It’s a dose of antibodies that works right away to help fight off severe RSV infection for at least five months. Getting the shot in October – just before RSV season -- provides an infant with extra antibodies to build their immunity during the fall and winter months.  

In November 2023, Cook Children’s saw a spike in RSV at our Urgent Care centers and Emergency Departments, the highest volume of cases in recent years.   

“RSV is one of the most common winter viruses. All of us catch RSV in the first couple of years of life," said Mary Suzanne Whitworth, M.D., Medical Director of Pediatric Infectious Diseases at Cook Children’s.

In older children, RSV typically causes cold-like symptoms such as cough and runny nose. But babies under 12 months don’t have fully developed immune systems, Dr. Whitworth said. They tend to get sicker with RSV, a leading cause for wintertime hospitalization in infants.

Severe RSV in infants tends to impact the lungs. Infants should be seen by a doctor if they’re struggling to breathe. If your baby is sick, Dr. Whitworth said, watch for rapid breathing, flared nostrils, airway congestion, wheezing or a rattle you can hear or feel in their chest. Other concerning signs are excessive sleepiness, lack of appetite and trouble feeding.

The Food and Drug Administration (FDA) approved the preventive medication, called nirsevimab, in 2023 after clinical trials showed it reduces the risk of hospitalization for RSV by 75%.

Every infant under age 1 needs the medication ahead of RSV season, Dr. Whitworth said. Some older babies need the shot too if they have certain underlying health conditions. Here’s the breakdown. 

Stopping RSV Two Ways

The first option Pfizer's Abrysvo, given during weeks 32-36 of pregnancy.  Maternal antibodies are passed to your baby and protect against RSV for about six months after birth.   

Infants who don’t have maternal antibodies should get a dose of nirsevimab shortly before the RSV season. Infants born from October to March should receive the medication within one week of birth, according to the U.S. Centers for Disease Control and Prevention (CDC).

The CDC also recommends nirsevimab for certain young children shortly before their second RSV season. This higher-risk group includes children who were preemies, or those with chronic lung disease, compromised immune systems or cystic fibrosis.

The injection delivers safe and effective antibodies, Dr. Whitworth said, and the most common side effect is soreness from the needle stick. She encourages parents to ask their baby’s pediatrician for the shot in October, before hospitalizations for RSV start climbing in infants.

“They are going to be exposed to RSV. It is a virus we are exposed to regularly all winter long.” she said. “The immediate benefits of the shot are huge.”

Cook Children’s has the RSV shot available at our seven Neighborhood Health Centers in the Fort Worth area and more than 40 pediatric offices from Aledo to Willow Park.

Additionally, the Tarrant County Health Department is offering this product to infants ages 2 – 8 months with state-funded insurance or no insurance and infants 8 – 19 months with a qualifying diagnosis.   

Related Stories

Physicians Say New Antibody Shot Could Be Game Changer
Medication to Prevent RSV

By Jean Yaeger

National Infant Immunization Week amplifies a key point: Vaccines safely and effectively protect babies against various diseases.  

This campaign of awareness, which runs April 24-30, emphasizes the proven track record of shots that fight vaccine-preventable diseases such as polio, Hepatitis B and measles. Who benefits when an infant is immunized? The child, their family and the wider community.

Parents should know that vaccines work to stop the spread of infectious diseases at home, in daycare and school settings, and in the general population. Certain shots are needed before kids enter kindergarten, seventh grade and college. But babies and toddlers need shots too before they can be enrolled in a child care center or pre-kindergarten program.

In order to start or stay in daycare in Texas, state law requires proof of up-to-date records for eight vaccines, including periodic booster shots. Regular visits to the pediatrician’s office can help children and teens stay on track for their vaccines – or get caught up if they’re behind. 

The Texas Department of State Health Services (DSHS) ensures compliance during licensing visits by checking the immunization records that the daycare centers keep for each child. Records should include the child’s name, the date the vaccine was received (month, day and year), the provider’s initials or stamp to validate, and clinic contact information.

A conscientious exemption affidavit should be submitted if a child is following an alternative vaccine schedule. According to DSHS rules, a current record or exemption must be on file; otherwise, the child in daycare is considered “vaccine delinquent.”

The DSHS website lists the 2022-2023 minimum vaccine requirements in a chart, in English and Spanish. The chart covers:

• DTaP (Diphtheria, tetanus, and pertussis) – doses by 3 months, 5 months, 7 months and 19 months
• Polio – doses by 3 months, 5 months and 19 months
• HepB (Hepatitis B) – doses by 3 months, 5 months and 19 months
• Hib (Haemophilus influenzae type b) – doses by 3 months, 5 months and 16 months
• PCV (Pneumococcal conjugate) – doses by 3 months, 5 months, 7 months and 16 months
• MMR (Measles, mumps and rubella) – one dose by 16 months 
• Varicella (Chickenpox) – one dose by 16 months
• HepA (Hepatitis A) – doses by 25 months and 43 months

Flu and rotavirus vaccines are not required but may be recommended by the child’s health care provider.

