Pediatrics Vaccinations for Children By Komal Luthra Independent Study Mentorship Spring Semester 2014 Mentor: Dr. Michael Binder M.D. Teacher: Mrs. Kristi Click Disclaimer: Some information in this presentation comes from outside sources.

Introduction Mentor: Dr. Binder, M.D. Pediatrician Description: medical doctors who diagnose and treat infants, children, and adolescents Education: 4-year college degree, 4 years of medical school, 3 years of residency Certification: American Board of Pediatrics (ABP) Weebly: http://komalluthra.weebly.com/

Mentorship Site UTMB Pediatric and Adult Primary Care

A look inside the patient rooms….

Did you know…..? 1.6 million people die from pneumococcal disease every year according to the Global Alliance for Vaccines Immunization program in March of 2010. This figure includes 800,000 younger children below the age of 5. In 2005, 345,000 people died due to measles. 311,000 of those people were children under the age of five. Each year in the U.S., hepatitis A infection causes 125,000 to 200,000 people to become ill, and 70 to 100 people die due to the infection. A study showed that the recommended immunization series prevents approximately 10.5 million cases of infectious illness every year and 33,000 deaths in the United States only. Measles infected about 56,000 Americans between 1989 and 1991 and killed 166 people.

Vaccinations Killed or weakened organism that causes the body to build immunity against that organism Can be injected or taken orally Prevent diseases and infections such as diphtheria, hepatitis A, measles, polio, rubella, tetanus, varicella, and mumps Helps protect public health Types of Vaccines: Live, attenuated vaccines Inactivated vaccines Subunit vaccines Toxoid vaccines Conjugate vaccines

How Do Vaccines Work? Work with body’s immune system Imitate the infections without causing the illness Causes the immune system to create the same response it does when a bacteria or virus enters the body Makes the body able to fight the vaccine-preventable disease in the future

Ingredients in Vaccinations Antigens- help the body develop immunity Preservatives- prevent contamination Thimerosal - mercury containing preservative Stabilizers – help vaccines remain unchanged and stay potent during storage and transportation Sugars and gelatin Residual inactivating ingredients- kill viruses and inactivate toxins during the manufacturing process Formaldehyde

Ingredients in Vaccines (continued) Adjuvants - help stimulate the response to the antigens Aluminum salts Residual cell culture materials- help grow enough of the virus or bacteria to make the vaccine Egg Protein Residual antibiotics – prevent contamination by bacteria during the manufacturing process Neomycin and sulfa drugs

Tdap Vaccine Protects you from tetanus, diphtheria, and pertussis Tetanus (Lockjaw) Tightening of the muscles Kills 1 out of 5 people who are infected Diphtheria Formation of a thick coating in the back of the throat Leads to breathing problems, paralysis, heart failure, and possibly death Pertussis (Whooping cough) Severe coughing spells Leads to weight loss, incontinence, and rib fractures

Tdap Vaccine (continued) One dose routinely given to children at the age of 11 or 12 Risks/Side effects Mild: pain, redness, swelling, mild fever, headache, nausea, vomiting, chills, body aches, rash, and tiredness Moderate: swelling of the entire arm and fever over 102ᵒF Severe: swelling, severe pain, bleeding , and redness in the arm

MMR Vaccine Protects you from measles, mumps, and rubella Measles Causes rash, cough, runny nose, eye irritation, and fever Can lead to ear infection, pneumonia, seizures, brain damage, and possible death Mumps Causes fever, headache, muscle pain, and swollen glands Can lead to deafness, meningitis, and painful swelling of the testicles or ovaries Rubella Causes rash, arthritis, and mild fever

MMR First dose: 12-15 months of age Second dose: 4-6 years of age Risks/Side effects Mild: fever, mild rash, swelling of the glands in the cheeks or the neck Moderate: Seizure, temporary stiffness and pain in the joints, temporary low platelet count Serious: serious allergic reaction, permanent brain damage, deafness, long-term seizures, and lowered consciousness

Immunization Schedule from the UTMB Pediatric Clinic

Survey Purpose: to address the concerns of the parents and gain an understanding of their views of vaccinations 21 paper surveys were given to parents in the pediatric clinic 33 online surveys were given to family friends and teachers who have children

Survey Results Question 2: Do you believe that vaccinations are beneficial? 52 parents answered “yes” to this question while 2 parents answered “no”. About 96% of parents answered “yes” to this question. 100% of the parents who took the paper survey answered “yes” while 93.9% of parents who took the online survey answered “yes”.

Question 3: Have you ever researched about vaccines and their side effects? 42 parents answered “yes” to this question while 12 answered “no”. About 22% of parents have not researched about vaccines and their side effects.

Question 4: Has your child ever experienced any side effects from the vaccines? 24 parents answered “yes” to this question while 30 parents answered “no” to this question. The percentages are 44.4% and 55.6%, respectively.

Question 5: Have you ever felt worried or concerned about your child being vaccinated? 16 parents answered “yes” while 38 answered “no”. The percentages are 30% and 70 % respectively.

Question 6: Do you think or have you ever thought that you should wait to have your child vaccinated? 15 parents answered “yes” to this question while 39 answered “no”. The percentages are 28% and 72% respectively.

