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Vaccine Q & A:
Information About Immunization

Fact-based vaccine information

With so much available information on vaccines, separating fact from fiction can be tricky. These answers to common questions concerning vaccination are based on scientific information and have been verified using credible medical, scientific, and government vaccine references.

Vaccines by disease

Influenza vaccines

  • Isn't the flu just a really bad cold?

    It's easy to understand why parents may think this. Colds and the flu can share some of the same symptoms, such as a sore throat and runny or stuffy nose. But influenza is not your common cold; it's an illness that can lead to serious complications.58

    While most people recover from the flu within a few days' or weeks' time, it can lead to pneumonia, bronchitis, and sinus and ear infections.51

    Adolescents with chronic medical conditions, such as asthma or diabetes, are at especially high risk of flu-related complications. (Young children and adults 65 years of age and older also have a higher risk.)59

    Each year, the flu sends approximately 226,000 people in the United States to the hospital. While it is most deadly among adults 65 years of age and older, it can be deadly at any age.59

    As you can see, the flu isn't just a nasty bug that can keep your adolescent home from school or keep you out of work caring for them. It's serious. A flu vaccine is the best way to help protect your adolescent (and you, your family, and other children) against this preventable disease and to keep it from spreading.

  • What flu symptoms should I look for?

    The flu comes on quickly. If your child starts to have some of the symptoms listed below, it could be the flu.58

    • Fever (usually high)
    • Headache
    • Extreme fatigue
    • Dry cough
    • Sore throat
    • Runny or stuffy nose
    • Muscle aches

    Keep in mind that other illnesses, including the common cold, share some of these symptoms. So if your child develops flu-like symptoms and you're concerned, don't hesitate to check with a health care professional.

  • At what age should my child get the flu vaccine and at what time of the year?

    The flu vaccine is now recommended every year. In 2010, the CDC's (Center for Disease Control) Advisory Committee on Immunization Practices recommended "universal" flu vaccination—meaning everyone 6 months and older should get it—so more people would be protected against influenza every year.60

    The CDC recommends that your child get a flu vaccine as soon as it becomes available.51

Pertussis vaccine

  • Isn't whooping cough one of those old-fashioned diseases that are no longer in the United States?

    Whooping cough may sound like an old-fashioned disease, but it's very much a modern problem.

    In pre-vaccine days, whooping cough or pertussis was a major source of illness and death among infants and children, with hundreds of thousands of cases reported each year in the United States. The number of cases dropped dramatically to about 1000 in 1976, thanks to vaccination.25

    In recent years, however, pertussis cases have been climbing. For example, the number of cases reported each year tripled between 1990 and 2009.134

    Pertussis is very contagious. It starts like a common cold, with a runny nose, sneezing, and maybe a mild cough. But unlike the common cold, the cough can become severe making it difficult to catch one's breath and resulting in the whoop-like sound. The cough can last weeks and result in cracked ribs, pneumonia, and hospitalization.57

    While infants are at the greatest risk for pertussis, adolescents and adults have accounted for an increasing number of cases in recent years.57 California was the state hardest hit by pertussis in 2010, with 9120 reported cases, including 10 infant deaths—a reminder of why immunization is so important.24

    The best way you can protect your adolescent from pertussis is through immunization.57

  • Why is it important for adults to get vaccinated?

    Babies can get pertussis from those who are closest to them.53,135,136 Researchers have found that when a source was identified, in up to 83% of infant pertussis cases babies caught the disease from a family member, primarily a parent.53

    It is estimated that vaccinating family members of newborns could prevent 76% of pertussis cases in infants younger than 3 months of age.151 It's important that adults and adolescents, especially those in close contact with an infant, receive a single dose of Tdap (Tetanus Diphtheria Pertussis) vaccine.145

  • What if my adolescent was already vaccinated for pertussis as a child?

    Young children are given the DTaP (diphtheria, tetanus, and acellular pertussis) vaccine, which helps protect them against diphtheria, tetanus, and pertussis, but that protection wears off as they get older. So that is why your preteen needs a booster shot known as Tdap.51 It also helps protect against those 3 same diseases, but is designed for adolescents and adults.

