Childhood Immunizations

The importance of immunizations

Immunization is key to preventing disease among the general population. Vaccines benefit both the people who receive them, and the vulnerable, unvaccinated people around them because the infection can no longer spread through the community if most people are immunized. In addition, immunizations reduce the number of deaths and disability from infections, such as measles, whooping cough, and chickenpox.

Although children receive the majority of the vaccinations, adults also need to be sure they are already immune to certain infections and/or stay up-to-date on certain vaccinations, including varicella, seasonal influenza, tetanus, diphtheria, pertussis (whooping cough), measles, mumps, rubella, zoster, human papillomavirus (HPV), pneumococcal (polysaccharide), hepatitis A and B, flu, and meningococcal. Childhood illnesses, such as mumps, measles, and chickenpox, can cause serious complications in adults. 

About guidelines for childhood immunizations

Many childhood diseases can now be prevented by following recommended guidelines for vaccinations:

  • Meningococcal vaccine (MCV4). A vaccine to protect against meningococcal disease.

  • Hep B. This protects against hepatitis B.

  • Inactivated polio vaccine (IPV). A vaccine to protect against polio.

  • DTaP. This protects against diphtheria, tetanus (lockjaw), and pertussis (whooping cough).

  • Hib vaccine. A vaccine to protect against Haemophilus influenzae type b (which causes spinal meningitis and other serious infections).

  • MMR. This protects against measles, mumps and rubella (German measles).

  • Pneumococcal vaccine/PCV13 (pneumococcal conjugate vaccine). A vaccine to protect against pneumonia, infection in the blood, and meningitis. Another form of pneumococcal vaccine, PPSV (pneumococcal polysaccharide vaccine) is used in special conditions and in adults.

  • Varicella. This protects against chickenpox.

  • Rotavirus. This prevents infections caused by rotavirus (RotaTeq or Rotarix)

  • Hep A. This protects against hepatitis A.

  • HPV. This protects from human papillomavirus, which is linked to cervical cancer and other cancers. 

  • Seasonal influenza. This protects against different flu viruses.

A child's first vaccination is given at birth. Immunizations are scheduled throughout childhood, with many beginning within the first few months of life. By following a regular schedule, and making sure a child is immunized at the right time, you are ensuring the best defense against dangerous childhood diseases.

Reactions to immunizations

As with any medication, vaccinations may cause reactions, usually in the form of a sore arm or low-grade fever. Although serious reactions are rare, they can happen, and your child's doctor or nurse may discuss these with you before giving the shots. However, the risks for contracting the diseases the immunizations provide protection from are higher than the risks for having a reaction to the vaccine.

Treating mild reactions to immunizations in children:

  • Fussiness, fever, and pain. Children may need extra love and care after getting immunized. The shots that keep them from getting serious diseases can also cause discomfort for a while. Children may experience fussiness, fever, and pain at the immunization site, after they have been immunized.

  • Fever. Fever is part of your child’s immune response to the vaccine, so as long as your child is not extremely uncomfortable, it is best not to treat the fever. To keep your child comfortable: 

    • Give your child plenty to drink.

    • Clothe your child lightly. Do not cover or wrap your child tightly.

    • Sponge your child in a few inches of lukewarm (not cold) bath water.

You can find out more about fevers on this Q&A, offered by CHOP’s Vaccine Education Center.

  • Swelling or pain. Swelling and pain at the injection site is also caused by the immune response to the vaccine. These are the result of the changes in the area of the vaccination site as immune system cells travel to the site to respond to a perceived germ. A clean, warm washcloth may be applied over the sore area as needed for comfort.

Aspirin and the risk for Reye's syndrome in children 

Aspirin should not be given to children or teenagers because of the risk for Reye's syndrome, a rare but potentially fatal disease. Therefore, pediatricians and other healthcare providers recommend that aspirin not be used to treat any fever in children.

If more serious symptoms occur, call your child's doctor right away. These symptoms may include:

  • Large area of redness and swelling around the area where the injection was given. The skin area may be warm to touch and very tender. There may also be red streaks coming from the initial site of the injection.

  • High fever

  • Child is pale or limp

  • Child has been crying incessantly

  • Child has a strange cry that is not normal (a high-pitched cry)

  • Child's body is shaking, twitching, or jerking

Reviewed by Paul A. Offit, MD

Next Steps