Preventative Care

Importance of Establishing With PCP

Reasons members with a new medical provider should make an appointment to establish.

  • To establish your health baseline
  • Building a trusting, long-term relationship with your medical provider
  • To establish health and wellness goals (lose weight; lower cholesterol; maintain a healthy lifestyle)
  • Establishing with a provider will help you start achieving your goals
  • Understand your current health and potential future illnesses
  • Preventative care
    • Immunizations
    • Screenings (mammograms, colonoscopies, etc.)
  • Appropriately treat existing illness
  • Referral to specialists if needed
  • Medication assessment
  • Help assess mental and emotional health

The first step in a healthy lifestyle is participating in your medical care, and this begins with establishing care with your primary care provider for a more active life in the future.

Well Child Checks

Your child’s Primary Care Provider, or PCP, wants to see your child, even when they are not sick. These “well-child visits” are very important, and are different from the appointments when they are sick. The American Academy of Pediatrics (AAP) recommends that babies visit their pediatrician for a well child check-up as a newborn, one month of age, two, four, six, nine, twelve, fifteen, eighteen, and twenty-four months of age, and then once a year from ages three to six. For adolescents, bwtween ages 10-19, they need an annual exam with their PCP.

At these visits, the doctors and nurses look at the big picture of your child’s growth and well-being. The primary care provider will assess and track your child’s physical, behavioral, developmental and emotional status as they grow and is a critical opportunity to detect possible developmental delay or disability, and early treatment of this is key. This is also an important time for parent-doctor communication. Make the most of these visits and write down any concerns or questions you have about your child and take them with you to these appointments.

Immunizations/Vaccines

Children

Why are vaccines so important? It is always better to prevent a disease than to treat it after it occurs. Over the years, vaccines have prevented countless cases of disease and saved millions of lives. Vaccination is one of the best ways parents can protect their infants, children, and teens from 16 potentially harmful diseases. Young babies can get very sick from vaccine-preventable diseases, and the vaccine schedule is designed to protect young children before they are likely to be exposed to potentially serious diseases and when they are most vulnerable to serious infections. When we receive a vaccine, it contains the same antigens that cause the disease, but the antigens in the vaccine are either killed or weakened to the point that they don’t cause the disease, but are still strong enough to make our immune system produce antigens that lead to immunity-so in other words, we get protection without having to get sick first.

2017 Recommended Immunizations for Children from Birth Through 6 Years OldDownload Chart Here

Birth to 18 years Recommended immunization Schedule

Adults

Vaccines are not just for children. In fact, vaccine-preventable diseases such as the flu and pneumonia now kill more adults than children in the U.S. By getting vaccinated, you can stay healthier and prevent spreading disease to everyone around you. If your healthcare provider doesn’t bring up the topic of vaccines, be sure to ask. The CDC recommends that all adults receive the following:

  • An annual influenza (flu) vaccine
  • Td vaccine (every 10 years)
  • Tdap vaccine (once instead of Td vaccine and during each pregnancy for women)

*you may need other vaccines as an adult based on other factors like chronic disease, travel outside of the U.S, etc.

Adult Immunization Schedule

Pregnancy

Vaccines can help protect you and your baby against serious diseases. When you are pregnant and receive a vaccine, you aren’t only protecting yourself-you are giving your baby some early protection too! This immunity the baby receives when you get vaccinated during pregnancy will protect baby during the few first months of life. The CDC recommends you get a whooping cough (Tdap) and flu vaccine (if pregnant during flu season) to help protect yourself and your baby. Some vaccines, such as the measles, mumps and rubella (MMR) vaccine, should be given a month or more before pregnancy. It is safe for you to receive vaccines right after giving birth, even while breastfeeding.

Pregnancy and Vaccination

Information for pregnant women
Vaccines help protect you and your baby against serious diseases.

You probably know that when you are pregnant, you share everything with your baby. That means when you get vaccines, you aren’t just protecting yourself—you are giving your baby some early protection too. You should get a flu shot and whooping cough vaccine (also called Tdap) during each pregnancy to help protect yourself and your baby.

Whooping Cough Vaccine

Whooping cough (or pertussis) can be serious for anyone, but for your newborn, it can be life- threatening. Up to 20 babies die each year in the United States due to whooping cough. About half of babies younger than 1 year old who get whooping cough need treatment in the hospital. The younger the baby is when he or she gets whooping cough, the more likely he or she will need to be treated in a hospital. It may be hard for you to know if your baby has whooping cough because many babies with this disease don’t cough at all. Instead, it can cause them to stop breathing and turn blue.

