Vaccines represent one of the greatest public health advances of the past 100 years. A vaccine is a substance that is given to a person or animal to protect it from a particular pathogen—a bacterium, virus, or other microorganisms that can cause disease. The slideshow below was created to outline common child and adolescent vaccines from Kristen A. Feemster’s Vaccines: What Everyone Needs to Know.
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Hepatitis B (HepB) recombinant vaccine
DISEASE: Hepatitis B—a virus transmitted through blood and other body fluids; can also be transmitted from mother to infant. It causes acute and chronic liver disease. Chronic infection can lead to liver failure, cirrhosis, or cancer (causes 50% of hepatocellular cancer).
BRIEF HISTORY: Before vaccine introduction, about 18,000 children less than 10 years old were infected each year. Since the vaccine introduction, only 2,895 cases were reported in 2012. 90% of infected infants develop chronic infection.
CURRENT ROUTINE SCHEDULE IN THE US: First dose: birth, Second dose: 1– 2 months, third dose: 6– 18 months. After birth, the vaccine may be given as part of a combination vaccine (DTaP– HepB– IPV) at 2, 4, and 6 months.
REPORTED ADVERSE EVENTS: Pain or soreness at the injection site, mild fever, headache, fatigue.
VACCINE EFFECTIVENESS: Over 90% protection to infants, children, and adults immunized with 3- dose series before exposure to the virus. Some people may not respond to the first series and will require a second series.
Image credit: “Hepatitis B virus” by jrvalverde. CCo Public Domain via Pixabay.
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Rotavirus (RV1 and RV5) – Oral live attenuated virus vaccine
DISEASE: Rotavirus is a virus that infects the lining of the intestines and causes diarrhea and sometimes vomiting; can lead to severe dehydration. It is spread through fecal-oral route.
BRIEF HISTORY: Before vaccine introduction, 2.7 million children were affected every year. Almost every child had a rotavirus infection by age 5 years. Since vaccine introduction there have been 40,000– 50,000 fewer rotavirus hospitalizations per year since 2008.
CURRENT ROUTINE SCHEDULE IN THE US: First dose: 2 months, 2nd dose: 4 months, third dose: 6 months, RV1 is 2- dose series, RV5 is 3 – dose series
REPORTED ADVERSE EVENTS: Vomiting, diarrhea, irritability, fever.
VACCINE EFFECTIVENESS: Approximately nine out of ten vaccinated children are protected from severe rotavirus illness, whereas seven out of ten children will be protected from rotavirus infection of any severity.
Image credit: “Transmission electron micrograph of multiple rotavirus particles” by Dr Graham Beards. CC by 3.0 via Wikimedia Commons.
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Haemophilus influenzae type b conjugate (Hib)
DISEASE: Haemophilus influenza type b is bacteria that cause pneumonia, bloodstream infections, meningitis, and infections of the bones and joints.
BRIEF HISTORY: Before vaccine introduction, there were about 20,000 children under 5 years with serious (or fatal) infections per year. Since vaccine introduction 25 reported cases per year 2003– 2010. Most cases among un- or under-vaccinated children.
CURRENT ROUTINE SCHEDULE IN THE US: First dose: 2 months, 2nd dose: 4 months, 3rd dose: 6 months, fourth dose: 12– 15 months, OR 3rd dose: 12– 15 months.
REPORTED ADVERSE EVENTS: Pain and soreness at injection site.
VACCINE EFFECTIVENESS: 95-100% effective at preventing serious infections after primary series.
Image credit: “Haemophilus influenzae bacteria” by Centers for Disease Control and Prevention/Dr. W.A. Clark. Public Domain via Wikimedia Commons.
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Inactivated Polio vaccine (IPV)
DISEASE: Poliovirus is an enterovirus that first infects the throat and lining of the intestines and then can invade an infected person’s brain and spinal cord, causing paralysis (paralytic poliomyelitis)
BRIEF HISTORY: Before the polio vaccine, there were 13,000– 20,000 cases of paralytic polio per year. The United States has been polio-free since 1979; the last imported case was in 1993. There has been near eradication worldwide
CURRENT ROUTINE SCHEDULE IN THE US: 1st dose: 2 months 2nd dose: 4 months 3rd dose: 6– 18 months 4th dose: 4– 6 years May be given as part of a combination vaccine (DTaP– HepB– IPV) at 2, 4, and 6 months
REPORTED ADVERSE EVENTS: Redness and pain at injection site
VACCINE EFFECTIVENESS: More than 90% immune after 2 doses; 99% immune after 3 doses
Image credit: “Transmission electron micrograph of Polioviruses” by Dr Graham Beards. CC BY-SA 4.0 via Wikimedia Commons.
