Ask the Pediatrician: Baby Vaccines

Vaccination is the best way to protect your baby against many dangerous diseases. Yet some parents choose not to vaccinate. They have doubts about the safety of the vaccines, or they believe the threat of the diseases has passed. We asked pediatrician Edward Pickens, MD, about these concerns and why it’s important for your baby to get all the recommended immunizations.

Why is it important for a baby to have all the recommended vaccines?

Because we are fortunate enough to live in a time where we have the ability to prevent a lot of the terrible infections that were present even 15 to 20 years ago, such as bacterial meningitis. Because of immunizations, we have been able to almost completely eradicate some of them.

In the 1950s, polio was still a tremendously feared infection. Today, we have almost completely eradicated it through immunizations. Measles is the same, although there are occasional outbreaks of measles still. In the 31 years since I’ve been practicing, I’ve seen tremendous decreases in the frequency of infections such as meningitis because of vaccines.

However, there are still occasional outbreaks of some of the infections we vaccinate against; right now, there is an outbreak of pertussis in parts of North Carolina, and there is also an outbreak of measles in other parts of the country. These outbreaks are totally preventable, but these infections can be very dangerous (even fatal) to young children.

Is it risky for my baby to have too many vaccines at once?

No. In fact, when you catch a cold, you probably get more of a challenge to your immune system than when you get several vaccines at the same time. It doesn’t overload the immune system. In fact, there is some evidence that if you give multiple vaccines at the same time, you get better responses to all of them.

Aren’t there some known side effects?

The only common side effect is muscle soreness, and even that isn’t very significant most of the time.

The only common side effect is muscle soreness, and even that isn’t very significant most of the time. The way you would know that your baby’s muscles are sore is that he or she would get a little bit fussier and maybe a little more irritable. Side effects beyond that are not very common. Fever is certainly a possibility, which we see occasionally, but the newer versions of the vaccines have a much lower likelihood of fever than vaccines that were used in the past.

Is it OK for me to space out the vaccines instead of having all the recommended ones at a particular visit?

You certainly can, and if it is a choice between separating them and not having them at all, I think separating them would be the better choice. The downside to separating them is that the baby is experiencing shots on more occasions. I think as far as the baby is concerned, anything greater than zero is all the same whether you’re having one, two or three shots. It’s still an event where they’re upset. If you separate the shots, you’re upsetting them multiple times.

Still, I want to make sure that parents are comfortable with the immunization plan, and if separating them means that their baby is getting them, then I think that’s acceptable. If you separate them, just be sure not to put too much time between the actual doses, or they end up being delayed. When vaccines are delayed, your baby’s immunity from a previous immunization starts to wear off. So it’s important to stay on the recommended schedule.

What about the study that links vaccines to autism?

There is no evidence of an association between vaccines and autism. The study that claims otherwise was fabricated. The lead author on that study made up the data. All of his co-authors have since stated they were not aware of a fabrication and have retracted their previous claims. Studies show completely unvaccinated children have the exact same rates of autism as vaccinated children.

I understand the concern that autism still remains fairly mysterious. We’ve had an increase in the prevalence of autism, and a lot of us are very interested in figuring out why that’s happening. While immunizations have become the easy explanation, and there really is no data to suggest there’s a link.

Isn’t there mercury in some of these vaccines?

Mercury was in a preservative called thimerosal that used to be in some vaccines. However, it was taken out of most of the vaccines many years ago. Multidose vials need a preservative. However, most pediatricians use single-dose vials that don’t require preservatives. None of the vaccines given at UNC Health Care practices have thimerosal in their vaccines.

Are there benefits to getting vaccines as a baby?

Immune systems are more responsive to vaccines in general when you’re very young. When you get older, your immune system becomes less and less responsive to vaccines. While some look at babies and think they are delicate and weak, I look at a baby and think they’re tough as nails. They are strong, and their immune systems can handle so much more than ours. We get much better long-term responses when we immunize at a young age than as an adult.

Aren’t there some kids who can’t get vaccinated?

Yes. Kids with a weakened immune system, such as those with leukemia, are not able to get certain vaccines. Those kids rely on others to be vaccinated to protect them. The idea is that if everyone around them is vaccinated, then they do not risk getting an infection because no one around has it. As you have more and more unimmunized people out there, you’re actually putting at risk the people who are not able to get vaccines.

For more information, talk to your child’s pediatrician. Find one near you in the UNC Physicians Network.