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Disease and Vaccines
“Recommended childhood vaccines provide protection for your child against a host of life threatening and/or debilitating diseases. The following information includes information about the diseases along with the vaccine(s) recommended for your child to protect them from each disease. At the end of each description is a link to the Vaccine information sheets (VISs) for that disease and vaccine. Vaccine information sheets (VISs) are information sheets produced by the Centers for Disease Control and Prevention (CDC) that explain to vaccine recipients, their parents, or their legal representatives both the benefits and the risks of each recommended vaccine. Federal law requires that a VIS be handed to you for review before a vaccine is given to your child.
Vaccine information sheets (VISs) are available in PDF format (To install the free Adobe® Reader® for PDF viewing please click the Adobe Acrobat button below)
Measles
Measles is a respiratory disease caused by a virus. Measles is spread from person to person through coughing and sneezing and is considered highly contagious. Measles starts with a high fever, cough, runny nose, and red, watery eyes (often called “pink eye”). A rash soon appears that generally shows first on the face then spreads to the rest of the body and lasts for five days to a week. Severe water loss (dehydration) develops in many children with measles.
Pneumonia develops as a consequence of measles in about 5 percent of young children that get it. Most of the children that have historically died from measles have died from the secondary pneumonia infection. In older children, measles can cause an infection of the brain (encephalitis) which can lead to brain damage. Historically 1 out of every 1,000 children who got measles developed a brain infection with about 25 percent of those brain infection cases resulting in permanent brain damage to the child. Measles is still one of the leading causes of death in African countries and is easily imported to the U.S. via air travel.
Prior to the development and licensing of a vaccine against measles in 1962 there were about 3 to 4 million cases of measles, 48,000 hospitalizations for measles and 3,000 deaths from measles in the United States. Since the introduction of the measles vaccine the rate of infection from measles in the United States averages between 80 and 100 cases per year with almost no hospitalizations and almost no reported deaths. Two vaccines are currently in use to protect your child from Measles in the United States: M-M-R® II (combination Measles, Mumps, and Rubella vaccine) and Attenuvax® (Measles vaccine only). Link to MMR Vaccine
VIS http://www.cdc.gov/nip/publications/VIS/vis-mmr.pdf
Mumps
Mumps is a disease of the lymph nodes caused by a virus. Mumps is spread from person to person through coughing and sneezing and through close contact with infected persons including simply talking to them. Mumps has traditionally been a disease seen in children under the age of ten, although you can get mumps at any age. The most common sign of mumps is swelling of the cheeks and jaw, caused by inflammation in the salivary glands. Most children infected with mumps also develop a fever and headache, muscle ache, and swelling of the lymph nodes close to the jaw. Mumps can cause more serious illness and can cause deafness. Historically, about 1 child in every 10 who gets mumps will also get an inflammation of the coverings of the brain and spinal cord (meningitis). Mumps can also cause an infection of the brain (encephalitis) which can lead to permanent brain damage. About 1 out of every 4 teenage or adult men who get mumps will develop a painful swelling of the testicles (orchitis) which can lead to sterility and testicular cancer.
Prior to the development of the mumps vaccine around 1967 there were 200,000 cases of mumps in the United States annually with 20 to 30 associated deaths. Since the introduction of the mumps vaccine the rate of infection from mumps in the United States averages a few hundred cases per year with no reported deaths. However there have been several large outbreaks in the recent years among unprotected individuals. Two vaccines are currently used to protect your child from Mumps in the United States:, M-M-R® II (combination Measles, Mumps, and Rubella vaccine) and Mumpsvax® (Mumps vaccine only). Link to MMR Vaccine VIS http://www.cdc.gov/nip/publications/VIS/vis-mmr.pdf
Rubella
Rubella, (also known as German Measles and sometimes called “three-day measles”), is a respiratory disease caused by the rubella virus. Rubella is spread from person to person through coughing and sneezing and through close contact with infected persons. The first symptoms of rubella infection are a fever, swollen glands and a light rash on the face which often resembles measles. The rubella virus occasionally causes an infection of the brain (encephalitis) which rarely leads to permanent brain damage. Rubella virus can also cause a decrease in blood platelets (the cells that help the blood to clot) and in adolescent and adult women the virus can cause arthritis. Death from rubella infection is not common in individuals infected with the disease after birth. The most devastating results of a rubella infection are seen when the virus infects a woman during pregnancy. Historically, up to 85 percent of infants whose mothers were infected with rubella virus in the first three months of their pregnancy gave birth to children who were born blind, deaf, with heart defects or mentally retarded.
