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Immunization Program
"Plain Talk About Childhood Immunizations"

Compare the Risks:  Disease vs. Immunization

Risk of Disease and
Serious Complications
Risk of Serious Reaction
From Being Immunized
Haemophilus influenzae type b
Hib Vaccine:
Hib disease
Before vaccine Hib was the leading cause of bacterial meningitis (1 in 200) among children under 5 years of age in the United States. 20,000 children in the US under age 5 got severe Hib disease each year and nearly 1,000 people died.

60% of cases occur in children younger than one year

Neurologic damage: up to 45 in 100 children with invasive Hib disease

Death: 1 in 20 children with invasive Hib disease

No known association between Hib vaccine and serious adverse events.

Weigh the Risks between Disease and Immunization

Inactivated Polio Vaccine:
38,000 cases per year prior to vaccine, including 21,000 cases with paralysis. 58,000 cases in 1952. During 1970s, several outbreaks in the U.S. in non-immunized populations, none in United States since 1979.
Permanent paralysis: 1 in 100

Death: 1 in 20 children and 1 in 4 adults with paralytic polio.

No known association between IPV and serious adverse events.
MMR Vaccine:
Prior to the introduction of vaccine, 400,000 reported cases per year. In 1989-91 epidemic: 55,622 cases due to large number of unimmunized children, 45% less than 5 years old; 20% hospitalized, 123 deaths. Thrombocytopenia (bleeding tendency from temporary decrease in blood platelets): about 1 in 30,000
MMR Vaccine
Measles Component:
Severe allergic reaction: less than 1 in 1,000,000.
MMR Vaccine
Mumps Component:
Cases: 200,000 per year before vaccine became available, currently 3,000-5,000 per year
Encephalitis: 2 in 100,000

Testicular swelling: 1 in 5 adults

Deafness: 1 in 20,000

Death: 1 in 3,000 to 1 in 10,000

Severe allergic reaction: less than 1 in 1,000,000
MMR Vaccine
Rubella Component:
12.5 million cases in 1964-65, including 2,100 infant deaths, 11,250 fetal deaths, and 20,000 newborns born with congenital rubella syndrome (see below).
Arthritis (usually temporary): 7 in 10 adult women.

Thrombocytopenia:: 1 in 3,000

Congenital Rubella Syndrome: (deafness, cataracts, mental retardation) in 1 in 4 infants if women infected in early pregnancy.

Death: 1 in 3,000 to 1 in 10,000

Arthritis (usually temporary): Up to 1 in 4, usually teenage or adult women (not children).

Severe allergic reaction: less than 1 in 1,000,000

DTaP Vaccine
Diphtheria Component:
15,000 deaths in U.S. each year. Outbreak in Washington State during 1970s; 40 cases in U.S. 1980-93. With decreased immunizations, over 50,000 cases in the former Soviet Union and Eastern Europe in 1995.

Death: 1 in 10

No known association between diphtheria vaccine and serious adverse events.
DTaP Vaccine
Tetanus Component:
Prior to vaccine, 600 cases and 180 deaths per year in U.S. 50-100 cases per year in the United States: more than 500,000 deaths per year worldwide.

Death: 1 in 3

Severe neuritis (inflammation of the nerves): 1 in 100,000

Severe allergic reaction: 1 in 1 million
DTaP Vaccine
Pertussis Component:
(Whooping Cough): Prior to vaccine, 200,000 cases and 8,000 deaths per year in U.S. Over 400 confirmed cases in King County, WA in 1999. 69% of all U.S cases less than 5 years old, and almost half of these were younger than 12 months old.

Pneumonia: 1 in 8

Convulsions/seizures: 1 in 100
Death: 1 in 500

Fever greater than 105º F: 1 in 16,000 doses

Prolonged crying for 3 hours or more: 1 in 1,000 doses
Seizure or convulsions: 1 in 14,000 doses
NOTE: The Institute of Medicine concluded that there is no evidence that pertussis vaccine causes SIDS (Sudden Infant Death Syndrome)
Hepatitis B:
Hepatitis B Vaccine:
An estimated 200,000 - 300,000 people infected each year in the U.S.

Nine of 10 infants infected at birth will become lifelong carriers of the disease, and one out of four of these infants will ultimately die of liver failure.

Hospitalizations per year: 11,000

Deaths per year: 4,000 - 5,000

Severe allergic reaction: 2 in 100,000 doses.
Varicella Vaccine:
Prior to vaccine, 3 -4 million cases per year in United States; 12,000 hospitalized with complications.

Nine out of ten people in a household who have not had chickenpox already will catch the virus if exposed to an infected household member.

Disease is more severe and complications more frequent in adolescents and adults, and in those with weakened immune systems.


Bacterial infection of skin lesions and scarring

Brain inflammation
Reactivation of varicella virus as Herpes Zoster (shingles) in later life
Hospitalizations: 3 in 1,000 cases
Deaths: 100 per year in the U.S., mostly in healthy children and adults.
Seizure caused by fever: less than 1 in 1,000 people vaccinated.

Pneumonia is very rare.

Hepatitis A:
Hepatitis A Vaccine:

125,000-200,000 cases in U.S. each year.

10-15% of cases have prolonged or recurring disease lasting up to 6 months.
Deaths: 70-100 per year in U.S.
No known association between hepatitis A vaccine and serious adverse events.
Pneumococcal Disease:
7-valent conjugate vaccine:
Streptococcus pneumoniae is the leading cause of bacterial meningitis in the U.S. Children under 2 years are at highest risk for serious disease. In children under 5 years of age, pneumococcal infection causes:

Meningitis: over 700 cases per year

Bacteremia (blood infection): 13,000 cases per year
Ear infections: 5,000,000 per year
Deaths: 200 per year
No known association between pneumococcal conjugate vaccine and serious adverse events.
23-valent polysaccharide vaccine:
Severe allergic reaction: Less than 1 in 10,000 doses
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All information is general in nature and is not intended to be used as a substitute for appropriate professional advice. For more information please call (206) 296-4600 (voice/TDD).

Updated: Tuesday, December 10, 2002 at 09:11 AM PST

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