Topic Overview
What are immunizations?
Immunizations help protect
you or your child from disease. They also help reduce the spread of disease to
others and prevent epidemics. Most are given as shots. They are sometimes
called vaccines, or vaccinations.
In many cases when you get a
vaccine, you get a tiny amount of a weakened or dead form of the organism that
causes the disease. This amount is not enough to give you the actual disease.
But it is enough to cause your
immune system to make
antibodies that can recognize and attack the organism
if you are ever exposed to it.
Sometimes a vaccine does not
completely prevent the disease, but it will make the disease much less serious
if you do get it.
Some immunizations are given only one time.
Others require several doses over time.
Why should you get immunized?
- Immunizations protect you or your child from dangerous
diseases.
- They help reduce the spread of disease to others.
- Getting immunized costs less than getting treated for the
diseases that the shots protect you from.
- Vaccines have very few serious side effects.
- They are often needed for entrance into school or day care. And
they may be needed for employment or for travel to another country.
If you are a woman who is planning to get pregnant, talk
to your doctor about what immunizations you have had and what you may need to
protect your baby. And if you live with a pregnant woman, make sure your
vaccines are up-to-date.
Traveling to other countries may be
another reason to get immunized. Talk with your doctor months before
you leave, to see if you need any shots.
What immunizations are recommended for children and adolescents?
Ask your doctor what shots your child should get.
The immunization schedule includes vaccines for:
- Bacterial meningitis.
- Chickenpox.
- Diphtheria, tetanus, and pertussis (also known as whooping
cough).
- Flu (influenza). This vaccine is not given to children younger
than 6 months.
-
Haemophilus influenzae type b disease,
or Hib disease.
- Hepatitis A.
- Hepatitis B.
- Human papillomavirus (HPV).
- Measles, mumps, and rubella.
- Pneumococcal disease.
- Polio.
- Rotavirus.
Immunizations start right after birth, and many are given
throughout a baby's first 23 months. Booster shots (the later doses of any
vaccines that need to be repeated over time) occur throughout life.
Fewer immunizations are needed after age 6. But older children and teens
need shots too (such as those for bacterial meningitis and for tetanus,
diphtheria, and whooping cough). Some shots are also given during adulthood
(such as a tetanus shot).
It is important to keep a good
record(What is a PDF document?)
,
including a list of any reactions to the vaccines. When you enroll your child
in day care or school, you may need to show proof of immunizations. Your child
may also need the record later in life for college, employment, or travel.
Talk to your doctor if
you or your child plans to be in a group living situation, like a college
dormitory or summer camp. You may want certain shots, like those for meningitis.
What vaccines are recommended for adults?
The
vaccines you need as an adult(What is a PDF document?)
depend not only on your age, lifestyle, overall health, pregnancy status, and travel plans
but also on who you are in close contact with and what vaccines you had as a child.
Talk to your
doctor about which vaccines you need. Depending on your situation, you may need
vaccines for:
- Chickenpox.
- Flu.
- Hepatitis A and/or B.
- Human papillomavirus (HPV).
- Measles, mumps, and rubella.
- Pneumococcal disease.
- Polio.
- Shingles.
- Tetanus, diphtheria, and pertussis.
In some states, pharmacists can give some of these shots.
What are the side effects of vaccines?
Most side
effects from vaccines are minor, if they occur at all. Ask your doctor or pharmacist about
the reactions that could occur. They may include:
- Redness, mild swelling, or soreness where the shot was given.
- A slight fever.
- Drowsiness, crankiness, and poor appetite.
- A mild rash 7 to 14 days after chickenpox or
measles-mumps-rubella shots.
- Temporary joint pain after a measles-mumps-rubella shot.
Serious reactions, such as trouble breathing or a fever
of 104.5 F (40.3 C) or higher,
are rare. If you or your child has an unusual reaction, call your
doctor.
It is much more dangerous for a child to risk getting the
diseases than it is to risk having a serious reaction to the vaccine.
Can vaccines cause other problems?
Some parents
question whether mercury-containing thimerosal (used as a preservative in
vaccines) might cause
autism. Studies have not found a link between
thimerosal-containing vaccines and autism.1 Today, all
routine childhood vaccines made for the U.S. contain either no
thimerosal or only trace amounts.2
Some
people worry that the shot for measles, mumps, and rubella can cause autism in
children. This is because symptoms of autism are first noticed around 1 year of
age, which is about the same time children get their first shot for measles.
But many studies have been done, and no link has been found between this
vaccine and autism.3
Frequently Asked Questions
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Childhood Immunizations
Recommended immunizations
The U.S. Advisory
Committee on Immunization Practices (ACIP), the American Academy of Pediatrics,
and the American Academy of Family Physicians recommend a specific
childhood immunization schedule each year.
Immunizations are recommended because they protect
against diseases (give
immunity) or make a disease less severe if your child
does get it. The schedule outlines the immunizations and booster shots needed
from birth through age 18, as well as when catch-up
immunizations should be given.
The
schedule for a premature infant is the same as for a
full-term infant, except for hepatitis B vaccine.
Many immunizations require more
than one dose, given at varying intervals. Although your child does not need to
restart the series if a scheduled dose is missed, the immunization should be
given as soon as possible.
The childhood
immunization schedule has immunizations for:4
This shot (called Varivax) protects against
chickenpox.
Who should get it?
