Who Should and Should Not Receive the Vaccine

Who should receive the vaccine?

• Due to the high risk of disease in children, all children younger than five years should receive the Hib vaccine, beginning at two months of age.
• Children over five years usually do not need Hib vaccine. Older children or adults with specific health conditions such as sickle cell disease, HIV/AIDS, removal of spleen, bone marrow transplant, or cancer treatment with immune-suppressant drugs need to be protected from Hib by the vaccine.

Unimmunized children are at increased risk of developing Hib when they are:

• Daycare attendees
• Household contacts of someone with Hib
• Those with a low socioeconomic status
• African-American
• Native American
• Immunocompromised because of sickle-cell disease, leukemia, human immunodeficiency virus (HIV) infection, or the absence of the spleen

Who should not receive the vaccine?

• Children younger than six weeks old
• People who have had a life-threatening allergic reaction (anaphylaxis) to a previous dose of Hib vaccine should not receive additional doses.
• People who are moderately or severely ill should consult with their physician before receiving any vaccine.

Rubella

Rubella is caused by a virus that is transmitted from person to person in mucus droplets coughed or sneezed into the environment. Rubella usually is a mild illness. Symptoms include low-grade fever and swollen lymph nodes in the back of the neck followed by a generalized rash. Complications may include joint pain, a temporary decrease in platelets, and encephalitis (inflammation of the brain). Temporary arthritis may also occur, particularly in adolescents and adult women.

Rubella in expectant women often leads to congenital rubella syndrome (CRS) in their fetuses. This is a devastating disease characterized by deafness, mental retardation, cataracts and other eye defects, heart defects, and diseases of the liver and spleen that may result in a low platelet count with bleeding under the skin. The incidence and severity of congenital defects are greater if infection occurs during the first month of gestation. Up to 85% of expectant mothers infected in the first trimester will have a miscarriage or a baby with CRS.

The World Health Organization estimated that, in 1999, 110,000 infants were born with CRS worldwide. Although most CRS occurs in developing countries, it also continues to occur in the U.S., mostly among unimmunized Hispanics.

Before a vaccine was available, there was a rubella outbreak in the U.S. (1963 to 1964), during which 12 million people developed the disease. Because many of those infected were expectant mothers, 11,000 fetuses died and 20,000 babies were born with permanent disabilities as a result of exposure to the virus. The number of cases of rubella fell very sharply once the rubella vaccine was licensed in 1969; today there are fewer than 1,000 cases of rubella reported each year in the U.S. on average and less than 10 cases of congenital rubella syndrome.

Because of intense misinformation about MMR in the United Kingdom, MMR vaccine coverage has declined across Europe, resulting in outbreaks of measles and mumps in multiple countries, including the United States and Canada, and congenital rubella in the Netherlands and Canada. There were 42 cases of rubella among pregnant women with two fetal deaths and 12 affected infants. Ironically, one of the few known causes of autism was the congenital rubella syndrome, autism having occurred in 20% of rubella-affected babies prior to the licensure of rubella vaccine. MMR vaccine, therefore, protects against autism by preventing congenital rubella syndrome.

Date: 2016-06-12; view: 6