Christina Sherrod, M.D. and the staff at Cook Children’s Pediatrics Southlake will make copies of the patient’s vaccine record and also fill out a health statement form for the daycare if requested. Dr. Sherrod said the vaccine requirements serve as a safety net to help families know when to bring in their babies and toddlers for shots. “That’s the practical side of it,” she said.

For instance … Kids' Place, located across the street from Cook Children's Medical Center in Fort Worth, sends reminder notifications to parents whenever a child is due for their next vaccines.

But the ultimate goal is preventing an outbreak of disease. “If you have a daycare full of 400 kids, and fewer than 95% are vaccinated against measles, that could easily lead to an outbreak in the daycare and in the community,” Dr. Sherrod said.

At Cook Children’s neighborhood clinics across Fort Worth and nearby cities, the medical teams also promote immunizations as recommended by the American Academy of Pediatrics and the Centers for Disease Control and Prevention. 

“Adhering to this vaccine schedule is the best way to protect children and keep them healthy,” said Sharhonda Ansley, M.D. at Cook Children’s Neighborhood Clinic Northside. “By keeping up with their child’s regular checkup visits, parents will help ensure they are prepared for daycare and kindergarten. And the healthier we will all be!”

Dr. Ansley and Dr. Sherrod both pointed out that the symptoms of some diseases can be mild for some patients but serious or even fatal for babies. 

Your Questions Answered

How do vaccines work? Dr. Sherrod puts it this way: “A vaccine injects a protein or molecule into your body that tricks the immune system to make your body think you're getting that disease. It makes your immune system ramp up and build antibodies and memory T cells to prevent getting ill in case you're exposed to the real disease later on.”

What's it like to immunize an infant? Some vaccines are given orally. If it’s an injection, the needle goes into the thigh, and a Band-Aid is applied. The baby usually cries. “You can't warn a baby that the shot is coming, and you can't explain to them why,” Dr. Sherrod said. “The truth is they do really well and they usually calm down very quickly.”

What are some tips to help with discomfort afterward? Breastfeeding or a bottle can be soothing. Don’t give Tylenol right away. “Usually if the baby needs Tylenol, it's that evening or maybe even the next day. I tell parents to go home and see how their baby does. A lot of babies get kind of sleepy the day after their shots. If they have a fever and they're fussy, go ahead and give them Tylenol. But a lot of babies never need it. They just go home, maybe sleep a little bit more, and are fine.”

Anything else? The bacteria that might cause an ear infection or sinus infection in an older child can cause brain damage or even death to a 2-month-old, whose immune system is more immature.  Vaccines benefit the babies who receive them as well as the bigger picture of public health in our country. “It's a privilege that we have these vaccines,” Dr. Sherrod said. “As a nation, we really don't know how bad it can be without these vaccines. I just hope enough people keep getting them that we can continue to see that disease prevention.”

Children and teens need up-to-date shot records to start the new school year, and the doctors at Cook Children’s are eager to help get students caught up on their routine immunizations.

Alice Phillips, M.D. at Cook Children’s Pediatrics Cityview said vaccines can prevent contagious diseases such as hepatitis, measles and mumps from spreading through the classroom and to family members at home.

“We can look back at history and see stories about polio and whooping cough and the toll that that took on our kids and on our society. We do not want to go back to that,” Dr. Phillips said. “Vaccines are safe. They work. And they are tried and true and proven over many decades.”

But the latest annual immunization report by the Texas Department of State Health Services identified a drop in overall vaccination coverage among kindergarteners during the 2021-2022 school year. The report also cited a high number of seventh-graders behind on shots for meningitis and Tdap (tetanus, diphtheria and pertussis).

In the report, the COVID-19 pandemic was listed as the main reason more children missed out on their required vaccines last year. Additional barriers to immunization include lack of transportation, missed opportunities, lengthy wait, and lack of culturally appropriate educational materials, according to the state health department.

Dr. Phillips pointed out that only 85% of Fort Worth Independent School District kindergarten students were current with their measles shots last school year. To reach herd immunity, and limit transmission, the rate should be 90-95%, she said.

Many families were afraid to come to the pediatrician for their child’s annual checkup during the early months of the pandemic in 2020, Dr. Phillips said. Most of her patients have since received any overdue vaccines.  

