Fourth-Month Vaccination
The fourth-month vaccination recipient is now the most common recommended vaccine for children worldwide. It begins at 12 months of age but can be given anytime between 9 and 15 months.
The series has two or three doses, depending on which vaccine is chosen. For example, DTaP (diphtheria, tetanus, pertussis) comes in a five-dose and three-dose Hib (Haemophilus influenza type B) schedule.
The prevalence of use of different formulations varies by country due to factors including trust in vaccines, access to vaccines through the public health system or private provider payment systems, availability of funding for immunizations through national budgets or donor support for specific diseases, perceptions about disease severity and the need for a vaccine. For example, the US recommends a 5-dose DTaP schedule and a 3-dose Hib vaccine series.
Many countries have adopted the pentavalent vaccine (DPT+Hep B+Hib), which is given in five shots over six months, starting at two months of age. This is part of routine immunization programs for all infants aged 2–3 months as DPT-HepB-Hib Vaccine (Triple Combination) in India.
Black fever typhus from fleas from dogs and rodents can cause life-threatening illness and death. Still, vaccination before exposure is required to protect against disease and reduce transmission between animals and humans because few safe and effective drugs are available to treat this infection.
4-month vaccines worse than two months:
A new analysis of the CDC’s National Immunization Survey for children aged 19 to 35 months suggests that getting all recommended vaccinations on time by age two may be worse for your child than just getting them later.
The findings, published in Frontiers in Public Health, suggest that delaying certain vaccinations and spacing them out over a more extended period might reduce vaccine-related health complications.
This is important because under vaccination when kids go without some or even all vaccines, it has been linked to higher rates of potentially fatal diseases such as whooping cough and measles than fully vaccinated kids.
According to the Centers for Disease Control and Prevention (CDC), doctors should vaccinate children against 14 infectious diseases beginning at birth. But few doctors follow the CDC’s lead. As a result, the percentage of children under age two who receive no vaccines has quadrupled since 2001 to 1.3 percent in 2013, according to an earlier study cited by the authors.
Given this trend, researchers hypothesize that “parents are placing their children at an increased risk for vaccine-preventable diseases” and that “delaying or spacing out infant vaccinations could be increasing the risk that children will contract these illnesses.”
They analyzed data from more than 1,200 kids between 19 and 35 months old who had received four doses of DtaP (diphtheria, tetanus, pertussis), one dose of the polio vaccine, and one shot against pneumococcus bacteria.
They found that 4-month-old babies were significantly more likely than 2-month old babies to have fever and seizures after receiving the vaccines and that these episodes lasted several days. For babies aged 4 to 6 months, the seizure risk increased six times compared with their younger counterparts.
Older infants also had a greater chance of developing other health problems such as diarrhea and ear infections within 42 days of vaccination than their age peers who received shots later.
The authors say they do not know why young children may be more vulnerable to vaccine side effects than older ones but suspect it is because they are less immune or have weaker immune systems.
How many shots at four months:
The analysis was observational and didn’t prove that vaccines caused seizures or fevers in young children. Still, the authors say their findings warrant further investigation into whether delaying vaccinations could reduce these short-term risks.
In the meantime, “parents of infants should not avoid vaccination,” they say. The benefits of early vaccination for preventing vaccine-preventable diseases still outweigh the risks, they noted.
“The decision to delay or refuse a vaccine is based on concern that a child could suffer from either an immediate reaction or a long-term adverse event.” However, delaying vaccines may have some potential drawbacks. It can lead to parents losing track of their children’s immunization schedule and ending up waiting for future shots as well.
This puts children at risk of getting sick when they are older and puts other kids at risk who aren’t vaccinated because disease outbreaks tend to spread more easily among nonvaccinated individuals.
what shots do babies get at six months:
The authors caution that parents should not wait to vaccinate their children after the first six months. “Vaccines are recommended at specific ages for a reason,” noted study co-author Paul Wise, an epidemiologist at Stanford University in California. Just because vaccines are deemed safe for older kids doesn’t mean that they’re risk-free for younger ones, he said.
