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97 Cornerstone Drive, Cary NC 27519 (Stone Creek Village)

Delayed Vaccines

A lot of research has gone into determining the best timing for immunizations. The recommended schedule is designed to give children the earliest possible protection from disease in the safest possible way. Delaying immunizations not only puts children at increased risk of vaccine-preventable disease but may increase side effects. If you choose to delay immunizations because you want to avoid side effects be sure to discuss the schedule with us. Certain alterations in the schedule can help avoid side effects. For example, we can avoid giving the Pneumococcal vaccine and the flu vaccine at the same time to avoid a slightly increased risk of fever.

It is Cornerstone Pediatric and Adolescent Medicine’s policy that all patients must be up to date or in the process of becoming up to date if their immunizations have been delayed for any reason.

Special care for unimmunized and under-immunized children

Rashes, coughs, vomiting, diarrhea, and fevers are common during childhood. These symptoms can be caused by common childhood illnesses or more serious vaccine-preventable diseases. It’s important for parents to know the signs and symptoms of vaccine-preventable diseases so serious illnesses can be diagnosed and treated as early as possible. Don’t hesitate to call us if your child develops symptoms that worry you.

Make sure that everyone who cares for your child knows that your child is missing immunizations so he or she will get the best possible care.

2 to 6-month immunizations help prevent:

Diphtheria is a disease that causes fever, sore throat, weakness, and swollen glands. What distinguishes diphtheria from other common childhood illnesses is a gray membrane that develops in the nose and throat that can cause severe difficulty breathing. Diphtheria can cause nerve damage, heart damage, or even death from respiratory complications. Unimmunized infants with fever or breathing difficulty need to be seen by a doctor.

Pertussis, also known as Whooping Cough, is a disease that causes runny nose and congestion, cough, fever, and red runny eyes. The symptoms last several weeks but become worse after the second week. The cough is characterized by vomiting after prolonged coughing bouts and by a “whooping” noise before the cough that’s caused by difficulty inhaling. Unimmunized infants who develop fever, respiratory difficulty, blue face with coughing, coughing that causes vomiting, or prolonged cough (2 or more weeks)  need to be seen by a doctor.

Tetanus is a life-threatening bacterial disease that causes painful muscle spasms that interfere with your ability to breathe. There is no cure. Symptoms can occur days to weeks after bacteria enter your body through a wound. Unimmunized infants who develop fever need to be seen by a doctor. Unimmunized people who develop stiff muscles of the neck, jaw, back or abdomen, or painful muscle spasms that last several minutes need to be seen in the emergency department. If your child gets a deep or dirty wound, you may want to consider getting a tetanus shot within 8 hours even if you don’t give other vaccines. All wounds should be thoroughly cleaned as soon as possible but cleaning cannot always prevent tetanus.

Pneumococcal sepsis, pneumonia, ear infections, and meningitis: Pneumococci are the most common cause of bacterial meningitis, pneumonia, blood infections, and ear infections in young children. Unimmunized infants should be seen by a doctor if they develop a fever, a rash with fever, cough, severe irritability, lethargy, ear pain, rapid breathing, stiff neck, a marked decrease in eating and drinking, or a change in behavior that concerns you.

Haemophilus influenzae type B (H. flu) sepsis, meningitis, pneumonia, and ear infections:  H flu. is a bacterium that is not related to the flu virus. It can cause meningitis, blood infection, pneumonia, and bone and joint infections.  Unimmunized infants who develop fever, stiff neck, rapid breathing, bad cough, ear pain, lethargy, extreme irritability, a marked decrease in eating and drinking, red or painful joints, or a change in behavior that concerns you need to be seen by a doctor.

Rotavirus: Rotavirus is the most common cause of severe diarrhea in children. Unimmunized infants should be seen by a doctor if they develop fever, bloody stools, severe diarrhea, vomiting for more than 3 hours, lethargy, or signs of dehydration like dry mouth, no tears, and little or no urination.

Polio: Polio is a virus that can cause breathing difficulty, paralysis, and possibly death. Polio is rare in this part of the world. It begins like so many other childhood illnesses with fever, sore throat, vomiting, and headache, but muscle pain, stiffness, weakness, and tenderness can develop. Permanent paralysis is common. There is no cure for the disease only prevention through vaccination. Unimmunized infants and children who develop muscle pain, stiffness, tenderness, or weakness following an illness should be seen by a doctor.

Hepatitis B: Hepatitis B is a viral illness that is spread through blood and intimate contact. Infants are at most risk at birth but can get hepatitis B from a human bite, or contact with an infected person’s saliva, blood, or other body secretions. Many infected people do not know they have it. Acute symptoms include nausea, vomiting, fever, aches and pains, dark urine, yellow skin or eyes, and fatigue. Anyone who develops dark urine, yellow skin, or yellow eyes needs to be seen by a doctor. Unimmunized infants who develop fever, vomiting for more than 3 hours, severe abdominal pain, signs of dehydration, yellow skin or eyes, or dark urine need to be seen by a doctor.

The Flu: The flu virus causes high fever, cough, sore throat, headache, aches and pains. Many people develop ear infections, sinusitis, pneumonia, or life-threatening complications from the flu. There is treatment for the flu if it is started in the first 48 hours of illness. Unimmunized infants and children who develop a fever with cough, headache,  and sore throat should be seen in the first 48 hours of illness. Infants and children who are lethargic or extremely irritable, have respiratory distress or seem very sick should be seen right away.

