Vaccines and immunizations: What you need to know | Health Care

In 1796, a British doctor introduced an inoculation against smallpox, ushering in the modern era of vaccinations. Once-ravishing diseases including typhoid, diphtheria, and polio were largely driven off the world stage.

In late summer of 2023, families within our Rochester region are gearing up for two fall rituals: The return to school and the start of the respiratory-virus season. Health officials have warned that this might be a particularly intense winter, with a triple threat from COVID-19, flu, and RSV.

Fortunately, we will have vaccines for all three illnesses — including an updated COVID inoculation and, for the first time, a vaccine for RSV, a disease that spiked last year and shows signs of potentially doing so again.

That makes it especially important to draw attention to National Immunization Awareness Month in August.

In my practice as a family medicine physician, my patients often have questions about vaccine efficacy, safety, and timing. Here’s what I tell them:

Do vaccines work? Viruses are very smart and some of them change rapidly. The goal of getting vaccinated against COVID, influenza, and RSV is not to guarantee you won’t contract the disease; it’s to avoid severe illness. I personally have stayed up to date on my COVID vaccines — yet I’ve had COVID twice. However, I’ve never had to go on a respirator or face multi-organ system failure. Vaccination mitigates the risk of severe outcomes.

Are vaccines safe? Yes, they have been tested thoroughly. Vaccines may have short-lived side effects, such as a sore arm or flu-like/COVID-like symptoms. But the myths about their dangers are untrue. There’s a myth that the mRNA COVID vaccine was rushed out too fast. It wasn’t. That science has existed for decades; it just got emergency-use authorization because we needed it. Some people have had concerns that ASD (Autism Spectrum Disorder) might be linked to certain childhood vaccines, but studies have shown that there is no link between receiving vaccines and developing ASD. The MMR (measles, mumps, rubella) vaccine is recommended at 12-15 months of age, and ASD can begin to show signs as early as 15 months or before. Hence, the important distinction between correlation vs. causation: Just because two things correlate does not necessarily mean that one causes the other. There is overwhelming evidence that vaccines are safe and effective.

When should I get vaccinated? When school doors open back up is when we start seeing the emergence of some of the respiratory viruses. On the whole, it’s a good idea to get the vaccines when they become available and you are eligible.

What’s the latest information on herd immunity? Diseases like smallpox and polio were essentially wiped out through herd immunity. When was the last time you heard of someone using an iron lung? However, I don’t believe we’re ever going to completely wipe out COVID or the flu. Most likely, we’ll continue to roll out targeted vaccine formulations. Even so, herd immunity is still a relevant concept; the more people in a community who are vaccinated, the less opportunity the virus has to spread or mutate.

What vaccines do my family and I need? The Centers for Disease Control and Prevention (CDC) website offers a wealth of information and tools on Vaccines & Immunizations, including self-help tools to determine what vaccines are required or recommended. You can also talk to your primary care provider or pharmacist.

In New York, children must meet vaccination requirements to attend school or day care. There are medical exemptions, but in general, children entering pre-kindergarten must be vaccinated for:

• Diphtheria, Tetanus, and Pertussis (DTaP or Tdap)
• Polio
• Measles, Mumps, and Rubella (MMR)
• Hepatitis B
• Varicella (chickenpox)
• Haemophilus influenzae
• Pneumococcal Conjugate (PCV)

Once students reach the sixth grade or age 11, the Tetanus, Diphtheria, and Pertussis (Tdap) vaccine is required. Seventh-grade students need to have the Meningococcal Conjugate (MenACWY) vaccine, as well. This aligns with the child vaccination schedule created by the CDC, which is followed by all Rochester Regional Health Pediatrics offices.

What are some overlooked vaccines? Sometimes when a new vaccine comes out, the names are confusing and patients aren’t sure whether they need the new version. Here are some I might call to patients’ attention:

• Prevnar 20: This is the newest pneumonia vaccine. The CDC recommends it for patients over age 65 and those who have certain compromising conditions such as asthma or diabetes.
• Shingrix: The CDC recommends this two-dose shingles vaccine for adults 50 and older, even if they’ve already had the earlier Zostavax vaccine.
• HPV: Parents might consider getting their children—boys and girls—vaccinated against the cancer-causing Human Papillomavirus virus as early as age 9.

I never berate my patients who choose not to get vaccines. It’s a personal decision. I just tell patients: I advise vaccines, I get them, my children get them.

Briani K. Jackson MD, is the lead physician at Country Village Family Medicine, Rochester Regional Health.