Vaccines For Special Groups Of Children

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Vaccines For Special Groups Of Children

In addition to the above-mentioned routine vaccines, there are three vaccines recommended for children in certain situations:

Hepatitis A

The hepatitis A virus is a common cause of inflammation of the liver (hepatitis). This illness may be associated with fever, yellowing of the skin and eyes (jaundice), loss of appetite, nausea, vomiting, and tiredness (malaise). Symptoms usually last two to four weeks, but in a minority of cases can last several months or longer. The virus is shed in the stool of an infected person and transmitted by personal contact or exposure to contaminated food and water.

In many parts of the world, hepatitis A is so common that almost every adult has been infected at some point in his or her life. In the United States, there are certain areas of the country with higher than average rates of hepatitis A disease.

A vaccine to protect against hepatitis A infection was licensed in 1995 for individuals 2 years of age and older. The hepatitis A vaccine currently is recommended for:

• Children living in areas with consistently higher rates of hepatitis A. This includes 11 states where the prevalence of hepatitis A is greater than twice the national average: Alaska, Arizona, California, Idaho, Nevada, New Mexico, Oklahoma, Oregon, South Dakota, Utah and Washington. (Routine vaccination also can be considered in six states where the prevalence of hepatitis A is less than twice but greater than the national average: Arkansas, Colorado, Texas, Missouri, Montana and Wyoming.)

• Children traveling to countries where the disease is highly prevalent. This includes all countries other than Canada, Japan, Australia, New Zealand, Scandinavia and those in Western Europe.

• Children with chronic liver disease or blood-clotting disorders.

Influenza

Influenza (the flu) is a virus that causes serious disease in lots of people, particularly in the winter, and results in many doctor visits, hospitalizations and even deaths.

The flu shot protects against influenza and can be given to children as young as 6 months of age. It is recommended specifically each year for children who have certain diseases that put them at higher risk of serious complications from the flu. These include children with significant heart disease (for example, acquired or congenital heart disease), lung disease (for example, asthma or cystic fibrosis), diabetes, sickle cell disease, kidney disease, muscular dystrophy or HIV infection.

This vaccine is also available for any other child or adult who wishes to be protected against the flu. Children younger than 9 years of age who have never had a flu shot before need two doses of the vaccine at least one month apart to improve their likelihood of developing protection during the flu season. Everyone who should or wants to be vaccinated against the flu must receive the flu vaccine every year, because the viral strains from last year's vaccine will not fully protect against the viral strains expected to be around the United States this year.

Meningococcus

Neisseria meningitidis (meningococcus) is a bacterium that can cause serious infections in the coverings of the brain and spinal column (spinal meningitis) or in the blood (bacteremia, also called sepsis or meningococcemia). Many children die of or are permanently disabled by these infections.

Many colleges are now recommending the meningococcal vaccine to their incoming freshmen. Between 1991 and 1998, the highest rates of meningococcal disease were in infants younger than 1 year of age and in people aged 18 to 23 years. There have been several outbreaks on college campuses, with cases clustered among those students, particularly freshmen, living in a dormitory.

The current meningococcal vaccine is approved for use in children 2 years of age and older. A single dose protects against the four types of meningococcal infections (A, C, Y and W-135) responsible for many of the cases of meningococcal disease in the United States.

The American College Health Association, American Academy of Pediatrics and CDC recommend that health-care providers counsel college freshmen who live in dormitories about meningococcal disease and the benefits of this vaccine. The American Academy of Pediatrics and CDC also recommend that this vaccine be given to children older than 2 years of age who are at high risk of meningococcal disease, including those children who have problems with their spleens or with special proteins involved in fighting the meningococcal bacteria. Unfortunately, we currently do not have an effective meningococcal vaccine that works in children younger than the age of 2 years.

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Last updated:	February 14, 2002