Update on Vaccines

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Update on Vaccines

• Provided courtesy of
• Vaccine Education Center at
• The Childrens Hospital of Philadelphia

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Keeping Babies Healthy

• Being Immunized

• Immunity from Mom

• Surviving Disease

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Immunity from Mom

• Before birth- antibodies cross the placenta
• After birth antibodies in breast milk
• Called passive immunity
• Short-lived weeks, months?
• Not specific baby may or may not have
  protection against a particular disease-causing
  agent

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Surviving Disease

• Immune response is generated after coming into
  contact with the disease-causing agent
• Called active immunity
• Typically provides long-lasting immunity
• Disease can vary in severity
• Can result in death

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Being Immunized

• Develops in response to a vaccine
• Provides active immunity
• Typically provides long-term immunity
• Dose, timing and pathogenicity(potential for
  severity) are controlled
• Does not result in death

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Impact of Vaccines in the 20th 21st Centuries
Disease Pre-Vaccine Est. Cases/Year Cases Reported in 2010 Percent Decrease
Diphtheria 21,053 0 100
Tetanus 580 8 99
Pertussis 200,752 21,291 89
Measles 530,217 61 gt99
Mumps 162,344 2,528 98
Rubella 47,745 6 gt99
Chickenpox gt4 million 449,363 89
Rotavirus 62,500 7,500 88
Source Epidemiology and Prevention of Vaccine-Preventable Diseases, 12th Edition, May, 2011, p G7. Source Epidemiology and Prevention of Vaccine-Preventable Diseases, 12th Edition, May, 2011, p G7. Source Epidemiology and Prevention of Vaccine-Preventable Diseases, 12th Edition, May, 2011, p G7. Source Epidemiology and Prevention of Vaccine-Preventable Diseases, 12th Edition, May, 2011, p G7.
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Keeping Babies Healthy

• Being Immunized

• Immunity from Mom

1st

• Surviving Disease

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But some question whether this is true.

• Why?

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Position related to vaccines is based on a
variety of factors.
Experiences
Beliefs
Family
Anecdotes
Friends
Healthcare Providers
Co-workers
Education
News stories
Articles/Books
Teachers
TV shows/stars
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Because trust in vaccines is based on a variety
of factors, a single response will not convince
everyone.

• Trusting is hard. Knowing who to trust, even
  harder.
• Maria V. Snyder, Poison Study

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But, we do have information about who parents
trust for vaccine information

• A recent study by Abbey M. Jones and colleagues,
  found that
• Parents use between 2 and 6 sources for vaccine
  information.
• The most commonly cited source was their childs
  healthcare provider (almost 92 percent).
• Printed materials (VIS) were used by 84 percent.
• Parents/friends were a source about 54 percent of
  the time.
• About 40 percent cited the Internet as a good or
  excellent source of information, but only about
  20 percent reported using it as a source of
  information.
• Advances in Preventive Medicine, Parents
  Source of Vaccine Information and Impact on
  Vaccine Attitudes, Beliefs, and Nonmedical
  Exemptions. 2012. doi10.1155/2012/932741.

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Some of these factors have a greater influence on
vaccine decisions.
Experiences
Beliefs
Family
Anecdotes
Friends
Healthcare Providers
Co-workers
Education
News stories
Articles/Books
Teachers
TV shows/stars
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When the trust account is high, communication is
easy, instant, and effective.

• Stephen R. Covey, The 7 Habits of Highly
  Effective People
• Powerful Lessons in Personal Change

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What are the concerns?

• Babies are too young Too many vaccines
• Schedule not well-tested Vaccines cause other
  diseases
• Vaccines contain harmful ingredients

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ConcernBabies are too young to be immunized.

• While the womb is sterile, the world is not.
• Not too young to get disease Not too young to
  get a vaccine
• Vaccines are given so they will be protective
  during the babys period of vulnerability.

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ConcernBabies get too many vaccines.

• Vaccines for 14 diseases by 2 years of age
• Thousands of viruses and bacteria
• Immune system has millions of cells can make
  billions of antibodies.
• Vaccines today contain fewer immunologic
  components than those of the past.

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Vaccines Then and Now
Year Number of Vaccines Number of Immunologic Components
1900 1 200
1980 7 3,041
2013 14 150
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ConcernThe vaccine schedule is not well-tested.

• Individual vaccines are tested extensively
• Phase I
• Phase II
• Phase III
• Studies include concomitant-use studies
• Post-Licensure studies (phase IV)

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ConcernThe vaccine schedule is not well-tested.

• Who gets a vaccine is determined by the
  recommendations.
• Recommendations are based on
• Susceptibility
• Seasonality
• Morbidity
• Mortality

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ConcernThe vaccine schedule is not well-tested.

• The notion that vaccines are given as a
  one-size-fits-all approach is a myth
• High-risk groups
• Different doses (e.g., high dose influenza for
  people 65 or older, hepatitis A vaccine)

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Is it OK to alter the schedule?

• Contraindications are reasons not to get a
  vaccine
• Previous allergic reaction to a vaccine
• No live viral vaccines while getting chemotherapy
• Precautions are things to keep in mind when
  getting a vaccine and may be reasons to delay
  vaccines
• Moderate or severe illness
• Recent blood transfusion
• Uncontrolled seizures
• Arbitrary changes to space out or skip certain
  vaccines are not tested, and, therefore, not
  recommended.

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ConcernVaccines cause diseases

• Myth Influenza vaccine causes flu
• Shot is not live and cannot replicate
• Nasal spray is live but is designed to
  replicate minimally and only at in the
  temperatures of the nose, not the lungs.

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ConcernVaccines cause diseases

• Vaccines do not cause
• Autism
• SIDS
• Diabetes
• Multiple sclerosis
• Guillian-Barré syndrome
• Asthma
• Allergies
• Any concerns are studied if a causal
  relationship was found, use of the vaccine would
  be re-evaluated.

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ConcernVaccines contain harmful chemicals.

• Aluminum is used as an adjuvant.
• Exposure from food in first 6 mos. of life is
  greater than in vaccines
• Harmful when kidneys are not functioning AND
  exposure is high

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ConcernVaccines contain harmful chemicals.

• Thimerosal used to be used as a preservative.
• Now only in multi-dose vials of influenza vaccine
• Ethyl mercury versus methyl mercury

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ConcernVaccines contain harmful chemicals.

• Additional topics related to vaccine ingredients
• Stabilizers (gelatin)
• Manufacturing residuals (formaldehyde,
  antibiotics, egg proteins)
• Fetal cells

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Additional Resources

• The next few slides include samples of the
  resources offered or written by the Vaccine
  Education Center at
• The Childrens Hospital of Philadelphia

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Compilation Resources
Websites vaccine.chop.edu vaccine.chop.edu/parents
Booklets
DVD
Book
Mobile App
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Vaccines Videos

• Vaccines and Your Baby What is immunity?
  http//www.chop.edu/video/vaccines-and-your-baby/h
  ome.html?pos3 Vaccines and Your Baby Can
  babies handle vaccines so young
  http//www.chop.edu/video/vaccines-and-your-baby/h
  ome.html?pos14

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Disease-Specific Resources
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Disease-Specific Resources

• www.Prevent-HPV.org

• Meningococcus Vaccine Why do College Students
  Need It?

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For New Moms
Vaccines and your Baby booklet
Vaccines DVD
Cling Showing Recommended Immunization Schedule
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Thank you!