Your Child's First Vaccines: What You Need to Know

Why get vaccinated?

Vaccine-preventable diseases are much less common than they used to be, thanks to vaccination. But they have not gone away. Outbreaks of some of these diseases still occur across the United States. When fewer babies get vaccinated, more babies get sick.

Seven childhood diseases that can be prevented by vaccines:

1. Diphtheria (the 'D' in DTaP vaccine)

Signs and symptoms include a thick coating in the back of the throat that can make it hard to breathe.

Diphtheria can lead to breathing problems, paralysis, and heart failure.

• About 15,000 people died each year in the U.S. from diphtheria before there was a vaccine.

2. Tetanus (the 'T' in DTaP vaccine; also known as Lockjaw)

Signs and symptoms include painful tightening of the muscles, usually all over the body.

Tetanus can lead to stiffness of the jaw that can make it difficult to open the mouth or swallow.

• Tetanus kills 1 person out of every 10 who get it.

3. Pertussis (the 'P' in DTaP vaccine, also known as Whooping Cough)

Signs and symptoms include violent coughing spells that can make it hard for a baby to eat, drink, or breathe. These spells can last for several weeks.

Pertussis can lead to pneumonia, seizures, brain damage, or death. Pertussis can be very dangerous in infants.

• Most pertussis deaths are in babies younger than 3 months of age.

4. Hib (Haemophilus influenzae type b)

Signs and symptoms can include fever, headache, stiff neck, cough, and shortness of breath. There might not be any signs or symptoms in mild cases.

Hib can lead to meningitis (infection of the brain and spinal cord coverings); pneumonia; infections of the ears, sinuses, blood, joints, bones, and covering of the heart; brain damage; severe swelling of the throat, making it hard to breathe; and deafness.

• Children younger than 5 years of age are at greatest risk for Hib disease.

5. Hepatitis B

Signs and symptoms include tiredness; diarrhea and vomiting; jaundice (yellow skin or eyes); and pain in muscles, joints, and stomach. But usually there are no signs or symptoms at all.

Hepatitis B can lead to liver damage and liver cancer. Some people develop chronic (long-term) hepatitis B infection. These people might not look or feel sick, but they can infect others.

• Hepatitis B can cause liver damage and cancer in 1 child out of 4 who are chronically infected.

6. Polio

Signs and symptoms can include flu-like illness, or there may be no signs or symptoms at all.

Polio can lead to permanent paralysis (can't move an arm or leg, or sometimes can't breathe) and death.

• In the 1950s, polio paralyzed more than 15,000 people every year in the U.S.

7. Pneumococcal Disease

Signs and symptoms include fever, chills, cough, and chest pain. In infants, symptoms can also include meningitis, seizures, and sometimes rash.

Pneumococcal disease can lead to meningitis (infection of the brain and spinal cord coverings); infections of the ears, sinuses and blood; pneumonia; deafness; and brain damage.

• About 1 out of 15 children who get pneumococcal meningitis will die from the infection.

Children usually catch these diseases from other children or adults, who might not even know they are infected. A mother infected with hepatitis B can infect her baby at birth. Tetanus enters the body through a cut or wound; it is not spread from person to person.

Vaccines that protect your baby from these seven diseases:

Information about childhood vaccines

Vaccine	Number of Doses	Recommended Ages	Other Information
DTaP (diphtheria, tetanus, pertussis	5	2 months, 4 months, 6 months, 15-18 months, 4-6 years	Some children get a vaccine called DT (diphtheria & tetanus) instead of DTaP.
Hepatitis B	3	Birth, 1-2 months, 6-18 months
Polio	4	2 months, 4 months, 6-18 months, 4-6 years	An additional dose of polio vaccine may be recommended for travel to certain countries.
Hib (Haemophilus influenzae type b)	3 or 4	2 months, 4 months, (6 months), 12-15 months	There are several Hib vaccines. With one of them, the 6-month dose is not needed.
PCV13 (pneumococcal)	4	2 months, 4 months, 6 months, 12-15 months	Older children with certain health conditions may also need this vaccine.

Your healthcare provider might offer some of these vaccines as combination vaccines-several vaccines given in the same shot. Combination vaccines are as safe and effective as the individual vaccines, and can mean fewer shots for your baby.

