RV) vaccine, administered at 2 months and 4 or 6 months of age, depending on the vaccine brand.

Rubella (German measles)

  • Caused by a virus.
  • Spread from person to person through the air by coughing, sneezing, or just breathing.
  • Usually a mild disease, causing swollen glands in the neck, fever, rash on the face and neck, and sometimes arthritis-like symptoms.
  • The greatest danger from rubella is to unborn babies. If a pregnant woman gets rubella, her unborn baby has about an 80-percent chance of “congenital rubella syndrome” (CRS), which can lead to deafness, blindness, mental impairment, or heart or brain damage. Miscarriages are also common.
  • In 1964-65, before vaccine, rubella infected 12.5 million people in the United States and led to 20,000 cases of CRS.
  • Can be prevented with the MMR (Measles, Mumps, and Rubella) vaccine, administered at 12 through 15 months and 4 through 6 years of age. Infants 6 months to 11 months old should have 1 dose of MMR shot before traveling abroad.

Tetanus (lockjaw)

  • Caused by bacteria.
  • Tetanus is often found in soil and also found in saliva, dust and manure.
  • Enters the body through cuts, burns, or other breaks in the skin – not spread from person to person.
  • About three weeks after exposure, a child could become cranky, get a headache, or have spasms in the jaw muscles.
  • Tetanus can then produce a toxin that causes painful muscle cramps in the neck, arms, legs, and stomach – strong enough to break a child’s bones.
  • A child might have to spend several weeks in intensive care. One or two out of every 10 die.
  • Can be prevented with the DTaP (Diphtheria, Tetanus, and Pertussis) vaccine, administered at 2 months, 4 months, 6 months, 15 through 18 months, and 4 through 6 years of age.

Varicella (chickenpox)

  • Caused by varicella virus.
  • Spread from person to person through the air by coughing, sneezing, or just breathing.
  • Causes an itchy rash all over the body, fever, and drowsiness.
  • Usually mild, but can cause skin infections and encephalitis (inflammation of the brain).
  • For every 100,000 infants younger than 1 year old who get chickenpox, about 4 die.
  • If a pregnant woman gets chickenpox around the time of delivery, the baby can be infected, and 1 out of 3 will die if not treated quickly.
  • Before vaccine, almost every child (about 4 million each year) got chickenpox.
  • Can be prevented with the Varicella (chickenpox) vaccine, administered at 12 through 15 months and 4 through 6 years of age.

Sources:
CDC: Parent’s Guide to Childhood Immunizations
CDC: Vaccines for Your Children
CDC: Vaccine-Preventable Diseases and the Vaccines that Prevent Them

The following vaccines that children routinely receive between birth and 6 years old protect against 14 diseases:

  1. Hepatitis A (HepA) vaccine
  2. Hepatitis B (HepB) vaccine
  3. Hib (Haemophilus influenzae type b) vaccine
  4. Influenza (flu) vaccine
  5. PCV13 (pneumococcal disease) vaccine
  6. Polio vaccine
  7. Rotavirus (RV) vaccine
  8. Varicella (chickenpox) vaccine
  9. DTaP (Diphtheria, Tetanus, and Pertussis) vaccine
  10. MMR (Measles, Mumps, and Rubella) vaccine

These vaccines are given by injection (shot), except for rotavirus, which is a liquid that is swallowed.

Vaccines aren’t just for infants—adolescents and adults need vaccines to stay healthy and help strengthen community immunity. Please see the recommended vaccination schedules for children, adolescents and adults in our Resources section.

Sources:
CDC Parent’s Guide to Childhood Immunizations
CDC: Vaccines for Your Children
CDC: Vaccine-Preventable Diseases and the Vaccines that Prevent Them

Currently, the United States has the safest, most effective vaccine supply in its history. Hundreds of medical studies completed over many decades by credible and respected doctors and scientists across the world have found that vaccines are safe for the overwhelming majority of children and adults. Clinical trials are conducted to evaluate the safety and effectiveness of a vaccine before it can be brought to market. Vaccines are first tested in laboratory studies and animal studies. Learn more about how vaccines are developed.

If the results indicate the vaccine is safe, additional testing in people must be done before the vaccine can be approved by the Food and Drug Administration. Learn more about how vaccines are licensed.

By the time a vaccine is offered to the public, it has been studied for at least 15 to 20 years in tens of thousands of study participants, by thousands of scientists, statisticians and health care providers.

Vaccine safety is a shared responsibility among the federal government, state and local health departments, health care providers and the public. To help meet this shared responsibility, government agencies and their partners have established several coordinated systems to monitor the safety of vaccines after they have been licensed for public use. These systems, such as the Vaccine Adverse Event Reporting System and the Vaccine Safety Datalink Project, are used together to help scientists monitor the safety of vaccines.

See the CDC infographic: The Journey of Your Child’s Vaccine

Sources:
CDC: Vaccine Testing and the Approval Process
Children’s Hospital of Philadelphia: Process of Vaccine Development
Children’s Hospital of Philadelphia: Licensure, Recommendations and Requirements

Vaccines help develop immunity by imitating an infection. This type of infection doesn’t cause illness, but it does cause the immune system to produce antibodies that help protect you from the disease in the future. Vaccines contain ingredients called antigens, which tell the body’s immune system to create those antibodies.

Every day, a healthy child’s immune system successfully fights off thousands of antigens—the parts of germs that cause the body’s immune system to go to work.

The antigens in vaccines come from the germs themselves, but the germs are weakened or killed so they cannot cause serious illness. Vaccines contain only a tiny fraction of the antigens that children encounter every day in their environment, even if they receive several vaccines on one day.

  • Kids are exposed to 2,000 to 6,000 antigens every day.
  • A strep throat infection, for example, exposes children to at least 25 to 50 antigens. That’s comparable to the antigens in the vaccines that infants get at their two-month visit–the DTaP, IPV, HepB, Hib, and rotavirus vaccines combine to just 54 antigens.

And even though children receive more vaccines to protect against more diseases now compared to 30 years ago, the actual number of antigens in vaccines is dramatically less than decades ago because vaccine technology has improved, making vaccines more efficient.

  • In 1980, the recommended vaccines contained more than 15,096 antigens.
  • Today’s vaccines contain only 173 antigens in 12 vaccines that protect children and teens against 16 vaccine-preventable diseases.

Vaccines today work better than ever
Source: Plotkin’s VACCINES, 7th Edition

Vaccines also contain very small amounts of other ingredients—all of which play necessary roles either in making the vaccine, or in ensuring that the final product is safe and effective.

While some of the names of certain ingredients may sound strange or even alarming, the ingredients are necessary and safe. Talk to your child’s doctor about any questions you have about vaccine ingredients.

See our answer on vaccine ingredient safety here.

Sources:
CDC: Making the Vaccine Decision
Children’s Hospital of Philadelphia: Vaccine Ingredients
Verywell: Antigen Counts in Vaccines

Immunity is the body’s way of protecting against and preventing disease. Children are born with an immune system composed of cells, glands, organs, and fluids located throughout the body. The immune system recognizes germs that enter the body as “foreign invaders” (called antigens) and produces proteins called antibodies to fight them.

The first time a child is infected with a specific antigen (say measles virus), the immune system produces antibodies designed to fight it. This takes time. Usually the immune system can’t work fast enough to prevent the antigen from causing disease, so the child still gets sick. However, the immune system “remembers” that antigen. If it ever enters the body again, even after many years, the immune system can produce antibodies fast enough to keep it from causing disease a second time. This protection is called immunity.

Vaccines contain the same antigens (or parts of antigens) that cause diseases. For example, measles vaccine contains measles virus. But the antigens in vaccines are either killed, or weakened to the point that they don’t cause disease. However, they are strong enough to make the immune system produce antibodies that lead to immunity. Your child gets protection without having to get sick. Through vaccination, children can develop immunity without suffering from the actual diseases that vaccines prevent.

Every day, a healthy child’s immune system successfully fights off thousands of antigens—the parts of germs that cause the body’s immune system to go to work.

The antigens in vaccines come from the germs themselves, but the germs are weakened or killed so they cannot cause serious illness. Vaccines contain only a tiny fraction of the antigens that children encounter every day in their environment, even if they receive several vaccines on one day.

  • Kids are exposed to 2,000 to 6,000 antigens every day.
  • A strep throat infection, for example, exposes children to at least 25 to 50 antigens. That’s comparable to the antigens in the vaccines that infants get at their two-month visit–the DTaP, IPV, HepB, Hib, and rotavirus vaccines combine to just 54 antigens.

And even though children receive more vaccines to protect against more diseases now compared to 30 years ago, the actual number of antigens in vaccines is dramatically less than decades ago because vaccine technology has improved, making vaccines more efficient.

  • In 1980, the recommended vaccines contained more than 15,096 antigens.
  • Today’s vaccines contain only 173 antigens in 12 vaccines that protect children and teens against 16 vaccine-preventable diseases.

Vaccines today work better than ever
Source: Plotkin’s VACCINES, 7th Edition

While your child may experience some mild symptoms such as a slight fever after getting vaccinated as a result of their immune system learning to fight the antigens, these mild symptoms are extremely minor compared to the potentially life-threatening symptoms they may get if they come in contact with the actual diseases.

Sources:
CDC: Why Are Childhood Vaccines So Important?
Verywell: Antigen Counts in Vaccines

Most vaccine-preventable diseases are spread from person to person. If one person in a community gets an infectious disease, he or she can spread it to others who are not immune. But a person who has been vaccinated is less likely to get that disease and spread it to others. This helps protect people who aren’t immunized, including those who can’t be vaccinated and those for whom vaccination was not successful. For very few people, underlying illnesses may affect their immune system response and in turn, they may need additional vaccination or protection. The more people who are vaccinated, the fewer opportunities a disease has to spread.


Source: Center for Disease Control and Prevention

If one or two cases of disease are introduced into a community where many people are not vaccinated, outbreaks will occur, like the outbreak of whooping cough at a Traverse City, Mich. school in 2014.

Depending on the disease and how easily it can spread, vaccination rates may need to be as high as 80 to 95 percent for community immunity to take place.

Learn more about community immunity and how vaccines protect everyone.

Sources:
CDC: What Would Happen If We Stopped Vaccinations?
The College of Physicians of Philadelphia: History of Vaccines
Children’s Hospital of Philadelphia: Vaccines and the Immune System

To provide the best protection, some vaccines require an additional dose or doses as we get older.

For example, the pertussis vaccine offers a good level of protection within the first two years of getting vaccinated, but then protection decreases over time. This is known as waning immunity, which is the loss of protective antibodies over time. Similarly, actually getting the disease and developing antibodies through the infection may only protect you for a few years.

This is why it’s so important to follow the Centers for Disease Control and Prevention (CDC) recommended immunization schedule. For example, the pertussis vaccine includes shots at 2, 4 and 6 months of age, with booster shots at between 15 and 18 months old and between 4 and 6 years old, in order to be fully vaccinated. In addition, adults are encouraged to stay up-to-date on their vaccinations, especially pregnant women, parents and people interacting with infants and children. See the CDC’s recommended immunization schedule for adults.

