This document provides practical tips and addresses common concerns about vaccines. It discusses who should and should not receive vaccines based on factors like illness, medications, and allergies. While some concerns about vaccine safety and efficacy are addressed, the overall message is that vaccines are very effective and safe public health tools, and the benefits of vaccination far outweigh the risks of natural infection. The rare serious adverse events are usually not caused by the vaccines. Widespread vaccination is needed to fully eliminate diseases.

1. I. Practical Tips About Vaccines
II. Common Concerns about Vaccines
VACCINES

2. VACCINES

4. I. PRACTICAL TIPS ABOUT VACCINES
1. FEAR OF SHOTS

5. • 3 P’s for helping children/infants during vaccinations.
- Pharmacological (pain medicine): - topical anesthesia
and sugar water (infants).
- Psychological (thoughts and behaviors): - Hold and
breast feed(for infants); Breathing deeply (children) and
distractions.
- Physical (Body positions and Activities): Breathe
deeply (parent) and distract(infant); hold in lap…
1. FEAR OF SHOTS

6. 2. WHO SHOULDN’T GET VACCINE
• Any child who has had a severe reaction to a vaccine should not
receive another dose of the same vaccine.
• Severe reactions include:
- DIFFICULTY BREATHING
- HIVES
- LOW BLOOD PRESSURE
- SHOCK
- USUALLY OCCURING IMMEDIATELY AFTER RECEIVEING
THE VACCINE(SHOT).
• Weakened vaccines shouldn’t be given to children with
leukemia, lymphoma and other types of cancers or AIDS.
• The live, weakened vaccine include MMR and Varicella vaccine.

7. 2. WHO SHOULDN’T GET VACCINE
(VACCINE REACTION RATE)

8. 3. VACCINATING CHILDREN WHO LIVE WITH
SOMEONE WITH WEAKENED IMMUNITY

9. • Children living with someone who has weakened
immunity (such as leukemia, lymphoma and other types
of cancers) can receive all types of vaccines that are
recommended for children.
• Children who receive vaccines that contain only a part
of a virus or bacterium (hepatitis B, Hib, DTaP) or a
killed virus (IPV) are also not contagious.
3. VACCINATING CHILDREN WHO LIVE WITH
SOMEONE WITH WEAKENED IMMUNITY

10. 4. CHILDREN WHO ARE ILL
• Unfortunately, illness is common reason for many
children to miss vaccines.

11. 4. CHILDREN WHO ARE ILL (CONTD…)
• It is safe to give all of the recommended vaccines to
children with minor illness.
Minor illness include:
- low grade fever
- ear infections, cough, running nose, diarrhoea, or
vomiting.
• Several studies found that children with minor illness
were not at greater risk of side effects and had a similar
immune response after immunization as children
without minor illnesses.

12. 5. VACCINATING CHILDREN WITH PREGNANT
MOTHERS

13. 5. CHILDREN WITH PREGNANT MOTHERS
• Sometimes infants and toddlers are scheduled to
receive vaccines at the same time that their mother is
pregnant.
• Children who receive live, weakened vaccines
(Measles, Mumps and Rubella or Varicella) are not
likely to be contagious.
• Therefore, a child whose mother is pregnant may
receive all the recommended vaccines.

14. 6. CHILDREN WHO ARE BREAST FEEDING
• It is unlikely that the antibodies found in
breast milk can interfere with the ability of
vaccines to induce protective immunity in
infants.
• Therefore, all infants who are breast-
feeding may receive all the recommended
vaccines.

15. 7. CHILDREN WHO TAKE STEROIDS
• Steroids are commonly given to children with common
diseases such as Asthma, or poison envy.
• Since steroids can weaken the immune system,
parents ask whether it is safe to give vaccines at the
same time children are getting steroids.
• The answer is Yes or NO.
• It is safe for children who received steroids
cream or steroids sprays(aerosols) to get
vaccines.

16. 7. CHILDREN WHO TAKE STEROIDS (CONTD…)
• Vaccines are also safe for children who received
steroids for less than 2 weeks. However, children who
received high doses(2mg per kg of body weight) of
steroids per day of prednisone or its equivalent by
mouth for more than 2 weeks should not receive like,
weakened virus vaccines (specifically, MMR or
Varicella)
• High Doses of Steroids may decrease child’s ability to
fight infection, as well as the ability to build up immunity
after vaccination.

17. 8. CHILDREN WITH ANTIBIOTIC ALLERGIES
• Some Children have severe allergies reactions to Antibiotics.
• These reactions may include hives, difficulty breathing, low
blood pressure or shock.
• None of the vaccines contain antibiotics to which children are
usually allergic.
• Some vaccines contain trace amounts of antibiotics that are
extremely rare cause of allergic reactions and to which most
children are never been exposed (Specifically, neomycin,
polymixin B, and Streptomycin)
• Therefore, Children Allergic to penicillin, amoxicillin,
Cephalosporin, or sulfa drugs may receive all recommended
vaccines.

