Vaccination Confusion - Why?

A BABY BORN IN 2001 WHO RECEIVES ALL recommended vaccinations will undergo 24 inoculations by the age of 16. That's twice as many inoculations as a baby born just a decade ago.

So why not combine all of the vaccines in a single shot? One reason is that some combinations may weaken the effectiveness of the individual components. Also, multiple vaccinations are more expensive than individual vaccines.Yet another caution is the possible long-term effects of multiple vaccinations. Some researchers suggest a correlation between increased asthma and other chronic diseases in children and the increase in both the number and frequency of childhood vaccinations.

In 1998, the American Medical Association reported on physician surveys that indicated 20 percent of physicians object to or express concern about giving three injections, and even more object to four.

The newest member of the childhood vaccine arsenal, RotaShield, can be given in combination with other vaccines such as DTAP (or DTP), Hib, hepatitis B, or polio vaccines. On August 31, 1998, the US Food and Drug Administration (FDA) licensed the rotavirus vaccine, and in November the American Academy of Pediatrics (AAP) recommended that it be given to infants at two, four, and six months of age, with doses no less than three weeks apart.

The vaccine is also recommended by the Centers for Disease Control's Advisory Committee on Immunization Practices (ACIP). However, Theodore Ganiats, MD, of the American Academy of Family Practice (AAFP) opposes the rotavirus vaccine mandate. Ganiats said the recommendation "could necessarily override patient preference by promoting use of a vaccine that doesn't produce herd immunity and for which the cost is not yet known." 

Drug trials in the US, Finland, and Venezuela have shown the vaccine to be 48 to 68 percent effective against rotavirus and 80 percent effective against the severe diarrhea associated with it.

Though severe diarrhea is associated with the rotavirus, RotaShield is not a diarrhea vaccine. It is a rotavirus vaccine. Children will still get diarrhea, even after being inoculated with RotaShield.

Made by Wyeth-Ayerst Pharmaceuticals, RotaShield is produced by using four live viruses, three from the rhesus monkey and one human strain. These viruses are propagated on fetal rhesus diploid cells. Sucrose, monosodium glutamate (MSG), potassium monophosphate, and potassium diphosphate are added to stabilize the rotavirus.

RotaShield is a live virus and should not be given to a child who is immunocompromised. The product insert suggests that the virus is shed in the stools and that immunocompromised persons should stay away from rotavirus vaccine recipients for up to four weeks.

In vaccine trials, 21 percent of infants had fevers over 100.4 degrees F after the first dose; 2 percent had fevers over 102.2 degrees F; 17 percent showed decreased appetite; 41 percent showed signs of irritability; and 20 percent showed decreased activity after the first dose.

Other reported reactions included otitis media, bronchitis, conjunctivitis, flu syndrome, fever, bronchiolitis, increased cough, pneumonia, gastroenteritis, pharyngitis, asthma, rhinitis, rash, dyspepsia, eczema, meningitis, hepatitis, and seizures.

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