Immunizations help protect
you or your child from disease. They also help reduce the spread of disease to
others and prevent epidemics. Most are given as shots. They are sometimes
called vaccines, or vaccinations.
In many cases when you get a
vaccine, you get a tiny amount of a weakened or dead form of the organism that
causes the disease. This amount is not enough to give you the actual disease.
But it is enough to cause your
immune system to make
antibodies that can recognize and attack the organism
if you are ever exposed to it.
Sometimes a vaccine does not
completely prevent the disease, but it will make the disease much less serious
if you do get it.
Some immunizations are given only one time.
Others require several doses over time.
Why should you get immunized?
Immunizations protect you or your child from dangerous
diseases.
They help reduce the spread of disease to others.
Getting immunized costs less than getting treated for the
diseases that the shots protect you from.
Vaccines have very few serious side effects.
They are often needed for entrance into school or day care. And
they may be needed for employment or for travel to another country.
If you are a woman who is planning to get pregnant, talk
to your doctor about what immunizations you have had and what you may need to
protect your baby. And if you live with a pregnant woman, make sure your
vaccines are up-to-date.
Traveling to other countries may be
another reason to get immunized. Talk with your doctor 6 months before you
leave, to see if you need any shots.
What immunizations are recommended for children and adolescents?
Ask your doctor what shots your child should get.
The immunization schedule includes vaccines for:
Diphtheria, tetanus, and pertussis (also known as whooping
cough).
Polio.
Measles, mumps, and rubella.
Chickenpox.
Rotavirus.
Bacterial meningitis.
Hepatitis B.
Hepatitis A.
Human papillomavirus (HPV).
Haemophilus influenzae type b disease,
or Hib disease. This infection can lead to serious illness in young children,
including pneumonia and meningitis.
Pneumococcal disease. This infection can cause meningitis and
other serious illnesses in young children.
Flu (influenza). This vaccine is not given to children younger
than 6 months.
Immunizations start right after birth, and many are given
throughout a baby's first 23 months. Booster shots (the later doses of any
vaccines that need to be repeated over time) occur throughout life.
Fewer immunizations are needed after age 6. But older children and teens
need shots too (such as those for bacterial meningitis and for tetanus,
diphtheria, and whooping cough). Some shots are also given during adulthood
(such as a tetanus shot).
It is important to keep a good
record(What is a PDF document?)
,
including a list of any reactions to the vaccines. When you enroll your child
in day care or school, you may need to show proof of immunizations. Your child
may also need the record later in life for college, employment, or travel.
Talk to your doctor if
you or your child plans to be in a group living situation, like a college
dormitory or summer camp. You may want certain shots, like those for the flu or
meningitis.
What vaccines are recommended for adults?
The
vaccines you need as an adult(What is a PDF document?)
depend on your gender, age, lifestyle, travel plans,
overall health, and what vaccines you had as a child.
Talk to your
doctor about which vaccines you need. Depending on your situation, you may need
vaccines for:
Chickenpox.
Flu.
Hepatitis A and/or B.
Human papillomavirus (HPV).
Measles, mumps, and rubella.
Pneumococcal disease.
Polio.
Shingles.
Tetanus, diphtheria, and pertussis.
What are the side effects of vaccines?
Most side
effects from vaccines are minor, if they occur at all. Your doctor will explain
the reactions that could occur. They may include:
Redness, mild swelling, or soreness where the shot was given.
A slight fever.
Drowsiness, crankiness, and poor appetite in some babies.
A mild rash 7 to 14 days after chickenpox or
measles-mumps-rubella shots.
Temporary joint pain after a measles-mumps-rubella shot.
Serious reactions, such as trouble breathing or a fever
of 104.5
°F (40.3
°C) or higher,
are rare. If you or your child has an unusual reaction, call your
doctor.
It is much more dangerous for a child to risk getting the
diseases than it is to risk having a serious reaction to the vaccine.
Can vaccines cause other problems?
Some parents
question whether mercury-containing thimerosal (used as a preservative in
vaccines) might cause
autism. Studies have not found a link between
thimerosal-containing vaccines and autism.1 Today, all
routine childhood vaccines made for the U.S. market contain either no
thimerosal or only trace amounts.2
Some
people worry that the shot for measles, mumps, and rubella can cause autism in
children. This is because symptoms of autism are first noticed around 1 year of
age, which is about the same time children get their first shot for measles.
But many studies have been done, and no link has been found between this
vaccine and autism.3
Should you get immunizations to protect yourself from anthrax or smallpox?
It's scary to think that someone might use the germs
that cause diseases like
anthrax and
smallpox as weapons. But the U.S. Centers for Disease
Control and Prevention (CDC) does not recommend immunizations for these
diseases. And the vaccines are not available to the general public.
The CDC does recommend that certain people be immunized, such as some lab
workers, health care workers, and military members.
You can find
the latest information about vaccine recommendations for anthrax and smallpox
at the CDC's Web site:
For smallpox information, go to www.bt.cdc.gov/agent/smallpox.
For anthrax information, go to
www.bt.cdc.gov/agent/anthrax/vaccination/index.asp.
Health Tools
Health Tools help you make wise health decisions or take action to improve your health.
Decision Points focus on key medical care decisions that are important to many health problems.
The U.S. Advisory
Committee on Immunization Practices (ACIP), the American Academy of Pediatrics,
and the American Academy of Family Physicians recommend a specific
childhood immunization schedule each year.
