Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: New DPT Vaccine and Immunization Update

Category: Child Care


The American Academy of Pediatrics just recently approved an acellular pertussis vaccine. This is a new DTP booster which does not have the risk of reaction that the old DTP had. The old DTP was associated with fever in about 50% of doses given as well as other possible complications. This new vaccine is recommended to be given at the 15 to 18 month dose and the 4 to 6 year old dose. The standard DTP is still recommended for the 2, 4 and 6 month dose.

The Academy feels there is insufficient data at present regarding the use of the acellular vaccine in the primary series (2, 4 and 6 months) to switch over to those doses at the present time. This new vaccine was licensed by the United States Food and Drug Administration in December of 1991 but has just recently hit the market, health units and pediatricians offices. Japan is the only country in which the acellular vaccine was previously licensed. It was used exclusively in Japan since 1981.

Minor side effects which may occur from the new acellular vaccine include fever and drowsiness. Local reactions such as redness and swelling are found to be much less frequent than the old vaccine. Whether or not more serious reactions (such as a change in consciousness which is thought to occur with the old pertussis vaccine in about one per million cases) will occur with the new acellular vaccine is unclear. Studies are ongoing as to the safety and ability of this new vaccine to adequately immunize infants in the primary series (2, 4 and 6 months). The results of these should be available within the next year. Other vaccines which will be added in the next few years include hepatitis vaccine once the United States finds a way of paying for it. This will be a series of three shots given to all infants born in the United States as well as teenagers who have never been immunized before. At the present time, this is in limbo because there is no payment scheme available.

High risk children should be immunized through whatever means, either through their pediatrician or health unit. Chicken pox vaccine is also being studied and may be given in the near future.

Measles, mumps and rubella vaccine has been successful since those three vaccines were added in combination. Unfortunately, since '89 we are seeing a fairly strong increase in cases of measles, both in the United States and around the world. For that reason we are now giving second vaccines to all children starting from kindergarten age all the way up to college age. It is very important to do this and also to do a better job of getting measles vaccine to third world nations where hundreds of thousands of children are still dying from complications of measles.

Polio is a disease which is essentially wiped out in the United States but is still killing and crippling children in the third world. We must continue to immunize those children and to adequately immunize all Americans to polio, diphtheria, pertussis, tetanus, measles, mumps, rubella and hemophilus influenza which causes meningitis. All of these vaccines are safer and more effective than ever in the past but they only work if the children receive them. In many large cities in our country, 50% of children below school age are not immunized or are partially immunized.

A new vaccine which we may see soon is the chicken pox vaccine. This has been shown to be effective now in studies over the past ten years and will probably be a routine vaccine in a few years.

Finally, hepatitis B vaccine, which is now available, is recommended for all children in society to try to stop the dread complications of hepatitis B.

We are presently giving it to all high risk children but, because of funding problems, it is not being given to all newborns. Hopefully, this funding problem will be solved within the next year and we will begin to immunize all children against hepatitis along with their DPT and Polio and Hib; we can then wipe out another dread disease which is still killing and hurting thousands of children annually in the United States.

The CDC recently passed laws requiring all physicians to provide written explanations of vaccines prior to giving them in the office as well as in health units. Ask the doctor or health unit to give you a copy of this early because it may take you several minutes and even hours to read through it and understand it. This can save you time when you do bring your children in for their vaccine.