In the period between 1963 and 1964, before the United States began routinely recommending rubella immunizations, there was an epidemic of rubella that resulted in 12 million cases of rubella and an estimated 20,000 infants born with congenital rubella syndrome (CRS), with 2,100 neonatal deaths and 11,250 miscarriages. Of the 20,000 infants born with CRS, 11,600 were deaf, 3,580 were blind and 1,800 were mentally retarded. Before the rubella vaccination became available in 1969, epidemics occurred every 6-9 years and pandemics every 10 to 20 years. Since the introduction of the rubella vaccine in the United States the number of cases of children with birth defects caused by a rubella virus infection during pregnancy has been reduced to about five cases per year.
Rubella vaccine given to a female child not only protects her from the disease as a child but also protects her future unborn children from potential exposure to rubella while in the womb. Rubella vaccine given to a male child not only protects him from the disease as a child but also removes from him the potential of spreading the disease as an adult to a child or a pregnant woman. Two vaccines are currently used to protect your child from Rubella in the United States: M-M-R® II (combination Measles, Mumps, and Rubella vaccine) and Meruvax® II (Rubella vaccine only). Link to MMR Vaccine VIS http://www.cdc.gov/nip/publications/VIS/vis-mmr.pdf
Diphtheria
Diphtheria is a respiratory disease caused by the toxin that is released from an infection by a bacterium known as Corynebacterium diphtheriae. Diphtheria is spread from person to person through coughing and sneezing. The bacteria usually multiply in the throat resulting in the release of the toxin and a thick, gray coating at the back of the throat that causes difficulty in breathing and swallowing. This membrane can choke the infected person. Sometimes, the membrane forms in the nose, on the skin, or other parts of the body as well. Symptoms or diphtheria include gradual onset of a sore throat and low-grade fever. The bacterium also produces a toxin in the form of a harmful protein that can invade the heart, the kidneys and the nerves and may cause muscle paralysis, heart and kidney failure, and death. Approximately 5% of people who develop diphtheria (500 out of every 10,000) die from the disease and many more suffer permanent damage.
Prior to the development and licensing of a vaccine against diphtheria in the 1920s there were about 200,000 cases of diphtheria and 15,000 deaths from diphtheria in the United States. Since the introduction of the diphtheria vaccine in the United States, record low levels of infection have occurred, with only one case of diphtheria reported in the United States in 1999.
Several vaccines are currently used to protect your child from Diphtheria in the United States including Diphtheria and tetanus toxoids adsorbed (Diphtheria vaccine in combination with tetanus vaccine), Tripedia® (Diphtheria vaccine, Tetanus Toxoid, and acellular Pertussis vaccine combined), Infanrix® (Diphtheria vaccine, Tetanus Toxoid, and acellular Pertussis vaccine combined), TriHIBit® (Diphtheria vaccine, Tetanus Toxoid, acellular Pertussis vaccine and Hib conjugate vaccine combined), DAPTACEL™ (Diphtheria vaccine, Tetanus Toxoid, and acellular Pertussis vaccine combined), Pediarix™ (Diphtheria vaccine, Tetanus Toxoid, acellular Pertussis vaccine, hepatitis B vaccine, and inactivated polio vaccine combined), BOOSTRIX™ (Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed for use in 10-18 year old persons - preservative free), and ADACEL™ (Tetanus and Diphtheria Toxoids Adsorbed for use in 11-64 year old persons - preservative free). Currently in the United States no diphtheria-only vaccine is available. Link to DTaP Vaccine VIS http://www.cdc.gov/nip/publications/VIS/vis-dtp.pdf; Link to Td Vaccine VIS http://www.cdc.gov/nip/publications/VIS/vis-td.pdf
Tetanus
Tetanus (also known as lockjaw) is a disease of the nervous system caused by the toxin that is released from an infection from a bacterium known as Clostridium tetani which lives in the soil. The bacterium usually enters the body when a person gets a cut or a puncture wound to the skin. Once in the body the bacterium produces the toxin which causes severe and painful spasms of the muscles. Commonly early symptoms of tetanus include a locking of the jaw, stiffness in the neck and abdomen, and difficulty swallowing. Later symptoms include fever, elevated blood pressure, and severe muscle spasms. Tetanus can be fatal when muscle spasms of the throat block the windpipe resulting in near instant death from suffocation. Tetanus can also cause severe damage to the heart.