Question 7:  Are you worried or have you been worried about your child receiving multiple vaccines at one time? 24 parents answered “yes” while 30 answered “no” to this question. The percentages are 44% and 56% respectively.

Question 8: Do you believe that vaccines cause autism and/or sudden infant death syndrome? 8 parents answered “yes” to this question while 46 answered “no”. The percentages are 15% and 85% respectively.

Question 9: What are some side effects that you are aware of Question 9: What are some side effects that you are aware of? If you are not aware of any, please leave this question blank. Allergic reaction Fever Irritability/discomfort Behavioral changes Seizures Soreness at the injection site Eczema Pain Nausea

Question 10: Do you have any questions about vaccinations? 3 parents answered “yes” to this question while 51 answered “no”. The percentages are 6% and 94% respectively.

Final Product: Educational Pamphlet Purpose: to educate parents about vaccinations and addresses their concerns Includes information about the side effects, why one should not wait to vaccinate, why the misconceptions are not true, diseases that are prevented by vaccinations, and why children need to be vaccinated

6 Misconceptions of Vaccinations Infections/diseases started to disappear before vaccines were introduced. Most of the people who get a disease have been vaccinated. There are “hot lots” of vaccines that have been associated with more harmful effects than the others. Vaccines cause harmful side effects, death, and other unknown long-term effects. Vaccines-preventable diseases have been eliminated from the U.S., so there is not need to be vaccinated. Giving a child multiple vaccines for different diseases at one time increases the risk for harmful side effects and causes the immune system to become overloaded.

Vaccines and Autism 1998- Dr. Wakefield’s study which included a description of 12 children with diarrhea and abdominal pain 2002-Dr. Wakefield’s paper claimed that 75 out of 91 children with autism had the measles virus genome in intestinal biopsy tissues. Study published in the British Medical Journal found no rise in the incidence of autism in children who received the MMR vaccine 23 studies refute a connection between MMR and autism Only 3 studies suggest a connection between MMR and autism

Do not wait to have your child vaccinated! Vaccinate them TODAY!

Thank You!  During this mentorship experience, I had the opportunity to observe pediatric patient care. I learned a lot about the importance of vaccinations and the concerns of parents. This mentorship has increased my interest in medicine. I would like to thank my mentor, Dr. Michael Binder, Mrs. Kristi Click, and my parents, Dr. Gurinder Luthra and Mrs. Bhawna Luthra for making this mentorship a great learning experience.

Works Cited "Basics." Vaccines.gov. U.S. Department of Health and Human Services, n.d. Web. 20 Feb. 2014. <http://www.vaccines.gov/basics/index.html>. “How Vaccines Prevent Diseases." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 08 Mar. 2012. Web. 21 Feb. 2014. <http://www.cdc.gov/vaccines/parents/vaccine-decision/prevent-diseases.html>. “Immunization." World of Microbiology and Immunology. Ed. Brenda Wilmoth Lerner and K. Lee Lerner. : Gale, 2010. N. pag. Science in Context. Web. 10 Apr. 2014. <http://ic.galegroup.com/ic/scic/ReferenceDetailsPage/ReferenceDetailsWindow?failOverType =&query=&prodId=SCIC&windowstate=normal&contentModules=&mode=view&displayGro upName=Reference&limiter=&currPage=&disableHighlighting=false&displayGroups=&sortB y=&search_within_results=&p=SCIC&action=e&catId=&activityType=&scanId=&documentI d=GALE|CV2644650231&source=Bookmark&u=leag77573&jsid=6c71fe4ded3d731f863c3f2a e9974bfb>. Immunization Action Coalition (IAC): Vaccine Information for Health Care Professionals. Immunization Action Coalition, n.d. Web. 4 Apr. 2014. <http://www.immunize.org>. "Immunization." American Academy of Pediatrics. American Academy of Pediatrics, n.d. Web. 3 Mar. 2014. <http://www2.aap.org/immunization/index.html>.

Works Cited (continued) "Pediatrician: Career Summary, Job Outlook, and Educational Requirements." Pediatrician: Career Summary, Job Outlook, and Educational Requirements. DegreeDirectory.org, n.d. Web. 20 Feb. 2014. <http://degreedirectory.org/articles/Pediatrician_Career_Summary_Job_Outlook_and_E ducational_Requirements.html>. Turkington, Carol, and Bonnie Lee Ashby. "Vaccine." Health Reference Center. Facts On File, Inc. Web. 6 Apr. 2014. <http://www.fofweb.com/activelink2.asp?ItemID=WE48&SID= 5&iPin=EIDT0607&SingleRecord=True>.  "Vaccines and Immunizations." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, n.d. Web. 22 Feb. 2014. <http://www.cdc.gov/vaccines/default.htm>. "Vaccine Information Sheets (VIS)." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 24 Jan. 2014. Web. 22 Feb. 2014. <http://www.cdc.gov/vaccines/hcp/vis/index.html?s_cid=cs_000>. "Whooping Cough / Pertussis - Causes - Symptoms - Diagnosis - Treatment - Prevention | Medindia." Medindia. N.p., n.d. Web. 20 Apr. 2014. <http://www.medindia.net/patients/patientinfo/whooping-cough.htm>. "Why Vaccinate?" Vaccinate Your Baby. Every Child By Two, n.d. Web. 22 Feb. 2014. <http://www.vaccinateyourbaby.org/why/index.cfm>.