- Two doses are given to all children 12 months of age and
older who have not had chickenpox—one at age 12 to 15 months and one at age 4
to 6 years.
The combination MMRV (ProQuad) shot can be given in
place of Varivax. The vaccines for chickenpox, measles, mumps, and rubella are
all in this one shot. Many states require that children entering day care or
school get immunized against chickenpox unless they can show proof of immunity
(through blood test results or having had chickenpox).
This shot (immunization)
protects against
diphtheria,
tetanus, and
whooping cough (pertussis).
Who should get it?
- Five doses are given to all children—one at age 2 months, one
at 4 months, one at 6 months, one at 15 to 18 months, and one at 4 to 6
years.
This immunization helps protect against the
seasonal flu and the H1N1 (swine) flu. Flu viruses are always changing, so the flu
vaccines are updated every year.
Who should get it?
Flu immunization is recommended once a year
for:5
- All children ages 6 months and older.
- Children younger than 9 years of age who are getting the
immunization for the first time need two doses. These doses should be
given at least 4 weeks apart.
- Children younger than 9 years old who got only one dose
in their first season need two doses before or during the next season.
After that, one dose yearly is needed.
- Household contacts and caregivers of children from birth up
to 5 years of age and of any child who is at high risk for complications of the
flu.
- Anyone who has a chance of complications from the flu or is
more likely to need medical care if infected.
Healthy children ages 2 and older can usually get the
nasal spray form (FluMist)(What is a PDF document?)
instead of the
flu shot(What is a PDF document?)
. Protection lasts up to a year for both vaccine types.
For more information about the flu, see the topics Influenza (Seasonal Flu) and H1N1 Influenza (Swine Flu). For the most current CDC guidelines about seasonal flu, go to www.cdc.gov/flu. For the most current CDC guidelines about H1N1 flu, go to www.cdc.gov/h1n1flu.
This shot protects against bacteria that can cause an infection in the
lungs (pneumonia) or the covering of the brain (meningitis), skin and bone infections, and other
serious illnesses in young children. It does not protect against viral
influenza (flu).
Who should get it?
- All children need three or four doses, starting at 2 months
of age and ending by 15 months of age.
- Children who are older than 5 years and have certain health
conditions may also need this shot.
This shot protects against
hepatitis A.
Who should get it?
- All children starting at 1 year of age need two doses,
given at least 6 months apart.
- Anyone who will be in close contact with an adopted child from a country that has high rates of hepatitis A needs two doses. This includes household contacts and babysitters. This recommendation only applies for the first 60 days the child is in the United States.6
This shot protects against
hepatitis B.
Who should get it?
- All children need at least three doses. The first dose is
given right after birth, before the child leaves the hospital. The remaining
doses are given by 6 to 18 months of age. Children who have not been immunized
for hepatitis B and are age 18 years or younger can get the shots over a period of about 6 months.
This shot (called M-M-R II) protects
against
measles,
mumps, and
rubella.
Who should get it?
- Two doses are given to all children—one at age 12 to 15
months and one at age 4 to 6 years.
There is a measles, mumps,
rubella, and varicella (MMRV, or ProQuad) shot that also protects against
chickenpox (varicella). Talk to your child's doctor about the pros and cons of the MMRV shot(What is a PDF document?)
. It can be given to children ages 12 and younger.
This shot (called PCV, or Prevnar) protects
against meningitis, blood infections (sepsis), and
ear infections. In March 2010, the CDC recommended that the new vaccine PCV13 be used instead of PCV7 vaccine. PCV13 protects against more types of pneumococcal disease than PCV7 did.
Who should get it?
- Four doses are given to all children—one at age 2 months,
one at 4 months, one at 6 months, and one at 12 to 15 months.
- One dose is given to healthy children ages 24 to 59 months
who did not get all the doses before.
- Children ages 24 to 71 months who have medical conditions and
did not get all the doses before may need one or two doses.
- All children ages 14 to 59 months who finished the full series of PCV7 shots need one dose of PCV13. Children who have medical conditions and are younger than 6 years of age need one dose of PCV13, even if they finished the full series of PCV7 shots or had the PPSV shot.
Polio
(What is a PDF document?)
This shot protects against
polio.
Who should get it?
- Four doses are given to all children—one at age 2 months, one
at 4 months, one at 6 to 18 months, and one at 4 to 6 years.
This immunization (called RotaTeq or Rotarix) protects against
rotavirus infection, which causes severe diarrhea.
Who should get it?
- Three doses of RotaTeq are given to all children—one at age 2
months, one at 4 months, and one at 6 months. If your child gets Rotarix, two
doses are given—one at age 2 months and one at 4 months.
This immunization is swallowed rather than given as a
shot. Without this vaccine, most children will get infected by the time they are
about 5 years old.
Other immunizations
Your child's doctor may suggest other shots if your child
is at higher risk than other children for certain health problems. These may include:
This shot protects against
bacterial
meningitis and blood infections (sepsis).
Who should get it?
- Some children ages 2 through 10 who have a higher risk than
other children for getting and having severe problems from meningitis need one
shot.
- Children who have a damaged or missing
spleen, who have certain
immune system problems, or who travel or live in areas
of the world where the disease is common also need one shot.
Some children need booster shots.7 Check with your child's doctor.
This shot does
not necessarily reduce the risk of getting
pneumonia. But it can prevent some of the serious
complications of pneumonia, such as blood infections (sepsis).
Who should get it?