Heather Miller, M.D. at Cook Children’s Neighborhood Clinic Northside also saw a trend of families not making appointments -- or canceling, or not showing up -- for well-child visits because of COVID-19 concerns during the past two years. To make up for the shots they missed, some 6-year-olds are now coming in for vaccines normally given at age 4.  

Dr. Miller has good news for children and teens who fell behind: There are combination vaccines that can be given in most cases, meaning “fewer pokes,” as she puts it.

Most of the patients that Dr. Miller and her colleagues see at the Neighborhood Clinic Northside are on Medicaid or the Children’s Health Insurance Program (CHIP), which is available to those who can’t afford private health coverage. She wants parents to know that the Texas Vaccines for Children Program provides vaccines to eligible children from birth through age 18.

Dr. Miller says getting back-to-school vaccinations will help protect children from potentially serious complications from those diseases. “That’s why we’re here,” she said, “to help keep children healthy.”

Cook Children’s families can go to the MyCookChildren’s patient portal to schedule an appointment or access the immunization records needed for school registration. Dr. Miller said the staff at the neighborhood clinics can help their families navigate the portal or print out a copy of immunization records. 

In addition to the delays the pandemic caused, Dr. Phillips believes vaccine hesitancy also played a role in the 2021-2022 drop in the immunization rate.  She invites parents to ask questions and talk to the doctor about any concerns.  

“Let me discuss with you what I know – the science, the data – to tell you why these vaccines are safe for your child and why they are effective at preventing illness for not only your child but all of their friends and the community,” said Dr. Phillips, who describes a team partnership of trust between the physician and patient families working together to keep kids healthy.

“I truly believe after 25 years of doing this, that what’s absolutely best for their child is to be fully immunized and protected, because these diseases are still out there,” Dr. Phillips said.

Vaccines Checklist

Because many vaccines are typically given in the first 12-18 months of life, an incoming kindergartner might not have received a vaccine since her first birthday. Between the ages of 4-6, these additional vaccines are due:

• MMR (measles, mumps and rubella)
• DTaP (diphtheria, tetanus and pertussis)
•  IPV (inactivated poliovirus)
•  Varicella (chickenpox)

And an incoming seventh-grader might not have received a vaccine since he was a preschooler. Between the ages of 11-12 years, these additional vaccines are due:

• MCV4 (meningitis)
• Tdap (tetanus, diphtheria and pertussis)
• HPV (human papillomavirus)

A booster of the meningitis vaccine is also recommended at age 16.

Cook Children’s follows the vaccine schedule adopted by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.

____________________________________________________________________________________________________________________________________

For 10 key facts about immunizations, including why it’s important to follow a vaccination schedule, go to Vaccine and Immunization (cookchildrens.org)

To view the recommended ages for shots from birth through the teen years, go to cook-childrens-vaccinefacts2.pdf (cookchildrens.org)

Meet Heather Miller, M.D.

Dr. Miller’s desire to become a doctor took root as she grew up in the Piney Woods of East Texas. She earned a Bachelor of Arts in Biology from the University of Texas at Austin, then attended the University of Texas Medical Branch for medical school and residency. Along the way she proudly served in the U.S. Air Force for three years as a General Medical Officer at Lackland Air Force Base in San Antonio. After fulfilling her military commitment and completing pediatric residency training, she started her career at Cook Children’s Northside Clinic in 2002. Then came a 10-year journey following other career opportunities in San Antonio, Mississippi and New Mexico.

With a happy heart, this native Texan returned to Fort Worth and rejoined the Northside Neighborhood Clinic. Reconnecting with Cook Children’s has been a wonderful homecoming. She feels blessed to have this opportunity to provide care for the children and families of North Texas once again. Her special interests in pediatric care include safety and prevention as well as behavior and development

With her husband Steven and son Andrew, Dr. Miller enjoys exploring the world and taking trips by train.

Learn more about Dr. Miller here.

To identify the hot spots, researchers from the University of Texas at Austin and Johns Hopkins University looked at each area’s volume of international travel from foreign countries with large measles outbreaks and the prevalence of nonmedical exemptions from childhood vaccinations.

The same researchers previously predicted outbreaks in Washington, Oregon and New York which are all experiencing an influx of measles cases.

“For measles, most experts believe that there will be one to two deaths per 1,000 cases, most likely infants. We are set to see over 1,000 cases in the U.S. in 2019. So, for the first time since the 1980s, we may expect infant deaths from measles in the U.S.,” said the study’s lead author, Sahotra Sarkar, a philosophy and integrative biology professor at UT Austin and an expert on public health, in UT news. “We have long known that vaccine avoidance is a critical public health issue in the U.S. and Europe. Our results show how travel from regions elsewhere compounds this risk.”

