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CDC Immunization Schedule

CDC Recommended Vaccine Schedule (age: 0-6 years)
CDC Recommended Vaccine Schedule (age: 7-18 years)
CDC Recommended Vaccine Schedule (Adults)
Virginia Pediatric Group AAP Vaccination Schedule (our schedule for AAP Vaccines.)


SHOULD I VACCINATE MYCHILD?
WHAT IS IN VACCINE?
DO CHILDREN STILL GET THESE DISEASES?
ARE THESE DISEASES REALLY SERIOUS?
HOW ARE VACCINES TESTED?
ARE THERE LONG-TERM EFFECTS OF VACCINES?
WHAT ABOUT AUTISM?
WHAT ABOUT MERCURY IN VACCINES?
CAN VACCINES "OVERLOAD" MY CHILD'S IMMUNE SYSTEM?
WOULD MY CHILD GETA DISEASE IF NOT VACCINATED?
UNDERSTANDING THE MMR CONTROVERSY: THE STORY BEHIND Dr. WAKEFIELD

More information on vaccines and vaccine safety

SHOULD I VACCINATE MY CHILD?
Because most vaccine preventable diseases are so uncommon in the United States, it can be hard to understand why we need to keep vaccinating our children. In addition, it seems every few months the news media is reporting that vaccines can cause serious side effects. Parents like you want to protect your children from harm, but without all the information it can be hard to decide whether or not to have your child vaccinated. Your doctors at Virginia Pediatric Group believe children should be vaccinated. Here’s why: 1) these diseases still exist in the world, and your child could come in contact with them through people moving to your community or people who have traveled to other parts of the world, 2) these diseases can cause severe illness in some children, and 3) if infected with a disease, your child could pass it on to others, which could cause them serious illness as well. We understand that you may have questions about the safety of vaccines for your child. This brochure will provide you with answers to some common questions, as well as books, medical journals, and websites where you can find more information.
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WHAT IS IN VACCINE?
Vaccines are made with actual disease bacteria or viruses that are either killed or weakened. Vaccines produce long-lasting immunity from disease without making your child sick. Vaccines work the same way as a natural infection. The body reacts to viruses or bacteria in vaccines by making antibodies. An antibody is a special kind of protein made by white blood cells that fights infections. Antibodies are disease specific, so a child who has a polio vaccination, but not a chickenpox vaccination, has antibodies to fight polio, but not chickenpox. The body will use these antibodies to fight off the disease if it ever enters the body again. Vaccines also contain other ingredients, called additives. These additives are there to keep vaccine ingredients stable from changes in temperature or environment. These additives are safe, although very rarely they can cause serious allergic reactions in some people. Different vaccines contain different additives. For detailed information on the additives in each vaccine, ask your doctor or pharmacist for a list of the ingredients found in the vaccine package materials. You can also find most of these “package inserts” online at: http://www.vaccinesafety.edu/package_inserts.htm.
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DO CHILDREN STILL GET THESE DISEASES?
Yes. Since these diseases still occur in other parts of the world, and because the world becomes smaller each day due to international travel, vaccine preventable diseases can be spread due to people traveling or moving to your community. A recent study in Colorado showed that unvaccinated kids were 22 times more likely to get measles and 6 times more likely to get whooping cough than vaccinated kids.
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ARE THESE DISEASES REALLY SERIOUS?
Yes, for some children the diseases can be very severe. Chickenpox, measles and whooping cough can cause serious harm like deafness, brain damage, and even death. In 1990-1991 in Philadelphia, a measles outbreak resulted in over 1,500 cases and nine deaths when vaccination coverage in the city decreased.
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HOW ARE VACCINES TESTED?
Vaccines go through three phases (levels) of testing in people before they are licensed for nationwide distribution. Studies in people take place only after the vaccine has been tested in a laboratory and then tested in animals. Animals are used because their immune system is similar to people. Tests on animals help predict the effect on people. Each test phase is reviewed by the Food and Drug Administration (FDA) to make sure that every vaccine is safe and effective. The three phases are briefly described below. The people receiving the vaccine are closely monitored for their safety during all three test phases.

After the series of studies is complete,
FDA scientists must review and approve the: 1) study results, 2) package insert materials, and 3) manufacturing plans. FDA may then conduct more tests of the vaccine in its laboratories. Next, FDA inspectors make sure that the manufacturing plant is able to produce the vaccine properly. All of this is done before the vaccine is licensed for the public. This license covers both the vaccine and the manufacturing plant. When the vaccine is in production, the FDA requires the company to test samples from each lot (batch) for safety, potency, and purity. FDA also carries out its own spot testing. The entire process – from reviewing the study results to FDA spot testing – is required for all companies that make vaccines. For more on what happens after the vaccine studies, visit the FDA website at
http://www.fda.gov/opacom/factsheets/justthefacts/19vaccine.html

