Vaccines

A seasoned pediatrician learns something new after a mother offers a moral defense against the Varivax vaccine for her son.

There is no room in the office refrigerator for Monday's vaccine delivery. Your son's mini-fridge is an ideal temporary fix. True or False?

The mother of a 12-year-old boy resists your suggestion that he receive the HPV4 vaccine today. She asks three good questions. Do you know the answers?

It's Monday morning and you're only 20 minutes behind. Per routine, you ask the mother of the 12-month-old in your office if she has any questions about the shots he's about to receive...

The mother of a 12-month-old says she'd rather her son have the chickenpox ("It's such a mild disease...") than be vaccinated today. Here, the pros and cons.

FluBlok, new this year, is egg-free but approved for persons aged 18 to 49 years only. The other options, and precautions, are discussed here.

The 5-year-old in your office has asthma and is egg-allergic. Mom wants him to have a flu shot today, but only if it can be given safely. Can it? With which vaccine?

If you aren't ready with the answer to this question and a way to put it in context for parents, you just might not get another chance. What would you say?

Here's how to put a parent's concern to rest.

Since mom went to the hassle of bringing along the 4 year old to her little brother's appointment, why not help make it worth the trip and get her up-to-date, too?

Here, in the second in a series of podcasts, Dr Ellen Clayton reviews findings of a landmark Institute of Medicine study on vaccine safety and offers information about specific vaccines that may be very useful to you when you answer questions from worried parents.

The issue of vaccine safety has been making headlines lately. Some of the publicity-particularly in the lay press and television-has been negative.

You and your colleagues are undoubtedly hearing questions from a lot of concerned parents about the new guidelines for vaccinating young boys against HPV infection. What are the chief concerns-and how can you best address those concerns?

What exactly are the new guidelines for vaccinating boys against HPV infection-and why is this development good news for both men and women?

How will you address this question when your patients ask? Find out in this podcast.

As the calendar advances to the fall months, we are reminded everywhere that it’s time for the annual influenza vaccination. In August 2011, the Advisory Committee on Immunization Practices (ACIP) updated its vaccination recommendations to include new guidelines for children ages 6 months through 8 years, and for persons with egg allergy.

My 18-month-old son has had a diaper rash, with no other symptoms, within a few days of eating a poached egg on 3 separate occasions.

Vaccination against infectious diseases has saved millions of lives. The recurrent threat of influenza pandemics and the prevalence of global HIV infections underscore the need for better-designed, more effective vaccines.

The lay public is being increasingly educated about the significant impact of HPV infection and the potential benefits of vaccination in reducing female cervical cancer. More medical providers need to recognize the substantial disease that could be prevented in men.

It certainly is reasonable for pediatricians to discharge patients if parents consistently refuse vaccinations. More than one-third of surveyed pediatricians agree.1 Although the American Academy of Pediatrics suggests avoiding the dismissal of vaccination refusers, it also recommends consideration of dismissal “when a substantial level of distrust develops, significant differences in the philosophy of care emerge, or poor quality of communication persists.”

Newborns and young infants represent the population most at risk for the burden of severe pertussis-related and influenza-related morbidity and mortality. The sources of these infections in infants are often unclear but are probably adolescents and adults (pertussis) and children and adults (influenza)

With the sole exception of the multidose influenza vaccine, childhood vaccines are now thimerosal-free. Communicating this fact (with signs in clinic) is a quick and effective way of making this concern a non-issue. It helps reinforce the message that vaccines are safe. Parents are made aware that the pediatrician is cognizant of their concerns and has endeavored to address those concerns.

The importance of vaccination has been well proved over the years for both individuals and the community as a whole. According to the 2004 to 2006 National Immunization Survey sponsored by the CDC, about 80% of children in the United States are up-to-date (UTD) with their immunizations, a rate that although respectable still leaves room for improvement.

Invasive pneumococcal disease (IPD) in children can cause serious illness-including meningitis, pneumonia, and bacteremia-and death. Fortunately for children, their families, and their pediatricians, the incidence of IPD in children younger than 5 years has dropped significantly following the widespread adoption of the pneumococcal conjugate vaccine (PCV).

On awakening in the morning, a 2-year-old girl was noted to have left-sided facial swelling and was brought to the emergency department. The child had had no fever, trauma to the area, pain, or difficulty in swallowing. Her medical history was unremarkable. Her immunizations were up-to-date; she had received both doses of the measles, mumps, and rubella (MMR) vaccine about 6 months before presentation. There were no sick contacts.