Vaccination and Immunization

With the significant decline in disease caused by Haemophilus influenzae type b and Streptococcus pneumoniae achieved through vaccination, Neisseria meningitidis has moved to the forefront. Its emergence as the most important cause of bacterial meningitis challenges the pediatrician to prevent and control this terrible disease. Meningococcal disease can be easily misdiagnosed. It may present with different clinical manifestations, and its signs and symptoms may mimic those of common viral illnesses, such as influenza. The onset and progression of meningococcal disease are rapid. Although the rate of disease is highest in infants, morbidity and mortality rates for this disease are highest in adolescents and young adults, despite the existence of effective therapies.1

With the recent licensing of conjugated, quadrivalent meningococcal vaccine (MCV4) and likely approval of other "childhood" vaccines to prevent disease during adolescence and adulthood, the national immunization program ventures onto new ground.

Saying that child immunization rates in America are a disaster, former First Lady Rosalynn Carter on Monday called for universal immunization registries.

It has been difficult to determine the impact of influenza infection on infants and young children, because annual outbreaks of respiratory syncytial virus infection often overlap influenza outbreaks. But careful epidemiologic tests, combined with accurate, simple-to-perform viral diagnostic studies, have now clearly demonstrated that young children--particularly those younger than 2 years--are hospitalized because of influenza at a rate that equals or exceeds the influenza hospitalization rate for the elderly.

2004 immunization schedule for January to June 2004

Keeping track of changes in immunization recommendations is the best way to be certain that our patients receive maximal benefit.

The biggest change in this year's schedule is the addition of the seven-valent pneumococcal conjugate vaccine.

Many families feel that pediatricians just don't listen when they try to voice concerns about vaccines. Our recommendation: Identify each family's specific issues, target your response accordingly, and use a nonconfrontational approach. Time-consuming lectures on big subjects like immunology generally aren't needed.