Among the “GOAT” (greatest of all time) public health achievements is the development of immunizations. British physician Edward Jenner developed the first vaccine. In 1796, he used cowpox virus to create protection against smallpox. Since then, scientists have created countless inoculations for various illnesses. Unfortunately, not all the information about vaccines out there today is correct. So, what’s true and what’s a myth?
A vaccine is a solution of weakened, killed, or fragmented microorganisms (germs) that is administered to prevent disease. The vaccine acts like an infection, encouraging the body to produce antibodies against a given disease. Later, when the vaccinated person encounters that disease, the immune system recognizes it and fights it off. Here, you can evaluate your knowledge of immunization, and learn more about their administration, from birth to age 18:
1. Fact or fiction: A healthy, full-term (37-42 weeks) infant begins receiving immunizations at 2 months-old
Fiction: Immunization starts at birth, with the hepatitis B vaccine. Infants who did not receive a birth dose should begin the series as soon as possible. Vaccinations for multiple diseases begin at two months of age:
- Rotavirus (RV)
- Diphtheria, tetanus, acellular pertussis (DTaP)
- Hemophilus influenzae type B (hib)
- Pneumococcal polysaccharide (PPSV23)
- Inactivated polio (IPV)
- Hepatitis B (HepB) — 2nd dose
2. Fact or fiction: When and which immunizations doctors administer to preterm infants depends on the infant’s weight and size
Fiction: Birth weight and size are not factors in deciding when or which vaccines to administer to a stable preterm infant, except for hepatitis B vaccination. In most cases, preterm infants (born before 37 weeks’ gestation) should receive vaccinations at the same chronological age and according to the same schedule as full-term infants and children. The full dose of each vaccine is used; it is not reduced or divided.
A preterm infant with a birth weight less than 2,000 grams (4.4 pounds) may not have an adequate response to Hepatitis B vaccine at birth. At the chronological age of one month, however, preterm infants, regardless of birth weight, are likely to respond as adequately as larger infants.
3. Fact or fiction: If a child is mildly ill, immunization can proceed using the recommended schedule for healthy children
Fact: Since a mild illness does not affect how well the body responds to a vaccine, your child can still be vaccinated if he or she has:
- A low grade fever
- A cold, runny nose, or cough
- An ear infection (otitis media)
- Mild diarrhea
Doctors at leading health organizations, like the American Academy of Pediatrics and the American Academy of Family Practice, recommend that children with mild illnesses receive vaccinations on schedule. There is no health benefit to waiting to immunize your child if he or she has a mild illness. Children need to get their vaccines on time so that they are protected against serious, even life-threatening diseases.
Vaccines have only a tiny fraction of the bacteria and viruses that children encounter naturally. The immune system can fight minor illnesses and respond well to vaccines at the same time.
Like any medication, vaccines may cause mild side-effects, like a slight fever or soreness at the injection site. To help, put a cool, wet washcloth on the sore area or ask your child’s doctor about using acetaminophen or ibuprofen for discomfort.
4. Fact or fiction: Pregnant women should receive the flu vaccine during pregnancy
Fact: Influenza (flu) is more likely to cause illness that results in hospitalization in pregnant people than in women of the same age who are not pregnant. Flu can even be harmful for a developing baby. Fever, a common flu symptom, has an association with neural tube (spine and brain) defects and other poor outcomes for a developing baby.
Getting vaccinated during pregnancy also protects a baby from flu during the first several months after birth, from antibodies the mother passed on during the pregnancy. Antibodies are also passed on in breast milk, protecting the breastfed infant.
5. Fact or fiction: In children taking an antibiotic, immunizations should be delayed until 7 days after the child completes taking the antibiotic
Fiction: Antibiotics work against a disease a child already has. Vaccines provide protection against getting a disease. Antibiotics have no effect on viruses, or the production of antibodies against diseases. They have no effect on vaccines for viruses or for vaccines for bacterial illnesses.
6. Fact or fiction: Human papilloma virus (HPV) vaccination should be administered at age 9. It should not be administered after the age of 15
Fiction: HPV is the most common sexually transmitted infection (STI). There are more than 40 HPV types. All of them can infect both men and women. The types vary in their ability to cause genital warts. They can also infect other regions of the body, including the mouth and throat. Infection can progress to cancers of the cervix, vulva, penis, anus, and mouth.
HPV vaccination is routinely recommended at age 11–12 years, although it can start at age nine. Catch-up HPV vaccination is recommended for all persons through age 18 years if not adequately vaccinated. Immunization is a two or three-dose series depending on age at initial vaccination:
- Age 9–14 years at initial vaccination: Two-dose series at first dose with the second dose 6–12 months later. The minimum interval between doses is five months. If the second dose is administered too soon, it should be repeated.
- Age 15 years or older at initial vaccination: Three-dose series at first dose, with the second dose 1–2 months later, and the third dose six months after the first dose. There should be a minimum interval of four weeks between dose one and dose two. The interval between dose two to dose three should be 12 weeks. Repeat the last dose if there is fewer than five months between the first and third doses.
- Interrupted schedules: If the vaccination schedule is interrupted, the series does not need to be restarted.
7. Fact or fiction: Varicella vaccine is administered at 6 months-old and again at 6 years-old
Fiction: Varicella vaccine is a two-dose series starting at age 12–15 months, then at 4-6 years. Dose two may be administered as early as three months after dose one.
For dose one in children between 12–47 months, it is recommended that the MMR (measles, mumps, rubella) and varicella vaccines should be given as separate injections. Some parents choose to give both vaccines in a single injection using a mixed solution (MMRV).
8. Fact or fiction: COVID-19 vaccinations begin at 6 months of age
Fact: The Centers for Disease Control and Prevention (CDC) recommend COVID-19 vaccines for everyone ages six months and older, and COVID-19 boosters for everyone five years and older. Ongoing safety monitoring ensures that the vaccination is safe for children and teens. The known risks and potential severe complications of the disease outweigh the potential risks of having a rare adverse reaction to vaccination.
9. Fact or Fiction: Vaccines in which the infectious agent is alive and weakened produce the strongest immune response
Fact: There are several different types of vaccines.
- Live attenuated vaccines, in which the infectious agent is alive but weakened, mimic natural infection, producing a strong immune response.
- Subunit vaccines, which are generated from parts of the infectious agent (often surface proteins) generally produce long-lasting immune protection.
- DNA vaccines contain one or more segments of the infectious agent’s genetic material. Cells use the genetic information to produce immune-stimulating proteins. These vaccines are relatively inexpensive and simple to produce. They are associated with long-lasting immunity.
- RNA vaccines, like DNA vaccines, contain segments of genetic material. They are also less expensive than other types of vaccines and easier to produce. It was RNA vaccines that were developed quickly and used to help stop the spread of COVID-19, or limit the severity of illness, during the global pandemic.
10. Fact or Fiction: No vaccines have ever had an association with autism
Fact: Autism spectrum disorder (ASD) is a developmental disability that causes significant communication, social, and behavioral challenges. The CDC’s Autism and Developmental Disabilities Monitoring Network finds that about one in 44 children have ASD across the United States.
Some people have had concerns that ASD might have a link to childhood vaccines, but hundreds of studies have shown that there is no link between receiving vaccines and developing ASD.
Your best source of information for parents on vaccines from birth through 18 years is the CDC website: Vaccines for Your Children