Prior to the introduction of the tetanus vaccine in the early 1940’s about 600 annual cases of tetanus were reported in the United States causing 180 deaths. Currently in the United States an average of 43 cases of tetanus are reported annually with 7 deaths. It is important to note that since this bacterium lives in the soil, it can not be eradicated; therefore it is critical to receive tetanus vaccines every ten years (which is the length of time of effectiveness of the vaccine). Several vaccines are used to protect your child from Tetanus in the United States including Tripedia® (Diphtheria vaccine, Tetanus Toxoid, and acellular Pertussis vaccine combined), Infanrix® (Diphtheria vaccine, Tetanus Toxoid, and acellular Pertussis vaccine combined), TriHIBit® (Diphtheria vaccine, Tetanus Toxoid, acellular Pertussis vaccine and Hib conjugate vaccine combined), DAPTACEL™ (Diphtheria vaccine, Tetanus Toxoid, and acellular Pertussis vaccine combined), Pediarix™ (Diphtheria vaccine, Tetanus Toxoid, acellular Pertussis vaccine, hepatitis B vaccine, and inactivated polio vaccine combined), BOOSTRIX™ (Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed for use in 10-18 year old persons - preservative free), and ADACEL™ (Tetanus and Diphtheria Toxoids Adsorbed for use in 11-64 year old persons - preservative free). Additionally DT or Td (Diphtheria vaccine in combination with tetanus vaccine) is recommended as a booster dose every 10 years, following the completion of the childhood series, for life. Link to DTaP Vaccine VIS
http://www.cdc.gov/nip/publications/VIS/vis-dtp.pdf; Link to Td Vaccine VIS
http://www.cdc.gov/nip/publications/VIS/vis-td.pdf
Pertussis
Pertussis (also known as whooping cough) is a respiratory disease caused by a bacterium known as Bordetella pertussis. Pertussis is transmitted by coughing and sneezing, and is highly contagious. Pertussis can be caught at any age but is most serious and potentially life threatening in children. Pertussis is one of the most contagious human diseases, so it is a great risk to those who are unvaccinated. Pertussis will develop in 90% of unvaccinated children living with someone with pertussis, and in 50% to 80% of unvaccinated children who attend school or daycare with someone with pertussis.
Historically, approximately 50 out of every 10,000 people who develop pertussis die from the disease. When a child is infected with pertussis they develop thick, sticky mucus in their windpipe. This mucus causes severe spells of coughing as the body tries to clear the windpipe of this mucus obstruction. It is common for the child to cough five to ten times in succession before finally being able to breathe in. When the child finally breathes in they will make a characteristic “whoop” sound which is where the disease gets its common name from. The severe spells of coughing from pertussis can last two to three weeks. Pertussis can also cause severe pneumonia and seizures. The severe spasms of coughing can interfere with eating, drinking, and the ability to breathe.
