Most likely, you have never seen a child with diphtheria or heard the “whoop” of whooping cough (pertussis). While these diseases have almost disappeared because of immunizations, they are still killing children in other countries. It’s important for all parents to remember that children can still be exposed to these diseases by simply flying in an airplane or by visiting a foreign country.

Hepatitis B

Hepatitis B is a serious liver disease caused by a virus. The hepatitis B virus is spread by contact with blood or other body fluids of an infected person. Hepatitis B can enter the blood stream, attack the liver, and cause severe illness – even death.

Infants and children who become infected with the hepatitis B virus are at the highest risk of developing lifelong infection, which often leads to death from liver disease and liver cancer. Approximately 25 percent of children who become infected with lifelong hepatitis B virus die of related liver disease as adults.

Source: Centers for Disease Control & Prevention


Given as Diphtheria, Tetanus, Acellular Pertussis — DTaP

Diphtheria is a serious disease caused by poison produced from the bacteria. It frequently causes heart and nerve problems. The death rate is 5 percent to 10 percent, with higher rates (up to 20 percent) in the very young.

In the 1920s, diphtheria was a major cause of illness and death for children in the United States. Although diphtheria is rare in the United States, it is still a threat. Diphtheria is common in other parts of the world.

Source: Centers for Disease Control & Prevention


Given as Diphtheria, Tetanus, Acellular Pertussis — DTaP

Pertussis (whooping cough) is most severe during the first year of life. Even in older children, it can cause prolonged coughing spells that last for many weeks. These spells make eating, drinking, and breathing difficult. When the coughing spells cause vomiting, infants lose weight and become dehydrated. Other complications of pertussis include pneumonia, seizures, central nervous system involvement, and rarely death.

Source: Centers for Disease Control & Prevention


Given as Diphtheria, Tetanus, Acellular Pertussis — DTaP

Tetanus is a severe, often fatal disease. The bacteria that cause tetanus are widely distributed in soil and street dust, are found in the waste of many animals, and are resistant to heat and germ-killing cleaners.

People who get tetanus suffer from stiffness and spasms of the muscles. The larynx (windpipe) can close, causing breathing difficulties. Muscle spasms can be so severe that they cause bone fractures. Some people go into a coma and die. Approximately 30 percent of people who develop tetanus die.

Source: Centers for Disease Control & Prevention


Given as Inactivated Polio Virus – IPV

The polio virus can cause minor infections that heal after a few days or rapidly progressive, serious infections that are complicated by paralysis, permanent physical disability, and even death. Before the polio vaccine was available in the United States, 13,000 to 20,000 cases of paralytic polio occurred each year. These annual epidemics left thousands of victims – mostly children – in braces, crutches, and wheelchairs for life.

Source: Centers for Disease Control & Prevention


Pneumococcal infections include ear infections, sinusitis, pneumonia, and meningitis. All of these diseases can have serious complications. Pneumococcal disease kills about 40,000 people each year.

Source: Centers for Disease Control & Prevention


Given as Measles, Mumps, Rubella – MMR

Before the measles vaccine was available, nearly everyone in the United States got measles (7-day measles). There were approximately 3-4 million cases each year. As many as 20 percent of people with measles required hospitalization, and almost 10 percent suffered complications such as diarrhea, ear infections, or pneumonia. When the virus infected the brain, permanent damage to brain function occurred.

Measles is one of the most infectious diseases in the world. More than 90 percent of people who are not immune will develop measles if they are exposed to the virus. In 1998, most cases of measles were associated with international visitors or United States residents who were exposed to the measles virus while traveling abroad.

Source: Centers for Disease Control & Prevention


Given as Measles, Mumps, Rubella – MMR

Before the mumps vaccine was introduced, mumps was a major cause of deafness in children, occurring in approximately 1 per 20,000 reported cases. Mumps is usually a mild viral disease. However, rare conditions such as swelling of the brain, nerves, and spinal cord can lead to serious side effects such as paralysis and seizures.

Serious side effects of mumps are more common in adults than children. Swelling of the testes is the most common side effect in males past the age of puberty, occurring in up to 20 percent to 50 percent of men who become ill with mumps. An increase in miscarriage has been found among women who develop mumps in the first three months of their pregnancy. If the mumps vaccination were to stop, the number of cases could go back to prevaccine levels of more than 200,000 cases per year.

Source: Centers for Disease Control & Prevention


Given as Measles, Mumps, Rubella – MMR

While rubella (German measles, 3-day measles) is usually mild in children and adults, up to 90 percent of infants born to mothers who become infected with rubella in the first three months of pregnancy will develop congenital rubella syndrome, resulting in heart defects, cataracts, mental retardation, and deafness.

Source: Centers for Disease Control & Prevention

Haemophilus Influenzae (Hib)

Before the Hib vaccine became available, Haemophilus influenzae was the most common cause of bacterial meningitis in infants and children, affecting about 16,000 children in the United States each year. One in 20 children with Haemophilus meningitis died. Twenty percent to 30 percent of the survivors were left with permanent brain damage.

Source: Centers for Disease Control & Prevention


Varicella (chickenpox) is always present in the community and is highly contagious. Before licensing of the chickenpox vaccine in 1995, almost every adult in the United States had been infected by the virus. Chickenpox was responsible for an estimated 4 million illnesses, 11,000 hospitalizations, and 100 deaths each year.

Chickenpox is usually mild, but may be severe. Complications such as bacterial infections, loss of fluids (dehydration), pneumonia, and central nervous system involvement can occur. Furthermore, even after the chickenpox infection has healed, the inactivated virus remains in the body and can cause another problem – shingles. Shingles, a painful rash occurring when the inactive virus living in a nerve becomes active, affects about 300,000 people each year. Only people who have had chickenpox can get shingles.

Source: Centers for Disease Control & Prevention

Vaccination Schedule


Hepatitis B #1

2 months

DTaP #1
Polio (IPV) #1
Hib #1
Hepatitis B #2
Pneumococcus #1

4 months

Polio (IPV) #2
Hib #2
DTaP #2
Pneumococcus #2

6 months

DTaP #3
Hib #3
Pneumococcus #3

12 months

MMR #1
Varicella (Chickenpox)

15 months

Hib #4
Hepatitis B #3
Pneumococcus #4

18 months

Polio (IPV) #3
DTaP #4

4-6 years

MMR #2
Polio (IPV) #4
DTaP #5

11-12 years

Tetanus, Diphtheria booster (Td)

The following vaccines should be given if previously recommended doses were missed or given earlier than the recommended age:

Hepatitis B, MMR, Varicella (Chickenpox).

Source: Childhood Immunization Schedule – US, Jan-Dec 2001, approved by the Advisory Committee on Immunization Practices, the American Academy of Pediatrics and the American Academy of Family Physicians.