Immunizations are recommended because they protect
against diseases (give
immunity) and make a disease less severe if your child
does get it. The schedule outlines the immunizations and booster shots needed
from birth through age 6 and for ages 7 through 18, as well as when catch-up
immunizations should be given.
Many immunizations require more
than one dose, given at varying intervals. Although your child does not need to
restart the series if a scheduled dose is missed, the immunization should be
given as soon as possible. Consult your doctor or public health department if
your child missed an immunization or to find out whether your child needs a
specific immunization.
This shot (called Varivax) protects against
chickenpox.
Who should get it?
Two doses are given to all children 12 months of age and
older who have not had chickenpox-one at age 12 to 15 months and one at age 4
to 6 years.
The combination MMRV (ProQuad) shot can be given in
place of Varivax. The vaccines for chickenpox, measles, mumps, and rubella are
all in this one shot. Many states require that children entering day care or
school get immunized against chickenpox unless they can show proof of immunity
(through blood test results or having had chickenpox).
Children younger than 9 years of age who are getting the
immunization for the first time should get two doses. These doses should be
given at least 4 weeks apart.
Children younger than 9 years old who got only one dose
in their first season should get two doses before or during the next season.
After that, one dose yearly is needed.
Household contacts and caregivers of children from birth up
to 5 years of age and of any child who is at high risk for complications of the
flu.
Anyone who has a chance of complications from the flu or is
more likely to need medical care if infected.
Healthy children age 2 and older can usually get the
nasal spray form(What is a PDF document?)
of the vaccine (FluMist) instead of the
flu shot(What is a PDF document?)
. Protection lasts up to a year for both vaccine types.
For the most current CDC guidelines, go to www.cdc.gov/flu.
This shot protects against bacteria that can cause an infection in the
covering of the brain (meningitis) or lungs (pneumonia), skin and bone infections, and other
serious illnesses in young children. It does not protect against viral
influenza (flu).
Who should get it?
All children need three or four doses, starting at 2 months
of age and ending by 15 months of age.
Children who are older than 5 years and have certain health
conditions may also need this shot.
All children need at least three doses. The first dose is
given right after birth, before the child leaves the hospital. The remaining
doses are given by 6 to 18 months of age. Children who have not been immunized
for hepatitis B and are age 18 years or younger can be given the shots
separately over a period of about 6 months.
Two doses are given to all children-one at age 12 to 15
months and one at age 4 to 6 years.
Research has shown no link between the
MMR shot and autism.3 There is a measles, mumps,
rubella, and varicella (MMRV, or ProQuad) shot that also protects against
chickenpox (varicella). It can be substituted for either or both doses of MMR
in children ages 12 and younger.
This immunization (called RotaTeq or Rotarix) protects against
rotavirus infection.
Who should get it?
Three doses of RotaTeq are given to all children-one at age 2
months, one at 4 months, and one at 6 months. If your child gets Rotarix, two
doses are given-one at age 2 months and one at 4 months.
This immunization is swallowed rather than given as a
shot. Without the vaccine, most children will get infected by the time they are
about 5 years old. Rotavirus infection causes severe diarrhea.
Other immunizations
Combination vaccines are
preferred to separate shots because they reduce the number of needle pricks.
Examples include:
Comvax (Hepatitis B/Haemophilus influenzae type b)
Kinrix (Diphtheria, tetanus, pertussis/Polio)
Pediarix (Diphtheria, tetanus, pertussis/Polio/Hepatitis
B)
Pentacel (Diphtheria, tetanus, pertussis/Polio/Haemophilus influenzae type b)
TriHIBit (Diphtheria, tetanus, pertussis/Haemophilus influenzae type b)
Your child's doctor may suggest other shots if your child
is at higher risk than other children for certain health problems. One example
is:
This shot protects against
bacterial
meningitis and blood infections (sepsis).
Who should get it?
Some children ages 2 through 10 who have a higher risk than
other children for getting and having severe problems from meningitis need this
shot.
Children who have a damaged or missing
spleen, who have certain
immune system problems, or who travel or live in areas
of the world where the disease is common also need this shot.
Two forms of the meningococcal vaccine are available:
Menactra (MCV4) and Menomune (MPSV4). Menactra is usually preferred because it
may protect your child longer than Menomune.
Keeping good immunization records
It is important
to keep accurate records of immunizations, including any reactions to the
vaccines. When you enroll your child in day care or school, you may need to
show proof of immunizations. Also, your child may need the record later in life
for college, employment, or travel.
Know when each immunization should be scheduled, and put
reminder notes on your calendar. You also may want to ask your doctor to send
you notices when immunizations are due.
Have your doctor go over your child's immunization record with
you during each office visit.
Keep the record in a safe place, and never throw it away. It is
an important part of your child's lifelong medical records.
To print a list of recommended immunizations based on
your child's birth date, go to the U.S. Centers for Disease Control and
Prevention (CDC) interactive Web site at
www2a.cdc.gov/nip/kidstuff/newscheduler_le.
If your child age 6 years or younger didn't get all of his or her shots,
find out which ones are needed at
www.cdc.gov/vaccines/recs/scheduler/catchup.htm.
