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Give it a shot

PacMed physician weighs in on the pros and cons of immunizing children

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As the transition from summer break to back to school nears its completion, parents are scrambling to ensure their children are prepared for the school year ahead. Pencils? Check. Composition notebooks? Check. Immunizations? For some guardians, vaccinating their children isn't a simple task to be crossed off a to-do list. The topic of immunizations is a contentious one, and finding sound, unbiased advice on the issue may be hard to come by. Luckily, Pacific Medical Centers' pediatric physician Emmanuel Eusebio, MD, is here to inform readers about the facts of immunizing children so parents can make educated decisions confidently.

The topic of immunizing children is a controversial one. Why do you believe this is the case?

Controversy exists because on one hand, vaccines can save thousands of lives, and on the other, adverse reactions, although infrequent, can be devastating. Parents face the difficult decision on what is best for their child and which vaccines their child should receive.

What immunizations are typical for the back-to-school season?

The requirements for back-to-school immunizations are dependent on the age of the child and the vaccination laws within each state. In Washington, parents must provide a Certificate of Immunization Status (CIS) or a Certificate of Exemption (COE) in order for their children to attend school.

Some of the more important vaccinations occur just before kindergarten because it's the first major exposure for many kids. Therefore, there are several shots they need before they register for school. These include DtaP. This vaccine helps children under age 7 develop immunity to diphtheria, tetanus and whooping cough, also known as pertussis -- an easily communicable disease that spreads from coughing. We saw a fairly large rise in these diseases in the King County area last year. The younger the child, the more dangerous the exposure is. It can be especially scary in an infant.

Prior to starting school, children will also get a measles/mumps/rubella (or MMR) shot and a shot for chickenpox (also called varicella). Measles and chickenpox are both highly contagious and are often spread through the respiratory system by coughing, sneezing or even coming in contact with an infected person.  

Another common vaccination for younger children is IPV, which is formulated to ward off polio. This disease isn't as common in the Puget Sound area, but the polio vaccination is still an important one to maintain as the disease can be contracted when traveling.

For older children, another set of boosters happens around age 11 or 12, including a tetanus booster and Menactra, which prevents one of the bacterial versions of spinal meningitis. Menactra is the most recent vaccine added to the recommended immunization schedule.

In addition to age-appropriate vaccinations, routine influenza shots are pertinent for people of any age, especially from kindergarten through high school. It's hard to predict how severe any given year of influenza is going to be on the community, so it's best to be safeguarded in advance.

What pros can parents be assured of by immunizing their children? In opposition, what cons can be found by doing this?

Most childhood vaccines are 90-99 percent effective in preventing disease. For example, the measles vaccine has decreased childhood deaths from measles by 74 percent. The cons are that although adverse reactions are rare, the Vaccine Adverse Event Reporting System (VAERS) acknowledges that vaccines may be linked to anaphylaxis, encephalopathy and inflammatory diseases, possibly causing a variety of other disabilities.

Is there a middle ground that can be found in this debate? Are there some immunizations you feel are imperative for children to receive?

The middle ground would likely be found where statistical analysis, objective data, and scientific evidence take precedence over emotional arguments and personal anecdotes. Everything we do in life carries some degree of risk, be it flying to another city, driving to work, or even biking to school. However, the things we do to keep ourselves and our communities safe often need to be prioritized over our own personal preferences. The imperative vaccines for anyone depend on a variety of factors, like age, environmental exposures, activities and travel, among others. For children attending public schools, either the previously mentioned CIS or COE are required for enrollment.

Is there anything else you would like parents and readers to know about this topic?

Be sure to have an open dialogue with your child's pediatrician about any questions or concerns that arise. Take the time to calmly listen to the evidence, do your own research, weigh the benefits and risks, and make decisions that are best for your kids, and for all of the children in the communities you serve.

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