Death from chicken pox declined 88%, from 4.1 in ten million people to just 0.5 per ten million.  The study by the CDC was published in the August 2011 issue of the AAP journal Pediatrics, comparing death rates in the early ’90′s (before introduction of the vaccine) to the mid-2000′s.

This improvement occurred with a single injection.  Subsequently, a 2-dose regimen has been introduced, because other research has shown that 5% of children don’t achieve proper immunity to chickenpox from a single injection.

So we can expect even better numbers, the next time the numbers are run!

–  David Epstein, MD

Over a thousand mothers and their infants on an Indian reservation were studied.  Infants whose mothers received flu vaccines were 40% less likely to catch influenza themselves, and 40% less likely to be hospitalized for it.

The effect of fathers’ flu shots on the health of their infants was not studied, but one can assume that it would benefit the kids as well.

Since 1997, experts have recommended that pregnant women should be given flu vaccine.  But acceptance of this advice has been very slow.  Many of the families in my practice are happy to have the infants vaccinated, but the parents are reluctant to be vaccinated themselves.

But, as an accompanying editorial says: “Maternal influenza vaccination targets 2 high-risk groups with 1 vaccine dose – we can’t afford not to act.”  Perhaps this study will reassure these parents, and encourage them to get their own flu shots every year!

–  David Epstein, MD

Archives of Pediatric and Adolescent Medicine.  Vol 165, No. 2, Feb 2011, p. 104-111.

The ads recall a time when many children were crippled or killed by contagious diseases.  Grandparents hold their own young grandchildren, while talking about members of their own families who died or were crippled by illnesses that nowadays we rarely experience.  Vaccinations that we routinely administer to our patients are highly effective at keeping children safe from these dangerous diseases.

To view these ads, click here.

–  Dr. Epstein

Routine vaccination prevents illness.  Another recent study has confirmed the value of these shots.  In the June 2009 issue of Pediatrics, doctors in Denver, Colorado investigated 156 cases of clinically proven whooping cough (Pertussis) in children, ages 2 months to 18 years.  When compared with kids who received the standard immunization schedule, children of “refusers” were much more likely to get sick from whooping cough – 20 times more common!

This study demonstrates two things.  First, vaccines prevent illness (not surprisingly).  Second, these kids didn’t get much protection from “herd immunity.”  They weren’t protected by the fact that other kids in their community had been immunized.

Bottom line: don’t delay!  Get your kids vaccinated according to the recommended schedule.  If you have questions, I’d be happy to discuss them with you.

–  Dr. Epstein

http://pediatrics.aappublications.org/cgi/content/abstract/123/6/1446

Rotarix vaccine protects babies from infection with Rotavirus, an intestinal virus causing vomiting and diarrhea which can be severe.  Since the introduction of Rotarix (and a similal vaccine, RotaTeq, from another manufacturer), rates of infection and hospitalization from Rotavirus infection have dropped significantly.

The contaminant is a virus that infects pigs and other animals, but not people (as far as we know).  There have been no reports of illness, and I have heard no complaints from my patients about side effects from Rotavirus vaccine.  However, it is possible that the current batch of Rotarix may eventually be recalled.  (Currently, doctors are being asked to refrain from using their stores, but we’re not yet being asked to return it to the manufacturer.)

For more information, please see the “News” section on the front page of our website,  www.dmpKids.com.

–  David Epstein, MD

This is certainly not a “new” vaccine;  the H1N1 vaccines are just like the regular seasonal vaccine, made by the same manufacturers, who use the same egg-culture process.  There’s a different flu virus inside, but that’s little different than the “new” seasonal flu vaccine that comes out each autumn.

Side effects?  I’ve heard of no reactions from my patients so far, other than occasional 1-2 days of fever.  So there’s no reason to be more fearful of the Swine Flu vaccine than any other routine immunization.  (Click here to visit my post last month about the safety of flu vaccines.)

It’s unfortunate that there’s so much noise and misinformation about flu vaccines.  Much of it stems from recent political activity from groups who oppose universal vaccination.  (Click here to see my thoughts about that issue.)

But the facts are plain.  Thousands of people die each year from influenza.  The CDC reports that 324 Americans have died from Flu since April (as of 2/10/10), including 260 children.  (Click here to see the data.) Thousands more have been hospitalized.

But I’m not aware that anyone ever died from a flu shot.  The balance of safety is certainly convincing: we’re all better off getting vaccinated!

–  David Epstein, MD

We’ve only received 100 doses of the shot for infants and toddlers so far.  We hope to have further shipments soon, so that we can vaccinate everybody, but it’s possible we’ll run out temporarily.  Remember that you need 2 doses (at least 3 weeks apart) for the best immunity (estimated at 85%), but the first shot gives some useful protection (estimated at 75%).  So we’ll try to give everybody the first dose before we start giving boosters.  Once we have received enough vaccine, we’ll start administering the boosters.

We have also received a second shipment of the H1N1 shot for older kids (with preservative).  So now we have enough H1N1 vaccine to vaccinate all our high-risk patients for their first vaccine.  If your child has asthma (or other high risk illness), you should be on our schedule now to receive the first dose.  I’ll post a note here when we have enough for boosters.  We now have enough seasonal flu vaccine for all our patients as well; all kids should be given both.

To give you some perspective, Delaware Modern Pediatrics has received only 300 of the 2300 doses of H1N1 we ordered for our patients.  Obviously, supplies are still tight.  This is not the fault of the Division of Public Health; the manufacturing process for flu vaccine is antiquated and slow.  We have similar supply problems with the seasonal flu vaccine in most years (though not this year); but the shortages haven’t been as noticeable because demand for flu shots has never been this high.

Should you have your kids vaccinated through school?  Yes, absolutely, if you can!  The only exception is for kids with asthma (or other serious underlying disease) who are being offered only the nasal flu vaccine at school; those patients should be given the injection (available through our office for our current patients).

The vaccine we have received is a shot.  It’s the type “with preservative.”  If your child is able to receive the Swine Flu vaccine from another source, such as your school, I strongly encourage you to do so!  The only exception is if the school’s vaccine is the nasal “Flu-Mist” type, which is a live virus, which would be contra-indicated for kids with chronic conditions such as persistent asthma.

So, regrettably, we still can’t schedule flu shots for kids not on the high-risk list.  I still expect to receive further shipments of H1N1 vaccine – and I expect that we’ll be able to vaccinate all our patients by the end of the flu season!  I’ll post a note on the blog here, when we receive enough to vaccinate everybody.

–  David M. Epstein, MD

Should you sign your child up?  Yes!   If the school is ready to give your child a flu vaccine, I recommend that you participate.   We expect to have the vaccine in stock also, but I don’t know when it will be delivered.  If you’d prefer that we administer it instead of your school’s nurse, we’ll be happy to help.  (I’ll post a note on the blog when we get it in!)

The Swine Flu nasal vaccine probably will be delivered before the injections.  The live nasal flu vaccines are perfectly appropriate for any child over 2 years old, if they don’t have asthma (severe enough to have 4 attacks a year or more, or needing daily asthma medication.)

–  David Epstein, MD

If we were not able to give your child (under 2) seasonal flu vaccine because we were out of stock for the past couple of weeks, you may now call to make an appointment and get caught up!  I encourage everybody to get vaccinated!

–  David Epstein, MD