You may worry that
immunizations are dangerous if given when your child has a cold or other minor
illness. Talk to your child's doctor if you have
concerns about the timing of immunizations. But keep
in mind that immunizations can usually still be given during a mild illness,
while medicines are being taken, and in other situations where a child may not
be in perfect health. Also,
getting several vaccines at the same time is as safe
as getting one shot at a time.6 There are very few
reasons for which doctors suggest that a person
postpone or not get an immunization.
Some parents also fear that the measles-mumps-rubella (MMR) vaccine may
cause their child to develop
autism. Misleading stories about the
MMR shot and autism have circulated through Web sites, the media, and word
of mouth. But scientific studies investigating these claims have found no
connection between autism and the vaccine.3
Adolescent Immunizations
Recommended immunizations
The importance of
continued
immunizations at ages 11 through about 21 years
(adolescence) is not always recognized. Adolescents need to continue their
immunization series and receive booster shots for ongoing protection (immunity) against diseases. Many adolescents were born
after the current recommendations for certain immunizations, such as for
hepatitis B, were established. So they did not receive all their needed shots
(injections) in early childhood.
The U.S. Advisory Committee on
Immunization Practices (ACIP), the American Academy of Pediatrics, and the
American Academy of Family Physicians recommend a specific
immunization schedule for children and adolescents
each year.4 This schedule outlines the immunizations
and booster shots needed during adolescence and also when catch-up
immunizations should be given.
To print a list of what shots are
needed, go to the U.S. Centers for Disease Control and Prevention (CDC)
interactive Web site at www2.cdc.gov/nip/adultImmSched.
Immunizations given during adolescence usually include:
This immunization helps protect against the
flu. Flu viruses are always changing, so the flu
vaccines are updated every year. Protection lasts up to a year for each flu
vaccine type.
Household contacts and caregivers of anyone who is at high risk
for complications of the flu.
Anyone who wants to reduce the chance of becoming ill with
the flu or spreading it to others.
Healthy people ages 2 years through 49 years can
usually get the
nasal spray flu vaccine (FluMist)(What is a PDF document?)
. Pregnant women can get the flu shot but not
FluMist.
For the most current CDC guidelines, go to
www.cdc.gov/flu.
This shot (called
Gardasil) protects against four types of
HPV that together cause most cases of
cervical cancer and
genital warts.7 The shot also
protects against some uncommon cancers, such as vaginal cancer.
Who should get it?
Girls 11 or 12 years old need three doses, given over 6
months. (The shot can be given to girls who are 9 or 10 years old.)
The CDC also recommends this shot for females 13 to 26 years
old who did not get it when they were younger. But the American Cancer Society
states that there is not enough evidence to recommend for or against the shot
for women 19 to 26 years old.8
If your daughter already has HPV infection, talk with
her doctor about whether to get immunized. The shot has not been shown to help
existing HPV infection, but it may protect her from other HPV
infections.7
For help deciding if the HPV
vaccine is right for your daughter, see:
Some adolescents may need or
want additional immunizations for situations that increase a person's risk for
exposure to disease, such as being in group living situations (when attending
college or summer camp) or traveling to foreign countries. These immunizations
may include:
This is important if your child never had
chickenpox or never got this shot.
This
shot (called Varivax) protects against chickenpox.
Who should get it?
Adolescents and adults who are not already immune to the
chickenpox virus need this shot. Anyone who gets this shot at age 13 or older
should get two doses at least 4 weeks apart.
Chickenpox infection can be very serious when it occurs
after childhood.
Adolescents may need this shot if they did not get it as a
child. Talk to your child's doctor if your child never got this shot.
Some states and communities have set up routine immunization
because hepatitis A occurs there more often than in other areas. Adolescents
living in these areas need this shot.
Adolescents in communities where outbreaks of hepatitis A
are happening may need this shot.
This shot does
not necessarily reduce the risk of getting
pneumonia, but it can prevent some of the serious
complications of pneumonia, such as infection in the bloodstream (bacteremia)
or throughout the body (septicemia).
Who should get it?
Adolescents with certain chronic diseases, such as
diabetes or heart disease, need this shot.
Immunization safety
Most side effects from
vaccines are minor, if they occur at all. The doctor may have your child stay
in the office for up to 15 minutes after the shots are given, to watch for any
reactions.
Many parents worry that immunizations are dangerous if
given when their child has a cold or other minor illness. Talk to your child's
doctor if you have
concerns about the timing of shots. But keep in mind
that shots can usually still be given during a mild illness, while medicines
are being taken, and in other situations where a child may not be in perfect
health. There are very few reasons for which doctors suggest that a person
postpone or not get an immunization.
Consult your doctor or public health department if your child missed an
immunization or to find out whether your child needs a specific immunization.
For more information about each vaccine, see the topic
Vaccine Information Statements.
Adult Immunizations
Recommended immunizations
Your need for
immunizations does not end when you reach adulthood.
The specific shots (injections) you need as an adult are determined by factors
such as your age, gender, lifestyle, type and locations of travel, overall
health, and previous immunizations. Tetanus and diphtheria shots need to be
repeated every 10 years throughout adulthood in order to keep your
immunity.
Each year the U.S. Advisory
Committee on Immunization Practices (ACIP), the American College of Obstetrics
and Gynecologists, the American College of Physicians, and the American Academy
of Family Physicians recommend a specific
adult immunization schedule(What is a PDF document?)
.
