Get an 'A' in Vaccines
Never Too Late to Be Up to Date continued...
"Early on, when immunizations became available ... (parents) were
flocking to clinics to get shots for their kids. But as vaccines have been more
and more successful -- and there is less direct memory in parents of how bad
these diseases are -- it's dropped a little bit on the priority list," says
Dr. David W. Fleming, of the Oregon Health Division in Portland.
The chickenpox vaccine, for example, has been on the market since May 1995
and recommended by the CDC since '96. Yet varicella has remained the leading
cause of vaccine-preventable deaths in this country, according to Dr. Estrada.
And immunization rates in some regions are still as low as 25%, according to
Hepatitis B is another case in point. The disease occurs primarily in older
children and young adults. Pediatricians have been less enthusiastic in giving
According to Dr. Fleming, who is also a member of the Advisory Committee on
Immunization Practices (ACIP), health-care providers tend to be more jazzed
about newer immunizations if they prevent childhood ailments the doctor has
treated. "I think we're seeing the same phenomenon with parents," he
Don't Forget Your Middle-Schooler
There is slight variation by state, but generally, 11- to 12-year-olds need
vaccines against hepatitis B, measles, mumps, rubella and varicella, if
previously recommended doses were missed or given earlier than the recommended
In May 1999, the ACIP recommended that all states require varicella
vaccination, or evidence of immunity, for children entering child care and
And there is talk of adding chickenpox to the existing measles, mumps and
rubella vaccine to pack a quadruple wallop into a single needle stick. But that
product won't be developed right away, Dr. Fleming says, and will mainly aid
younger children who now face 13 separate injections by age 6.
A Td shot -- tetanus and diphtheria toxoids -- is recommended at 11 to 12
years of age if more than five years have elapsed since the last dose of DTP,
DTaP or DT. Routine Td boosters are recommended every decade.
Dr. Fleming, himself the father of children in the immunization age range,
says it helps to talk to children about the need for the shots. Children recall
being sick, or having a friend who was sick, and can understand the shot as a
"trade-off" to prevent future sickness.
"I'm not above bribery and combining a visit to the ice-cream
store," admits Dr. Fleming, "so the child has a short-term reason to
want to get their shot."