Before the vaccine for pertussis was developed there were about 200,000 cases of pertussis annually in the United States with about 8,000 deaths from the disease yearly. Currently in the United States there is an average of 8,000 reported cases of pertussis with about 10 deaths per year. Experts suggest that this number is greatly underestimated and there may actually be between 900,000 and 1 million cases per year. Several vaccines are used to protect your child from Pertussis including Tripedia® (Diphtheria vaccine, Tetanus Toxoid, and acellular Pertussis vaccine combined), Infanrix® (Diphtheria vaccine, Tetanus Toxoid, and acellular Pertussis vaccine combined), TriHIBit® (Diphtheria vaccine, Tetanus Toxoid, acellular Pertussis vaccine and Hib conjugate vaccine combined), DAPTACEL™ (Diphtheria vaccine, Tetanus Toxoid, and acellular Pertussis vaccine combined), Pediarix™ (Diphtheria vaccine, Tetanus Toxoid, acellular Pertussis vaccine, hepatitis B vaccine, and inactivated polio vaccine combined), BOOSTRIX™ (Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed for use in 10-18 year old persons - preservative free), and ADACEL™ (Tetanus and Diphtheria Toxoids Adsorbed for use in 11-64 year old persons - preservative free). Link to DTaP Vaccine VIS
http://www.cdc.gov/nip/publications/VIS/vis-dtp.pdf
To hear and see audio and video clips of children wracked with cough and gasping for air as a result of pertussis please visit the website of the Texas Department of Health's Online Continuing Education at http://www.completecast.com/pertussis/sounds_video.htm.
Hepatitis B (HepB)
Hepatitis B is a disease of the liver caused by the hepatitis B virus. Hepatitis B is spread through blood and infected bodily fluids which means that it could be spread through bites and scratches that result in broken skin, contact with the blood of an infected person or by having unprotected sex with an infected person. In the United States hepatitis B is most commonly spread through sexual contact or injection drug use but in other parts of the world it is most commonly spread to infants by their infected mothers. Infection with the hepatitis B virus can cause inflammation of the liver (hepatitis), severe liver disease (cirrhosis) and cancer of the liver. Most children who are infected with the hepatitis B virus don’t feel sick and there may be no symptoms when first infected. In fact, only a small percentage of infected children will show symptoms ranging from loss of appetite, tiredness, vomiting, nausea, jaundice (yellowing of the skin and/or eyes) or joint pain and many of these symptoms may be attributed to something other than hepatitis B by the parent or physician. The likelihood of early symptoms increases with the person's age. Most people who get infected with hepatitis B will get better but some individuals will become carriers of the disease with the virus remaining in their blood stream for a long time (up to several decades). These individuals will have the ability to infect others with the disease even though they do not look or feel sick. Transmission from parent to child during normal contact is not documented and is not likely to occur.
Transmission from hepatitis B infected mothers to their newborn babies during childbirth is possible. Without intervention, a mother who is positive for the hepatitis B surface antigen has a 20% risk of passing the infection to her offspring at the time of birth. This risk is as high as 90% if the mother is also positive for the hepatitis B antigen. If a newborn is exposed to hepatitis B from the mother during delivery then the vaccine will still be able to work to prevent the infection in the newborn if the newborn is given the hepatitis B vaccine promptly (at the birthing hospital). This is because the hepatitis B virus takes up to seventy days between initial exposure and the development of the disease. If the vaccine is given at childbirth then the vaccine will cause the newborns immune system to develop the necessary antibodies much faster than the disease can develop and in plenty of time to fight off the infection. An estimated 1.25 million people in the United States have chronic hepatitis B infection and each year approximately 4,000 to 5,000 children are infected with hepatitis B in the United States. The younger the age at which the disease is acquired