Your doctor will consider your
medical and immunization history (and documentation) when deciding which shots
you need.
To print a list of which shots you may need, go to the
U.S. Centers for Disease Control and Prevention (CDC) interactive Web site at
www2.cdc.gov/nip/adultImmSched.
This immunization helps protect against the
flu. Flu viruses are always changing, so the flu
vaccines are updated every year. Protection lasts up to a year for each flu
vaccine type.
People with a
chronic health condition, such as
asthma,
diabetes, heart or lung disorders, or an impaired
immune system (which puts them at high risk for complications of the
flu).
Women who are or will be pregnant during the flu
season.
Household contacts and caregivers of all children younger
than 5 years old and close contacts of others who are at high risk for
complications of the flu.
People who live in nursing homes or long-term care centers.
Anyone who wants to reduce the chance of becoming ill with
the flu or spreading it to others.
Healthy people ages 2 years through 49 years can
usually get the
nasal spray flu vaccine (FluMist)(What is a PDF document?)
. Pregnant women can get the flu shot but not
FluMist.
For the most current CDC guidelines, go to
www.cdc.gov/flu.
For help deciding if the flu shot is right for
you, see:
Adults who have not received the vaccine series for hepatitis
B need this shot when occupation, travel, health condition, or lifestyle
increases their risk of exposure.
Three doses are needed over at least 4 months.
A hepatitis combination vaccine (Twinrix) is recommended for those who
are at risk for both hepatitis A and hepatitis B. This vaccine is approved in
the United States only for those 18 years of age or older.
Adults born during or after 1957 may need one or two doses
if they do not have evidence of immunity.
Women should avoid becoming pregnant for 28 days after
getting the MMR shot. Women who are known or suspected to be pregnant and
people who have impaired immune systems should not get this shot.9
This shot does
not necessarily reduce your risk of getting
pneumonia, but it can prevent some of the serious
complications of pneumonia, such as infection in the bloodstream (bacteremia)
or throughout the body (septicemia).
Who should get it?
All people 65 years of age or older need this shot.
People ages 2 years to 64 years who have a chronic disease
(such as heart or lung disease), do not have a
spleen, or have a damaged spleen also need this
shot.
People ages 19 to 64 years who have asthma or who smoke
cigarettes need this shot.
This shot is different from the pneumococcal conjugate
(PCV) shot that is recommended for children. Most adults only need one dose of
PPSV for protection. Some people might need to get a booster shot after 5
years.
The Tdap shot protects against
tetanus,
diphtheria, and
whooping cough (pertussis). The Td shot does not
protect against pertussis.
Who should get it?
All adults need Td booster shots every 10 years throughout
life.
All adults 19 to 64 years of age should have one shot of
Tdap in place of a Td shot.
Tdap is usually only given if it has been at least 10
years since a person's last Td booster. The CDC recommends getting Tdap 2 years
or less from the last dose of Td for:
People with greater risk for pertussis.
Health care workers who have direct contact with
patients.
Child care providers and other adults having close
contact with infants less than 12 months old. (Ideally, women would get this
dose before pregnancy.)
The more immunizations you get in a short time frame,
the more likely you are to react with arm swelling and redness at the site of
the shot. But it may be worth a mild reaction to protect a young infant who is
at risk for pertussis.
Other immunizations
Some adults may need or want
additional immunizations for situations that increase a person's chance for
exposure to disease. These immunizations may include:
This shot (called
Gardasil) protects against four types of
HPV that together cause most cases of
cervical cancer and
genital warts.7 The shot also
protects against some uncommon cancers, such as vaginal cancer.
Who should get it?
The CDC recommends this shot for females 13 to 26 years old
who did not get it when they were younger. (Three doses are given over 6
months.) But the American Cancer Society states that there is not enough
evidence to recommend for or against the shot for women 19 to 26 years
old.8
If you already have HPV infection, talk with your
doctor about whether to get immunized. The shot has not been shown to help
existing HPV infection, but it may protect you from other HPV
infections.7
This shot
protects against bacterial
meningitis and blood infections (sepsis).
Who should get it?
An adult needs this shot if he or she:
Has a greater chance of becoming infected during an
outbreak of bacterial meningitis.
Has a damaged spleen or has had the spleen
removed.
Travels to or lives in areas of the world where
meningitis is common, such as to certain parts of Africa or to Saudi Arabia
during the Hajj.
Lives in a college dorm.
The meningococcal conjugate (MCV4) vaccine, called
Menactra, is given to people 2 years to 55 years of age who need this
immunization. Adults older than age 55 are immunized with the meningococcal
polysaccharide (MPSV4) vaccine, called Menomune.
Consult your doctor or public health department if
you missed an immunization or to find out whether you need a specific
immunization. For more information about each vaccine, see the topic
Vaccine Information Statements.
Before you become pregnant, it is best to
discuss your immunization history with your doctor. If you need the chickenpox
or measles, mumps, and rubella (MMR) shots, wait at least 4 weeks after the
immunization before becoming pregnant.
The CDC recommends the
inactivated influenza vaccine (flu shot) for all women who are or who plan to
be pregnant during the flu season. Pregnant women should not receive the nasal
spray flu vaccine.
Also, pregnant women should not receive the HPV
vaccine.
