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Thank you for tuning into the Well Within Reach podcast, I’m your host Katie Salwei. Back for part 2 of our series in pediactrics is our board certified pediatrician, Dr. Margarita Mankus. Thank you for coming back and joining us Dr. Mankus.

Dr. Margarita Mankus (Guest): It’s no problem. Thanks so much for inviting me.

Host: So today we’re going to kind of continue on with our series and we’re going to talk about immunizations and the importance of childhood vaccines, which I know is a really big topic going on. So let’s start with what is an immunization?

Dr. Mankus: Well an immunization is a general term for a product that stimulates a person’s immune system to produce immunity to a specific disesase, so that causes protection of the person from that disease. So the majority of vaccines of course are administered through needle injections but they can also be administered by the mouth or some of them can be sprayed into the nose.

Host: And why is this so important to get these immunizations rather than just build up your immunization – or build up your immune system by not getting those?

Dr. Mankus: I think that’s a great question and I think that’s a question that I get a lot of, so what I generally say is if an unvaccinated child gets exposed to a disease germ then the child’s body may not be strong enough to fight off the disease. So before vaccines, there were many children who died from diseases that vaccines now prevent such as whooping cough, measles, and polio. Those same germs, they still exist, but because babies are protected by vaccines, we don’t see them nearly as often. One that I get this question a lot about particularly the chicken pox vaccine because a lot of people ask, “well why do we need the chicken pox vaccine? It’s such a mild disease and for years before the chicken pox vaccine was available, there were lots of kids who had it and it usually causes only very mild symptoms.” And so what I generally say to those parents is that of course in many cases children experience a very mild case of chicken pox but there are cases that can be complicated and there are cases of children who can get chicken pox and get a lot of complications from it. Some children get blisters that can become infected, others can develop pneumonia. So there’s no way to really tell in advance how severe your child’s symptoms will be. So before the vaccine was available, actually about 50 children died every year from chicken pox and about 1 in 500 children who got chicken pox was hospitalized. So even though it’s a much – the reason why we recommend universally vaccinating kids for chicken pox is because the side effects of the vaccine, which is generally a little bit of arm soreness, a little bit of tenderness at the site of the vaccine, is usually much, much, much lower than the risk of the complications that could possibly happen from getting the disease. So rather than getting pneumonia, the vaccine might just cause a sore arm for a couple of days. So the risks of the disease itself are much higher than the risks of the vaccine.

Host: Definitely, so is there a set timeline schedule for these immunizations? I know there’s a lot of them. I have three little boys and it feels like we’re getting immunizations all the time, but is there a set schedule you guys follow?

Dr. Mankus: There is yeah and I love to – I usually like to – I think that – I like to tell parents so they know what to expect ahead of time. I think that’s important. As a parent, I think it’s important to know – to have information available so that you know what to expect. The worse of course is when you go to the doctor and you’re not expecting to get shots and especially for the kid, that’s a little bit scary when they don’t know if they’re going to get shots or not. So I usually like to provide that to all my parents, and there’s a great vaccine schedule that’s easy to read that’s available on the CDC website, so that’s www.cdc.gov/vaccine.

Host: Okay, so that’s a great thing to have on hand. I know my oldest is scared of getting vaccines even though it’s telling him why we get them and why they’re important and so you know it’s always a fight [laughter].

Dr. Mankus: - It’s good to know ahead of time. I think that’s one thing I tell parents is that having your kids know ahead of time when they go, so they know what to expect. I think that helps to kind of ease some of their anxiety and help them to – and then of course when there’s appointments that they don’t get vaccines that helps for them to know that too.

Host: Definitely. So is there a rhyme or reason for this specific vaccine schedule? Because I know they fall into schedules, but like is there a reason for why you do boosters of certain ones and not of others?

Dr. Mankus: Absolutely, absolutely that’s also a great question and a question that I get a lot but the reason that we have the vaccine schedule the way they do and a lot of parents have concerns like, “Why are my kids getting vaccines so young?” And there’s one, the initial vaccine, the hepatitis B vaccine we actually recommend in the hospital even before they go home from the hospital. So parents ask me is it necessary? Why would they want to give vaccines so early? Is it better to maybe wait until they’re a little bit older, but the general theme of the vaccine schedule that we have is that this recommended schedule protects infants and children by providing immunity early in life before they come into contact with those life threatening diseases. So children receive immunizations so early because they’re susceptible to diseases at a young age and the consequences of these diseases can be very serious and even life threatening for infants and young children. So there are vaccines that of course we recommend boosters for and there’s a few that they get multiple doses of the same vaccine. So I tell parents, getting every recommended dose of each vaccine provides your child with the best protection possible, and so depending on the vaccine, your child may need more than one dose to build up high enough immunity to prevent disease or to boost immunity that fades over time.

