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NF -30.83 110-42.06 Plus Postage.*Chijd Care;. *donnunicable Diseasts; Disease Control;*Health.. Guides; ;lassunization Prograss;-Parent .

Respopsibility; *Preventive. medicine; Risk*Vaccination'

This esbooklet addressed to parents provideilrsition on seven serious childhood diseases and the vaccines thatcan riovite protection for each. A description of-the causes, -syliptoas, natural course and possible cosplicationg_of each. of theseven d iseases---seasles,polios-rubella or Geri= aeasles7 *d!ps,dipthgtia, pertussis'Or vhdbping cough, and tetanus--is "followed-.by*_inforiation on appropriate vaccination. The possible side effects of

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vaccination for each disease are dealt with in some detail._Asuggested issunization-sChedule is included. (CE4

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HOODpNIZATIO

EASLES:-.--P-01.10*.RUEIELLA (German -kepsles

--t MUMPSDIPHTHERIAPERTIASIS. (Whooping ,Cough)

*--TETANIA

_U.S. DEPARTMENT OF HEALTH, EDUCATION,AND-WELFARE_Public,Health Service

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HOW IMMUNIZATION WORKSSmall' quantities of the organisms that cause a disease (or of

materials produced from thote organisms) are made into vaccines.These vaccines are injected-into the body or are taken LICrouth.The body' reacts by gioducing disease-fighting substancesanti-bodies--that buildup in the system and guard against infection fora long time, pften for a lifetime. Thui, immunization stimulates thebody to defend itself against a particulgr disease. *

_CHILDREN AND IMMUNIZATIONBabies are immune to many diseases when they 'are born.-Wit

this immunity, which they reeved from their mothersjs Onlytemporary. It wears b1 during the first year of life. That's whyimmuhization programs, which help young bodies build theirpermanent defenses against disease, should be started,early andcarried out faithfully. .

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DHEW epblication No. tos) 77-5058. . October 1977

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TENTS4

AVORD TO PARENTS

MEASLES

POLIOV

RUBELLA (German Measles)

MUMPS

DIPHTHERIA

PERTUSSIS (Whooping Cough)

TETANUS

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-IMMUNIZATION SCHEDULES s 20

KEEP IMMUNIZATION RECORDS

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AMORD TO PARENTS

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Of the-52 million children iri theUnited States who are under the ,age of 15, more than 20 millionhave not been immunized againstone on more of the. childhood clis:.eases. In other words, almost 40percent of our children are indanger of catching seven serious'diseases: measles, polio, rubella(German measles), mumps, diph-theria, pertussis (whooping cough)and tetanus.

It is important that parents under-stand what: can happen- when their_children are not fully immunized.The 'childhood dise;ases can, anddo, cause crippling and, sometimes,death. Nit matter what you may-hte heard, these ilfnesaas areserious. Their complications can belegible.

With the qxception of tetanus,these diseases are very contagiouvThey spread, more rapidly thdnmast people realize, from child tochild and, from community to com-munity. As long as millions of chil-dren remain unprotected againstthem, serious outbreaks of diseaseeven epidemicswill continue_tooccur.

tt is also important that parentsunderstand what protection vac-cines give and what risks, if any,vaccines pose to their, Children.Generally, vaccines-are among ouisafest and Most effective medi-cinep. Each year, about 100 milliondoses are given in this country,most of them to infants and children

as part of their:routine irhmuniza-- -

Like most :medicines, however,vaccines- can cause side elfects.These: are usually- milda -slightfever; a,--sorg arm, a mild- rash,and of brief duration. But on Tare

- occasion they_are serious; whichbis-why vaccines should be given only'by physicians :Cr other qualified

health professionals.the Public Health Servith and

-the overwhelming majority of medi-cal experts in this country andabroad believe that the benefits ofcomplete immunization faL oat-Weigh the risks. The Service strong-ly recommends that all-healthy chit-dren be immunized against' all ofthe vaccine-preventable, childhooddiseases. Are your children fullyprotected? If not, what should.you

.o about it?

deCision to have your clip-- dren vaccinated is yours, alone,, to

make. The purpose of this booklet,`which -discusses the -things, youshould know about seven danger--ous diseases and the vaccines thateatilirevent them, is to help youmake- that decision on the basisof accurate 'information.

