Immunizations - Introduction

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Side Effects and Anti-Immunization Groups

Many parents are worried that some vaccines are not safe and may harm their baby or young child. They may ask their doctor or nurse to wait, or even refuse to have the vaccine. However, it is important to think about the risks of not vaccinating, as well.

Some people believe that the small amount of mercury (called thimerosal) that is a common preservative in multidose vaccines causes autism or ADHD. However, studies have NOT shown this risk to be true.

• Thimerosal is a preservative that has been used in many vaccines since the 1930s. (Preservatives are necessary to prevent vaccine contamination with live organism in vials that are used for vaccinating multiple people.) The amount of mercury introduces into vaccines has been very small (approximately 25 micrograms of mercury per 0.5 mL dose, according to the Food and Drug Administration).
• All vaccines recommended for children aged 6 or younger contain either no thimerosal or only trace amounts of it, with the exception of the inactivated influenza vaccine. (A limited supply of this vaccine, containing only trace amounts of thimerosal, is available for use in infants, children, and pregnant women.) A trace amount means that a given dose of vaccine contains less than 1 part per million.
• The American Academy of Pediatrics and the Institute of Medicine (IOM) all agree that vaccines or any component of vaccines do not cause autism. They conclude that benefits of vaccinations outweigh the risk

Some parents are also worried that they or their child can get the infection from some vaccines, such as the MMR, the varicella, or the nasal spray flu vaccines. However, unless you have a weakened immune systems, this is very, very unlikely.

Like many medications, there is always a chance an immunization can cause adverse events.

Of great concern are anti-immunization organizations and web sites, which were formed mostly because of unsubstantiated reports linking small numbers of serious problems to some vaccines. The following watchdog systems are now in effect to monitor side effects from vaccination:

• VAERS (Vaccine Adverse Event Reporting System) is a government service that registers all adverse events reported after vaccination, including those not related to the vaccine. It is useful for surveillance but has limitations. For example, the service may record the same case more than once. In addition, more serious events that occur soon after a vaccination are more likely to be reported than later and milder events, and such events are not necessarily linked to the vaccine.
• VSD (Vaccine Safety Datalink) is a linked database that analyzes the records of more than 5 million patients each year. It is more accurate than VAERS, although the information it contains is not as timely.
• The CDC has established the national network of Clinical Immunization Safety Assessment (CISA) Centers. It provides services to physicians to help them evaluate and manage patients who may have had a side effect.

Studies using these systems are ongoing and none to date have confirmed reports of any significant association between most vaccines and severe side effects that would outweigh the benefits of these important and lifesaving agents.

No vaccine is 100% safe. Allergic and serious reactions are possible. In 2 cases, the early oral live polio vaccine and the first rotavirus vaccine, problems did occur, and some were serious. It is important to note, however, that even in these cases, the vaccines were withdrawn and the severe events were still far fewer than the number of lives saved. Both of these vaccines have been changed and are now safe.

However, deciding not to immunize a child also involves risk. The potential benefits from receiving vaccines far outweigh the potential risks.

• After immunizations were introduced on a wide scale, infections such as tetanus, diphtheria, mumps, measles, pertussis (whooping cough), and polio became rare. All of these illnesses used to lead to lifetime disabilities or even death
• Newer immunization have also decreased certain types of meningitis, pneumonia, and ear infections in children.
• Pregnant women may contract infections that can be very dangerous to their fetus. Vaccines reduce this risk.

Tips for Helping Small Children Before, During, and After Vaccinations

Infants often accept the first injection easily, since they are not expecting it. It gets more difficult, however, with each additional injection. Simply providing love and warmth can help children of all ages tolerate immunizations.

Additional tips:

• Do not lie and tell an older child that an injection will be painless. Some health care providers suggest telling your child that it stings a little, and to count to 5 while the vaccine is being administered.
• Ask the doctor if it is OK to give the child a dose of acetaminophen (Tylenol) after a vaccination if pain or fever causes distress. Ibuprofen (Motrin, Advil) or other non-aspirin pain relievers may be acceptable alternatives. (Children should NEVER take aspirin.)
• A cooling spray may work by numbing the skin a little.
• Longer needles, rather than shorter ones, may help reduce pain.
• Have your child take a deep breath right before the injection and blow out very hard while it is being given.
• Give a sweet fluid before the shot and a little reward, such as a lollipop, immediately after the shot. Sugar actually has mild pain relieving properties for infants.

Review Date: 10/12/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).