The Texas Department of Public Safety has confirmed 15 measles cases in Texas this year, including one in each: Tarrant, Dallas and Denton counties and two in Collin County. Comparatively, Texas had nine measles cases in 2018 and only one in 2017.

Already this year, more than 760 cases of measles have been confirmed in the United States, the highest number in decades.

Physicians at Cook Children’s call this news frustrating because measles is a disease once thought to be all but gone from the planet. Texas has one of the highest rates of unvaccinated children in the U.S., partly due to a 2003 state law allowing parents to opt out of getting their children immunized for reasons of conscience.

“It’s not a coincidence that as we have seen more people hesitant to receive the vaccine, we have seen the number of measles cases increase nationwide,” said Justin Smith, M.D., a pediatrician at Cook Children’s. “The numbers are very concerning.”

Measles is a highly contagious respiratory illness spread by contact with an infected person through coughing and sneezing. Measles is so contagious that if someone has it, 90 percent of the people around that person who are not immune will become infected.

The Centers for Disease Control and Prevention (CDC) recommends children who are older than 12 months get two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Teens and adults should also be up to date on their MMR vaccination.

Two doses of the MMR vaccine are about 97% effective at preventing measles; one dose is about 93% effective.

"Populations who choose to not follow the recommended vaccine schedule are actually setting up the perfect conditions for the diseases they are unvaccinated for to erupt into an outbreak. It is really not a question of whether these outbreaks will occur but when," said Jason Terk, M.D., a Cook Children's pediatrician.

Other Texas counties to make the Top 25 were Harris at No. 9 and Travis at No. 22.

To learn more about where you can receive vaccines in the Tarrant County area, visit the Immunization Collaboration of Tarrant County website.

For More on This Topic:

• 25 U.S. Counties Identified as Most at Risk for Measles Outbreaks
• Vaccines and Immunizations
• Immunization Collaboration of Tarrant County
• Common Questions About Immunizations
• Why Children Like Olivia Need You to Immunize
• From Vaccine Hesitant to Pro Vaccines. Why This Mom Changed Her Mind.
• Pediatricians Remember Experiences with Measles
• What The First Measles Case in Tarrant County Means for Your Child
• 'Vaccines Are Safe and Effective'
• When It Comes to Your Kids It's Never Just a Virus
• Measles Outbreaks Increase as Vaccination Rates Decrease
• Measles In the Classroom
• MMR/thimerosal/mercury: What you should know

Two children tested positive for the Influenza A virus from the week of Sept. 16 through Sept. 22, 2018, according to Laboratory results from Cook Children's.

For the week, 85 children were tested for the flu, with 83 tests coming back negative. Interestingly, the first case of the flu was confirmed during the same (Sept. 21) in 2017.

The goods news is that flu vaccines are available at our Cook Children’s pediatrician's offices now.

Getting the flu vaccine is one of the most important things you can do for your child this time of year. Yes, hand washing and avoiding ill contacts are good ideas but that’s not going to be what ultimately protects your child from flu.

No one likes getting a flu shot, kids and parents included, but it’s essential to your child’s health. Here are 5 important facts about the flu shot you should know:

1. Get your child the shot. The American Academy of Pediatrics is recommending flu shots for every child over 6 months of age. Children and elderly adults are the most at risk for serious illness, hospitalization and death from the flu. Children under 2 and those with chronic medical conditions are at higher risk, but healthy children are hospitalized and die from the flu every year!
2. Get your own flu shot. Getting yourself protected helps to prevent the spread of flu in your house. It will decrease the risk of you contracting it, even if someone in your house gets it … and taking care of sick kids while you are sick is one of the hardest things I’ve ever done as a parent. If you have a child under 6 months with whom you have frequent contact (who cannot receive the vaccination) it is extremely important.
3. Ignore any early data about the effectiveness of the flu vaccine. Last year, early data about flu vaccine effectiveness caused many to skip their shot. But, at the end of the year, protection rates ended up being average (and any protection is better than none). Just get it done.
4. Choose the injectable vaccine. Nasal flu vaccines will be available again at some offices this year. However, based on past years, I am strongly recommending that patients get the injectable vaccine. After giving nasal flu vaccine for years before studies showed it wasn’t working, I’m not taking that risk with my children or my patients until we know more about how it’s working over the next few years.
5. Go ahead and get your child scheduled. Pediatric studies have not shown a decrease in effectiveness during a flu season because of getting the shot done early. Getting the vaccine at least 2 weeks before the season starts is critical to making sure they are protected and we never know what vaccine supplies will be when the season hits.

