YOUR CHILD TODAY: BIRTH TO 12 MONTHS

It takes 2-month-old Amanda only a few seconds to realize she has received her first vaccination. Ouch! With her loud wail, parents wince. As the pediatric nurse soothingly says, "It's all over," Amanda's dad gently wipes away her tears.

For most babies, immunizations bring only fleeting discomfort, but for others, severe reactions can result?in rare cases, disability or death. How can parents know they're making a wise decision?

Since every vaccine carries both risks and benefits, it's smart to become familiar with current controversies and contraindications to specific immunizations prior to your baby's 2-month checkup. In this way, you'll be better able to make an informed choice.

Vaccines: Pro and Con
Four types of immunizations are routinely given to children under 2: DPT (diphtheria, pertussis and tetanus); OPV (oral polio vaccine); HIB (hemophilus influenza B); MMR (measles, mumps and rubella, or German measles). The American Academy of Pediatrics recommends the following schedule (with additional vaccines later):

• 2 months: DPT, OPV, HIB
  
• 4 months: DPT, OPV, HIB
  
• 6 months: DPT, HIB
  
• 15 months: MMR (In measles-prevalent areas, mmr may be given at 12 months; consult your child's doctor about what is recommended in your area.)
  

Those who support routine immunization in infancy?including the Centers for Disease Control, the American Academy of Pediatrics, the American Medical Association, and the United States Public Health Service?believe the benefit of immunity to specific diseases clearly outweighs the risks, especially since severe reactions appear rare.

Critics of mandatory childhood vaccination question this. Debate centers on lack of adequate research concerning vaccine-related injuries. In response to these concerns, Congress passed the National Childhood Vaccine Injury Act in 1986 and asked the Institute of Medicine to conduct preliminary risk studies, which found that adverse reactions to vaccines are rare.

Where to Learn More

What You Need to Knowby the American Academy of Pediatrics presents general information. Distribution of this booklet to parents has been required since 1992; it's free from your physician's office or public health clinic.

Health Information for International Travel gives information on various vaccines, including risks and benefits. Send $5 to Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402; or call 202-783-3238 to order with a credit card.

Vaccines: Are They Really Effective? by Neil Z. Miller explores current controversies about adverse vaccine reactions, mandatory immunizations and adequacy of new product testing. Costs $7.95, plus postage and handling: National Vaccine Information Center, 512 W. Maple Ave., Suite 106, Vienna, VA 22180; 703-938-DPT3.

The Food & Drug Administration(www.fda.gov).

6 Questions to Ask

To make an informed choice about immunizing your baby, here are six easy-to-remember questions to ask your health care provider:

1. How effective is this immunization?
   
2. What adverse reactions may result from this vaccine?
   
3. Which children are more likely to experience an adverse reaction?
   
4. Does my baby have any conditions to contraindicate immunization at this time?
   
5. How long does immunity last from this vaccine?
   
6. Have there been any reports of contaminating agents in this vaccine?
   

In addition to talking to your baby's doctor, you may want to do additional reading (see box). As a parent it is your right and your responsibility to make the best choice possible for your baby.

?Debra Evans
Mother, childbirth educator, and author Austin, TX

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