- Children ages 2 years and older who have certain chronic diseases, such as
diabetes or heart disease, need this shot at age 2 or as soon as possible after it is known that they have a chronic illness. This shot is usually given after the PCV series is finished.
Combination vaccines
Combination vaccines are
usually preferred to separate shots because they reduce the number of needle pricks.
Examples include:
- Comvax (Hepatitis B/Haemophilus influenzae type b)
- Kinrix (Diphtheria, tetanus, pertussis/Polio)
- Pediarix (Diphtheria, tetanus, pertussis/Polio/Hepatitis
B)
- Pentacel (Diphtheria, tetanus, pertussis/Polio/Haemophilus influenzae type b)
- TriHIBit (Diphtheria, tetanus, pertussis/Haemophilus influenzae type b)
Keeping good immunization records
It is important
to keep accurate records of immunizations, including any reactions to the
vaccines. When you enroll your child in day care or school, you may need to
show proof of immunizations. Also, your child may need the record later in life
for college, employment, or travel.
- Know when each immunization should be scheduled, and put
reminder notes on your calendar. You also may want to ask your doctor to send
you notices when immunizations are due.
- Have your doctor go over your child's immunization record with
you during each office visit.
- Keep the record in a safe place, and never throw it away. It is
an important part of your child's lifelong medical records.
To print a list of recommended immunizations based on
your child's birth date, go to the U.S. Centers for Disease Control and
Prevention (CDC) interactive website at
www2a.cdc.gov/nip/kidstuff/newscheduler_le.
If your child age 6 years or younger didn't get all of his or her shots,
find out which ones are needed at
www.cdc.gov/vaccines/recs/scheduler/catchup.htm.
For a form you can use to track your child's immunizations, see the
childhood immunization record(What is a PDF document?)
.
Immunization safety
You may worry that
immunizations are dangerous if given when your child has a cold or other minor
illness. Talk to your child's doctor if you have
concerns about the timing of immunizations. But keep
in mind that immunizations can usually still be given during a mild illness,
while medicines are being taken, and in other situations where a child may not
be in perfect health. Also,
getting several vaccines at the same time is as safe
as getting one shot at a time.8 There are very few
reasons for which doctors suggest that a person
postpone or not get an immunization.
Some parents fear that the measles-mumps-rubella (MMR) vaccine may
cause their child to develop
autism. Misleading stories about the
MMR shot and autism have circulated through websites, the media, and word
of mouth. But scientific studies have found no
connection between autism and the vaccine.3
Adolescent Immunizations
Recommended immunizations
The importance of
continued
immunizations in adolescence (ages 11 through about 21 years) is not always recognized. Adolescents need to continue their
immunization series and receive booster shots for ongoing protection (immunity) against diseases. Many adolescents were born
after the current recommendations for certain immunizations, such as for
hepatitis B, were established. So they did not receive all their needed shots
(injections) in early childhood.
The U.S. Advisory Committee on
Immunization Practices (ACIP), the American Academy of Pediatrics, and the
American Academy of Family Physicians recommend a specific
immunization schedule for children and adolescents
each year.4 This schedule outlines the immunizations
and booster shots needed during adolescence and also when catch-up
immunizations should be given.
To print a list of what shots are
needed, go to the U.S. Centers for Disease Control and Prevention (CDC)
interactive website at www2.cdc.gov/nip/adultImmSched.
Immunizations given during adolescence usually include:
This immunization helps protect against the seasonal
flu and the H1N1 (swine) flu. Flu viruses are always changing, so the flu
vaccines are updated every year. Protection lasts up to a year for each flu
vaccine type.
Who should get it?
Flu immunization is recommended once a year for:5
- All people ages 6 months and older.
- Household contacts and caregivers of anyone who is at high risk
for complications of the flu.
- Anyone who wants to reduce the chance of becoming ill with
the flu or spreading it to others.
Healthy people ages 2 years through 49 years can
usually get the
nasal spray flu vaccine (FluMist)(What is a PDF document?)
instead of the flu shot. Pregnant women can get the flu shot but not
FluMist.
For more information about the flu, see the topics Influenza (Seasonal Flu) and H1N1 Influenza (Swine Flu). For the most current CDC guidelines about seasonal flu, go to www.cdc.gov/flu. For the most current CDC guidelines about H1N1 flu, go to www.cdc.gov/h1n1flu.
Human papillomavirus (HPV)
The vaccines Cervarix(What is a PDF document?)
and Gardasil(What is a PDF document?)
protect against two types of human papillomavirus (HPV) that cause
cervical cancer. Gardasil also protects against two types of HPV that cause
genital warts. And it
protects against some uncommon cancers, such as vaginal cancer.
Who should get it?
- Girls 11 or 12 years old need three doses of either Cervarix or Gardasil, given over 6
months. (The series of shots can be given to girls as young as 9 or 10 years old.)
- Females 13 to 26 years
old who did not get it when they were younger should get this series of shots.
- Males ages 9 to 26 can get three Gardasil shots to reduce the chance of getting genital warts.
If your child already has HPV infection, talk with
your doctor about whether to get your child immunized. The shot has not been shown to help
existing HPV infection, but it may protect your child from other HPV
infections.
For help deciding if the HPV
vaccine is right for your daughter, see:
-
HPV: Should My Daughter Get the Vaccine?
This shot protects against
bacterial
meningitis and blood infections (sepsis).
Who should get it?
