Emory Report

March 2, 1998

 Volume 50, No. 23


Immunizations keep deadly
diseases in the history books

Every parent knows at least part of the immunization drill: taking a reluctant child to the doctor's office for one or more mildly painful injections, perhaps bribing said child with a treat afterward if she behaves herself. Childhood immunizations are now routine-indeed, they are required by law for school and day care-yet most parents don't think much about what immunizations really do.

When a person is exposed to disease, the body's immune system responds by creating antibodies to fight the disease. These antibodies help the body protect itself against the disease long after first exposure. Immunizations work by prompting an immune response in the body without the risk of exposure to the disease, thus preventing illness.

Thanks to effective vaccines, the days of deadly epidemics for several childhood diseases are long past. Many parents today have never seen anyone in leg braces after a crippling bout with polio, and most couldn't identify the disease pertussis even if you told them to listen for the characteristic "whooping cough." Such ignorance is bliss because it shows off the success of vaccination campaigns.

Unfortunately, this happy innocence has its down side as well-without any personal experience with such killers as tetanus and diphtheria, parents may not take seriously the need to immunize their children against the diseases. Even doctors may not be very strict about keeping patients' shots up to date. Usually, though, parents and doctors want to make sure children are fully protected against major childhood diseases, so the main issue is simply getting the child to the office for shots.

Current immunization recommendations call for a series of shots against 10 different diseases to be given during a child's first two years. The recommendations are reviewed each year and agreed upon by the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices, the American Academy of Pediatrics and the American Academy of Family Physicians.

The cornerstone of the complex schedule is the "4-3-1" series:

  • four doses of DTP (diphtheria, tetanus or "lockjaw," and pertussis or "whooping cough"), given at two, four and six months, and around 15 months;
  • three doses of polio, given at two and four months, and around 12 months;
  • one dose of MMR (measles, mumps and rubella-"German measles"), given at 12-15 months.

Newer vaccines are also available against hepatitis B, haemophilus influenzae type B or "Hib" (which can cause meningitis), and varicella or "chicken pox." The hepatitis B vaccine is often given immediately after birth and followed with two more doses at around one and six months. Hib follows the same schedule as polio, and varicella should be given at around 12 months.

This is a simplified version of the approved schedule. Children with specific health problems may receive their immunizations at different times. Your physician can help you determine what is most appropriate for your child.

Parents interested in learning more about childhood immunizations can contact the CDC's National Immunization Program hotlines at 800-CDC-SHOT for general immunization information or 800-232-2522 for immunization clinic locations and other information. Or visit the program's web site at <http://www.cdc.gov/nip>.

Johanna Hinman is an MPH candidate at the Rollins School of Public Health and a research assistant on the Georgia Immunization Study. "Wellness" is coordinated by the Seretean Center for Health Promotion at the Rollins School of Public Health.

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