August is one of the busiest times for pediatricians. Offices are flooded with frantic calls from parents asking that their child be squeezed in for a physical for sports or mandatory immunizations.
Oh, the dreaded word — “shots!”
Parents often ask — over the cries of their frightened children — if all of these shots are necessary. My answer is always an emphatic “yes!”
According to the Centers for Disease Control and Prevention, among U.S. children born during 1994–2013, vaccination will prevent an estimated 322 million illnesses, 21 million hospitalizations and 732,000 deaths during their lifetimes. What most of us don’t realize is that before the turn of the century, diseases such as whooping cough, measles, rubella and Haemophilus influenza — which is not the same as the flu — struck hundreds of thousands of American infants, children and adults, many of whom died as a result. Thousands of children were also stricken with polio and either died or became permanently paralyzed.
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As vaccines were developed and became widely used, rates of these diseases declined. Because of this, many parents have become complacent and believe that their child is not at risk anymore. This couldn’t be further from the truth. We know that diseases can creep back into our communities.
Each year, measles outbreaks continue to occur around the country, including the largest number of cases in 2014 (383 cases) and last year with 189 cases from 24 states. This past June, an unvaccinated child who attended a Miami-Dade public school was confirmed to have contracted measles. An estimated 100 people were suspected to have been exposed by this one case.
The likelihood of your child coming down with measles, polio, chickenpox or whooping cough might be quite low today. But vaccinations are not just for protecting ourselves. They also protect the people around us who may not be able to receive vaccines. This is called herd immunity.
For example, infants aren’t immunized against measles until they are 12 months old. So if they are exposed, they are very susceptible to the disease. The infants face less risk of exposure if others vaccinate themselves. Other at-risk populations include cancer patients receiving chemotherapy, patients with congenital immunodeficiency and the elderly.
Vaccines protect our community and future generations by keeping diseases that we have eradicated from making a comeback. History tells us if we stop vaccinating, the diseases will return. This is especially important in our community, where thousands of children from all over the world come to live. Many of these kids have not been appropriately vaccinated in their native countries.
Thankfully, our schools do a great job requiring all new students to have their vaccines updated before entering the school system. The required Form DH 680, Florida Certificate of Immunization is used to document immunizations required for attendance in Florida schools, day-care facilities and family day-care homes.
Many parents ask for their children to be permanently exempt due to religious or philosophical objections. The law requires that religious objection requests be completed by the County Health Department. Community providers are prohibited from honoring these requests. Philosophical exemptions vary by state; Florida does not allow them.
Providers can complete temporary exemptions for those who are in the process of completing any necessary immunizations, but there must be an expiration date after which the exemption is no longer valid. They can also grant permanent medical exemptions for those children with severe allergic reactions following vaccination, as well as severe combined immunodeficiency/encephalopathy that is not attributable to another cause within seven days of being vaccinated. Receipt of chemotherapy or long-term immunosuppressive therapy also allows medical exemption.
Parents are strongly encouraged to follow the immunization schedule that is endorsed by every leading medical establishment, including the CDC and the American Academies of Pediatrics and Family Physicians. Vaccines have been scientifically proven to be safe. The United States currently has the safest, most effective vaccine supply in history. Vaccines undergo up to 10 years of testing, by law, before they are licensed for use. Once in use, vaccines are continually monitored for safety and effectiveness.
However, like any medication, vaccines can cause side effects. Most of these side effects are minor and include injection site reaction, mild fever, fatigue, headache and muscle and joint pain. An allergic reaction is possible, yet is extremely rare.
We encourage parents to empower themselves with valid scientific information about vaccines. The best resource is the Centers for Disease Control. Visit www.cdc.gov/vaccines for information about vaccination schedules, vaccine safety profiles, answers to common questions and more. It truly will enlighten parents who have any hesitation about immunizing their child. And discuss this information with your pediatrician. Together you can make an informed decision about what is best for your child.
Lisa Gwynn, D.O., is a pediatrician and director of the Pediatric Mobile Clinic at UHealth – the University of Miami Health System. For more information, visit UHealthSystem.com/patients/pediatrics.