A Sting Operation

My son's hair is too long; his sneakers are suddenly too small. It must be the end of summer, marked by a wistful sense of time passing.

We will soon go to the pediatrician for our annual back-to-school visit, exclaim at the inches and pounds gained, and boast about reading skills. Then, in will stride the smiling nurse with the dreaded silver tray of needles not well hidden beneath a paper towel. This is not a fun summer moment, but it is a necessary one – vaccines save thousands of lives and protect millions of children from potentially deadly diseases. 

Thanks to widespread immunization, diseases like polio, measles, diphtheria, rubella (German measles), mumps and tetanus - to name a few - were once common in the United States, but have been greatly reduced or eliminated. One unfortunate side effect of all this progress, however, is that as these diseases have dropped from our collective radar, so has our sense of urgency when it comes to immunization. Lapsing rates of immunization are responsible for a recent sharp rise in measles and for a whooping cough epidemic in California that has resulted in seven infant deaths and is said to be the worst in 50 years.

Viruses and bacteria are, for better or worse, household and classroom fixtures.  Bugs lurk on door knobs, shopping carts, ATM buttons, toys and books. The common cold virus can live up to three weeks on surfaces; and a cough across the playground can deliver germs at lightning speed. It is simply not possible to completely insulate ourselves or our children from exposures. But we can get vaccinated against the worst of these threats and enable our bodies to thwart many of the most harmful offenders.

When we encounter germs, our bodies respond by churning out antibodies that will defend against them. Vaccination works by exposing our bodies to bacteria or viruses in very small, controlled amounts. In the event that actual disease presents itself later in our lives, our bodies already know what to do. Sickness is averted; we are immune.

Vaccination prevents illness in our children, and it provides a huge public health benefit at school and beyond. But its success depends upon our cooperation.

"There is the concept of herd immunity," explains family medicine physician Dr. Lana Nguyen. "If 95 out of 100 people are immunized against polio for example, then the five unimmunized people - while susceptible - have a fairly low chance of contracting the disease because the other 95 are immunized and won't get it and pass it on. If on the other hand only 50 out of 100 people are immunized, now the pool of susceptible people is much larger. The 50 non-immunized folks can get the illness and pass it on to others triggering an epidemic." 

This actually happened between 1989 and 1991 when an epidemic of measles broke out in the United States, the result of a failure to vaccinate preschool-aged children, according to the Centers for Disease Control.

Typically, the herd immunity has protected the most vulnerable in our population, those who can not be or are too young to have yet been vaccinated. 

Even with this knowledge, some parents are skittish about vaccinating and worry that the vaccine itself will make their child sick. With vaccines made from dead, inert germs, there is no risk of illness. All vaccines given to infants under the age of one year are of this type, as infant immune systems are still maturing. Older children who receive vaccines made from live, attenuated virus, such as chicken pox and MMR (measles, mumps, and rubella), may react to the vaccine with a 'mini illnesses' such as low grade fevers or small rashes, which pass quickly.  Other side effects can include local soreness and swelling at the site of the injection, a temporary nodule at the injection site, crankiness and exhaustion.

The vaccine schedules recommended by the American Pediatric Association and the federal CDC take into account both the age when the child's immune system will work best and the need to protect infants and children as early as possible. 

If needles make your child (or you) feel a little squeamish, try these anxiety reducers:

• Remember that children take their cues from us – be calm, honest and matter a fact with your child about doctor visits.
• Bring a favorite toy, book or love for comfort.
• Pre-medicate with a little Tylenol or Ibuprofen to ease the discomfort afterwards.
• Nurse your infant to provide a great distraction during the vaccination process.
• Ask your pediatrician to space vaccines apart so that only one or two are given per session if this works better for your child.
• Ask your pediatrician to use cooling sprays or anesthetic creams to numb the skin before the shot.
• If you continue to have concerns about vaccines, talk about the vaccination schedule with your pediatrician. Many vaccination schedules can be adjusted and different forms of vaccines (such as non-mercury-based vaccines) are also frequently available.

            And of course, have a lollipop afterwards.

            Dr. Lana Nguyen and nurse Deborah Meshel provided information for this article.