Immunizations: Harder for Parents than for Kids
By Dr. Lisa Cassidy-Vu
There’s nothing like a list of immunizations to fill a new mom or dad with anxiety. Hepatitis B at birth. Diphtheria, tetanus, whooping cough, measles and mumps – and the list keeps growing.
Babies cry. Toddlers squirm. And parents wince with every shot.
Nationally, parents worry too about whether immunizations are safe. There’s been a lot of talk about a connection between the preservatives in some vaccines and autism, but I haven’t seen any credible evidence that there is a link. Still, I know that parents worry.
My patients ask me what I do with my own children – Ella, who is 2 1/2, and Aidan, 5.
Here’s what I tell them. Ella and Aidan have all their childhood vaccines on schedule. Sure, I hate to see them cry, so I try to stay calm when it’s time for a new round of shots. I hold them tight, and when we’re done we go out for a special treat, maybe a milkshake or a trip to the park.
I think when I tell them that my children have had all their immunizations they say to themselves, “Well, if it’s good enough for my doctor, it should be good enough for me.”
Still, there’s a daunting list of shots ahead for any newborn.
- 2 months: babies get shots against rotavirus, diphtheria, whooping cough, tetanus, pneumococcal, polio, Haemophilus influenzae and a hepatitis B booster
- 4 months: a round of boosters against rotavirus, diphtheria, whooping cough, tetanus, pneumococcal and polio and Haemophilus
- 6 months: more boosters
- 12 to 18 months: immunizations against against mumps, measles and rubella, chicken pox and hepatitis A
Most doctors also recommend an annual flu shot. Then, around their fifth birthday children get another round of boosters, this time against diphtheria, whooping cough, tetanus, measles, mumps, rubella, polio and chicken pox. And then they’re ready for kindergarten.
Fortunately, diphtheria, whooping cough and tetanus are covered by one vaccine called the DtaP and measles, mumps and rubella are covered by the MMR. But that’s still a lot of shots for tiny legs and arms. And a lot of worry for moms and dads.
I remind parents to bring a toy to distract children and a treat to make them feel better afterwards. And I remind them how common and how devastating these illnesses once were:
- Polio paralyzed and killed thousands of children. Diphtheria left children in a coma.
- The Haemophilus virus, which we refer to as Hib, sometimes led to meningitis.
- Some illnesses once considered common childhood illnesses like mumps and chicken pox have almost been eradicated.
I haven’t seen a case of chicken pox in at least two years and the only time I ever saw a case of mumps was on a medical mission trip to Honduras.
Lifelong Protection from STDs and Other Illnesses
In the last few years, we’ve introduced two more vaccines for preteens:
- The first is a vaccine against meningococcal, which protects against meningitis, recommended now at age 11 or 12 and again before a child goes to college.
- The second protects against a sexually transmitted disease called human papillomavirus, or HPV, which causes genital warts and cervical cancer.
The HPV vaccine requires three boosters, spread out over a year. A little over five years ago, we started recommending it for girls at age 11 or 12. Not surprisingly, many parents object. Mothers tell me they worry they are giving their daughters permission to become sexually active. I understand, but that’s not the way I see it.
The immunizations we give children protect them in childhood but, as importantly, the shots protect them for the rest of their lives. We think of many of the diseases we vaccinate against as childhood illnesses. Certainly mumps and chicken pox were once common among children. But these illnesses strike adults, too. And that’s where the HPV vaccine comes in. It’s the only vaccine we have against a cancer. Yes, cervical cancer is an illness of adult women. But if I can immunize a girl, when she’s still under her parent’s care and coming in for regular check-ups, then I can help protect her when she’s grown.
In 2011 we started recommending the HPV vaccine for boys. So far, none of my patients have agreed. Their sons will never get cervical cancer, so why worry, they say. Again, I don’t see it that way. The HPV virus is a sexually transmitted disease. If I can immunize that boy, when he’s grown he’s less likely to infect anyone.
It’s hard for parents to buy that public health argument. But I try. After all, immunizations have all but eliminated polio, measles, whooping cough and other diseases that once killed thousands. Why not try the same with a virus that causes cancer?
But mostly what I hear is the anxiety over the shot itself. With preteens and teenagers I talk them through it and try to keep them calm.
And with parents of infants and young children, I have the same advice I always do. Try to stay calm. Don’t warn them about the shots. Bring a toy, and if you forget, we always have crayons kids can use to draw on the paper bed sheet.
My kids look forward to a treat afterwards. They like colorful bandages. And they always recover sooner than I do.
Dr. Lisa Cassidy-Vu is an assistant professor of family medicine at Wake Forest Baptist Health.