What are Mandatory Vaccinations for Children?
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The body’s immune system helps protect against pathogens that cause infection. Most of the time, it’s an efficient system. It either keeps microorganisms out or tracks them down and gets rid of them.
However, some pathogens can overwhelm the immune system. When this happens, it can cause serious illness.
The pathogens most likely to cause problems are the ones the body doesn’t recognize. Vaccination is a way to “teach” the immune system how to recognize and eliminate an organism. That way, your body is prepared if you’re ever exposed.
Vaccinations are an important form of primary prevention. That means they can protect people from getting sick. Vaccinations have allowed us to control diseases that once threatened many lives, such as:
- whooping cough
It’s important that as many people as possible get vaccinated. Vaccinations don’t just protect individuals. When enough people are vaccinated, it helps protect society.
This occurs through herd immunity. Widespread vaccinations make it less likely that a susceptible person will come into contact with someone who has a particular disease.
How does vaccination work?
A healthy immune system defends against invaders. The immune system is composed of several types of cells. These cells defend against and remove harmful pathogens. However, they have to recognize that an invader is dangerous.
Vaccination teaches the body to recognize new diseases. It stimulates the body to make antibodies against antigens of pathogens. It also primes immune cells to remember the types of antigens that cause infection. That allows for a faster response to the disease in the future.
Vaccines work by exposing you to a safe version of a disease. This can take the form of:
- a protein or sugar from the makeup of a pathogen
- a dead or inactivated form of a pathogen
- a toxoid containing toxin made by a pathogen
- a weakened pathogen
When the body responds to the vaccine, it builds an adaptive immune response. This helps equip the body to fight off an actual infection.
Vaccines are usually given by injection. Most vaccines contain two parts. The first is the antigen. This is the piece of the disease your body must learn to recognize. The second is the adjutant.
The adjutant sends a danger signal to your body. It helps your immune system to respond more strongly against the antigen as an infection. This helps you develop immunity.
State Vaccination RequirementsState and local vaccination requirements for daycare and school entry are important tools for maintaining high vaccination coverage rates, and in turn, lower rates of vaccine-preventable diseases (VPDs). State laws establish vaccination requirements for school children. These laws often apply not only to children attending public schools but also to those attending private schools and daycare facilities.
All states provide medical exemptions, and some state laws also offer exemptions for religious and/or philosophical reasons. State laws also establish mechanisms for enforcement of school vaccination requirements and exemptions. Studies have shown that vaccine exemptions tend to cluster geographically, putting some communities at greater risk for outbreaks. Practices suggested in the literature to reduce non-medical exemptions include: States can consider strengthening the rigor of the application process, frequency of submission, and enforcement as strategies to improve vaccination rates.
In addition to state vaccination requirements, stronger healthcare practices such as more in-depth discussions with hesitant parents and establishing vaccination as the default are strategies to improve vaccination coverage rates. In summary, vaccination requirements that reach more children through a broad range of facilities, that have more requirements for receiving an exemption, that require parental documentation of exemption requests, and that are implemented with strong enforcement and monitoring may help promote higher rates of vaccination coverage, and in turn, lower rates of VPDs.
Ongoing provider outreach and public education about vaccines and the diseases they prevent may also lead to such an increase. CDC’s Public Health Law Program (PHLP) has compiled state statutes and regulations regarding school vaccinations.
Vaccines are very important for infants, but they’re not all given immediately after birth. Each vaccine is given on a timeline, and some require multiple doses.
This table can help you understand the timeline of each vaccine:
Name of Vaccine Age How many shots?
Hepatitis B Birth A second at 1–2 months, a third at 6–18 months.
Rotavirus (RV) 2 months A second at 4 months, a third at 6 months.
Diphtheria, tetanus, and whooping cough (DTaP) 2 months A second at 4 months, a third at 6 months, a fourth at 16–18 months; then every 10 years.
Haemophilus influenzae type b (Hib) 2 months A second at 4 months, a third at 6 months, a fourth at 12–15 months.
Pneumococcal conjugate vaccine PCV13 2 months A second at 4 months, a third at 6 months, a fourth between months 12 and 15.
Inactivated Polio Vaccine (IPV) 2 months A second at 4 months, a third at 6–18 months, a fourth at 4 to 6 years.
Influenza 6 months Repeat yearly.
Measles, mumps, and rubella (MMR) 12–15 months A second at 4–6 years.
Varicella 12–15 months A second at 4–6 years.
Hepatitis A 12–23 months A second at 6 months after the first.
Human papillomavirus (HPV) 11–12 years old 2-shot series 6 months apart.