All About the Flu

• Influenza (flu)
• Is it a cold or the flu?
• Is the flu vaccine a good idea for your family?
• Frequently asked questions about immunizations
• How can I comfort my baby during shots?
• Immunization schedule
• Is the Flu vaccine a good idea for your family?
• Your child's immunizations: influenza vaccine

That’s the concern of many of the state’s physicians based on new numbers from the Texas Health and Human Services department.

In its Annual Report of Immunization Status, 56,738 kindergarten through 12^th grade students were reported as having a conscientious exemption on file at the school. This number represents 1.07 percent of the number of students reported enrolled by schools in the survey.

This is on top of a recent report by the Centers for Disease Control and Prevention that states that Texas is one of 21 states that is currently being monitored for the spread of measles. The CDC says there has been 107 cases reported this year and that the majority of those cases weren’t vaccinated.

The amount of children who aren’t receiving at least one vaccination for a nonmedical reasons has been steadily on the rise since Texas lawmakers passed what’s known as conscientious exemption in 2003. Parents and legal guardians can choose for their child not to receive an otherwise required immunization for their child because of reasons of conscience, including religious beliefs.

Fifteen years ago, about 2,300 students opted out of at least one vaccine.

In an editorial in the Star-Telegram that urged parents to provide immunization for their children, Dr. Peter Hotez warned that “we are extremely vulnerable to a measles outbreak in Texas.”

Dr. Hotez, who is director of the Texas Children’s Hospital Center for Vaccine Development, recently co-authored a study on vaccine exemptions published by the Public Library of Science Journal of Medicine.

Texas was named one of 18 states that allows non-medical exemptions, and identified Tarrant County and Fort Worth as national “hot spots” for a potential outbreak. The study found that parents of at least 518 kindergartners in Tarrant County schools last year opted to not get preventive shots for their children.

“These numbers are very concerning,” said Justin Smith, M.D., a pediatrician and Medical Advisor for Digital Health at Cook Children’s. “In 2000, the United States declared that measles was eliminated from this country. Now, more and more kids aren’t getting immunized and diseases like measles has returned to this country. I don’t think that’s a coincidence. Measles is very serious. Measles can cause pneumonia and children under the age of 5 have a higher risk of hospitalization.”

Dr. Hotez’s study found that children not given the measles, mumps and rubella vaccine are 35 times more likely to contract measles than a vaccinated child.

Keeping vaccination rates relatively high (somewhere around 90 percent) actually helps protect all children (vaccinated or not) from diseases, Dr. Smith said. In addition, when outbreaks occur, even children who are vaccinated become at risk for contracting disease due to the number of possible exposures.

"Populations who choose to not follow the recommended vaccine schedule for themselves and for their children are actually setting up the perfect conditions for the diseases they are unvaccinated for to erupt into an outbreak. It is really not a question of whether these outbreaks will occur but when," Jason Terk, M.D., a Cook Children's pediatrician.

No topic triggers as much controversy on our social media sites or Checkup Newsroom as vaccines. When it comes to the HPV vaccine, people are especially passionate.

You may have seen the comments on Cook Children’s Facebook page after we announced an upcoming Facebook Live event. “Take The Shot. Prevent Cancer. A Conversation About HPV” will feature experts from Cook Children’s and Baylor Scott & White at 1:30 p.m. CST on Thursday, April 12.

We know there is a small but aggressively vocal group of people who have made their mind up on this issue. No amount of science will sway their firm stance against vaccines.

However, we feel it’s important as a health care organization to provide facts for our readers. That’s why we are taking this opportunity to discuss some of the arguments against the HPV vaccine and debunk many of the myths being spread on the Internet.

Myth 1: The HPV Vaccine is New

The United States currently has the safest, most effective vaccine supply in history. Years of testing are required by law to ensure the safety of vaccines before they are made available for use in the United States. This process can take 10 years or longer. Once a vaccine is in use, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) monitor any possible side effects (adverse events) through the Vaccine Adverse Event Reporting System and other vaccine safety systems.

The HPV vaccine – Gardasil^® 9 – went through years of extensive safety testing before they were licensed by FDA. Tens of thousands of people participated in studies for the HPV vaccines. No serious safety concerns were identified in these clinical trials. FDA only licenses a vaccine if it is safe, effective and the benefits outweigh the risks. CDC and FDA continue to monitor HPV vaccines to make sure they are safe and beneficial for the public.

Click here to learn more.

Myth 2: The HPV Vaccine Causes Side Effects

While no vaccine or medicine is completely without risk, the Centers for Disease Control and Prevention (CDC) & the Food and Drug Administration (FDA) review all safety info on HPV vaccines. Most reported adverse events following HPV vaccination are considered minor. Pain at injection site, headache, nausea, fever & fainting are the most common adverse events after HPV vaccination. Fainting occurs in some people because the vaccine stings a little more when it is given. Keeping vaccine recipients in a seated position for 15 minutes after the injection prevents fainting episodes. Click to learn more.