corresponds to a higher likelihood that the disease will develop into chronic liver disease or liver cancer. That is why the ACIP recommends vaccinating children in the United States against hepatitis B. Several vaccines are used to protect your child from Hepatitis B in the United States including Engerix-B® (Hepatitis B Recombinant which contains only the hepatitis B vaccine), Recombivax HB® (Hepatitis B Recombinant which contains only the hepatitis B vaccine); Comvax® (Hepatitis B in combination with Haemophilus influenzae type b (Hib) vaccine); Pediarix™ (Hepatitis B in combination with DTaP (Diphtheria-Tetanus-acellular Pertussis) and inactivated polio vaccines); and Twinrix® (Hepatitis B in combination with hepatitis A vaccine). Link to Hepatitis B Vaccine VIS http://www.cdc.gov/nip/publications/VIS/vis-hep-b.pdf
Haemophilus Influenzae type b (Hib)
Haemophilus Influenzae type b (Hib) is a severe bacterial infection that occurs primarily in infants. Hib is transmitted by coughing and sneezing. Hib infects the lining of the brain causing meningitis. A Hib infection is most serious in children from birth to approximately 3 years of age. There is little risk of getting Hib after age 5. Symptoms include skin and throat infections, an inflammation of the coverings of the brain and spinal cord (meningitis), pneumonia, bloodstream infection (sepsis), infection of the joints (arthritis), and infections of the bones (osteomyelitis). The disease usually begins with a high fever, a decreased appetite and irritability and then evolves to drowsiness, sometimes a stiff neck and/or a headache. If sepsis occurs there can be fever, low blood pressure and the child can go into shock. In the throat, Hib can cause severe swelling sufficient to close the windpipe and cause suffocation. Historically, on average 1 out of 20 children who contract Hib will die from the disease. Of those children who survive the disease, 1 out of 5 will be left blind, deaf, mentally retarded or learning disabled.
Before the vaccine for Hib was developed in 1987 there were about 20,000 cases of Hib infections and between 400 to 500 Hib related deaths per year in the United States. Additionally, cases of meningitis from Hib were the leading cause of acquired mental retardation in the United States. Since the introduction of the vaccine the incidence of Hib has declined by 97-99 percent with fewer than 54 cases of Hib infections and 10 fatal cases of invasive Hib diseases reported on average each year. Several vaccines are used to protect your child from Hib in the United States including ActHIB® (either Hib vaccine alone or Hib in combination with DTaP (Diphtheria-Tetanus-acellular Pertussis) vaccine dependant on the reconstitute that is used), PedvaxHIB® (Hib vaccine), HibTITER® (Hib vaccine), and Comvax® (Hib in combination with recombinant hepatitis B (HBV) vaccine). Link to Hib Vaccine VIS http://www.cdc.gov/nip/publications/VIS/vis-hib.pdf
Influenza (flu)
Influenza (also known as the flu) is a highly infectious disease caused by a virus. The flu is spread by contact with an infected person and by coughing and sneezing. Symptoms include fever and chills, dry cough, runny nose, body aches, headache, and sore throat. The flu usually begins with high fever, chills, severe muscle aches and headache that are very severe. A runny nose, cough and sometimes a burning sensation in the chest often occur once the fever and muscle aches subside. This is the result of damage that the virus causes to the lining of the trachea and the air passages between the trachea and the lungs (the bronchi).
Influenza vaccines have been in use in the United States since 1945. Historically, complications from the flu occur in up to 25 percent of those who contract the disease and can include severe bacterial pneumonia, dehydration and worsening of chronic medical conditions such as congestive heart failure, asthma or diabetes. Inflammation of the heart (myocarditis) may also occur as a result of a flu infection. Children may get sinus problems and ear infections from the flu as well. On average influenza causes approximately 36,000 deaths and 148,000 hospitalizations each year in the United States. While more than 90% of influenza-related deaths are in people aged 65 years or older, young children are at high risk for hospitalization due to flu complications.