    And remember, getting this booster not only helps protect your adolescent, but can also help reduce the spread to infant family members too young to be vaccinated. (Sadly, more than half of infants under the age of 1 who get pertussis have to be hospitalized.)51

  • When are adolescents supposed to get a pertussis booster?

    The CDC recommends a single dose of Tdap vaccine for adults and adolescents. If your adolescent is between 11 and 18 years of age and hasn't received the Tdap vaccine—or if you're unsure—ask your health care professional about getting it now.51

HPV (Human Papilloma Virus) vaccination

  • What can you tell me about HPV?

    As a parent, it's something you may not want to think or worry about, but HPV is serious. In fact, HPV is the most commonly sexually transmitted virus in the United States.61

    There are actually different types of HPV—certain types can cause genital warts and others can cause cervical cancer.61

    It's estimated that about 20 million people (both men and women) are infected with HPV, and the virus is most common in those who are in their late teens and early twenties.61,51

    What's also worrisome is that most people who become infected with HPV do not show symptoms, so an infected person may not know he or she has the virus or is spreading it to a partner.61

    Vaccines can protect teens and young adults against some of the most common types of HPV.61

  • Who should be vaccinated against HPV and why is it necessary?

    HPV vaccination is important because at least 50% of sexually active people will get HPV at some point in their lives—and many won't even know it.61

    The CDC recommends that all girls 11-12 years of age be vaccinated against HPV. Both of the HPV vaccines available protect against HPV types that cause most cervical cancer, and 1 of them also protects against HPV types that cause most genital warts.51

    Boys and young men should also get vaccinated to prevent genital warts.51 To get the best protection, preteens should get all 3 doses of an HPV vaccine before their first sexual contact—meaning before they could be exposed to HPV.61 If your teenager or young adult child did not receive any or all of the HPV shots when they were younger, talk with your health care professional.

Vaccines for infants

  • I thought babies were born with immunity. Isn't that right?

    Babies are born with what's called passive immunity that they receive from their mothers—but unfortunately this protection doesn't last as long as moms might expect.57

    A mother can pass on immunity only if she herself has been immunized or had a disease. This immunity, passed through the placenta and from breast milk, may only possibly last a month to about a year.45

    Immunity against certain diseases, such as whooping cough, wanes over time.47 Protection passed from a mother to her newborn is often not strong enough to fight off an infection during the first few months of an infant's life.46

    Vaccines, on the other hand, provide active immunity, which mimics what is acquired from natural infection or disease. Active immunity gives infants protection against potentially life-threatening disease.57

    As your infant grows, the protection from some vaccines may begin to wear off, and an additional dose (a booster dose) may be recommended to continue to provide protection against certain diseases.47

  • Is it dangerous for babies to receive several vaccines during the same medical visit?

    This is an understandable worry for a parent. But there is a lot of reassuring evidence that multiple vaccinations at the same time do not overload a healthy baby's immune system.48

    Vaccines routinely recommended for children use only a small portion of the immune system's memory. In fact, only tiny fragments of viruses or bacteria are in vaccines compared with the large amounts of germs children come in contact with every day.48

    Parents who are worried about the increasing number of recommended vaccines also may take comfort in knowing that vaccines today expose children to fewer bacterial or viral parts than in the past, yet protect against more diseases.48

  • Aren't so many vaccines too much for a child's immune system?

    A baby's immune system can handle considerably more germs than they will ever get from vaccines. In fact, babies are exposed to thousands of germs every day from the day they are born. As one doctor said, "Worrying about too many vaccines is like worrying about a thimble of water getting you wet when you are swimming in an ocean."9

  • Can I spread out the vaccination schedule for my child so there is more time between each shot?

    Some flexibility is built into the vaccination schedule with age ranges for individual vaccines. For example, the chickenpox vaccine may be given at any point from 12 to 15 months of age.49 You can see where there's some flexibility and create a schedule for your child by using the CDC's childhood immunization schedule.

    The childhood immunization schedule is designed to work best with a child's immune system at certain ages and at specific times, at the time when the child is at higher risk for most diseases.50 For these reasons, it is not advised to change the recommended schedule.

    Spreading out shots can leave your child unprotected and open to getting serious diseases. It has also been shown that not sticking to the schedule can result in outbreaks of disease.50

    Because you may not know the vaccination status of other children, you can at least make sure your own child is protected by having him or her vaccinated.