Approximately 79 million doses of HPV vaccine have been distributed since the vaccine was introduced, and no serious side effects have been linked to HPV vaccination. The most common side effects after HPV vaccine are mild and include pain in the arm where the shot was given, fever, dizziness, and nausea. For more information, click here.

Myth 3: The HPV Vaccine Could Cause Fertility Problems For My Child

Currently, there no legitimate data or any evidence that suggest getting the HPV vaccine will have an effect on future fertility for women. In fact, getting vaccinated and protecting against HPV-related cancers can help women and families have healthy pregnancies and healthy babies.

Not getting HPV vaccine leaves people vulnerable to HPV infection and related cancers. Treatments for cancers and precancers might include surgery, chemotherapy, and/or radiation, which might cause pregnancy complications or leave someone unable to have children. Click here to learn more.

Myth 4: A Child 11 Or 12 Years Old Is Too Young To Receive The Vaccine

For HPV vaccine to be most effective, the series should be given prior to exposure to HPV. Most of our kids (80 percent) will become infected with the types of HPV that can cause cancer unless they get vaccinated. Waiting increases the chance that they will become infected before the vaccine can protect them. Click to learn more.

Like all vaccines, we want to give HPV vaccine earlier rather than later. If you wait, your child may need three shots instead of two. More information on this topic can be found here.

Myth 5: HPV Vaccination Gives My Child Permission to Be Promiscuous

Research actually shows the opposite. According to a study published by the American Academy of Pediatrics (AAP), HPV vaccination among 11 to 12 year olds did not increase sexual activity-related outcomes such as pregnancy, STD infection or testing or contraceptive counseling. Click here to read the study.

Studies tell us that getting the HPV vaccine doesn’t make kids more likely to start having sex. However, HPV is a very common infection in women and men that can cause cancer. Starting the vaccine series today will help protect your child from the cancers and diseases caused by HPV as an adult. Intimate contact that is short of intercourse (making out) is sufficient to transmit HPV. Click to learn more.

Myth 7: I Heard The Shot Causes HPV

The HPV vaccine does not cause HPV infection or cancer. The HPV vaccine is made from one protein from the virus, and is not infectious, meaning that it cannot cause HPV infection or cancer. Not receiving HPV vaccine at the recommended ages can leave one vulnerable to cancers caused by HPV. Click here to read about the science behind this statement.

Myth 8: The HPV Vaccine Is Too Expensive

Are you interested in getting HPV vaccine for your child but concerned about the cost? The Vaccines for Children (VFC) Program may be able to help. VFC provides vaccines for children ages 18 years and younger, who are uninsured, Medicaid-eligible, American Indian or Alaska Native. Learn more by clicking here.

Myth 9: The HPV Vaccine Damages Women’s Ovaries

The CDC is aware of public concern about the safety of HPV vaccine. Since the vaccine’s introduction in 2006, vaccine safety monitoring and studies conducted by the CDC, FDA and other organizations have documented a reassuring, excellent safety record. There is no current evidence that HPV vaccines cause reproductive problems in women.

Myth 10: The HPV Vaccine Contains Dangerous Amounts of Aluminum

Small amounts of aluminum have been used safely in vaccines for more than 70 years. It’s added to help the body build stronger immunity against the germ in the vaccine. Aluminum is one of the most common metals found in nature and is present in air, food and water. The amount of aluminum present in vaccines is low and is regulated by the U.S. Food and Drug Administration (FDA).

Aluminum is present in U.S. childhood vaccines that prevent hepatitis A, hepatitis B, diphtheria-tetanus-pertussis (DTaP, Tdap), Haemophilus influenzae type b (Hib), human papillomavirus (HPV) and pneumococcus infection. Click here to learn more.

Myth 11: The HPV Vaccine Doesn’t Really Prevent Cancer

Every year, more than 30,000 people in the US are diagnosed with a cancer caused by HPV. That’s one case every 20 minutes.

More Articles On HPV:

• New Study Says Boys Less Likely to be offered HPV vaccination
• ‘We Have a Vaccine That Can Prevent Cancer'
• Texas Ranks Near Last in HPV Vaccination Rate
• Study Finds 1 in 9 Males Infected with Oral HPV
• Pediatrician Leads New Initiative To Improve HPV Vaccination Rates
• Protection From HPV Now Easier For Kids
• Early Evidence Shows HPV Is Working
• HPV Raises Risk of Head and Neck Cancer Sevenfold
• What's New With the HPV vaccine?