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Pneumococcal Conjugate (PCV13)–Conjugate protein vaccine
DISEASE: Streptococcus pneumonia is bacteria that cause ear and sinus infections, pneumonia, bloodstream infections, and meningitis, especially in young children and older adults. The current vaccine targets 13 serotypes (of about 90 total serotypes)
BRIEF HISTORY: Before vaccine introduction there were 17,000 cases of invasive disease (bloodstream infections, meningitis) and 5 million cases of middle ear infection among children under 5 years old. Since the introduction of the vaccine, there has been a 99% reduction in invasive disease caused by vaccine serotypes in children under 5 years old and a 76% reduction in disease caused by all types. Significant decreases in older adults (65+ years old) due to herd immunity
CURRENT ROUTINE SCHEDULE IN THE US: 1st dose: 2 months, 2nd dose: 4 months, 3rd dose: 6 months, 4th dose: 12– 15 months
REPORTED ADVERSE EVENTS: Pain and swelling at the injection site, fever, high fever (>102°F), Decreased appetite, irritability
VACCINE EFFECTIVENESS: 97% reduction in invasive disease caused by vaccine types among children. 75 out of 100 adults age 65 years or older are protected against invasive pneumococcal disease
Image credit: “Streptococcus pneumoniae” by Janice Haney Carr. Public domain via Wikimedia Commons.
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Influenza—IIV and LAIV (IIV—inactivated influenza virus vaccine, LAIV— live attenuated influenza virus vaccine)
DISEASE: Influenza virus causes respiratory infections and pneumonia. Complications include secondary bacterial pneumonia, respiratory failure, and death. Circulating strains of influenza may change each year, which leads to almost yearly changes to the influenza vaccine.
BRIEF HISTORY: Yearly epidemics—activity usually peaks December— March 200,000 hospitalizations per year. Highest hospitalization rates among young children, infants, and older adults
CURRENT ROUTINE SCHEDULE IN THE US: 6– 23 months: annual vaccination (IIV only) 1 or 2 doses 2– 8 years: annual vaccination 1 or 2 doses (IIV or LAIV) 9 years and older: annual vaccination 1 dose only (IIV or LAIV)
REPORTED ADVERSE EVENTS: Redness, soreness, or swelling at the injection site; muscle aches; headache; low- grade fever
VACCINE EFFECTIVENESS: Vaccine effectiveness varies by year. Generally reduces the risk of influenza by 50– 60% when most circulating flu viruses are similar to vaccine viruses
Image credit: “influenza virus” by CDC Influenza Laboratory. Public Domain via Wikimedia Commons.
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Hepatitis A—Inactivated virus vaccine
DISEASE: Hepatitis A virus causes mild to severe liver disease. Symptoms include fever, stomach pain, jaundice (yellowing of the skin), and nausea. 15% of cases hospitalized.
BRIEF HISTORY: Before vaccine introduction there were 30,000– 60,000 reported cases per year. Since vaccine introduction there have been about 1,600– 2,500 reported cases per year.
CURRENT ROUTINE SCHEDULE IN THE US: 2-dose series between 12 and 23 months; separate the 2 doses by 6–18 months.
REPORTED ADVERSE EVENTS: Pain, redness, and tenderness at the injection site, headache, mild fever, feeling “out of sorts,” fatigue.
VACCINE EFFECTIVENESS: 68% reduction in hepatitis A hospitalizations since vaccine introduction.
Image credit: “Hepatitis A virus” by CDC/Betty Partin. Public Domain via Wikimedia Commons.
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Human papillomavirus (HPV9)—Recombinant vaccine
DISEASE: Human papillomavirus (HPV) is the most common sexually transmitted infection, affecting 80% of all men and women during their lifetime. The majority of new infections occur in 15- to 24-year-olds. Some types of the virus can cause cancers of the anus, cervix, oropharynx, penis, rectum, vagina, and vulva, as well as genital warts. Vaccine protects against 9 HPV types associated with about 85% of cervical cancers.
BRIEF HISTORY: Each year in the United States, HPV causes 30,700 cancers in men and women and over 300,000 new cases of genital warts
CURRENT ROUTINE SCHEDULE IN THE US: 2-dose schedule: 0, 6–12 months for adolescents aged 11 or 12 years. 3-dose schedule for adolescents who receive first HPV dose at age 15 years or older: 0, 1–2, and 6 months
REPORTED ADVERSE EVENTS: Pain, redness, or swelling at the injection site; slight fever. Rare: fainting
VACCINE EFFECTIVENESS: Approximately 70% reduction in prevalence of cancer-causing serotypes observed since vaccine introduction. HPV9 has an estimated potential to prevent 90% of anogenital cancers caused by HPV
Image credit: “Papilloma virus” by National Cancer Institute. Public Domain via Wikimedia Commons.
Featured image credit: “Syringe” by qimono. CC0 Public Domain via Pixabay.
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