Vaccines also are not perfect. Depending on the vaccine, about 1 percent to 5 percent of children who are vaccinated fail to develop immunity. If these children are exposed to that disease, they could get sick. Sometimes giving an additional vaccine dose will stimulate an immune response in a child who didn’t respond to the first dose. For example, a single dose of measles vaccine protects about 95 percent of children, but after two doses, almost 100 percent are immune.

Sometimes a child is exposed to a disease just prior to being vaccinated, and gets sick before the vaccine has had time to work. Sometimes a child gets sick with something that is similar to a disease they have been vaccinated against. This often happens with flu. Many viruses cause symptoms that look like flu, and people even call some of them flu, even though they are really something else. Flu vaccine doesn’t create immunity to these viruses (like the common cold).

Sources:
CDC: Pertussis FAQ
CDC: Parents’ Guide to Childhood Immunizations FAQ

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What to expect before, during and after vaccination

There are things that you can do before, during and after vaccine visits to make them easier and less stressful.

Before the visit
Come prepared! Take these steps before your child gets a shot to help make the immunization visit less stressful on you both.

  • Read any vaccine materials you received from your child’s health care professional and write down any questions you may have.
  • Refer to the Center for Disease Control and Prevention recommended schedule to see which shots are recommended for your child’s age.
  • Learn more about the benefits and risks of the vaccines that your child will receive by reviewing the Vaccine Information Statements. You can find the Michigan-specific versions of the Vaccine Information Statements here. You can also request these documents at the doctor’s office.
  • Find your child’s personal immunization record and bring it to your appointment. An up-to-date record tells your doctor exactly what shots your child has already received. If you don’t already have a copy, you can talk to your child’s health care provider to request one.
  • Pack a favorite toy or book, and a blanket that your child uses regularly for comfort.
  • A mild illness is usually not a reason to reschedule a vaccination visit. Learn more about vaccines when your child is sick.

At the Doctor’s Office
If you have questions about immunizations, ask your child’s health care provider. They will give you Vaccine Information Statements for the shots that your child will be getting that day. These sheets include information about the risks and benefits of each vaccine. If your doctor doesn’t give you one you can request one.

For babies and younger children
Try these ideas for making the shots easier on your child.

  • Distract and comfort your child by cuddling, singing or talking softly.
  • Smile and make eye contact with your child. Let your child know that everything is ok.
  • Comfort your child with a favorite toy or book. A blanket that smells familiar will help your child feel more comfortable.
  • Hold your child firmly on your lap, whenever possible. Learn more about how to hold your child during shots.

Once your child has received all of the shots, be especially supportive. Try these tips for soothing your baby:

  • Swaddling (wrapping the baby in a blanket for warmth and comfort)
  • Skin-to-skin contact
  • Offering a sweet beverage, like juice (when the child is older than 6 months)
  • Breastfeeding

For older children and adolescents

  • Take deep breaths with your child.
  • Point out interesting things in the room to help create distractions.
  • Tell or read stories.
  • Support your child if he or she cries. Never scold a child for not “being brave.”

Before you leave the appointment, ask your child’s doctor for advice on using non-aspirin pain reliever and other steps you can take at home to comfort your child.

After the shots
Sometimes children experience mild reactions from vaccines, such as pain where the shot was given or a slight fever. These reactions are normal and will soon go away. The following tips will help you identify and minimize mild side effects.

  • Review any information your doctor gives you about the shots, especially the Vaccine Information Statements or other sheets that outline which side effects might be expected.
  • Use a cool, wet cloth to reduce redness, soreness and swelling in the place where the shot was given.
  • Reduce any fever with a cool sponge bath. If your doctor approves, give non-aspirin pain reliever.
  • Give your child lots of liquid. It’s normal for some children to eat less during the 24 hours after getting vaccines.
  • Pay extra attention to your child for a few days. If you see something that concerns you, call your doctor.

Source: CDC: Your Child’s Vaccine Visit

Like any medicine, vaccines can have side effects. Most are minor (for example, a sore arm or mild fever) and go away within a few days. Remember, vaccines are continually monitored for safety and are one of the safest medications available today, as they are given to healthy people. However, a decision not to vaccinate your child involves more risk and could put your child and others who come into contact with him or her at risk of contracting a potentially deadly disease.

See the full list of potential vaccine side effects on the CDC website and talk to your doctor about any questions or concerns about side effects.

Sources:
CDC: Vaccine Side Effects
CDC: Vaccine Safety

A mild illness is usually not a reason to delay vaccinations. Your doctor can help you decide which vaccines your child can still receive safely.

It’s tempting to cancel or reschedule a doctor’s appointment for vaccines when your child has the sniffles, an upset stomach, or a mild fever. But doctors at leading health organizations, like the Centers for Disease Control and Prevention, the American Academy of Family Physicians, and the American Academy of Pediatrics say mild illness usually is not a reason to put off vaccinations.

Your child may still be vaccinated if he or she has:

  • A low-grade fever (less than 101 degrees)
  • A cold, runny nose, or cough
  • Ear infection
  • Mild diarrhea

There is no health benefit to waiting to vaccinate your child if he or she has a mild illness. It’s important that children get their vaccines on time—even if they don’t feel well—so they’re protected against serious diseases.

It is not recommended to give your child pain or fever reducers before vaccination, but it is okay to give a non-aspirin pain reliever after the appointment as long as your doctor approves. Giving these medications before vaccination can interfere with the immune response.

Vaccines do not make a mild illness worse. A child’s immune system can respond to thousands of antigens every day. Antigens are things like bacteria and viruses that cause your child’s body to produce antibodies against them. Vaccines have only a tiny fraction of the antigens that children encounter on a daily basis. So, the immune system can handle getting vaccines to build immunity to diseases and fight minor illnesses at the same time.

Vaccines do not make symptoms of illness worse—though they may cause mild side effects, like a mild fever or soreness or swelling where the shot was given. To help with discomfort from these side effects, put a cool, wet washcloth on the sore area or ask your child’s doctor about using pain- or fever-reducing medicine.

Mild illness also does not affect how well the body responds to a vaccine. Vaccines build up protection in a child who is mildly ill as well as they do when the child is healthy.

Your child may not receive some vaccines if he or she has:

  • A chronic health condition (for example, cancer)
  • A weakened immune system (for example, if undergoing chemotherapy or is on certain medications after a transplant)
  • A previous allergic reaction to a vaccine

Reactions to a vaccine, such as fever, could make it harder to diagnose and treat a serious illness. And it’s possible that signs of the illness could be mistaken for a reaction to the vaccine.

If your child has a serious illness or medical condition, talk to your child’s health care provider.

Source: CDC: Vaccines When Your Child is Sick

In Michigan and across the United States programs are in place to help all parents afford vaccines for their children.

The Vaccines for Children (or VFC) program allows qualified families to get free vaccinations for their children at participating health care providers’ offices. Children from birth through 18 years of age can get VFC vaccines if they:

  • Are on Medicaid
  • Are eligible for Medicaid
  • Do not have health insurance
  • Are American Indian or Alaskan Native
  • Are under-insured

If your health insurance does not pay anything for vaccines, your child may be able to get VFC vaccines. Check with your child’s health care provider or your local health department.

Learn more about Michigan’s VFC program

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Vaccination schedule

Following the recommended immunization schedule protects infants and children by providing immunity early in life, before they are exposed to potentially life-threatening diseases.

The Centers for Disease Control and Prevention (CDC) sets the U.S. childhood immunization schedule based on recommendations from the Advisory Committee on Immunization Practices (ACIP)—a group of medical and public health experts. This schedule also is approved by the American Academy of Pediatrics and the American Academy of Family Physicians.

Infants and young children who do not follow the recommended immunization schedules and instead spread out shots—or leave out shots—are at risk of developing diseases during the time that the shots are delayed. This results in more frequent visits to the doctor’s office, more stress and anticipation of shots and increased costs for you.

There is no evidence that delaying or spreading out vaccines is any safer than simply following the recommended schedule set by the CDC. There is plenty of evidence that the recommended immunization schedule is safe and effective, as the timing of vaccines given has been carefully tested, studied and reviewed prior to being recommended for children.

If your child falls behind the recommended schedule, you can talk to your child’s doctor about catching them up, reducing the amount of time the child is left exposed to vaccine-preventable diseases.

Some vaccine-preventable diseases, such as pertussis (whooping cough) and chickenpox, remain common in the United States, and children may be exposed to these diseases during the time they are not protected by vaccines. In addition, the only way to keep some children safe is by ensuring that others around them are vaccinated. For example, some children with weakened immune systems—such as children undergoing chemotherapy—cannot safely receive certain vaccines. Other vaccines are safe for these children, but do not work well because their immune systems do not respond normally.

Parents who are concerned about the number of shots given at one time can reduce the number given at a visit by using the flexibility built into the current recommended immunization schedule. For example, the third dose of Hepatitis B vaccine can be given at 6 through 18 months of age. Parents can work with their child’s health care professional to have their child receive this dose at any time during this recommended age range.

Sources:
CDC: The Childhood Immunization Schedule
Children’s Hospital of Philadelphia: Vaccine Schedule

Young children—even newborns—begin vaccinations early in life to protect them from serious and deadly diseases that can infect them at a very young age. The effects of these diseases can be very serious, and even life-threatening, for infants and young children who are not protected by vaccination.

A child receives a vaccine based on decades of medical science that shows when the infant is likely to be most susceptible to the diseases and also when the infant will produce the best immune response to a vaccine.

An infant’s immune system is not fully developed until he or she is about six months old. Their immune systems are more vulnerable to infections and diseases than adults. Babies do receive antibodies from their mothers, and the antibodies are shared through the placenta during the last 1-2 months of pregnancy. As a result, newborn babies are immune to some diseases, but this immunity lasts only a few months. Also, most babies do not get protective antibodies against diphtheria, whooping cough, polio, tetanus, hepatitis B, or Hib from their mothers. This is why it’s so important to vaccinate babies before they are exposed to a disease. Through vaccination, infants will start to produce antibodies with each vaccine dose. Most vaccine series are started when babies reach two months old because this is when the high level of antibodies passed on by the mother begins to decline. With the decline in protection, it’s important to start the vaccine series to ensure babies are protected from disease.

Before 1985, the recommended immunization schedule included only seven vaccines and covered only seven diseases. The good news is that today, vaccines can protect children and teens from 16 potentially serious diseases.

Every day, a healthy child’s immune system successfully fights off thousands of antigens—the parts of germs that cause the body’s immune system to go to work. Vaccines contain only a tiny fraction of the antigens that children encounter every day in their environment, even if they receive several vaccines on one day.

  • Kids are exposed to 2,000 to 6,000 antigens every day.
  • A strep throat infection, for example, exposes children to at least 25 to 50 antigens. That’s comparable to the antigens in the vaccines that infants get at their two-month visit–the DTaP, IPV, HepB, Hib, and rotavirus vaccines combine to just 54 antigens.

And even though children receive more vaccines to protect against more diseases now compared to 30 years ago, the actual number of antigens in vaccines is dramatically less than decades ago because vaccine technology has improved, making vaccines more efficient.

  • In 1980, the recommended vaccines contained more than 15,096 antigens.
  • Today’s vaccines contain only 173 antigens in 12 vaccines that protect children and teens against 16 vaccine-preventable diseases.

