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Archive for the ‘Immunizations’ Category

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It’s time for me to make my annual plea for everyone to get their flu shot. In today’s column, I’d like to answer common questions I hear about influenza and the flu shot.

– Can’t I get the flu from the flu shot?

This is a very common myth and proven to be wrong. You cannot catch the flu from the flu vaccine. The flu vaccines that are given by needle are made with viruses that are killed (inactivated), and cannot cause an influenza infection.

– I’ve had the flu shot previously and I got the flu anyhow.

This is possible, but not likely, in that no vaccine is 100 percent effective.

– I’ve never had a flu shot and have never had the flu.

Consider yourself lucky, and as in most cases, one’s luck will usually wear out. Don’t take a chance, this could be the year.

– The flu is no big deal.

Tell that to those who have not survived a bout of influenza, or to the worker who misses a week or more of work, as well as the student missing time from school. Besides, having the flu can make you feel very miserable.

– I worry that it could be harmful to my baby/child to have yet another vaccination.Babies have a higher incidence of death due to influenza. There is no proof that the flu vaccine worsens or changes the effects of the other routine childhood vaccinations. The recommendation is that everyone from six months of age and older should receive the flu vaccine.

– I have already gave a chronic disease and I take lots of medications. Do I really need a flu shot too?

All the more reason to receive a flu shot since the flu is the most deadly for those with chronic medical conditions.

– I have a tremendous fear of getting a shot.

The flu vaccine is available as a nasal spray and is approved for those between the ages of 2 to 49 years of age. It has been proven to be more effective than the shot in children 2 to 8 years of age. The viruses used to develop the nasal spray flu vaccine are alive but weakened (attenuated).

– I’m pregnant, won’t a flu shot harm my baby?

Not only has the flu vaccine injection been proven to be safe during pregnancy, but is highly recommended for pregnant women in any trimester of pregnancy. Only the injection form of flu vaccine and not the nasal spray should be used in pregnancy.

– I’m 35 years old and healthy, do I really need a flu shot?

In 2009-10, the swine flu (H1N1 virus) took a particularly heavy toll on the age group 18 to 64 years of age. Better safe than sorry.

– Any reason I absolutely shouldn’t get a flu shot?

There are a few reasons, the most common being a prior allergic reaction to a flu shot or a severe allergy to eggs. The vaccine should be delayed if you have an illness with a fever.

– When should I get the shot?

The flu season typically begins as early as October and can last until late spring. Flu shots are currently available and I advise getting it sooner rather than later. It takes about two weeks after receiving the shot for it to become effective.

– Where can I get a flu shot?

Most major pharmacies such as Rite Aid, Walgreens and CVS, provide flu shots on a drop- in basis, as well as through most primary care doctor’s offices. Larger medical groups such as mine, the Palo Alto Medical Foundation, will have special drop in flu clinic days. For children, call your child’s primary care provider to find out how they are to receive a flu vaccination.

– How much will a flu shot cost me?

For most people it is free, either because they have a government insurance plan such as MediCare or MediCruz, or they have private insurance. For those who have no such coverage, the out-of-pocket cost of flu vaccine is between $30 to $50 depending on which vaccine is given.

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According to a recent public health alert, California is experiencing an epidemic of pertussis, with over 5,000 cases reported this year.

Santa Cruz County has had at least 60 known cases (twice the number as last year) and probably many more cases, which have not been reported or have yet to be diagnosed.

Pertussis, also called whooping cough, is a highly contagious infection of the lower respiratory tract, involving the lungs. It usually manifests as a mild persistent cough, but can advance to a severe cough. Often in children, this cough is followed by a high-pitched intake of breath that sounds like “whoop” – thus the name “whooping cough.”

Pertussis is caused by a germ which is a bacteria and not a virus. It is passed from an infected person who sneezes or coughs and therefore spreads infected tiny droplets into the lungs of anyone who may be nearby.

Once in the lungs, the germs can cause an infection, thereby creating inflammation and narrowing of the lung’s breathing tubes. This produces the cough and the characteristic whooping sound.

Infants are particularly vulnerable because they are not fully immune to whooping cough until they’ve received at least 3 immunization shots.

This leaves those 6 months and younger at greatest risk for catching the infection.

The pertussis vaccine one receives as a child wears off in 5 to 10 years, leaving most teenagers and adults susceptible to the infection during an outbreak.

Also, more parents are choosing not to vaccinate their children, thus lowering the number of immunized individuals. This, coupled with the fact that newer vaccines are less potent than the older ones, has increased transmission of pertussis.

The diagnosis of pertussis is often delayed or missed in infants because early symptoms are often mild and the serious cough may not begin for days or even weeks later.

A severe infection in infants can be fatal, although this is thankfully rare. Three infant deaths due to pertussis have been reported in California since the beginning of the year.

One must consider pertussis for anyone with a cough lasting more than 2 weeks, especially when the person generally feels well, coughs worse at night, and has prolonged coughing spells.

The vaccine for pertussis is combined with the tetanus and diphtheria vaccines which are routinely given to children in their first years of life, and to adults every 10 years.

Besides infants, those who especially need the vaccine protection are pregnant women in their third trimester because they will soon have contact with their unprotected infant.

Mothers have been found to be the greatest source of transmitting whooping cough to the newborn. Infants can also be protected by vaccinating those people who have close contact with them.

This “family” protection has been highly successful in protecting susceptible infants.

Tests are available to diagnose pertussis. The decision whether or not to test should be left to your doctor.

