Immunizations used to be the realm of the young. Babies would go through series after series of vaccinations. And toddlers would take their shots before entering preschool.
And they still do. But vaccines are now expanding to include all age ranges, in an attempt to ward off disease from the cradle to the grave.
What is more, immunization rates continue to gradually improve in the US, although not as quickly as public health officials would like.
About 77 percent of children 19 months to 35 months had received all their recommended vaccinations in 2007, according to the Centers for Disease Control and Prevention (CDC).
It falls short of the federal goal of 80 percent but is a small improvement over the 76 percent rate found in 2005.
"We may have a little way to go, but that's not bad," says Dr. Thomas Weida, at Penn State's Hershey Medical Center. The government's next goal is 90 percent of children in that age range immunized by 2010.
Public health officials see these regular vaccinations as a wall holding back terrible diseases that have plagued mankind for centuries: measles, whooping cough, rubella, diphtheria, tetanus, and mumps, among others.
"Vaccines are probably one of the top two or three public health interventions of all time," says Dr. Doug Campos-Outcalt, at the University of Arizona College of Medicine. "They now have been so successful they suffer from their success, because people don't see the diseases and the horrors associated with them."
The immunization goals are part of an effort to ensure that even those who do not receive vaccinations will be protected from disease by those who do, says Dr. Weida.
"You get something called herd immunity, although I wish there were a better name for it," he notes. "If you get enough people vaccinated, even people who aren't vaccinated are protected, because the disease can't transmit. The virus can't get past the wall of vaccinated people we've created."
Most of the biggest changes in the immunization schedule have targeted preteens ages 11 to 12, says Dr. Campos-Outcalt.
There are new immunizations available for meningitis, human papillomavirus (HPV), and tetanus/diphtheria/pertussis in that age range.
"It's kind of a coincidence," says Dr. Campos-Outcalt. "Several vaccines for that age group just kind of came up."
The HPV immunization is unique in that it is the first vaccine that can prevent a form of cancer. Girls are provided the vaccine to prevent the spread of HPV, a sexually transmitted disease that can result in cervical cancer.
"The issue is explaining the vaccine at a time when neither the child nor the parent want to think about this, when the girl is still preteen," says Dr. Weida. "I say, 'This is to prevent cervical cancer, and you have to receive it before you're infected.' "
Unfortunately, some vaccinations have been lagging in teenagers. Researchers have found that immunization goals for children 13 to 17 have fallen short in all the recommended vaccines.
The problem is that most children enter public elementary schools, where there are strict immunization requirements, says Dr. Weida. Not as many go on to college, however, where they would face the same requirements.
"There's not the same push if you're not going to college, so they don't think about it," he says.
Influenza is another disease receiving a huge immunization push from public health officials. The flu vaccine soon will be recommended for children through age 18, says Dr. Campos-Outcalt.
"I think eventually it will be universally recommended for everyone, every year," he says. "This is just an incremental step in that direction."
Dr. Weida agrees. "We need to do a better job at immunizing people against flu," he says. "Everyone over 50 should get one, and so should kids, because we're discovering they're the reservoir for flu. They're in a closed container called school, so they transmit it easily between themselves, and then they bring that little present home."
New vaccines also have been springing up for the elderly, specifically immunization that provides protection against pneumonia and shingles.
To keep track of all these changes, Dr. Weida recommends that families choose a physician and stick with him or her.
"If my patients come in for a routine visit or a sick visit, I'll look at their immunization record," he says. "You're not going to get that so much if you're bouncing around from provider to provider, because they're not going to have the record."
A more promising means of making vaccination easier is the movement toward creating nasal or oral vaccines, notes Dr. Campos-Outcalt. A nasal flu vaccine already has been produced, and others are on the way.
Always consult your physician for more information.
Immunization is key to preventing disease among the general population.
Vaccines benefit both the people who receive them, and the vulnerable, unvaccinated people around them, because the infection can no longer spread.
In addition, immunizations reduce the number of deaths and disability from infections, such as whooping cough and chickenpox.
Although children receive the majority of the vaccinations, adults also need to stay up-to-date on certain vaccinations, including tetanus and diphtheria.
In addition, those adults who have never had chickenpox or measles during childhood (nor the vaccines against these specific diseases) should consider being vaccinated.
Childhood illnesses such as mumps, measles, and chickenpox can cause serious complications in adults.
Many childhood diseases can now be prevented by following recommended guidelines for vaccinations:
A child's first vaccination is given at birth.
Immunizations are scheduled throughout childhood, with many beginning within the first few months of life.
By following a regular schedule, and making sure a child is immunized at the right time, you are ensuring the best defense against dangerous childhood diseases.
As with any medication, vaccinations may cause reactions, usually in the form of a sore arm or low-grade fever.
Although serious reactions are rare, they can happen, and your child's physician or nurse may discuss these with you before giving the shots.
However, the risks of contracting the diseases the immunizations provide protection from are higher than the risks of having a reaction to the vaccine.
Always consult your physician for more information.
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