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Two New Combination Vaccines Now Available
With 12 separate vaccines on the childhood schedule, and as many as 6 separate injections at any one visit, parents and doctors love to be able to combine vaccines into fewer injections. There are several combination vaccines that do just that. These include:
Chickenpox and MMR – combined as ProQuad (Merck).
DTaP, Hep B, and Polio – combined as Pediarix (GlaxoSmithKline).
HIB and Hep B – combined as Comvax (Merck).
DTaP and HIB – combined as TriHibit (Sanofi-Pasteur). This can only be combined for the 18 month dose. It isn’t combined for the first three doses.
Hep A and Hep B – combined as Twinrix (GlaxoSmithKline). This is only for adults 18 and older.
Using some of these combinations instead of the separate shots certainly cuts down on the pain. There are now two new combinations available for doctors and parents to choose from:
DTaP, HIB, Polio – combined as Pentacel.
DTaP, Polio – combined as Kinrix.
Here is what you need to know about these two new products:
Pentacel (made by Sanofi-Pasteur). This is a fairly useful option for infants to get at 2 months, 4 months, 6 months and/or 18 months of age. It turns three injections into just one at each of these visits. You would only use this combo for 3 out of 4 of these vaccine rounds, because a baby should only get 3 polio shots during infancy. The total chemicals and ingredients in this combined shot are similar to what would be given in the three separate injections, except that the amount of pertussis germs (from the DTaP part of the shot) is greater in Pentacel than in the corresponding DTaP made by Sanofi, called Daptacel. Infants who have begun their vaccines using separate injections can change to this combined form at any time, with their doctor’s guidance. You can read full details on this vaccine in The Vaccine Book (even though this shot just came out, I knew about it ahead of time and was able to include full details on it in the book).
Dr. Bob comments: This looks like a good idea. However, those patients following my Alternative Vaccine will notice that getting this vaccine gives the Polio component months earlier than my suggested schedule. I think this is fine for any patients who believe the decrease in injections is worth it.
Kinrix (made by Glaxo). This combination is only approved for use at the 5 year booster dose of DTaP and Polio. Instead of getting these two shots separately at that age, you can now get them combined together in one shot. Here’s the catch though: You have to have gotten a Glaxo brand of the DTaP vaccine as your infant rounds of DTaP (either the Glaxo brand Infanrix or Pediarix).
Dr. Bob comments: I’m not a fan of the Glaxo DTaPs due to their high aluminum content. So this isn’t a combo vax that I’ll be using. Labels: Vaccine News
Plain Mumps Vaccine Shortage - Should Babies Just Get the Full MMR?
Some parents are choosing to split the 1 year MMR vaccine into three separate shots. Although we don't know if this precaution is necessary, some worried parents prefer the choice of getting plain Mumps vaccine at 1 year, Rubella at 2 years, and Measles at 3 years.
With a shortage of the plain Mumps vaccine expected to last the rest of 2008, parents may not be able to get the Mumps vaccine for their babies for a while. I would suggest getting a rubella vaccine at 1 year, and then Mumps at 2 years (by the time any current one-year-olds are two, the shortage will hopefully be over).
Some parents are wondering if they should get the full MMR vaccine at age 1, not just to get coverage for mumps now, but also to get measles coverage in light of the recent increase in measles outbreaks. I think that this is a very valid choice to consider, especially for infants who are entering childcare or early preschool. For children who are not going to be in daycare or school until age 3 or 4, delaying the measles vaccine is less of a worry. Labels: Vaccine News
Dr. Bob Sears Offers Advice in March 21st New York Times Health Section on Vaccine Choices Parents Make
The recent measles outbreak (if you can call it that) in San Diego last month, in which twelve children came down with the illness after an unvaccinated family brought the disease back with them from Switzerland, raises awareness of a growing trend among families to decline certain vaccines.
This article raises the question, should parents have the right to decline vaccines when doing so may put the health and safety of other children at risk? In twenty states of our free nation, parents are allowed to decline vaccine for personal reasons. But in 28 states they must have a religious reason, and two states (West Virginia and Mississippi) don’t allow parents to decline them for any reason.