Please read the material '--on thefollowing pages and discuss anyquestions you have with your 'doc-tor Jr with the ;staff at the health_department clinic. Learn canabout-the serious diseases of child-hood-Then, make certain that your*chiklienare proteCted. Octob'er,1977

,KilEASLe

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IAre

Measles, alsotalled rubeola, redmeasles, hard measles and 9- or 10-day measles, is-the most serious of

--*-}the common childhood. diseases.4 Measles (not to be confused with

rubella; or German measles; seepage 12) can cause pneumonia,blindness and encephalitis, dr in-'flaMmation of-the brain, which oftenleads to ,permanent brain damageand deafnesi.

Measles is most likely to occurill the late winter and spring. Al-though it usually stiikes young.chil-.dren above the age of six months,medical experts report that mea-sles, and theother so- called child-hood diseases, 'as well,' are- pc-curling progressively, later irelife-,with outbreaks in high schools and.even in Colleges.

Usually, measles lasts-about twoweeks. It begins witli'symptoms like

- those of a bad cold.aad a temper-ature that may rise as high as 104degrees. A few days after the be-ginning of 'symptoms, a b tchy, redTrash appears on v,ari parts ofthe body. This rash, f des away,gradually, over a period of sevento ten days.: .

The complications ofcrneasles_areanother matter, As many as threeout of very 1Q cases of measles re-.suit in pneumonia. Enceptialitigoccurs once in every 1,000 - re-',paid cases. And, year after .year,there Is one -death for every 1,000,cases 61 measles reported to thePublic Health Service.

MEASLES om

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People catch measles by breath-_ ing in particles of the measles virusthat an infected person has ex-pelled while coughing, sneezing orsimply talking. So highly contagiousis this disease that in the early1960's, before a_vaccinelas-avail-able, measles struck huntedt jofthousands of children paeh yearand caused a great many deaths.In 1964; there were 485,083 repOrt-,ed oases in the United States andat least 421 deaths.

During the following decade, theintroduction and widespread use ofthe new measles vaccine broughtabout a tremendous reduction inmeasles cases in all parts Of thecountry. In 1974, only 22,094 casesand 20 deaths were reported to thePublic Health Service. 4

Unfortunately,.there has not beena coniinuing decline in the inci-dence of measles. F011owingslight increase in 1975, measles in- ilcidence jumped a startling 62 per-cent in 1976, from the 24,374 casesrepbrted in 1975 to a 1976 total of41,126 cases. And communicabledisease experts, vlho tracked out-breaks in several parts of the nationthis Past spring, predict that as-many as 60,000 cases will be re-

orted in 1977.Why is measles threatening

again-7- Because millions of Ameri-can y,oungsters have not been im-munized against it. At .present,more than 13 million children, or301tercent of all childien .under the

age of 14, have not been vacci-nated- These children can catch .measles and suffer its disabling,'complications. They can spread thedisease to others who have neverbe immunized. As long as all ofthese children remain unprotected,the communities in which they livewill remain wide open to outbreaksof this potentially tragic diseajse

Another sobering point. morethan -four million of the 13 millionunprotected children are (our yearsof age and Younger. The seriouscomplications of measles strikehardest in this age group.

Measles VaccinationAll healthy children who have

never had measles should be vac-cinated at the age of 15 months.The vaccine, first licensed for usein 1963, is very effective' and oneinjection produces long-lasting,

'probably lifelong. protection. Mea-sles vaccine can be given by Jitself or in a combination vaccinethat also protects against rubellaand mumps. One shot of are com-bination- vaccine protects the childagainst three diseases.