Some children should not get certain vaccines

Most children can safely get all of these vaccines. But there are some exceptions:

• A child who has a mild cold or other illness on the day vaccinations are scheduled may be vaccinated. A child who is moderately or severely ill on the day of vaccinations might be asked to come back for them at a later date.
• Any child who had a life-threatening allergic reaction after getting a vaccine should not get another dose of that vaccine. Tell the person giving the vaccines if your child has ever had a severe reaction after any vaccination.
• A child who has a severe (life-threatening) allergy to a substance should not get a vaccine that contains that substance. Tell the person giving your child the vaccines if your child has any severe allergies that you are aware of.

Talk to your doctor before your child gets:

DTaP vaccine, if your child ever had any of these reactions after a previous dose of DTaP:

• A brain or nervous system disease within 7 days
• Non-stop crying for 3 hours or more
• A seizure or collapse
• A fever of over 105°F

PCV13 vaccine, if your child ever had a severe reaction after a dose of DTaP (or other vaccine containing diphtheria toxoid), or after a dose of PCV7, an earlier pneumococcal vaccine.

Risks of a Vaccine Reaction

With any medicine, including vaccines, there is a chance of side effects. These are usually mild and go away on their own. Most vaccine reactions are not serious: tenderness, redness, or swelling where the shot was given; or a mild fever. These happen soon after the shot is given and go away within a day or two. They happen with up to about half of vaccinations, depending on the vaccine.

Serious reactions are also possible but are rare.

Polio, hepatitis B, and Hib vaccines have been associated only with mild reactions.

DTaP and Pneumococcal vaccines have also been associated with other problems:

DTaP vaccine

Mild problems: Fussiness (up to 1 child in 3); tiredness or loss of appetite (up to 1 child in 10); vomiting (up to 1 child in 50); swelling of the entire arm or leg for 1-7 days (up to 1 child in 30)-usually after the 4th or 5th dose.

Moderate problems: Seizure (1 child in 14,000); non-stop crying for 3 hours or longer (up to 1 child in 1,000); fever over 105°F (1 child in 16,000).

Serious problems: Long-term seizures, coma, lowered consciousness, and permanent brain damage have been reported following DTaP vaccination. These reports are extremely rare.

Pneumococcal vaccine

Mild problems: Drowsiness or temporary loss of appetite (about 1 child in 2 or 3); fussiness (about 8 children in 10).

Moderate problems: Fever over 102.2°F (about 1 child in 20).

After any vaccine:

Any medication can cause a severe allergic reaction. Such reactions from a vaccine are very rare, estimated at about 1 in a million doses, and would happen within a few minutes to a few hours after the vaccination.

As with any medicine, there is a very remote chance of a vaccine causing a serious injury or death.

The safety of vaccines is always being monitored. For more information, visit: www.cdc.gov/vaccinesafety.

What if there is a serious reaction?

What should I look for?

Look for anything that concerns you, such as signs of a severe allergic reaction, very high fever, or unusual behavior.

Signs of a severe allergic reaction can include hives, swelling of the face and throat, and difficulty breathing. In infants, signs of an allergic reaction might also include fever, sleepiness, and lack of interest in eating. In older children, signs might include a fast heartbeat, dizziness, and weakness. These would usually start a few minutes to a few hours after the vaccination.

What should I do?

If you think it is a severe allergic reaction or other emergency that can't wait, call 911 or get the person to the nearest hospital. Otherwise, call your doctor.

Afterward, the reaction should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your doctor should file this report, or you can do it yourself through the VAERS website at www.vaers.hhs.gov, or by calling 1-800-822-7967.

VAERS does not give medical advice.

The National Vaccine Injury Compensation Program

The National Vaccine Injury Compensation Program (VICP) is a federal program that was created to compensate people who may have been injured by certain vaccines.

Persons who believe they may have been injured by a vaccine can learn about the program and about filing a claim by calling 1-800-338-2382 or visiting the VICP website at www.hrsa.gov/vaccinecompensation. There is a time limit to file a claim for compensation.

How can I learn more?

• Ask your healthcare provider. He or she can give you the vaccine package insert or suggest other sources of information.
• Call your local or state health department.
• Contact the Centers for Disease Control and Prevention (CDC):
  • Call 1-800-232-4636 (1-800-CDC-INFO) or
  • Visit CDC's website at www.cdc.gov/vaccines or www.cdc.gov/hepatitis

Vaccine Information Statement

Multi Pediatric Vaccines

11/05/2015

42 U.S.C. § 300aa-26

Department of Health and Human Services

Centers for Disease Control and Prevention

Many Vaccine Information Statements are available in Spanish and other languages. See www.immunize.org/vis.

Muchas hojas de información sobre vacunas están disponibles en español y en otros idiomas. Visite www.immunize.org/vis.