Feb 15, 2015

What To Ask About Vaccinations

Most pediatricians follow the recommended schedule for childhood vaccinations, making parents’ jobs easier. But with all the new vaccines that have been rolled out in recent years, it’s a good idea to have a vaccine conversation with your doctor, especially when it comes to older children and adults. Here are some questions you may not think to ask, along with notes on why they’re important.

What vaccines does my teenager need?

Three vaccines have recently become available for teenagers: one that guards against meningitis; another that includes protection against pertussis, or whooping cough; and a third for cervical cancer. The meningococcal vaccine protects teenagers against potentially deadly meningitis and bloodstream infections.

It used to be recommended only for those entering college, but the new form has longer-lasting protection and is now recommended starting at age 11, as the protection will now carry teenagers through college, when risk is highest. Children 8 to 12 may also be at risk at overnight camps and on sports teams.

The Tdap vaccine, for tetanus, diphtheria and pertussis, is now routinely recommended for teenagers as well as adults. In the past, teenagers would get just tetanus and diphtheria boosters because of safety concerns surrounding the pertussis vaccine, but the new vaccine is considered safe. Pertussis boosters are necessary because the immunization effects of the single shot fade. Whooping cough is one of the few vaccine-preventable diseases that are still not under control.

The third vaccine, Gardasil, protects teenage girls against cervical cancer by taking aim at the human papilloma virus, or H.P.V. It is recommended at age 11 to 12 and requires three injections over a six-month period — or up to age 26 for those who did not get it when younger.

Does my teenager need a chickenpox booster?

The initial recommendation for the chickenpox vaccine was one shot for children 12 to 18 months old. In 2005, because of evidence that the vaccine wears off, it was recommended that all children get a booster dose between ages 4 and 6. Children 8 to 12 and teenagers who received one dose as infants but haven’t gotten the booster need to get one, research shows, because the effects can wear off and getting chickenpox later in life can have serious complications.

What new vaccines does my child need?

There are two new recommendations, one for hepatitis A and another for flu.

The flu vaccine is now recommended for children 6 months to 5 years old. A new intranasal form, approved for 2- to 5-year-olds, can be given instead of a shot. Ask about the cost difference between the two if you’re paying out of pocket, as the nasal spray is more expensive. A flu shot is also recommended for older children with chronic conditions like asthma.

The hepatitis A vaccine was initially recommended only in certain states where the incidence of the disease was high but is now recommended for all children beginning at 1 year old.

Should I get my child a thimerosal-free flu shot?

The evidence is very strong that there is no connection between autism and thimerosal, a mercury-containing vaccine preservative. But a thimerosal-free influenza vaccine for children is available.

As an adult, what shots do I need?

Nearly 50,000 Americans die of vaccine-preventable diseases each year, and 99 percent of them are adults. Adults need tetanus and diphtheria boosters every 10 years.

What if I’m pregnant?

A woman who is thinking of having a baby or who works in a health care or child care setting should ask about the Tdap vaccine against tetanus, diphtheria and pertussis (whooping cough). Adults, even those without symptoms, can spread pertussis to infants younger than 2 months, before they are vaccinated, putting them at serious risk. If you know you’re going to have a baby, the entire family and even grandparents should be up to date on their pertussis vaccinations.

Do you send reminders out about boosters or other vaccinations?

Most doctors don’t. But if they did, there would be more compliance.

Do I need the vaccine against shingles?

People who have had chickenpox are at risk for shingles as they get older. The herpes zoster vaccine protects against shingles and is approved for people 60 and older, although some doctors give it “off label” to younger adults. Many insurers don’t pay for it (it can cost up to $300), and Medicare’s coverage is spotty. Shingles can be very painful, and one in five patients have lingering debilitating pain, so immunization is highly recommended.

Do I need any other vaccines if I’m over 50?

The annual influenza vaccine is recommended for all people over 50. The pneumococcal vaccine, which protects against pneumococcal pneumonia, is recommended for people 65 and older.

What vaccine side effects should I look out for?

Vaccine Information Statements, produced by the Centers for Disease Control and Prevention, explain the benefits, risks and potential side effects of various vaccines, from anthrax to yellow fever. Federal law requires that these or similar informational statements must be handed out before certain vaccinations are given. It’s good practice to review this material to become aware of possible side effects and what symptoms to look for.

What if a bad reaction occurs?

Most reactions are not serious, but federal health officials urge vaccine recipients to help them monitor reactions by reporting to their doctors unusual symptoms like high fever, behavior changes or allergic reactions like difficulty breathing, rapid heart beat, dizziness, hives or wheezing and asking the doctors to file a Vaccine Adverse Event Report. Patients can file reports themselves through www.vaers.hhs.gov or by calling (800) 822-7967. –Source: NY Times

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