Until recently (1976), measlesvaccine was given .at. or before 12months of- age, rather than at 15.Doctors now believe that vaccina-tion at 15 months gives much betterimmunity. Therefore, if your chil-dren were immunized before theirfirst birthdays, your doctor probablywill want to give them a second

; MEASLESseshot, to 'make sure that they. havethe best -possible protectitm.,

Possible Side Effects of VaccinationOne out of every four -children._

who rebeiVe measles, vaccine willhavea minor reiciiona slightfever or-a mild rash. These common

-- reactions occur seven to eighteendays' after vaccination.-last only aday or- two and-usually do not,,harm-the child in any way.

Although experts are not sure, itseems that about one out of everyone million children-who get themeasles shot may have 'a more"serious reaction, such as enceph--alitii linflammation of the brain).Parents should, be aware of this

but not alarnied by 'it.Seridus reactions are extremelyrare. Medical authorities agree that--the benefits of immunizationagainst measles far outweigh any

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Poliomyelitis,(intantile paralysis)is a contagious viral disease that,in its severe form, can cause per-_; ,manent varalysis.-Although it oc-curs only rarely today, thanks to thewidespread use OP vaccines, polio I

is fatal IR.-about one out of everyten cases. .Polio is an _extremelydangerous disease, and- ev,ery,parent should know about it. ,

Polio is caused by _three types ofvirus !tat live hi the noses, throats-and, especially in the intestinaltracts of infected people. typevirus ts the most frequent cause ofillness and paralysis. Virui TypesII and Ill are milder and_ do notusually cause outbreakd-. Polio oc-curs.thost often irrchildren betweenthe ages of one and sixteen. Many",1

-people who are infected by the f- -

polio virus have ho syfriptoms buf __"may still spread the disease td'others.

The milder forms of polio usually'begin abruptly and Wit, at most, afew days. When symptoms arepresent, they include fever; sorethroat, nausea, headache and stom-

. ach' acheSometimes, the patientwill feel, pain_and stiffness in theilea" Pack bhd legs.,

Paralytic polio. begins with thesesame symptoms, but severe musclepain is usually present, and ifparalysis occprs, if does s_ o withinthe first week.

There is no specific treatm ent for_polio, and the 'degree of recoveryvaried from' patient to patient.

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'About half of all patients who re-cover have mild disabilities or noneat all. The rest may suffer pdma-nent paralysis, much of it. severe-

._ As noted earlier, paralytic polio isfatal in abaft ten percent of allcases. .

A quarter of A century ago, poliowas-a:fairly common disease, muchfeared by parents of small children.With the develOPMent of the firstpolio vaccine, in 1954, this picturebegan to change. Over the next20 years, as this vaccine 'gainedacceptance and as the newer, oral

., vaccine .(first licensed in 1961)carne into use, the number of cases.of paralytic polio plumreted, from18,000 in 1954 t9 seven in 1974.Last year, just nine cases were re-,ported to the Public.lt, HealthService.

It is tempting to view the datafrom recent years as proof thatpolio is no 'longer a threat. Thefact is, however, that while polio'cases may be few in nutnber today;the outlook for tomorrow is' omi-nous. Over the past several years,ever as case rates have dropped,the number of children not' pro-

. tected against polio has liacredsed..Today, almost 19 million' children,or 36 percent of 'WI youngtters_ 14'years of age and, under, are inade-quately, 'immunized, against thisonce-feared _disease Whendren, are not protected, polio can

strike and'spread.

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In an '18-day_ period_ in the fall of/972, paralytic polio invaded a pri-vate bdarding school in New Eng-land, infecting 11 of the school's128 students. Medical experts whoinvestigated the outbreak foundthat mgre than half of the studentbody, .including ten of the childrenwho became ill, had never beenimmunized against polio. Althoughthe Outbreak took no lives, sevenof the-eleven infected youngsterswere left with significant to severeparalysis-

Polio Vac.cinatiOnAll ghealtny infants and young

people between 'the ages of sixweeks and 19 years who have never,been immunized against polici.'should receive polio vaccine in aseries of properly -spaced doses.TwO kinds of vaccine are available.

