Q. My child cried inconsolably for three hours after she received the DTaP vaccine. Is it safe for her to receive another dose at her next appointment?
A. Because your baby experienced a reaction to the vaccine, it’s important to be sure your child’s doctor is aware of this and it is added to her medical record. The reaction your daughter experienced is considered to be a “precaution” to getting future doses of the vaccine, meaning that she can still receive future doses of the DTaP vaccine; however, the relative risks and benefits should be discussed with your child’s doctor before the vaccination is given.
Because pertussis, in particular, is circulating in many parts of the country and young infants are most susceptible to complications from the disease, you might still conclude that the relative benefits of the vaccine outweigh the risks. Previous experience has shown that in most cases, infants who experience inconsolable crying after the first dose of DTaP do not experience the same reaction after subsequent doses.
Over the past weeks we’ve received some questions about the influenza vaccine that might also be helpful for you to know the answers to.
Q. Are there risks of influenza from the nasal spray vaccine entering the brain and causing an infection like encephalitis?
A. Even during influenza infections, encephalitis is not a complication because influenza viruses are not able to reproduce in brain cells. In addition, the way the intranasal influenza vaccines works is that the virus reproduces a small number of times in the cooler temperatures of the nasal passages, but cannot reproduce in the warmer temperatures in the lungs, which is where influenza viruses typically reproduce and cause infection. It is not likely that the virus would enter the brain; however, because the virus can only grow at the cooler temperatures of the nose, in the same way that it cannot reproduce in the lungs, it would not be able to reproduce in the brain either.
Q. I am wondering whether or not to give my child the flu vaccine because my grandfather died in his 20s from Guillain-Barré syndrome.
A. The risk of a child dying from influenza is greater than the risk of developing Guillain-Barré syndrome (GBS). Influenza deaths happen in a number of children every year, and Guillain-Barré syndrome has not been shown to be caused by the influenza vaccine. Here is some additional information:
Q. When is the best time for me and my family to receive the influenza vaccine?
A. Influenza season can start as early as the fall, so the American Academy of Pediatrics (AAP) recommends receiving the influenza vaccine as soon as it is available. Because it takes about two weeks after receiving the vaccine for you to be fully protected, it’s important to get the vaccine early. This is especially important for children and adults with higher risk of suffering complications from influenza.
People at increased risk of experiencing complications include young children, pregnant women, adults 65 years of age and older, and individuals with underlying medical conditions, such as chronic heart, lung and kidney conditions.
Q. I feel like the flu vaccine doesn’t work because every year I still get the flu even though I was vaccinated.
A. Influenza vaccine protects against three or four influenza viruses expected to circulate during influenza season. However, two other factors should be considered.
First, some years the vaccine strains are not as good of a match with the circulating strains as we would like. In these cases, people who were vaccinated may still get influenza. For most of them, their disease will be less severe and shorter than if they had not been vaccinated.
Second, during the period when influenza is common, many other viruses are also circulating. Often these viruses cause colds and other illnesses that cause flu-like symptoms, such as congestion, runny nose, sneezing, coughing, sore throat, vomiting, nausea and diarrhea. Sometimes people with these symptoms will attribute them to influenza even though the virus is not to blame for the illness.
Have you ever had a question about vaccines, but didn’t have time get to the computer? If so, we have great news! You can now send the Vaccine Education Center your questions whenever you’re on the go. Our Vaccines on the Go: What You Should Know app includes an “Ask the VEC” button at the bottom of the page in the following sections of the app: “Vaccines,” “Safety” and “About Us.”
Q. I have a trip to Europe planned but am worried about the measles and rubella outbreaks happening there. Should I postpone my trip?
A. Although the U.S. Centers for Disease Control and Prevention (CDC) has not issued measles-related travel alerts at this time, they have issued rubella-associated travel alerts for people who are traveling to Japan and Poland. The CDC recommends travelers to Japan and Poland practice enhanced precautions and make sure they are immune to rubella prior to traveling. Pregnant women who are not immune to rubella (either by previous rubella vaccination or infection) should not travel to Japan or Poland during these outbreaks.
If traveling to a country where measles or rubella outbreaks are occurring, the following precautions should be taken:
All travelers should also be mindful of their health during travel and in the days and weeks after travel. If you develop a fever or serious illness, contact your healthcare provider immediately and be sure to mention your recent travels.
