Pediatrician Describes New Vaccines for Children

September 07, 2006
News Office: Phyllis Brown (415) 502-6397

Updating a child's immunizations is an annual back-to-school rite of passage for all parents, but immunizations have been changing, and this year is no different.

The American Academy of Pediatrics traditionally has recommended that children receive nine vaccines for 13 primary childhood diseases. But UCSF pediatrician and clinical professor of pediatrics, Dr. William DeGoff, said that young children may get a break and receive one less shot this year.

"Rather than having to do MMR (measles, mumps and rubella) and varicella in two different shots they can be given in one combined shot. That's new this year, and that saves a needlestick, which is what most little kids care about," said DeGoff.

"For kids under 12, they've only been doing one dose of varicella vaccine, but they're probably going to be doing two doses in the near future. This will provide the additional immunity," he said, because the varicella vaccine has been only about 70 percent to 80 percent effective.

Whether or not children receive a combined MMR and varicella vaccine will depend upon which versions of the inoculations their health care professional is using, he said.

The new HPV or human papillomavirus vaccine is being recommended for girls 11 and 12 years old, to prevent cervical cancer, precancerous genital lesions, and genital warts due to HPV. The vaccine, called Gardasil, gives protection against four different strains of the HPV.

The inoculation is administered in a series of three injections over a six-month period. The second and third doses should be given at two and six months (respectively) after the first dose. HPV vaccine may be given at the same time as other vaccines.

"Studies have shown that this vaccine will have a phenomenal benefit to society, saving lives and saving a lot of money in the long run, even though right now the vaccines themselves are expensive," DeGoff said.

Another vaccine that is in the offing, DeGoff said, is one that will immunize children against rotavirus, a viral infection that can cause severe diarrhea, vomiting, fever and dehydration (gastroenteritis) in infants and young children. The availability of the rotavirus vaccine is imminent, he said.

"The virus is the main reason why kids vomit and get dehydrated, and is a major cause of dehydration and death in Third-World countries," he explained. The vaccine will be administered at 2, 4 and 6 months of age.

The nine traditional vaccines are:

  • DTaP: Combines vaccines against three diseases, diphtheria, tetanus and pertussis, into one shot. Children need five DTaP shots for maximum protection. The first three shots are given at 2, 4 and 6 months of age. The fourth booster shot is given between 15 and 18 months, and a fifth shot -- another booster -- is given when a child enters school, at 4 to 6 years.
  • Hepatitis A: The vaccine is 94 percent to 100 percent effective in preventing hepatitis A. Children between 12 and 23 months of age should receive the two-time vaccine, administered at least six months apart.
  • Hepatitis B: Three doses of the vaccine are needed for full protection from the disease. The first dose is usually given at birth. This is particularly important for children whose mothers are chronically infected. For other babies, the first dose can be given between birth and 2 months of age. The second dose is recommended at 1 to 4 months, and the third at 6 to 18 months. These three doses should protect children for life.
  • Hib or Haemophilus Influenza Type B: Children should get either three or four doses. The vaccine is recommended at 2, 4, 6 and 12 to 15 months of age (the 6-month dose is not given with one brand of vaccine).
  • Influenza: One dose of the vaccine is recommended annually beginning around October or November. For children younger than 9 who are getting influenza vaccine for the first time, two doses are recommended, at least a month apart, depending on the type of vaccine.
  • MMR: Combines vaccines for measles, mumps and rubella into one shot. Most children who get the vaccine develop immunity to all three diseases, and protection is believed last a lifetime. Two doses of vaccine are recommended, with the first dose given at 12 to 15 months of age. The second may be given four weeks after the first, but it is usually given at 4 to 6 years. No boosters are needed.
  • Pneumococcal: Four doses of the vaccine are recommended, at 2, 4, 6 and 12 to 15 months of age. Children who are late starting the series may need fewer doses. Children 5 years old and older usually should not get pneumococcal conjugate vaccine. But some older children (those with certain chronic diseases or damaged immune systems) should still get a pneumococcal vaccine. There is a different vaccine -- called pneumococcal polysaccharide vaccine -- that can be given to these children and to adults.
  • Polio: Children should get four doses of the vaccine, the first three doses at 2, 4, and 6 to 18 months of age, and a booster dose at 4 to 6 years.
  • Varicella: The vaccine should be given separate and prevents chicken pox in 70 percent to 80 percent of people who receive it, and is expected to provide lifelong immunity. A single dose of the vaccine currently is recommended for children at 12 to 18 months of age, usually at the same time as the MMR vaccine. Children who miss this shot can still get a single dose of the vaccine until their 13th birthday. After the 13th birthday, two doses are recommended, given four to eight weeks apart.