Diphtheria is a very serious bacterial disease that can make a person unable to breathe, cause paralysis, or even heart failure.
About 10% of the people who get diphtheria die from it. Before the DPT shot was introduced, 17,000 children died in a single year in the United States alone in a diphtheria epidemic.
Over the last several years, only a very few cases of diphtheria have been reported in the United States. In 1988 there were zero cases. This is primarily because most children have had shots to protect them.
Tetanus, also called lockjaw, is caused by a bacterium that is common in the soil. When this germ gets into an open cut or wound, an unprotected person can contract tetanus, which creates serious muscle spasms that can be strong enough to snap the spine.
Even with modern medical care, about 30% of the people who get tetanus die from the disease.
Tetanus was once very widespread, but since 1975 only 50 to 100 cases have been reported each year in the United States.
Pertussis, more commonly known as whooping cough, can either be a very mild or a very serious disease. It is extremely contagious. It causes repeated spells of coughing that can make it difficult to eat, drink, or breathe.
The number of pertussis cases has climbed in recent years. In 2004, there were 25,827 reported cases.
In most adults, pertussis is very mild. Almost 20% of all adults with chronic coughs may have pertussis that they mistake for allergies or a cold.
In young children it is more severe. It causes repeated spells of coughing that can make it difficult to eat, drink, or breathe.
Babies under 1 year old are most affected. About 1 out of every 200 babies who get pertussis will die of it. Another 1 out of every 200 will have lifetime brain damage. As many as 2% will have seizures, 22% will get pneumonia, and many (even in this modern era of reduced hospitalization) will be sick enough to be hospitalized.
Moderate reactions to the DTaP vaccine occur in 0.1% or less of children and include ongoing crying (for three hours or more), a high fever (up to 105 degrees F), and an unusual, high-pitched crying.
Less than 0.06% of children will have a febrile seizure or a period of shock-collapse, where they become pale and limp for a short period. While these side effects are certainly disturbing, all of the above problems are temporary and have never been demonstrated to create a long-term problem of any kind.
Severe problems from the DTaP immunization happen very rarely (less than 1 in a million doses or less than 0.0001%). These include a serious allergic reaction, a prolonged seizure, a decrease in consciousness, lasting brain disease, or even death.
Major epidemiological studies looking at neurologic risks related to immunization have been unable to demonstrate a causal relationship between DPT and any severe, chronic neurologic disorder.
Many of the reactions to the older DPT (or DTP) injection were from the pertussis component. Children in the United States now receive the newer DTaP vaccine rather than the older DPT vaccine. The DTaP vaccine is a newer and safer vaccine because the pertussis component has been changed.
When should the measles vaccine be given? How effective is it?
The measles vaccine is an effective vaccine in preventing measles. After 2 doses of the measles vaccine, over 99% of recipients will be immune to measles. The initial dose of the measles vaccine is usually administered after a child is 12 months of age. The second dose is recommended at the age of kindergarten entry (i.e. age 4-6 years), but may be given any time 1 month after the first dose. In areas where measles is very common, the vaccine can be given as young as 6 months of age, but protection is suboptimal. In these children, repeat vaccination at 12-15 months and 4-6 years is recommended. When the vaccine is not completely effective, it at least minimizes the length, and particularly the severity, of the disease.
Measles has been a major cause of suffering and death at least since the societies of ancient China, Persia, and Rome. Measles epidemics ravaged Europe throughout the Middle Ages, and attacked the Americas beginning in 1657. Before the measles vaccine became generally available in 1965, there were 3 to 9 million cases of measles in the United States each year. It was a common cause of pneumonia, blindness, seizures, brain damage and death. From 1997-2004, the incidence of measles in the United States ranged from 37-116 cases per year (Redbook 2006), and serious complications are far less common. In developing countries, however, measles is still widespread, infecting almost all unimmunized children by the age of 4. The mortality rate in unimmunized children remains about 10%, and blindness is common if the child is unimmunized and malnourished.
Most children are ready to tackle the challenge of potty use somewhere between age 2 and shortly after their third birthday, with boys generally at the latter end of this range. Click here for potty training tips.
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