- All adolescents should get this shot at age 11 or 12. Teens
ages 13 to 18 who haven't had the shot should get it as soon as possible.
- All college freshmen who live in dormitories and have not had
this shot should get it.
Some people need booster shots.7 Check with your doctor.
This booster shot
protects against
tetanus,
diphtheria, and
whooping cough (pertussis).
Who should get it?
- All adolescents ages 11 or 12 need one Tdap shot. Teens
ages 13 to 18 who haven't had the shot should get it as soon as possible.
Other immunizations
Some adolescents may need or
want additional immunizations for situations that increase a person's risk for
exposure to disease, such as being in group living situations (when attending
college or summer camp) or traveling to foreign countries. These immunizations
may include:
This is important if your child never had
chickenpox or never got this shot.
This
shot (called Varivax) protects against chickenpox.
Who should get it?
- Adolescents and adults who are not already immune to the
chickenpox virus need this shot. Anyone who gets this shot at age 13 or older
should get two doses at least 4 weeks apart.
Chickenpox infection can be very serious when it occurs
after childhood.
This shot protects against
hepatitis A.
Who should get it?
- Adolescents may need this shot if they did not get it as a
child. Talk to your child's doctor if your child never got this shot.
- Some states and communities have set up routine immunization
because hepatitis A occurs there more often than in other areas. Adolescents
living in these areas need this shot.
- Adolescents in communities where outbreaks of hepatitis A
are happening may need this shot.
- Anyone 1 year of age and older who is
traveling to certain foreign countries, such as those
in Central or South America, also needs this shot.
- Anyone who will be in close contact with an adopted child from a country that has high rates of hepatitis A needs this shot. This includes household contacts and babysitters. This recommendation only applies for the first 60 days the child is in the United States.6
Two doses are needed over at least 6 months.
This is important if your child never got this
shot.
This shot protects against
hepatitis B.
Who should get it?
- Anyone 18 years of age or younger who has not had this shot
should get three doses over a period of about 6 months.
This is important if your child never
got this shot.
This shot protects against
measles,
mumps, and
rubella. There is a measles, mumps,
rubella, and varicella (MMRV, or ProQuad) shot(What is a PDF document?)
that also protects against
chickenpox (varicella). It can be substituted for either or both doses of MMR
in children ages 4 to 12.
Who should get it?
- If your child did not get either or both doses, he or she
should try to get immunized at age 11 or 12.
College students usually need to have a written record
showing proof of
immunity, such as having received two doses of
MMR.
This shot does
not necessarily reduce the risk of getting
pneumonia. But it can prevent some of the serious
complications of pneumonia, such as blood infections (sepsis).
Who should get it?
- Adolescents with certain chronic diseases, such as
diabetes or heart disease, need this shot.
Immunization safety
Most side effects from
vaccines are minor, if they occur at all. The doctor may have your child stay
in the office for up to 15 minutes after the shots are given, to watch for any
reactions.
Many parents worry that immunizations are dangerous if
given when their child has a cold or other minor illness. Talk to your child's
doctor if you have
concerns about the timing of shots. But keep in mind
that shots can usually still be given during a mild illness, while medicines
are being taken, and in other situations where a child may not be in perfect
health. There are very few reasons for which doctors suggest that a person
postpone or not get an immunization.
Consult your doctor or public health department if your child missed an
immunization or to find out whether your child needs a specific immunization.
For more information about each vaccine, see the topic
Vaccine Information Statements.
Adult Immunizations
Recommended immunizations
Your need for
immunizations does not end when you reach adulthood.
The specific shots (injections) you need as an adult depend not only on your age, lifestyle, overall health, pregnancy status, and travel plans
but also on who you are in close contact with and what vaccines you had as a child. Tetanus and diphtheria shots need to be
repeated every 10 years throughout adulthood in order to keep your
immunity.
Each year the U.S. Advisory
Committee on Immunization Practices (ACIP), the American College of Obstetrics
and Gynecologists, the American College of Physicians, and the American Academy
of Family Physicians recommend a specific
adult immunization schedule(What is a PDF document?)
.
Your doctor will consider your
medical and immunization history (and documentation) when deciding which shots
you need.
To print a list of which shots you may need, go to the
U.S. Centers for Disease Control and Prevention (CDC) interactive website at
www2.cdc.gov/nip/adultImmSched.
Immunizations given during adulthood may include:9
This shot (called Varivax) protects against
chickenpox. Chickenpox infection can be very serious
when it occurs after childhood.
Who should get it?
- Adults who are not already immune to the chickenpox virus
need two doses, given at least 4 weeks apart.
- Women who don't have evidence of immunity and recently gave
birth should get this shot.
Pregnant women and people with
immune system problems should not get this
shot.
This immunization helps protect against the seasonal flu
and the H1N1 (swine) flu. Flu viruses are always changing, so the flu
vaccines are updated every year. Protection lasts up to a year for each flu
vaccine type.
Who should get it?
Flu immunization is recommended once a year for:5
- All adults. It is especially important for:
- People with a
chronic health condition, such as
asthma,
diabetes, heart or lung disorders, or an impaired
immune system (which puts them at high risk for complications of the
flu).
- Women who are or will be pregnant during the flu
season.
- Household contacts and caregivers of all children younger
than 5 years old and close contacts of others who are at high risk for
complications of the flu.
- People who live in nursing homes or long-term care centers.
