Part of having a healthy baby is to make sure she has regular checkups and gets all the shots she needs. Shots, or "immunizations"  (pronounced i-myoo-nuh-ZAY-shuns), help the body defend against or get over a serious disease. Sometimes people use the words “vaccines” and “vaccinations” when talking about immunizations.

Immunizations are one of the best ways to avoid serious diseases caused by some viruses or bacteria. But, in order for vaccines to be most effective, everyone needs to get their immunizations.

Diseases can change over time. When people choose not to protect themselves from illnesses, the viruses or bacteria that cause these diseases get a chance to change into new forms that the original vaccine may be unable to protect the body against. So it’s important for everyone to be immunized.

Remember:

• The more people who are immunized, the less the risk of serious illness for everyone.
• If parents don’t have their children immunized, they place all children—and their community—at risk.

Health experts constantly review immunizations for safety. When needed, they change how the immunizations are made or when they are given. Vaccines are regularly studied to make sure they are safe and effective.

The Centers for Disease Control and Prevention recommends that all babies up to the age of 3 receive the following immunizations:

• Hepatitis B
• Rotavirus
• Diphtheria, tetanus, pertussis (DTaP)
• Haemophilus influenzae Type b (Hib)
• Pneumococcal (PCV)
• Inactivated polio (IPV)
• Influenza (flu)
• Measles, mumps, rubella (MMR)
• Varicella (chickenpox)
• Hepatitis A
• Meningococcal

Risks and Side Effects
Some immunizations may have a few side effects. But the benefits of immunizations far outweigh the risks. When children get their shots, they are protected against very serious, even life-threatening diseases.

The vast majority of children do not have side effects. For those that do, they usually aren’t serious. Some immunizations result in low fever, rash or soreness at the injection site. Although your baby may seem like he is getting sick, these reactions are good signs that your baby’s immune system is working and learning to fight off infections.

In rare cases, a child may have a serious allergic reaction to an immunization. Signs of such a reaction include breathing problems, wheezing, hives, dizziness, fainting, an irregular heartbeat and weakness. This kind of reaction happens within a few minutes or a few hours after the shot. Call a health care provider right away if your child has any of these symptoms.

In very rare cases, an immunization can cause high fever or a seizure within a few days after the shot. Call a health care provider or go to the emergency room right away if your child has either of these symptoms. Again, most children do not have these side effects and these problems generally don’t last long.

Several years ago some people were concerned about a possible link between autism and shots received in childhood. Researchers have since concluded that immunizations do not cause autism. For more information, read the March of Dimes fact sheet on autism.

If you are concerned about the risks of immunizations, talk to your health care provider for more information.

The Immunization Schedule for Children
The U.S. Centers for Disease Control and Prevention has developed a schedule for when a child should get his immunizations or series of shots. Some parents worry about the number of shots a child gets at one time and they may think that too many shots at once may overwhelm their baby. The CDC has done much research to ensure the health and safety of children when it comes to immunization schedules. Studies show that kids’ bodies—even infants—can handle many shots at once. Having several vaccines at once is safe, even for a newborn. However, if you’re still concerned, talk to your child’s health provider.

Immunizations prevent the following diseases:

• Hepatitis B – Causes a long illness. Can lead to liver disease or cancer.
• Rotavirus – Causes watery diarrhea, fever, nausea and vomiting.
• Diphtheria – Causes a thick coating in the nose, throat and airway. Can lead to breathing problems, heart failure, paralysis or even death.
• Tetanus (lockjaw) – Causes serious, painful spasms of all muscles. Can cause the jaw to “lock” so that the patient cannot open the mouth or swallow. Some patients with tetanus die.
• Pertussis (whooping cough) – Causes coughing and choking for several weeks. Can lead to pneumonia, seizures, brain damage or even death.
• Haemophilus influenzae Type b – Causes meningitis, pneumonia and other infections. (Meningitis is an infection of the lining of the brain and spinal cord.) Can lead to brain damage or even death. Haemophilus influenzae Type b is not the illness commonly known as the flu.
• Pneumococcus – Causes pneumonia, meningitis, bloodstream infections and some ear infections. Can lead to brain damage or even death.
• Polio – Causes fever, sore throat, nausea, headache, diarrhea, stomachache, and stiffness in the neck, back and legs. Can lead to breathing problems, paralysis or even death.
• Influenza (the flu) – Causes fever (usually high), muscle aches, extreme tiredness, dry cough, sore throat, runny or stuffy nose and, less commonly, nausea, vomiting and diarrhea. The flu can be serious in young children. Can lead to pneumonia, bronchitis, sinus and ear infections, or even death.
• Measles – Causes rash, cough and fever. Can lead to diarrhea, ear infection, pneumonia, brain damage or even death.
• Mumps – Causes fever, headache and swollen glands around the jaw. Can lead to hearing loss; painful, swollen testicles; or meningitis.
• Rubella (German measles) – Causes rash, mild fever, swollen glands and arthritis. Rubella can cause pregnant women to lose their babies or have babies with birth defects, such as deafness, blindness, heart disease and brain damage.
• Varicella (chickenpox) – Causes fever, itchy blisters and sometimes more serious illness. Skin and lung infections may also occur.
• Hepatitis A – Causes fever, nausea and vomiting, diarrhea and jaundice (yellowing of the skin and eyes). Can lead to serious liver disease.
• Meningococcal disease – Causes high fever, headache, stiff neck, nausea and vomiting. Can lead to deafness, brain problems and even death.

Thimeresol
Several years ago, some people became concerned about thimeresol, a preservative used in some vaccines. Thimeresol contains mercury, which can be dangerous to health. Some people worried that thimeresol could cause autism.

After a lot of careful research, medical experts have found no link between thimeresol and autism. Thimeresol is no longer used in vaccines, except in tiny amounts in some flu shots. If you are concerned about thimeresol, ask your children’s health care provider to use thimeresol-free vaccines.

For More Information

• Immunization Initiatives, hosted by the American Academy of Pediatrics (information for families and health care professionals)
• A parent's guide to kids' vaccines from the U.S. Centers for Disease Control and Prevention
• "Why does my child need to be immunized?" from the American Academy of Pediatics
• Vaccine Education Center, The Children's Hospital of Philadelphia: Information on vaccines and schedules

September 2009