Vaccines for Children: List By Age, Benefits, Safety
Vaccines: Saving Lives And Money For Over 200 Years
A brief but important bit of good news today. Stop me if you've heard this before on Science-Based Medicine, but vaccines have saved many lives since the very late 18th century when Edward Jenner first published his work on the prevention of smallpox through inoculation with the cowpox (vaccinia) virus. Most of these saved lives have been young children dependent on the choices made by the families and the governments that they just happened to have been born into.
One of the most important of the choices made here in the United States has been the Vaccines for Children (VFC) program. Established in 1994 through an Act of (a more functional) Congress, the VFC program had its origins during the aftermath of several large measles outbreaks occurring from 1989 through 1991 across the country. These outbreaks primarily involved children, particularly unvaccinated infants and toddlers from racial/ethnic minority groups living in so-called "inner city" areas. Thousands were infected and several young children died.
The VFC program was established so that all recommended vaccinations would be made available without cost to eligible children. This includes kids 18 years and younger that are eligible for Medicaid, uninsured, or whose insurance does not include coverage of the recommended vaccines. Also included are children from the high risk American Indian and Alaskan Native populations. The VFC program is made up of more than 60 state, local and territorial programs funded by the CDC.
So has the VFC program been successful over the past 30 years? Yes, it has. And spectacularly so. For just one example touted by the CDC in a recently published report, close to 90% of eligible children from 2011 through 2020 received the MMR vaccine regardless of race, ethnicity, SES, or locale. These are kids that would have been at significant risk of slipping through the cracks otherwise, and could have kicked off an outbreak or helped spread measles during one of the several outbreaks that have occurred recently.
The research team behind the CDC report mentioned above set out to "assess and quantify the health benefits and economic impact of routine U.S. Childhood immunizations among both VFC-eligible and non-VFC-eligible children born during 1994-2023." They found that among the approximately 117 million children born during this period, vaccinations prevented more than half a billion lifetime cases of illness, 32 million hospital admissions, and about 1.1 million deaths. They estimated a net savings of $540 billion in direct costs and $2.7 trillion in societal costs. That's a lot of costs!
It's clear, in my opinion, that vaccines save lives and are extremely cost effective as public health interventions. It is a bit complicated, however, to gauge exactly how much the VFC program specifically has contributed to the overall societal benefit of vaccines. Many children move in and out of eligibility and may have received some of the immunizations without requiring help from the program, for example. And the number of vaccines purchased by the program changes from year to year and from vaccine to vaccine. But to give some important perspective, the program handed out more than 70 million vaccines in 2023 alone. The recipients of these vaccines were all less likely to have had access to them otherwise because of financial hardships, which makes it is hard to argue that the impact could be anything but significant.
And this report didn't even include influenza, COVID-19, and RSV immunizations in the analysis, meaning that it could have underestimated the health and economic benefits of childhood vaccines overall. To be fair, it might also be an overestimate. It is challenging to take hygiene and precautions such as physical distancing into account for some illnesses, meaning that vaccines might not have prevented as many cases as assumed, but the authors conclude that routine childhood shots are cost-saving even with a "worst-case scenario assumption".
What about global immunization efforts? In April, the WHO put out a study which held up immunizations to be the most important contribution of any health intervention when it comes to making sure that babies reach adulthood. They found that the measles vaccine has been the most important of the past 50 years, giving it credit for 60% of all lives saved due to immunization. Overall, worldwide vaccinations have saved more than 150 million lives and added 10.2 billion full health years over the past 5 decades.
As great as this all sounds, it isn't good enough. There are still millions of children at risk around the world, a decent number of which are here in the United States. Efforts like the VFC program obviously need to be expanded, but we also need to develop more effective ways to reach the vaccine hesitant caregivers out there as well. Misinformation and disinformation is rampant these days, and it goes all the way to the top of many local and state governments. And we are currently facing the potential, again, for it to come from the White House. If only there was something that people who care about the health of children, and adults too for that matter, could do…in November perhaps.
Is It Too Early For A Flu Shot? Do You Really Need A COVID Booster? What Floridians Need To Know About Fall Vaccines
The signs already are up at Florida pharmacies: Get your flu shot.
But should you?
What about the new COVID booster approved by the Food & Drug Administration last week? Is it worth getting?