Healthy people ages 2 years through 49 years can
usually get the
nasal spray flu vaccine (FluMist)(What is a PDF document?)
instead of the flu shot. Pregnant women can get the flu shot but not
FluMist.
Adults ages 65 and older can get a high-dose flu shot, starting in the fall of 2010.10 Studies are being done to see if the high-dose shot protects older adults better than the standard-dose shot.
For more information about the flu, see the topics Influenza (Seasonal Flu) and H1N1 Influenza (Swine Flu). For the most current CDC guidelines about seasonal flu, go to www.cdc.gov/flu. For the most current CDC guidelines about H1N1 flu, go to www.cdc.gov/h1n1flu.
For help deciding if the flu shot is right for
you, see:
-
Flu Vaccines: Should I Get a Flu Vaccine?
-
Myths About the Flu Vaccine.
This shot protects against
hepatitis A.
Who should get it?
- Adults who will be
traveling to certain foreign countries, such as those
in Central or South America, need two doses given at least 6 months
apart.
- Adults who have certain risk factors, such as long-term
(chronic) liver disease, also need two doses.
- Anyone who will be in close contact with an adopted child from a country that has high rates of hepatitis A needs two doses. This includes household contacts and babysitters. This recommendation only applies for the first 60 days the child is in the United States.6
This shot protects against
hepatitis B.
Who should get it?
- Adults who have not received the vaccine series for hepatitis
B need this shot when occupation, travel, health condition, or lifestyle
increases their risk of exposure.
Three doses are needed over at least 4 months.
A hepatitis combination vaccine (Twinrix) is recommended for those who
are at risk for both hepatitis A and hepatitis B. This vaccine is approved in
the United States only for those 18 years of age or older.
This shot protects against
measles,
mumps, and
rubella.
Who should get it?
- Adults born during or after 1957 may need one or two doses
if they do not have evidence of immunity.
Women should avoid becoming pregnant for 28 days after
getting the MMR shot. Women who are known or suspected to be pregnant and
people who have impaired immune systems should not get this shot.11
This shot does
not necessarily reduce your risk of getting
pneumonia, but it can prevent some of the serious
complications of pneumonia, such as infection in the bloodstream (bacteremia)
or throughout the body (septicemia).
Who should get it?
- All people 65 years of age or older need this shot.
- People ages 2 years to 64 years who have a chronic disease
(such as heart or lung disease), do not have a
spleen, or have a damaged spleen also need this
shot.
- People ages 19 to 64 years who have asthma or who smoke
cigarettes need this shot.
This shot is different from the pneumococcal conjugate
(PCV) shot that is given to all children. Most adults only need one dose of
PPSV for protection. Some people may need a booster shot after 5 years.
This shot (called Zostavax) protects against
shingles.
Who should get it?
- Adults ages 60 and older need one dose, whether or not they've
had shingles before.
Zostavax is not a substitute for the chickenpox shot
(Varivax).
The Tdap shot protects against
tetanus,
diphtheria, and
whooping cough (pertussis). The Td shot does not
protect against pertussis.
Who should get it?
- All adults need Td booster shots every 10 years throughout
life.
- All adults 19 to 64 years of age should have one shot of
Tdap in place of a Td shot.
Tdap is usually only given if it has been at least 10
years since a person's last Td booster. The CDC recommends getting Tdap 2 years
or less from the last dose of Td for:
- People with greater risk for pertussis.
- Health care workers who have direct contact with
patients.
- People who live with or care for infants younger than 12 months old. (Ideally, women would get this
dose before pregnancy.)
The more immunizations you get in a short time frame,
the more likely you are to react with arm swelling and redness at the site of
the shot. But it may be worth a mild reaction to protect a young infant who is
at risk for pertussis.
Other immunizations
You may need or want
additional immunizations if certain situations raise your chance for
exposure to disease. Or you may have missed shots when you were younger. Or a vaccine may not have been offered when you were younger. These immunizations may include:
Human papillomavirus (HPV)
The vaccines Cervarix(What is a PDF document?)
and Gardasil(What is a PDF document?)
protect against two types of human papillomavirus (HPV) that cause
cervical cancer. Gardasil also protects against two types of HPV that cause
genital warts. And it
protects against some uncommon cancers, such as vaginal cancer.
Who should get it?
- Females 13 to 26 years old need three doses of either Cervarix or Gardasil, given over 6
months.
- Males ages 9 to 26 can get three Gardasil shots to reduce the chance of getting genital warts.
If you already have HPV infection, talk with your
doctor about whether to get immunized. The shot has not been shown to help
existing HPV infection, but it may protect you from other HPV
infections.
This shot
protects against bacterial
meningitis and blood infections (sepsis).
Who should get it?
- An adult needs this shot if he or she:
- Has a greater chance of becoming infected during an
outbreak of bacterial meningitis.
- Has a damaged spleen or has had the spleen
removed.
- Travels to or lives in areas of the world where
meningitis is common, such as to certain parts of Africa or to Saudi Arabia
during the Hajj.
- Lives in a college dorm.
The meningococcal conjugate vaccine is given to people ages 2 years to 55 years who need this
immunization. Adults older than age 55 are immunized with the meningococcal
polysaccharide (MPSV4) vaccine, called Menomune. Some people may need booster shots after 5 years.7
This shot protects against
polio.
Who should get it?
- Adults whose travel or job puts them at increased risk for exposure
to polio need three doses of this shot.
