A Quick Overview of the Latest Changes.
The Department of Health and Human Service (HHS) recently rolled out some major changes to the established childhood vaccine schedule. Six of the 17 recommended vaccines were moved from a mandatory status to one of “shared clinical decision-making.” These include Hepatitis A and B, Rotavirus, Tetravalent Meningococcal, and COVID vaccines. Thankfully, these vaccines will still be manufactured, available to patients, and covered by insurance. Former members of the recently-revamped Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics (AAP) expressed displeasure with the announcement and encouraged parents to continue to pursue a full complement of vaccines for their children to protect them from illness.
Hepatitis A and B are both contagious forms of liver disease. While Hepatitis A usually presents like a severe stomach flu (fever, nausea, vomiting, diarrhea), it can require hospitalization for dehydration. Hepatitis B can cause similar symptoms but carries a risk of transformation into more chronic liver disease, jaundice, cirrhosis, liver cancer, and death. Hepatitis A vaccine is a series of 2 shots at least 6 months apart, and Hepatitis B comes in a 3-shot series that is complete by 6 months of age.
Rotavirus is a highly contagious gastrointestinal illness that brings a fever, violent vomiting, abdominal pain, and very watery diarrhea. Since its introduction in 1998, the oral Rotavirus vaccine has demonstrated up to 95% protection from serious Rotavirus infection, meaning fewer children being seen in the ER for IV fluids and hospital admission. This vaccine is administered as a 3-dose series at 2, 4, and 6 months of age.
The tetravalent Meningococcal vaccine protects against four strains of this bacterial infection of the brain and the meninges (the tissue layers surrounding the brain and spinal cord) that cause more half of meningitis cases in kids under 11 years old; the other culprit is Meningitis B, a germ covered by a separate vaccine. Symptoms of meningitis include headache, light sensitivity, brain swelling, seizures, vascular collapse (requiring limb amputation), hearing or vision loss, intellectual compromise, and death. It often looks like a flu-like illness at the start and progresses quickly and relentlessly. According to the World Health Organization (WHO), one in six patients who get meningitis will die. Of the survivors, 20% will have a long-term disability as a result. The tetravalent Meningococcal vaccine is given at 11 and 16 years old.
The COVID vaccine has been politically polarizing since its introduction in 2020. As COVID morphs into different variants (more contagious, less deadly), vaccine manufacturers have tried to keep up with the most up-to-date protection against this contagious virus.
Worth mentioning is the Human Papilloma Vaccine (HPV), a 2-shot series administered 6 months apart most often at 11 years of age (but available as young as 9 years of age). The newer recommendations limit patients to one, not two, doses. Introduced in 2006, this vaccine was initially intended for administration to females only, to protect against the virus responsible for about 99% of cervical cancers and 75% of vaginal cancers. It worked so well that its recommendation was expanded to include males, to protect against other forms of genital cancers (HPV causes over 90% of anal cancers), some head and throat cancers, and genital warts.
The changes to the childhood vaccine schedule were not spurred by new evidence or reports of adverse vaccine-related outcomes. Most physicians who have dedicated their lives to the health and wellness of their patients will agree that prevention is the best protection. Vaccines have a long and trustworthy track record as our strongest defense against preventable childhood illness. Immunization prevents hospitalization, safeguards against meningitis-related brain damage, defends against cancer, and saves lives.