18. 9. CHILDREN WITH EGG ALLERGIES
• Some children are highly allergic to proteins in eggs.
• Allergic reactions includes Hives, difficulty breathing and shock.
• Both Measles and Mumps vaccines are made in cells originally
derived from chick eggs. However, not enough chick proteins
are contained in the final vaccine preparations to cause
problems.
• Recent studies have shown that even children with severe egg
allergies can receive Measles – Mumps Vaccines without
difficulty.
• Children with severe egg allergies should not, however receive
either the Influenza or Yellow fever vaccines.

20. 10. PREMATURE BABIES
• Most premature infants, including those with low birth
weights, can be immunized at the usual chronological
age.

21. • The only exception to this rule is the Hepatitis B
vaccine. Premature infants (children born within 36
weeks’ gestation with a birth weight of less than 4.4
pounds) whose mothers are not infected with the
Hepatitis B virus should receive the vaccine at two
months of age rather than at birth.
• Those premature infants whose mothers are infected
with the Hepatitis B should receive vaccine at birth,
independent of body weight.
10. PREMATURE BABIES (CONTD…)

22. 11. GIVING VACCINES SIMULTANEOUSLY
• Because children receive 11 vaccines routinely, some
children could receive 4-5 vaccines during a single visit
to the doctor.
• Some manufacturers are working for combined
vaccines.
• All routinely recommended vaccines can be given
simultaneously, there is no evidence that giving one
vaccine significantly interferes with the immunity
caused by another. Nor is there evidence that any of
the vaccines increases the rate of side effects of
another. Different vaccines should, however, be given
at the same sites of the body.

23. 12. MISSED VACCINES
• A missed vaccine doesn’t mean that the series
must be started all over again/. If a dose of
DTaP, IPV, HiB, or hepatitis B is missed, the
series of immunizations can be continued after
the missing dose(s) is given.

24. 13. VACCINATING CHILDREN ADOPTED FROM
OTHER COUNTRIES
• Children vaccinated in other countries should be
immunized according to the same schedule as that
required for children in the current country. However, a
written record of immunization should be provided as
evidence that a child has been vaccinated ether in
this country or elsewhere.

25. 13. VACCINATING CHILDREN ADOPTED FROM
OTHER COUNTRIES
• The majority of vaccines made in other parts of the world,
including developing countries, are produced with adequate
quality control standards and are of reliable potency.

26. II. COMMON CONCERNS ABOUT VACCINES
1. VACCINES DON’T WORK
• best example of the impact of vaccines: -
the vaccine that prevents meningitis caused by the bacterium
Haemophilus influenzae type b (Hib).
• After, the introduction of Hib vaccine, the incidence of Hib
memingitis declined to fewer than 50 cases per year from
15,000 cases (during 1990).
• A Dramatic reduction in the incidence of diseases such as
measles, mumps, German measles, polio, diphtheria, tetanus,
and pertussis occurred within several years of the introduction
of vaccines against them.

27. VACCINES WORK
• VACCINES NOT ONLY WORK, BUT THEY WORK PHENOMENALLY WELL.

28. 2. VACCINES AREN’T NECESSARY
• In some ways, vaccines are victims of their own success.
• Most young parents have never seen a case of some diseases.
So they question the continued need for vaccines.
• Vaccines should be given for 3 reasons:
- prevent some highly prevalent diseases within the country
(polio)
- Prevent some diseases still present in the environment
(measles)
- Prevent some diseases which have been virtually eliminated in
the country but may b prevalent in other areas of the world
(disease might be acquired during international travel)

29. 3. VACCINES ARE NOT SAFE
• in some cases, a person’s immune system will not
generate an adequate response. As a result, he or she
will not be effectively protected after immunization.
• That said, the effectiveness of most vaccines is high.
The inactivated polio vaccine offers 99% effectiveness
after three doses. The varicella (chickenpox) vaccine is
between 85% and 90% effective in preventing all
varicella infections, but 100% effective in preventing
moderate and severe chicken pox.

30. 3. VACCINES ARE NOT SAFE (CONTD…)
• Almost all vaccines can cause pain, redness, or tenderness at
the site of injection. And some vaccines cause more severe side
effects.
Example: Pertussis vaccine can cause persistent, inconsolable
crying or high fever.
Although none of the severe symptoms results in permanent
damage, they can be quite frightening to parents.
• Vaccines are brought in use (licensed) only after successful trial
on a number of cases.
• Information about the side effects of vaccines are on Vaccine
Safety Datalink (VSD)

31. 4. INFANTS ARE TOO YOUNG TO BE
VACCINATED
• Children are immunized in the first few months of life because
several vaccine-preventable diseases infect them when they are
very young.
Eg: Pertussis, Hib meningitis, Hepatitis B, and so on.