COVID-19 is a viral illness that initially causes headaches, cough, mild runny nose, sore throat, and sometimes fever. While some people only have mild cold-like symptoms and recover on their own, others can become critically ill with shortness of breath, hypoxia (low oxygen), and multiple organ failure resulting in prolonged hospitalization or death. COVID-19 can also cause delayed symptoms affecting the brain, lungs, heart, and other organs that can last for months. Testing for COVID-19 is widely available. If you suspect you have it, get tested and avoid contact with others for 5 days and wear a mask around others for an additional 5 days. If symptoms fail to improve after a few days or if you develop a fever for more than 3 days, shortness of breath or difficulty breathing, lethargy, chest pain, confusion, heart palpitations, or become extremely ill, seek medical attention. If symptoms persist or redevelop see your doctor. Avoid vigorous exercise for 10 days following infection and until all symptoms are resolved.

If you’re worried that your child may have a vaccine-preventable illness or a fever, please let our staff know as soon as you arrive at our office and have your child wear a mask in the waiting room if possible. We are happy to supply masks at the front desk and will get you and your child into an exam room as quickly as possible.

If your child is not fully immunized, please make sure that your immunizations are up to date so you can help protect your child.

12 to 24-month vaccines:

Boosters for many of the vaccines given in the first year (diphtheria, pertussis, tetanus, Haemophilus influenzae B, Polio, and flu) are given to children ages one to 2. Continue to watch for symptoms of those vaccine-preventable illnesses especially when you travel or when your child starts daycare or school. In addition, the vaccines in the second year of life help prevent these illnesses:

Measles begins with a high fever (usually more than 102.5), cough, runny nose, and red watery eyes. There is not any yellow discharge from the eyes. The throat becomes red and there are white spots on a red background in the mouth by the second or 3rd day. About 3 days after the fever starts a red rash develops on the face and spreads all over the body. Measles can lead to pneumonia, brain damage, and deafness. Your child should be seen by a doctor if he develops a fever with a rash, lethargy, extreme irritability, trouble breathing, stiff neck, marked decrease in appetite or drinking, or behavior that worries you.

Mumps is a viral infection of the salivary glands. It starts with fever, headache, muscle aches, and fatigue. Tenderness and marked swelling of the glands under the ears on one or both sides of the neck develop making the neck look very swollen. Mumps sometimes causes inflammation of the testes, ovaries, or brain too. Please bring your child to a doctor if fever and neck swelling develop especially if these symptoms are accompanied by abdominal pain, testicular pain, or change in behavior.

Rubella is a viral illness that causes low fever (less than 102), runny nose and red eyes without yellow discharge, tender lymph nodes in the back of the neck and behind the ears, and a pink rash that starts on the face and spreads all over. Rubella is usually not severe in children but if a pregnant woman is exposed to the disease, the unborn baby can die or develop birth defects. Please call if you think your child might have rubella.

Chickenpox is a viral illness that starts with high fever, headache, fatigue, and loss of appetite. About 2 days after the fever starts itchy fluid-filled blisters develop. They usually start on the face and trunk and spread over several days. The blisters pop and leave scabs. Occasionally inflammation of the brain or a bacterial infection of the skin, lungs, or blood develops. Children with fever and rash, lethargy, rapid breathing, changes in balance, decreased fluid intake, skin infection, or changes in behavior that concern you need to be seen by a doctor.

Hepatitis A is a viral illness that causes nausea, vomiting, abdominal pain, yellowing of the skin and eyes, light-colored stools, dark urine, fatigue, and joint pain. If your child develops these symptoms he needs to be seen by a doctor.

Immunizations for school-aged children and teens

Boosters for tetanus, diphtheria, pertussis, measles, mumps, rubella, polio, flu, and chickenpox are given to school-age children. Continue to look for symptoms of those diseases as well as those below.

Human Papilloma Virus (HPV) is a viral illness that causes cancer of the cervix in women and warts on the genitalia, anus, and vocal cords of men and women. Teens should be seen by a doctor for new growths on the genitals and women should start getting pap smears by age 21 or sooner if they’re sexually active. Vaccinated young women don’t need pap smears as often as unvaccinated women.

Meningococcal Meningitis is a serious bacterial disease that causes both meningitis (infection of the lining of the brain) and sepsis (blood infection). Sometimes a distinctive red/purple rash develops. The rash does not blanch when you press on it. Anyone with a high fever, severe headache, stiff neck, body aches, nausea or vomiting, lethargy, and rash needs to be seen immediately.

If you’re worried that your child may have a vaccine-preventable illness or a fever, please let our staff know as soon as you arrive at our office and have your child wear a mask in the waiting room if possible. We are happy to supply masks at the front desk and will get you and your child into an exam room as quickly as possible.

If your child is not fully immunized, please make sure that your immunizations are up to date so you can help protect your child.

Because vaccines don’t 100% guarantee that your child is immune, exposure to undervaccinated people puts vaccinated people at risk of all the above diseases. If you are concerned that your child has the above sets of symptoms, seek medical care regardless of immunization status.

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