Vaccines

Vaccines

by | Dec 6, 2020 | Infection Control, Preventative Care | 0 comments

Aloha everyone!

Can you believe it’s already December?! Time sure does fly by. I love seeing all the lights while driving down the street. It really boosts my morale. So awesome.

Anyway, Dr. Honda here, and with all this talk about a COVID vaccine coming out soon, I wanted to take a moment to talk about vaccines in general and give an update on the COVID vaccine.

For those of you already registered with our clinic, you know that one of our requirements to be a part of our clinic is that we require our patients to be vaccinated. It’s one of those things that we as Pediatricians strongly believe in. We are always happy to discuss vaccines in more detail for those who may be hesitant prior to registering to become a patient at our clinic. Remember, we want you to choose a Pediatrician that’s the right fit for you and your family.

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Here we go!

Okay now, let’s educate or re-educate about vaccinations! First things first, I know it seems like there are a TON of vaccines for your child. I mean it seems like every time your keiki comes in to the doctor’s office after birth, they get a shot. I wish I could say it wasn’t so, but it’s kind of true…at least up to the 2 year old visit, then it spaces out more. Only the 9 month check-up (if otherwise caught up) is when they have a little bit of a break during the first year. Below is a copy of the vaccine schedule. We also included it at the end of our personalized baby book! Check it out if you already received one!

Here is a good visual from the CDC of the vaccine schedule…give or take. Some need to catch up on their vaccinations, so their schedules may look a little different. We also do our best to provide shots with combinations to prevent multiple pokes. For example, we could give DTaP, IPV, and HiB all in one. Therefore, it’s one shot instead of 3 shots.

What different diseases do vaccines protect against?

As you can see in the vaccine schedule above, there are many diseases that vaccines protect against! The newsletter would be WAYYY too long if we discussed each disease. BUT if you have a specific question about one of the vaccines or would like to know more about the disease, message us! We would be happy to discuss more. Here’s the list!

  • Diphtheria
  • Tetanus
  • Pertussis
  • Polio
  • Haemophilus Influenzae Type B
  • Hepatitis A
  • Hepatitis B
  • Measles
  • Mumps
  • Rubella
  • Varicella
  • Pneumococcal
  • HPV (Human Papilloma Virus)
  • Meningococcal
  • Rotavirus
  • Influenza

Why are there so many doses of the same vaccine?

If you looked at the the chart above, you’ll notice that the same vaccine is given multiple times. Why is that? Sometimes it takes more than one dose (for example 5 with DTaP) to allow the body to develop the right immune response. Ya but my grandma and great grandma didn’t have to receive this many vaccines. You’re right. That’s partially true. For example, here’s a list of the diseases that were covered by vaccines in the late 1940s

  • Smallpox
  • Diphtheria
  • Tetanus
  • Pertussis

Now, go back to the prior list. WOW. What a difference, huh? Luckily, medicine has advanced to protect your keiki against so many diseases.

Also notice that smallpox is no longer on the list. It’s considered eliminated since it’s eradicated WORLDWIDE. Like there have been ZERO cases since the 1980s. So amazing!

So, we have a vaccine … everyone’s protected, right?

No, not quite. I think many of you have heard of herd immunity. What this means is that you protect others that aren’t immunized once a certain percentage of the population is protected. See the images below!

To learn more about herd-immunity: https://www.pbs.org/wgbh/nova/article/herd-immunity/

How are different vaccines classified?

To simplify it, there are inactivated vaccines, attenuated live vaccines, and other (subunit, polysaccharide, recombinant, conjugate and toxoid).

  • In the inactivated vaccinethe virus is killed.
    • Examples of inactivated vaccines are the hep A, polio and influenza
  • In live attenuate vaccines, the virus is weakened to the point that it will not cause the same infection as the wild virus, but it elicits enough of an immune response to develop immunity
    • Examples of live vaccines are the measles, mumps and rubella vaccine, varicella, and rotavirus.
  • Subunits, polysaccharide, recombinant, conjugate, and toxoid. (I know. A lot of big science words). But these are vaccines that only contain pieces of the bacteria or virus in order to provide an immune response.
    • Examples include HiB, Hepatitis B, HPV, pertussis, PCV (pneumococcal), meningococcal (meningitis), tetanus

COVID-19 Vaccine Update

Okay now that we have some background information on vaccines, I wanted to take some time to discuss where we are with the COVID-19 vaccine. Most of the news is focusing on Pfizer and BioNTech, so we will focus on that discussion. Moderna is the other company studying the vaccine.

Big takeaways

  • This was a randomized, placebo-controlled, double-blinded study. These are the key words you want to hear in a study. This helps to make sure that the study prevents as much bias as possible.
  • It’s a mRNA vaccine that targets one of the COVID-19 proteins
  • It’s a 2-dose series 21 days apart
  • The vaccine started to include children as young as 12 years old

The vaccine efficacy was noted to be 90% and then later noted to be 95%. The Moderna vaccine had an efficacy of 95%. What does that mean?

The efficacy is the risk reduction of getting COVID in those who are vaccinated compared to those who are not. So, by having a 95% efficacy, those who are vaccinated will have a 95% reduced risk of getting COVID compared to those who do not get the vaccine.

To put this into perspective, here are some numbers of vaccine efficacy for common vaccinations.

  • Measles: 93% after the first dose, 97% after the second dose.
  • Polio: 90% after 2 doses, >99% after 3 doses.
  • Yearly flu shot: 40-60%

But what about the keiki?!

Only recently (October-November) has Pfizer started enrolling children as young as 12 years old in their studies. Moderna is planning to do the same. The data for this age group may take a while before we understand the efficacy of the vaccine for children. Eventually, studies will include those even younger but that also takes time. Small doses, careful observation. This is a must. The right data needs to be produced before considering the vaccine safe in these age groups. As this can take time, the American Academy of Pediatrics is pushing for children to be included in the vaccine trials so that we may know sooner rather than later whether the vaccine is safe.

Going back to herd immunity, how much of the population needs to be vaccinated?

This is hard to predict, but in an article by Omer et al., they predicted that approximately 50-67% of the population would need to be vaccinated. Others are saying 70%. There’s still so much to learn about this virus!

Omer SB, Yildirim I, Forman HP. Herd Immunity and Implications for SARS-CoV-2 Control. JAMA. 2020;324(20):2095–2096. doi:10.1001/jama.2020.20892

How long will I be immune once I receive the vaccine?

We still don’t know that information. But with time, research will help guide us! We’re not sure if repeat immunization will be needed or if this first series of vaccination will be sufficient.


So, in a nut shell, vaccines are important to us because it protects us against dangerous diseases. There’s still a lot we didn’t discuss in this newsletter such as what to look out for after vaccination, when is vaccination not appropriate, which diseases need additional types of vaccinations, etc. COVID-19 vaccination has very promising data but unfortunately, not much with children…yet.

As always, call or message us if you have a question regarding vaccination and your keiki. We are here for you.

Love,

Your Keānuenue ‘Ohana