AskDrSears - The Vaccine Book: August 2008

Two New Combination Vaccines Now Available

Friday, August 22, 2008

With 12 separate vaccines on the childhood schedule, and as many as 6 separate injections at any one visit, parents and doctors love to be able to combine vaccines into fewer injections. There are several combination vaccines that do just that. These include:

Chickenpox and MMR – combined as ProQuad (Merck).
DTaP, Hep B, and Polio – combined as Pediarix (GlaxoSmithKline).
HIB and Hep B – combined as Comvax (Merck).
DTaP and HIB – combined as TriHibit (Sanofi-Pasteur). This can only be combined for the 18 month dose. It isn’t combined for the first three doses.
Hep A and Hep B – combined as Twinrix (GlaxoSmithKline). This is only for adults 18 and older.

Using some of these combinations instead of the separate shots certainly cuts down on the pain. There are now two new combinations available for doctors and parents to choose from:

DTaP, HIB, Polio – combined as Pentacel.
DTaP, Polio – combined as Kinrix.

Here is what you need to know about these two new products:

Pentacel (made by Sanofi-Pasteur). This is a fairly useful option for infants to get at 2 months, 4 months, 6 months and/or 18 months of age. It turns three injections into just one at each of these visits. You would only use this combo for 3 out of 4 of these vaccine rounds, because a baby should only get 3 polio shots during infancy. The total chemicals and ingredients in this combined shot are similar to what would be given in the three separate injections, except that the amount of pertussis germs (from the DTaP part of the shot) is greater in Pentacel than in the corresponding DTaP made by Sanofi, called Daptacel. Infants who have begun their vaccines using separate injections can change to this combined form at any time, with their doctor’s guidance. You can read full details on this vaccine in The Vaccine Book (even though this shot just came out, I knew about it ahead of time and was able to include full details on it in the book).

Dr. Bob comments: This looks like a good idea. However, those patients following my Alternative Vaccine will notice that getting this vaccine gives the Polio component months earlier than my suggested schedule. I think this is fine for any patients who believe the decrease in injections is worth it.

Kinrix (made by Glaxo). This combination is only approved for use at the 5 year booster dose of DTaP and Polio. Instead of getting these two shots separately at that age, you can now get them combined together in one shot. Here’s the catch though: You have to have gotten a Glaxo brand of the DTaP vaccine as your infant rounds of DTaP (either the Glaxo brand Infanrix or Pediarix).

Dr. Bob comments: I’m not a fan of the Glaxo DTaPs due to their high aluminum content. So this isn’t a combo vax that I’ll be using.

Labels: Vaccine News

New Flu Vaccine Recommendations for Older Children

Monday, August 11, 2008

The American Academy of Pediatric announced a new policy for the flu vaccine. They will now recommend a flu shot for every child age 6 months through 18 years of age at the start of flu season each year. For the past few years the flu vaccine had only been recommended for all kids 6 months to 5 years. Prior to that, the flu vaccine was only used for select children with certain chronic medical conditions that would make the flu more dangerous to them.

The new policy is hoped to go into effect for this coming flu season (2008/2009), but officials aren’t sure if supplies of the flu vaccine will be adequate. It will definitely be in effect for the 2009/2010 flu season. Parents who have been giving their young children a flu shot every year will probably just continue this practice throughout childhood without putting much thought into it. However, parents with older children who aren’t used to this routine will now be faced with deciding whether or not to get the shot each year.

The flu shot has always been controversial because the disease has a very low fatality or complication rate for healthy children and young adults and the shot has a high rate of flu-like side effects. People wonder if they even need it. Each year there are about 100 fatalities in infants, children, and teens combined, and a few thousand fatalities in the elderly. So getting the flu shot certainly can help minimize these tragic deaths. The problem is, the flu shot doesn’t always work. Each year officials have to predict which strains to put into the vaccine for the next year. If they guess wrong and different flu strains circulate (as in 2007/2008), the flu shot doesn’t help much.

There’s really no right or wrong answer, in my opinion. You either get the shot or you don’t. The most critical part of this decision is to make sure you are getting a mercury-free version. As flu season approaches, I will post an update on how to tell which flu shots don’t contain mercury for this coming year.

Labels: Vaccines and their diseases