Host: Okay well and I know they’re – I’m sorry

Dr. Mankus: No, no that’s all, sorry.

Host: [laughter] I apologize. And I know there’s also a – I mean if you’re vaccinating, it’s safe for your child to get vaccinated, but you’re protecting those kids and people who are unable to get vaccinated. Do you hear that in your practice as well?

Dr. Mankus: Absolutely. I think that’s a great point you bring up Katie too is that immunizing individual children also helps to protect the health of our community, especially like you mentioned those people who can’t be immunized, children who are too young to be vaccinated, or those who can’t receive certain vaccines for medical reasons, and the proportion of people – and there’s a small proportion also of people who don’t respond to a particular vaccine, so it’s also important in terms of the health of the community at large.

Host: Okay, so kind of on this schedule piece that we were talking about, is there a recommended or required wait time between some of those vaccines that we get?

Dr. Mankus: Yes there is. There are some – and of course that’s all available through the CDC website and also provided by your pediatrician, but there are certain vaccines that you need to – before there’s a certain minimum required amount of time between booster shots, so it kind of depends on each individual vaccine but that’s something you can talk about with your pediatrician and also refer to the CDC schedule to get more information about any of that.

Host: Okay, what happens if my child gets behind in their scheduled vaccines? They may have been sick, unable to get it, or may have been traveling at the time they needed it. Is there a way that you can make them up?

Dr. Mankus: Absolutely, absolutely, and that’s something I – I tell my patients that all the time. It’s never too late to vaccinate your children. So at any point, I think parents sometimes feel frustrated or maybe they feel overwhelmed and they feel like it’s been so long, is it too late to do things? And what I always say is that it’s never too late to start vaccinating or to catch up with vaccines, so definitely talk to your doctor about getting their vaccines caught up.

Host: Definitely. So I know you mentioned the CDC a few different times, is there any other trusted sources you tend to send parents to if they’re on the fence about vaccinating?

Dr. Mankus: Well the CDC is definitely my favorite because they do a really nice job. They give a lot of extensive helpful information for parents and they refer to certain – to medical literature, they refer to a lot of good scientific sources so I think that’s my favorite source for vaccines, but another great one that I like to refer parents to is a website. It has actually a lot of information, not even just for vaccines, it’s got information for lots of other common questions that parents have in general. It’s called www.healthychildren.org and it’s a website designed by the American Academy of Pediatrics and it’s got lots of great useful information about all sorts of topics.

Host: Wow well that’s a great resource to have on hand, especially when Google out there, people Googling different things. You can find just about anything you want there, but a trusted source like that is definitely one to bookmark. So is there anything else that you want people to know about these immunizations? If they’re on the fence about something or can they call to talk to somebody about it?

Dr. Mankus: Sure, I think in generally I say don’t be afraid to continue having the conversation, don’t be afraid to ask questions, and I – in general with vaccines with my patients I like to have an ongoing conversation and the important thing for me is, again, the long term relationship with my patients and so I generally like to say if – I want you guys – I want everybody to have all the information about all the different vaccines. Not all vaccines are necessarily the same, so I tell parents some – there’s some – if parents who prefer to get some vaccines but not others, I think we can work with that. I think – I generally recommend all the routine vaccinations but I think it’s important to keep the conversation ongoing, and if at any point, like I say, it’s never too late to vaccinate, so if you – if you feel later on you know what, I feel comfortable and I’d like to start vaccinating now or you know maybe I just want to wait until later on and I think that it’s just never too late so I’d like to have that as an ongoing conversation with all my patients.

Host: Well thank you so much for all the information. If you are needing some additional information, Dr. Mankus did provide a website either the cdc.org or .gov I apologize or healthychildren.org for some medical information on these vaccines. So thank you again for joining with us today Dr. Mankus and thank you for tuning in to Well Within Reach podcast with pediatrician Dr. Margarita Mankus, and your host Katie Salwei. If you missed part 1, how to find a pediatrician, be sure to visit riversidehealthcare.org.