June 22, 2011 - The back-to-school bell will be ringing before you know it across much of Georgia, particularly as many school systems now observe a year-round calendar schedule. Some students will return to class as early as August 1.

August is also National Immunization Awareness Month and the Georgia Association of Physician Assistants (GAPA) wants to remind parents to be sure their children’s immunizations are up-to-date. It’s an important item that should be at the top of every child’s back-to-school list.

“Why should parents immunize their children? Vaccines help prevent infectious diseases and save lives,” said Ben Taylor, PA-C, PhD. Taylor is GAPA’s public information chair and works in multiple emergency departments in Georgia and South Carolina. “It is always better to prevent a disease than to treat it. Vaccines prevent disease in the people who receive them and protect those who come into contact with unvaccinated individuals.”

Taylor explained that infant and childhood immunizations are responsible for nearly eliminating many diseases that once killed thousands of children each year in the United States. Vaccine-preventable diseases have a costly impact, resulting in increased doctor visits, hospitalizations and premature deaths. Plus, sick children have to stay home, which means a parent often loses time from work.

“We don't vaccinate just to protect our children,” Taylor continued. “We also vaccinate to protect our grandchildren and their grandchildren. Our children don't have to get smallpox shots anymore because the disease no longer exists. If we keep vaccinating now, parents in the future may be reassured that diseases like polio and meningitis won't infect, cripple or kill their children.”

The advent of immunizations is one of the most significant public health achievements of the 20th century. Vaccines have eradicated smallpox, eliminated wild poliovirus in the US, and significantly reduced the number of cases of measles and other diseases.

“Many of us may remember or still have a family member who was affected by a vaccine-preventable illness,” observed Taylor. “Perhaps it was an uncle who had testicular problems after getting the mumps, a cousin who suffered from the disabling effects of polio, or an aunt who died from Hib meningitis or measles. But it is extremely unusual to come across a child today who has a vaccine-preventable illness such as polio, measles or diphtheria.”

Many such infections have been eradicated in the US, and there are even some (younger) physicians who have never seen some of those illnesses. The Centers for Disease Control (CDC) has determined that Rubella (German measles) is no longer be considered a “major public health threat” in the United States. But still, tens of thousands of Americans die each year from vaccine-preventable diseases.

Not long ago a measles outbreak in Utah sent a number of students and teachers to be quarantined in their homes. That state’s law does not require children to be immunized and they can get an exemption from health officials. But if there is an outbreak of a disease in the school, then those affected are required to stay home. Two to three percent of students in the affected schools were not immunized and became at-risk or affected by the outbreak and quarantine.

Every year, the CDC’s Advisory Committee on Immunization Practices publishes a new schedule showing which vaccines are recommended and when to get them. This schedule is endorsed by the American Academy of Pediatrics and the American Academy of Family Physicians. All 50 states require some immunizations for school entry (typically for kindergarten, seventh grade and college). However, parents can elect to exempt their children from immunizations. There are three types of exemptions:

•    Medical exemptions are for children who have a valid medical contraindication to a vaccine or vaccine component (e.g., history of anaphylaxis to a previous dose of vaccine).
•    Religious exemptions are for individuals whose religious beliefs oppose immunizations.
•    Philosophical exemptions are for individuals with a personal, moral or philosophical belief against some or all immunizations.

“Vaccinations are one of the best ways to put an end to the serious effects of certain diseases,” concluded Taylor. “Don’t let your loved ones become a statistic. Give them the gift of a life free from preventable diseases and have them vaccinated today.”

10 Things Every Parent Should Know about Immunizations

1.    Why your child should be immunized

Children need immunizations to protect them from dangerous childhood diseases. These diseases can have serious complications and even kill. If a child is not vaccinated and is exposed to a disease, the child’s body may not be strong enough to fight it. If we did not have vaccines, diseases that vaccines now prevent, such as whooping cough, measles and polio, would kill thousands annually. These same germs exist today, but babies are now protected by vaccines, so we do not see these diseases as often.

Immunizing your child also helps to protect the health of our community, especially those who are not immunized. People who are not immunized include those who are too young to be vaccinated (e.g., children less than a year old cannot receive the measles vaccine but can be infected by the measles virus), those who cannot be vaccinated for medical reasons (e.g., children with leukemia), and those who cannot make an adequate response to vaccination. Also protected, therefore, are people who received a vaccine, but who have not developed immunity to it. In addition, people who are sick are less likely to be exposed to disease germs that can be passed around by unvaccinated children. Immunizations slow down and/or stop disease outbreaks.