The preferred and most widelyused vaccine is the trivalent oralpolio vaccine, which is madefromlive but weakened polio vim's and istaken by mouth. This 'vaccine .is,effective in preventing the spreadof polio and_gives protection fOrlong time, provably for life. -

The secomrkind of polio vaccine -

is made Irdm, killed polio virus-endis given in a Series cif injections.:This vaccine is not widely used inthe at this tityf, mainly be-cause Most polio experts do .notfeet that it is, as effective in con-trolling Olio in this countryas

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POLIO t

oral vaccine. Iniectable_polio vac-cine is most often "recommendedfor persons who have low resist-ance to infections and ,foi individ-uals who will be traveling to a place

' where polio is common.As noted above, oral polio vac-

cine is preferred by moil polioexperts at this time. Yo Lmgschildrenshould_get two doses of oral vac-cine iri the first yeait, of life, usuallyat two and four months of.age, anda. third dose at about 18 months ofage. Some doctors, particularly inparts of the world where polio isstill common, give three doses inthe 'first year,- at two, four and sixmonths, and a dose at 18 rabriths.To assure full and fortg-laiting pro-,tection, a booster dose should begiven at four to six yeari of age,before= the child enters school.

Older children who are. gettingtheir firSt oral vaccine shotild re-ceive three properly spaced. doses.{See the immunization schedulesfor infants and older Mildren at the,back df -fhis bookie*

POSSible Side Effects of*Vaccination

There is virtually gp risk of-side,effects, of any liffid with ,injectablepolio Vaccine.,ilteryirarelyonly

once tirt;,,every'Iour milliondoes--4a person who receives-oralpolio vaccine or who comes in con-

Itadt With someone who" hasit recently duelops perma-

nentoaralysis and may die ;If you have any questions about

polio or polio vaccines, you Shouldnot hesitate to discus's-them withyour ciactor,or with the people' atthe health department clinic, Likemost other vaccines, the oral polioVaccine carries ementof risk. But, "tilechances of you a/1 g a seri-ous reaction totthe Aral polio vac-cine are very rare---literally one infar million. We takb a, far greaterrisk with the health of our childrsohwhen we allow them to gtt unpro-tected against pOlio.- '

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Rubella, also called GermanmeasleS and- 3-diy measles, is acommon, usually mitd: disease of

r childhood, although it, may alsoaffect adults, and -- outbreaks arocommon among unvaccinated teen:alters: Rubelia occurs most oftenthe winter and spring and is Dighly:,contagibus. People catchbreathing in particles of :rubella:virus that sicl$ people -have ex --

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The usual :symptoms of rubellaare mild discomfort, a slight feverfor perhips 24 hoofs and a rgattthat appears on the face and neckand lasts tOr aday or tko. Youngadults yMo get rubella may ex,perience swollen glinds ,in Theback-of thalpeck and some tem-.

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porary pain and stiffness -,in.thejoints ,(arthritis).

Recovery from rubella is almostalways speedy and complete. ODW-everand hem's why' this other-wise mild disease is so dangerousa woman who' gets rubella early".in her pregnancy stands a 20 to 25percent chance of giving birth to adeformed baby The possibility thatshe will have a miscarriage is even.greater.

Although rubella occurs all overthe country each year (12,090 casesin 1975), the last big epidemic wasin 1964. As a result of that epi-demic, some 20,000 babies wereborri in this country with severebirth defects, and an estimated 30,-(No women had miscarriages..

RUBELLA

. The most common birth defectscaused by the rubella virus-, areblindness, amage tc; the heart andmajor arsteriet, 'deafnek, bnor-

_malty small brains and -mental re-.lardation. The best way to protectexpectant- mothers and their Off-spring from .these trtagiofr effects isto immunize children and thereby

-eliminate the .source of infection.,The child with can't catch, 'rubellacan't spread it, to his or her motherOr to other preghant wortien.

At present, more than 14 millionchildren,. or 35 percent of all chil-dren 12 years of age and under,have not been ;mmunized against

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. Rubella Vaccination%I healthy children who have

. never had rubella should be. vac-cinated Sher their first bikthday.,Thevaccine; which has been in usesince 1969, is highly effective, andohe ipjecton producei long-lasting,probably -lifelong, prbtection.

