Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Dec 11, 2018
Last Modified Date: Dec 11, 2018
Published Date: Aug 31, 2017
TABLE OF CONTENTS
Chapter 1: Introduction to Vaccines Chapter 2: Child and Adult Disease Immunizations Chapter 3: Recommended Immunization Schedule: Birth through age 18 Chapter 4: Do you Know if You are Immunized? Here’s How to Find Out
Introduction to Vaccines
Vaccines are dead or weakened forms of the organisms that cause diseases. When someone is vaccinated, the immune system recognizes these organisms as foreign substances and produces antibodies to fight them. These antibodies remain in the blood, protecting people from getting serious diseases such as mumps and measles.
Child and Adult Disease Immunizations
The Centers for Disease Control and Prevention develops an annual vaccination schedule for adults and children, which helps patients and medical professionals better understand who needs to be immunized against specific diseases. The use of immunizations has nearly eradicated some diseases that used to kill thousands of people per year, but some people have concerns about the long-term effects of immunizations on children. It is important to discuss these concerns with a doctor and determine whether the possible benefits outweigh the risks.
Childhood Disease Prevention Through Immunization
Children receive immunizations from the time they are born, making it possible to prevent or minimize the effects of contagious illnesses. The first vaccine given to infants is the hepatitis B vaccine. If a child’s mother is hepatitis B surface antigen-positive, then the baby also receives a dose of hepatitis B immune globulin. The second dose of this vaccine is given when a child is 1 to 2 months old. The final dose is given at no earlier than 24 weeks old. The minimum age for a DTaP (diphtheria, tetanus, and pertussis) vaccination is 6 weeks of age. The final dose of this vaccination must be given at least six months after the third dose, but it can be given as early as 12 months of age. Children should also receive vaccinations for influenza, pneumonia, inactivated poliovirus, varicella, hepatitis A, meningitis, measles, mumps, and rubella before they reach six years of age.
Older children also need immunizations, but some immunizations are only given to children in high-risk groups or children who need to catch up on their childhood immunizations. All children need the DTaP, meningitis, and influenza vaccines. The CDC also recommends that girls receive three doses of the human papillomavirus vaccination between the ages of 11 and 12. Hepatitis A and pneumococcal pneumonia vaccinations are given to children who have a high risk for developing these diseases.
The CDC recommends several immunizations for adults, as vaccines have completely eliminated smallpox and other diseases that used to kill thousands of adults each year. The immunization schedule is based on age group and certain risk factors. All adults should receive an annual influenza immunization, especially those with a high risk of developing the flu. Adults also need immunizations for varicella, human papillomavirus, pneumonia, herpes zoster, meningitis, hepatitis A, hepatitis B, tetanus, diphtheria, pertussis, measles, mumps, and rubella. The human papillomavirus is only available until the age of 26. Adults only need the pneumonia, meningitis, hepatitis A, and hepatitis B vaccines if they are at risk due to their occupations or lifestyle choices.
These vaccinations are contraindicated in adults who have certain medical conditions. Pregnant women should not get the varicella, herpes zoster, or measles, mumps, and rubella vaccines. These vaccines are also contraindicated in people who have compromised immune systems and in people who have HIV with a T lymphocyte count of less than 200 cells per microliter of blood.
Benefits of Immunizations
The greatest benefit of immunizations is that they protect the public from widespread illnesses. In the early 1950s, nearly 2,000 people died from polio each year. The polio vaccine was introduced in 1955. Since that time, polio has been nearly eliminated from the Western Hemisphere. Prior to 1988, approximately one in 200 children developed bacterial meningitis caused by Haemophilus influenza type b. Since the introduction of the vaccine for this type of meningitis, there have been very few cases of the disease. German measles, also known as rubella, affected nearly pregnant women between 1964 and 1965. Their infants were born with heart defects, deafness, and other birth defects. Now that there is an effective vaccine for the disease, German measles pose almost no threat to pregnant women.
Another benefit of immunizations is that they save a considerable amount of money. The U.S. Department of Health and Human Services estimates that the United States saves $8.50 in medical costs for every dollar spent on the DTaP vaccine. When the department accounts for lost work time, disability, and death, the amount saved increases to $27 for every dollar spent. For every dollar spent on the MMR vaccine, the United States saves $13.
Health Concerns of Immunizations
Some parents, educators, and medical experts are concerned about the possible adverse effects of vaccinations. Some vaccines contain adjuvants, which are substances used to increase the immune system response to the vaccine. One of the most common adjuvants used in vaccinations is aluminum. This metal is found in the DTap vaccination as well as the vaccinations for hepatitis A, hepatitis B, human papillomavirus, Haemophilus influenza type b, and pneumococcus infection. There is some concern that the aluminum can cause health problems in those who receive these vaccines.