I believe our nation can tolerate a certain percentage of unvaccinated children without risking the overall public health in any significant way. Since most children are vaccinated, our nation has enough “herd immunity” to contain outbreaks like this one. However, in the San Diego case, some infants caught measles before they were old enough to even be vaccinated. Fortunately, all cases passed without complications, as is usually the case with measles.
So the question is, are unvaccinated parents putting the rest of our children at risk? Maybe a little. But in my opinion parents SHOULD have the right to make health care choices for their children. They should not be forced into vaccinating if they feel strongly against it.
Click here to read the whole New York Times story.
Dr. BobLabels: Vaccine News
Merck Vaccine Recall
Merck Recalls 1.2 Million Doses of HIB and HIB/Hep B Vaccines Due to Possible Contamination
This week Merck announced a recall of over a million doses of their PedVaxHIB brand of HIB vaccine that protects against a now rare form of infant meningitis as well as their ComVax brand of HIB/Hepatitis B combination vaccine. Routine testing of their manufacturing facility found some equipment was contaminated with a bacterium called Bacillus Cereus. Under normal conditions, the manufacturing process is sterile to avoid contaminant bacterial growth within the vaccine product. Bacillus Cereus is a common cause of diarrhea food poisoning when consumed in contaminated food. If any of these bacteria happened to contaminate any of the batches of vaccines and was injected into a baby, the possible effects are unknown, although it is thought that it may only result in a rash around the injection site. It is not yet known if any of the bacteria actually made it into the vaccine bottles. The problem is expected to shut down Merck’s production of these two vaccines for about 9 months.
What can parents do? The first thing is to find out if your doctor even uses the Merck brand of these two vaccines. Many doctors use another brand of HIB vaccine called ActHIB, and don’t use the combination HIB/Hep B vaccine. IF your doctor uses the Merck brands, ask the office manager if your child received any doses from the recalled batches. The nurse will have written the batch numbers your child received in the chart. If your child did not receive a recalled batch, then you have nothing to worry about. If your child DID receive a possibly contaminated vaccine, and shows no unusual rash or signs of skin or muscle infection around the injection site, then there is most likely nothing you need to do or worry about. Granted, the effects of injecting these bacteria into the body may be unknown, but theoretically the body’s immune system should be able to kill the germs. And keep in mind, we don’t even know if any of the germs made their way into any of the vaccine bottles.
The bottom line is that there is no treatment and nothing to do right now as long as you don’t see any problems. You can be concerned, even angry, and I’m sure you’ll worry, like any parent would. But there’s nothing you really need to do as long as the injection site seems fine and your baby did not show any bothersome reactions to the vaccine. Labels: Vaccine News
Should Goverment have the Right to Make Vaccines Mandatory?
In an exclusive interview with Newsweek.com, Dr. Bob addresses the question “Should state governments have the right to make vaccines mandatory?” The state of Maryland sued a couple thousand parents and students who had declined chickenpox and hepatitis B vaccines, literally forcing the parents to decide between having their pre-teens vaccinated for these diseases or face stiff fines. Maryland state law dictates that vaccines are mandatory, unless a family has religious objections. 29 other states have similar laws, while 20 states allow parents to decline vaccines simply for personal reasons. This case raises the question, should states have the right to force vaccination? Personally, I say no. Vaccines should be a personal medical decision that every family living in a free country should have the right to make. Having said that, I must admit that if there were a very serious and contagious disease spreading through the country killing a considerable amount of people, I might agree that in this situation it might be a good idea for the government to insist on vaccinations for the public good, IF the public good is threatened. In the case of hepatitis B and chickenpox, however, I can’t really say that these two diseases threaten public safety. Sure, hep B is bad, but it’s a sexually transmitted disease. So there are ways to prevent it and protect yourself, OR choose vaccination. And since chickenpox only kills about 1 in 65,000 people who catch it, you can’t really say that’s a threat to public safety either. Hopefully more and more states will follow the example of us Californians (and 19 other states) and allow parents free choice in this matter. Click here to read Dr. Bob’s exclusive interview with Newsweek.com.Labels: Vaccine News
Dr. Bob Sears Featured in the NY Times
Dr. Bob Sears Featured in the NY Times Review of a New CDC Study Demonstrating the Effectiveness of Vaccines Over the Twentieth Century
