Vaccines, for whom and why? To vaccinate or not? 

This is a subject of controversy among parents, doctors and even between countries that differ on which vaccines are important, hardly or not at all.

Obviously if you live in the USA, it is best to follow the recommendations of your family doctor and also the rules of the schools that require certain vaccinations before starting the school year.

We have mandatory vaccinations (at least in the US) before entering school or university and travel vaccines in some countries including countries in the tropics. There are also  recommended vaccines for adults up to old age.

If this sounds complicated, in fact, the recommendations of the CDC (Center of Disease Control) in Atlanta gives doctors all the latest information about vaccines and especially possible epidemics in a country or region of the world.

So if you have travel plans in the United States or elsewhere, better check if you need to take some precautions before traveling.

Normally the United States, family physicians have the vaccine in their offices or clinics and patients do not need to move in a vaccination center as in other countries.

Among the requirements before school starts, at least for the first entry into the school system in New York, a review of tuberculosis, Mantoux or PPD (Protein Pure Derivative) is requested. Another blood test the Quantiferon is now utilized to replace the PPD. You should know that BCG (Bacille Calmette-Guerin) against tuberculosis, which is normally applied after birth, particularly in France and Brazil among others, can indeed give a positive PPD. This test will possibly be positive for the first seven years then it becomes negative. In short, if your child or yourself have a positive PPD after the age of seven, it means that you or your child have been in contact with someone infected with tuberculosis. In this case, your doctor should do a chest X-ray and suggest an antibiotic for prevention of activation of tuberculosis.

Vaccines for children in the United States, from birth to 18 years the list is impressive and includes:

Hepatitis B (three doses)

Rotavirus (two doses)

Diphtheria, Tetanus and Pertussis (five doses)

Dipthtérie, Tetanus and Pertussis (one dose for those older than seven years and every ten years)

Haemophylus influenza (minimum three doses)

Pneumococcal (four doses)

Polio (injectable – four doses, not the old oral)

Influenza (two doses for children each year and annually for all adults)

MMR – measles, mumps, rubéolle (two doses)

Varicella (two doses)

Hepatitis A (two doses)

HPV – Human Papillomavirus (age 11 to 26 years – three doses, boys and girls)

Meningitis (two doses).

Pneumoccoccal (one dose after 65 years)

Zona Shingles (a dose after 60 years).

We still do not have the vaccine for Hepatitis C, Ebola, HIV, Dengue, Chikungunya, Malaria and many others.

It is true that longevity was around fifty years in 1900 is now over 85 years on average. Maybe the vaccination is for something.

And remember:  “By protecting yourself you protect others”

Albert Levy MD FAAFP
Assistant Professor Medicine, Mount Sinai School of Medicine,
911 Park Avenue New York NY 10075
Tel: 212 288 7193