FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

IMMUNIZATIONS: A 'SHOT' OF PREVENTION WORTH A POUND OF CURE!

I'm going to do something different for this week's column. Instead of responding to a reader's question, I am going to share with you information about immunizations. This is prompted, in part, from a recent memo for physicians licensed in Michigan reminding us to immunize our patients prior to the start of the school year. (Confused? I now live and practice in Ohio, but I still maintain my license in several states, including Michigan.)

First, I want to remind you of the benefits of immunizations for both children and adults. Infectious diseases are a major cause of preventable loss of life throughout the world. Since most of these deaths are in developing countries, they are removed from our daily thoughts. But, on an international scale, the carnage from infectious diseases is huge. For instance, more than a million individuals die each year from tetanus alone. Countless numbers of children die from diphtheria, influenza and other vaccine preventable diseases. The real tragedy is that the vast majority of these deaths could have been prevented by an aggressive worldwide immunization program.

Fortunately, solid immunization policies are already in place in our country. In Ohio in 1998, the most recent year for which statistics are available, 77 percent of children received the recommended immunizations. This has increased over the past few years because of efforts by the Ohio Department of Health, individual physicians and schools. The recent mailing I got from Michigan was part of their plan to increase the number of children there receiving immunizations.

Most states have laws requiring immunization of children before they can attend public school. Obviously, these rules are not always strictly enforced or the immunization rate would be greater. They do work, however. By the time Ohio children enter school, the immunization rate is up to 95 percent. The remaining unimmunized children remain susceptible to these infectious diseases. This not only poses a health risk to the child, but it also makes it possible, if they should get the illness, for them to spread the infection to others who have not be immunized.

The current recommendations for immunizations that have been approved for the United States are as follows: By the time a child is 18 months old, he or she should have had a series of three Hepatitis B shots. The series of four diphtheria, tetanus and pertussis (DTaP) immunizations should be completed by then, too. Polio immunization is a series of three shots, and this is a change as of July 1999 from the previous use of oral polio vaccine. Chickenpox, that is also called varicella, requires one shot as does the measles, mumps and rubella (MMR) immunization.

Between the ages of 4 and 6, when the child enters school, booster shots for DTaP, polio and MMR are needed. Between ages 11-12 booster does of tetanus and diphtheria are needed, and subsequent boosters are needed every 10 years thereafter. Additional shots of MMR and varicella may be needed depending upon when the first series was completed.

So check your children's immunization record before school starts. Now is the time to get their shots up to date. And while you're at it, check you own. Have you had a tetanus and diphtheria booster in the last 10 years? And don't forget to get your annual influenza shot in the fall and a pneumonia immunization if you are over 64 or have respiratory problems. The old adage is certainly true. An ounce -- or, in this case, shot -- of prevention is better than a pound of cure.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701. Past columns are available online at http://www.FamilyMedicineNews.org.