2.    Diseases that childhood vaccines prevent

•    Diphtheria
•    Haemophilus influenza type b (Hib disease - a major cause of bacterial meningitis)
•    Hepatitis A
•    Hepatitis B
•    Human Papillomavirus (HPV)
•    Measles
•    Meningococcal
•    Mumps
•    Pertussis (Whooping Cough)
•    Pneumococcal (causes bacterial meningitis and blood infections)
•    Polio
•    Rotavirus
•    Rubella (German measles)
•    Tetanus (Lockjaw)
•    Varicella (Chickenpox)

3.    Number of doses your child needs

The following vaccinations are recommended by age two and can be given over five visits to a doctor or clinic:
•    4 doses of diphtheria, tetanus and pertussis vaccine (DTaP)
•    3-4 doses of Hib vaccine (depending on the brand used)
•    4 doses of pneumococcal vaccine
•    3 doses of polio vaccine
•    2 doses of hepatitis A vaccine
•    3 doses of hepatitis B vaccine
•    1 dose of measles, mumps and rubella vaccine (MMR)
•    2-3 doses of rotavirus vaccine (depending on the brand used)
•    1 dose of varicella vaccine
•    2-3 doses of influenza vaccine (six months and older) (number of doses depends on child's birthday)

4.    As with any medicine, there may be minor side effects.

For the most part these are minor and go away within a few days. Very rarely does an individual suffer from a severe side effect that may last for an entire lifetime. Side effects can occur with any medicine, including vaccines. Depending on the vaccine, these can include: slight fever, rash or soreness at the site of injection. Slight discomfort is normal and should not be a cause for alarm. Your healthcare provider can give you additional information.

To reduce the pain and the discomfort that a vaccine may cause, the administration of acetaminophen is recommended. The dosage should be within the prescribed limits and should be given with a time gap of two hours between doses. To provide relief from redness and swelling at the injection spot, placing a cold wet clean towel is recommended.

To combat a high temperature caused by a vaccine (greater than 100.4?), give plenty of fluids to ensure that the child does not become dehydrated. Place the child in some loose fitting clothing and keep them under a fan to cool them. Do not put your child in cool bath water as this may reduce the body’s core temperature.

5.    It is extremely rare, but vaccines can cause serious reactions.

Severe allergic reactions known as anaphylaxis may be seen in some people. Anxiety, swelling of the lips, hives, breathing difficulties and collapse may be seen in these individuals. These people need to go to an emergency department where these symptoms can be managed. As a parent you must weigh the risks. Serious reactions to vaccines are extremely rare. The risks of serious disease from not vaccinating are far greater than the risks of serious reaction to a vaccination.

6.    What to do if you have a serious reaction

If you think you or your child is experiencing a persistent or severe reaction, call your doctor or get the child to a doctor or emergency department right away. Write down what happened and the date and time it happened. Ask your doctor, nurse or health department to file a Vaccine Adverse Event Report form or go to http://www.vaers.hhs.gov to file this form electronically.

7.    Why you should not wait to vaccinate

Children under five years of age are especially susceptible to disease because their immune systems have not built up the necessary defenses to fight infection. Many of the diseases that vaccines prevent against can be very dangerous and even life-threatening to infants. While it’s true that newborn babies are immune to many diseases from antibodies transferred from their mothers, this immunity may only last up to six months after birth (and may only protect against diseases to which the mother is immune). Even still, young children do not have maternally-derived immunity against vaccine-preventable diseases such as whooping cough. And newborns, babies and toddlers can all be exposed to diseases from parents and siblings, other children in group settings like daycare, or anyone they come into contact with at home or in public. By immunizing on time (by age two), you can protect your child from disease and also protect others at school or daycare.

8.    Be sure to track your shots via a health record

A vaccination health record helps you and your healthcare provider keep your child's vaccinations on schedule. If you move or change providers, having an accurate record might prevent your child from repeating vaccinations he or she has already had. A shot record should be started when your child receives his/her first vaccination and updated with each vaccination visit. As our children get older, it may be necessary to get copies of the shot record (i.e., it becomes lost or destroyed accidentally). Check with all your child's previous healthcare providers. Don't forget visits to your local public health department or neighborhood clinic. You can also check with any schools your child has attended to see if they have retained a record of immunizations required for school entrance. Adolescents might have received certain vaccines (such as hepatitis B vaccine) in school. Some areas have centralized immunization registries that keep electronic records of all vaccines given in that area. To ask about the possibility of such a registry in your area, call your state immunization coordinator and/or the coordinator of any states where your child used to live. State immunization coordinator contact information can be accessed at www.immunize.org/coordinators.

Individuals can contact their healthcare provider or county health departments to ensure their immunization records are current.

9.    Some are eligible for free vaccinations

A federal program called Vaccines for Children provides free vaccines to eligible children, including those without health insurance coverage, all those who are enrolled in Medicaid, American Indians and Alaskan Natives, those whose health insurance dues do not cover vaccines and those who go to Federally Qualified Health Clinics or Rural Health Centers. For more information on this program, go to: http://www.cdc.gov/features/vfcprogram/.

10.    More information is available

•    For general immunization questions:
The CDC Contact Center at 1-800-CDC-INFO
(1.800.232.4636) English and Español

•    For questions about vaccines and vaccine-preventable diseases frequently asked by people calling the TTY Service Hotline:
1.888.232.6348 (TTY hotline)
http://www.vaccines.ashastd.org/ttyservice.html

•    The National Healthy Mothers, Healthy Babies Coalition
2000 N. Beauregard Street
6th Floor
Alexandria, Virginia 22311
Phone: 703.837.4792
www.hmhb.org

•    Do you know what vaccines are recommended for adults and adolescents? Take this quiz (for ages 11 and older) to find out which vaccines YOU may need. http://www2a.cdc.gov/nip/adultImmSched/

The mission of the Georgia Association of Physician Assistants is to promote high quality, cost-effective, accessible health care as part of a Physician-directed PA/Physician team. Georgians can find a member PA near them by clicking on the “Find a PA” tab at gapa.net.