Vaccination is the best protection against

16 major diseases and among the greatest

gifts a parent can give a child. Getting your child

immunized should start when she's very young, and continue

through adolescence.

By Sam Gaines

Measles is making a comeback. Whooping cough keeps

hanging around. Increasingly, diseases once thought nearly

eradicated are returning. Why? Because not all parents are

getting their children vaccinated.

Vaccines are much more than a good idea. They've made the difference

in saving children's lives throughout the last century, and still do today.

Indeed, some of the most devastating diseases that affect children have

been greatly reduced or eradicated completely thanks to vaccination.

"Vaccines are one of the single most important things you can do to

protect your child from deadly and debilitating diseases," says Ari Brown,

M.D., FAAP, a practicing pediatrician in Austin, Texas, and member of the

American Academy of Pediatrics (AAP) Council on Communications

and Media. "Many of the diseases we protect against with vaccines are not

treatable once you get the disease."

Consider this pre- and post-vaccination information:

77 Smallpox: This terrible disease once killed nearly 1,000 children per year.

It was completely eradicated in 1977 thanks to the smallpox vaccine.

77 Diphtheria: In 1920, nearly 150,000 cases were reported in the United

States, with more than 13,000 deaths. By 2002, only one case was

reported nationwide.

77 Pertussis (whooping cough): More than 107,000 cases were reported

in 1922, with nearly 5,100 deaths. In 2002, only 9,771 cases were

reported nationwide.

77 Polio: In the years 1951-54, more than 16,000 cases of paralytic polio

were reported, leading to nearly 1,900 deaths. The wild-type viruscaused

type of paralytic polio was eliminated from the Western

Hemisphere in 1991, thanks to the vaccine.

77 Measles: An average of 450 Americans died from measles each year

between 1953 and1963. But because of the vaccine, measles cases

have been reduced by more than 99 percent compared with the

pre-vaccine era.

Vaccine Safety

Are vaccines safe? That's a very important concern all parents have about anything that goes into their children's bodies, and vaccines

are no exception.

The good news is that the U.S. immunization program is among the safest in the world. Vaccines are tested for years before they are

approved for use in the general population. These tests include all eligible age groups and combinations of all appropriate vaccines, to be

sure that each is safe when given with the others.

In rare, unpredictable circumstances, a vaccine can cause health problems for a child. When this happens, the U.S. has a Vaccine Injury

Compensation Program. This tiny risk must be weighed, however, against the far greater risk of contracting a serious disease that could

threaten a child's life. In 2007, vaccines are estimated to have prevented 14 million infections and saved 33,000 lives.

"Your pediatrician has devoted his or her life to protecting children and keeping them healthy," Dr. Brown explains. "If they had any

concerns about shots, they would be the first to stop or change what they recommend. Remember, most of us pediatricians are parents!

While it's easy to think of vaccines as an early childhood necessity,

the truth is that immunization is just as important for older children

and adolescents. The AAP recommends the following vaccinations for

children between the ages of 11 and 19 if they haven't received the

full dosages:

Don't Forget to

Vaccinate Adolescents!

77 Meningococcal disease: Recommended for all teens age 11

through 18 for protection against this devastating illness. It's also

recommended for all college freshmen living in dorms regardless of

age.

77 Human Papillomavirus (HPV): This series of three vaccines

provides immunity against several types of the virus that cause

cervical cancer.

77 Tetanus, diphtheria, pertussis (whooping cough) (Tdap, Td):

Children 11 or 12 years of age need a Tdap booster at this time, and

will need another booster every 10 years.

77 Hepatitis B (HepB)

77 Measles, Mumps, Rubella (MMR)

77 Polio

77 Varicella: If the child hasn't had chickenpox and hasn't been

vaccinated, the two-dose vaccination is necessary. A teen who only

received one dose of the vaccine as a child should get the second

dose now, as well.

77 Polio

77 Influenza

77 Pneumococcal disease: Some adolescents with chronic health

problems should receive this vaccine. Your pediatrician can guide

you as to whether this is recommended for your child.

77 Hepatitis A: While anyone can get hepatitis A, certain teens are at

greater risk. Talk to your pediatrician about your child's risks and the

benefits of this two-dose vaccine.

Among the newer shots is the meningococcal vaccine, which

protects young people against an aggressive, potentially lethal

condition. This rapidly developing disease kills 10 percent of those

it strikes and leaves about 15 percent of survivors with brain

damage, hearing loss, or amputated limbs. Approximately 15 to 20

percent of the population are carriers of the bacterium and never

show symptoms. The CDC reports that only 12 percent of those

eligible had received the vaccine by 2006, leaving far too many at

risk. The vaccine prevents four of the five strains of meningococcal

meningitis, which cause about 70 percent of cases in the U.S. Most

insurers cover the vaccination.

Another critically important vaccine that was recently licensed is

the HPV vaccine, which prevents two of the most common types

of virus linked to cervical cancer, as well as two of the most

common types of genital warts. Cervical cancer is the second-most

prolific type of cancer among American women. "I think this is a

very important vaccine for older girls," says David Tayloe, M.D, FAAP.

