How Vaccines Work
Immunizations use dead or substantially weakened microorganisms to stimulate the immune system to make antibodies that will protect a child by fighting off infection in the event she encounters a serious disease. And generally, vaccines do this with only minor side effects -- soreness at the injection site, low-grade fever, crankiness, and, with the measles and chickenpox vaccines, a mild rash. Although parents often panic, thinking their baby is sick, these reactions are really signs that your child's immune system is working. (But if she has a seizure or an allergic reaction -- such as hives, difficulty breathing, rapid heartbeat, or dizziness -- see your doctor immediately and alert the Vaccine Adverse Events Reporting System at 800-822-7967 or vaers.hhs.gov.)
Children can get vaccinated even if they have a mild cold or low fever. However, if your kid is seriously ill, reschedule the shots. The vaccines won't be effective because her immune system is too busy fighting the infection to respond to the vaccine. Children with immune systems compromised by immune-suppressing medications, cancer, or AIDS shouldn't get the measles-mumps-rubella or chickenpox vaccines because the live virus components could make them ill. And if your child has allergies, ask her pediatrician if she should get the MMR (which contains gelatin), influenza (which contains eggs), or hepatitis B (which contains yeast) vaccines.
When new vaccines like RotaTeq, the oral vaccine against rotavirus, are recommended, it can take a few months for the vaccine to show up in doctors' offices. But you're not out of options. When my pediatrician said she wasn't offering the rotavirus vaccine this year, I asked her to special-order it for my 14-week-old son. I had to pay more, but it was worth it.
Payment and Records
While we're on the subject of cost, are there options if you don't have health insurance? The federal Vaccines for Children program provides free vaccines to any child on Medicaid or without health insurance. Ask your pediatrician if she participates in the program or call your local health department to find a clinic that does.
So how do you keep track of all these shots? Most pediatricians send parents home with a card that lists each vaccine and the date it was given. (You can get blank forms at immunize.org/catg.d/p2022b.pdf.) Keep it in your wallet or diaper bag for easy access at well-baby visits. Dr. Boom recommends scanning the records into your computer once your child completes a series of vaccines, such as the DTaP 2-, 4-, and 6-month shots. Then file the card in a safe place because you'll need proof of vaccinations for school.
Your pediatrician may also participate in one of the many regional and state immunization registries. Although parents can't access these records, any doctor can, and being listed in the registry ensures that even if you move or change doctors, the records won't be lost. And years from now, even decades, if your child is ever asked which vaccines she's had, it won't be a mystery.