The Importance of Immunizations

with George Frommell, M.D., Pediatrician, Advanced Healthcare

Posted: July 1, 2004

Thanks to immunizations, the world is free from smallpox, and polio is not the ever-present worry to American parents as it was before an effective vaccine was discovered in 1955.

To eradicate polio and other potentially fatal diseases from the world, parents need to immunize their children, explained George Frommell, M.D., a pediatrician with Advanced Healthcare.

Children who are not immunized can serve as potential harbors for that disease, putting themselves and others at risk. In addition, the ease of international travel means that diseases cross borders, spreading to unvaccinated Americans.

George Frommell, M.D., Pediatrician, Advanced Healthcare "The ultimate goal of immunizations, according to the American Academy of Pediatrics, would be the eradication of a specific disease, and the immediate goal would be to prevent this disease in individuals."

What is a vaccine?
Vaccines contain weakened forms of specific diseases that, in their unadulterated states, could kill or cripple. The vaccines stimulate the body’s immune system, which produces antibodies which are able to attack the virus or bacteria. If the child is exposed to the disease at a future point, he or she will have the antibodies necessary to fend it off.

With some vaccines, one dose is enough to provide immunity to the disease. Others, said Dr. Frommell, require that children receive booster doses.

“All the immunizations have a failure rate,” he said, “and that’s why booster doses are given.”

In most cases, the immunizations and boosters are enough to provide the necessary protection. Where they are not, he said, children remain at risk for diseases. That’s why it’s particularly important that all children be immunized – the more who are, the less chance there is that a particular disease will be around to be contracted.

While there are some risks associated with vaccines, Dr. Frommell said that the benefits far outweigh them.

“These diseases are much worse,” he said, “and they lead to many more deaths than if the vaccines were not available.”

Today’s immunizations
Children in the United States are immunized against hepatitis B; diphtheria, pertussis, tetanus (given as a single shot and called DTaP), haemophilus influenza B (HiB); polio; measles, mumps, rubella (given as a single shot and called MMR); pneumococcus (can cause meningitis, pneumonias, blood poisoning and ear infections); and varicella (chickenpox).

Side effects from immunizations are generally minimal, Dr. Frommell said, and may include a mild fever, possible soreness or redness at the injection site, and/or irritability.

In the 27 years since Dr. Frommell began his practice, he’s seen a number of changes in the number and quality of immunizations.

“There was no vaccine against HiB, pneumococcus or chickenpox, Hepatitis B was available but not given to newborns, the DPaT has replaced the DPT, and we changed from the live to the inactive form of the polio vaccine,” he said.

Those changes are important, he said. The original DPT vaccine had potentially serious side effects, due to the pertussis, or whooping cough, component of the vaccine. Those included high fevers, possible seizures and high-pitched crying that persisted for more than three hours. The acellular pertussis vaccine has greatly diminished those rare side effects.

The live polio vaccine, which was given by dropper or on a sugar cube, was effective for most people. But infants or caregivers with depressed immune systems were at risk, and six to eight cases of vaccine-related polio per year were reported regularly. The inactivated polio vaccine, given by injection, has eliminated that situation.

In the five to seven years since the pneumoccus immunization has been around, Dr. Frommell said that meningitis and the blood disease related to this bacteria has dropped dramatically. The same goes for HiB, a bacteria which causes meningitis in infants and children. That vaccine was first introduced about 20 years ago.

Hepatitis B is transmitted in the same way as AIDS. Dr. Frommell said the decision was made to immunize children while they were young in order to prevent them from susceptibility to the disease in adolescence or adulthood.

Regarding chickenpox, too many people mistakenly consider it a benign disease, Dr. Frommell said.

“Children are still dying from chickenpox,” he said. “The main complication is a secondary bacterial infection with streptococcus or staphyloccus, and these are very serious infections and frequently lead to death.” For this reason, he cautions parents against voluntarily exposing their children to chickenpox.

The immunization schedule
Immunizations are given based on a schedule recommended by the American Academy of Pediatrics. The Web site www.cdc.gov/nip/ offers a current schedule of recommended immunizations.

While it’s advised that children receive their immunizations within the suggested time frame, Dr. Frommell said it was understood that there are situations in which that’s not possible.

“People adopt children from foreign countries,” he said, “and the vaccine information supplied to the adoptive parent may or may not be accurate.”

In some situations, illness may preclude a child receiving his or her vaccines on schedule.

“If the infant or child is running a high fever, has an ear infection or some moderate to severe illness, the vaccine should be postponed until the child gets well,” he said. “It can be given, though, if the child has a mild cold or upper respiratory illness without any serious problems.”

We Have Answers Do you have medical questions or need help finding a doctor? The experts at Columbia St. Mary's and Advanced Healthcare can help. Click here.