Some people have reported fainting or febrile seizures in children who have received vaccines. Medical care providers are now encouraged to observe patients for at least 15 minutes after administering immunizations to ensure that these adverse events do not occur. The number of fainting episodes increased with the licensure of the TDaP, meningococcal conjugate, and human papillomavirus vaccines for teenagers. Fainting is most common in teens who have received the human papillomavirus vaccine. The CDC found that complaints of febrile seizures after vaccination were rare. It is important to note that this type of seizure can occur any time a child has a fever and may not be directly related to vaccination.
There was also some concern about the use of thimerosal in vaccines. This substance is a preservative that contains mercury. Since mercury can cause serious effects, especially in children, the American Academy of Pediatrics called for vaccine manufacturers to reduce or eliminate the use of thimerosal in vaccines. Since 2001, only certain influenza vaccines have contained thimerosal. It is no longer used in other types of vaccinations. The Institute of Medicine reported that there may be a slight causal link between thimerosal and autism, but since this substance is no longer used in most vaccines, the CDC and other health agencies are conducting more research into the relationship between vaccines and autism.
Recommended Immunization Schedule: Birth through age 18
- Hepatitis B Vaccine (HepB) – This vaccine is given in a series of three doses to achieve immunity. Recommendations are that the first dose be given at birth, the second at between one and two months of age and the third between 6 and 18 months of age.
- Rotavirus Vaccine (RV) – This vaccination is given in two doses or three doses, depending upon the vaccine used. The vaccine is administered at 2 months and 4 months of age, and in a three-dose vaccination, at 6 months of age.
- Diphtheria, Tetanus, and Acellular Pertussis Vaccines (DTap) – A series of five doses of this vaccine are given, administered at the ages of 2 months, 4 months, 6 months, 15-18 months and 4-6 years.
- Haemophilus influenzae type b (Hib) – Depending upon the vaccine used, Hib is administered in a primary series that consists of 2 doses, given at ages 2 months and four months, or a 3-dose series, given at 2 months, 4 months and 6 months, then a booster dose is administered between the ages of 12 and 15 months.
- Pneumococcal Conjugate (PCV13) – Administered in four doses, this vaccine is given at the ages of 2 months, 4 months, 6 months and 12-15 months.
- Inactivated Poliovirus (IPV) – A four dose series, this vaccine is given at ages 2 months, 4 months, 6-18 months and 4-6 years.
- Influenza (IIV; LAIV) – Children, after the age of 6 months, are given an initial series of two doses of influenza vaccine. After that initial series, one dose should be administered annually.
- Measles, Mumps, Rubella (MMR) – This vaccination is given in two doses, the first administered between 12 and 15 months of age and the second given between the ages of 4 and 6 years.
- Varicella (VAR) – Two doses of this vaccine are given to children, one at 12-15 months of age and the other at 4-6 years old.
- Hepatitis A (HepA) – Two doses of this vaccine are necessary for immunity, the first given at a minimum age of 12 months and the second given 6 -18 months afterwards.
- Meningococcal (Hib-MenCY, MenACWY-D, or MenACWY-CRM) – Two doses of this vaccine are administered, a primary dose at age 11-12 years and a booster dose at age 16-18.
- Tetanus, diphtheria, acellular pertussis (Tdap: 7 yrs) – One dose of this vaccination is given at age 11-12 years.
- Human papillomavirus (HPV2: females only; HPV4: males and females) – This vaccine is given in a three-dose series between the ages of 11 and 12 years.
Here is a simple breakdown of vaccinations given to children at each age (PDF):
- Birth – HepB
- 1-2 Months – HepB
- 2 Months – RV, DTaP, Hib,PCV13 and IPV
- 4 Months – RV, DTaP, Hib, PCV13 and IPV
- 6 Months – DTaP, Hib, PCV13, and RV if a three-dose vaccine is used.
- 6-18 Months – HepB, IPV
- 6-23 Months – IIV
- 12-15 Months – MMR, VAR, Hib and PCV13
- 12-23 Months – HepA
- 4-6 Years – DTaP, IPV, MMR, and VAR
- 11-12 Years – Tdap, HPV2, Meningococcal and Human papillomavirus vaccinations.
- Once Per Year – Influenza (IIV; LAIV) Recommended Immunization Schedule: Adults(PDF)
- Influenza – One dose annually.
- Tetanus, diphtheria, pertussis (Td/Tdap) – Every 10 years.
- Human papillomavirus (HPV) Female – Women should have three-dose series between the ages of 19-26.
- Human papillomavirus (HPV) Male – Men should be given a three-dose series between the ages of 19-21.
- Zoster – One dose for adults age 60 and over.
- Measles, Mumps, Rubella (MMR) – 1-2 doses of this vaccine between ages 19 and 55.
- Pneumococcal polysaccharide (PPSV23) – One-dose for adults over the age of 65.
Immunizations Matter: Are Yours Up-To-Date?
