COMING YOUR WAY: VACCINE UPDATE
Charles Grose, MD, Professor and Director of Infectious Disease,
Department of Pediatrics, University of Iowa.
Fall 1996.

Measles vaccine.
In 1996 Iowa saw several cases of measles, so it is important to assure that the children in your practice have had their measles vaccination. Based on its ability to interrupt the annual cycle of measles outbreaks, the measles vaccine is one of the best ever developed. Since it uses a live, attenuated virus, immunized children may have a fever, and even a mild rash, 7 to 10 days after vaccination. Fevers that occur within 5 days following vaccination are probably due to another vaccine given at the same time, or to a concurrent illness.

Poliovaccine.
Heated debate continues about whether to change the immunization recommendations for poliovaccine in the U.S. Some voices call for a complete change to inactivated poliovaccine, to be used with DPT in a 4-valent injectable vaccine. This would avoid the dozen cases of vaccine-related polio that occur each year in the U.S. Conflicting voices express the concern that if other counties follow the lead of the U.S., it may result in less effective protection against polio. This is because administering the inactivated poliovaccine is more complex. It requires several injections, given at more frequent intervals than the live vaccine. Even in the U.S., where we use the easier-to-administer live poliovaccine, we have had difficulty maintaining an adequate level of immunization (>90%) through the first 6 years of childhood.

Hepatitis A vaccine.
Though the hepatitis A vaccine has received little publicity, it is an excellent inactivated virus vaccine. It is recommended for all health care workers who care for children, since the virus can be spread in the fecal material of children, often before the child exhibits symptoms such as jaundice. A few outbreaks occur in Iowa grade schools every year, so the virus is circulating within the state. In addition, families who travel outside the US should be vaccinated.