Diphtheria used to be a major cause of childhood illness and death. Through the 1920's about 150,000 people got diphtheria each year in the United States and about 15,000 of them died. The word diphtheria struck fear into the hearts of parents in those days, but today there are only a few cases a year. This change is due largely to our parents and grandparents, who got their children immunized.
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Haemophilus influenzae type b, or "Hib" disease has never been as well known as other childhood diseases, but it is just as dangerous. As recently as the mid-1980's, Hib disease struck one child out of 200 under 5 years old in the United States. Every year about 12,000 children got meningitis (inflammation of the covering of the brain) as a result of Hib. In fact, Hib disease was the leading cause of bacterial meningitis in children under five. About 1 in 4 of these children suffered permanent brain damage, and about 1 in 20 died. In addition, about 8,000 children a year suffered from other serious complications, such as pneumonia.
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Hepatitis A is a serious disease that causes liver inflammation. It is caused by the hepatitis A virus, which is found in the stool of persons with hepatitis A. It is usually spread by close personal contact and sometimes by eating food or drinking water that has been contaminated.
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Hepatitis B is a disease that affects the liver. It is one of several hepatitis diseases (for example, hepatitis A and hepatitis C). These are caused by different germs, but are similar in that they all affect the liver ("hepatitis" comes from the Greek words for "liver" and "inflammation").
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HPV is so common that almost everyone will be infected with HPV at some point in their lives. There are about 40 different types of HPV that cause infection, and although most HPV infections are asymptomatic, some persistent infections can lead to cancer in both men and women- including most cases of cervical cancer, as well as some cancers of the ano-genital area and oropharynx. In the US, HPV infections cause over 17,000 cancers in women, and over 9,000 cancers in men each year. Certain types of HPV can cause genital warts in women and men, as well.
HPV Vaccine Recommendations
Special considerations: The best way to increase uptake of HPV vaccine is to recommend it at the same time, in the same way as Tdap and meningococcal vaccine. For more information on giving a strong recommendation, raising rates in your office, and frequently asked questions about HPV9 visit the AAP HPV Champion Toolkit.
The CDC has also created vaccine safety fact sheets- a data summary and a parent fact sheet.
Resources
Influenza (flu) causes millions of illnesses, hundreds of thousands of hospitalizations and thousands of deaths every season. Influenza is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. Some people, such as older people, young children, and people with certain health conditions, are at high risk for serious flu complications. The best way to prevent the flu is by getting vaccinated each year.
Vaccine Recommendations
Special Considerations
Influenza vaccination rates are generally lower than rates for other vaccines, but the rates for those who need a second dose are particularly low. Consider implementing a reminder-recall system or vaccination-only appointments to better protect this vulnerable population.
For the latest information on vaccine supply for the season, visit the AAP Influenza Vaccine Supply page.
Additional Resources
Measles is a serious disease despite that it used to be a routine part of everyone's childhood, and also because we don't see it nearly as much as we used to. But measles can be deadly. The 10th century Persian physician Rhazes considered measles "more to be dreaded than smallpox." Measles still kills about a million people a year around the world. Measles can also cause a pregnant woman to miscarry or give birth prematurely.
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Meningitis is an infection of the spinal cord and fluid surrounding the brain. Meningococcal disease also causes blood infections. Children and young adults, particularly college freshmen who live in dormitories, are most often affected by meningococcal disease, but persons of any age can become infected. There are 2 types of meningococcal disease: bacterial and viral. Severity of the disease and treatment depend on which type a person has.
There are several vaccines available for meningococcal disease- one set for serogroups A, C, Y, and W (MCV4) and one set for serogroup B (MenB). MCV4 is routinely recommended for all adolescents at 11-12 years of age, with a booster dose at age 16. Younger children with certain high risk conditions should also be vaccinated with MCV4 vaccine- see the current AAP policy for details.
In addition, the ACIP has also made a Category B recommendation for Men B vaccine in adolescents and young adults, stating, "A serogroup B meningococcal (MenB) vaccine series may be administered to adolescents and young adults 16 through 23 years of age to provide short term protection against most strains of serogroup B meningococcal disease. The preferred age for MenB vaccination is 16 through 18 years of age." The decision to vaccinate is made individually by the physician and patient/family.
In February 2015, ACIP recommended routine use of MenB vaccines in certain groups of persons at increased risk for serogroup B meningococcal disease, including during outbreaks of serogroup B meningococcal disease. AAP recommendations on use of MenB vaccine are in process.
Vaccine Recommendations
Extra Doses
Don't forget that adolescents need 2 to 3 doses of meningococcal vaccine, depending on the serogroup protection and manufacturer chosen. Rates of the second dose for MCV4 are much lower than the first dose. Strategies such as reminder recall can help more fully protect adolescents against meningococcal disease.
See this letter from a group of organizations encouraging second dose vaccination for MCV4.
Before vaccines, mumps was a common childhood disease. The most obvious sign of mumps is swelling of the cheeks and jaw, which is caused by inflammation in the salivary glands. Children with mumps usually also get a fever and headache. Generally, mumps is a mild disease, but it does have its serious side.
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If you've ever seen a child with pertussis you, won't forget it. The child coughs violently, over and over, until the air is gone from his lungs and he is forced to inhale with the loud "whooping" sound that gives the disease its nickname, Whooping Cough. These severe coughing spells can go on for weeks. The child might turn blue from lack of air, or vomit after a coughing spell. A child with Whooping Cough can have difficulty eating, drinking, or even breathing.
Vaccine Recommendations
CDC Recommendations for Pregnant Women
Education for Families
The Streptococcus pneumoniae bacteria kills more people in the United States each year than all other vaccine-preventable diseases combined (about 40,000). It is commonly thought of as a disease of the elderly, but it also takes its toll among our children. It is the leading cause of bacterial meningitis in the country, hitting children under one year old the hardest. About 200 children die from invasive pneumococcal disease each year.
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Polio was one of the most dreaded childhood diseases of the 20th Century. An epidemic in the US in 1916 killed 6,000 people and left 27,000 more paralyzed. In the 1950's, parents refused to let their children go to movies or go swimming for fear of catching the disease.
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Rotavirus is the most common cause of diarrhea and vomiting in infants and young children. In fact, most children get rotavirus sometime before they are 5 years old. While many children have mild cases, others can get very sick.
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When children get rubella, it is usually a mild disease with a slight fever that lasts for about 24 hours and a rash on the face and neck that lasts two or three days. It can have serious consequences for pregnant women.
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Tetanus enters the body through cuts in the skin. It can get in through even a tiny pinprick or scratch, but it prefers deep puncture wounds or cuts, like those made by nails or knives. Children can also get tetanus following severe burns, ear infections, tooth infections, or animal bites. Rusty nails are often blamed for causing tetanus, but it is the tetanus bacteria, and not rust, that causes the disease. You can get tetanus from a shiny nail as easily as from a rusty one.
Vaccine Recommendations