When you get the whooping cough vaccine during your pregnancy, your body will create protective antibodies and pass some of them to your baby before birth. These antibodies will provide your baby some short-term, early protection against whooping cough.

Learn more at www.cdc.gov/pertussis/pregnant

Flu Vaccine

Changes in your immune, heart, and lung functions during pregnancy make you more likely to get seriously ill from the u. Catching the u also increases your chances for serious problems for your developing baby, including premature labor and delivery. Get the u shot if you are pregnant during u season—it’s the best way to protect yourself and your baby for several months after birth from u- related complications.

Flu seasons vary in their timing from season to season, but CDC recommends getting vaccinated by the end of October, if possible. This timing helps protect you before u activity begins to increase.

Find more on how to prevent the u by visiting www.cdc.gov/flu

Keep Protecting Your Baby after Pregnancy

Your ob-gyn or midwife may recommend you receive some vaccines right after giving birth. Postpartum vaccination will help protect you from getting sick and you will pass some antibodies to your baby through your breastmilk. Vaccination after pregnancy is especially important if you did not receive certain vaccines before or during your pregnancy.

Your baby will also start to get his or her own vaccines to protect against serious childhood diseases. You can learn more about CDC’s recommended immunization schedule for children and the diseases vaccines can prevent at www.cdc.gov/vaccines/parents/.

Even before becoming pregnant, make sure you are up to date on all your vaccines. This will help protect you and your child from serious diseases. For example, rubella is a contagious disease that can be very dangerous if you get it while you are pregnant. In fact, it can cause a miscarriage or serious birth defects. The best protection against rubella is MMR (measles-mumps-rubella) vaccine, but if you aren’t up to date, you’ll need it before you get pregnant.

Talk to your ob-gyn or midwife about maternal vaccines and visit: www.cdc.gov/vaccines/pregnancy/

Keep in mind that many diseases rarely seen in the United States are still common in other parts of the world. Talk to your ob-gyn or midwife about vaccines if you are planning international travel during your pregnancy. More information is available at www.cdc.gov/travel/.

Understanding How Vaccines Work

Diseases that vaccines prevent can be dangerous, or even deadly. Vaccines greatly reduce the risk of infection by working with the body’s natural defenses to safely develop immunity to disease. This fact sheet explains how the body fights infection and how vaccines work to protect people by producing immunity.

The Immune System
The Body’s Defense Against Infection

To understand how vaccines work, it is helpful to rst look at how the body ghts illness. When germs, such as bacteria or viruses, invade the body, they attack and multiply. This invasion is called an infection, and the infection is what causes illness. The immune system uses several tools to ght infection. Blood contains red blood cells, for carrying oxygen to tissues and organs, and white or immune cells, for ghting infection. These white cells consist primarily of B-lymphocytes, T-lymphocytes, and macrophages:

  • Macrophages are white blood cells that swallow up and digest germs, plus dead or dying cells. The macrophages leave behind parts of the invading germs called antigens. The body identi es antigens as dangerous and stimulates the body to attack them.
  • Antibodies attack the antigens left behind by the macrophages. Antibodies are produced by defensive white blood cells called B-lymphocytes.
  • T-lymphocytes are another type of defensive white
    blood cell. They attack cells in the body that have already been infected.

The first time the body encounters a germ, it can take several days to make and use all the germ- ghting tools needed to get over the infection. After the infection, the immune system remembers what it learned about how to protect the body against that disease.

The body keeps a few T-lymphocytes, called memory cells that go into action quickly if the body encounters the same germ again. When the familiar antigens are detected, B-lymphocytes produce antibodies to attack them.

How Vaccines Work

Vaccines help develop immunity by imitating an infection. This type of infection, however, does not cause illness, but it does cause the immune system to produce T-lymphocytes and antibodies. Sometimes, after getting a vaccine, the imitation infection can cause minor symptoms, such as fever. Such minor symptoms are normal and should be expected as the body builds immunity.

Once the imitation infection goes away, the body is left with a supply of “memory” T-lymphocytes, as well as B-lymphocytes that will remember how to ght that disease in the future. However, it typically takes a few weeks for the body to produce T-lymphocytes and B-lymphocytes after vaccination. Therefore, it is possible that a person who was infected with a disease just before or just after vaccination could develop symptoms and get a disease, because the vaccine has not had enough time to provide protection.

