All About Infant Immunizations: Q&A with Pediatrician Dr. Adam Spanier


Adam Spanier, MD, PhD, MPH is an Associate Professor of Pediatrics at the University of Maryland School of Medicine and a Pediatrician with University of Maryland Medical Center.

What vaccines are recommended for infants and children?

The Centers for Disease Control and Prevention (CDC) has a group of medical and public health experts called the Advisory Committee of Immunization Practices. They develop and regularly review vaccine recommendations. Parents should talk to their pediatrician or family doctor, or reference the CDC or American Academy of Pediatrics. It’s important to know the vaccine schedule is reviewed every six months and often gets updated to reflect new evidence.

Are there any recent changes to the vaccine schedule?

In fall 2016, there was a decrease in the amount of HPV vaccine children need. The guidelines used to recommend three doses, now it’s only two. Everyone’s happy when there’s fewer shots!

Why should infants get immunized?

Vaccines protect children. They help infants develop immunity to serious diseases that we don’t want them to get. One example is polio. Because of immunization, we’ve almost wiped out polio.

Why are some parents choosing not to have their infants immunized?

My experience has been that some people don’t trust the medical system. Sometimes people read something on the Internet that wasn’t necessarily fact-based. There was a paper published in a prominent medical journal many years ago that showed an association between vaccinations and autism. But the paper was withdrawn for inaccuracies in the data and there have been many studies since that have disproven it. Unfortunately, it’s like Pandora’s Box and it is hard to put the cork back the bottle (a mixed metaphor). There is a lot of misinformation on the Internet. I always refer my patients and their families to the CDC’s vaccine information statements (VIS), which provide everything you need to know in an easy-to-digest format. We’re required to give them to parents. It’s also just good practice.

What are some of the myths out there around infant immunization?

The most common myth is that vaccines cause autism, which is false. Autism is not something that can be diagnosed at birth; the child has to show signs. Signs of autism usually start around age 1 to 2 years, which is also a period where children are receiving immunizations frequently. So parents might assume they’re related. But this possible relationship has been thoroughly evaluated and they’re not related.

Is spacing out your infant’s immunizations a good idea?

No, it’s not a good idea for a few reasons. First, there is no evidence to support changing the spacing between vaccinations. Second, it may affect a child’s response to the vaccinations. The spacing recommendations are based on medical studies with years of data behind them. The timing is important too, in order for the vaccines to be effective. And there are certain windows of exposure. For example, the Rotavirus vaccine must be given within the first four months of life; once you get past that age, you aren’t able to get it. You don’t want to miss your opportunities to prevent serious illnesses.

What if a family can’t afford to have their child vaccinated?

These days, no child should be without insurance, but even without insurance, there are places to get free vaccinations. Vaccines for Children is a program that helps doctors’ offices get free vaccines for children whose families can’t afford them. Health departments also provide free vaccines to children in need.

Is there any reason a child should not get vaccinated?

There are very few reasons why a child shouldn’t be vaccinated. Usually it is related to specific vaccines and specific health conditions. A few vaccines are live vaccines and we don’t give them to a child who is immunosuppressed. When a child is on cardiac bypass, live vaccines are not recommended. These are rare, complicated issues. Most healthy kids can and should get vaccinated.

Can a vaccine make a baby or child sick?

Some parents have this misconception. The average child gets eight to 10 colds per year, so it’s more likely the child caught a cold around the time of the shot. If you have an infant and he or she is getting vaccines every couple of months, it’s statistically likely you’ll be getting a vaccine and also happen to have a cold. The regular vaccines do not have anything in them that cause cold symptoms.

Are there any side effects to infant vaccines?

The most common side effect of a shot is a little pain and sometimes swelling at the site of the shot, or a low-grade fever. It usually only lasts a couple of days. Most of the vaccines can’t cause illness because they’re not live viruses. Only a few vaccines are live viruses, and even those are very inactive viruses so the risk of getting the actual illness is practically nonexistent and transmission to anyone else is unlikely.

What are some ways to reduce child anxiety or fear around vaccinations?

Here are some suggestions:

  • Comfort techniques, such as a position where the baby or child can be held while getting a shot
  • Numbing medication
  • Distraction techniques, such as the Buzzy®
  • Sugar water solution, such as Sweet-Ease®

Often, kids are too young to be scared. Parents on the other hand sometimes get nervous when their child needs shots. There are some children who have anxiety related to shots and often they say afterward that it was no big deal. I don’t think it’s a good idea to surprise the child, but you also don’t want to build them up too much. Explain to children that they need a shot and it’s going to keep them healthy. Some kids get anxious, but most of the time they do just fine.

What’s the bottom line?

The vaccine schedule was based on decades of scientific evidence and expert guidance.  It is not a good idea for families to try to take medical practice into their own hands by making up a new schedule. Trust your doctor – he or she has the most up-to-date medical advice. When it comes to infant immunization, the problem is if too many people don’t get vaccinated, we start to see disease outbreaks. There have been mumps and measles outbreaks – many more in recent times and it happens where people haven’t had their shots and immunization coverage isn’t as great.

To make an appointment with Dr. Spanier or one of our other pediatricians, please call 410-225-8780.  Visit our website for more information. 

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