32. 5. IT’S BETTER TO BE NATURALLY INFECTED
THAN IMMUNIZED
• ―Natural‖ infection almost always causes better immunity than
Vaccination (only the Hib, pneumococcal, and tetanus vaccines r better
at inducing immunity than natural infection.
• Natural infection causes immunity after just ONE infection, vaccines
usually cause immunity only after several doses are given over a
number of years (example: DPT, Hepatitis B, etc are given at least
three times) But,
• Natural infection from polio virus can cause paralysis, Mental
retardation from Natural Hib infection, Liver failure from Hepatitis B and
so on.
• THE BENEFITS OF VACCINE-ACQUIRED IMMUNITY
EXTRAORDINARILY OUTWEIGH THE SERIOUS RISKS
OF NATURAL INFECTION.

33. 6. CHILDREN GET TOO MANY SHOTS

34. • Infants and young children commonly encounter and manage
many challenges to their immune system at the same time.
• 20 years ago children received 5 shots by two year of age and
as many as 2 shots at one time, now we have 11 routinely
recommended vaccines, children receive as many as 20 shots
by 2 yrs of age and five shots at a single visit. Many parents are
concerned abt whether children can handle these vaccines.
• But vaccines are just a small part of what babies or children
encounter everyday
6. CHILDREN GET TOO MANY SHOTS

35. 7. VACCINES WEAKEN THE IMMUNE SYSTEM
• Natural infection with certain viruses (wild type) can
indeed weaken the immune system. For example:
Children infected with measles are more susceptible to
bacterial infections of the bloodstream (sepsis)
• But vaccines are different. The vaccine are themselves
so disabled that they cannot weaken the immune
system.

36. 8. VACCINES ―USE UP‖ THE IMMUNE SYSTEM
• Dr. Meh Cohm and Dr. Rodney Langman theorized that, ―the no.
of MOS to which a body can respond depends on the no. of
cells in the blood that can make antibodies sufficient to
recognize all the relevant parts of the MOS.
Using this theory, it stood to reason that the no. of MOS to
which one response depends on one’s size. Elephant can
produce immunity to abt 100 times more MOS than humans.
• Although adult humans could make more antibodies to more
organisms than infants, scientists estimated that even young
infants could respond to abt 100,000 different orgns at one time.
Therefor, 11 vaccines use only abt 0.01 percent of the immunity
that is available.

37. 9. SOME VACCINES CONTAIN OTHER
INFECTIOUS AGENTS THAT MAY DAMAGE MY
CHILD
• Vaccines that are made with killed versions of pathogens—or with only a part
of the pathogen—are not able to cause illness. When a person receives
these vaccines, it is nearly impossible for him or her to become ill with the
disease
• It is important to note that attenuated vaccines can cause serious problems
for individuals with weakened immune systems, such as cancer patients.
These individuals may receive a killed form of the vaccine if one is available.
If not, their doctors may recommend against vaccination. In such cases,
individuals rely on herd immunity for protection.
• live, attenuated vaccines generate longer-lasting immunity than killed
vaccines. Thus, killed vaccines are more likely to require boosters to
maintain immunity. Killed vaccines, however, also tend to be more stable for
storage purposes, and can’t cause illness.

38. 10. VACCINES CAUSE AUTISMS

39. 10. VACCINES CAUSE AUTISMS

40. 10. VACCINES CAUSE AUTISMS
• This possibility was publicized after a 1998 paper by a British
physician who claimed to have found evidence that the MMR
(measles, mumps and rubella) vaccine was linked to autism.
• The potential link has been thoroughly explored; study after
study has found no such link, and the original 1998 study has
been formally withdrawn by the Lancet, which had originally
published it.
• It’s likely that this misconception persists because of the
coincidence of timing between early childhood vaccinations and
the first appearance of symptoms of autism.

41. 11. A MERCURY CONTAINING PRESERVATIVE
(THIMEROSOL) CONTAINED IN MANY
VACCINES HARMS CHILDREN.
• The preservative, thimerosal ( Thiosalicylic acid + Mercury),
which is used in some vaccines. The mercury contained in
thimerosol is an organic form called Ethylmercury.
• Preservative protect vaccines from bacterial contamination,
however multidose vials can be contaminated and lead to mild
or fatal infections. Mercury in high amount can cause damage to
the nervous system and kidney. Hence, IOM recommends DTaP,
Hib, and Hepatitis B vaccines free from thimerosol to be used in
USA.
• Studies have shown that low level thimerosol, in vaccines does
not cause neurological problems or autism.