_ Rubella vaccine is available byitself or in a combination vaccinethat also protects against measlesand mumps. A single shbt of thecombination vaccine. which isgiven at 15 months of age becauseit includes measles vaccine, prom,tects the child . against all threediseafes-.

Rubella vaccine should be givento nearly anyone who is not already

-protected against the disease, par,

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.. fshould not he given to pregnantwomen or tot women who do notintend to lake, every rirecautionagainst becoming pregnant for L

three_monthlafter vaccination It ispossible that the rubella vaccinemight cause_ 'the same kinds ofproblems for a pregnant womanthat neielladisease does.

Possible Side Effects ofVacclnat(on _ .

Rubella vaccine can., produceseveral side effects.,About one out,of every%even children will developa rash or some swelling -in theglands within a week or two follow-ing the shot. Then effects usuallylast only a day or two.

About one out of "every- 20 .chidren and as many as one out offou.r adults who receive the vac-cine will have some pain and stiff-ness in the joints. This conditionmay approf anywhere from two toten weeks after the shot It is usual-ly Mild and lasts for only two or.three days: .

. Although experts are not sure, itseems that about one out of everyone million children who receiverubella vaccine, may have a moreserious reaction, such as encepha-litis (inflammation of the brain),"Parents should be aware of thispossibility but not alarmed by it.Serious reactions'` are extremely-rare. Medical authorities agree thatthe benefits Of immunizationagainst rubella far outweigh the

ticularly to young .girls. But it asks.

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Mumps is a common disease ofchildren that'occurs most often in-

, the first half of the from latewinter to. early stniner. in 1976,almbst 38,000 cases were reportedto the- Public Health Service.

Likeoether preventable childhooddiseases (eRc-ecpt,letanusi, mumpsis contagious. The mumps virusspread- by person-to-person -colt- --tact. The favorite targets of thisvirus are children between the ages ,of five and ten, but raurfips Is 710respect& of age.' It also strikesteenagers and adults, ;often Withserious effeci.

:Painfully swollen glands is -'theface and neck, fever, eadacffe,earache: these are the symptoms,of mumps. Usually, there are 'Ili/disabling cOmplications,,end re-covery is complete. Inflammationof the covering of 'the.brain (men-ing-ftis) or of the brain, itself (en-cephalitis), occurs frequently, how-ever. Asinany, as one in everyseven to nine children v;"th mumpsmay show signs of thse compli-cations. 1-rowever, most patientsrecover fully and permanent darn-r,age, including deafness, occurs.very rarely.

In teenage and adult malei,mumps may produce, a painful irie

.flammation of the testicles. Thiscondition occurs in One case outof every four and sometimes (butrarely) results in sterility. Someother complications of mumps are ,

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-MUMPS

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liglainmation of the pancreai, thy-roid and kidneys and, in .femalepatients, inflammation of the ova-ries and breasts.

Today, neerly-25 million children.or more than half of all children la,,years of age and under, have notbeen immunized against this pain-ful- but easily prevented disease,,mumps. Are your children pro-,

-tected2,-

Wrrips liacdnation,All healthy children who have

never had mumps should be vac .cinated after Mei& first birthdays.The vaccine, which has beeh'in usesince -196.7 also can be given toolder children and adults. It is bigh-ly effective, and ose injection pro-duces long-lasting, probably life-long, protestioht

Mumps vaccine Is available byitself or in a combinkion vaccinethat afso proteCts against measlesand rubella:. One shot of the com-bination vaccine, which is giverat15 moriths of age because it in-tiudes measles vaccine, -protectsthe child-against all tljee diseases.

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Possible Side Effects ofVaccirratiOn

Mumps, vaccine produces a mild,brief fevet in'very rare instances.This fever may occur one or twoweekS after the shot. Occasionally.

-there ik some swelling of thesalivary glands.

