After age five, children are seen for annual physical examinations, usually on their birth date. This affords us the opportunity to continue to monitor growth and development, discuss age related issues and to update immunizations as they come due. This also helps you with up-to-the minute information for camp forms and day-care forms.

Next: what do all those initials mean?

Comvax: a combined vaccine containing Hepatitis B and Hib in one shot. Hepatitis is a disease spread by blood and sexual contact. Pediatricians give this protection in infancy as a public health policy to provide protection against this disease as early in life as possible. People who get Hepatitis B are infected for life and run the risk of cancer and chronic liver disease. The risk of death for disease acquired in early childhood is 25%.

Hib stands for Hemophilus Influenza type B. It is a serious invasive disease which can cause otitis media, sinusitis, pneumonia and meningitis. It was the leading cause of meningitis related brain damage and mental retardation before the vaccine was used. At that time upwards of 500 children a year suffered mental retardation as a result of this disease each year in New York State alone.

IPV: this is Polio vaccine made from dead polio virus which is injected. There is NO risk of acquiring Polio from this vaccine. Its use has replaced the oral vaccine which was live and carried a rare possibility of causing disease.

DtaP: this is a combination against Diphtheria, Pertussis (Whooping Cough) and Tetanus (Lockjaw). Diphtheria is a horrendous disease that we no longer see, of the upper respiratory passages and can include heart inflammation and injury to the nervous system. Death is a possible outcome.

Pertussis: is a disease that can become severe with a characteristic whooping type of cough which leaves the child exhausted. The cough can last for as long as ten weeks. Complications include seizure, pneumonia, encephalopathy and death.

Tetanus: this is a neurologic disease which causes severe muscle spasms and the inability to open the mouth due to an extreme spasm of the jaw muscles. Onset is gradual over a week and the disease subsides in a period of weeks for those who survive. Newborns often contract this disease through contamination of the umbilicus, in developing countries. This is rare in the United States.

Prevnar: this is a new vaccine against many types of pneumoccal bacteria which cause infection of the upper respiratory tract and lungs. Pneumoccus is the most frequent cause of middle ear infections. It is also responsible for sinusitis, pneumonia and meningitis in infants and young children. Pneumoccus is very often resistant to antibiotic therapy.

Varivax: this vaccine protects against chickenpox, which can cause severe complications – which are fortunately uncommon. Arthritis, hepatitis, encephalitis, meningitis, kidney disease are some of the infrequent problems caused by chickenpox. By itself, the disease is an unpleasant week-long malady that keeps both child and parent home until all sores have a dried crust.

MMR: this is, of course, Measles, Mumps and Rubella – all three are still around and troublesome.

Measles: is an acute illness with temperature over 101 degrees, cough, runny nose, conjunctivitis and a red blotchy rash. Complications include otitis media, pneumonia, laryngotracheitis and diarrhea, especially in young children. Acute encephalitis which frequently causes permanent brain damage, occurs in one of every thousand cases. Death due to respiratory and neurologic complications occurs in one to three of every one thousand cases reported in the United States.

Mumps: this disease causes swelling of the parotid salivary glands located at the angle of the jaw in front of the ears. One third of cases do not have this swelling. Complications are rare. However, after puberty this disease can cause swelling of the testicles. Sterility is rare though.

Rubella: the danger of this otherwise mild disease is to the fetus of pregnant women who contract the disease in the first three months of their pregnancy. Complications include cataracts, damaged retina, congenital glaucoma, heart defects, damage to the auditory nerve, inflammation of the brain and mental retardation. These infants are also often retarded in growth and can have blood disorders as well. If contracted in childhood Rubella is a mild illness with rash and swollen glands.

New vaccines are always in the pipe-line and we have had to make many changes in our vaccination schedules in recent years. We keep a close eye on these developments and off our patients every recommended new vaccine that is released.