Pregnant women who are due for their tetanus booster can
get immunized with Td vaccine. The CDC recommends that women who have not
previously had Tdap should get a dose of Tdap before getting pregnant or right
after their baby is born. This is to protect the newborn baby from whooping
cough (pertussis).
If you are pregnant, your children should still
get their immunizations on schedule. You do not need to speed up or delay your
other children's immunizations.
Immunizations and new health threats
In 2007, the
FDA approved the first vaccine for humans against bird flu (avian influenza). Immunization is not currently recommended for the public.
The vaccine will be kept in the U.S. government stockpile.10
Immunization safety
You may worry that
immunizations are dangerous if given when you have a cold or other minor
illness. Talk to your doctor if you have
concerns about the timing of shots. But keep in mind
that shots can usually still be given during a mild illness, while medicines
are being taken, and in other situations where you may not be in perfect
health. There are very few reasons for which doctors suggest that a person
postpone or not get an immunization.
Talk with your doctor or
public health department if your child missed an immunization or to find out
whether you need a specific immunization. For more information about each
vaccine, see the topic
Vaccine Information Statements.
Travel Immunizations
Recommended immunizations
Talk with your doctor
months in advance of a trip to find out whether any
immunizations are recommended. Certain factors, such
as your age and health, where you are going, and the length of your stay,
affect your risk of disease and your need for immunization.
Your age and health
People with certain medical
conditions, such as
immune system problems, may have different
immunization recommendations than healthy people. Also, young children who are
traveling may need to receive their routine immunizations sooner than normally
scheduled.
Where you travel
In
most developed countries (including Canada, Australia, New Zealand, Japan, and
western and northern European countries), the risk of exposure to serious
diseases is generally no greater than it is in the United States.
The risk of exposure to serious disease may be much higher in developing
countries (such as those in most parts of Africa and Asia and many parts of
South and Central America) than it is in most developed countries. This is
especially true for areas with poor sanitation (for example, poor water and
food handling).
If you are going to travel to South America or Africa, your
doctor may suggest that you get the
yellow fever vaccine(What is a PDF document?)
.
Travelers to developing countries should
take precautions to prevent hepatitis A infection,
which may include getting immunizations. Additional immunizations, such as
typhoid vaccine(What is a PDF document?)
, may be recommended. The need for these shots depends on your
immunization history, the specific area you plan to visit, the time of year,
and whether any outbreaks of disease have recently occurred.
How you travel and types of activities
Certain activities or modes of travel increase
your risk of exposure to disease. These include:
Exploring rural areas or those off the usual tourist
route.
Taking backpacking trips.
Visiting another country.
Length of stay
The
longer you stay in a country, the more exposure you have to local
pathogens that could cause harm.
Other immunizations
You can get information about
travel immunizations by:
Contacting your local health department or doctor.
Visiting the Web site of the Centers for Disease Control and
Prevention (CDC) at wwwn.cdc.gov/travel.
For more information on immunizations and health related
to travel, see the topic
Travel Health.
Bioterrorism and Immunizations
The United States
government has developed plans on how to respond to possible bioterrorism
threats.
A 2007 law called the Pandemic and All-Hazards
Preparedness Act ("Bioshield II") will help companies make more vaccines and
drugs that protect against bioterror agents.11
Certain diseases have been identified that pose the greatest threat to
the U.S. public. At this time, there is a supply of anthrax and smallpox
vaccines only. These
immunizations are not currently available to or
recommended for the general public. But the government has advised immunization
for people at high risk of exposure to anthrax or smallpox, such as health care
workers specifically designated to respond to a bioterrorism emergency. Some of
these recommendations are listed below.
This shot is for people at high risk of exposure, such as
certain lab workers, people who work with imported animals where preventive
standards are lacking (such as veterinarians who travel to work in other
countries), and certain military members.
Five shots are given over 18 months. And booster shots
are needed every year for continued protection (immunity).
This shot is for certain health care and public health workers,
infection-control specialists, and certain military members.
This shot is given once as several quick punctures on
the upper arm, using a special prong device. Immunity after a first-time
immunization is likely to be 3 to 5 years. If you have been immunized in the
past, successful revaccination may extend your immunity.
The
United States has enough smallpox vaccine to vaccinate Americans in an
emergency.12
More information about these
immunization recommendations can be found on the Centers for Disease Control
and Prevention (CDC) Web site at www.bt.cdc.gov/bioterrorism. For general
information about bioterrorism issues, see the topic
Terrorism and Other Public Health Threats.
When to Call a Doctor
Call 911 or other emergency services if you or your child develops any of the following
symptoms:
Behavior changes, such as passing out (losing consciousness), acting confused, being very sleepy or hard to wake up,
or not responding to being touched or talked to.
Many
immunizations are given as shots (injections). Your
child may experience brief pain as the needle penetrates the skin or muscle.
And some vaccines cause more discomfort than others. In general, you can help
decrease your child's discomfort by making sure that
he or she is physically comfortable and well rested before getting immunized.
You can use home treatment measures to help relieve some of the common minor
reactions to immunizations.
Relieve mild reactions to immunizations
You can
help relieve some of the common, temporary, mild reactions to immunizations
with basic home care.
Fever. A child may develop a slight
fever after getting immunized. Give your child
acetaminophen (such as Tylenol) or
ibuprofen (such as Advil) to help lower a fever,
especially at a temperature of
102
°F (38.89
°C) or higher. Talk
to your doctor before giving ibuprofen to a baby 3 months of age or younger.