Have you had all your immunizations? If you're not sure, you're not alone. Given the ever-growing number of vaccines available to protect Americans against communicable diseases, keeping up with immunizations can be a challenge. To help medical professionals and their patients keep up-to-date, a recommended immunization schedule is released annually. These schedules are endorsed by the Advisory Committee on Immunization Practices, the Centers for Disease Control and Prevention, the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists based upon the research and recommendations of scientists, physicians and public health officials.
Do you Know if You are Immunized? Here’s How to Find Out
Immunizations are essential both for personal health and to control vaccine-preventable diseases that might otherwise become a public health crisis. However, given the long list of immunizations every American needs, many adults aren't sure whether they've received them all. If this is you, don't play a guessing game with your health. You can find out for sure whether you're protected from these diseases via immunization testing, which tests the blood for antibodies produced by the immune system as a response to vaccination.
How do I get my immunization records? That's a common question for adults who may be traveling overseas, enrolling in college courses or even applying for certain jobs that require employee vaccinations. So how does one go about retrieving those records? Unfortunately, there isn't one standard answer to that question, since record-keeping policies vary according to where you live, but here are some tips on where to start looking – as well as what you can do to remedy the situation if you don't have any luck in finding your immunization record.
Finding Your Childhood Immunization Record
If you're enrolling in college and have run up against the requirement to prove your immunization status, the first place to ask the question “Where can I get a copy of immunization records?” is the school's health office. They hear this question all the time from students and may have some suggestions as to where to find these records in your area. Your local Health Department may offer some assistance as well, since many city, county and state health departments keep registries of childhood vaccinations in their jurisdiction. Contacting your high-school may help, since they may still have your immunization records on file if you're a fairly recent graduate, or your family doctor or the pediatrician you saw as a kid may have your records or know where to get them. Last, but not least, look through family records if they're available, especially baby books or your old school records. Many parents do tuck away important papers from their kids' school days, including immunization records.
Where Can I Get My Immunization Record As An Adult?
If you need a record of the vaccinations you have received as an adult, you will likely have to do a bit more digging, since with the possible exception of immunizations you had during your college years, you can't expect much of a result by asking your school or your parents. However, contacting doctors, hospitals or clinics that have treated you as an adult may yield some results, or if you have been in the military, chances are that you can request a copy of immunization records from your time of service.
What If I Can't Locate My Immunization Record?
Even in areas that keep an immunization registry, old records are generally only kept for a certain period of time. Many records of childhood vaccinations are only kept until a person reaches 18 years of age, and doctors and clinics generally don't store records for more than 3 to 5 years after a patient leaves their care. So whether it is childhood immunization records or adult ones you're looking for, there is a chance that you won't be successful in finding them. So what can you do to satisfy the need for proof of immunization or immunity if your records are no longer available?
People who are unsure whether they've been vaccinated or need proof of immunity against certain vaccine preventable diseases can resolve this issue via immunization testing. This type of testing is done by taking a blood sample, then sending it to a lab, where it will be tested for antibodies to these vaccine preventable diseases that indicate that a person has immunity – either from immunization or a previous bout with the disease that confers immunity. Among the diseases for which this testing can be done are measles, mumps, rubella, hepatitis A, B, and C, tetanus, diphtheria, chicken pox and shingles. Your other option is to repeat vaccinations you have no record of receiving. Check with CDC recommendations and your doctor to determine if this is appropriate in your case.
Lastly, whether you are able to locate your records or have to go the route of immunization testing and/or repeat immunizations, save yourself the trouble of going through the same sort of hassle again. Make several copies of your immunization and immunity information and tuck them away in a safe place, and be sure to add documentation of any new immunizations you receive in the years to come to that information, keeping your records up to date – just in case you encounter circumstances that require you to present them in the future.
More Information and Resources
- Immunizations Overview: This article explains what immunizations are and why they are so important.
- Childhood Immunizations Are Important: This resource explains why it is important for children to receive immunizations.
- Hepatitis B Shots for Babies (PDF): This brochure explains why hepatitis B vaccinations are recommended for young children.
- DTaP Vaccine: This article provides an overview of the DTaP vaccination and explains the benefits of getting this vaccine.
- Frequently Asked Questions About Immunizations: This article addresses some of the most common questions people have about childhood immunizations.
- Flu Shots for Kids: This article from the Mayo Clinic explains the types of flu vaccinations available for children.
- Kids’ Vaccine Slashes Meningitis: This article explains why it is so important for kids to receive the HiB vaccination.
- The Polio Vaccine: This article discusses the history of the polio vaccine developed by Jonas Salk.
- Parents Reject Vaccines: This article discusses the backlash against vaccines due to some of their potential effects.
- Vaccine Safety Concerns: The Minnesota Department of Health addresses some concerns regarding the safety of immunizations.
- Thimerosal Vaccines: This article from the FDA addresses the use of thimerosal in vaccines.
- Facts on Vaccine Safety: This detailed article from the American Academy of Family Physicians debunks some of the most common myths about vaccines.