Q. My child has autism and I have read that giving probiotics before vaccines will help protect him from further neurologic damage caused by vaccines. Is this true?
A.Your question is most easily addressed in two parts:
Vaccines have not been found to damage the neurologic systems of children with or without autism, so parents of children with autism can take comfort in these findings.
Probiotics are a type of bacteria that typically reside in the digestive tract where they help with digestion and might provide protection from disease-causing bacteria. Because some children with autism experience gastrointestinal issues, parents sometimes wonder about giving probiotics. Our best evidence related to the use of probiotics is from studies of children who recently took oral antibiotics. Because antibiotics kill indiscriminately, some doctors and scientists wondered whether giving probiotics would help restore the normal bacterial environment in the intestine after use of antibiotics. To date, the data do not strongly support this.
While some evidence exists that it may work, a review of studies related to this topic (published in the Journal of the American Medical Association [JAMA] in May 2012) found that many of the studies supporting this notion were poorly designed. Further, most of the studies did not consider or comment on the known negative effects related to the use of probiotics, such as bloodstream infections or endocarditis.
Q. My son is traveling abroad for a school trip. How can I find out if he needs any vaccines?
A. Depending on your son’s destination, he may need to receive vaccines or travel medications prior to leaving. Typically, routine vaccinations, such as Tdap, MMR, polio, hepatitis A, hepatitis B, chickenpox, pneumococcus, Haemophilus influenzae type b (Hib), meningococcus and influenza should be up to date before traveling. In addition, you should consider taking your son to a travel clinic well in advance of the trip, so any additional vaccines or travel needs can be addressed.
Q. Why does my baby need to get a dose of hepatitis B vaccine shortly after birth if I know that I’m not infected with the virus?
A. Although many babies infected with hepatitis B are exposed while passing through the birth canal of an infected mother, some can become infected through exposure to small quantities of blood from an infected person, such as on a toothbrush, washcloth or razor. Because the quantities of blood capable of transmitting the virus can be miniscule and because many children do not suffer symptoms of infection, children can be unknowingly infected. In fact, before the hepatitis B vaccine was routinely recommended, about 16,000 children less than 10 years of age were infected with the virus every year. If infected with hepatitis B, children are more likely to suffer long-term infection, liver damage and liver cancer. Because many people do not know they are infected, it’s difficult to protect children from every situation that may expose them to the virus. For these reasons, babies are given three dose of hepatitis B vaccine, with the first dose given shortly after birth.
Q. My baby is going for her two-month well visit in a few weeks. What vaccines will be given and how can I prepare for the upcoming visit?
A. During your baby’s two-month well-child visit, she will likely receive vaccines to prevent diphtheria, tetanus, pertussis, Haemophilus influenzae type b, rotavirus, pneumococcus, polio and hepatitis B. While this seems like a lot of shots, several of these may be offered as combination vaccines and the rotavirus vaccine is given orally.
You’re already getting prepared by finding out what to expect and learning about the vaccines and diseases they prevent. If you need additional information, check the “A Look at Each Vaccine" pages on our websites.
You should write down any questions you have for the doctor. If you are comfortable with your decision, your baby will respond to your mood and be more relaxed. You can also help your baby by bringing her favorite toy or blanket to the appointment. Some moms also find that holding or feeding the baby during shots helps the baby be more comfortable.
Q. Why are multiple doses of vaccines necessary?
A. Vaccines can require multiple doses for a number of reasons. First, certain types of vaccines, such as those made with purified proteins or inactivated toxoids, provide more complete protection after a person receives more than one dose. Second, immune responses sometimes weaken, so additional doses may be necessary so that people can respond readily to invading viruses and bacteria.
Q. My friend is not having her children immunized. I am going to be having a baby soon. Is it safe to allow my baby to be around them?
A. Any time your baby is around other people, he or she could be exposed to viruses or bacteria. Because your friend’s children are not immunized, they will be more susceptible to the dangerous childhood illnesses that are commonly kept at bay because of high levels of immunization. Therefore, you may want to limit your baby’s exposure to these children, especially if they are ill.
As your baby is immunized, he or she will be less likely to get the diseases against which she was vaccinated. However, because vaccines don’t always afford complete protection, it will still be important to remain vigilant.
In recognition of “Cervical Cancer Awareness” month, this edition of “Ask the VEC” features the question and answer page from our Prevent HPV campaign.
Go to www.prevent-HPV.com to ask a question or see what others are asking about HPV and the vaccine.
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