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HOUSE CALL: Answers about vaccines for children and adults

 

Parents often ask me about vaccines, why and if they are needed and how many shots should be given at a time. Here are my answers to the most-asked questions.

Q: How many diseases should babies be vaccinated against?

A: They should be protected against 14 diseases. Thanks to the development of combination products, they shouldn't have to receive more than three shots at any given time.

Q: Is it OK to space them out so they don't get so many in such a short period of time?

A: Not really. The schedule was designed in a way that maximizes protection and minimizes risk of infection. Any deviation from the schedule places the infant at greater risk of contracting a potentially fatal infection!

Q: What about vaccines and autism? 

A: There is no credible evidence that vaccines have anything to do with autism. The original research which suggested a possible link with the MMR vaccine has been discredited.

Q: Does my child really need vaccines if everybody else is getting them?

A: Yes. The power of vaccines is enhanced by what we call "herd immunity." If a very high percentage of children are vaccinated, then the germs can never get a chance to spread. If too many children are not protected, the herd immunity doesn't work and breakouts occur. This has been a problem with measles in Europe and is now spreading to the United States.

Q: My child got a flu shot but got the flu anyway. Are vaccines all that good?

A: No vaccine (or medication of any sort) is perfect. The influenza virus sometimes mutates during a season, so the shots aren't as effective as hoped. Flu shots usually do provide protection and save thousands of lives every year. The same is true with the chicken pox vaccine. Some children still get a milder case of pox. Over all, the vaccine has nearly eliminated death from chicken pox.

Q: Are vaccines just for kids?

A: No. Adults should receive several vaccines, depending on age and health status. There has been an outbreak of pertussis (whooping cough) in the St. Louis area over the last few years. Adults should get the vaccine (Tdap), especially if they are around babies who are especially susceptible. I recommend vaccines against Hepatitis A, as well, because Hepatitis A is the most common vaccine-preventable cause of death among American adults. Other adult vaccines help prevent shingles, pneumonia and the flu.

Joel S. Koenig, MD, is a board-certified pediatrician and neonatologist who serves as chief of pediatrics at Missouri Baptist Medical Center and as professor of clinical pediatrics at Washington University. He received his medical degree from Yale University and Vanderbilt Medical School and completed his residency in pediatrics in newborn medicine at St. Louis Children's Hospital


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