14 Common Vaccination Questions Answered

When my daughter was born seven years ago, I followed the vaccine plan that my doctor recommended without question. But when my son arrived three years later, I questioned this schedule. My playgroup had many talks about the shots -- several of my mom friends were forgoing them, and celebrities on the talk show circuit suggested a link between vaccines and autism. I was confused and overwhelmed. One mention of the word "vaccine" would set my heart racing. I know I'm not alone -- which is why we talked to experts to set the record straight about this controversial subject. Here are the top things you need to know about vaccines.

"The only other way to prevent infectious diseases is to keep your child in a bubble, which is impossible," says Ari Brown, MD, coauthor of Baby 411 and a spokesman for the American Academy of Pediatrics (AAP). Even being careful about who comes in contact with your child and the places he goes is no guarantee that he'll stay healthy. And if your vaccinated child does get a disease, his symptoms, with the vaccine, will be less serious than if he hadn't had the shot.

You may have heard that breastfeeding your child passes immunity on to him. But he gets antibodies only for diseases that you're immune to, and these antibodies last just until your baby is 3 to 6 months old. In fact, this is why doctors recommend several vaccines during your baby's first few months: so he's well protected by the time he outgrows this natural immunity.

Illnesses like mumps and measles do still exist today -- and can be very serious and sometimes deadly. "Many diseases that we vaccinate against are rare in this country, but they're not rare in the rest of the world, so they're really just a plane ride away," says Meg Fisher, MD, medical director of The Children's Hospital at Monmouth Medical Center, in Long Branch, New Jersey. A good example is mumps; a recent outbreak in New York and New Jersey was traced to a child who'd traveled to Britain (where the vaccination rate is lower).

Although our country's vaccination program protects against many diseases, it can only do that if most people stick to the schedule. And that means your decision isn't just a family affair. There's something called "herd immunity," where your child may be protected from an illness if 90 percent of the people in your community are vaccinated. If several parents ban the shots, their unprotected kids won't protect one another. Plus, if parents continue to vaccinate, certain diseases will be knocked out in the future. That's what happened with smallpox -- it was eradicated thanks to years of adherence to inoculation.

Experts do consider vaccines to be supersafe because they're studied very extensively. First, a vaccine goes through clinical trials. Then, the FDA reviews these findings to determine the vaccine's safety and effectiveness. Once approved, the FDA monitors production. An example: for each vaccine lot, manufacturers must submit test results that prove potency, safety, and purity. And together, the FDA and Centers for Disease Control and Prevention monitor vaccine use and safety.

"Of all the theories on autism, the vaccine link has been studied the most, and there is just no solid scientific or clinical evidence to back up these claims," Dr. Brown says. "What we do know is that not vaccinating over this concern leaves your child at risk for serious diseases." Experts say the vaccine-autism link originated more than a decade ago when a medical journal published a study of only 12 children. Since then, the study has been thoroughly discredited.

Another safety concern has been the mercury-containing preservative thimerosal. But it's been removed from vaccines, or at least reduced to trace amounts, since 2001. The one exception: the flu shot. However, there are thimerosal-free options.

Some parents believe that their kids should catch certain illnesses to boost immunity, and they arrange "parties" so the child gets infected with a disease such as chicken pox. But chicken pox is very uncomfortable (think a really itchy rash all over the body). And unlike vaccines -- which may provoke fever, redness, a sore arm, or other minor side effects -- getting an actual disease like chicken pox, measles, or the mumps can lead to serious risks and complications such as paralysis, retardation, deafness, and even death.

If baby has the sniffles or a low-grade fever (less than 100.4°), it's fine to go ahead with the shots. "Her immune system is already revved up fighting the cold, so it will possibly be more effective in responding to shots," Dr. Brown says. But if your child has a high fever, wait until she's better. You may also need to hold off on vaccines if she has a weakened immune system or is undergoing other medical treatment, but discuss this with your doctor.

If your child is allergic to egg proteins, which are used in influenza vaccines, she likely can be safely vaccinated. Your doctor can help determine if your baby's potential allergy to the vaccine outweighs the protection it offers, says Julia McMillan, MD, a pediatrics professor at Johns Hopkins University, in Baltimore.

There's a lot of buzz about alternative vaccine schedules, which delay, withhold, separate, or stagger vaccines. Supporters of these schedules say that spacing out the shots, particularly the three injections of the MMR (measles-mumps-rubella) inoculation, doesn't overwhelm a child's immune system and lowers the risk for developing autism. But, Dr. Fisher says, "the immune system is easily able to respond to the vaccines, so there is no problem with giving several vaccines on the same day. There is no evidence that spreading out the vaccines results in fewer side effects."

Other experts caution against the alternative schedules too. "The alternative schedule isn't based on science," Dr. Brown says. "There's no proof that a staggered vaccination schedule is safer." Not to mention that the current immunization recommendations were put together based on a great deal of scientific research and years of study. They're also scheduled according to the earliest possible time to protect your baby. That said, if your child happens to miss a shot, just take her to get the vaccine as soon as possible.

Side effects like redness and tenderness at the injection site, mild fever, and fussiness are normal. But the AAP suggests calling your doctor if your child has any of the following symptoms a few minutes to a few hours after a shot:
*A fever higher than 103°
*A seizure
*Black-and-blue marks or hives in spots where the shot wasn't given

Originally published in American Baby magazine.