Antibiotics can be effective especially when given soon after symptoms begin. After several weeks of symptoms, they are much less effective.

Family members can also be prescribed preventative antibiotics. Remember that pertussis is caused by bacteria and can usually be treated with an antibiotic, but if you just have a bad cough from something like routine bronchitis, which is caused by a virus, antibiotics are not effective.

Your doctor will be able to determine the proper diagnosis and treatment.

Bottom line: I recommend to immunize your children and keep immunizations up to date for yourselves.

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Small pox, polio, diphtheria, tetanus, measles, mumps and rubella are all potentially life-threatening diseases that have been almost completely eliminated from our society during our lifetimes. The reason for this is the routine childhood immunization program that has been widely accepted in the United States, as well as most of the modern world.

We often hear about the supposed side effects of immunizations, but we rarely hear about children getting the very diseases that the vaccines protect against. That’s because the immunization program has worked so well in preventing diseases that could have killed millions and caused untold suffering.

In fact, we’ve been so successful immunizing children and preventing diseases that some might wonder whether vaccines are still needed.

Here’s why immunizations are still necessary:

– Newborn babies are immune to many diseases, because they have antibody protection from their mothers. This immunity is mostly gone by the end of the first year of life, leaving unvaccinated babies susceptible to the abovementioned vaccine-preventable illnesses.

– Although our country has virtually eliminated these diseases, many Third World countries with poor immunization programs are still plagued by vaccine-preventable illnesses. These diseases are only a plane ride away. An infected traveler could bring such an illness back to the States, where it could spread rapidly if people were not adequately immunized.

– In the U.S., pertussis (whooping cough) is making a comeback, and tetanus is still infecting some people.

– Widespread immunization is necessary because it helps to keep a disease from spreading within a population. This helps to protect those few who, whether by choice or by necessity, are not immunized.

Immunizations are safe. A decade ago, an unsubstantiated study tried to link immunizations to autism. A well-publicized article from England sounded the alarm connecting the measles, mumps and rubella vaccine to autism. This started a grassroots movement that has led many to reject all vaccinations. However, the majority of the authors of that article have withdrawn their support for it, and the lead author was found guilty of professional misconduct and had his license to practice medicine revoked.

Many well-controlled scientific studies have all concluded that there is no scientific or statistical relationship between immunizations and autism.

Unfortunately, the rates of immunized children entering kindergarten in Santa Cruz County are some of the lowest in the nation, with only 84 percent fully vaccinated. The San Lorenzo Valley is even lower, with just 65 percent fully immunized.

Just recently, Felton had a measles scare, prompting a major investigation. The outcome was favorable this time, as it did not infect anyone except the carrier, but a significant epidemic could spread through our area in the future because of our low immunization rates.

Until vaccine-preventable illnesses are eliminated worldwide, as with deadly smallpox — a result of the most successful immunization program ever — I strongly recommend that as many of our children as possible be routinely immunized and thus protected from potentially life-threatening diseases.

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As we begin the year, I’d like to review routine immunizations that are recommended for adults.

I feel that immunizations have been proven safe and are very effective in preventing many illnesses, and they have saved a countless number of lives from potentially deadly diseases.

Why do adults need immunizations? Some adults incorrectly assume that vaccines they received in childhood will protect them for the rest of their lives. This is mostly true, except for three points:

  • Some adults believe they received vaccinations as children, but they never actually did.
  • Newer vaccines were not available previously.
  • The effectiveness of a vaccine lessens with time.

As we age, we become more susceptible to common infections, such as those caused by influenza (flu) and pneumococcal bacteria.

These are what I feel are the most important adult vaccines:

  • Influenza: every fall season for all adults, especially those past 65 years of age
  • Tetanus with diphtheria and pertussis (whooping cough): every 10 years
  • Pneumococcal (pneumonia): men and women age 65 and older
  • Shingles: everyone 50 years or older
  •  Rubella (German measles): women of child-bearing age

Young women and men may want to check with their doctors about HPV, human papilloma virus. Travelers, especially those going to Africa, Latin America or Asia, should consider hepatitis A and typhoid vaccines.

Next time you have a reason to see your doctor, talk about routine immunizations and make sure you are up to date. Remember, it pays to keep a step ahead of illness and disease.

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There’s an abundance of hype in the media these days concerning the safety and necessity of the H1N1 swine flu vaccine.

There are those who oppose any type of immunization, those who believe in conspiracy theories and those who just don’t trust science-based medicine. And, of course, there are many individuals who have a justifiable worries about anything that is new and possibly not adequately tested.

The fact is that this H1N1 vaccine uses the same technology, processes and facilities that are used to make the yearly seasonal flu vaccine, which, over the past 30 years, has proven to be reliable and safe.

The H1N1 vaccine has been tested extensively, and so far, no significant side effects have been noted. The only difference between this vaccine and the yearly flu vaccine is that the H1N1 vaccine targets a different strain of the influenza virus.

We must remember that any time a new drug or therapy is tested on thousands of individuals, it eventually comes to market to treat millions of people. Overall, we have a very good track record of providing new drugs to those who benefit greatly from them.

Smallpox, which was a scourge of the world, has been virtually eliminated by a vaccine. Polio, measles, mumps and rubella have been controlled where vaccinations are available.

Physicians constantly grapple with the concept of risk versus benefit when treating patients. As with life in general, there are no absolute guarantees in medicine, but I believe the benefit of preventing complications from H1N1 flu outweighs the risk of the vaccine itself.

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