PARENTS Report: Vaccine Update 2007

Hepatitis to Poliovirus

Hepatitis B

This is your baby's first vaccine, usually given in the hospital hours after birth. He'll get two more doses before 18 months. This infectious liver disease can become chronic and last a lifetime.

Did you know? Since Hepatitis B is sexually transmitted and not typically associated with babies, the vaccine perplexes some parents; but the first dose is important because an (unknowingly) infected mother can easily pass the virus on to her child during delivery, says Margaret Fisher, MD, editor-in-chief of the American Academy of Pediatrics' Immunizations and Infectious Diseases. And the stakes are higher for babies: Ninety percent of infant cases become chronic -- compared with only 6 percent of cases in adults -- and one in four babies die.

Diphtheria, Tetanus, Pertussis

The DTaP, as it's now known, is a five-dose vaccine that guards against diphtheria (a respiratory disease), tetanus (a potentially fatal bacterial infection), and pertussis (whooping cough). The "a" in DTaP stands for "acellular" pertussis; this newer version of the shot has fewer side effects, such as soreness and fever, than the previous DTP vaccine, which contained "whole-cell" pertussis. Your baby receives four doses from 2 to 18 months and the last one between ages 4 and 6. Between ages 11 and 12, your child needs a slightly different booster called Tdap.

In the news: "Whooping cough is the only vaccine-preventable disease that's actually on the rise," says Dr. Fisher. The infection causes long coughing spells -- sometimes powerful enough to crack a rib -- and the signature "whooping" sound when a child gasps for air between coughs. There are a variety of reasons for the surge in cases. Adults may not have been fully immunized, and some vaccines given in the 1980s were less effective. Immunity for whooping cough wanes five to 10 years after vaccination; that's why preteens -- and all adults -- should get a booster. Although older kids and adults generally recover from whooping cough, the biggest risk is that they'll pass along the highly contagious disease to young children. "It's most dangerous for babies to get pertussis in their first six months, before they've had three doses of the vaccine," says Dr. Halsey. The stats are grim: Ninety percent of the pertussis-related deaths reported to the Centers for Disease Control and Prevention (CDC) between 2000 and 2004 were infants under 4 months old.

Haemophilus Influenzae Type b (Hib)

Meningitis is a potentially lethal inflammation of the lining of the brain and spinal cord. The viral type tends to resolve on its own without treatment, but bacterial meningitis can be fatal in a matter of days. Before this vaccine debuted in the late 1980s, Hib was the leading cause of bacterial meningitis in children under age 5, and two-thirds of cases were in children younger than 18 months, says Dr. Fisher. Today, the vaccine comes in either a two- or three-dose series starting at 2 months and ending at 12 to 15 months. It's been amazingly effective: Hib incidence has plunged 99 percent.

Inactivated Poliovirus

In 1953, Jonas Salk's discovery of a safe and effective polio vaccine was huge news; the paralyzing viral disease that tended to strike children had terrified parents. Babies used to get an oral vaccine containing weakened live virus, but it carried a very small risk of actually causing polio. Since 2000, American doctors have only used the inactivated poliovirus shot, which can't cause the disease. Your child gets it at 2 months, 4 months, and 6 to 18 months, as well as a booster between ages 4 and 6.

Did you know? Polio is still a threat -- there were more than 1,300 cases worldwide this year. "Because of international travel and adoption, even Americans are at risk," says Henry Bernstein, DO, chief of general pediatrics at Dartmouth-Hitchcock Medical Center, in Lebanon, New Hampshire. Because 95 percent of people who contract the virus don't develop symptoms (paralysis occurs in fewer than 1 percent of cases), it can be easy to overlook -- making immunization even more critical.

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