Vaccines today work better than ever
Source: Plotkin’s VACCINES, 7th Edition

Sources:
CDC: The Childhood Immunization Schedule
Children’s Hospital of Philadelphia: Vaccine History
American Academy of Pediatrics: Do Multiple Vaccines Overwhelm or Weaken the Infant’s Immune System?
Verywell: Antigen Counts in Vaccines

No parents like to see their child cry or get upset. Many parents become uncomfortable, concerned and stressed out when they learn about the number of vaccines recommended for children. It does seem like a lot of shots! Please be assured that it is very safe for your child to receive several different vaccines during one visit. Mild discomfort immediately following a vaccine is still better than your child getting a potentially life-threatening and vaccine-preventable disease.

Scientific data show that this results in very few side effects. Studies also show that combination vaccines (which combine multiple vaccines into a single vaccine) pose no greater risk for side effects than vaccines given individually. These vaccines also are as effective in the combined form as they are when given separately.

Please know, too, that vaccines do not overload a child’s immune system. Vaccines contain ingredients called antigens, which tell the body’s immune system to create those antibodies.

Every day, a healthy child’s immune system successfully fights off thousands of antigens—the parts of germs that cause the body’s immune system to go to work.

The antigens in vaccines come from the germs themselves, but the germs are weakened or killed so they cannot cause serious illness. Vaccines contain only a tiny fraction of the antigens that children encounter every day in their environment, even if they receive several vaccines on one day.

  • Kids are exposed to 2,000 to 6,000 antigens every day.
  • A strep throat infection, for example, exposes children to at least 25 to 50 antigens. That’s comparable to the antigens in the vaccines that infants get at their two-month visit–the DTaP, IPV, HepB, Hib, and rotavirus vaccines combine to just 54 antigens.

And even though children receive more vaccines to protect against more diseases now compared to 30 years ago, the actual number of antigens in vaccines is dramatically less than decades ago because vaccine technology has improved, making vaccines more efficient.

  • In 1980, the recommended vaccines contained more than 15,096 antigens.
  • Today’s vaccines contain only 173 antigens in 12 vaccines that protect children and teens against 16 vaccine-preventable diseases.

Vaccines today work better than ever
Source: Plotkin’s VACCINES, 7th Edition

Sources:
CDC: The Childhood Immunization Schedule
American Academy of Pediatrics: Do Multiple Vaccines Overwhelm or Weaken the Infant’s Immune System?
Verywell: Antigen Counts in Vaccines

One dose of a vaccine is not enough to protect a child against some diseases. Depending on the vaccine and the disease, more than one dose is needed to build high enough immunity to prevent the disease, boost immunity that fades over time, make sure people who did not get immunity from a first dose are protected, or protect against germs that change over time, such as flu. This is because what’s in most childhood vaccines is inactive (i.e. dead) viruses or bacteria, which is why vaccines can’t get you sick. But because the viruses or bacteria are inactive, the immune system needs to respond to it multiple times for full protection. Scientists and medical providers study the best combination of timing and number of doses needed for full protection against diseases.

Learn more about this concept, known as waning immunity.

Source: CDC: The Childhood Immunization Schedule

Combination vaccines take two or more vaccines that could be given individually and put them into one shot. Children get the same protection as they do from individual vaccines given separately—but with fewer shots.

At a doctor’s visit, your child may only get two or three shots to protect him or her from five diseases, instead of five individual shots. Fewer shots may mean less pain for your child and less stress for you.

Combination vaccines help parents, doctors, and nurses keep children up to date on vaccines. Combining vaccines into fewer shots may also mean that more children will get recommended vaccinations on time. And that means fewer delays in disease protection for children.

Combination vaccines do not overload your child’s immune system. Vaccines contain ingredients called antigens, which tell the body’s immune system to create those antibodies. Every day, a healthy child’s immune system successfully fights off thousands of antigens—the parts of germs that cause the body’s immune system to go to work.

The antigens in vaccines come from the germs themselves, but the germs are weakened or killed so they cannot cause serious illness. Vaccines contain only a tiny fraction of the antigens that children encounter every day in their environment, even if they receive several vaccines on one day.

  • Kids are exposed to 2,000 to 6,000 antigens every day.
  • A strep throat infection, for example, exposes children to at least 25 to 50 antigens. That’s comparable to the antigens in the vaccines that infants get at their two-month visit–the DTaP, IPV, HepB, Hib, and rotavirus vaccines combine to just 54 antigens.

And even though children receive more vaccines to protect against more diseases now compared to 30 years ago, the actual number of antigens in vaccines is dramatically less than decades ago because vaccine technology has improved, making vaccines more efficient.

  • In 1980, the recommended vaccines contained more than 15,096 antigens.
  • Today’s vaccines contain only 173 antigens in 12 vaccines that protect children and teens against 16 vaccine-preventable diseases.

Vaccines today work better than ever
Source: Plotkin’s VACCINES, 7th Edition

Some examples of common combination vaccines for children are:

  • Comvax, which combines the vaccines that prevent Haemophilus influenzae type b and Hepatitis B
  • Twinrix, which combines the vaccines that prevent Hepatitis A and Hepatitis B
  • Pediarix, which combines the vaccines that prevent tetanus, diphtheria and pertussis (whooping cough), Hepatitis B, and polio
  • ProQuad, which combines the vaccines that prevent measles, mumps and rubella and varicella (chickenpox)
  • Kinrix, which combines the vaccines that prevent tetanus, diphtheria and pertussis (whooping cough) and polio
  • Pentacel, which combines the vaccines that prevent tetanus, diphtheria and pertussis (whooping cough), polio and Haemophilus influenzae type b

Before a combination vaccine is approved for use, it goes through careful testing  to make sure the combination vaccine is as safe and effective as each of the individual vaccines given separately. And, just as with individual vaccines, there are systems in place to watch for any rare reactions to combination vaccines that can be detected only after the vaccine is used widely.

Learn more about each vaccine and what they protect against.

Sources:
CDC: Combination Vaccines
Verywell: Antigen Counts in Vaccines

The Centers for Disease Control and Prevention sets the U.S. childhood immunization schedule based on recommendations from the Advisory Committee on Immunization Practices (ACIP) — a group of medical and public health experts. This schedule also is approved by some of the nation’s top medical doctors at the American Academy of Pediatrics and the American Academy of Family Physicians. To develop recommendations for each vaccine, ACIP works year-round, reviewing available data on new and existing vaccines and diseases.

The information ACIP reviews for each vaccine always includes:

  • The safety and effectiveness of the vaccine when given at specific ages: Only vaccines licensed by the Food and Drug Administration are recommended, and vaccine makers must conduct detailed tests to show that a vaccine is safe and effective at specific ages.
  • The severity of the disease: Vaccines recommended for children prevent diseases that can be serious for them, potentially causing long-term health problems or death.
  • How many children get the disease if there is no vaccine: Vaccines that do not provide benefit to many children may not be recommended.
  • The differences in how well a vaccine works for children of different ages: The ability of vaccines to help the body produce immunity can vary depending on the age of the child receiving the vaccine.

Learn more about ACIP considerations in the vaccine recommendation process, including recommended ages for administration of various vaccines to children.

Sources:
CDC: The Childhood Immunization Schedule
CDC: Advisory Committee on Immunization Practices

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Get the facts about vaccines

As a parent, it’s smart to question and be aware of anything that goes into your child’s body. Many parents naturally have questions about ingredients in vaccines, specifically when they hear words such as aluminum, formaldehyde, thimerosal, gelatin and antibiotics. However, parents can be reassured that ingredients in vaccines are minuscule, safe and necessary.

Ingredients in vaccines are all there for a reason – to help the vaccine work better and to keep the vaccine safe. Common ingredients in vaccines are:

  • Adjuvants: Adjuvants (like aluminum) help vaccines work better. They enhance the immune response, decreasing the quantity of vaccine needed to gain protective immunity, or lowering the number of doses required.
  • By-products: Some products (like formaldehyde) are used during vaccine manufacturing to make sure viruses are inactivated and are removed except for a tiny trace.
  • Stabilizers: Stabilizers (like gelatin) are added to vaccines to protect the active ingredients from breaking down during manufacture, transport and storage.
  • Preservatives: Preservatives (like trace amounts of thimerosal) prevent bacterial or fungal contamination. Early in the 20th century, most vaccines were packaged in vials that contained multiple doses. Doctors and nurses would draw up a single dose and place the vaccine back in the refrigerator. Unfortunately, sometimes bacteria would inadvertently enter the vial and cause infections. Preservatives, originally added in the 1930s, solved this problem.

Aluminum: Aluminum is present in our environment; the air we breathe, the water we drink and the food we eat all contain aluminum. The average person takes in an estimated 30 to 50 milligrams of aluminum every day, mainly from foods, drinking water, and medicines. Not all vaccines contain aluminum, but those that do typically contain about .125 milligrams to .625 milligrams per dose, or roughly 1 percent of the daily amount we all take in naturally.

For example, in the first six months of life, babies receive about 4 milligrams of aluminum if they get all of the recommended vaccines. However, during this same period they will be exposed to about 10 milligrams of aluminum if they are breastfed, 40 milligrams if they are fed regular infant formula, and up to 120 milligrams if they are fed soy-based infant formula.

Aluminum salts have been used as adjuvants in vaccines in the United States since the 1930s.  Adjuvants enhance the immune response by allowing for lesser quantities of active ingredients and, in some cases, fewer doses.

Some people wonder about the difference between aluminum injected in vaccines versus aluminum ingested in food. Typically, infants have between 1 and 5 nanograms (billionths of a gram) of aluminum in each milliliter of blood. Researchers have shown that after vaccines are injected, the quantity of aluminum detectable in an infant’s blood does not change and that about half of the aluminum from vaccines is eliminated from the body within one day.

See more information on aluminum in vaccines.

Formaldehyde: Vaccines contain antigens, or inactive versions of the viruses or bacteria they are protecting against. Formaldehyde is used during the manufacture of some vaccines to make sure these viruses or bacteria are dead. While most formaldehyde is purified away, small amounts remain. It is important to realize that formaldehyde is also a natural by-product of processes in our bodies, so it is commonly found in the bloodstream. The quantity of formaldehyde found in our blood is 10 times greater than that found in any vaccine.

Thimerosal: Thimerosal, a mercury-containing preservative, is no longer used as a preservative in any childhood vaccine except for the influenza vaccine, and some versions of the influenza vaccine are thimerosal free. Mercury is a naturally occurring element found in the earth’s crust, air, soil and water. As a result, we are all exposed to mercury. Thimerosal is also found in trace amounts in some multi-dose preparations of the influenza vaccines as a preservative to help prevent the vaccine from becoming contaminated with bacteria, which could cause infection.

Today, breastfed infants are exposed to 15 times more mercury in breast milk than is contained in the influenza vaccine.

More information on thimerosal is available from the Centers for Disease Control and Prevention and the Children’s Hospital of Philadelphia.

Other ingredients: The amount of good and bad information online about vaccines can be overwhelming and confusing, but you can’t believe everything you read about ingredients in vaccines. For example, no vaccine contains, or has ever contained, antifreeze.

