Hepatitis B Vaccine (HBV)

Hepatitis B virus (HBV) affects the liver. Those who are infected can become lifelong carriers of the virus and may develop long-term problems such as cirrhosis (liver disease) or cancer of the liver.

Immunization Schedule

Hepatitis B vaccine usually is given as a series of three injections. The first shot is often given to infants shortly after birth. If the mother of a newborn carries the hepatitis B virus in her blood, the infant needs to receive the first shot within 12 hours after birth, along with another shot (HBIG) to immediately provide protection against the virus. If a newborn's mother shows no evidence of HBV in her blood, the infant may receive the hepatitis B vaccine any time prior to leaving the hospital. It may also be delayed until the 1- or 2- month visit to your doctor.

If the first dose is given shortly after birth, the second shot is given at 1 to 2 months and the third at 6 to 18 months. For infants who don't receive the first shot until 1 to 2 months, the second shot is given at 3 to 4 months and the third at 6 to 18 months. In either case, the second and third shots are usually given in conjunction with other routine childhood immunizations.

Why the Vaccine Is Recommended

The hepatitis B vaccine usually creates long-term immunity. Infants who receive the HBV series should be protected from hepatitis B infection not only throughout their childhood but also into the adult years. Eliminating the risk of infection also decreases risk for cirrhosis of the liver, chronic liver disease, and liver cancer. Young adults and adolescents should also receive the vaccine if they did not as infants.

Possible Risks

Serious problems associated with receiving the HBV vaccine are rare. Problems that do occur tend to be minor, such as fever or redness or tenderness at the injection site.

When to Delay or Avoid Immunization

• if your child is currently sick, although simple colds or other minor illnesses should not prevent immunization
• if a severe allergic reaction (called anaphylaxis) occurred after a previous injection of the HBV vaccine

Caring for Your Child After Immunization

The vaccine may cause mild fever, and soreness and redness in the area where the shot was given. Depending on the age of your child, pain and fever may be treated with acetaminophen or ibuprofen. Very young infants should not be given either medication, but for older infants or children, you can check with the doctor about the appropriate dose.

When to Call the Doctor

• if you're not sure of the recommended schedule for the hepatitis B vaccine
• if you have concerns about your own HBV carrier state
• if moderate or serious adverse effects appear after your child has received an HBV injection

Read More

Varicella (chickenpox) Vaccine

The varicella vaccine protects against chickenpox (varicella), a common and very contagious childhood viral illness.

Immunization Schedule

The varicella vaccine is given by injection between the ages of 12 and 15 months, followed by a booster shot at 4 to 6 years of age for further protection. Older kids under the age of 12 years who have not had chickenpox may also receive the vaccine, with the two doses given at least 3 months apart. Kids 13 years or older who have not had either chickenpox or the vaccine would need two vaccine doses at least 1 month apart.

Why the Vaccine Is Recommended

The varicella vaccine prevents severe illness in 95% of children who are immunized. It's up to 85% effective in preventing mild illness. Vaccinated kids who do get chickenpox generally have a mild case.

Possible Risks

Serious reactions are extremely rare. Possible mild effects are tenderness and redness where the shot was given, fever, fatigue, and a varicella-like illness. A rash can occur where the shot was given or elsewhere on the body up to 1 month after the injection. It may last for several days but will disappear on its own without treatment.

When to Delay or Avoid Immunization

• if your child is currently sick, although simple colds or other minor illnesses should not prevent immunization
• if your child has an allergy to gelatin or to the antibiotic neomycin that has required medical treatment
• if your child has recently received gamma globulin or a blood transfusion
• if your child has immune system problems related to cancer; is taking prednisone, steroids, or other immunosuppressive drugs; or is undergoing chemotherapy or radiation therapy

Caring for Your Child After Immunization

Pain and fever may be treated with acetaminophen or ibuprofen. Check with your doctor about the appropriate dose.

When to Call the Doctor

• if you aren't sure if the vaccine should be postponed or avoided
• if there are problems after the immunization

Read More

Influenza Vaccine

Influenza, commonly known as "the flu," is a highly contagious viral infection of the respiratory tract.