At the CVS at 2300 N. Flamingo Road in Pembroke Pines, pharmacy manager Linda Molaka is already fielding these questions as the fall respiratory illness season approaches. Federal health authorities said they expect a similar or slightly better respiratory virus season this fall, if enough Americans get vaccinated.
Molaka has the new 2024 updated Moderna shots in stock, along with doses of the flu vaccine manufactured to match this season's strains. Respiratory virus season typically begins in October but peaks between December and February. So, timing vaccinations could help you keep your immunity levels highest when you need it the most. If you get it too early, you run the risk of reduced protection against flu infection later in the flu season, particularly among older adults.
"The flu shot takes two weeks to build immunity, so late September or early October would probably be best," Molaka said.
By now, most people recognize that a vaccine — whether for flu, COVID, or RSV — won't fully ensure you don't get a virus. "It's just a matter of trying to protect ourselves, so if we do get something, our symptoms are not as serious," Molaka said.
On Aug. 19, the federal government launched a national campaign, Risk Less. Do More. It is aimed at increasing awareness of vaccines that reduce serious illness. Health officials estimate that during the six months of last fall and winter, respiratory infections caused 800,000 hospitalizations. "Vaccines for COVID-19, flu, and RSV have helped to save millions of lives, keep countless people out of the hospital, and provided peace of mind for the country," said Health & Human Services Secretary Xavier Becerra. As fall approaches and people spend more time indoors, I encourage everyone to protect themselves and their loved ones by getting vaccinated."
Linda Molaka, the pharmacy manager at the CVS at 2300 N. Flamingo Road in Pembroke Pines, says the pharmacy just received the new Moderna COVID vaccine for 2024. The pharmacy also has the current flu vaccine in stock. (Mike Stocker/South Florida Sun Sentinel) The flu shot This year's flu vaccine contains two influenza A strains (H1N1 and H3N2) and one influenza B strain. "With rare exceptions," the flu shot is recommended for everyone 6 months and older. Florida pharmacies including CVS, Publix, Walgreens and Walmart began giving the vaccine for influenza to customers in August, either as a shot or by nasal spray. They advertise: "No cost to you with insurance." (That includes Medicare.) The cost of a flu shot without insurance will depend on where you go, but it typically ranges from about $25 to $90
Despite what some people believe, a flu vaccine cannot cause flu illness. The shot is made with inactive viruses, and the nasal spray is made with attenuated (weakened) live flu viruses and also cannot cause flu illness. But you can get side effects, including headache, muscle aches and soreness where the shot was given. You might also get a runny nose from the nasal spray.
The Centers for Disease Control & Prevention recommends that all people 6 months and older get a yearly flu vaccine. Although getting sick with flu is possible even if you have been vaccinated, a flu shot can help reduce the severity of illness in people who do get sick.
Scientists are hopeful this year's flu shot will help keep people healthy. So far, it has been a good match to the flu strains in Australia, which tends to predict how the season will play out in the United States.
Manufacturers discussed a combined flu and COVID shot last year. James Mansi, vice president of Medical Affairs with Moderna, says the company is still working on a combined vaccine, but it won't be ready this season.
Federal health officials say getting the flu and COVID vaccines on the same day is okay.
Molaka says she has been giving both, usually in the same arm. "It seems convenient. Your arm will probably be sore for either of them, so this is one and done."
CVS is vaccinating ages 3 and up for COVID and flu.
Some pharmacies are offering incentives: Patients who receive any CDC-recommended vaccine at a CVS pharmacy, for example, will receive a $5 off $20 coupon to use on in-store purchases, and ExtraCare members will also receive $2 rewards for each vaccine received.
The updated COVID vaccineThe CDC has reported high levels of COVID in wastewater in many counties in Florida. But COVID has become so normalized that people are "so over" getting vaccinated. Even more, the summer wave revealed higher levels of COVID-19 did not necessarily translate into similar increases in emergency visits and hospitalizations or deaths.
During an Aug. 23 media briefing, CDC Director Dr. Mandy Cohen said COVID continues to be a more dangerous virus than flu, and the largest numbers of hospitalizations and deaths from COVID happen in the winter months. He noted that it's not just seniors at risk for severe disease. "We saw a wave this summer of COVID infections, and when we look at who went to the emergency room for COVID, we actually saw that it was highest for those under the age of 5. … we definitely know that this impacts those over 65 who have the highest risk, but we can't forget that at every age group there are risks, including our young children,"
Anyone who wants a COVID shot now has choices.