You can give acetaminophen to your baby who is 3 months of age or younger, but
use caution. Check with your doctor first if you are not sure your young
baby's fever is related to getting immunizations. Do not give aspirin to anyone younger than age 20 because of the risk of
Reye syndrome. For more information on fevers, see the
topic
Fever, Age 3 and Younger or
Fever, Age 4 and Older.
Swelling or redness. The area around the shot (injection) site may become red and
swollen. Apply a wrapped ice pack or cool compress to the area for about 10 to
20 minutes. If this does not reduce the symptoms, give your child a dose of
acetaminophen or ibuprofen to help relieve the discomfort.
Fretfulness and poor appetite. For a few hours after getting immunized, a baby may be fretful
and drowsy and may refuse to eat. Plan quiet activities at home for the evening
after your child receives an immunization. Hold and cuddle your child when
needed. Keep your home at a comfortable temperature, because your child is more
likely to be fretful if he or she gets too warm.
Skin rash. A mild skin rash may arise 7 to 14 days after your child gets
the chickenpox or measles, mumps, and rubella (MMR) shot. These types of rashes
can last several days and go away without treatment.
Call 911 or other emergency services if you or your child develops any of the following
symptoms:
Behavior changes, such as passing out (losing consciousness), acting confused, being very sleepy or hard to wake up,
or not responding to being touched or talked to.
For more information about reactions to immunizations, see
the When to Call a Doctor section of this topic.
Other Places To Get Help
Organizations
American Academy of Pediatrics
141 Northwest Point Boulevard
Elk Grove Village, IL 60007-1098
Phone:
(847) 434-4000
Fax:
(847) 434-8000
E-mail:
kidsdocs@aap.org
Web Address:
www.aap.org
The American Academy of Pediatrics (AAP) offers a
variety of educational materials, such as links to publications about parenting
and general growth and development. Immunization information, safety and
prevention tips, AAP guidelines for various conditions, and links to other
organizations are also available.
Centers for Disease Control and Prevention (CDC):
National Center for Immunization and Respiratory Diseases
1600 Clifton Road
Atlanta, GA 30333
Phone:
1-800-CDC-INFO (1-800-232-4636)
TDD:
1-888-232-6348
E-mail:
cdcinfo@cdc.gov
Web Address:
www.cdc.gov/vaccines
The CDC's National Center for Immunization and
Respiratory Diseases has information about vaccines and the diseases that can
be prevented by immunization. The Web site includes the recommended
immunization schedules for children, teens, and adults. There is also
information about vaccine side effects and safety, school and state
requirements, and immunization records. Interactive schedules are also
available.
Centers for Disease Control and Prevention, Travelers'
Health
1600 Clifton Road, N.E.
Atlanta, GA 30333
Phone:
1-877-FYI-TRIP (1-877-394-8747) toll-free
Web Address:
www.cdc.gov/travel
The CDC's Travelers' Health Web site provides health information
for the traveler. The Web site provides information on immunizations that are
needed for travel to various areas of the world. It also provides information
for safe travel, including traveling with children and people with special
needs. Information about current outbreaks of disease in the world is also
provided. The CDC is the leading federal agency for protecting U.S. citizens'
health and safety by providing credible health information and health
promotion.
Immunization Action Coalition
1573 Selby Avenue
Suite 234
St. Paul, MN 55104
Phone:
(651) 647-9009
Fax:
(651) 647-9131
E-mail:
admin@immunize.org
Web Address:
www.immunize.org
The organization works to increase awareness of the need
for immunization and to boost immunization rates.
National Network for Immunization
Information
301 University Boulevard
Galveston, TX 77555-0351
Phone:
(409) 772-0199
Fax:
(409) 747-4995
E-mail:
nnii@i4ph.org
Web Address:
www.immunizationinfo.org
The National Network for Immunization Information provides
information on immunizations, including each of the recommended childhood
vaccines, the recommended childhood immunization schedule, tips on using the
World Wide Web as a source of immunization and health information, and links to
other helpful sites. You can also search for the vaccines that each state
requires before entry into school or day care.
Parker SK, et al. (2004). Thimerosal-containing
vaccines and autistic spectrum disorder: A critical review of published
original data. Pediatrics 114(3): 793-804.
U.S. Food and Drug Administration (2008). Thimerosal in vaccines. Available online: http://www.fda.gov/cber/vaccine/thimerosal.htm#3.
Demicheli V, et al. (2005). Vaccines for measles,
mumps and rubella in children. Cochrane Database of Systematic Reviews (4). Oxford: Update Software.
Centers for Disease Control and Prevention (2009).
Recommended immunization schedules for persons aged 0 through 18 years-United
States, 2009. MMWR, 57(51 and 52): Q1-Q4. Also available
online: http://www.cdc.gov/mmwr/PDF/wk/mm5751.pdf. [Erratum in MMWR, 57(53): 1419. Also available online:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5753a5.htm?s_cid=mm5753a5_e.]
Centers for Disease Control and Prevention (2008).
Prevention and control of influenza: Recommendations of the Advisory Committee
on Immunization Practices (ACIP). MMWR, 57(RR-7): 1-60.
Also available online: http://www.cdc.gov/mmwr/PDF/rr/rr5707.pdf.