It’s important to look to the most trusted physician, research, and public health organizations in the world for answers. The Centers for Disease Control and Prevention has compiled into a table the ingredient list for most vaccines. While the table may be helpful for people concerned about particular allergies or ingredients, it is important to realize that the table does not indicate quantities in each vaccine. In most cases, the quantities are so small that they do not cause allergic reactions or symptoms of toxicity. Talk to your child’s doctor about any questions or concerns you have about vaccine ingredients.

Sources:
CDC: Ingredients of Vaccines Fact Sheet
CDC: Parents’ Guide to Childhood Immunizations FAQ
Children’s Hospital of Philadelphia: Vaccine Ingredients Q&A

It’s best to talk to your child’s health care provider about your child’s allergies and any concerns you may have regarding allergies and vaccines. Some ingredients in vaccines can cause allergic reactions. In addition to gelatin, other ingredients in vaccines such as egg proteins, antibiotics and yeast proteins might cause an allergic reaction. Latex used in vaccine packaging is also a concern related to allergies.

Egg proteins: Because the influenza and yellow fever vaccines are grown in eggs, the final products may contain egg proteins. Advances in vaccine technology have resulted in significantly lower quantities of egg proteins in the influenza vaccine; therefore, people with egg allergies can now get influenza vaccine. However, it is recommended that children who are severely allergic to eggs remain in the office for 15 minutes after getting the influenza vaccine in case of any reaction.

Antibiotics: Antibiotics are used to prevent bacterial contamination during production of some vaccines. However, the types of antibiotics used in vaccines are not those to which people are usually allergic.

Yeast proteins: A couple of viral vaccines are made in yeast cells; these include hepatitis B vaccine and the human papillomavirus vaccine. Although the vaccine is purified away from the yeast cells, about 1 to 5 millionths of a gram remain in the final product. The good news is that people who are allergic to bread or bread products are not allergic to yeast, so the risk of allergy from yeast is not likely.

Latex packaging: A small number of vaccines are packaged with materials that include latex. While it is rare that patients have a reaction to latex in vaccine packaging, people with latex allergies should consult with their allergy doctor before getting any vaccines packaged in this way.

Corn and peanut oils: Vaccines do not contain either corn or peanut oils.

Source:
Children’s Hospital of Philadelphia: Vaccine Ingredients Q&A

No. One of the most frequent concerns expressed by some parents is that certain vaccines might cause autism. Please know there is absolutely no credible medical or scientific evidence to support any link between vaccines and autism. In fact, numerous credible medical, science-based studies have shown that there is no link between receiving vaccines and developing autism. You can read more about these studies on the Centers for Disease Control and Prevention website, the Children’s Hospital of Philadelphia website and the Autism Science Foundation website.

Concerns about autism and vaccines typically center on three areas:

  1. The combination measles-mumps-rubella (MMR) vaccine
    In 1998, a British researcher named Andrew Wakefield raised the notion that the MMR vaccine might cause autism. In the medical journal The Lancet, he reported the stories of eight children who he claimed developed autism and intestinal problems soon after receiving the MMR vaccine. It is important to know that the Wakefield study was later retracted for scientific misconduct, as his studies were exposed as fraudulent and his data misrepresented.However, to test Wakefield’s discredited claims, researchers performed a series of studies comparing hundreds of thousands of children who had received the MMR vaccine with hundreds of thousands who had never received the vaccine. They found that the risk of autism was the same in both groups. The MMR vaccine, in fact, did not cause autism. Some parents wary of the safety of the MMR vaccine stopped getting their children immunized. As immunization rates dropped, outbreaks of measles and mumps led to hospitalizations and deaths that could have been prevented. Read the scientific studies on the Autism Science foundation website.
  2. Thimerosal, a mercury containing preservative previously contained in several vaccines
    Several studies have shown that thimerosal in vaccines does not cause autism. Thimerosal is a mercury-containing preservative that was used in vaccines to prevent contamination. Thimerosal is no longer used as a preservative in any childhood vaccine except for the influenza vaccine. Attention by the news media has caused some parents to fear that thimerosal contained in vaccines might have harmed their children. Addressing these concerns, scientists performed several studies to determine whether thimerosal causes autism. Hundreds of thousands of children who received thimerosal-containing vaccines were compared to hundreds of thousands of children who received the same vaccines free of thimerosal. The results were clear: The risk of autism was the same in both groups; thimerosal in vaccines did not cause autism. Read the scientific studies on the Autism Science foundation website.
  3. Concern that babies receive too many vaccines too soon
    Before they are licensed, new vaccines are tested alone or in combination with existing vaccines. These studies determine whether new vaccines change the safety and effectiveness of existing vaccines and whether existing vaccines affect the new vaccine. These studies are performed every time a new vaccine is added to the existing vaccination schedule.

Every day, a healthy child’s immune system successfully fights off thousands of antigens—the parts of germs that cause the body’s immune system to go to work. Vaccines contain only a tiny fraction of the antigens that babies encounter every day in their environment, even if they receive several vaccines on one day.

  • Kids are exposed to 2,000 to 6,000 antigens every day.
  • A strep throat infection, for example, exposes children to at least 25 to 50 antigens. That’s comparable to the antigens in the vaccines that infants get at their two-month visit–the DTaP, IPV, HepB, Hib, and rotavirus vaccines combine to just 54 antigens.

And even though children receive more vaccines to protect against more diseases now compared to 30 years ago, the actual number of antigens in vaccines is dramatically less than decades ago because vaccine technology has improved, making vaccines more efficient.

  • In 1980, the recommended vaccines contained more than 15,096 antigens.
  • Today’s vaccines contain only 173 antigens in 12 vaccines that protect children and teens against 16 vaccine-preventable diseases.

Vaccines today work better than ever
Source: Plotkin’s VACCINES, 7th Edition

Here is a list of 4 of the more than 20 reputable studies that have found no relationship between MMR vaccine and autism. These studies illustrate the variety of methods that have been used to investigate whether MMR vaccine is linked to autism.

Immunization Safety Review: Vaccines and Autism.
Institute of Medicine. The National Academies Press: 2004

Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study
by Mady Hornig et al. PLoS ONE. September 2008.

Age at First Measles-Mumps-Rubella Vaccination in Children with Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta
by Frank DeStefano et al. Pediatrics. February 2004.

A Population-Based Study of Measles, Mumps and Rubella Vaccination and Autism
by Kreesten Meldgaard Madsen et al. New England Journal of Medicine. November 7, 2002.

Sources:
CDC: Vaccines Do Not Cause Autism
Children’s Hospital of Philadelphia: Vaccines and Autism
Children’s Hospital of Philadelphia: Vaccine and Autism Q&A

Yes, but it is a positive link! Vaccines provide protection against sudden infant death syndrome (SIDS). The American Academy of Pediatrics recently expanded their guidelines for infant sleep safety and SIDS risk reduction. Infants should be immunized, as evidence suggests that vaccination reduces the risk of SIDS by 50 percent.

Babies receive many vaccines to protect them when they are between 2 to 4 months old, when they are most susceptible to vaccine-preventable diseases. This age range is also the peak age for SIDS. The timing of the 2-month and 4-month shots and SIDS has led some people to question whether they might be related.

Multiple research studies have been conducted seeking possible links between vaccines and SIDS. Results from these studies and continued monitoring show that vaccines do not cause SIDS. Studies include:

  • A study looked at the ages and seasons of infant deaths after vaccinations reported to the Vaccine Adverse Event Reporting System (VAERS). This study examined VAERS reports following tetanus, diphtheria and pertussis and hepatitis B vaccinations found no link between SIDS and these vaccines.
  • A 2003 Institute of Medicine (IOM) report “Immunization Safety Review: Vaccination and Sudden Unexpected Death in Infancy.” The committee reviewed scientific evidence focusing on sudden unexpected death in infancy and looked for possible relationships between SIDS and vaccines. Based on all the research findings they reviewed, the committee concluded that vaccines did not cause SIDS.
  • Additional work on defining SIDS and reviewing the literature by the Brighton Collaboration, an international network of vaccine safety experts.
  • As a result of the American Academy of Pediatrics’ 1992 recommendation to place healthy babies on their backs to sleep, and the success of the National Institute of Child Health and Human Development’s Back to Sleep campaign in 1994, SIDS deaths have declined considerably.

Sources:
CDC: Vaccines and SIDS
Children’s Hospital of Philadelphia: Vaccines and SIDS
Seattle Mama Doc: New Data And 10 Ways To Reduce SIDS And Suffocation Risk In Babies

Guillain-Barré syndrome (GBS) is a rare disorder in which a person’s own immune system damages their nerve cells, causing muscle weakness and sometimes paralysis. It often follows infection with a virus or bacteria. Most people recover fully from GBS, but some people have permanent nerve damage. In the United States, about 3,000 to 6,000 people develop GBS each year, whether or not they received a vaccination.

Studies suggest that it is more likely that a person will get GBS after getting the flu than after vaccination. It is important to keep in mind that severe illness and death are associated with flu, and getting vaccinated is the best way to prevent flu infection and its complications.

Vaccine safety monitoring systems are used to investigate cases of GBS that start after vaccination. Tracking vaccine safety is a high priority for the Centers for Disease Control and Prevention. Several systems are in place to monitor vaccine safety.

Source: CDC: Vaccines and Guillain-Barre Syndrome

Vaccine development typically begins not at a pharmaceutical company, but in a research laboratory in a university, medical center or small biotech company. During this time, several different scientists or groups of scientists may be working toward the same goal: developing a vaccine against a certain virus or bacteria.

By the time a vaccine is offered to the public, it has been studied for at least 15 to 20 years in tens of thousands of study participants, by thousands of scientists, statisticians, health care providers and other personnel, and has cost at least $1 billion dollars to produce.

Currently, the United States has the safest, most effective vaccine supply in its history. Clinical trials are conducted to evaluate the safety and effectiveness of a vaccine before it can be brought to market. Vaccines are first tested in laboratory studies and animal studies. If the results indicate the vaccine is safe, additional testing in people must be done before the vaccine can be approved by the Food and Drug Administration (FDA).

Many potential vaccines that never go beyond the research stage. Scientists and researchers are constantly evaluating a product during the trials to determine whether they are worth pursuing. Many ideas are abandoned during the different trial phases.

Learn more about each stage of the vaccine development process and how vaccines are licensed.

See the CDC infographic: The Journey of Your Child’s Vaccine.

Sources:
CDC: Vaccine Testing and the Approval Process
Children’s Hospital of Philadelphia: Process of Vaccine Development
Children’s Hospital of Philadelphia: Licensure, Recommendations and Requirements

Children do not receive any known health or medical benefits from following schedules that delay vaccines. Vaccines are arguably the safest, best-tested products we put into our bodies, so the choice not to get them or to delay them is a choice to take a different and much more potentially serious risk.

Infants and young children who do not follow the recommended immunization schedules and instead spread out shots—or leave out shots—are at risk of developing diseases during the time that the shots are delayed. This results in more frequent visits to the doctor’s office, more stress and anticipation of shots and increased costs for you.

There is no evidence that delaying or spreading out vaccines is any safer than simply following the recommended schedule set by the CDC. There is plenty of evidence that the recommended immunization schedule is safe and effective, as the timing of vaccines given has been carefully tested, studied and reviewed prior to being recommended for children.