The results of this study were based on data collected by the CDC’s Vaccine Safety Datalink. The researchers analyzed information on 1,184 children between 19 and 35 months old who had received four doses of DtaP (diphtheria, tetanus, pertussis), one dose of the polio vaccine, and one shot against pneumococcus bacteria before the age of 2.
The fever and seizure risk that the researchers observed in younger kids occurred after any of the four vaccinations given at two months, four months, and six months old. The children with seizures also had fevers at least as high as 102 degrees Fahrenheit within 5 to 12 days of vaccination.
Babies aged 4 to 12 weeks had a threefold increased risk for seizures or fever following their first vaccine shot compared with those who already received one or more attempts before they turned four weeks old, according to the study published Aug. 23 in JAMA. These symptoms most often appear within 3 to 10 days after vaccination.
How to treat baby fever after vaccination:
“This study makes it clear that vaccines are a double-edged sword,” said Paul A. Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia. “On one hand, they prevent all sorts of infections that can be deadly, and on the other hand, there are side effects like fever and seizures.”
But even though these reactions may cause discomfort for babies, they’re rarely dangerous to their health, said Offit, who was not involved with this research. For example, the authors note in their paper that febrile seizures affect up to 7 percent of all children between ages six months and five years old – but only 1 to 2 percent require medical treatment or hospitalization.
Most adverse events occurred within three days of vaccination, but fevers were also seen up to 14 days after immunization.
The researchers recommend that parents consult their child’s doctor immediately if they notice seizures or other concerning signs following immunization. Then, they can get appropriate treatment and work with their providers to ensure future vaccinations are not delayed. Parents should also be sure to store and discard any vaccine leftover after immunizations properly, so it doesn’t become contaminated, Byington added.
4-month-old immunization side effects:
The study was limited because it relied on parents to report seizures and fever after vaccinations, but experts say the vaccine safety dataset is reasonably reliable.
“It is often difficult for clinicians who are not familiar with vaccines to appreciate that these events are, in fact, due to the vaccine,” said Dr. Carrie Byington, professor of pediatrics at the University of Utah School of Medicine in Salt Lake City.
“Parents should be reassured by this research which indicates that true complications from common childhood vaccines are quite rare.”
Despite overwhelming scientific evidence showing the effectiveness and safety of vaccines, many parents still fear them worrying that shots can cause autism or other health problems in babies. The concern has led some parents to decline recommended vaccinations, putting their kids and other vulnerable people in the community at risk for outbreaks of vaccine-preventable diseases like measles.
“While it is clear that some parents still have concerns about vaccines, hopefully, this study will help to end the debate once and for all,” Offit said. “Vaccines are one of our greatest public health achievements.”
What vaccine is given at four months:
The study is observational, which means it doesn’t show cause and effect. And finding that children 4 to 12 weeks old who received previous vaccinations had a greater risk of seizures is not the same as demonstrating that those vaccines caused the attack.
According to guidelines from the Centers for Disease Control and Prevention, babies under four months old need at least five shots before they can go home from the hospital. The first shot protects against hepatitis B; the second and third ones protect against rotavirus, a highly contagious virus that causes severe diarrhea; and the fourth one boosts immunity against polio. The fifth shot contains protection against diphtheria, tetanus, and pertussis (whooping cough).
Third DTP-ib vaccine:
In addition to these initial shots, kids should get vaccines against several other diseases before starting kindergarten, including chickenpox, pneumococcal disease, and the flu.
Babies can receive five more vaccinations by age two years old to protect against hepatitis A; polio; measles, mumps, and rubella (MMR); varicella (chickenpox); and Haemophilus influenzae type b (Hib). The doctor may recommend giving some of these earlier than six months of age, depending on where you live.
Offit said there are many possible reasons why children between 4-12 weeks old who had received previous vaccinations might have a greater risk of seizures compared with children who did not yet get any previous immunizations.
For example, he said, parents of children who recently got vaccines might be more likely to notice and report unusual symptoms at 4-12 weeks old because they would closely watch for any potential side effects.