Immunizations
If there is anything that I do as a clinician that has been shown study after study, decade after decade that has the most say in how I am doing in preventing disease and death (morbidity and mortality) in my patients, it is my ability to give kids immunizations. Hands down, not even close. I technically will be doing my part for public health in the pediatric sector if that is all I do all day every day. The stethoscope might as well be made of Red Vines and play the polka when I listen to hearts when compared to my ability to prevent disease and death with the immunizations we give kids.
Because these immunizations are so good at what they do, they are a bit of a victim of their own success. Polio, diphtheria, (and until recently) measles, mumps, and rubella have become so far back in the public consciousness of active dangerous diseases that there has been less urgency felt by each generation of parents to fully vaccinate kids. But let me again just assure families that vaccines/immunizations/shots are literally (not figuratively) the most studied, monitored, and rigorously developed medical treatments ever produced for medicine in the entire history of medicine. If you are comfortable with your pediatrician recommending, and you giving, an antibiotic or antiviral or surgery to help your child, then you should be 1000 times more enthusiastic about the science and validity of giving people vaccines to prevent disease. Because that is how much more evidence we have for the safety and efficacy of these medicines than anything else in not just pediatrics, but in all of medicine. Even after we give the vaccines, the vaccine reporting database is the most comprehensive and in-depth monitoring tool in all of medicine around the world, looking for even the slightest possible side effects or ineffectiveness of these vaccines.
This is a big reason why all kiddos in my practice are required to be fully vaccinated. My reasoning for this is two-fold. First, I see my job as a pediatrician to not only care for each individual child but also to provide for all the kids in my community. Vaccines let me do that. For every chicken pox vaccine I give, that is one less kiddo who can pass chickenpox onto another patient of mine undergoing chemotherapy who would die if exposed to chicken pox due to their lacking immune system. Every pertussis (whooping cough) vaccine is one less kiddo who can pass on whooping cough to a baby who would need ICU care for such a violent cough. If I am not looking out for all those I care for both directly or indirectly, then what am I doing here, ya know?
The second big point is that as your child’s pediatrician, the main reason I feel parents come to me is to get my opinion and take on their child’s medical concerns. An honest and educated take on their concerns with my years of experience with thousands of patients and my ability to sift through the mountains of data and studies to come up with what I think is the best treatment option for their child. If I have a family who refuses the vaccines that I recommend (as well as the CDC, AAP, FDA, WHO, etc.), vaccines that again are the most studied and verified medical treatment ever, then what reason does that family have to believe or trust any other medical guidance I provide that is based on way less evidence? Every family should be able to trust what their pediatrician says. There is a pediatrician out there for every family, and not all families will be a perfect fit with our clinic for many reasons, including when it comes to vaccines.
Okay, now after all that…
With any medical treatment or medicine, there is the possibility of side effects, even with Tylenol or putting an ice pack on something, there are always possible side effects. Luckily for us with so many studies and such good monitoring, we know what we are looking for and how to help.
The mild side effects that we can expect are pain, inflammation, and fever. The pain is understandable when we inject a medicine with a needle, it doesn’t feel great, especially if you are a little kiddo and are tensing up or fighting with us while giving the vaccine, the soreness will usually be a bit worse, but nothing that a few leg or arm massages throughout the day and possibly Tylenol/acetaminophen can’t help to get over the soreness.
The other side effects have more to do with the body’s natural process of developing an immune response so the child (or adult) getting a vaccine has those antibodies and that immune system memory to prevent and fight these diseases. Inflammation around the injection site can cause a few hours to a few days of soreness, redness, or sometimes a bump under the skin. Tincture of time will make these signs of inflammation dissipate but Tylenol/acetaminophen or Advil/Motrin/ibuprofen can definitely take some of the inflammation markers away. However if a kiddo gets a robust immune response from a close-by lymph node, that lymph node can remain slightly larger than it was before the vaccination as it is ready to help protect the body. The same goes with fever: the body is letting us know it is working to make a good immune response. The fevers usually occur in the first 48 hours after the shot, and most of the time don’t need more than just a few extra cuddles for little kiddo, but Tylenol/acetaminophen if needed will help to lower the temperature and make the kiddo more comfy. No problem.
As far as worse possible side effects, first off, they are extremely rare. Second of all, if you were to take a second and look at the full warning labels for Tylenol or ibuprofen, it would read like a horror story, but again, all these are exceedingly rare. There is a standard set of questions asked before giving vaccines to basically eliminate this super duper rare risk for serious side effects as well.