Post licensure safety
The Vaccine Adverse Event Reporting System (VAERS) monitors vaccine safety after the vaccine is licensed by the FDA. VAERS receives reports on side effects following vaccinations.
The VAERS employees at the FDA and the CDC use the information to make sure known side effects do not increase and new or very rare side effects are detected. Drug companies that manufacture vaccines also conduct ongoing studies to assess the effectiveness of vaccines. These studies are required as part of the vaccine’s license. For more information on vaccine testing and licensure, see the FDA’s website at: www.fda.gov/cber/vaccine/vacappr.htm
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ARE THRE LONG-TERM EFFECTS OF VACCINES?
Some parents are concerned that vaccines can cause long-term autoimmune disorders, such as asthma, multiple sclerosis, or diabetes. Well-designed epidemiologic studies have shown no relationship between these chronic diseases and vaccines.  It is true that there have been examples of vaccines causing serious health problems. For example, the oral polio vaccine, which is no longer used in the U.S., very rarely caused polio. In 1976, the flu vaccine was associated with an increase in Guillain-Barre syndrome. Also, in rare circumstances; vaccines have caused serious side effects like seizures and allergic reactions. It’s important to consider both the risks and benefits when making decisions about vaccines for your child. It is true that, as with any medicine, there are risks of side effects from vaccines. However, most of these side effects are mild, and only very rarely are they life-threatening.
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WHAT ABOUT AUTISM?
In 1998, British doctors published a report of a group of eight children who had developed autism after receiving the measles-mumps-rubella (MMR) vaccine. They proposed that the vaccine had caused the children’s intestines to leak toxins into the bloodstream which damaged brain tissue, causing autism. In 2010, Britain’s General Medical Council ruled that these doctors had acted “dishonestly and irresponsibly” in conducting this research.  The journal (Lancet) retracted the report, but not before it drove a mass hysteria that resulted in people refusing MMR vaccination to the point where it has become a significant public health problem in the U.K. where it had been nearly eradicated.  There have been a number of scientific studies refuting any causal association between MMR and autism and it is clear that, although it would be convenient to have a something so straight-forward to blame it on, it is not the cause.  Separating the vaccine components has no purpose or benefit.

There have also been assertions that mercury in vaccines (thimerosal) was a cause of autism.  Numerous studies have, as well, shown not to be true.  In fact, any trace of mercury has been absent from nearly all pediatric vaccines since 2001.  Quite simply, the theory of vaccine-related causation is scientifically unsupportable.

Autism continues to be an enormous public health issue in this country and elsewhere around the world. In the U.S. it affects an estimated 1 in 100 births and is growing at a rate of 10-17% year. It is easy to understand why parents of affected children would welcome news about the cause and prevention of this debilitating disorder. But over the last decade we have seen scarce resources squandered on study after study disproving the connection between vaccines and autism and disproving questionable treatments like extreme diets and chelation therapy.

For more information on this topic:
CDC http://www.cdc.gov/vaccinesafety/concerns/mmr_autism_factsheet.htm
Vaccine Center at the Children’s Hospital of Philadelphia http://www.chop.edu/vaccine

You can also read both the 2001 and 2004 Institue On Medicine (IOM) reports on MMR vaccine and autism  http://www.iom.edu/project.asp?id=4705 .
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WHAT ABOUT MERCURY IN VACCINES?
Mercury is a common metal that is found throughout the environment in different forms (for example, methyl mercury is an environmental contaminant found in fish). Thimerosal, which contains 49% ethyl mercury, was used as a preservative in some vaccines from the 1930s until 1999. In June of 1999, the FDA announced that infants who received several thimerosal-containing vaccines in the first few months of life could be exposed to mercury levels that are higher than recommended. In July of 1999, the Public Health Service and the American Academy of Pediatrics recommended that thimerosal be taken out of vaccines as a precautionary measure and to reduce overall mercury exposure in children. Thimerosal has been removed from all vaccines, except for some types of flu vaccine. Even though it is still present in trace amounts in some vaccines, these trace amounts are too small to have any biologic effect. For a list of which vaccines used to contain thimerosal, and when thimerosal was removed from each vaccine, visit the FDA website http://www.fda.gov/cber/vaccine/thimerosal.htm .

It has been suggested that mercury in vaccines may have caused autism in some children. Several scientific studies have been unable to prove this link.  For example, thimerosal was removed from childhood vaccines in Denmark 10 years ago, yet autism cases have continued to rise there.  In 2004 the IOM, an independent, nonprofit organization that reviews important health topics for the U.S. government, reviewed the evidence on this issue. The IOM concluded that there is no association between autism and thimerosal containing vaccines. (see link above under “What about autism?”) Nonetheless, some parents and scientists continue to have questions about a possible association and CDC is currently conducting a more detailed study of thimerosal-containing vaccines and autism.
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CAN VACCINES "OVERLOAD" MY CHILD'S IMMUNE SYSTEM?
The number of vaccines given to children has increased from 5 forty years ago to 11 today. A fully vaccinated child will receive as many as 20 separate shots by their second birthday.  See the childhood and adolescent vaccine schedule recommended by the CDChttp://www.cdc.gov/vaccines/recs/schedules/child-schedule.htm. It’s no wonder that many parents worry their child’s immune system will be overwhelmed by having to handle so many vaccines. However, an infant’s immune system is designed to respond to a very large number of antigens (foreign proteins that cause an immune system response), and babies are constantly exposed to new antigens from the moment they’re born in the food they eat and the air they breathe. For instance, if all 11 vaccines were given to an infant at once, only about 0.1% (one tenth of one percent) of their immune system would be “used up”.   Put another way, it would take 10,000 vaccines given at the same time before a child’s immune system would be overwhelmed. Another point to consider is that, even though children receive more shots today, the number of antigens in those shots has actually gone down over the years. When children received the smallpox vaccine, they were exposed to about 200 different proteins. Now that children no longer need smallpox vaccine, they receive less than 130 proteins from all 11 recommended vaccines combined. The number of proteins has also been reduced because of better technology in vaccine production.
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WOULD MY CHILD GET A DISEASE IF NOT VACCINATED?
He may or may not. If an unvaccinated child were exposed to the disease, there is a good chance he would get the disease. However, if your child is not exposed, due in large part to “community immunity,” he would not get the disease. If enough people in the community are immunized against certain diseases, then it is more difficult for that disease to get passed from person to person. Community immunity also protects people who are too sick or too young to receive the vaccine, or people who have received a vaccine that didn’t produce an immune system response.
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