"Many women have contracted some form of HPV by the time they

reach their 50s, and they are at increased risk of developing

cervical cancer as a result. This vaccine means a 90 percent

reduction in the likelihood of a girl developing cervical cancer."

Renée Jenkins, M.D, FAAP, says the key to helping parents

remember these important vaccines is the "protection visit" with a

pediatrician, which the CDC and AAP recommend for all preadolescents

at 11 or 12 years old. This visit with a pediatrician is a

chance for the child and doctor to discuss the many things that

can put a teen's health at risk. "We have to talk about injuries,

smoking, sexuality, and drugs and alcohol, among other things," Dr.

Jenkins says. "We talk about managing those risks from a health

perspective, to help the child prepare for what he or she will face

growing up and maturing."

And that's a great time to get adolescent vaccines taken care

of, too.

These are just a few examples of the profound impact vaccines have

made in saving children's lives and preventing serious consequences of

conditions like bacterial meningitis. In recent years, newer vaccines have

made dramatic inroads in fighting even more diseases. "Immunization

has been the most successful public health program of the 20th century,"

says Renée Jenkins, M.D., FAAP, president of the AAP. "The diseases that

we used to see that killed and permanently disabled children, we just don't

see those any more."

Indeed, vaccination may be a victim of its own success. "I think our

problem is that many parents never saw those diseases or heard of

someone who had polio or diphtheria," Dr. Jenkins says. "So they don't

have a sense of what life is like without immunity. And now we're seeing

these diseases making a comeback." Jenkins points out that there were

more than 20,000 cases of pertussis (whooping cough) in 2005, and eight

infants died from it. "There have been multiple outbreaks of measles in

three states, too," she adds, "all coming from other countries and exposing

vulnerable children."

Not every nation has access to an up-to-date vaccination program. At a

time when the world is "smaller" than ever, thanks to the ease of

international travel and global trade, the importance of protecting your

children with a full schedule of vaccines cannot be understated. Sick people

- carriers of many of the diseases we vaccinate against - can bring

exposure to these diseases from other parts of the world, or unvaccinated

U.S. travelers returning from other countries can unwittingly bring

(import) diseases to the U.S., exposing schoolmates, family, and friends.

"Basically, you're just a plane ride away from potentially fatal diseases," says

David Tayloe, M.D., FAAP, president-elect of the AAP.

Stay on Schedule

Vaccines are given according to a schedule that has been created based

on extensive study and analysis. Some vaccines protect against a single

disease, while others - called combo vaccines - offer protection against

several diseases with a single injection.

The vaccination schedule (see page 28) is designed to give immunized

children the maximum protection as soon as safely possible. It may be

tempting, but creating your own vaccine timetable, rather than following

the recommended schedule, is not a good idea. "Basically, if you make up

your own schedule, you're choosing to give shots at time intervals and

combinations that have not been studied," Dr. Brown says. "We don't

know how that will impact your child's immune response. What we do

know is that it is like playing Russian roulette. It may leave your child

unprotected from potentially deadly diseases."

Vaccination for Life

Many of us think of vaccination as something that applies only to early

childhood. But getting immunized against contagious disease is a lifelong

need. In fact, vaccination should continue throughout the life of a child,

including in the adolescent years. (See "Shots for Teens" sidebar for more

information.) Even for adults, the annual flu shot is a scheduled part of

keeping healthy - all the more so, the older we get.

Just as important as the initial vaccinations are the booster shots, which

are designed to build on the previous vaccines' effectiveness to continue

immunity.

Protection for Everyone

Unfortunately, some parents forget or skip the vaccines, which

undercuts the effectiveness of a very important concept in vaccination:

herd immunity.

Herd immunity is the benefit everyone receives from a vaccinated

population once immunization reaches a critical level. When enough

people are vaccinated, everyone - including those who are too young

or too sick to be immunized - receives some protection from the

spread of diseases.

The Recent

Measles Outbreak

One of the most infectious diseases in the world,

measles frequently finds its way into the U.S. via

international visitors from nations where the vaccine

doesn't exist or isn't widely used. The World Health

Organization reported that nearly 1 million measles-related

deaths occurred in developing countries in 1999.

In the U.S., the measles vaccine has been so widely

embraced that we have seen a reduction of more than 99

percent in measles cases, compared to the pre-vaccine era.

In fact, the CDC announced in 2000 that measles had been

eliminated, thanks to the measles vaccine.

But a recent outbreak of measles points to a dangerous

trend among some parents who are not immunizing their

children against measles or other diseases. This poses a real

risk to the health of all unvaccinated children. In August,

the CDC announced that 15 children under 20 had been

hospitalized with the disease, and 131 had been diagnosed

since the beginning of 2008. Many of the children who

were diagnosed had not been vaccinated by choice, or

were too young. It is believed that the sick children

contracted measles from children who had traveled

overseas.

To Dr. Tayloe, one important point must be made.

"Parents should not get their immunization information

from TV stars or other non-scientific advocates," he says.

"The right person to ask is your pediatrician. Don't be afraid

to ask any question you have about vaccination. Your

pediatrician is there to help you understand why

vaccination is so important, and above all to do everything

he or she can to safeguard your child's health."