    Some children should not receive certain vaccines for medical reasons. For example, they may be allergic to certain ingredients contained in the vaccine (though severe allergic reactions are rare) or have a weakened immune system. In those cases, sometimes a vaccine may be delayed or skipped altogether.50

    For children who should not receive certain vaccines, their only protection from infectious disease is the immunity of people around them.16

  • Why does the government require children attending school to be vaccinated?

    We can think of school immunization laws the same way we think of traffic laws. We obey them not only to protect ourselves and our passengers, but to protect everyone else on the road.

    Vaccines help protect not only the person being vaccinated, but everyone around them. This is especially important for kids who are left unprotected because they can't get immunized for medical reasons.9

    To see your state's immunization laws, visit the National Network for Immunization Information website.

  • Can some children be exempted from school immunization laws?

    All states have medical exemptions for people who can't receive certain vaccines.9 To see your state's immunization laws, visit the National Network for Immunization Information website.

Vaccines for teenagers and adolescents

  • Don't adolescents get all the vaccines they need as children?

    It is true, children get many of the vaccines they need when they're younger. But actually, the need for vaccination doesn't stop at childhood.

    Some vaccines your adolescent got as a child begin to wear off as he or she gets older, so additional doses (boosters) are needed to help provide long-term protection.51

    Adolescents may think they're immune from getting sick or from bad things happening to them. However, you know better. As adolescents approach their teen years, they generally are at greater risk for certain diseases, such as meningococcal disease—a potentially life-threatening bacterial infection.51,52

    Adolescents can also spread diseases, such as whooping cough (known medically as pertussis), to infants. So if you have a baby in the house, making sure your adolescent is vaccinated helps protect your little one, too. In fact, whooping cough is often spread by household members, and it can be deadly for infants.25,53

    If your teen or preteen is like most adolescents, it may have been a while since he or she had that last wellness visit. Adolescents typically have fewer wellness visits than young infants and children, so it's important that they get the most out of every appointment and find out if they're up-to-date on all age-appropriate vaccinations.54

  • Isn't meningitis something that only college students should be worried about?

    College students—particularly freshmen who live in dormitories—aren't the only ones who may be at an increased risk for meningococcal disease, or bacterial meningitis as it's also called. Younger adolescents may also be at risk for this serious disease. The rates of meningococcal disease are highest in infancy, with a second peak in adolescents around 18 years of age.52

    Meningococcal disease is caused by bacteria that infect the bloodstream, brain, and spinal cord. Early symptoms can be confused with those of the flu, such as headache and fever. Other symptoms may appear, such as a stiff neck, nausea, vomiting, feeling confused, and appearing "out of it."55

    The disease spreads quickly. Even with treatment, it can cause organ failure, brain damage, amputation of the limbs, or death within hours of the symptoms appearing.55

  • Why are adolescents and young adults at increased risk for bacterial meningitis?

    Anyone can get meningococcal disease, which is highly contagious. But adolescents and young adults have certain lifestyle behaviors that put them at increased risk.

    Living in close quarters, such as in dormitories, boarding schools, and sleep-away camps provides the perfect environment for the spread of meningococcal disease, which is transmitted through close, face-to- face contact with someone who is infected.52

    Coughing or sneezing can spread meningococcal disease, as with a common cold. It can also be spread by sharing things, like drinking glasses, water bottles, eating utensils, and kissing.55

  • At what age should my adolescent get the meningococcal vaccine?

    Meningococcal vaccination is recommended for preteens and teens beginning at 11 years of age, with a booster dose by 16-18 years of age.49,51 Talk to your health care professional to be sure your teen is up to date with his or her immunization(s).

    If you have more questions about the vaccine, then be sure to talk to your school nurse or health care professional for more information.

  • Isn't whooping cough one of those old-fashioned diseases that are no longer in the United States?

    In pre-vaccine days, pertussis was a major source of illness and death among infants and children, with hundreds of thousands of cases reported each year in the United States. The number of cases dropped dramatically to about 1000 in 1976, thanks to vaccination.25

    Unfortunately, in recent years, pertussis has made a strong comeback.25 In fact, there are an estimated 800,000 to 3.3 million adult and adolescent cases of whooping cough each year in the United States.56 Pertussis is very contagious. It starts like a common cold, with a runny nose, sneezing, and maybe a mild cough. But unlike the common cold, the cough can become severe making it difficult to catch one's breath and resulting in the whoop-like sound. The cough can last weeks and result in cracked ribs, pneumonia, and hospitalization.57

  • But what if my adolescent was already vaccinated for it as a child?

