Friday, April 18, 2014
Inquirer Daily News

Vaccines and Medications

POSTED: Monday, March 31, 2014, 9:30 AM

Looking for a resource that has all you need to know about vaccines from a trusted source? The Vaccines on the Go: What You Should Know app from The Vaccine Education Center at The Children's Hospital of Philadelphia offers a breadth of information on vaccines in an easy navigable format.

The app includes information about:

  • Vaccines and the diseases they prevent, along with potential side effects
  • Vaccine safety topics, including autism, vaccine safety monitoring systems, and too many vaccines
  • Types of vaccines and how they’re made
  • Recommended immunization schedules for children, teens and adults

You can also find a list of vaccine-related videos, such as vaccines for babies, and human papillomavirus and the HPV vaccine.

POSTED: Monday, March 24, 2014, 10:16 AM
Allen Smith, 21, from West Hollywood, Calif., gets a free vaccine against bacterial meningitis at the AIDS Healthcare Foundation in West Hollywood, Calif., Monday, April 15, 2013. (AP Photo/Damian Dovarganes)

Bacterial meningitis is a contagious and potentially lethal infection. Recent cases at Princeton and Drexel universities and the infection of an 8-year-old Collegeville elementary school student have raised concerns about the disease across the area. I hope to provide anxious parents with some understanding of the nature of this disease and its spread.

Historically, three species of bacteria accounted for the vast majority of cases of childhood bacterial meningitis: Hemophilus influenzae type b, Streptococcus pneumoniae, and Neisseria meningitides.  The advent of modern vaccines has eliminated the disease caused by the first two bacteria for the most part.  Neisseria meningitides remains as the most common cause of disease among healthy children and adolescents in the United States.

The disease is spread by respiratory secretions. While the disease is contagious, the attack rate is relatively low. Among household contacts of individuals with meningococcal disease, secondary cases appear at a rate of 2 to 4 in 1,000 household contacts. Children under 5, adolescents and young adults, and the elderly are the groups at highest risk for infection. Most cases occur as single instances, but outbreaks of the disease do occur, often on college campuses or in military barracks.

POSTED: Monday, February 3, 2014, 6:00 AM
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Pregnant teens should receive the Tdap vaccine for each pregnancy to protect themselves and their babies against tetanus, diphtheria and pertussis, preferably during week 27 through week 36 of gestation, regardless of time since previous Td or Tdap vaccine, according to new vaccine recommendations released last week.

Each year, the American Academy of Pediatrics, the American Academy of Family Medicine and the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, and the American College of Obstetricians and Gynecologists release up dated recommendations and schedules for routine vaccinations of children aged 0 to 18 years of age. 

The combined recommendations this year cover 14 separate vaccine preparations that provide protection for 17 separate diseases. Some of these immunizations, such as the diphtheria, tetanus and polio, have been available for decades. Other vaccines such as those for human papillomavirus (HPV) and rotavirus are relatively new to the vaccine schedules. The recommended changes vary from year to year. 

POSTED: Tuesday, December 24, 2013, 6:00 AM
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If you're holding out on getting your child vaccinated for the flu because of an egg allergy, you might not need to! In general, almost all egg-allergic patients can receive the vaccine, after evaluation by an allergist.

Most flu vaccines contain a small amount of egg protein. There is sometimes anxiety about administering the flu vaccine to people who are allergic to egg, especially children and pregnant women. Some primary care providers prefer not to give the vaccine in these cases.

With the administration of the vaccine, there is a consent form asking about egg allergy. The Centers of Disease Control and Prevention recommends everyone get the vaccine, and that those with egg allergy be observed for 30 minutes after it’s given to make sure there is no reaction. In general, if a past reaction was severe, this observation should be completed in an allergist’s office. If the reaction was mild, the primary care provider may be able to give the vaccine and observe the patient.