Immunization Schedule

These groups, who are at increased risk of flu-related complications, should receive the flu shot every year:

• all children between 6 months and 18 years old, especially those 6 to 59 months old
• any child or adult with chronic medical conditions, such as asthma, cystic fibrosis, diabetes, sickle cell anemia, and HIV/AIDS
• children and teens on long-term aspirin therapy
• anyone age 50 and older
• women who will be pregnant during the flu season
• anyone who lives or works with infants (especially those under 6 months old)
• residents of long-term care facilities, such as nursing homes
• health care personnel who have direct contact with patients
• out-of-home caregivers and household contacts of anyone in any of these high-risk groups

In the past, there have been times when there were vaccine shortages and delays. So talk with your doctor about availability.

For kids younger than 9 who are getting a flu shot for the first time, it's given in two separate shots a month apart. It can take about 2 weeks after the shot is given for the body to build up protection to the flu.

Another non-shot option called the nasal mist vaccine came on the market in 2003 and is now approved for use in healthy 2- to 49-year-olds. But this nasal mist isn't for everyone, and can't be used by high-risk children and adults or pregnant women.

Why the Vaccine Is Recommended

The flu vaccine reduces the average person's chances of catching the flu by up to 80% during the season. Getting the shot before the flu season is in full force gives the body a chance to build up immunity to, or protection from, the virus.

The shot usually becomes available between September and mid-November. Although you can get a flu shot well into flu season, it's best to try to get it earlier rather than later, if your doctor thinks it's necessary. However, even as late as January there are still 2 to 3 months left in the flu season, so it's still a good idea to get protection.

Even if you or your child got the vaccine last year, that won't protect you from getting the flu this year, because the protection wears off and flu viruses constantly change. That's why the vaccine is updated each year to include the most current strains of the virus.

Possible Risks

Given as one injection in the upper arm, the flu shot contains killed flu viruses that will not cause someone to get the flu, but will cause the body to fight off infection by the live flu virus. Getting a shot of the killed virus offers protection against that particular type of live flu virus if someone comes into contact with it.

Some of the most common side effects from the flu shot are soreness, redness, or swelling at the site of the injection. A low-grade fever and aches are also possible. Because the nasal spray flu vaccine is made from live viruses, it may cause mild flu-like symptoms, including runny nose, headache, vomiting, muscle aches, and fever. Very rarely, the flu vaccine can cause serious side effects such as a severe allergic reaction.

When to Delay or Avoid Immunization

People who should not get the flu shot include:

• infants under 6 months old
• anyone who's severely allergic to eggs and egg products because the ingredients for flu shots are grown inside eggs. Tell the doctor if your child is allergic before he or she gets a flu shot.
• anyone who's ever had a severe reaction to a flu vaccination
• anyone who's had Guillain-Barré syndrome (GBS, a rare medical condition that affects the nerves) within 6 weeks of getting a flu shot
• anyone with a fever

Caring for Your Child After Immunization

Pain and fever may be treated with acetaminophen or ibuprofen. Check with your doctor about the appropriate dose. Some doctors recommend a dose just before the immunization. A warm, damp cloth or a heating pad also may help minimize soreness. Moving or using the limb that has received the injection often reduces the soreness as well.

When to Call the Doctor

• if you aren't sure if the vaccine should be postponed or avoided
• if there are problems after the immunization

Read More

Hepatitis A Vaccine (HAV)

The hepatitis A virus (HAV) causes fever, nausea, vomiting, and jaundice, and can lead to community-wide epidemics. Childcare centers are a common site of outbreaks.

The vaccine is recommended for children 12-23 months old, followed by a second dose 6 months later. The vaccine is also recommended for older kids and adults who are at high risk for the disease, including those who are traveling to locations where there are high rates of HAV.

Why the Vaccine Is Recommended

Vaccination against HAV can help stop epidemics from developing in the community, in addition to protecting the individual child. Some infected children do not have any symptoms, and can spread the virus to others. The more young children who are vaccinated against HAV, the more limited the spread of disease will be in a community.

Possible Risks

Side effects are usually mild fever, and tenderness, swelling, and redness at the site of the injection.

When to Delay or Avoid Immunization

• if your child is currently sick, although simple colds or other minor illnesses should not prevent immunization
• if your child had an allergic reaction to the first dose of hepatitis A vaccine

Caring for Your Child After Immunization

Your child may experience fever, soreness, and some swelling and redness in the area where the shot was given. Pain and fever may be treated with acetaminophen or ibuprofen. Check with your doctor about the appropriate dose.

When to Call the Doctor

• if you aren't sure if the vaccine should be postponed or avoided
• if there are problems after the immunization

Read More