As a young resident making pediatric hospital rounds in Houston more than thirty years ago, Michael F. Tosi, MD, Professor of Pediatrics at Icahn School of Medicine at Mount Sinai, remembers the almost daily presence of sick children under age 5 battling Haemophilus influenzae type b (Hib), a leading cause of bacterial meningitis.
“Some children died or became brain damaged from the disease,” says Dr. Tosi, also Interim Chief of the Division of Pediatric Infectious Diseases at Icahn School of Medicine. “Today, we have seen it nearly disappear. I imagine the generation of pediatricians before me had a similar experience watching polio vanish from the United States due to that vaccine.”
Indeed, widespread U.S. immunization programs that eliminate preventable diseases such as Hib, polio, and measles have been among the country’s greatest public health successes. A recent outbreak of measles in the United States, however, has renewed public discussion about the safety and importance of pediatric vaccines.
Inside Mount Sinai turned to two highly respected specialists to discuss why vaccinations are vitally important to children’s health: Dr. Tosi and Ramon Murphy, MD, MPH, Clinical Professor of Pediatrics and Preventive Medicine, Vice Chair of the Department of Pediatrics, Voluntary Affairs, and Director of Patient Care, Arnhold Global Health Institute, Icahn School of Medicine at Mount Sinai.
Q. Are pediatric vaccinations safe?
Dr. Murphy: The current recommended pediatric vaccines are extraordinarily safe and effective. Common side effects such as fever and local reactions such as tenderness or slight swelling at the injection site are easily managed with analgesics and cool compresses. While more severe reactions such as a high fever are rare, they can also be managed.
Q. What are medically valid reasons for not vaccinating a child?
Dr. Murphy: I would recommend not vaccinating a child if he or she has previously had a severe reaction to that particular vaccine or to a component of the vaccine. Also, it is not advisable to administer certain live virus vaccines to someone who is immune suppressed, immune deficient, or pregnant.
Q. In your work with underserved populations overseas, how often do you see these diseases?
Dr. Murphy: When children do not have access to vaccines, the consequences are dreadful, and many die from preventable diseases.
Q. Has the elimination of childhood diseases through vaccinations led to a more laissez-faire attitude about their importance?
Dr. Tosi: I think many people are unaware of the devastating effects these illnesses had in children before vaccines were available and may feel a sense of security that, ironically, leads some to refuse vaccination.
Q. Why is it important to stick to a strict vaccination schedule?
Dr. Tosi: The recommended vaccination schedules are designed to optimize the effectiveness of the vaccines in children being immunized. They are based on research studies that confirm the ideal dosages and intervals between vaccines. In unusual cases, it may be advisable to modify the schedule to accommodate the need for more rapid development of immunity in a particular individual.
Q. Are all children in the United States able to receive vaccinations, regardless of their family income or legal status?
Dr. Tosi: Nearly 50,000 U.S. providers and many city health departments administer vaccines under a federally funded program called “Vaccines for Children,” regardless of the child’s legal status or the family’s ability to pay.