    Young children are given the DTaP vaccine, which helps protect them against diphtheria, tetanus, and pertussis, but that protection wears off as they get older. So that is why your preteen needs a booster shot known as Tdap.51 It also helps protect against those 3 same diseases, but is designed for adolescents and adults.

    And remember, getting this booster not only protects your adolescent, but may also help reduce the spread to any infant family member too young to be vaccinated. (Sadly, more than half of infants under the age of 1 who get pertussis have to be hospitalized.)51

  • When are adolescents supposed to get a booster?

    The CDC recommends a single dose of Tdap vaccine for adults and adolescents. If your adolescent is between 11 and 18 years of age and hasn't received the Tdap vaccine—or if you're unsure—ask your health care professional about getting it now.49 Learn more about diphtheria and tetanus.

  • What's the difference between the flu and a cold?

    Colds and the flu can share some of the same symptoms, such as a sore throat and runny or stuffy nose. But influenza is not your common cold; it can cause serious complications.58

    While most people recover from the flu within a few days or week's time, it can lead to pneumonia, bronchitis, and sinus and ear infection.58

    Adolescents with chronic medical conditions, such as asthma or diabetes, are at especially high risk of flu-related complications. (Young children and adults 65 years of age and older also have a higher risk.)59

    Each year, the flu sends approximately 226,000 people in the United States to the hospital. While it is most deadly among adults 65 years of age and older, it can be deadly at any age.59

    A flu vaccine is the best way to protect your adolescent (and you, your family, and other children) against this preventable disease and to keep it from spreading.59

  • What are some symptoms of the flu?

    The flu comes on quickly. If your adolescent starts to have some of the symptoms listed below, it could be the flu.58

    • Fever (usually high)
    • Headache
    • Extreme fatigue
    • Dry cough
    • Sore throat
    • Runny or stuffy nose
    • Muscle aches

    Keep in mind that other illnesses, including the common cold, share some of these symptoms. So if your adolescent develops flu-like symptoms and you're concerned, don't hesitate to call your health care professional.

  • At what age should my adolescent get the flu vaccine and at what time of the year?

    The flu vaccine is now recommended every year. In 2010, the CDC's Advisory Committee on Immunization Practices has introduced the "universal" flu vaccination strategy—meaning everyone 6 months and older should get immunized—to help protect more people against influenza every year.60

    The CDC recommends that your adolescent get a flu vaccine as soon as it becomes available.51

  • What can you tell me about HPV (Human Papilloma Virus)?

    As a parent, it's something you may not want to think or worry about, but HPV is serious. In fact, HPV is the most common sexually transmitted virus in the United States.61

    There are actually different types of HPV—certain types can cause genital warts and others can cause cervical cancer.61

    It's estimated that about 20 million people (both men and women) are infected with HPV, and the virus is most common in those who are in their late teens and early twenties.61,51

    What's also concerning is that most people who become infected with HPV do not show symptoms, so an infected person may not know he or she has the virus or is spreading it to a partner.61

    Vaccines can help protect teens and young adults against some of the most common types of HPV.61

  • Who should be vaccinated against HPV and why is it necessary?

    HPV vaccination is important because at least 50% of sexually active people will get HPV at some point in their lives—and many won't even know it.61

    The CDC recommends that all girls 11-12 years of age be vaccinated against HPV. Both of the HPV vaccines available help protect against HPV types that cause most cervical cancer, and 1 of them also protects against HPV types that cause most genital warts.51

    Boys and young men should also get vaccinated to prevent genital warts. To get the best protection, preteens should get all 3 doses of an HPV vaccine before their first sexual contact—meaning before they could be exposed to HPV.61 If your teenager or young adult child did not receive any or all of the HPV shots when they were younger, talk with your health care professional.

  • What other vaccine-preventable diseases should I know about?

    Vaccination has done a lot to wipe out infectious diseases in the United States. Yet certain diseases that we thought were gone are still here.