Although experts are not sure, it

seems that about one out of everyone million children who get thetriumps-shot may have a more seri-ous reaction, such as encephalitis(inflammation of the brain) Parentsshould be aware of this possibilitybut not alarmed by it_ Serious re-actions are 'eXtYamely rare The dis-ease, itself, however, can be painful"and ,disabling. This is why medical,autborities agree that the benefits

immunization against mumps faroutweigh the risks.

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plpi-ITHERIA,FEBTOSIS, AND TETANUS

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Diphtheria, pertussis (whoopingcough) and tetanus (lobkjaw) aresurlous diseases that usually occurin cbildien, although each, esPe-daily tetanus, also strikes adults..Effective protection against thesediseaSes, in the form of a-combina-tion vaccine called.DPT, has beanavailable and widely used since theearly 1950's2 Yet, today,- nearly 13-million children, or 24,1kircent of allchildren 13 years of age and under,are inadequatelyziMmunized.

this section discusses 'diph-theria, pertussis and tetanus, in that`order, and describes the`-benefitsand risks of the DPI vaccine..

DIPHTHERIA 'Years ago, diphtheria was a

widespread and greatly feared dis-,Before the turn of thetentury,

15 out of every 10,000 Amesicansdied of diphtheria each Year.Through the 1920's, about 159,000cases occurred annually, with about15,000 Maths.

Sinc'e that time, the dispafe hasgradually detrined. There were 910

..cases in 1960, 435 in 1970 AV only16 in 1976. Nevertheless, 3110-theria remains a threaArripanyparts of the U.S. today,, and* be-cause it is most dangerous in thevery young, it is still a disease that

,parents should know about andhave their children "proiectedagaina

Diphtheria is caused by a bac-tdrium that is found in the mouth,

DIPHTHERIA, PERTUSSIS, and TETANUSI

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throat and nose of an infected per-son. This germ is easily passed toothers in the tiny droplets of mois-ture that are expelled by coughingor sneezing. Diphtheria also canbe spread by carriers pCople who.harbors the bacteria but remain inApparent good health.

Usually, diphtheria develops in'the throat, where a patch or patchesOf grayish membrane,may.'begin to

-forth. Other early symptoms aresore throat, a slight fever and chills.If the Membrane continues to grow,it-can interfere with swallowing. Ifit extends to the windpipe, it, canblock the passage of air and causethe patient to suffocate.

Diphtheria is a treatable condi-tion, but if treatment is in-adequate,or if it is not begun-in time, a power-fist toxin, ,or poison, may be pro-duced by the diphtheria bacteriaand may spread throughout thebody. The poison may cause serious complications such as paralysisthat lasts for as twig as Three orfour months, heart failure orbrOncho-pneumonia. Five to tenpercent of all diphtheria cases arefatal.

PERTUSSIS-Pertussis, or whooping cough, as

it is_nore commonly known, is a:highly contagious disease that oc--curs with greatest frequency in latewinter and early spring and is mostlikely to strike children under theale of seven.

Pertussis is caused by a bac-terium that is found in the mouths,noses and throats of infected per-sons and is spread, through the air,'to others. ,

hen it begins. pertussis actslike a common cold, accoinpaniedby an irritating cough, As; the dis-ease tightets its -grip. on tee airwaysfrom-the lungs, the coughincreasesin intensity and occurs in, violentand prolonged spasms, wilt' hiQ'h-pitched whooping sdunds between

.each spasm, as the patient fights toinhale air.

A severe case of whoopingcough prepares the way for a rangeof grave _complications, emotethem convulsions, collapse of thelungs. pneumonia and brain dam-age. These effects are most Iffrelyto occur in the very young, andehen they do, they call be fatal.

. Tin-less adequate treatment is givenearly in the course of Op disease,one infant in four who_gels whoop-irt cough before the age of viz .

months will not survive.

TETANUSTetanus, commonly cared lock-

--jaw, occurs in children and adultswith roughly 'equal frequency. In1975, the latest year for whibh com-plete data are ayailable, theke were102 cases in the U S 45 of whichwere fatal Tetanus is a diseaie thatno one can afford to ignore.