Meningococcal conjugate (MenACWY) 11–12 years old Booster at 16 years old serogroup B meningococcal (MenB) 16–18 years old.
Pneumococcal (PPSV23) 19–65+ years old.
Herpes zoster (Shingles—RZV formulation) two doses at 50 years old.
Vaccines do not cause autism. Despite much controversy on the topic, researchers haven’t found a connection between autism and childhood vaccines. In fact, the original study that ignited the debate years ago has been retracted.
Are vaccine side effects dangerous?
Any vaccine can cause side effects. Usually, these side effects are minor — a low-grade fever, fussiness, and soreness at the injection site. Some vaccines cause a temporary headache, fatigue, or loss of appetite.
Rarely, a child might experience a severe allergic reaction or a neurological side effect, such as a seizure. Although these rare side effects are a concern, the risk of a vaccine causing serious harm or death is extremely small. The benefits of getting a vaccine are much greater than the possible side effects for almost all children.
Of course, vaccines aren’t given to children who have known allergies to specific vaccine components. Likewise, if your child develops a life-threatening reaction to a particular vaccine, further doses of that vaccine won’t be given.
Why are vaccines given so early?
The diseases that childhood vaccines are meant to prevent are most likely to occur when a child is very young and the risk of complications is greatest. That makes early vaccination — sometimes beginning shortly after birth — essential. If you postpone vaccines until a child is older, it might be too late.
Is it OK to pick and choose vaccines?
In general, skipping vaccines isn’t a good idea. This can leave your child vulnerable to potentially serious diseases that could otherwise be avoided. Consider this: For some children — including those who can’t receive certain vaccines for medical reasons (such as cancer therapy) — the only protection from vaccine-preventable diseases is the immunity of the people around them. If immunization rates drop, vaccine-preventable diseases might once again become common threats.
If you have reservations about particular vaccines, discuss your concerns with your child’s doctor. If your child falls behind the standard vaccine schedule, ask the doctor about catch-up immunizations.
Like any medication or supplement (including vitamins), vaccines can cause side effects and reactions.
After being vaccinated, it’s common for your child to have mild (but harmless) side effects. These can last a few hours or days after vaccination.
This is the body’s natural response, as it’s working hard to build immunity against the disease. This is known as the inflammatory response or reaction. These reactions should not disrupt daily activities and can be treated if needed.
Common vaccine side effects may include:
- a low fever
- being fussy
- being sleepier than usual
- a stiff, slightly swollen, or sore arm (or leg) where the needle went in
You can give your child medicine to help with the pain or lower the fever. Ask your healthcare provider what is recommended.
There is a small chance of an allergic reaction to a vaccine (less than 1 in 1 million). In very rare cases this can be a serious reaction known as anaphylaxis. This type of reaction usually happens shortly after the vaccine is given.
This is why your healthcare provider will ask you to stay in the clinic for 15 to 20 minutes after your child’s vaccination. They will know how to treat your child if a reaction happens.
Your healthcare provider will then report the information to their public health department. This is to make sure abnormal or unexpected reactions are monitored and dealt with quickly.
Signs of a serious allergic reaction to a vaccine include:
- swelling of the face
- breathing problems (wheezing)
- blotchy skin on the body (hives)
Once again, other serious reactions to vaccines are very rare. Call your healthcare provider or public health office (CLSC in Quebec) if your child has unusual symptoms after vaccination.
These symptoms may include:
- unusual sleepiness
- fever above 40°C (104°F)
- crying or fussing for more than 24 hours
- worsening swelling where the needle went in
As a parent, you know your child best. If you see any of these symptoms, talk to your healthcare provider right away.
Risk of getting the disease from a vaccine:
Experts have developed different types of vaccines, including some that contain killed germs (inactive) and others that contain live but weakened germs (attenuated).
Inactive vaccines, such as the polio vaccine, use inactive or killed germs in the vaccine development process. It is not possible to develop disease from vaccines that are made with inactive or killed germs (viruses and bacteria).
This is because the killed infectious agent cannot reproduce or multiply. However, the body’s defense system still recognizes these dead germs as foreign bodies, stimulating an immune reaction.
Live vaccines, like the MMR vaccine, use live germs that are weakened (attenuated) during the vaccine development process. Live vaccines are very effective because the weakened germs act like a natural infection, building up the body’s immune system without causing any serious symptoms.
Your child could experience very mild symptoms of the disease but this is rare. For example, unlike the severe symptoms of a natural measles infection, the weakened germs in the vaccine could result in a few spots on the skin or a mild to moderate fever. These mild symptoms are not dangerous and can actually demonstrate that the vaccine is working effectively to build immunity.
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