- Adults who never had the full series of oral polio vaccine (OPV) or inactivated polio vaccine (IPV) and who have an increased risk of being exposed to polio need the shots they missed.
Routine polio immunization is not recommended for
adults (ages 18 and older) who live in the United States.
Consult your doctor or public health department if
you missed an immunization or to find out whether you need a specific
immunization. For more information about each vaccine, see the topic
Vaccine Information Statements.
Immunizations and pregnancy11
Before you become pregnant, discuss your immunization history with your doctor. If you need the chickenpox
or measles, mumps, and rubella (MMR) shots, wait at least 4 weeks after the
immunization before becoming pregnant.
The CDC recommends the
inactivated flu shots (seasonal and H1N1) for all women who are or who plan to
be pregnant during the flu season. Pregnant women should not receive the nasal
spray flu vaccines.
Also, pregnant women should not receive the HPV
vaccine.
Pregnant women who are due for their tetanus booster can
get immunized with Td vaccine. The CDC recommends that women who have not
previously had Tdap should get a dose of Tdap before getting pregnant or right
after their baby is born. This is to protect the newborn baby from whooping
cough (pertussis).
If you are pregnant, your children should still
get their immunizations on schedule. You do not need to speed up or delay your
other children's immunizations.
Immunizations and new health threats
In 2007, the
FDA approved the first vaccine for humans against bird flu (avian influenza). Immunization is not currently recommended for the public.
The vaccine will be kept in the U.S. government stockpile.12
Immunization safety
You may worry that
immunizations are dangerous if given when you have a cold or other minor
illness. Talk to your doctor if you have
concerns about the timing of shots. But keep in mind
that shots can usually still be given during a mild illness, while medicines
are being taken, and in other situations where you may not be in perfect
health. There are very few reasons for which doctors suggest that a person
postpone or not get an immunization.
Talk with your doctor or
public health department if you missed an immunization or to find out
whether you need a specific immunization. For more information about each
vaccine, see the topic
Vaccine Information Statements.
Travel Immunizations
Recommended immunizations
Talk with your doctor
months in advance of a trip to find out whether any
immunizations are recommended. Certain factors, such
as your age and health, where you are going, and the length of your stay,
affect your risk of disease and your need for immunization.
Your age and health
People with certain medical
conditions, such as
immune system problems, may have different
immunization recommendations than healthy people. Also, young children who are
traveling may need to receive their routine immunizations sooner than normally
scheduled.
Where you travel
In
most developed countries (including Canada, Australia, New Zealand, Japan, and
western and northern European countries), the risk of exposure to serious
diseases is generally no greater than it is in the United States.
The risk of exposure to serious disease may be much higher in developing
countries (such as those in most parts of Africa and Asia and many parts of
South and Central America) than it is in most developed countries. This is
especially true for areas with poor sanitation (for example, poor water and
food handling). For example:
The need for travel immunizations depends on your
immunization history, the specific area you plan to visit, the time of year,
and whether any outbreaks of disease have recently occurred.
How you travel and types of activities
Certain activities or modes of travel increase
your risk of exposure to disease. These include:
- Exploring rural areas or those off the usual tourist
route.
- Taking backpacking trips.
- Visiting people in another country.
Length of stay
The
longer you stay in a country, the more exposure you have to local
pathogens that could cause harm.
Other immunizations
You can get information about
travel immunizations by:
- Contacting your local health department or doctor.
- Visiting the website of the Centers for Disease Control and
Prevention (CDC) at wwwn.cdc.gov/travel.
For more information on immunizations and health related
to travel, see the topic
Travel Health.
Bioterrorism and Immunizations
The United States
government has developed plans on how to respond to possible bioterrorism
threats.
A 2007 law called the Pandemic and All-Hazards
Preparedness Act ("Bioshield II") will help companies make more vaccines and
drugs that protect against bioterror agents.13
Certain diseases have been identified that pose the greatest threat to
the U.S. public. At this time, there is a supply of anthrax and smallpox
vaccines only. These
immunizations are not currently available to or
recommended for the general public. But the government has advised immunization
for people at high risk of exposure to anthrax or smallpox, such as health care
workers specifically designated to respond to a bioterrorism emergency. Some of
these recommendations are listed below.
This shot protects against
anthrax.
Who should get it?
- This shot is for people at high risk of exposure, such as
certain lab workers, people who work with imported animals where preventive
standards are lacking (such as veterinarians who travel to work in other
countries), and certain military members.
Five shots are given over 18 months. And booster shots
are needed every year for continued protection (immunity).
This shot protects against
smallpox.
Who should get it?
- This shot is for certain health care and public health workers,
infection-control specialists, and certain military members.
This shot is given once as several quick punctures on
the upper arm, using a special prong device. Immunity after a first-time
immunization is likely to be 3 to 5 years. If you have been immunized in the
past, successful revaccination may extend your immunity.
The
United States has enough smallpox vaccine to vaccinate Americans in an
emergency.14
More information about these
immunization recommendations can be found on the Centers for Disease Control
and Prevention (CDC) website at www.bt.cdc.gov/bioterrorism. For general
information about bioterrorism issues, see the topic
Terrorism and Other Public Health Threats.
When to Call a Doctor
Call
911
or other emergency services if you or your child develops any of the following
symptoms:
- An
allergic reaction, such as difficulty breathing,
wheezing, hives, hoarseness, paleness, weakness, a fast heart rate, or
dizziness.