If your child falls behind the recommended schedule, you can talk to your child’s doctor about catching them up, reducing the amount of time the child is left exposed to vaccine-preventable diseases.

Parents who are concerned about the number of shots given at one time can reduce the number given at a visit by using the flexibility built into the current recommended immunization schedule. For example, the third dose of Hepatitis B vaccine can be given at 6 through 18 months of age. Parents can work with their child’s health care professional to have their child receive this dose at any time during this recommended age range. But remember, by vaccinating your child at the earliest recommended age, they are protected earlier in life. The longer you wait to give a dose, the longer your child goes not fully protected.

Learn more about why you should use the recommended schedule  and how it is developed.

Sources:
CDC: The Childhood Immunization Schedule
Children’s Hospital of Philadelphia: Altering the Schedule

 

No, doctors are not paid by pharmaceutical companies to give vaccinations. Their only incentive to recommend vaccination is to keep your child healthy and protected from serious diseases.

As experts in kids’ health, doctors make recommendations based on years of studies, scientific research, and firsthand experience treating illness. They know the many proven life-saving benefits of vaccines.

The truth is doctors often lose money on vaccines. A study published in the Journal Pediatrics shows that the costs of giving vaccines exceeded the amount that the insurers and health plans reimburse to cover the cost of administering the vaccine.

Source: Immunize for Good

In fact, the chickenpox vaccine was not available when many of us were children, which is why we did not get the shot. However, chickenpox can actually be a painful, serious disease. In many cases, children experience a mild case of chickenpox, but other children may have blisters that become infected. Others may develop pneumonia. There is no way to tell in advance the severity of the symptoms your child will experience. And, if you don’t get vaccinated during childhood and are exposed as an adult, you are more likely to experience severe symptoms.

Before vaccine was available, about 50 children died every year from chickenpox, and about 1 in 500 children who got chickenpox was hospitalized.

Source: CDC: Infant Immunizations FAQ

Babies may get some temporary immunity (protection) from mom during the last few weeks of pregnancy—but only for the diseases to which mom is immune. Breastfeeding may also protect your baby temporarily from minor infections, such as colds. But these antibodies do not last long, leaving your baby vulnerable to disease.

Vaccination is one of the best things you can do to protect you and your baby against serious diseases. You probably know that when you are pregnant, you share everything with your baby. That means when you get vaccines, you aren’t just protecting yourself—you are giving your baby some early protection too. You should get a flu shot and whooping cough vaccine (also called Tdap) during each pregnancy to help protect yourself and your baby.

Your ob-gyn or midwife may recommend you receive some vaccines right after giving birth. Postpartum vaccination will help protect you from getting sick and you will pass some antibodies to your baby through your breastmilk. Vaccination after pregnancy is especially important if you did not receive certain vaccines before or during your pregnancy.

It is safe for you to receive vaccines right after giving birth, even while you are breastfeeding. Be sure to discuss each vaccine with your health care professional before getting vaccinated.

Sources:
CDC: Pregnancy and Vaccination
CDC: What You Need to Know About Pregnancy and Vaccines

It isn’t very common, but it can happen. Depending on the vaccine, about 1 percent to 5 percent of children who are vaccinated fail to develop immunity. For very few people, underlying illnesses may affect their immune system response and in turn, they may require additional vaccination or protection.

Sometimes giving an additional vaccine dose will stimulate an immune response in a child who didn’t respond to the first dose. For example, a single dose of measles vaccine protects about 95 percent of children, but after two doses, almost 100 percent are immune.

Some vaccines, like the pertussis (whooping cough) vaccines, are effective but not perfect. They typically offer good levels of protection within the first two years of getting vaccinated, but then protection decreases over time. This is known as waning immunity, which is the loss of protective antibodies over time. Similarly, natural infection may also protect you only for a few years.

This is why it’s so important to follow the Centers for Disease Control and Prevention (CDC) recommended immunization schedule. For example, the pertussis vaccine includes shots at 2, 4 and 6 months of age, with booster shots at between 15 and 18 months old and between 4 and 6 years old, in order to be fully vaccinated. And the CDC recommends the tetanus-diphtheria-pertussis (Tdap) shot for everyone 11 years old and older, including pregnant women.

Sources:
CDC: Pertussis FAQ
CDC: Parents’ Guide to Childhood Immunizations FAQ

With an inactivated (killed) vaccine, it isn’t possible. Dead viruses or bacteria can’t cause disease. With live (weakened) vaccines, some children get what appears to be a mild case of disease (for example, what looks like a measles or chickenpox rash, but with only a few spots). This isn’t harmful, and can actually show that the vaccine is working. A vaccine causing full-blown disease is extremely unlikely.

Source: CDC: Parents’ Guide to Childhood Immunizations FAQ

The U.S. Food and Drug Administration sets specific guidelines on what must be included in a vaccine package insert. Specifically, any side effect that occurred after receiving the vaccine during the clinical trials must be reported, even if that side effect was reported as occurring at a similar rate among people who received the placebo.

Data collected during clinical trials are given to the Centers for Disease Control and Prevention (CDC) to help them make vaccine recommendations to healthcare professionals. The CDC looks specifically for side effects that happen more often in people who received the vaccine than those who received the placebo. Only side effects that happen more often in the group that received the vaccine, in comparison to the group that received the placebo, are listed on the CDC website as possible side effects.

This is why the package insert and the CDC list may have different side effects for vaccines. The FDA requires all side effects to be reported on the package insert, even if they happen as frequently among the placebo group during clinical trials.

Source:
Children’s Hospital of Philadelphia: Vaccine Schedule & Other Schedule Issues

RotaShield® vaccine was the first vaccine to prevent rotavirus gastroenteritis approved for use in the United States in August 1998. Its removal from the market is a good case study for how the Centers for Disease Control and Prevention (CDC), Advisory Committee on Immunization Practices (ACIP), American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) quickly worked together and took action based on increased reports of incidents to the Vaccine Adverse Event Reporting System (VAERS) and removed the vaccine from use.

In the U.S., some infants developed intussusception–a rare type of bowel obstruction–soon after RotaShield® was licensed in August 1998. At first, it was not clear if the vaccine or some other factor was causing the bowel obstructions. The CDC quickly recommended that use of the vaccine be suspended and immediately started two emergency investigations to find out if receiving RotaShield® vaccine was causing some of the cases of intussusception. Based on the results of the investigation, CDC estimated that RotaShield® vaccine increased the risk for intussusception by one or two cases of intussusception among each 10,000 infants vaccinated. When the results of these investigations became available, the ACIP withdrew its recommendation to vaccinate infants with RotaShield® vaccine, and the manufacturer voluntarily withdrew RotaShield® from the market in October 1999.

More information about this case is available on the CDC website.

Source:
CDC: Rotavirus Vaccine (RotaShield®) and Intussusception

Varicella (chickenpox), rubella (the “R” in the MMR vaccine), hepatitis A, one version of the shingles vaccine, and one preparation of rabies vaccine are all made by growing the viruses in fetal embryo fibroblast cells. Fibroblast cells are the cells needed to hold skin and other connective tissue together. The fetal embryo fibroblast cells used to grow vaccine viruses were first obtained from elective termination of two pregnancies in the early 1960s. These same embryonic cells obtained in the 1960s have been used continuously to make vaccines since that time.

No further sources of fetal cells are needed to make these or other vaccines.

Fetal cells were originally used because:

  1. Viruses need cells to grow and tend to grow better in cells from humans than animals (because they infect humans).
    Almost all cells die after they have divided a certain number of times; scientifically, this number is known as the Hayflick limit, and for most cell lines it is around 50 divisions; however, fetal cells can go through many more divisions before dying.
  2. As scientists studied these viruses in the lab, they found that the best cells to use were the fetal cells mentioned above. When it was time to make a vaccine, they continued growing the viruses in the cells that worked best during these earlier studies.

Dr. Paul Offit of the Children’s Hospital of Philadelphia talks more about this issue in this brief video:

Source:
Children’s Hospital of Philadelphia: Vaccine Ingredients – Fetal Tissue

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Government/school requirements

Whenever children are brought into group settings, there is a chance for diseases to spread. Children must follow state vaccine laws to attend school. These laws are the minimum standard to help prevent disease outbreaks in school settings. The best way to protect your child from other serious diseases is to follow the Centers for Disease Control and Prevention recommended vaccination schedule. Talk to your health care provider to make sure your child is fully protected.

Source:
Michigan Department of Health and Human Services: Vaccine Recommendations and School or Daycare Rules: What is the difference?

School immunization laws are set by individual states. Public health programs, such as immunization, are designed to protect the health of the public — that is, everybody. Remember that vaccines protect not only the person being vaccinated, but also people around them. Immunization laws exist not only to protect individual children, but to protect all children — including the very small number of kids who, for medical and religious reasons, are unable to be vaccinated and remain susceptible to vaccine-preventable diseases.

We know all parents are busy, so making vaccines mandatory for schools and daycares helps move vaccination higher up on the priority list. More importantly mandating vaccines for school and child care entry keeps children safe from serious diseases while in school settings.

In Michigan, parents with school-age children have the option to sign a vaccination waiver for philosophical or religious reasons. In 2014, the Michigan Department of Health and Human Services reported that less than 75 percent of young children and adolescents in Michigan were fully immunized, and Michigan ranked sixth highest in the U.S. for the number of parents who seek medical, philosophical or religious waivers exempting their children from school vaccine requirements.

As of 2015, parents who want a waiver for their child must attend an information session at their local health department. A year after implementing this reform, there were nearly 8,000 fewer childhood immunization waiver requests. In 2016, Michigan’s waiver rate dropped from 4.6 percent to only 2.8 percent.

Mandatory vaccination might not be a perfect solution, but it is a practical solution to a difficult problem and a way to protect the health of many thousands of Michigan children.

Source: CDC: Parents’ Guide to Childhood Immunizations FAQ

Under certain circumstances, yes. All states allow medical exemptions, so children who cannot safely receive certain vaccines are not required to get them. Most states also allow religious exemptions for children whose religion prohibits vaccination. Finally, some states allow philosophic exemptions for people who oppose vaccination on non-religious grounds. To protect themselves and others, unvaccinated students may be prohibited from attending classes if there is an outbreak of a vaccine-preventable disease at their school or in their community.

In Michigan, parents with school-age children have the option to sign a vaccination waiver for philosophical or religious reasons. As of 2015, parents who want a waiver for their child must attend an information session at their local health department.

Learn more about required vaccines for child care and preschool.

Learn more about required vaccines for school entry in Michigan.

Michigan Department of Health and Human Services: Vaccine Recommendations and School or Daycare Rules: What is the difference?

Source: CDC: Parents’ Guide to Childhood Immunizations FAQ

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Protecting yourself & your family from the flu

The flu — short for influenza — is an illness caused by influenza viruses. The flu spreads from person to person through the air by coughing, sneezing or just breathing. Symptoms usually appear suddenly and include fever, sore throat, cough, headache, chills and muscle aches. Most people who get the flu will recover in a week or two, but some people have more serious complications such as ear and sinus infections, pneumonia, bronchitis and inflammation of the heart.