    Part of the reason is that we live in a global society, where people cross borders every day. An outbreak of measles in 2011 brought that reality home, when 89% of cases reported in the first 6 months were traced to US residents traveling abroad, foreign visitors, or were linked to imported cases.62 The outbreak was a sobering reminder that infectious diseases that are rare here, but widespread elsewhere in the world, are just a plane ride away.

Vaccine side effects and efficacy

  • Can a child actually get the disease from a vaccine?

    Almost never. With inactivated vaccines (those that don't contain a live sample of the germ disease), it isn't possible. A dead virus or bacteria, or part of a virus or bacteria, can't cause disease.

    When a vaccine contains a live yet weakened sample of the disease, some children get what appears to be a mild case of the disease. For example, what looks like a measles or chickenpox rash but with only a few spots. This isn't harmful and shows that the vaccine is doing its job.

  • Can a child get the disease even after being vaccinated?

    It's possible, but it depends on the vaccine. Here are a few situations where this could happen:

    • With most vaccines, about sometimes the vaccinated child fails to develop immunity. If this happens and the child is exposed to that disease, they could get sick. Sometimes an additional dose of the vaccine will provide better protection in the child.157
    • A child could get exposed to a disease just before getting vaccinated, so they can get sick before the vaccine has a chance to work.157
    • After getting vaccinated with the flu shot, a child could coincidentally come down with something that seems like the flu, such as a common cold. This could make the parent wonder if the flu shot gave the child the flu. However, the flu shot can't give anyone the flu. A lot of viruses can be mistaken for the flu, but the flu shot doesn't protect against these viruses.9
  • Aren't the diseases we vaccinate against essentially gone in the United States?

    Many vaccine-preventable diseases may be largely unseen in this country, but they are certainly not gone. Outbreaks of chickenpox, whooping cough, influenza, and measles still send otherwise healthy children to the hospital and even cause their deaths every year.48,26 In fact, smallpox is the only disease that has been wiped out worldwide as the result of vaccination.27 Measles, however, affects more than 20 million people worldwide each year—and is a leading cause of vaccine-preventable deaths among young children.63

    Then there are diseases like whooping cough (known medically as pertussis). It may sound like an old-fashioned disease, but it's very much a modern-day problem. Cases of whooping cough occur across the country every week. In fact, 92% of whooping cough deaths have occurred in infants younger than 4 months of age, who are too young to be fully immunized and the most vulnerable.26

    Very often, a parent, sibling, or another family member is the source of an infant's whooping cough—another reason why it's important for all members of your family to be vaccinated.53

  • Why vaccinate against diseases that other countries have, but the United States doesn't have?

    Because we live in a global society, diseases we thought were gone remain a possibility in the United States. People and goods cross borders every day, and with them come another kind of frequent flyer: infectious disease germs.

    Whether you travel or not, everyone can get exposed to disease. Someone you know could go on an overseas trip and bring a disease back home. Or, someone from outside of the United States could visit your community and bring a disease with them.

    The United States is fortunate to have widely available vaccinations. We have a highly vaccinated population of children, which helps shield them from invading germs.64 But we have to keep vaccinating because pockets of unvaccinated children provide the opening infectious diseases need to take hold, leading to outbreaks.

    That's just what happened in 2008, when 140 confirmed measles cases were reported in the United States—the largest number since 1996.57 Of those, 89% were brought into the United States, or associated with imported cases from other countries—particularly countries in Europe, where there were measles outbreaks. Many of the cases occurred among unvaccinated school-aged children.62

    This measles outbreak is a reminder that deadly diseases may be just 1 unvaccinated traveler away.

Vaccine ingredients & science

  • Does the MMR vaccine cause autism?

    Vaccines do not cause autism.65 This debate started when a study that linked autism to the MMR (Measles Mumps Rubella) vaccine was published. However, an independent panel looked into the study and concluded that it was flawed, so much so that the panel said the author of the study conducted it in a way that was "dishonest, irresponsible, and misleading." The study was then retracted.66

  • Aren't some vaccine ingredients toxic?

    Some vaccine ingredients could be toxic, but at much higher levels. This concerns some parents, but the fact is that any substance—even water—can be toxic given a large enough dose. But at a very low dose, even an otherwise toxic substance can be safe.

