U.S. Public Health Service Capt. John Iskander, chief of Defense Health Agency Public Health’s Immunization Healthcare Division and a board-certified pediatrician, addresses some of the common concerns parents have with childhood vaccines.
Many dangerous, and once common, diseases have nearly disappeared from the United States because of routine vaccines given in childhood. Vaccines save lives and prevent unnecessary burden on our health care systems by protecting people before they are infected and without having to experience disease symptoms.
The Centers for Disease Control and Prevention’s recommended childhood immunization schedule provides protection for up to 16 diseases by the time children reach school age, and even more when they reach adolescence and young adulthood.
Despite that success, concerns still linger about vaccines and their safety and effectiveness. We asked U.S. Public Health Service Capt. John Iskander, chief of Defense Health Agency Public Health’s Immunization Healthcare Division and a board-certified pediatrician, to help address some of the common concerns parents have with childhood vaccine.:
Q: If vaccines are so great, why do you have to get so many doses of some of them?
Iskander: One of the things that makes vaccines great, lifesaving, and very safe is how carefully they are studied before they are approved for use. Studies of new vaccines involve thousands of children and are used to decide how many doses of a vaccine are needed to protect against diseases, and at what ages they should be given.
For many childhood vaccines, several doses are given before six months of age so that infants have protection after infection-preventing antibodies they’ve received from their mothers before birth have worn off.
Some highly effective vaccines given in childhood require only a few doses. For instance, two doses of Measles, Mumps, and Rubella vaccine prevent measles in 99 percent of vaccinated people.
Q: Why do we still see measles outbreaks if everyone gets the vaccine in childhood?
Iskander: Because not everyone gets vaccinated! Measles outbreaks still occur in the U.S. when an unvaccinated person brings the measles virus into a community. The virus can spread like wildfire from one unvaccinated person to another. Outbreaks of measles occur in communities where there are many unvaccinated people. The level of vaccination against measles needed to prevent spread of the disease is very high—more than nine out of 10 people need to be vaccinated to protect people and their communities. So, it’s important for everyone who can be vaccinated to get vaccinated.
Q: Why does the routine schedule have so many shots given so close together?
Iskander: For many childhood vaccines, several doses are given before six months of age so that infants have protection after antibodies they’ve received from their mothers have worn off. Most vaccines are given less frequently after age six months as children begin to sustain their own immunity.
Q: If my child is going to be home-schooled, why are childhood vaccines necessary?
Iskander: Speaking as the father of a child who was home-schooled, I know it’s important for all children to be up to date on childhood vaccines. None of us live in a bubble. Home-schooled children go to social and sports events and may attend classes with other home-schooled children. In all these settings, children can catch serious diseases preventable through vaccination, especially if other children (or adults) in those groups are unvaccinated.
Q: Why does my child need to start getting vaccines as soon as they’re born?
Iskander: Infants are at high risk for life-threatening infections during their first few months of life. While newborns get some protection against infection through antibodies they receive from their mother before birth (and after birth if they receive breast milk), this protection fades within the first six months. Getting vaccines right after birth and at two, four, and six months of age prepares babies’ immune systems to actively fight off serious diseases after their mother’s antibodies aren’t there to protect them anymore.
Infants who are born before their due date, even by a few weeks, get less protection from their mothers. Premature babies get additional benefits from being up to date on all recommended vaccines by six months of age.
Q: Why do children need the HPV vaccine if they’re not sexually active?
Iskander: HPV vaccines protect males and females against multiple types of cancer, some of which have been increasing. Most parents want to protect their children from cancer, and the vaccine is given in adolescence in hopes that full immunity develops before sexual activity begins. The evidence is clear that being vaccinated against HPV does not promote promiscuity or early sexual activity.
Q: What options do I have to protect my child from RSV?
Iskander: Respiratory syncytial virus, or RSV, frequently causes serious illness requiring hospitalization in infants and children under age of two. For the first time, there are vaccine prevention options. Pregnant women can be vaccinated with a licensed vaccine against RSV (called Abrysvo) between 26–32 weeks of pregnancy in order to protect their infants after birth. Another option is for infants to receive a single dose antibody product (called Beyfortus), which is given like a vaccine after birth and up to age six months. Some children with specific medical conditions may receive a second dose of Beyfortus between ages of eight to 19 months. Parents should consult with their health care professional about which immunization they should get.
Q: What vaccines is my child authorized to get through TRICARE?
Iskander: TRICARE provides coverage for all vaccines recommended by the CDC. For more information, see the CDC’s Recommended Vaccines by Age at https://www.cdc.gov/vaccines/vpd/vaccines-age.html.
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