A CDC study published today, Nov 14, 2007, in the Journal of the American Medical Association discussed how vaccines are responsible for a 90% drop in fatalities from some diseases and a 100% elimination of fatalities from other diseases. The same also applies to the actual number of cases of the diseases as well. Now, I know what you’re thinking if you are part of the anti-vaccine crowd – this study is just more propaganda launched by the CDC to quell the opposition. Pretty much every anti-vaccine book or website I’ve read discusses how diseases were already declining before its vaccine was ever introduced. They say that measles was already on the way out, and we didn’t need the vaccine. Polio was on the decline and would have gone away without the vaccine. And the list goes on. They even show statistical flow charts of the disease trends to back up their point. As you know, I’m typically quite sensitive and sympathetic toward the worries and issues that parents have about vaccines. And in The Vaccine Book I’ve tried to help parents get better informed about these issues so they can understand how to more safely vaccinate their children. But I must say, when it comes to the question of whether or not vaccines work and have eliminated or decreased disease, it’s pretty clear to me that the CDC and the American Medical Association have it right. Now I don’t just say this because I believe the medical establishment. I’ve looked at all the data myself. I’ve reviewed disease statistics and trends over the twentieth century, seen when each vaccine was introduced, and to me it’s obvious that as soon a vaccine began, the disease sharply declined and in same cases eventually disappeared. Cases in point: Pertussis – this vaccine was introduced in the 1940s, and there was an immediate decrease in the disease. Polio – this vaccine was introduced in the 1950s with an immediate impact, and eventual eradication of the disease from the entire western hemisphere. Measles and Rubella – these two diseases decreased significantly with the vaccine and are now extremely rare. HIB meningitis – this severe disease used to kill babies left and right, but as soon as the vaccine began in the 1980s there was a sharp decline and it is now almost unheard of. Chickenpox – this shot became universally used in the 1990s, and we’ve seen a dramatic decline ever since. With this clear association between disease trends and vaccines, why are vaccine opponents still skeptical of the vaccines’ effectiveness? Why do they claim the diseases would probably just have gone away anyway, or at least decreased dramatically? It’s because some of the above diseases were beginning to decline before the shot was started, due to improved sanitary conditions and better healthcare. But I don’t believe the diseases would have gone away completely (like polio and smallpox) without the vaccines. And we wouldn’t have seen the diseases decrease to the point they are today. Take chickenpox, for example. This disease has been around for centuries, and everyone used to get it. If sanitation and quality healthcare were going to help decrease chickenpox, we should have seen a decline by the 1970s or 80s. But we didn’t, until we began using the shot in the mid 1990s. And the same can be said of HIB. In fact, MOST vaccine-preventable diseases aren’t even related to poor sanitation, poor living conditions, or healthcare access. Virtually all these diseases occur equally among the rich and the poor, the clean and the dirty, those who have good access to healthcare and those that don’t. Another factor to consider is that many vaccine-preventable diseases aren’t actually treatable. These include measles, mumps, rubella, polio, rotavirus, hepatitis A, and human papillomavirus. Some diseases can improve with treatment, but sometimes don’t respond well to current treatment options, including chickenpox, pertussis, tetanus, hepatitis B, and the flu. Therefore, the quality of healthcare doesn’t have a significant effect on preventing fatalities in many of these diseases. Victims can still die even with the best care in the world. The best way to prevent the deaths is to prevent the diseases from occurring in the first place. So, in my opinion, vaccines have played a tremendous role in eliminating or limiting the diseases in our country. I also know there is much more than just this one issue that goes into deciding whether or not to vaccinate, and how to vaccinate in the safest manner possible. There is so much that parents need to know and think about. I encourage all parents to become informed and educated as they begin their baby’s vaccinations. Click here to view the New York Times ArticleLabels: Vaccine News
Nasal Spray Flu Vaccine Now Approved for Kids as Young as Two Years of Age
FluMist, the nasal spray form of the flu vaccine, has been used as an alternative to getting an injected flu shot for many years for ages 5 years through 50 years. This week, FluMist was just approved for use down to age 2 years. Does the nasal spray have any advantages over the shot, besides being pain-free? It has been shown to be more than 50% effective than the flu shot. However, the nasal spray also has a slightly higher rate of flu-like side effects. A major advantage of the nasal spray is that it is mercury free. Many brands of the flu shot still contain mercury. The single-dose vials of the Fluzone brand of the flu shot are the only flu shots that are completely mercury free. Labels: Vaccine News
How to Make Sure Your Baby's Flu Vaccine is Mercury-free
Almost 10 years ago the American medical community was rocked by the realization that millions of infants were being overloaded with mercury from childhood vaccinations. Medical policy-makers and vaccine manufacturers scrambled to remove mercury from vaccines, and by the end of 2002 mercury was a thing of the past. Or was it? Mercury has now been removed from all vaccines except for some formulations of the flu vaccine (and some diphtheria-tetanus shots). But when you take your child in to the doctor's office for the flu shot this year, there may not be any mercury-free flu shots left. For the upcoming flu season, here are the brands your doctor can choose from: - Fluvirin brand is approved for kids 4 years and older and adults. Mercury is used in manufacturing, but then filtered out.