Even healthy people can get the flu, and it can be very serious. The flu causes more deaths each year than any other vaccine-preventable disease — mostly among older people, but it is also very dangerous for children and young adults.

Source:
CDC – Flu Symptoms & Diagnosis

Many people use the term “stomach flu” to describe illnesses with nausea, vomiting or diarrhea, but this isn’t caused by the influenza virus. These symptoms are caused by many different viruses, bacteria or even parasites.

While these symptoms can sometimes be related to the flu — more commonly in kids than adults — these problems are rarely the main symptoms of influenza. The flu is a respiratory disease and not a stomach or intestinal disease. Symptoms usually appear suddenly and include fever, sore throat, cough, headache, chills and muscle aches.

Sources:
CDC – Misconceptions about Seasonal Flu and Flu Vaccines
CDC – Flu Symptoms & Diagnosis

The flu is more dangerous than the common cold for children. Each year, millions of children get sick with seasonal influenza; thousands of children are hospitalized and some children die from flu.

Children commonly need medical care because of the flu, especially before are 5 years old. Children with chronic health problems like asthma, diabetes and disorders of the brain and nervous system also are at higher risk.

The Centers for Disease Control and Prevention (CDC) estimates that influenza has resulted in between 9.2 million and 35.6 million illnesses, between 140,000 and 710,000 hospitalizations and between 12,000 and 56,000 deaths annually since 2010.

A total of five influenza-associated pediatric deaths in Michigan have been reported for the 2016-17 season. Nationally, 108 influenza-associated pediatric deaths have been reported for the 2016-17 flu season.

Sources:
CDC – Disease Burden of Influenza
CDC – Children, the Flu and the Flu Vaccine
MDHHS – Michigan Flu Focus Surveillance Reports

Everyone is at risk for seasonal influenza. The Centers for Disease Control and Prevention (CDC) recommends everyone six months and older get a flu vaccine.

While flu can make anyone sick, certain people have a higher risk of developing serious flu complications:

  • Pregnant women
  • Children younger than 5 years, but especially children younger than 2 years old
  • People 65 years of age and older
  • People of any age with certain chronic medical conditions

It’s also important that people who live with or care for those at high risk of serious flu complications get vaccinated, including:

  • Health care workers
  • Parents, family and friends around children younger than 6 months of age who are too young to be vaccinated
  • People caring for their elderly parents, or other elderly adults

See the CDC’s full list of people who are at high risk of serious flu complications.

Source:
CDC – Key Facts About Seasonal Flu Vaccine

The best way to protect against the flu is to get a flu vaccine every flu season. Flu is a contagious respiratory disease that can lead to serious illness, hospitalization, or even death. Every flu season is different, and influenza infection can affect people differently. Even healthy people can get very sick from the flu and spread it to others.

The Centers for Disease Control and Prevention (CDC) recommends a yearly flu vaccine for everyone 6 months of age and older as the first and most important step in protecting against this serious disease.

It is important for you and your family to get the flu vaccine EVERY year, because:

  • Flu viruses are constantly changing, so flu vaccines are updated from one season to the next to protect against the viruses that research suggests will be most common during the upcoming flu season.
  • A person’s immune protection from the flu vaccine declines over time. Yearly vaccination is needed for the best protection.

In addition to getting a seasonal flu vaccine, you can take everyday preventive actions like staying away from sick people and washing your hands to reduce the spread of germs. If you or your family members are sick with flu, stay home from work or school to prevent spreading flu to others.

Also, if you have a loved one who develops flu-like symptoms, especially those at high risk for flu complications, it’s important to see a healthcare provider for possible treatment with flu antiviral drugs. These drugs work best if given within 48 hours of when symptoms start.

Source:
CDC – Prevent Seasonal Flu

The timing of flu is very unpredictable and can vary in different parts of the country and from season to season. Seasonal flu viruses are present year-round, but flu activity usually begins as early as October and can continue as late as May. Flu activity most commonly peaks in the United States between December and February.

Source:
CDC – Frequently Asked Flu Questions 2017-2018 Influenza Season

A flu shot cannot cause flu illness. The flu vaccine does not have a live virus in it, so it is impossible to get the flu from the vaccine.

The most common side effects from the flu shot are soreness, redness, tenderness or swelling where the shot was given. Low-grade fever, headache and muscle aches also may occur. These are expected side effects from the vaccine and generally do not last long. These reactions should not be misinterpreted as getting sick with flu from the vaccine. The most common reactions people have to the flu vaccine are considerably less severe than the symptoms caused by actual flu illness.

In randomized, blinded studies, where some adults get inactivated flu shots and others get salt-water shots, the only differences in symptoms was increased soreness in the arm and redness at the injection site among people who got the flu shot. There were no differences in terms of body aches, fever, cough, runny nose or sore throat.

Serious allergic reactions to flu vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after the vaccination. If you have questions or concerns about the flu vaccine, be sure to talk to your child’s doctor.

Source:
CDC – Misconceptions about Seasonal Flu and Flu Vaccines

Influenza leads to hospitalizations and deaths every year. However, the flu vaccine only causes mild side effects that usually are better within a day or two. The risk of developing severe flu related complications is much greater than the risk of flu vaccine side effects.

Making sure you and your family are vaccinated each year is the safest way to protect against the flu. The benefits of getting vaccinated against the flu far outweigh the risks.

Source:
CDC – Misconceptions about Seasonal Flu and Flu Vaccines
Children’s Hospital Of Philadelphia – A Look at Each Vaccine: Influenza Vaccine

Making sure you and your family are vaccinated each year is the safest way to protect them against the flu. But sometimes, people might get flu symptoms even though they have been vaccinated against the flu.

People can get sick from other respiratory viruses such as rhinoviruses (which are associated with the common cold) and cause symptoms similar to the flu and also spread during flu season. The flu vaccine only protects against influenza, not other illnesses.

Another explanation is that it is possible to be exposed to influenza viruses, which cause the flu, shortly before getting vaccinated or during the two-week period after vaccination when the body is still developing immune protection.

Lastly, people who have been vaccinated may still get the flu if they are exposed to a flu virus that is very different from the viruses the vaccine is designed to protect against. There are many different flu viruses that spread and cause illness among people. For more information, see the Centers for Disease Control and Prevention’s information on different flu viruses.

Sources:
CDC – Misconceptions about Seasonal Flu and Flu Vaccines
CDC – Influenza (Flu) Viruses

Vaccines help develop immunity by imitating an infection. This doesn’t cause illness, but it does cause the immune system to produce antibodies that help protect you from the disease in the future. Vaccines contain ingredients called antigens, which tell the body’s immune system to create antibodies to protect against those antigens.

Every day, a healthy child’s immune system successfully fights off thousands of antigens — the parts of germs that cause the body’s immune system to go to work.

The antigens in vaccines come from the germs themselves, but the germs are weakened or killed so they cannot cause serious illness. Vaccines contain only a tiny fraction of the antigens that children encounter every day in their environment, even if they receive several vaccines on one day.

Ingredients in vaccines are all there for a reason — to help the vaccine work better and to guarantee vaccine safety. Most ingredients in vaccines are already present in our bodies or our environment — the air we breathe, the water we drink and the food we eat.

Common ingredients in vaccines are:

  • Adjuvants: Adjuvants (like aluminum) help vaccines work better. They enhance the immune response, decreasing the quantity of vaccine needed to gain protective immunity, or lowering the number of doses required.
  • By-products: Some products (like formaldehyde) are used during vaccine manufacturing to make sure viruses are inactivated and are removed except for a tiny trace.
  • Stabilizers: Stabilizers (like gelatin) are added to vaccines to protect the active ingredients from breaking down during manufacture, transport and storage.
  • Preservatives: Preservatives (like trace amounts of thimerosal) prevent bacterial or fungal contamination. Early in the 20th century, most vaccines were packaged in vials that contained multiple doses. Doctors and nurses would draw up a single dose and place the vaccine back in the refrigerator. Unfortunately, sometimes bacteria would inadvertently enter the vial and cause infections. Preservatives, originally added in the 1930s, solved this problem.

Thimerosal, a mercury-based preservative, is used in trace amounts in some versions of the flu vaccine, although most versions are thimerosal-free. This preservative is used to protect flu vaccines packaged in multi-dose vials. Each time a vaccine dose is drawn from a multi-dose vial, bacteria or fungi can enter the vial. Receiving a vaccine contaminated with bacteria or fungi can be dangerous and cause infections. Preservatives help prevent contamination of multi-dose vials each time individual doses are drawn.

Mercury is a naturally occurring element found in the earth’s crust, air, soil and water. As a result, we are all exposed to mercury. Today, breastfed infants are exposed to 15 times more mercury in breast milk than is contained in the influenza vaccine.

More information on thimerosal is available from the Centers for Disease Control and Prevention (CDC) and the Children’s Hospital of Philadelphia. A  is available from the CDC.

Other ingredients: The amount of good and bad information online about vaccines can be overwhelming and confusing, but you can’t believe everything you read about ingredients in vaccines. For example, no vaccine contains, or has ever contained, antifreeze.

It’s important to look to the most trusted physicians, research, and public health organizations in the world for answers. The CDC has compiled an ingredient list for most vaccines. While this information may be helpful for people concerned about particular allergies or ingredients, it is important to realize that the ingredient list does not indicate quantities in each vaccine. In most cases, the quantities are so small that they do not cause allergic reactions or symptoms of toxicity. Talk to your child’s doctor about any questions or concerns you have about vaccine ingredients.

Sources:
CDC: Ingredients of Vaccines Fact Sheet
CDC: Parents’ Guide to Childhood Immunizations FAQ
Children’s Hospital of Philadelphia: Vaccine Ingredients Q&A
CDC: Thimerosal in Flu Vaccine
CDC: Flu Vaccine Safety Information

Flu vaccination can keep you from getting sick with flu.

  • Flu vaccine prevents millions of illnesses and flu-related doctor’s visits each year. For example, during 2016-2017, flu vaccination prevented an estimated 5.3 million influenza illnesses, 2.6 million influenza-associated medical visits, and 85,000 influenza-associated hospitalizations.
  • In seasons when the vaccine viruses matched circulating strains, flu vaccine has been shown to reduce the risk of having to go to the doctor with flu by 40 percent to 60 percent.

Flu vaccination can keep you out of the hospital.

  • Flu vaccine prevents tens of thousands of hospitalizations each year. For example, during 2016-2017, flu vaccination prevented an estimated 85,000 flu-relatedhospitalizations.
  • 2014 study showed that flu vaccine reduced children’s risk of flu-related pediatric intensive care unit (PICU) admission by 74 percent during flu seasons from 2010-2012.
  • In recent years, flu vaccines have reduced the risk of flu-associated hospitalizations among adults on average by about 40 percent.
  • 2018 study showed that from 2012 to 2015, flu vaccination among adults reduced the risk of being admitted to an intensive care unit (ICU) with flu by 82 percent.

Flu vaccination helps prevent the flu in people with chronic health conditions.

Vaccination helps protect women during and after pregnancy.