The Dallas Morning News reports that person from another state who had mumps traveled to Dallas for the National Cheerleaders Association All-Star National Championship, which took place Feb. 23-25 at the Kay Bailey Hutchison Convention Center. 

At this point no Texas residents have developed mumps in connection with the case, but people are urged to watch for symptoms. 

This is another reminder about the value of vaccination in preventing what can be serious illness. Mumps cases decreased 99 percent after the introduction of a successful strategy for vaccination.

Here's a quick look at mumps cases over the years according to the CDC:

*Case count is preliminary and subject to change

** Cases as of Jan. 27, 2018 Case count is preliminary and subject to change

Just in time for the holidays a reader wrote in with this question:

“My friend...was told by her grandson’s pediatrician that her grandchildren who are vaccinated should never be around any unvaccinated children. Well, the parents of her other grandchildren do not want to vaccinate their small children…As a result there are no more family gathering with all grandchildren. They have to spend holidays on separate days. My question is: Why would the pediatrician say this? If the children who are vaccinated and the children are not showing symptoms what’s the problem?”

This is definitely a sad and tricky situation and one that we should use extreme care when discussing.

One thing I will say is that no matter what one’s choice about vaccinating is, parents believe they are making the choice in the best interest of their child. Of course, I have strong opinions about how important it is, but this discussion is not for the faint of heart.

There are probably some doctors that would tell you it’s no big deal and you shouldn’t worry about it (I would disagree with them). There are other doctors that would say you should never have your child around children who are unvaccinated regardless of your child’s health (I recognize this is not reasonable in many situations).

Here are the questions to consider:

1. How old is the child? The younger the child, the more vulnerable they will be to infection. They cannot receive protection for chicken pox or measles before 1 year. Older children who are fully vaccinated have a significant amount of protection and they likely encounter an unvaccinated child at school every day.
2. Who isn’t vaccinated? This question is about family members which makes transmission of infectious diseases more likely than if you just walked by someone on the street and were not interacting with for longer periods of time.
3. Can you have an open conversation with those involved? The discussion is clearly more complicated than simple medical advice as it broaches on several tricky areas including family dynamics and vaccination.

The easy (get out of having to make a committed answer) is that there is no one answer to the question. The family should talk with their doctor about their specific concerns and make a decision with their counsel.

Should I stop the blog post there? Not so fast.

Instead, I want to give you a framework for having that discussion with your doctor.

What diseases should I be worried about?

I believe that all vaccines are important, period. But there are 3 diseases that jump to the top of my list when considering this issue:

1. Flu

Flu season is predictable in that it comes every single year at roughly the same time. It is unpredictable in that we never know how widespread it will be and how severe the cases will be when it does come around. Flu is particularly dangerous in babies and they cannot be vaccinated until they are 6 months old. Remember that the flu vaccine isn’t perfect, so I’m not saying that everything’s cool if we all have flu vaccines but it would seem logical to get as much protection surrounding the baby as possible.

2. Pertussis

Pertussis, or whooping cough, is still common and is a very serious disease for anyone who gets it. In children, teenagers and adults it tends to cause a very rough and painful cough that lasts for weeks to months. I know of adults who have had broken ribs because the coughing is so hard. The real danger for pertussis comes in small babies (less than 3-4 months). These babies commonly have spells of coughing that cause them to stop breathing; leading to ICU stays for intubation and unfortunately, death. Babies are vaccinated against pertussis at 2, 4 and 6 months which increases the number of children who are protected with each shot but they go on to get another vaccine at 4 and 11 years as well. So, when are they fully protected? It’s impossible to say. In addition, vaccines are not perfect so even vaccinated infants who are exposed could develop pertussis. Pertussis still occurs commonly in the United States and is generally carried by older children and adults who are coughing but do not know that they have pertussis. Just like flu, having the vaccine does not prevent disease 100% and I still feel that we need to do something better with the pertussis vaccine but again, it would seem logical to increase protection as much as possible.

3. Measles

Measles is another disease that still occurs in the United States. In 2014, there was a record number of 667 confirmed measles cases reported to the Center for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases (NCIRD). That’s the highest number of cases since measles elimination was documented in the U.S. in 2000. Measles can cause pneumonia and have a higher risk of hospitalization in children under 5. Children receive their first measles vaccine at 1 year of age, but they have no protection from measles until then.

What criteria should I use for being around others?

