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

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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

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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

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Rotavirus Vaccine

Rotavirus is a common virus that causes diarrhea, especially in infants and young children. Childcare centers are a common site of outbreaks.

The vaccine, which is a liquid given by mouth, is recommended at ages 2, 4, and 6 months.

Why the Vaccine Is Recommended

Rotavirus can cause dehydration secondary to large amounts of diarrhea, and can result in children requiring hospitalization. Vaccination against rotavirus can help stop spread in the community, in addition to protecting the individual child.

Possible Risks

Side effects can include diarrhea and vomiting, in addition to fever.

When to Delay or Avoid Immunization

• if your child is currently sick, although simple colds should not prevent immunization
• if your child had an allergic reaction to a previous dose of the vaccine
• if your child has an abnormality of the digestive system or a gastrointestinal disease
• if your child has a history of intussusception, a type of serious bowel blockage
• if your child has recently received gamma globulin or a blood transfusion
• if your child has immune system problems related to cancer, leukemia, or lymphoma; is taking steroids or other immunosuppressive drugs; or is undergoing chemotherapy or radiation therapy

Caring for Your Child After Immunization

Depending on the age of your child, fever may be treated with acetaminophen or ibuprofen. Check with your doctor to see if you can give either medication, and to find out the appropriate dose. If vomiting or diarrhea occur, make sure to give your child small, frequent amounts of fluid and watch for signs of dehydration, such as less urine than usual.

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

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HPV Vaccine

Human papillomavirus (HPV) is a sexually transmitted disease (STD) that causes genital warts and changes in the cervix that can result in cervical cancer.

The vaccine is recommended for girls 11 or 12 years old, as well as for older girls who are unvaccinated. It is given as a series of three shots over a 6-month period.

Why the Vaccine Is Recommended

Because HPV can cause serious problems such as genital warts and cervical cancer, a vaccine is an important step in preventing infection and protecting against the spread of HPV. It works best when given before a girl becomes sexually active.

Possible Risks

Side effects are usually mild fever and tenderness, swelling, and redness at the site of the injection. Dizziness, fainting, nausea, and vomiting may also occur after the shot.

When to Delay or Avoid Immunization

• if your daughter is currently sick, although simple colds or other minor illnesses should not prevent immunization
• if your daughter had an allergic reaction to the first dose of HPV vaccine
• if your daughter has had a severe allergic reaction to yeast
• if your daughter is pregnant
• if your daughter has a bleeding disorder (discuss with your hematologist)

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

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Immunization Schedule

This immunization schedule is a handy reference to help you keep track of which vaccines your child needs to receive and when.

Types of Vaccines

Four different types of vaccines are currently available:

1. Attenuated (weakened) live viruses are used in some vaccines such as in the measles, mumps, and rubella (MMR) vaccine.
2. Killed (inactivated) viruses or bacteria are used in some vaccines, such as in IPV.
3. Toxoid vaccines contain a toxin produced by the bacterium. For example, the diphtheria and tetanus vaccines are toxoid vaccines.
4. Conjugate vaccines (such as Hib) contain parts of bacteria combined with proteins.

Immunizations for Travel

Specific information about which immunizations are required by travelers to each country worldwide is available directly from the Centers for Disease Control and Prevention (CDC). Ask your doctor for more information.

Depending on the type and length of travel, some vaccines may be recommended. Most immunizations should be given at least 1 month before travel. Take your child's immunization records with you when you travel internationally.

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