Tetanus is caused by a bacteriumthat present just about every-

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.DIPHT1101A, PERTUSSI.S,and-TETAkUS

where, .but mostly in soil, dust,manure and in the digestive tractsof man and many animals. Tetanusis riot transmitted from one personto another. Rather, the germs enterthe body through a woundsome-;

i es one as Small as a pinprick.,bu ore often, -through deep pund-lure ounds and lacerations, such,as those.made by nails and knives.

.t.-Buch. wounds are difficult to-cleanadequately, and If the tetanus bac-teria were present on the nail orknife, they may remain deep in-thewound, where they thrive and pro-duce poison that attacks the body:snervous system..

TIV person who has not been,immunized against tetanus and inwhom the infection develops has, atbest, a 50-50 chance of surviving.The first symptom& are likely to beheadache, irritability and muscularstiffness in the jaw and neck. As thepoi&On steps up its attack, the jaw,neck and limbs become locked inspasm, the abdominal musclesgrow rigid and the body may bewracked by waves of painful con-

e vulsions.Doctors treat the terrible symp-

toms of tetanus with powerful tran-quilizers, anti-spasmodic drugs andspecial diets that are designed topreserve patient's strength.Even so, the convulsions may con -tinue or increase in frequency tothe point at,which the patient diesof lack of oxygen, heart failure or

- simple exhaustion.

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A great many factors determine_the outcome of an indo;idual se_of tetanus, but even wish the besthospital care, about half of allgases are fatal.

1112T VaccinationThe combination DP-- vaccine

provides a high degree of immunityfOr a number of years against diph-:therie, pertu;sis and tetanus Butthis protection must be renewedperiodically, throe bout lif withbooster doses. -

AlJ healthy infants should receivethe OPT'veccind:tegirining with a-series of three shots, at biro, -fouiand six month's of age. Earlygization is iMportant- these dis-eases are deadly, -andinfants,haveno natural immunity tokwo of Merry

(pertuesie and tetanus.A founts dose-of vaccine should

be liven 12 niointlis after the third,at about the ege of 18 months; afifth dose is needed when the childis. four to six years old, before heOf she enters schbol. From- then on.booster doses for diphtheria andtetanus (protection from whoopingcough shouldn't be necessary) arilgiven every ten years, throughoutlife, to maintain a high lev'el,of pro-tection. .

Older childen, (over six years ofage) and adults who have not been

shotild receiVe a seriesof shoiS for diphtheria and tetanusonly and booster doses every tenyears thereafter. Whopping cough

IPITHERIA,PERTUSSIS, XI &TETANUS

I *;

_ _ vaccine is not included in thebinationNactine- for older individ-.uals or in The booster doses,-be-cause this disease Is not usually aAreal beyond -childhood.

.Posible Side-pfects ofVaccination.

Most -children' will have A slightlever and be, cranky sometime in

----thd,diy or two after taking the OPTshoe Setbe children will deyelopsoreness and swelling in the areaWhere the shbt was given.

About one out of every 7,000children who get the spot wi have

more serious side elect, such asa'high fever or a convulsion. A andmay also cry for several hours orgo into shock an get pale. Stillmore rarely,aboul., once in every100,000 doses--enCephalitis (in-

_ flammation of the brain) or braindamage may occur.

Check. with your doPtor or withthe people at the health departmentclinic if you have -any questionsabout the OPT vacoinee:Thereare.risks associated-with its use, asMere are'with almost any vaccine.-But- serious reactions are few and

- far between. Given the deadly sari-ousness of the diseases that theOPT vaccine prevents, parents have

-Jitite choice but to make certainthat their children are fully pro-

_ tectect

21

I

e

19

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MMUNIZATiON SCHEDULES

Vaccines work best wheh they'are given at the recommended time --and on a regalar schedule. Measled-

) vaccine, for example, is not usually-given to infants before they reachthe age of 15 months. Whensit'isgiven earlier than that, it may not,be as effective. Oral polio and DPTvaccines mast be given oveCiperiod of time, in 'a series of lroperly spaced doses. Stheduling is im;portant.