The Moderna and Pfizer shots use the mRNA platform and have been updated to target the KP..2 strain, one of the FLiRT variants that have been spreading since early spring.
However, COVID mutates quickly, and new strains have already emerged. According to the CDC's Nowcast, KP.3.1.1 became the dominant strain in August, accounting for 36.8% of cases. That mutation has surpassed KP.3 (which overtook KP.2 earlier this summer).
"The good news is that all the emerging K3 variants are likely to be neutralized or covered by our updated COVID-19 vaccine, " said Mansi with Moderna. "What we've developed should be a good, close match to those subvariants and should provide that protection going into the fall-winter months ahead."
Mansi said the risk of long COVID rises with each infection, regardless of severity. "Studies have shown that staying up to date with one's COVID vaccine reduces the risk of Long COVID by 70%," he said.
A third COVD vaccine is available and gained FDA approval on Friday for people 12 or older. Novavax is different than the other two COVID vaccines in that it is built on a well-established protein-based platform rather than using mRNA technology. The updated formula for Novavax targets JN.1, the "parent strain" of the currently circulating variant.
Anyone who had the virus this summer can still get an updated shot, but they need to wait four to six months, experts say.
Timing a COVID vaccine for optimal protection against a winter wave could be tricky. Experts say the vaccine provides strong protection against infection for up to three months and protection against severe disease for up to six months.
CVS pharmacies, as well as other outlets, have the flu vaccine available. (Mike Stocker/South Florida Sun Sentinel) RSV While not as well known as the flu or COVID, Respiratory Syncytial Virus is a respiratory virus that can infect the lungs, nose, and throat and be serious for infants and older adults.
"In Florida, RSV doesn't have a peak season. There's potential to get it year-round," said Molaka at CVS.
Recently, the CDC has simplified its recommendations for who should get the RSV vaccine. The agency recommends that some infants and Americans older than 75 be vaccinated. The vaccine is also recommended for people ages 60 and older who have a weakened immune system, chronic lung and heart conditions, or who live in a nursing home.
Cohen at the CDC notes that RSV vaccines are not recommended annually like the flu vaccine, and one shot should cover you for at least two winter seasons.
This year, people can choose from three brands of RSV vaccines: GSK, Pfizer, and Moderna. Each differs slightly in possible reactions and effectiveness.
The shingles shotMolaka said pharmacists typically recommend the shingles shot to patients 50 or older who come in for a flu or COVID-19 vaccine. Shingles is a painful viral disease that causes a rash of blisters on the skin. People get shingles when the virus that causes chickenpox reactivates in their bodies.
The shingles vaccine is given as a two-dose series, with the second dose given 2 to 6 months after the first. People who get the vaccine often get flu-like symptoms and fatigue in the following days.
"That's because the body is building immunity," Molaka said.
She says any short-term side effects are worth the protection. "Shingles is such a painful, painful condition."
New research offers another reason to get a shot: Two large studies found shingles vaccines may reduce dementia risk.
Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.Com.
Originally Published: August 30, 2024 at 10:37 a.M.
To Stop Mpox From Becoming The Next Pandemic, We Must Address Global Vaccine Inequities
Aug. 27, 2024
Matias is an infectious diseases doctor at Harvard Medical School.
In early 2022, I cared for one of the first patients with mpox in Massachusetts. As an infectious diseases physician, I remember the deep uncertainty I felt, and the fear in my patient's eyes as a painful rash spread over their body. We were in uncharted territory — there were no proven treatments, and the number of cases was rapidly increasing. We decided to use tecovirimat (TPOXX), an antiviral developed for smallpox, to slow the disease's progression. When patients began to recover, it felt like a breakthrough — a moment of hope in the midst of yet another epidemic.
Fast-forward to today, and we face a new challenge. Recently, the World Health Organization declared a public health emergency of international concern due to a rapidly expanding mpox outbreak in Central Africa. Soon after, cases were confirmed in Sweden and Thailand, signaling potential international spread.
Today, we have mpox vaccines that will be vital to combating the outbreak. Yet these vaccines sit on shelves in wealthy nations far from where they're most urgently needed.
