Good News on Baby Shots, But… (Article)

We still have more children to immunize as the recent Disney measles outbreak demonstrates, but there is great cause for celebration by pediatricians and public health officials: vaccination rates among young children are actually quite high. From 2012-2013, many of the most important vaccines for young children such as the measles vaccine (MMR), hepatitis B vaccine, poliovirus vaccine, and chicken pox vaccine have been administered to over 90% of children aged 19 -35 months. It is estimated that this level of vaccination in children born between 1994 and 2013 will prevent 322 million illnesses, 21 million hospitalizations, and 732,000 deaths during these children’s lifetimes.  What a tremendous achievement! But it is too early to rest on our laurels. In order to get the maximum benefit from vaccines for our children, we need to continue to improve vaccine delivery for every child. Currently, we are having problems getting the children of families with either very low and very high incomes vaccinated.

Continue reading

Mandatory Flu Shot for Preschoolers? (Article)

Should the influenza vaccine be made mandatory for young children? Though childcare facilities have long required many vaccines to prevent children from contracting diseases, the influenza vaccine has often been overlooked. As the flu is generally perceived to be less threatening than diseases such as Hepatitis B, polio, or diphtheria, many parents forgo the recommended influenza vaccine and focus on more serious disease vaccines. However, the flu spreads rapidly and relentlessly, especially throughout childcare facilities, and it can cause a child to become very sick. Typically, the flu causes a high fever, sore throat, coughing, nausea, vomiting, and severe body aches, but in more severe cases, it can lead to hospitalization and even death. Pre-school aged children are especially prone to severe flu-related illnesses and complications. Thus, the flu cannot be overlooked, and if a small annual vaccine can prevent it, perhaps it’s time to tweak the list of recommended vaccines.

The state of Connecticut was the second U.S. state to implement the required influenza vaccines for children between the ages of 6 and 59 months who were entering childcare facilities. Since September of 2010, when Connecticut added the vaccine to the required vaccine list, the vaccine rate increased from 67.8 % to 84.1%, while the number of hospitalizations showed a marked decrease. Connecticut is a prime example of the effectiveness of the vaccine in preventing the spread of the illness.

As we can see, the influenza vaccine is incredibly effective. If this one little step in prevention can prevent our children from suffering the miserable symptoms of the flu and spreading it to others, perhaps our states should reconsider their vaccine policies. For those who would be against the vaccine for medical or religious reasons, waivers would be available, so overall, such policies would do far more good than harm. Even if states are slow to enact such changes, consider getting your child vaccinated anyway. Your precious child will be kept safe from the flu virus inevitably found hiding all over childcare facilities. In addition to the vaccine, washing hands, avoiding contact with the sick, and avoiding touching the eyes, nose, and mouth will help reduce the risk of getting the flu. Most importantly, for your child’s sake, don’t hesitate, vaccinate!

I welcome your comments at my blog, Until next time.

Smo Notes:

Written collaboratively by Keri Register and Paul Smolen M.D.

Vaccine Costs and Benefits (Article)

In all aspects of our lives, it is useful once in a while to stand back and evaluate our decisions, our priorities, and our courses of action. This is true in our personal lives as well as our societal decisions. Are we making the best use of scarce resources, are we as a society helping our most vulnerable, and are our decisions cost effective? In other words, does the benefit of an action outweigh its costs?

Fortunately, the geniuses at the Center for Disease Control did such an analysis for an action that every parent must confront: vaccinating or not vaccinating their children. The CDC analyzed costs and benefits that the 78.6 million children born between 1994-2013 received from vaccines in the US. Pediatricians, family doctors, state and federal policy makers, and health departments did a great job of vaccinating children, achieving a 90% vaccination rate during these years. Here were the staggering estimates of benefits of vaccines for this cohort of children during these years:

  • 322,000,000 childhood illnesses were prevented
  • 21,000,000 hospitalizations were prevented
  • 732,000 premature childhood deaths were prevented
  • Net savings in healthcare cost to families, insurance companies, and taxpayers were estimated to be $295 billion dollars
  • Net savings to society: a whooping $1.38 trillion dollars!

I think by anyone’s standards vaccines are incredibly effective tools. Think of all the family turmoil, pain and suffering, and long-term injury to children that getting routine childhood shots was able to prevent. Take a good look at these staggering numbers and imagine all those sick children and agonized families who never even had to step into a healthcare facility. From a cost-benefit standpoint, can it get much better?

I welcome your comments at my blog, Until next time.

Smo notes:

Morbidity and Mortality Weekly Report (MMWR)

Benefits from Immunization During the Vaccines for Children Program Era — United States, 1994–2013

 April 25, 2014 / 63(16);352-355

Written by Paul Smolen M.D.

Delaying or Missing DPaT Shots…Dangerous (Article)

Whooping cough, a disease once thought to be a relic of medical history is making a comeback in the 21st century. It is becoming a real threat for the infants of today. Most parents, have heard of the DPaT vaccine but don’t understand what it does to  help their children.  Many parents are finding out the hard way just how important it is to the health of their young infants.  Among the myriads of vaccines available for infants, the DPaT vaccine is well-worth special notice.  The DPaT vaccine prevents three harmful and possibly lethal diseases, including diphtheria, tetanus, and pertussis ( also known as whooping cough). Whooping cough is the most common of the three and is highly contagious, causing uncontrollable coughing, choking, and dangerous difficulty in breathing. Because of its effectiveness, the DPaT vaccine is a highly recommended vaccine for infants, and requires repeated injections at ages 2 months, 4 months, 6 months, 15-18 months, and 4-6 years. For a variety of reasons, many infants are not receiving this vital vaccine at a young enough age to prevent life-threatening pertussis.


A recent study published in JAMA Pediatrics revealed how important it is for your children to get their DPaT shots on time.  These researchers revealed that missing doses of DTaP drastically increases the risk of contracting whooping cough. Jason Glanz, of Kaiser Permanante Colorado, and his colleagues examined children from 3 months to 3 years who missed three or four doses of DPaT.  Alarmingly these children were 19 times and 28 times more likely to have whooping cough, respectively than their vaccinated friends. Dr. Glanz also found that almost half of all the cases of whooping cough he studied occurred in children who had missed doses of the vaccine. Researchers predicted that almost 40% of those cases of whooping cough could have been prevented with on-time vaccinations. The research is clear; the risk of catching whooping cough drastically increases with each missed vaccine. It is now clear that late and missed  vaccination with DPaT vaccine is part of the cause of  the recent outbreak of whooping cough across the U.S.


So, if your child is up to date on all their DPaT vaccinations, keep up the good work!  If you think your child may have missed a dose, please don’t hesitate to call your doctor and schedule an appointment. Life gets hectic, and sometimes it’s really easy for a little vaccine to slip through the cracks but remember, prevention is the best medicine, so make those appointments a priority!


I welcome your comments at my blog,  Tell us what you think or share a story. Until next time.


Smo Notes:



Written collaboratively by Keri Register and Paul Smolen M.D.