Types of Vaccines

Scientists take many approaches to designing vaccines. These approaches are based on information about the germs (viruses or bacteria) the vaccine will prevent, such as how it infects cells and how the immune system responds to it. Practical considerations, such as regions of the world where the vaccine would be used, are also important because the strain of a virus and environmental conditions, such as temperature and risk of exposure, may be di erent in various parts of the world. The vaccine delivery options available may also di er geographically. Today there are ve main types of vaccines that infants and young children commonly receive:

  • Live, attenuated vaccines fight viruses. These vaccines contain a version of the living virus that has been weakened so that it does not cause serious disease in people with healthy immune systems. Because live, attenuated vaccines are the closest thing to a natural infection, they are good teachers for the immune system. Examples of live, attenuated vaccines include measles, mumps, and rubella vaccine (MMR) and varicella (chickenpox) vaccine. Even though these vaccines are very effective, not everyone can receive them. Children with weakened immune systems—for example, those who are undergoing chemotherapy—cannot get live vaccines.
  • ­Inactivated vaccines also fight viruses. These vaccines are made by inactivating, or killing, the virus during the process of making the vaccine. The inactivated polio vaccine is an example of this type of vaccine. Inactivated vaccines produce immune responses in different ways than live, attenuated vaccines. Often, multiple doses are necessary to build up and/or maintain immunity.
  • ­Toxoid vaccines prevent diseases caused by bacteria that produce toxins (poisons) in the body. In the process of making these vaccines, the toxins are weakened so they cannot cause illness. Weakened toxins are called toxoids. When the immune system receives a vaccine containing a toxoid, it learns how to fight o the natural toxin. The DTaP vaccine contains diphtheria and tetanus toxoids.
  • ­Subunit vaccines include only parts of the virus or bacteria, or subunits, instead of the entire germ. Because these vaccines contain only the essential antigens and not all the other molecules that make up the germ, side effects are less common. The pertussis (whooping cough) component of the DTaP vaccine is an example of a subunit vaccine.
  • Conjugate vaccines fight a different type of bacteria. These bacteria have antigens with an outer coating of sugar-like substances called polysaccharides. This type of coating disguises the antigen, making it hard for a young child’s immature immune system to recognize it and respond to it. Conjugate vaccines are effective for these types of bacteria because they connect (or conjugate) the polysaccharides to antigens that the immune system responds to very well. This linkage helps the immature immune system react to the coating and develop an immune response. An example of this type of vaccine is the Haemophilus influenzae type B (Hib) vaccine.

Vaccines Require More Than One Dose

There are four reasons that babies—and even teens or adults for that matter—who receive a vaccine for the rst time may need more than one dose:

  • For some vaccines (primarily inactivated vaccines), the first dose does not provide as much immunity as possible. So, more than one dose is needed to build more complete immunity. The vaccine that protects against the bacteria Hib, which causes meningitis, is a good example.
  • In other cases, such as the DTaP vaccine, which protects against diphtheria, tetanus, and pertussis, the initial series of four shots that children receive as part of their infant immunizations helps them build immunity. After a while, however, that immunity begins to wear o . At that point, a “booster” dose is needed to bring immunity levels back up. This booster dose is needed at 4 years through 6 years old for DTaP. Another booster against these diseases is needed at 11 years or 12 years of age. This booster for older children—and teens and adults, too—is called Tdap.
  • For some vaccines (primarily live vaccines), studies have shown that more than one dose is needed for everyone to develop the best immune response. For example, after one dose of the MMR vaccine, some people may not develop enough antibodies to fight o infection. The second dose helps make sure that almost everyone is protected.
  • Finally, in the case of the u vaccine, adults and children (older than 6 months) need to get a dose every year. Children 6 months through 8 years old who have never gotten the u vaccine in the past or have only gotten one dose in past years need two doses the first year they are vaccinated against u for best protection. Then, annual u shots are needed because the disease-causing viruses may be different from year to year. Every year, the u vaccine is designed to prevent the specific viruses that experts predict will be circulating.

The Bottom Line

Some people believe that naturally acquired immunity—immunity from having the disease itself—is better than the immunity provided by vaccines. However, natural infections can cause severe complications and be deadly. This is true even for diseases that most people consider mild, like chickenpox. It is impossible to predict who will get serious infections that may lead to hospitalization.

Vaccines, like any medication, can cause side effects. The most common side effects are mild. However, many vaccine-preventable disease symptoms can be serious, or even deadly. Although many of these diseases are rare in this country, they do circulate around the world and can be brought into the U.S., putting unvaccinated children at risk. Even with advances in health care, the diseases that vaccines prevent can still be very serious – and vaccination is the best way to prevent them.

For more information on vaccines call 800-CDC-INFO (800-232-4636) or visit http://www.cdc.gov/vaccines.

Adapted from the National Institute of Allergy and Infectious Diseases, Understanding Vaccines http://www.niaid.nih.gov/topics/vaccines/

For more information on vaccines, vaccine-preventable diseases, and vaccine safety: http://www.cdc.gov/vaccines/conversations