  • Vaccination reduces the risk of flu-associated acute respiratory infection in pregnant women by up to one-half.
  • 2018 study showed that getting a flu shot reduced a pregnant woman’s risk of being hospitalized with flu by an average of 40 percent.
  • Getting vaccinated can also protect a baby after birth from flu. (Mom passes antibodies onto the developing baby during her pregnancy.)
    • A number of studies have shown that in addition to helping to protect pregnant women, a flu vaccine given during pregnancy helps protect the baby from flu infection for several months after birth, when he or she is not old enough to be vaccinated.

Flu vaccination can save children’s lives.

  • A 2017 study was the first of its kind to show that flu vaccination can significantly reduce a child’s risk of dying from the flu.

If you do get sick with the flu, flu vaccination has been shown in several studies to reduce its severity.

  • A 2017 study showed that flu vaccination reduced deaths, ICU admissions, ICU length of stay, and overall duration of hospitalization among hospitalized flu patients.
  • 2018 study showed that among adults hospitalized with flu, vaccinated patients were 59 percent less likely to be admitted to the ICU than those who had not been vaccinated. Among adults in the ICU with flu, vaccinated patients on average spent 4 fewer days in the hospital than those who were not vaccinated.

Getting vaccinated yourself may also protect people around you

…including those who are more at risk for serious complications from the flu, like babies and young children, older people and people with certain chronic health conditions.

Source:
CDC – Key Facts About Seasonal Flu Vaccine

Because influenza viruses are constantly evolving, and the viruses that circulate among people often change from one year to another, flu vaccines change annually. Scientists around the world collect samples to identify which flu strains are most likely to be circulating in the next flu season and here in the United States, we get our flu strains from the southern hemisphere.

In February—well before a new flu season begins—the U.S. Food and Drug Administration recommends the different strains of influenza viruses that should be included in vaccines that are going to be produced for the upcoming U.S. flu season starting in the fall.  These seed viruses are produced and then distributed to manufacturers to be grown and included in the upcoming flu vaccine. During this vaccine development, manufacturers and the FDA test for potency and safety, as well as quality control tests such as sterility.

The process of flu vaccine production stays the same every year and the only thing that changes is the seed strain of influenza that’s estimated to be circulating in the coming year.  The process used to produce pandemic vaccine (such as the H1N1 vaccine) is identical to the process for producing any other seasonal flu vaccine.

Once a seasonal or pandemic vaccine has been developed and tested, the lots are released in the summer for distribution and use by the public in the fall, typically when flu season begins.

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Staying safe during COVID-19

The goal of the vaccine-approval process is to end up with a vaccine that is effective (the vaccine works in preventing the illness) and safe (there are no serious side effects or other problems). In the United States, this process has produced safe and effective vaccines for the flu, polio, measles, mumps, pertussis, and more. The process has saved millions of people from getting sick and dying for decades.

The stages of development generally follow this timeline:

  • Exploratory stage: This is the start of lab research to find something that can treat or prevent a disease. Vaccine development typically begins not at a pharmaceutical company, but in a research laboratory in a university, medical center, or small biotech company. Scientists in these laboratories are most often funded by grants from the government or private foundations.
  • Pre-clinical stage: Scientists use lab tests and testing in animals, such as mice or monkeys, to learn whether a vaccine might work. Many potential vaccines don’t make it past this point. But if the tests are successful and the U.S. Food and Drug Administration (FDA) signs off, it’s on to clinical testing.
  • Clinical development: This is a three-phase process of testing in humans.
    • Phase I usually involves fewer than 100 people and seeks to answer two main questions: does the vaccine generate the expected immune response (does it work in creating antibodies to protect someone from the disease) and is the vaccine safe (does the vaccine show any serious side effects)?
    • Phase II involves several hundred people, comparing those who did and did not receive vaccine. During this phase, scientists try to determine the proper dose of vaccine to be given, and they continue to study the vaccine’s safety. They also determine how to manufacture the vaccine — making sure the process and packaging creates a consistent vaccine, so that each batch produces similar results.
    • Phase III involves tens of thousands of study participants who are similar to the population that will receive the vaccine, again comparing those who did and did not receive vaccine. During these studies, as with the previous phases, no one working with the patients, testing the samples collected from patients, or calculating the results, knows which participants received the vaccine and which did not (this is called a “double-blind” study). Researchers are also studying how long the vaccine can be used before it expires, taking into consideration how it will be transported and stored.
  • Regulatory review and approval: Scientists with the FDA and U.S. Centers for Disease Control and Prevention closely review the data from the clinical trials before a vaccine can be licensed and approved.
    • Additionally, the Advisory Committee on Immunization Practices (ACIP) – a group of independent medical and public health experts who review data on new and existing vaccines and diseases – will make recommendations for approval and use within specific age groups.
  • Manufacturing: The vaccine goes into production. The FDA inspects the factory and approves drug labels.
  • Quality control: Scientists and government agencies use databases such as the Vaccine Adverse Event Reporting System (VAERS) and the Vaccine Safety Datalink Project to monitor vaccine safety.
    • VAERS collects and analyzes reports of adverse events that happen after vaccination. Anyone can submit a report, including parents, patients, and health care professionals. That report is then evaluated by medical experts and examined for trends to identify any vaccine safety issues.
    • The Vaccine Safety Datalink Project, a network of health care organizations across the U.S., analyzes health care information from over 24 million people, which scientists use to actively monitor safety.
    • Vaccine recommendations may change if safety monitoring reveals new information on vaccine risks (like if scientists detect a new serious side effect).
    • The approved COVID-19 vaccines will be utilizing these standard safety programs, which are already in place, and will also be utilizing the new quality control program known as V-Safe. This new program is a vaccination health checker which uses smartphone technology to monitor and receive reports about adverse side effects.

Sources:
CDC: Ensuring the Safety of COVID-19 Vaccines in the United States
CDC: Ensuring COVID-19 Vaccines Work
Children’s Hospital of Philadelphia: Questions and Answers about COVID-19 Vaccines
CDC: V-safe After Vaccination Health Checker

Thanks to unprecedented, worldwide collaboration from scientists, health and government officials, and manufacturers, the medical community was able to focus on the development and production of a safe and effective COVID-19 vaccine.  Through this strong collaboration we were able to see the COVID-19 vaccine research grow and expand so that we now have the first three COVID-19 vaccines authorized for use through an Emergency Use Authorization (EUA).

The first two COVID-19 vaccines that have been authorized for EUA, including the one authorized for youth ages 12-15, were built using a technology called mRNA, rather than using a weakened or dead virus as traditional vaccines do. Traditional vaccine production involves growing viruses in living cells and purifying the virus. There are challenges associated with this process that takes time. The mRNA vaccine has an advantage in that large amounts of the mRNA can be synthesized very rapidly.

mRNA vaccines teach our cells how to make a piece of a protein that triggers an immune response inside our bodies. That immune response, which produces antibodies, is what protects us from getting infected if the real virus enters our bodies. mRNA vaccines are being held to the same rigorous safety and effectiveness standards as all other types of vaccines in the United States.

In an Adenovirus-based vaccine, like the authorized Johnson & Johnson vaccine, scientists take part of the SARS-CoV-2 virus’s code (its DNA) and adds it to a modified adenovirus (the virus that can cause the common cold). This teaches your immune systems to learn to recognize and fight the SARS-CoV-2 virus without causing you to be infected. The vaccine will not give you the COVID-19 virus or cause you to be infectious to others.

While COVID-19 vaccines have been developed more quickly than has been done with other vaccines, speed did not decrease safety. In addition to the advantage for mRNA vaccine production, the timeline was shortened without sacrificing quality by:

  • Overlapping phase I and phase II clinical trials. Phase I studies include a small number of people and evaluate whether the vaccine causes an immune response and is safe. Scientists could look at data from a group of people as phase II was progressing to make these evaluations.
  • While completing large phase III trials, manufacturers began producing the vaccine, so that if it were shown to be safe and effective, they would have large numbers of doses ready. This is not normally done because if the vaccine does not work, the manufacturer will have spent a significant amount of money to produce something that needs to be thrown away.
  • While waiting for a vaccine to be ready, many other aspects of vaccine delivery were prepared (e.g., developing plans for how to distribute the first, limited quantities available, ensuring adequate supplies for distributing and administering vaccine.)

Past research on vaccines has identified potential successful approaches which has reduced the development time for a COVID-19 vaccine. These mRNA vaccines are a product of decades of study on RNA therapies and treatment by medical scientists. Beyond vaccines, cancer research has used mRNA to trigger the immune system to target specific cancer cells. mRNA technology has been used successfully for cancer immunotherapy by harnessing the body’s immune system to identify and kill cancer cells in the same way the immune system identifies and targets infection from viruses or diseases.

Sources:
CDC: Understanding mRNA COVID-19 Vaccines
Children’s Hospital of Philadelphia: Questions and Answers about COVID-19 Vaccines
The Promise of mRNA Vaccines

To date, a vaccine has not yet been authorized for children under the age of 12 years. Pfizer-BioNTech COVID-19 vaccine has emergency use authorization for those aged 12 through 15 years and has full FDA approval for people 16 years of age and older. Vaccine programs are rolling out at high schools, community clinics and pharmacies. Pfizer’s COVID-19 vaccine provides the opportunity to further protect your child from COVID-19 and help get life back to normal.

The currently authorized COVID-19 vaccines have gone through clinical trials and scientific review just like any other vaccine — including those your teenager has likely already received — and no standards of quality or safety were sacrificed.

Vaccination gets our kids back to the programs, activities and social interactions they need for appropriate academic, social-emotional and physical development. The sooner all eligible Michiganders are vaccinated, the sooner we can get our state — and our kids’ lives — back to normal.

Source:

Children’s Hospital of Philadelphia: Should My Child Get the COVID-19 Vaccine?

In many cases, teens with pre-existing conditions like diabetes, IBD or other autoimmune diseases, or those who are taking medications that compromise their immune system, are at higher risk of complications from COVID-19 infection. The COVID-19 vaccines that have been authorized for use cannot cause COVID-19, even in those with weak immune systems. Therefore, individuals with immune-compromising conditions may get the COVID-19 vaccine, as long as they are not in one of the following categories:

  • Have a severe allergy to a vaccine component (i.e., one that causes anaphylaxis or requires medical intervention)
  • Have a history of severe allergy to any vaccine or injectable medication

Talk with your child’s healthcare professional to discuss receiving an age appropriate COVID-19 vaccine for your child and to review individual risks and benefits.

We know that people with moderately to severely compromised immune systems are vulnerable to COVID-19 and may not build the same level of immunity to COVID-19 vaccines compared to those who are not immunocompromised. At this time, CDC recommends moderately to severely immunocompromised people to receive an additional/3rd dose of the mRNA COVID-19 vaccine.

Understanding that this is an additional primary dose and not a booster dose is an important distinction.

  • A booster dose is when a person has had a full COVID-19 vaccine series and overtime their immunity wanes.
  • An additional primary dose is needed for persons who received an initial full COVID-19 vaccine series but never built a good immune response. We see this in persons who have compromised immune systems.

Currently the mRNA vaccines (Pfizer-BioNTech and Moderna) have authorization for use in those moderately to severely immunocompromised to receive an additional/3rd dose of an mRNA vaccine, after receiving an initial 2-dose primary series of an mRNA COVID-19 vaccine. The age groups authorized to receive the additional dose are unchanged from those authorized to receive the primary vaccination series. mRNA COVID-19 vaccines:

Most people will not need an additional primary dose of COVID-19 vaccine. To determine if your child is eligible to receive an additional primary dose of an age appropriate COVID-19 vaccine after they have received their initial 2-dose vaccine series, talk to your health care provider.