Having cared for early cases during the 2022 outbreak, I've seen firsthand the devastation this disease can cause. To prevent this outbreak from becoming a pandemic, wealthy nations, led by the U.S., must take urgent action to address global mpox vaccine inequities.
With more than 17,000 cases and 500 deaths in 13 countries, concerns about global spread and more severe outcomes are growing. The current outbreak is driven by two lineages of mpox: Clade Ia, predominantly affecting children, and Clade Ib, a new lineage rapidly spreading through adult sexual networks. These new lineages appear more virulent and are affecting broader population groups than the Clade II lineage that caused the 2022–2023 global epidemic. Preliminary evidence suggests that TPOXX, while beneficial for some patients, may not be as effective against Clade 1 mpox as hoped, underscoring the continued importance of prevention through vaccination.
WHO launches plan to stanch mpox transmission and says the virus can be stoppedDuring the Clade II epidemic, wealthy nations effectively used the MVA-BN vaccine, produced by Bavarian Nordic. Now the WHO has urged increased production and requested donations from countries with stockpiles, but progress has been slow. The U.S. Recently pledged 50,000 vaccines — a fraction of the 7 million it aimed to stockpile by mid-2023. The European Commission and Bavarian Nordic pledged over 215,000 doses. These donations fall far short of the 10 million doses Africa CDC estimates are necessary.
Production scale-up has also been disappointing. Bavarian Nordic informed Africa CDC it could supply up to 2 million doses in 2024 and manufacture up to 10 million doses by the end of 2025 if there are firm purchase requests. These efforts are limited by the vaccine's prohibitive price: approximately $200 per course. That steep cost is why mpox vaccines never reached Africa after the 2022 outbreak, and it remains unclear how vaccine procurement will be funded now.
But producing and procuring vaccines is only the first step. Funds are needed to deploy them in the challenging settings where mpox is spreading. Jean Kaseya, director-general of Africa CDC, estimates an effective continent-wide response will require $4 billion. The U.S. Has announced just $55 million in emergency health assistance for mpox response in the region.
To prevent this outbreak from becoming a pandemic and to foster global health equity, the United States must lead in addressing this crisis.
Here's how: The U.S. Should commit to sharing at least 50% of its mpox vaccine stockpile with affected African nations within six months. This should be straightforward, as the U.S. Recently confirmed a $156.8 million contract with Bavarian Nordic, ensuring our stockpiles are replenished as we share. Additionally, the federal government should allocate $200 million in the next federal budget to expedite vaccine procurement and delivery as well as mpox response initiatives in endemic regions. This supports the preparedness and response plan the World Health Organization unveiled Monday, which requests $135 million for a global response including efforts to advance equitable access to vaccines and diagnostics over the upcoming six months. The U.S. Must also work closely with the WHO, governments, and pharmaceutical companies to expedite further donations, secure funding commitments, overcome regulatory hurdles, and facilitate vaccine production transfer to affected regions.
The gap between what's needed and what's available highlights persistent global vaccine inequities, showing how little we've learned from the Covid-19 pandemic. Without adequate resources, the mpox response will remain inadequate, posing a continued threat beyond Africa. The interconnected nature of global health means neglecting health equity anywhere threatens health security everywhere.
Graphic mpox images to educate the public are deeply problematicVaccines are just one component of a comprehensive package including diagnostics, therapeutics, and effective deployment systems necessary to fight the outbreak. Others might contend that addressing the vaccine shortage takes time. However, initiatives like Operation Warp Speed during Covid-19 show we can meet vaccine needs swiftly if prioritized.
Enhancing global vaccine equity is not just a moral imperative but a strategic investment in our long-term health security. I'll never forget the hope we all felt once Covid vaccines were distributed in the U.S. And case numbers began to fall. That same hope can be realized globally if we act decisively now. It's time to bring mpox vaccines to the people of Africa, who have for decades been at risk of this disease. Doing so would slow this outbreak, save lives, and benefit the people of the world. The choice is clear: Act now on vaccine equity or risk the consequences of a global mpox pandemic.
Wilfredo R. Matias, M.D., MPH, is an infectious diseases doctor at Harvard Medical School, a Paul and Daisy Soros fellow, and a public voices fellow of the OpEd Project. His work focuses on responding to epidemic infectious diseases and advancing global health equity.
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