- Behavior changes, such as passing out (losing consciousness), acting confused, being very sleepy or hard to wake up,
or not responding to being touched or talked to.
- A
seizure.
Call your doctor if:
- Redness and swelling at the site of the shot (injection) last
longer than 48 hours.
- A
fever lasts longer than 48 hours after receiving a
shot.
- Any unusual reaction occurs.
If a fever develops after an immunization, see one of the following topics to find out if you need to
call your doctor:
Talk with your doctor about whether you need special
immunizations because you:
- Are in close contact with people who have an infectious
disease.
- Have planned international travel, especially to developing
countries.
- Live with or visit a pregnant woman or baby.
- Live with someone who has an
impaired immune system.
Home Treatment
Help your child handle immunizations
Many
immunizations are given as shots (injections). Your
child may experience brief pain as the needle penetrates the skin or muscle.
And some vaccines cause more discomfort than others. In general, you can help
decrease your child's discomfort by making sure that
he or she is physically comfortable and well rested before getting immunized.
You can use home treatment measures to help relieve some of the common minor
reactions to immunizations.
Relieve mild reactions to immunizations
You can
help relieve some of the common, temporary, mild reactions to immunizations
with basic home care.
-
Fever. A slight
fever may occur after you or your child gets a shot.
Acetaminophen (such as Tylenol) or
ibuprofen (such as Advil) may help lower a fever. Follow the package instructions carefully. If you give medicine to your baby, follow your doctor’s advice about what amount to give. Check with your doctor first if you are not sure your young
baby's fever is related to getting immunizations. Do not give aspirin to anyone younger than age 20 because of the risk of
Reye syndrome. For more information on fevers, see the
topic
Fever, Age 11 and Younger or
Fever, Age 12 and Older.
-
Swelling or redness. The area around the injection site may become red and
swollen. Apply a wrapped ice pack or cool compress to the area for about 10 to
20 minutes. If this does not reduce the symptoms, acetaminophen or ibuprofen may help relieve the discomfort. Follow the package instructions carefully.
-
Fretfulness and poor appetite. For a few hours after getting immunized, a baby may be fretful
and drowsy and may refuse to eat. Plan quiet activities at home for the evening
after your child receives an immunization. Hold and cuddle your child when
needed. Keep your home at a comfortable temperature, because your child is more
likely to be fretful if he or she gets too warm.
-
Skin rash. A mild skin rash may arise 7 to 14 days after your child gets
the chickenpox or measles, mumps, and rubella (MMR) shot. These types of rashes
can last several days and go away without treatment.
For more information about reactions to immunizations, see
the When to Call a Doctor section of this topic.
Other Places To Get Help
Organizations
|
American Academy of Pediatrics: Immunization Information
|
| E-mail: |
cispimmunize@aap.org |
| Web Address: |
www.aap.org/immunization |
| |
|
Through the Childhood Immunization Support Program, the AAP strives to deliver current pediatrician-recommended information about the importance of immunizations. This Web site has information about vaccine safety, immunization schedules, vaccine-preventable diseases, personal stories, and more.
|
|
|
Centers for Disease Control and Prevention (CDC):
Vaccines and Immunizations
|
| 1600 Clifton Road |
| Atlanta, GA 30333 |
| Phone: |
1-800-CDC-INFO (1-800-232-4636) |
| TDD: |
1-888-232-6348 |
| E-mail: |
cdcinfo@cdc.gov |
| Web Address: |
www.cdc.gov/vaccines |
| |
|
This CDC Web site has information about vaccines and the diseases that can
be prevented by immunization. The Web site includes the recommended
immunization schedules for children, teens, and adults. There is also
information about vaccine side effects and safety, school and state
requirements, and immunization records. Interactive schedules are also
available.
|
|
|
Centers for Disease Control and Prevention: Travelers'
Health
|
| 1600 Clifton Road |
| Atlanta, GA 30333 |
| Phone: |
1-800-CDC-INFO (1-800-232-4636) |
| TDD: |
1-888-232-6348 |
| E-mail: |
cdcinfo@cdc.gov |
| Web Address: |
wwwn.cdc.gov/travel |
| |
|
The CDC's Travelers' Health Web site provides health
information for the traveler. The Web site provides information on
immunizations that are needed for travel to various areas of the world. It also
provides information for safe travel, including traveling with children and
with people who have special needs. Information about current outbreaks of
disease in the world is also provided. The CDC is the leading federal agency
for protecting U.S. citizens' health and safety by providing credible health
information and health promotion.
|
|
|
Immunization Action Coalition
|
| 1573 Selby Avenue |
| Suite 234 |
| St. Paul, MN 55104 |
| Phone: |
(651) 647-9009 |
| Fax: |
(651) 647-9131 |
| E-mail: |
admin@vaccineinformation.org |
| Web Address: |
www.vaccineinformation.org |
| |
|
The Immunization Action Coalition (IAC) works to
increase awareness of the need for immunization and to boost immunization
rates. This IAC Web site has videos and photos about vaccine-preventable diseases.