1. If your baby is under 6 months, use extreme caution. Many babies do not have full protection until after the 6 months shots. In addition, they cannot receive a flu vaccine until 6 months.
2. If your baby is under 1 year, I would also use caution. Your baby cannot be vaccinated against measles or chicken pox until 1 year.
3. After your child is vaccinated at 4 years, they have much of the protection that they need to protect themselves against the vaccine preventable diseases.
4. Babies or children who may not have a normal immune system-such as those with chronic illness or who were born premature deserve extra caution.
5. Anyone with symptoms of illness, especially fever, cough, congestion or rash, should not be around your baby or child regardless of your contacts’ vaccination status.

Can you get a definitive answer about when your baby can be around unvaccinated children? No, but you at least have some information to make an informed decision.

After you’ve discussed your plan with your pediatrician how do you handle the conversation with friends and family?

Here are some thoughts about some things you might say:

1. Our baby/child doesn’t have protection against many very dangerous diseases and we do not feel comfortable having her around people who could spread them to her.
2. Our baby/child has already been through so much, we can’t risk putting her through another medical problem. Especially something that we could have avoided.​
3. The doctor was emphatic that we cannot be out around anyone (especially someone who is not vaccinated or you could leave that out) until __________. (I’m fine with a family placing the “blame” completely on me.)

Aside from flu, I can’t think of any other disease for which we vaccinate where we are excited if only a few outbreaks happen here and there. Yet, despite relatively high vaccination rates at recommended times, we continued to see outbreaks of pertussis occur across the country.

A recent study, published early online for Pediatrics showed that the effectiveness of the new vaccine might even be worse than I thought. The study looked at the medical records of children diagnosed with pertussis. They looked to see if they had the newer, acellular vaccine as children and how long it had been since they received their Tdap (Tetanus, diphtheria and pertusiss) booster. This booster is usually given at age 11.

The most striking statements in the article is how quickly immunity from the vaccine decreases over just a few years after receiving the Tdap booster. The first year yields about 69 percent effectiveness. The second through fourth years decrease like this: 57 percent, 25 percent and 9 percent. We only give boosters for Tdap every 10 years.

The effectiveness was so bad that the authors concluded the study by saying: “We expect future pertussis epidemics to be larger as the cohort that has only received acellular pertussis vaccines ages. The results in this study raise serious questions regarding the benefits of routinely administering a single dose of Tdap to every adolescent aged 11 or 12 years.”

Will I stop giving pertussis vaccines to my 11 year olds? Would I skip it for my kids?

The answer to both of these questions, for now, is “No.”

Here are 3 reasons why:

1.There are very smart members of a group called the Advisory Committee on Immunization Practices (ACIP) that review vaccines and make new recommendations every year. These folks understand vaccines and the statistics surrounding their effectiveness better than anyone else in the country. They are not afraid to make changes that are based on very minute details (like whether you can be vaccinated with different brands of vaccines over time and they still work). There is no question they will review this study.

2.We have another disease for which we continue to vaccinate even though the vaccine strategy isn’t perfect and we continue to prevent thousands of severe cases and death from flu every year. Do we continue to look for better strategies and products for vaccination for both flu and pertussis? Yes. Do we throw out what we have because it isn’t perfect? No.

3.Even if the vaccine effectiveness wanes quickly, that one year of protection could be important for specific populations. Pregnant moms not only need to be protected from contracting the disease, they pass antibodies to their babies if the vaccine is given at the right time during pregnancy. Because of this, it is now recommended that pregnant moms receive the vaccine with each pregnancy. Perhaps we should consider giving a booster shot to all close contacts with the baby no matter when their last booster was given.

Reading this study and the subsequent articles I saw was disheartening. I have seen babies struggling to breathe and subsequently die from pertussis. It’s awful.

Undoubtedly, we need a better vaccine and strategy. For now, I’ll continue to do the best I can until we have something better.

Fever, headaches, joint and muscle aches, weakness, fatigue, diarrhea, vomiting, stomach pain and lack of appetite.

Over the next few months, many children will have these symptoms and many parents will, and should, call their Cook Children’s pediatrician because of how their child’s feeling.

Unfortunately, many parents will assume the worst … Ebola. But the chances of that being a reality are extremely low. While knowing it’s not likely to be Ebola may be a relief, it’s important to remember that Ebola is not the only dangerous virus on the horizon for our children. The symptoms listed above are much more likely to be the flu.

Investigation of 25 outbreaks of Ebola over 38 years has shown that only direct contact with a person with Ebola would cause someone to become infected. Right now, there’s no approved vaccine to limit the epidemic in West Africa.

On the other hand, influenza can be deadly. The 2013-2014 flu season led to 108 pediatric deaths in this country. The flu is spread readily through the air by small droplets which can be infectious to someone near a person who is coughing and sneezing and is much more easily acquired and easily prevented through vaccination.

Please make sure to get your children the flu vaccine and parents should get them too! ASAP. Both injection and nasal mist vaccines are effective.