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- According to Dr. Joe
- Joseph T. Cohn, M.D.
- 2009
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- Immunizations are among the most valuable discoveries of modern
medicine. Countless millions of lives have been saved and vast suffering
averted.
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- Immunization schedules are often devised to promote PUBLIC health over
not INDIVIDUAL health.
- Immunization schedules often reflect POLITICAL, SOCIAL, and ECONOMIC
motivations over MEDICAL considerations.
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- There are better INDIVIDUAL immunization regimens that differ from the
standard public health regimen.
- Some immunizations are great and others of dubious value.
- Alternate timing of immunizations can increase safety and efficacy
without sacrificing
protection.
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- In this presentation, the cumulative number of immunizations is
indicated in brackets [ ] at the bottom of the screen: the first number
is the cumulative number by age 2 years, the second is the cumulative
number by age 5 years.
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- Hepatitis B is a viral illness that can cause a severe acute illness
with abdominal pain, nausea, weakness, fever, and severe jaundice. It
can result in permanent liver damage. It can also cause a chronic liver
infection that can lead to cirrhosis and death.
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- Hepatitis B can be passed to a fetus or to an infant via breast milk if
the mother is infected.
Otherwise , it is transmitted only in blood and can be transferred only by
tainted transfusion, unsterile tatoos or piercing, sharing IV drug needles
and syringes, or sexual intercourse.
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- Hepatitis B can be prevented by avoiding risky behaviors and by testing
prior to pregnancy. The
immunization is highly effective, but efficacy is improved by waiting to
an older age.
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- Hepatitis-B immunization is
standard to give at birth, 1 month and 6 months of age.
- Although there is no risk of “schoolyard transmission”, it
is usually required for school attendance.
- I usually delay it until it is required.
- It is three shots: the boosters one month and six months after the
first. Delaying it to after age three years dramatically improves the
lifetime efficacy.
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- Standard: 1 day old, 1 month old, 6 months old
- My usual: start at age four years and give, again a month and then 6
months later.
- [3/3]
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- The rotavirus is a seasonal viral infection that afflicts all age
groups. It is often experienced by children and adults as a
“stomach flu” with watery diarrhea. In infants it can be devastating
with severe dehydration, possibly requiring hospitalization.
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- Rotavirus immunizations are given only at 2, 4, and 6 months of age.
- Since this disease, which causes severe watery diarrhea, is only
dangerous in infants, the immunization is only given to infants.
- There might be some rationale for giving it to older kids to prevent
contagion to the infants.
- I do not usually give this immunization at all.
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- Standard: 2,4, and 6 months
- My usual: not at all
- [6/6]
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- Diphtheria: a contagious bacterial infection that causes a severe sore
throat and a toxin that can cause heart damage
- Tetanus: a common soil germ that frequently causes simple wound
infections. Simple, EXCEPT when it is a deep or puncture wound- then it
can produce a toxin that causes rigid paralysis and death
- Pertussis, whooping cough: a contagious bacterial infection that causes
months of a spastic cough, potentially lethal in infants and toddlers.
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- DTaP diphtheria, tetanus, and inactivated pertussis (whooping cough)
immunization
- a combination of toxoids (inactivated poisons) to diphtheria and
tetanus, and an acellular
immunization against pertussis,
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- is usually given at 2,4,6, and 18 months and again at 5 years and 15
years.
- The DT is given thereafter at 10 year intervals.
- I think this is the most valuable of all immunizations given, and, with
improvements, is one of the safest and most effective.
- I usually give it at 3,6, 9, then 18 months and so on.
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- Standard: 2, 4, 6, 18 months and 5 years
- My usual: 3, 6, 9, 18 months and 5 years
- [10/11]
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- HIB is a contagious bacterial infection that causes meningitis in small
children, as well as pneumonia, ear infections, and epiglottitis.
- It also causes infections in adults, particularly the elderly, most
often sinusitis and pneumonia.
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- The shot is more effective the later you give it and fewer shots are
required the later you start: if you start at 7 months old, it is only 2
plus the booster, at 12 months old it is one plus the booster, and at or
after 15 months old it is a single shot.
- Since the statistics show clearly that the reduction in HIB in the
population is entirely related to the older kids getting immunized, I
immunize as late as possible for this, thus reducing the shot count
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- HIB (haemophilus influenzae type b) immunization is given at 2,4,6, and then a booster at least 6
months later, usually at 12 to 15 months.
- I give it before they start in daycare or preschool. At five years old it is no longer
required.
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- Standard: 2,4,6,12 months
- My usual: age two years or not at all
- [14/15]
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- Polio was a terrible infectious viral disease with major summer
epidemics.
- Poliomyelitis affects the nerves and causes paralysis. It can leave
permanent damage to nerves and muscles.
- It was wonderfully eliminated by immunization programs.
- It is gone from the USA but not from the world
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- IPV (inactivated polio vaccine) is usually given at 2,4, and 6
months of age, with a
booster at 18 months, and again at 5 years of age.