Each year, the flu vaccine must be reformulated and remanufactured. This is due to the variability of the prevalent strains of the flu that are in circulation around the globe. Experts monitor the prevalent strains and predict the three most likely virus strains that which will be affecting the United States in that upcoming flu season. The vaccine is then manufactured based upon those predicted strains. As a result of this variability of strains from year to year the flu vaccine from one season may not be effective in the next flu season. Several vaccines are used to protect your child from the flu in the United State including Fluarix®, Fluvirin®, Fluzone®, and FluMist®. Fluvirin® is approved for use in children 4 years of age and older; Fluzone® is approved for use in children 6 months of age and older; FluMist® is approved for use in children 5 years of age and older; and Fluarix® is approved for ages 18 and older. Link to Inactivated Influenza Vaccine (Flu shot) VIS http://www.cdc.gov/nip/publications/VIS/vis-flu.pdf. Link to Live, Intranasal Influenza Vaccine (FluMist) VIS http://www.cdc.gov/nip/publications/VIS/vis-flulive.pdf. To learn how inactivated Influenza vaccine is made please click here. (This document is in PDF Format which requires Adobe Acrobat Reader to view and prints nicest on legal sized paper).
Polio
Polio is a disease of the lymphatic and nervous systems caused by an intestinal virus. Polio is spread from person to person through contact with stool or saliva. Symptoms include fever, sore throat, nausea, headaches, stomach aches, vomiting and stiffness in the neck, back, and legs. Most persons who become infected with polio will not show signs of the illness. 1 out of every 1,000 people who become infected with polio will be paralyzed, usually in the legs and arms but sometimes in the muscles that assist breathing. Before the polio vaccine was developed in 1955 there were 13,000 to 20,000 people paralyzed and approximately 1,000 people who died from the disease in the United States each year. Currently polio is considered eradicated from the U.S. (and the entire Western Hemisphere). We continue to vaccinate against polio because of the fact that it still remains a threat in some countries and could be transported by an infected person back into the United States. There are two polio vaccines that are available to protect your child from this disease in the United State: IPOL® (Polio Vaccine Inactivated or IPV), and Pediarix™ (Inactivate Polio Vaccine in combination with DTaP and hepatitis B vaccines). Link to Polio Vaccine VIS http://www.cdc.gov/nip/publications/VIS/vis-IPV.pdf
Varicella (Chickenpox)
Varicella (also known as Chickenpox) is a virus of the herpes family called the varicella-zoster virus. Varicella is spread by contact with the fluid from the blisters on an infected person and by coughing and sneezing. It is highly contagious. Symptoms include a skin rash of blister-like lesions, usually on the face, scalp, or trunk of the body. The rash usually starts on the face and then spreads to other parts of the body. This rash begins as red bumps that progress to blisters which eventually “crust over” before falling off, usually in one to two weeks. It is not unusual for a child to get 300 to 500 blisters during a single chickenpox infection.
Before the vaccine was available in 1995 there were 3 to 4 million cases of chickenpox in the United States per year, mostly in children 10 years of age or younger. Current figures indicating the decline in incidence of varicella infection, complications and deaths are only available from select areas of the United States due to inadequate and inconsistent reporting levels from State to State. In those States where reporting is adequate and consistent there has been a decreased incidence in varicella infection of 67 to 82 percent. Complications are more common among adolescents and adults, and in immunocompromised persons of all ages, than in children. Historically 1 out of every 10,000 cases of chickenpox proved fatal with 23 out of every 10,000 cases progressing to pneumonia.
Chickenpox has also been an important risk factor for developing severe invasive “strep” (group A streptococcal disease), commonly referred to as “flesh-eating disease.” Treatment of this deep infection requires antibiotics and surgery to remove the infected tissue. 1 in 10,000 cases of chickenpox will result in bacterial infections, decreased blood platelets, arthritis, hepatitis, and brain inflammation which may cause a failure of muscular coordination.
