What Shots Are My Children Supposed To Get?

Here are the federally recommended childhood vaccine schedules, for children aged 0 through 6 years and 7 through 18 years, provided by the Centers for Disease Control and Prevention (CDC). In total, there are 69 doses of 16 vaccines for girls and 66 doses of 15 vaccines for boys. The calculation is as follows:

Nineteen flu, six diphtheria, six pertussis, six tetanus, four Hib, four Prevnar, four polio, three Hepatitis B, three rotavirus, three HPV, two measles, two mumps, two rubella, two varicella, two Hepatitis A, and one Menactra shot. Sixty-nine doses against sixteen different diseases. The National Vaccine Information Center (NVIC) offers information on some these diseases and vaccines.

But I Thought Shots Were Mandated For School?

The federal government lists the vaccines that they recommend all babies and school-age children receive. It's up to each state to determine which shots they choose to mandate for daycare and school attendance. Here's the U.S. map of exemptions by state:

If you'd like to see more detail on the percentage of children receiving exemptions by state, click HERE. NVIC provides a summary of available vaccine exemptions and a list of advocacy resources. The Immunization Action Coalition provides direct links to each of the state immunization websites. And the CDC publishes a page on state laws. They feature a database and a 39-page document from 2005-2006 on childcare and school requirements organized by vaccine-type.

Sometimes A Shot Is Not Just A Shot

Three of the shots listed above are combination shots that contain vaccines against more than one disease:

5 DTaP = 5 doses each of the diphtheria, tetanus, acellular pertussis vaccines (15 total)
1 Tdap = 1 dose each of the tetanus, diptheria, acellular pertussis vaccines (3 total)
2 MMR = 2 doses each of the measles, mumps, rubella vaccines (6 total)

There is controversy about the relative safety and efficacy of combination shots. Paul Offit, MD says "infants have the capacity to respond to about 10,000 vaccines at once." PhD scientists including vaccinologist Dennis Katkocin and research chemist Chia-Lung Hsieh admitted: "the greater the number of antigens that are combined or administered at a single office visit, the increased likelihood of an adverse reaction."

When vaccines and antigens are combined, viral or immunological interference can occur. Components of a vaccine chemically or physically interact with each other and can result in an alteration of the immune response to the vaccine. The head of Merck's virus and cell biology department stated: "Numerous studies have shown that when a monovalent dose of varicella vaccine is added to an MMR vaccine, the titer of antibody against varicella is reduced by about one-half. This is believed to be due to immunological interference by the measles vaccine" at a major international infectious disease conference in 2001. Maybe this is why Merck decreased mumps potency in their MMR vaccine in 2007 but did not take the same action in their standalone mumps shot. Logic says that it probably had something to do with an undesired effect with another component of the combined vaccine.

Many of the above shots include more than one serotype or strain of the disease. Serotypes are closely related microorganisms that are distinguished by a characteristic set of antigens. In other words, the vaccinated child's immune system is obligated to respond to the antigenic material of each of the different strains. For example:

Prevnar is called the pneumococcal 7-valent conjugate vaccine. It contains the cell membrane sugars of seven strains of pneumococcus, conjugated using diphtheria proteins. In May 2009, the FDA recently granted Wyeth priority review status for Prevnar-13, which contains 6 additional strains of pneumococcus.
Gardasil is also known as the human papillomavirus quadrivalent or 4 in 1 vaccine. It contains antigenic material of four different HPV serotypes.
Seasonal flu vaccines are trivalent. They contain three strains chosen by the World Health Organization (WHO) Global Influenza Surveillance Network as those mostly likely to cause the greatest degree of human suffering in the coming flu season.
The two licensed rotavirus vaccines, Rotarix and RotaTeq are quadrivalent and pentavalent vaccines, respectively, containing four and five different rotavirus antigens.

What Ingredients Are In Vaccines?

Straight from the CDC, here are the ingredients in vaccines, organized by ingredient and by vaccine. As you read the list, you're likely to be surprised and have many questions and concerns about safety. Excipients are inactive ingredients required for final production of the vaccine. The major categories are the growth media, adjuvants and preservatives:

Mercury-based thimerosal is not the only vaccine preservative available for use but it was the preservative of choice for vaccine manufacturers for over half a century before public safety and parent advocates created sufficient pressure for its removal from most pediatric vaccines. Mercury is still in most doses of the flu vaccine recommended for children. When you hear public health officials or politicians tell you that there are only levels of mercury in the vaccines, this is what you need to know:

Read about this in an open letter of resignation by a long-time pediatrician with two decades of membership in the American Adademy of Pediatrics. If you're interested in which vaccines still contain thimerosal, click HERE. Injecting mercury into our children is never a good idea; however, parent concerns regarding vaccination safety extend beyond thimerosal. Its removal from a vaccine does not mean that the vaccine is now safe .

Pub Med lists a number of articles discussing the safety, effectiveness and economy of adjuvants. The FDA offers a discussion about vaccine preservatives on their site. Generation Rescue highlights A Collection of Vaccine Ingredients and Possible Adverse Occurrences. Pediatrics, the official journal of the American Academy of Pediatrics, published Addressing Parents' Concerns: Do Vaccines Contain Harmful Preservatives, Adjuvants, Additives or Residuals? And Generation Rescue published A Collection of Vaccine Ingredients and Possible Adverse Occurrences.

The Package Inserts, Diseases and Other Information

Vaccine manufacturers disclose extensive information about their products in their package inserts. This information is widely available on the internet, including websites from the Department of Health and Human Services, the Immunization Action Coalition and the Institute For Vaccine Safety.

The most comprehensive website for balanced information on diseases and vaccines is the National Vaccine Information Center.

I also like Inside Vaccines. Click on the link for their blog and read about diseases, individual vaccines, useful CDC links and information about vaccine clinical trials.