by Ellen McLean, MD

A pediatrician's role includes not only diagnosing and treating diseases, but also preventing them. Immunizations are important in preventing many serious illnesses. I am going to discuss two vaccinations, Prevnar and Pediarix.

Prevnar, also known as Pneumococcal and conjugate vaccine, is an immunization that provides lifelong immunity against seven strains of the bacteria Streptococcus pneumonia. Streptococcus pneumonia is the most common bacterial cause of pneumonia, ear infections, blood infections, and meningitis, which is infection of the fluid surrounding the brain and spinal cord. Pneumococcal infection causes serious disease including death in children under 5 years old. At the highest risk for severe disease are children under 5 years old. This bacteria is spread through close contact from person to person and is becoming more resistant to antibiotics, making it difficult to treat. Therefore, it is very important to prevent your child from acquiring this infection by immunization with Prevnar.

The immunization schedule for Prevnar is 2 months, 4 months, 6 months, and 12 to 15 months. If your child is under 2 years old and was not vaccinated at these ages, he or she can still get Prevnar, but the number of doses might be less. Children between 2 and 5 years old who have not received the vaccine and are at high risk of serious pneumococcal infection should also be vaccinated. We can discuss these issues in the office.

Although Prevnar protects against seven strains of Streptococcus pneumonia, it does not protect against all strains, and it is possible for infants and children to acquire pneumococcal infection due to other strains of this bacteria. In addition, Prevnar does not protect against "Strep throat" which is caused by another bacteria.

Pediarix is our newest vaccination and protects against five different diseases: diphtheria, tetanus, pertussis, polio, and Hepatitis B.

• Diptheria is a bacteria that causes a thick covering in the throat, which can lead to breathing problems, paralysis, heart failure, and even death.
• Pertussis, also known as whooping cough, is a bacteria that can cause severe coughing spells making it difficult to eat, drink, or breathe. These spells can last for weeks and lead to pneumonia, seizures, brain damage, and death. Diptheria and pertussis are spread person-to-person.
• Tetanus is a bacteria that causes painful cramping of the muscles all over the body, and can lead to "lockjaw" (inability to open mouth or swallow) and death. People can get tetanus through cuts or wounds.
• Polio is a virus that can cause paralysis and death. It enters a person's body through the mouth.
• Hepatitis B is a virus that short-term can cause jaundice (yellow skin or eyes), loss of appetite, fatigue, muscle pain, joint pain, didiarrheaand vomiting. Long-term Hepatitis B can lead to brain damage, liver cancer, and death. It is spread through contact with bloody and body fluids of an infected person, such as a needlestick or even by sharing a razor or toothbrush.

Pediarix decreases the total number of shots given for these five diseases. The immunization schedule is as follows: 2 months, 4 months, and 6 months. Previously, nine shots were needed to receive three doses of each of these diseases: diphtheria, tetanus, and pertussis as DTaP in one injection; polio and Hepatitis B as separate injections. After three shots of Pediarix, a fourth dose of DTaP is still needed at 15 months and a fifth dose at 4 years. The fourth and final dose of polio is not needed until 4 years. The Hepatitis B series is completed after three immunizations of Pediarix.

Side effects of Pediarix and Prevnar are similar to other vaccinations and include tenderness, swelling, and redness at the site of injection. Fever, loss of appetite, fussiness, and drowsiness can also occur. However, fever is more likely to occur with Pediarix than with separately administered vaccinations. As with any medicine or vaccination, Pediarix and Prevnar can cause severe allergic reaction.

Of course, if you have any questions or concerns, we can discuss them at your child's next visit to our office.