POSTED: Wednesday, November 27, 2013, 6:00 AM
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Influenza immunization season is here. Between mid-September and New Years’ Day is the prime time to attempt to prevent the flu. People have more myths about “flu shots” than about almost any other medical procedure and certainly more than any other pediatric treatment.  The “flu shot,” which is killed vaccine, has been shown in carefully controlled studies to cause almost no side effects.  Some people (less than 30 percent) do get a very sore arm for a few days, but that is about it. 

Many people will tell you that I got a flu shot and “it made me sick, I had the flu ” because immunization is given during the time when the most people get ill from other viruses. When compared to a similar group who did not take the influenza immunization, there was absolutely no increase in illness in the vaccinated group.  But this time of year, we get primarily ill a lot from our loved ones such as our children in school and when you get ill near when you get a shot, you blame it on the shot. 

Flumist, the nasal influenza vaccine, is also very safe, but it will very rarely give the vaccinee a mild case of the flu since it is a live vaccine.  This is very uncommon, but does happen.  Since it is a live vaccine, it is not recommended in patients with asthma or if someone who is immune-suppressed, such as someone on cancer chemotherapy,  is living in the same house. The advantage of nasal flu over killed flu vaccination is that there is no shot in nasal flu.

POSTED: Monday, September 30, 2013, 9:44 AM
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Vaccine refusal played a role in the large whooping cough outbreak of 2010 in California, found a study released today online from Pediatrics. That year, 9,120 cases of whooping cough were reported in California, the most since 1947.

In March, I wrote a blog about whooping cough, also known as pertussis.  The impetus for that blog was new data that had emerged regarding that California outbreak. Evidence available then suggested that waning immunity associated with the new acellular pertussis vaccine may have contributed to the outbreak.

Unlike many states, California requires only a parent’s signature on a form to permit a child to enter school without vaccinations.  The state keeps a record of these non-medical vaccination exemptions (NMEs). In California, pertussis is a disease that must be reported to the state health department. The authors of this study examined geographic clusters of NMEs and geographic clusters of pertussis cases to see if the clusters overlapped. The authors found that:

  • The average rate of NMEs per census tract in California averaged 2 percent between 2005 and 2010
  • 39 census tracts within the state had NME rates that were significantly higher than the rates seen in the remainder of the state
  • The odds of finding a cluster of pertussis cases within one of these census tracks with high rates of NMEs were 2.5 times higher than the odds of finding a cluster of cases in the remaining census tracts; this difference remained after the results were adjusted for a number of demographic factors.
POSTED: Monday, September 2, 2013, 12:05 AM
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Once again, school has begun and our thoughts turn to one thing…the flu.  Every year, the world is treated to this wintertime malady and health policy officials along with pediatricians urge parents to protect their children through vaccination. This annual ritual raises a lot of questions. The Academy of Pediatrics released its flu vaccination recommendations online today for this year’s flu season.

Here are some commonly asked questions about the upcoming flu season and vaccination:

Most vaccines are given at infrequent intervals.  Why does my child have to receive a flu vaccine every year?

POSTED: Wednesday, August 28, 2013, 6:00 AM
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Today's guest blogger is Joanne Sullivan, the executive director of the Pennsylvania Immunization Coalition.

Considering it is one of the greatest marvels of medicine – the ability to inoculate human beings against deadly diseases – it’s hard to believe it’s necessary to designate any month of the year as National Immunization Awareness Month.

However, here we are, in August, recognizing and raising awareness of the importance of vaccines.

About this blog
The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Stephen Aronoff, M.D., M.B.A. Temple University Hospital
Christopher C. Chang, M.D., Ph.D Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Mario Cruz, M.D St. Christopher’s Hospital for Children, Drexel University College of Medicine
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist - The Anxiety Behaviors Clinic, CHOP
Gary A. Emmett, M.D. Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Lauren Falini Bariatric exercise physiologist, Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Crozer-Keystone Health System
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, RD Children's Hospital of Philadelphia
W. Douglas Tynan, Ph.D. Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Flaura Koplin Winston, MD, PhD Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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