- Sometimes the six month dose is omitted.
- Unless traveling to sub-Saharan Africa, or parts of Asia or Eastern
Europe, there is no realistic risk.
- I usually give this later: it is more effective. At 6, 9, and 18 months
of age, then a 5 year old booster is fine. Boost again every 10 years
for at-risk travel.
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- Standard: 2,4,6,18 months then 5 years
- My usual: 6,9,18 then age 5 years
- [18/20]
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- Influenza is a very common seasonal viral infection. It is usually
intense and uncomfortable. It can be lethal to children and elderly and,
rarely, young adults. About 75 children and 36,000 adults die every year
in the USA from flu. It mutates every year and, thus, immunity lasts
only a season.
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- Influenza (flu) immunization is an annual shot, best given in September.
- For kids less than 2 years a booster is needed.
- Until this was required, I usually gave it only to high risk kids: kids
with bad allergies, asthma, diabetes, etc.
- The flu is a very uncomfortable illness, potentially causing serious
complications.
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- Standard: every September and for those under two, again in January
- My usual: every September and for those under two in January, or not at
all
- [22/27]
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- This bacteria causes pneumonia, ear infections, sinus infections, and so
on. It is common in all age groups.
- Infections with this organism are usually easily treated with
antibiotics
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- Pneumococcus (Diplococcus Pneumoniae) immunization is usually given at
2,4, 6 months then a booster 6 months later.
- I usually give it only to high risk kids or when it is required by law.
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- Standard: 2,4,6,12 months
- My usual: only as required for school or daycare attendance, as above
- [26/31]
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- MUMPS is a viral illness that leads to severe swelling of a number of
organs in the body, most notably the salivary glands. It can also infect
the testicles and ovaries, as well as the pancreas, and rarely, the
brain. Rarely severe, it
can, however, lead to sterility, rarer still to other permanent injury.
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- MEASLES is often a severe viral infection that can inflame almost any
organ of the body. The
lungs, brain, liver, and heart can all be injured in this
infection. In small children
it can have devastating effects on the neurological system.
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- RUBELLA, also known as “german measles” is rarely more than
a minor viral illness. It is, however, devastating to a fetus if the
mother contracts rubella during pregnancy, leading to birth defects,
such as blindness and deafness.
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- MMR (mumps, measles(rubeola), rubella) immunization is usually at 15
months and again at 5 years old.
- I usually do just that, but I often postpone it to 24 months.
- This shot is three live viruses and not infrequently causes mild cases
of one or more of the three. It is very rarely dangerous.
- It has been cleared of its implication as the cause of autism and
leukemia.
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- Standard: 15 months and 5 years
- My usual: 15 months or later and 5 years
- [27/33]
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- Chickenpox is caused by the Herpes Varicella virus. It has a 7 to 21 day incubation
period and begins with a cough and sniffles. The pox then erupt on the
head and chest and then in crops out to the arms and legs. The pox itch
and hurt. If infected or scratched they can scar. Rarely, internal organs
can be affected (lungs, brain, heart, liver). It is very dangerous in
pregnancy, often causing pneumonia. Getting chicken pox gives lifelong
immunity, but can lead to Herpes Zoster – shingles – later
in life, a reactivation of the dormant virus.
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- Varicella (chickenpox, herpes varicella) immunization is usually at 12
months old.
- It is often boosted at 5 years old.
- I try not to give it at all: wild chickenpox is safer and more
immunizing for kids!
- If they have not gotten wild chicken pox by the time it is required by
law, I give it. If they have
not had chickenpox by 12 years old I give it then, as chickenpox in
teens and adults is much more dangerous and debilitating. Chickenpox in
pregnancy is very dangerous!
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- Standard: 12 months, 5 years
- My usual: at age five or as
required by law if not naturally immunized, or at age 12 years
- [28/33]
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- Hepatitis-A immunization is not required in most places and I rarely
give it except to travelers.
- Usually a mild, flu like illness, it rarely causes liver injury or
persistent problems.
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- Standard: 12 and 15 months
- My usual: not at all
- [30/35]
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- A very serious bacterial infection, meningococcal meningitis infects the
membranes around the brain and the spinal fluid.
- It can spread throughout the body and be rapidly lethal.
- It is treatable with antibiotics, but often damages too rapidly to
treat.
- About 1 in 5 to 10 Americans are asymptomatic carriers of this bacteria.
About 1 in 100,000 Americans contract this disease annually and between
1 to 10 in 10 million die of it annually.
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- Meningococcal vaccine is now being required for school attendance in NJ
at grade six.
- Previously it was suggested or required for entering college freshman or
for sleep-away camps.
- Meningococcal meningitis is rare but very dangerous. The immunization is
only moderately effective.
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- Standard: before sixth grade (NJ law)
- My usual: to comply with law, or before college, or not at all
- [30/36]
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