Atkinson W, et al., eds. (2007). Epidemiology and Prevention of Vaccine-Preventable Diseases,
updated 10th ed. (The Pink Book). Washington, DC: Public Health Foundation.
Also available online:
http://www.cdc.gov/vaccines/pubs/pinkbook/default.htm.
U.S. Department of Health and Human Services, Centers
for Disease Control and Prevention (2007). Quadrivalent human papillomavirus
vaccine: Recommendations of the Advisory Committee on Immunization Practices
(ACIP). MMWR, 56(RR-2): 1-24. Also available online:
http://www.cdc.gov/mmwr/PDF/rr/rr5602.pdf.
Saslow D, et al. (2007). American Cancer Society
guideline for human papillomavirus (HPV) vaccine use to prevent cervical cancer
and its precursors. CA: A Cancer Journal for Clinicians,
57(1): 7-28.
Centers for Disease Control and Prevention (1998,
updated 2007). Guidelines for Vaccinating Pregnant Women From Recommendations of the Advisory Committee on Immunization Practices (ACIP). Available online:
http://www.cdc.gov/vaccines/pubs/preg-guide.htm.
U.S. Food and Drug Administration (2007). FDA approves
first U.S. vaccine for humans against the avian influenza virus H5N1.
FDA News. Available online:
http://www.fda.gov/bbs/topics/NEWS/2007/NEW01611.html.
Mitka M (2007). Bioterror vaccine production: Take 2.
JAMA, 297(6): 575-576.
Centers for Disease Control and Prevention (2007). Smallpox fact sheet: Vaccine overview. Available online: http://www.bt.cdc.gov/agent/smallpox/vaccination/facts.asp.
Other Works Consulted
American Academy of Pediatrics (2007). Hepatitis A
vaccine recommendations. Pediatrics, 120(1): 189-199.
Also available online:
http://aappolicy.aappublications.org/cgi/reprint/pediatrics;120/1/189.pdf.
Centers for Disease Control and Prevention (1998).
Measles, mumps, and rubella-Vaccine use and strategies for elimination of
measles, rubella, and congenital rubella syndrome and control of mumps:
Recommendations of the Advisory Committee on Immunization Practices (ACIP).
MMWR, 47(RR-8): 1-59. Also available online:
http://www.cdc.gov/mmwr/PDF/rr/rr4708.pdf.
Centers for Disease Control and Prevention (2000).
Preventing pneumococcal disease among infants and young children:
Recommendations of the Advisory Committee on Immunization Practices (ACIP).
MMWR, 49(RR-09): 1-38. Also available online:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4909a1.htm.
Centers for Disease Control and Prevention (2005). A
comprehensive immunization strategy to eliminate transmission of hepatitis B
virus infection in the United States, Recommendations of the Advisory Committee
on Immunization Practices (ACIP) Part 1: Immunization of infants, children, and
adolescents. MMWR, 54(RR-16): 1-23. Also available
online: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5416a1.htm. [Erratum in
MMWR, 55(06): 158-159. Also available online:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5506a6.htm.]
Centers for Disease Control and Prevention (2006). A
comprehensive immunization strategy to eliminate transmission of hepatitis B
virus infection in the United States, Recommendations of the Advisory Committee
on Immunization Practices (ACIP) Part II: Immunization of adults.
MMWR, 55(RR-16): 1-33. Also available online:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5516a1.htm. [Erratum in
MMWR, 56(42): 1114.]
Centers for Disease Control and Prevention (2006). Prevention of hepatitis A through active or passive immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 55 (RR-7): 1-23. Also available online: http://www.cdc.gov/mmwr/PDF/rr/rr5507.pdf.
Centers for Disease Control and Prevention (2006).
Preventing tetanus, diphtheria, and pertussis among adolescents: Use of tetanus
toxoid, reduced diphtheria toxoid and acellular pertussis vaccines:
Recommendations of the Advisory Committee on Immunization Practices (ACIP).
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http://www.cdc.gov/mmwr/PDF/RR/RR5503.pdf.
Centers for Disease Control and Prevention (2006).
Preventing tetanus, diphtheria, and pertussis among adults: Use of tetanus
toxoid, reduced diphtheria toxoid and acellular pertussis vaccine:
Recommendations of the Advisory Committee on Immunization Practices (ACIP) and
Recommendation of ACIP, supported by the Healthcare Infection Control Practices
Advisory Committee, for Use of Tdap Among Health-Care Personnel.
MMWR, 55(RR-17): 1-37. Also available online:
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Centers for Disease Control and Prevention (2007).
Prevention of varicella: Recommendations of the Advisory Committee on
Immunization Practices (ACIP). MMWR, 56(RR-4): 1-48.
Also available online: http://www.cdc.gov/mmwr/PDF/rr/rr5604.pdf.
Centers for Disease Control and Prevention (2007).
Revised recommendations of the Advisory Committee on Immunization Practices to
vaccinate all persons aged 11-18 years with meningococcal conjugate vaccine.
MMWR, 56(31): 794-795. Also available online:
http://www.cdc.gov/mmwr/PDF/wk/mm5631.pdf.
Centers for Disease Control and Prevention (2008).
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Immunization Practices (ACIP). MMWR, 57(Early Release):
1-30. Also available online: http://www.cdc.gov/mmwr/PDF/rr/rr57e0515.pdf.
[Erratum in MMWR, 57(28): 779. Also available online:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5728a5.htm.]