Source:
Children’s Hospital of Philadelphia: Should My Child Get the COVID-19 Vaccine?

COVID-19 Vaccines for Moderately to Severely Immuncompromised People-CDC

Routine well-child visits and vaccine visits are essential, even during the COVID-19 pandemic. It’s important that your family continue to receive their immunizations on time and according to the schedule recommended by the U.S. Centers for Disease Control and Prevention (CDC). Many of these diseases are serious. At a time when our healthcare system is already overwhelmed, it’s critical that we avoid outbreaks of preventable diseases, like measles, pertussis (whooping cough), and mumps.

Learn more about why it’s important to follow the CDC-recommended schedule.

The U.S. currently has three COVID-19 vaccines authorized and recommended for emergency use authorization, with the Pfizer-BioNTech COVID-19 vaccine receiving recent FDA full approval for use in 16 years of age and older. The Pfizer-BioNTech COVID-19 vaccine continues to be available under EUA  for individuals 12 through 15 years and for the administration of a third dose in certain immunocompromised individuals The Moderna COVID-19 vaccine and Johnson & Johnson COVID-19 vaccines are recommended for use in those 18 years of age and older.

Please keep in mind that COVID-19 vaccine may be administered without regard to timing of other vaccines. This means that your child may receive an age appropriate COVID-19 vaccine and other vaccines on the same day or at any time before or after another vaccine.

In addition to mask requirements and phone screenings, many medical offices are taking extra steps to make sure that well visits can happen safely during the COVID-19 outbreak, including:

  • Scheduling sick visits and well-child visits during different times of the day
  • Asking patients to remain outside until it’s time for their appointment to reduce the number of people in waiting rooms
  • Offering sick visits and well-child visits in different locations

Prepare for the visit by calling your child’s healthcare provider to ask when your child’s vaccinations are due and what policies and procedures are in place at the office.

Sources:
CDC: Routine vaccinations during COVID-19
CDC: Keep Children Healthy during the COVID-19 Pandemic

When available to them, get them vaccinated with the COVID-19 vaccine. To date, we have the Pfizer-BioNTech COVID-19 vaccine available to those 12 and older.

  • Help stop the spread of COVID-19 by teaching your child about COVID-19 health and safety measures.
  • Avoid people who are sick (coughing and sneezing).
  • Stay home when you are sick, except to get medical care.
  • Cover your coughs and sneezes with a tissue and throw the tissue in the trash.
  • Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food.
  • If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if visibly dirty.
  • Clean and disinfect high-touch surfaces daily in household common areas (like tables, hard-backed chairs, doorknobs, light switches, remotes, handles, desks, toilets, and sinks).
  • Launder items, including washable plush toys, as appropriate and in accordance with the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting for the items and dry items completely. Dirty laundry from a sick person can be washed with other people’s items.

It’s important to teach your children and teens how to practice social distancing, especially for those who are not eligible to be vaccinated. The key to slowing the spread of COVID-19 is to limit contact as much as possible. The U.S. Centers for Disease Control and Prevention (CDC) is recommending that children over the age of 2 wear masks when going out in public where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission.

For infants, the best way is to limit exposure and avoid unnecessary public contact. If going out is essential and you must bring your baby:

  • Keep the outing short and always follow the 6 feet distancing rule.
  • Cover the infant carrier (not your baby) with a light blanket. This will help protect your baby, but still gives them the ability to breathe comfortably. Do not leave the blanket on the carrier in the car or at any time when your baby and carrier are not in your direct view. Check on your baby often.
  • Do not put a cloth face covering on your baby, or any child under the age of 2.
  • Never leave children alone in the car. The temperature in your car can become deadly in a short time.
  • Wash your hands (and any children’s hands) as soon as you return home.

The U.S. currently has three COVID-19 vaccines authorized for emergency use (EUA). The Pfizer-BioNTech COVID-19 vaccine received FDA full approval for use in 16 years of age and older. The Pfizer-BioNTech COVID-19 vaccine continues to be available under EUA  for individuals 12 through 15 years and for the administration of a third dose in certain immunocompromised individuals  The Moderna COVID-19 vaccine and Johnson & Johnson COVID-19 vaccines are authorized for use in those 18 years of age and older.

You can find additional information from the CDC about preventing COVID-19 here:

Source:
CDC: COVID-19 Frequently Asked Questions

The U.S. Centers for Disease Control and Prevention (CDC) recommends that everyone 2 years of age and older wear a cloth face covering that covers their nose and mouth in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission.

Cloth face coverings should NOT be put on babies or children younger than 2 years of age because of the danger of suffocation. Children younger than 2 years of age are listed as an exception as well as anyone who has trouble breathing or is unconscious, incapacitated, or otherwise unable to remove the face covering without assistance.

Wearing cloth face coverings is a public health measure people should take to reduce the spread of COVID-19 in addition to (not instead of) social distancing, frequent hand washing, and other everyday preventive actions. Medical face masks and N95 respirators are still reserved for healthcare personnel and other first responders.

For more information about face coverings/masks and how to make your own, visit the CDC’s website.

More specifics on face coverings from the Michigan Department of Health and Human Services can be found here.

Until a significant portion of our population is vaccinated, we will all need to continue some preventative measures such as wearing masks, social distancing, and handwashing to reduce the spread of COVID-19 in our communities. Our best protection from COVID-19 is to complete the vaccine series.

Sources:
CDC: Cloth Face Coverings
CDC: COVID-19 Frequently Asked Questions
MDHHS: Face Coverings Frequently Asked Questions

The symptoms of COVID-19 appear to be similar in children and adults. Children with confirmed COVID-19 have generally presented with mild, cold-like symptoms, such as fever, runny nose and cough. Vomiting and diarrhea have also been reported.

Babies under 1 year old and children with certain underlying conditions may be more likely to have severe illness from COVID-19. Studies are ongoing regarding how the disease impacts everyone, including children.

Health officials are advising parents to watch for symptoms related to a rare but serious inflammatory condition seen in children and linked to COVID-19, called multisystem inflammatory syndrome (MIS-C). If you notice any of the following symptoms, call your pediatrician:

  • A fever lasting more than 24 hours
  • Abdominal pain, diarrhea or vomiting
  • Rash or changes in skin color
  • Trouble breathing (call 911 if this symptom is present)
  • Your child seems confused or overly sleepy​

Be sure to let your pediatrician know if your child has tested positive for COVID-19 or has been exposed to the virus. Your pediatrician will let you know if your child can be seen in the office or if you need to go to the emergency department.

While potentially serious, MIS-C appears to be rare, and most cases of COVID-19 in children are mild.

Sources:
CDC: COVID-19 Frequently Asked Questions
CDC: For Parents – MIS-C associated with COVID-19
CDC: MIS-C and COVID-19
AAP: MIS-C and COVID-19

There are many different kinds of vaccines being explored to combat COVID-19.

The first two vaccines that received Emergency Use Authorization (EUA), use a technology called messenger RNA (mRNA) to protect against infectious diseases. To trigger an immune response, many vaccines put a weakened or inactivated germ into our bodies, but not mRNA vaccines. Instead, they teach our cells how to make a protein—or even just a piece of a protein—that triggers an immune response inside our bodies. That immune response, which produces antibodies, is what protects us from getting infected or seriously ill if the real virus enters our bodies.

COVID-19 mRNA vaccines give instructions to our cells to make a harmless piece of what is called the “spike protein.” The spike protein is found on the surface of the virus that causes COVID-19 disease.

COVID-19 mRNA vaccines are given in the upper arm muscle. The cells use these instructions to make the protein piece. After the protein piece is made, the cell breaks down the instructions and gets rid of them.

Next, the cell displays the protein piece on its surface, similar to how the COVID-19 virus would. Our immune systems recognize that the protein doesn’t belong there and begins building an immune response and making antibodies, like what happens in natural infection with COVID-19.

At the end of the process, our bodies have learned how to protect against future infection. The benefit of mRNA vaccines, like all vaccines, is that those vaccinated gain protection without ever having to risk the serious consequences of getting sick with COVID-19.

In an Adenovirus-based vaccine, like the authorized Johnson & Johnson vaccine, scientists take part of the SARS-CoV-2 virus’s code (its DNA) and adds it to a modified adenovirus (the virus that can cause the common cold). This teaches your immune systems to learn to recognize and fight the SARS-CoV-2 virus without causing you to be infected. The vaccine will not give you the COVID-19 virus or cause you to be infectious to others.

Sources:
University of Michigan: The Top 5 COVID-19 Vaccine Candidates Explained
CDC: Understanding mRNA COVID-19 Vaccines
Children’s Hospital of Philadelphia: Questions and Answers about COVID-19 Vaccines
CDC: Different COVID-19 Vaccines
MDHHS: How mRNA vaccines work
MDHHS: How Adenovirus-based vaccines work

Influenza (flu) and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. COVID-19 is caused by infection with a new coronavirus and flu is caused by infection with influenza viruses.

There are some key differences between flu and COVID-19:

  • COVID-19 seems to spread more easily than flu and causes more serious illnesses in some people. It can also take longer before people show symptoms and people can be contagious for longer.
  • Another important difference is there are multiple FDA-licensed influenza vaccines produced annually to protect against the flu. Currently, we have two (many under development) COVID-19 vaccines that have been approved by the U.S. Food and Drug Administration for emergency use authorization.

Because some of the symptoms of flu and COVID-19 are similar, it may be hard to tell the difference between them based on symptoms alone, and testing may be needed to help confirm a diagnosis.

Source:
CDC: Similarities and Differences between Flu and COVID-19​

Right now, we do not know how long antibodies last after infection. There is not enough information currently available to say if or for how long after infection someone is protected from COVID-19, which is also known as natural immunity. Early evidence suggests natural immunity from COVID-19 may not last very long, but more studies are needed to better understand this. Cases of reinfection with COVID-19 have been reported but remain rare​.​ It’s important to remember that the virus that causes COVID-19 is very new, and scientists are actively working to study it.

Data from clinical trials indicate that mRNA COVID-19 vaccines are safe in persons with evidence of a prior COVID-19 infection. Vaccination should be offered to persons regardless of history of prior symptomatic or asymptomatic COVID-19 infection, this includes people with prolonged post-COVID-19 symptoms. Viral testing to assess for COVID-19 infection or serologic testing to assess for prior infection solely for the purposes of vaccine decision-making is not recommended.

Vaccination of persons with known current COVID-19 infection should be deferred until the person has recovered from the acute illness (if the person had symptoms) and criteria have been met for them to discontinue isolation. This recommendation applies to persons who develop COVID-19 infection before receiving any vaccine doses as well as those who develop infection after the first dose but before receipt of the second dose. While there is no recommended minimum interval between infection and vaccination, current evidence suggests the risk of COVID-19 reinfection is low in the months after infection but may increase with time due to waning immunity.

Sources:
Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States
CDC: Frequently Asked Questions about COVID-19 Vaccination
Children’s Hospital of Philadelphia: Questions and Answers about COVID-19 Vaccines

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