Infection during pregnancy can allow the passing of the virus to the fetus, resulting in abnormalities in 2% of cases. The fetus can develop scarring of the skin and affected limb(s), limb deformities (hypoplesia), eye damage, low birth weight, brain atrophy, and mental retardation. The virus sometimes leads to fetal death and/or spontaneous abortion. Some babies infected while still a developing fetus will die in infancy. Note: Once infected with the varicella virus it remains in the body for life and may reappear as shingles, particularly in ederly persons. Add info about new vaccine The vaccine available to protect your child from varicella in the United States is Varivax®. Link to Varicella (Chickenpox) Vaccine VIS http://www.cdc.gov/nip/publications/VIS/vis-varicella.pdf
Pneumococcal Disease
Pneumococcal Disease is caused by a bacterium known as pneumococcus bacterium. While pneumococcus bacterium is present in many people's noses and throats it is still unknown why it suddenly invades the body and causes disease. Pneumococcal bacterium is spread by coughing and sneezing. It is the most common cause of pneumonia (which begins with high fever and then cough and stabbing chest pain), inflammation of the coverings of the brain and spinal cord (meningitis), bloodstream infection (sepsis) including the presence of live bacteria in the bloodstream (bacteremia), ear infections and sinus infections (sinusitis) in children under 2 years of age. Serious pneumococcal infections are most common in infants, toddlers, and the elderly.
Each year in the United States among children younger than five years of age, pneumococcal disease accounts for at least 1,400 cases of meningitis; 17,000 cases of bacteremia; 71,000 cases of pneumonia; and 5 to 7 million middle ear infections. In the general population (all age groups) pneumococcal disease is estimated to cause 150,000 to 570,000 cases of pneumococcal pneumonia; 16,000 to 55,000 cases of pneumococcal bacteremia; and 3,000 to 6,000 cases of pneumococcal meningitis. Pneumococcal disease has a higher incidence in individuals with certain health problems such as immune deficiencies, sickle cell disease, or lack of a functioning spleen. Additionally, there is a higher rate of infection in children of certain ethnic populations including African-American, Alaskan Native, and specific Native American populations.
Several vaccines are used to protect your child from pneumococcal disease in the United States including Prevnar® conjugate vaccine (7-valent - effective against 7 types of pneumococci), Pneumovax® 23 polysaccharide vaccine (23-valent - effective against 23 types of pneumococcus bacterium), and Pnu-Imune® 23 polysaccharide vaccine (23-valent - effective against 23 types of pneumococcus bacterium). Because polysaccharide vaccines are not effective in children younger than two to three years of age, Prevnar® conjugate vaccine is given to children as young as six weeks of age although the immunization schedule recommends first dose at two months of age. Link to Pneumococcal Conjugate Vaccine VIS http://www.cdc.gov/nip/publications/VIS/vis-PneumoConjugate.pdf
Hepatitis A (HepA)
Hepatitis A is a disease of the liver caused by the hepatitis A virus. Hepatitis A is spread primarily through food or water contaminated by feces from an infected person (i.e., an object contaminated with the stool of a person with hepatitis A is put into another person's mouth) and rarely through contact with infected blood. If symptoms are present, they include yellow skin or eyes, fever, weakness, tiredness, stomach ache, nausea, abdominal pain, loss of appetite, and dark urine. Adolescents and adults are more likely to develop signs and symptoms of the disease than young children so a child may be infected without a parent knowing it. Symptoms of the disease usually last less than two months. 10 to 15 percent of infections will cause prolonged or relapsing disease which can last up to six months. Each year in the United States Hepatitis A infection causes 125,000 to 200,000 people to become sick with 70 to 100 resulting deaths. Most deaths from Hepatitis A are related to underlying liver disease. Hepatitis A disease tends to occur in community-wide outbreaks sometimes attributed to many people having eaten from the same hepatitis A-infected food source or transmission from person to person in households and extended family settings. An infected person is most likely to spread hepatitis A virus during the two-week period before they know they are infected. Since most infected pre-school children show no symptoms of hepatitis A infection, they often unknowingly spread the hepatitis A virus to others including their pre-school classmates. Historically, children 2 to 18 years of age have had the highest rates of hepatitis A infections (15 to 20 cases per 100,000 in the early to mid 1990s). Since the introduction of the Hepatitis A vaccine in 1995 the rates have been on the decline and since 2002 the rate has become similar in all age groups with an estimated 20,000 cases in the United States in 2004. Several vaccines are available in the United States to protect your child from Hepatitis A including Havrix® (Hepatitis A vaccine alone), Vaqta® (Hepatitis A vaccine alone), and Twinrix® (Hepatitis A in combination with hepatitis B vaccine). Link to Hepatitis A Vaccine VIS http://www.cdc.gov/nip/publications/VIS/vis-hep-a.pdf