'Schedule For Infants'. On the following page. sugz

. gested immunization schedule forinfants whci are being immunizedfor the first time. This schedule_shows all the immunizations that achild shOuld receive, beginning atthe age of two months.

Y

Schedules _for Older 'Children =

If. your children were iinmu-nized when they were infants, con-tact your deCtor or the health de-_partment clinic and arrange to start,them on immunization programs.Don't delay. More than any other-grdup, active preschool andschool -age children need the pro-tection that only imn2uniattion pro- .vides.

IMMUNIZATION SCHEDULES

.Age

-2 mos.-4 mos;

6 mos. '

15 mosi

IF YOURCHILD IS TWO MONTHS "OLD : s

DiphtheriaPertussis -Tetanus "Polio Measles Rubella Mumps

A

18 mos.

*.4-6 yrs. -

Notes- .

Measies, rubella and mumps vaccines can be given in a combined.form, at about 15 months of age, with asingteinjection.

C-

CA

J.

Children shgled receive a sixth_ tetanus-diphtheria infection(booster) at age 14--18 years.

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Your doCtor,fflay recommend, schedules that differ somewhat fromthose that appear here. Generally, though, the first. schedule, below,shows the immunizations thai children one thrqugh five will get ontheir first visit to the doctor and on each visit thereafter. The secondschedule is recommended for children six years of age,and oldec.

IF YOUR ±OHILD IS ONE THROUGH FIVE YEARS OF AGE . .

''-First Visit Diphtheria, Pertussis, Tetanus (DPT)Polio .

1 mo. after first visit Measles, Rubella, Mumps*. . . . .

2 mos. after first visit, Diphtheria; Pertussis, Tetanus (DPT)

, 4 mos. after first visit

Polio

Diphtheria, Pertussis, Tetanus (DPT)_Polio (optional)

10-16 mos. after first visit Diphtheria, Pertussis,' Tetanus (DPT). Polio' t

Age I-14-1S years , Tetanus-Diphtheria (Td)repeat everya 10 years

*Not routineirgiven before 15 months of age. a"r"

z 4,

V

IF YOUR CHILD IS SIX YEARS. OF AGE OR OLDER . .

First Visit tetanus-Diphtheria (lid) -

Polio

1 mo. after first Visit Measles, Rubella, Mumps

2 mos. after first visit etanus-Diphtheria (Td)Polio

8-14 mos. after &it visit

Age 14-18 years'.

.

etanus-Diphtheria frgo-Folio

Tetamii-Diphtheria (Td)leileat everye 10 years

4

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KEEP. IMMUNIZATION BECORI/S:

1

Your doctor or the staff at theclinic will keep a record' of your '-children's immunizations, Nit you,should have one, too. An-up-to-daterecord, showing kindi of immuni-zations and dates received; helpsyOu to cooRerate with the 'doctor.;It serves agl a remiridar of visits=coming upof second and thirdimmunizations and bobster doses,that you won't warit young-_Sters to miss. It provides -comfort%ing evidence that your family iscompletely protected against severi;,-

. serious diseases. From time to:time.wheh your 'chili:lien enter school,for example, or when It hey enroll insummer camp; when.:Sfoiir familychanges doctorsttif evidencewill be good to have. Is

Your doctor will be happy to prb-vidran immunization record formfor you to keep. Most likely, it willlaolclike the ona on the Oppositepage. You can make all the entries.

401p. on such a forrn,yoursey, of eOurse.cf An even better idea is to have the

doctor date and sign your personalrecord each time an immunization._

given. That way, you can be surethat.the information is current andcprrebt.

.g6S. SCIVESSIMIT. PSIXSISC

_ _ ; _ten S1447,

MMU IZAT ON RECORD

AM. r- , .

BIRTH DATES

Firsti

.,

Second .

.

Third .

Fourth.

.

.

.

- Boosters,-.

.

._

. .

.

rffst.

..,

Second .

POLIO Third..... ,

Booster - , .

Booster ,

MEASLES.. .

RUBELLA,

MUMPS.

.

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