- Fluarix and FluLaval are for adults only. Fluarix filters out the mercury too, but FluLaval contains the full dose of mercury (25 micrograms).
- Fluzone is the only brand that is used in infants age 6 to 35 months. The half-dose infant and toddler sindle-dose vials are mercury-free, but there isn't enough to go around.
- Fluzone also makes a very small supply of mercury-free flu shots for older children and adults, so only the first kids in line will get one.
- Fluzone devotes most of their manufacturing facilities to making the full-dose mercury-containing large bottles of flu shots for all age groups.
Ask the nurse to physically show you the bottle as she prepares the shot. If it is Fluzone brand, and it is a small single-dose vial or a pre-filled single-dose syringe, then you can be sure it is mercury-free. If it is Fluvirin or Fluarix brand, then there is only a tiny, barely detectable, insignificant amount of mercury. If it is FluLaval brand, or the large 10-dose bottle of Fluzone, then just say no! What should you do if the only thing your doctor has left are shots with the full dose of mercury? First, healthy kids 5 years and older don't need a flu vaccine, but if you want one anyway, the nasal spray flu vaccine is mercury-free and was just approved for use down to age 2 years. Second, you can search elsewhere for any left-over mercury-free shots at other offices or clinics. Or you can simply decide to do without the flu vaccine for that year. This is especially true for pregnant women and young children. No one wants their developing fetus or infant to be exposed to mercury while their brain is developing. Do you even have to worry about mercury in the first place? The debate rages on. Researchers battle back and forth over this issue. We've known for decades that mercury is toxic to the brain and body tissues. But whether or not the amount in vaccines is enough to cause damage is still up in the air. Some research shows there is enough evidence of harm; other studies have determined there is not enough proof that the mercury in vaccines is dangerous. No study, however, has yet to prove for certain that this mercury is safe. Labels: Vaccine News
Vaccine Shortages September 2007
From time to time vaccine shortages occur for a variety of problems. Here are the current shortages that may affect the vaccine supplies at your doctor's office: ProQuad - The current supply of this combination of MMR and Chickenpox vaccine (by Merck) has run out, due to a variety of manufacturing factors. It is unclear how long it will remain unavailable. The shortage may continue into 2008. This vaccine is given at age 1 year and 5 years. However, the MMR and the Chickenpox vaccine can also be given separately. So this shortage won't disrupt the actual vaccine schedule. It simply means that the convenient combined shot won't be available. Mumps Vaccine - Some families choose to separate the MMR into its separate components. Well, the separate Mumps vaccine by Merck is in short supply and may not be available until October. If you are planning to get this vaccine, don't worry. There's no rush. Simply wait until your doctor has it back in. Chickenpox Vaccine - This is also in short supply, although we haven't run out completely. But doctors may run out for a week or two from time to time for the rest of the year. But don't worry - it can be given at any time after age 1. Hepatitis A Vaccine - the Merck brand of this shot (Vaqta) has run out. It's not expected to become available until early 2008. There is another brand, Havrix (by GlaxoSmithKline) which IS available for now Labels: Vaccine News
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