The site also offers information about common concerns and myths about
vaccines.
|
|
|
National Network for Immunization
Information
|
| 301 University Boulevard |
| Galveston, TX 77555 |
| Phone: |
(409) 772-0199 |
| Fax: |
(409) 772-5208 |
| E-mail: |
nnii@i4ph.org |
| Web Address: |
www.immunizationinfo.org |
| |
|
The National Network for Immunization Information provides
information on immunizations, including each of the recommended childhood
vaccines, the recommended childhood immunization schedule, tips on using the
World Wide Web as a source of immunization and health information, and links to
other helpful sites. You can also search for the vaccines that each state
requires before entry into school or day care.
|
|
References
Citations
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Parker SK, et al. (2004). Thimerosal-containing
vaccines and autistic spectrum disorder: A critical review of published
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-
Centers for Disease Control and Prevention (2009). Vaccine safety: Mercury and thimerosal. Available online: http://www.cdc.gov/vaccinesafety/concerns/thimerosal/index.html.
-
Demicheli V, et al. (2005). Vaccines for measles,
mumps and rubella in children. Cochrane Database of Systematic Reviews (4). Oxford: Update Software.
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Centers for Disease Control and Prevention (2010). Recommended immunization schedules for persons aged 0 through 18 years—United States, 2010. MMWR, 58(51 and 52): 1–4. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5851a6.htm?s_cid=mm5851a6_e.
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Centers for Disease Control and Prevention (2009). Updated recommendations from the Advisory Committee on Immunization Practices (ACIP) for use of hepatitis A vaccine in close contacts of newly arriving international adoptees. MMWR, 58(36): 1006–1007. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5836a4.htm?s_cid=mm5836a4_e.
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Centers for Disease Control and Prevention (2009). Updated recommendation from the Advisory Committee on Immunization Practices (ACIP) for revaccination of persons at prolonged increased risk for meningococcal disease. MMWR, 58(37): 1042–1043. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5837a4.htm?s_cid=mm5837a4_e.
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Atkinson W, et al., eds. (2009). Epidemiology and Prevention of Vaccine-Preventable Diseases,
updated 11th ed. (The Pink Book). Washington, DC: Public Health Foundation.
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on Immunization Practices (ACIP) Part 1: Immunization of infants, children, and
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MMWR, 55(06): 158–159. Also available online:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5506a6.htm.]
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comprehensive immunization strategy to eliminate transmission of hepatitis B
virus infection in the United States, Recommendations of the Advisory Committee
on Immunization Practices (ACIP) Part II: Immunization of adults.
MMWR, 55(RR-16): 1–33. Also available online:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5516a1.htm. [Erratum in
MMWR, 56(42): 1114.]
- Centers for Disease Control and Prevention (2006). Prevention of hepatitis A through active or passive immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 55 (RR-7): 1–23. Also available online: http://www.cdc.gov/mmwr/PDF/rr/rr5507.pdf.
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Preventing tetanus, diphtheria, and pertussis among adults: Use of tetanus
toxoid, reduced diphtheria toxoid and acellular pertussis vaccine:
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1303–1304. Also available online: http://www.cdc.gov/mmwr/pdf/wk/mm5611.pdf and
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Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
John Pope, MD - Pediatrics |
|
Last Revised
|
May 28, 2010 |
Parker SK, et al. (2004). Thimerosal-containing
vaccines and autistic spectrum disorder: A critical review of published
original data. Pediatrics 114(3): 793–804.
Centers for Disease Control and Prevention (2009). Vaccine safety: Mercury and thimerosal. Available online: http://www.cdc.gov/vaccinesafety/concerns/thimerosal/index.html.
Demicheli V, et al. (2005). Vaccines for measles,
mumps and rubella in children. Cochrane Database of Systematic Reviews (4). Oxford: Update Software.
Centers for Disease Control and Prevention (2010). Recommended immunization schedules for persons aged 0 through 18 years—United States, 2010. MMWR, 58(51 and 52): 1–4. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5851a6.htm?s_cid=mm5851a6_e.
Centers for Disease Control and Prevention (2010). Prevention and control of influenza with vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. MMWR, 59(RR-08): 1–62. Also available online: http://www.cdc.gov/mmwr/pdf/rr/rr5908.pdf. [Errata in MMWR, 59(31): 993 and MMWR, 59(35): 1147.]
Centers for Disease Control and Prevention (2009). Updated recommendations from the Advisory Committee on Immunization Practices (ACIP) for use of hepatitis A vaccine in close contacts of newly arriving international adoptees. MMWR, 58(36): 1006–1007. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5836a4.htm?s_cid=mm5836a4_e.
Centers for Disease Control and Prevention (2009). Updated recommendation from the Advisory Committee on Immunization Practices (ACIP) for revaccination of persons at prolonged increased risk for meningococcal disease. MMWR, 58(37): 1042–1043. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5837a4.htm?s_cid=mm5837a4_e.
Atkinson W, et al., eds. (2009). Epidemiology and Prevention of Vaccine-Preventable Diseases,
updated 11th ed. (The Pink Book). Washington, DC: Public Health Foundation.
Also available online:
http://www.cdc.gov/vaccines/pubs/pinkbook/default.htm.
Centers for Disease Control and Prevention (2010).
Recommended adult immunization schedule—United States, 2010. MMWR, 59(01): 1–4. Also available online:
http://www.cdc.gov/mmwr/PDF/wk/mm5901-Immunization.pdf.
Centers for Disease Control and Prevention (2010). Licensure of a high-dose inactivated influenza vaccine for persons aged =65 years (Fluzone high-dose) and guidance for use—United States, 2010. MMWR, 59(16): 485–486. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5916a2.htm?s_cid=mm5916a2_e.
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