42. 12. THE HEPATITIS B VACCINE CAUSES
SUDDEN INFANT DEATH SYNDROME (SIDS)
• Every year in the USA thousands of infants die of SIDS. The
Hepatitis B vaccine is now routinely recommended for infants as
a series of three vaccines. Therefore, some infants who get the
hepatitis B will invariably die from SIDS – Some will die from
SIDS soon after the vaccine is given. But it doesn’t mean that
child who get Hepatitis B vaccine are more likely to die from
SIDS.
• The cases of SIDS has decreased after the American Academy
of Pediatrics recommended ―Back to Sleep‖ for infants, ie,
parents were asked to let infants on their back instead of face
down. The result was a dramatic decline in SIDS and proved
that SIDS was not related to vaccines.

43. 13. PHARMACEUTICAL COMPANIES
OCCASIONALLY MANUFACTURE LOTS OF
VACCINES THAT CAUSE HIGH RATES OF
ADVERSE EVENTS (―HOT LOTS‖)
• Individual lots of vaccines that have usually high
rates of side effects have never been identified
(in USA).
• Hence, specific lots of vaccines have never been
withdrawn from use as ―hot lots‖

44. 14. VACCINE PREVENTED DISEASES OCCUR
MORE OFTEN IN VACCINATED PEOPLE THAN
IN NON-VACCINATED PEOPLE.
• On its face, this statement seems to be actually true.
However, it is important to understand why?
• Lets study a situation,
- 100 students live in a dormitory of a college
…
• It is reported that unvaccinated people have 35 times
more chance of getting Measles than Vaccinated.

45. 15. WHY CAN’T WE ERADICATE OTHER
DISEASES, AS WE DID WITH SMALLPOX?
• In theory, nearly any infectious disease for which an effective
vaccine exists should be eradicable.
• With sufficient vaccination levels and coordination between
public health organizations, a disease can be prevented from
gaining a foothold anywhere; eventually, without anyone to
infect, it must die off.
• A notable exception is tetanus, which is infectious but not
contagious: it’s caused by a bacterium commonly found in
animal feces, among other places. Thus, tetanus could not be
eradicated without completely removing the Clostridium
tetani bacterium from the planet.

46. 15. WHY CAN’T WE ERADICATE OTHER
DISEASES, AS WE DID WITH
SMALLPOX?(CONTD…)
• Smallpox is unusual, however, in the set of characteristics that made it
susceptible to eradication. Unlike many other infectious diseases, smallpox
has no animal reservoir.
• Another obstacle to eradication for many infectious diseases is visibility.
People with smallpox were highly visible: the smallpox rash was easily
recognizable, so that new cases could be detected quickly. Vaccination
efforts could be focused based on the location of the cases and potential
exposure to other individuals.
• Polio, by contrast, causes no visible symptoms in about 90% of the people it
infects. As a result, tracking the spread of the polio virus is extremely difficult,
which makes it a difficult eradication target.

47. • Perhaps most importantly, smallpox patients generally did not reach their
highest level of infectivity (that is, their ability to infect others) until after the
appearance of the smallpox rash. As a result, quick action to quarantine
infected individuals upon the eruption of the rash usually left enough time to
vaccinate anyone who had already been exposed, and prevent additional
exposures.
• Many infectious diseases do not allow for this kind of reaction time. Measles
patients, for example, can become infectious up to four days before the
appearance of the measles rash. As a result, they can pass the virus on to
many, many other people before anyone even knows that they are infected.
• Many people still think eradication is possible for certain diseases. Efforts are
ongoing to eradicate several diseases, such as polio and Guinea worm
disease (Dracontiasis)
15. WHY CAN’T WE ERADICATE OTHER
DISEASES, AS WE DID WITH
SMALLPOX?(CONTD…)

48. 16. WHAT IS HERD IMMUNITY? IS IT REAL? DOES
IT WORK?
• Herd immunity, also known as community immunity, refers to the
protection offered to everyone in a community by high
vaccination rates. With enough people immunized against a
given disease, it’s difficult for the disease to gain a foothold in
the community.
• This offers some protection to those who are unable to receive
vaccinations—including newborns and individuals with chronic
illnesses—by reducing the likelihood of an outbreak that could
expose them to the disease.

49. HERD IMMUNITY

50. 17. The hepatitis vaccine causes arthritis, multiple sclerosis, and
long term (chronic) neurological disorder.
18. Vaccines causes Diabetes.
19. The DPT vaccine causes a disease that looks like ―shaken
baby‖ syndrome.
20. The polio Vaccine is the cause of AIDS.
21. The polio vaccine is contaminated with a virus that causes
cancer.
22. Vaccines may contain the agent that causes ―Mad Cow‖
disease.
II. OTHER COMMON CONCERNS ABOUT VACCINES

53. THANK YOU…!!!