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Pneumococcal Vaccine for Children

Posted Aug 24 2008 1:49pm
DAVID R. MARKS, MD: Hi, and welcome to our webcast. I'm Dr. David Marks. There's a bacteria called pneumococcus that's a common cause of ear infections in kids. But it's also the leading cause of death from meningitis in kids. The good news is, there's a new vaccine to fight against it. The question is: Should every kid have it?

To help me answer these questions are two guests. The first is Dr. Dan Neuspiel. He's associate chairman of pediatrics at Beth Israel Medical Center. Welcome.

With him is Dr. Herschel Lessin. He's a pediatrician with the Children's Medical Group in Poughkeepsie, New York. Welcome.

Well, now that I've scared everybody with the meningitis, it is a common bacteria. And the question is, should all kids have this vaccine?

DANIEL NEUSPIEL, MD: That's an interesting question. The recent recommendations that came out that have recommended this vaccine for all children under two years of age. It's particularly protective against meningitis and serious pneumonia. But it also is protective against many cases of ear infections that children get.

There are some suggested recommendations for children over age two who have certain problems with their immune system that might make them more susceptible to this infection.

DAVID R. MARKS, MD: We should say, the name of the vaccine is Prevnar, which is the brand name. The generic name is, it's a conjugate pneumococcal vaccine. Correct?

HERSCHEL LESSIN, MD: Correct.

DAVID R. MARKS, MD: Tell me a little bit about the bacteria and all the different things that pneumococcus can cause.

HERSCHEL LESSIN, MD: Pneumococcus is a bacteria that's been around all the time. In the past, it causes about a third of all ear infections. And it's always been a cause of serious invasive infections like very bad pneumonias and meningitis. It was never the major cause of those, because there were other germs around. But we've managed to vaccinate against all those germs now, so now pneumococcus has emerged as a major germ.

And the problem is, it's a germ that, due to our over-use of antibiotics, has become extremely resistant to many of the antibiotics that we have that can kill it. Including the minor ones like ear infections.

So it's getting to be an increasing problem, because there's not much competition. It's harder to deal with, because it's resistant. And now we finally have a way to prevent it.

DAVID R. MARKS, MD: A lot of people worry about vaccines in general causing long-term complications or side effects. Is this a legitimate concern?

DANIEL NEUSPIEL, MD: It's not a major concern. Really, of the current vaccines in use, they have undergone extensive safety studies. And this particular vaccine has been in trials in Europe for a number of years now.

Now, of course, we don't know what's going to happen 10-20 years down the road, but that's why we have a surveillance system in place in this country to pick up adverse effects.

HERSCHEL LESSIN, MD: I would have to add that, in the old days, when we only had three or four vaccines, nobody questioned. If I said: Give the vaccine, people took it. In the last five or seven years, we've had too numerous to count new vaccines, some of which have not had a good safety record.

But the reality is that people are really somewhat over-focused on the "what might happen if I give this." And the reality is, very little happens when you give this, in the vast majority of the cases, and most of the things that are attributed to vaccines have absolutely no basis in science anywhere, period, despite what you hear.

What they forget to answer is: What happens if I don't give it? Because if your child is the one who decides to get meningitis and be brain-damaged or die, then there's a real problem when you don't give it. People never think about that. They think about sins of commission, giving it. They never think about sins of omission and not giving it, and they need to think about that.

DAVID R. MARKS, MD: So you recommend it for your patients? The majority of your patients?

DANIEL NEUSPIEL, MD: Yes.

HERSCHEL LESSIN, MD: Yes.

DAVID R. MARKS, MD: Okay, good. Well, that's the last word, then. Thank you very much, both of you, for joining us. Thank you for watching our webcast. I'm Dr. David Marks. Goodbye.

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