    We might not be aware of it, but we are exposed to small amounts of these same substances every day. For example, the average person takes in an estimated 30mg to 50mg of aluminum every day, mainly from foods, drinking water, and medicines. Not all vaccines contain aluminum, but those that do typically contain about 0.125mg to 0.625mg per dose, or roughly 1% of that daily average.9

  • Why are additives put in vaccines?

    Additives in vaccines serve some of the same functions as food additives—they can act as preservatives and help extend shelf life, and are only used in very tiny amounts. Small amounts of additives are also used to kill or inactivate vaccines.67 Here are some additives you may have questions about:

    • Aluminum is used in some vaccines to allow for a better immune response. Infants are constantly exposed to aluminum in a number of ways: it's present in air, water, food, even in breast milk. The amount used in vaccines, though, is a tiny fraction of the amount a baby would receive through breast milk or formula in the first 6 months of life. That small amount is eliminated quickly from a baby's body.68
    • Antibiotics are used to prevent growth of bacteria during production and storage and rarely cause allergic reactions.67,68
    • Thimerosal is a preservative that is no longer in most children's vaccines. It has been used in very small amounts to multidose vials of vaccine (which hold more than one dose) to prevent bacteria from contaminating the vaccine.8

    If you have any concerns about what additives are in a specific vaccine, be sure to talk to your child's health care professional.

  • How do vaccines work?

    Vaccines teach our immune systems how to recognize and fight bacteria and viruses before an infection happens.46 In this way, they work a lot like natural infection.

    When a person is exposed to a disease-causing germ, the immune system mounts a defense, producing substances known as antibodies to fight it. A vaccine creates a similar immune response by giving the body a small sample or part of the germ, so people develop resistance to the harmful bacteria or virus without actually getting the disease.46

    The immune system has a memory, so the next time the immunized person comes in contact with that germ, their immune system recognizes it and the antibodies work to fight it off.46

    Over time, the protection provided from some vaccines may begin to wear off. An additional dose of a vaccine, given as a booster, helps remind the immune system to stay on alert against certain diseases.47

  • How are vaccines made?

    It's only natural to want to know about the ingredients of a vaccine. You check food labels, so why shouldn't you be curious about what goes into a vaccine?

    For starters, vaccines are derived from viruses or bacteria, so people get protection, or immunity, from the disease, without getting the disease.69

    Vaccines are made in different ways:

    • Weak: Live viruses are damaged "weakened" so they cannot cause disease. The weakened viruses used in vaccines that help protect these include mumps, German measles (rubella), and chickenpox (varicella).
    • Dead: Bacteria or viruses are killed or inactivated. The inactivated polio vaccine is made this way.
    • Partial: Vaccines are also made by using only part of the virus or bacteria. The Hepatitis B (Hep B) vaccine is an example.69

    For a helpful animation showing how vaccines are made, click here.

  • Who approves and recommends vaccines?

    After successful testing in thousands of people, a vaccine is approved (licensed) for use in the United States by the US Food and Drug Administration (FDA).70

    Even after licensing, monitoring of a vaccine continues.70 The vaccine is then recommended for use in specific age groups by the CDC's Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP).33

    A lot of thought goes into developing the vaccination schedule. Each year, the schedule is reevaluated based on the most recent scientific data available. This helps make sure that children get the most protection against serious vaccine-preventable diseases.50

  • What's a combination vaccine?

    Combination vaccines contain more than 1 type of vaccine in a single injection. Practically speaking, they help reduce the number of injections your child would need to get, and they may help parents stay on track with the recommended immunization schedule.71

    Most important, combination vaccines are given to protect vulnerable children against infectious diseases during their early months, when they're most at risk.71

    The CDC, which recommends the immunization schedule, generally prefers the use of a combination vaccine over separate injections.71

    Studies have shown that the recommended vaccines are as effective in combination as they are in a single injection, and that they carry no greater risk for serious side effects—which, of course, is a parent's priority.71

  • Some vaccines are expensive. Is there a way to reduce the cost?

    Most insurance companies cover vaccinations. If not, there is a national program called Vaccines for Children (or VFC) that allows qualified families to get free vaccinations for their children at participating doctors' offices. You can learn more about the VFC program at the CDC website. You can also check with your local or state public health department for other options.9