Rotavirus
Rotavirus is a disease of the digestive tract caused by any of three strains of rotavirus (A, B and C). Strain A is the most common strain to infect humans. Infection from Rotavirus causes acute gastroenteritis (vomiting and diarrhea). Humans of all ages are susceptible to rotavirus infection. Children 6 months to 2 years of age, premature infants, the elderly, and the immunocompromised are particularly prone to more severe symptoms. The disease is the most common cause of severe diarrhea in children worldwide occurring in about 120 million people every year and it is responsible for the death of about 600,000 children per year in developing countries. In the United States the death rate from rotavirus infections is much lower because of successful hospital treatment of the vomiting and diarrhea. However, every year in the United States rotavirus is estimated to be responsible for up to 70,000 hospitalizations, approximately 250,000 emergency room visits among children younger than 5 years of age and 60 deaths. Rotavirus infection is also known by other names such as “Infantile diarrhea", "winter diarrhea", "stomach flu", "acute nonbacterial infectious gastroenteritis", and "acute viral gastroenteritis". Almost every child has been infected with rotavirus by age 5.
Rotavirus is transmitted by the fecal-oral route (hand-to-mouth contact where stool from an infected person’s contaminated hands spreads the virus). This is assumed to be the main means by which rotaviruses are transmitted in close communities such as pediatric and geriatric wards, day care centers and family homes. Infected food handlers may also contaminate foods that they handle which require no further cooking (salads, fruits, hors d'oeuvres, etc.). Rotaviruses survive quite well in the environment and sanitary measures adequate for bacteria and parasites generally seem to be ineffective against the virus.
There is one vaccine currently in use in the United States to protect your child from rotavirus: RotaTeq®. The vaccine is an oral vaccine. Link to Rotavirus Vaccine VIS http://www.cdc.gov/nip/publications/VIS/vis-rotavirus.pdf.
Human Papillomavirus
Human Papillomavirus (HPV) is part of the family of Papillomaviruses that infect the skin and mucous membranes of humans and a variety of animals. There are over 100 known strains of Papillomaviruses that can infect humans that are collectively named Human Papillomaviruses. Some of these HPV strains cause benign skin warts, or papillomas, which is where this virus family get its name. Common warts, plantar warts, warts under the fingernail or cuticle, and flat warts all result from these strains which can be caught both environmentally and by casual skin-to-skin contact.
Another group of HPVs (approximately 30 strains) are typically transmitted through sexual contact. They cause genital warts and cancers. Of those 30 strains, approximately 12 cause cervical cancer, anal cancer, vulvar cancer, head and neck cancers, and penile cancer. Infection from these sexually transmitted “Genital” HPV strains is very common. It is estimated that up to 75 percent of women will become infected with one or more of the sexually transmitted HPV types at some point during her adult life. Infection with sexually transmitted HPVs often goes unnoticed because most HPV types that infect the genitals tend not to cause noticeable symptoms. Sexually transmitted HPV infection is a necessary factor in the development of nearly all cases of cervical cancer. Widespread use of Pap testing has reduced the incidence and lethality of cervical cancer in developed countries but the disease still kills several hundred thousand women per year worldwide. Women with no history of HPV do not develop cervical cancer. Most women who are infected with HPV will not progress to cervical cancer and their immune system will clear them of the infection.
There is one vaccine currently in use in the United States to protect girls and women from some of the most common sexually transmitted strains of HPV that can cause cervical cancer and genital warts: Gardasil®. It is approved for administration to girls and women between the ages of 9 to 26 years of age. Link to Human Papillomavirus VIS http://www.cdc.gov/nip/publications/VIS/vis-hpv.pdf.
For more information on vaccines for children, adolescents, and adults, visit the CDC's National Immunization Program website at http://www.cdc.gov/nip/default.htm.