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[Erratum in MMWR, 57(26): 723. Also available online:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5726a3.htm.]
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Syncope after vaccination: United States, January 2005 to July 2007.
MMWR, 57(17): 457-460.
Centers for Disease Control and Prevention (2008).
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(ACIP) for use of 7-valent pneumococcal conjugate vaccine (PCV7) in children
aged 24-59 months who are not completely vaccinated. MMWR, 57(13): 343-344. Also available online:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5713a4.htm?s_cid=mm5713a4_e.
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pneumococcal infection in adults. Cochrane Database of Systematic Reviews (1).
Orenstein WA, et al. (2008). Diseases controlled
primarily by vaccination. In RB Wallace, ed., Wallace/Maxcy-Rosenau-Last Public Health and Preventive Medicine, 15th ed., pp. 101-153. New York: McGraw-Hill.
Orenstein WA, Pickering LK (2007). Immunization
practices. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 18th ed., pp. 1058-1070. Philadelphia: Saunders
Elsevier.
Thompson WW, et al. (2007). Early thimerosal exposure
and neuropsychological outcomes at 7 to 10 years. New England Journal of Medicine, 357(13): 1281-1292.
U.S. Department of Health and Human Services (2009).
Prevention of rotavirus gastroenteritis among infants and children:
Recommendations of the Advisory Committee on Immunization Practices (ACIP).
MMWR, 58(RR-2): 1-25. Also available online:
http://www.cdc.gov/mmwr/PDF/rr/rr5802.pdf.
U.S. Department of Health and Human Services, Centers
for Disease Control and Prevention (2006). General recommendations on
immunization: Recommendations of the Advisory Committee on Immunization
Practices (ACIP). MMWR, 55(RR-15): 1-48. Also available
online: http://www.cdc.gov/mmwr/PDF/rr/rr5515.pdf. [Erratum in MMWR, 56(11): 256. Also available online:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5611a6.htm?s_cid=mm5611a6_e.]
Weller PF (2005). Health advice for international
travelers. In DC Dale, DD Federman, eds., ACP Medicine,
Clinical Essentials, chap. 7. New York: WebMD.
Credits
Author
Debby Golonka, MPH
Editor
Susan Van Houten, RN, BSN, MBA
Associate Editor
Pat Truman, MATC
Primary Medical Reviewer
Michael J. Sexton, MD - Pediatrics
Specialist Medical Reviewer
William Atkinson, MD, MPH - Public Health and Preventive Medicine
This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
Parker SK, et al. (2004). Thimerosal-containing
vaccines and autistic spectrum disorder: A critical review of published
original data. Pediatrics 114(3): 793-804.
U.S. Food and Drug Administration (2008). Thimerosal in vaccines. Available online: http://www.fda.gov/cber/vaccine/thimerosal.htm#3.
Demicheli V, et al. (2005). Vaccines for measles,
mumps and rubella in children. Cochrane Database of Systematic Reviews (4). Oxford: Update Software.
Centers for Disease Control and Prevention (2009).
Recommended immunization schedules for persons aged 0 through 18 years-United
States, 2009. MMWR, 57(51 and 52): Q1-Q4. Also available
online: http://www.cdc.gov/mmwr/PDF/wk/mm5751.pdf. [Erratum in MMWR, 57(53): 1419. Also available online:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5753a5.htm?s_cid=mm5753a5_e.]
Centers for Disease Control and Prevention (2008).
Prevention and control of influenza: Recommendations of the Advisory Committee
on Immunization Practices (ACIP). MMWR, 57(RR-7): 1-60.
Also available online: http://www.cdc.gov/mmwr/PDF/rr/rr5707.pdf.
Atkinson W, et al., eds. (2007). Epidemiology and Prevention of Vaccine-Preventable Diseases,
updated 10th ed. (The Pink Book). Washington, DC: Public Health Foundation.
Also available online:
http://www.cdc.gov/vaccines/pubs/pinkbook/default.htm.
U.S. Department of Health and Human Services, Centers
for Disease Control and Prevention (2007). Quadrivalent human papillomavirus
vaccine: Recommendations of the Advisory Committee on Immunization Practices
(ACIP). MMWR, 56(RR-2): 1-24. Also available online:
http://www.cdc.gov/mmwr/PDF/rr/rr5602.pdf.
Saslow D, et al. (2007). American Cancer Society
guideline for human papillomavirus (HPV) vaccine use to prevent cervical cancer
and its precursors. CA: A Cancer Journal for Clinicians,
57(1): 7-28.
Centers for Disease Control and Prevention (1998,
updated 2007). Guidelines for Vaccinating Pregnant Women From Recommendations of the Advisory Committee on Immunization Practices (ACIP). Available online:
http://www.cdc.gov/vaccines/pubs/preg-guide.htm.
U.S. Food and Drug Administration (2007). FDA approves
first U.S. vaccine for humans against the avian influenza virus H5N1.
FDA News. Available online:
http://www.fda.gov/bbs/topics/NEWS/2007/NEW01611.html.
Mitka M (2007). Bioterror vaccine production: Take 2.
JAMA, 297(6): 575-576.
Centers for Disease Control and Prevention (2007). Smallpox fact sheet: Vaccine overview. Available online: http://www.bt.cdc.gov/agent/smallpox/vaccination/facts.asp.
