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    Expert Q&A: Childhood Vaccine Safety

    So are they recommended as separate injections?

    That is kind of left to the physicians. A clinician should explain the risks and benefits carefully with the child's parents. If they think the parent may not understand, there is a suggestion to give the MMR and varicella separately.

    How will I know if my child is having a bad reaction?

    If it's any unusual condition such as a high fever [over 100], weakness, or behavioral changes that are particularly concerning to the parent, such as the child is unresponsive ... the ones to really look out for are signs of a serious allergic reaction, and these can include difficulty breathing, hoarseness or wheezing, hives, weakness, a fast heartbeat, or dizziness.

    They should call the doctor and get to the [child's] personal doctor right away.

    If your kid is sick, should you get vaccinated or wait?

    A child with a mild common illness such as a cold or a low-grade fever does not have to wait to be vaccinated. It is preferable to delay vaccination for a child with a more severe illness.

    If they have just the sniffles or mild diarrhea, it would be OK to vaccinate.

    If my child is taking medications on a regular basis, such as for ADHD, or steroids, are there interactions with vaccines I need to be concerned about?

    The parent should consult with their health care provider before getting that vaccination. But in general the commonly used medications, including those for ADHD, are not known to have powerful interactions with vaccinations.

    Short-term steroid therapy is usually not a contraindication to administer live virus vaccines. ... There's no evidence of increased severity of reactions to live attenuated vaccine that's been reported among people receiving corticosteroid therapy by aerosol ... so that sort of therapy is not a reason to delay.

    Higher doses or longer-term treatment, someone probably being treated for a fairly chronic or severe medical condition, should consult with their health care provider before being vaccinated.

    My child has a weakened immune system. Is it safe to vaccinate?

    Again, it depends on the level of weakened immunity. If the child has leukemia or other types of cancer, or AIDS, they should not receive vaccines with live weakened or live attenuated vaccines. Examples of these include measles, intranasal influenza. Obviously any decisions ... should be made on a case-by-case basis in consultation with the child's doctor.

    We are talking about live vaccine. ... Most of the other vaccines are inactivated. Inactivated vaccines can be administered safely to persons with altered immunocompetence.

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