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ROUTINE WELL CHILD OFFICE VISITS:

• Newborn Visit
• 1-Month Visit
• 2-MonthVisit
• 3-Month Visit
• 4-Month Visit
• 6-Month Visit
• 9-Month Visit
• 12-Month Visit
• 15-Month Visit
• 18-Month Visit
• 2-Year Visit
• Starting Solids

IMMUNIZATIONS:

http://www.chop.edu/service/vaccine-education-center/home.html : the following is a very helpful link if you would like more information regarding vaccines.

Hepatitis B Hepatitis B is an infectious disease of the liver caused by the Hepatitis B virus. The virus is spread through contact with the blood or bodily fluids of an infected individual. It can cause both an acute and chronic illness. The acute illness causes liver inflammation and can present with vomiting and jaundice (a yellowing of the skin and the eyes). Chronic hepatitis B infection can eventually lead to cirrhosis of the liver and/or liver cancer. The immunization against Hepatitis B vaccine can be given at birth. It is a three dose series administered first at birth, then at either 1 month or 3 months, and finally at 9 months. This vaccine does not cause fever or any other significant side effects.

Diphtheria, Tetanus, and Pertussis (DTaP and Tdap) DtaP and Tdap are both combined vaccinations that protect against diphtheria, tetanus, and pertussis (whooping cough). DTaP is administered to children younger than 7 years old. Tdap is a booster vaccine given to older children, adolescents and adults.

• Diphtheria is a viral illness characterized by a sore throat, a low-grade fever, and an adherent membrane on the tonsils, pharynx, and/or nasal cavity.
• Tetanus infection often begins with mild spasms in the jaw muscles (lockjaw or trismus.) The spasms can also affect the chest, neck, back, abdominal muscles, and buttocks. Infection generally occurs through wound contamination with tetanus spores through a cut or deep puncture wound.
• Pertussis , commonly called whooping cough, is a highly contagious bacterial disease caused by Bordetella pertussis. Symptoms are initially mild, and then develop into severe coughing fits, which produce the high-pitched "whoop" sound. Pertussis is extremely contagious. Infection can lead to serious illness, hospitalization and even death, especially in newborns and young infants.
• DTaP is administered at ages 2 months, 4 months, 6 months, 18 months and 5 years.
• Tdap is administered at 11 years. The common side effects of the vaccination may include fever and fussiness and/or a local reaction: redness, swelling, and soreness at the injection site. The reactions may occur up to three days after the vaccination.

Pneumococcus (Prevnar-13) Streptococcus pneumoniae, or pneumococcus, is the main cause of community acquired meningitis and pneumonia in children. This organism also causes other serious invasive illnesses. Children under the age of two are most susceptible. The pneumococcal vaccine protects against thirteen different strains of the bacteria. This immunization is administered at ages 2 months, 4 months, 6 months, and 15 months. The most common side effects of this vaccine include fever, fussiness or irritability and increased sleepiness.

Polio (IPV) Polio is an acute viral infectious disease spread from person to person, primarily via the fecal-oral route. Affected individuals exhibit a range of symptoms. Polio preferentially infects the central nervous system, destroying motor neurons, leading to muscle weakness and paralysis. The polio immunization is administered at ages 2 months, 4 months, 18 months and 5 years. The most common side effect is soreness at the injection site.

Haemophilus influenzae Type B (Hib) Prior to the development of this vaccine, Haemophilus influenzae Type B (Hib) was the leading cause of bacterial meningitis in childhood. It also caused epiglottitis, pneumonia, sepsis, osteomyelitis (bone infections) and septic arthritis. This immunization is administered at ages 2 months, 4 months, 6 months, and 15 months. The common side effects are fever, redness, swelling or soreness at the injection site.

Rotavirus (Rotateq) Rotavirus is the most common cause of severe gastroenteritis in the US. It causes diarrhea and vomiting that can lead to severe dehydration and hospitalization. Since Rotavirus is spread easily from contact with contaminated hands or objects (fecal-oral transmission), it mostly affects infants and children less than 5 years of age. Rotateq is an oral vaccine that is extremely effective against Rotavirus disease. This immunization is administered at ages 2 months, 4 months, and 6 months. A possible side effect of the vaccine is mild diarrhea.

Varicella (Chickenpox) Chickenpox is a highly contagious disease caused by varicella zoster virus (VZV). It usually starts with a vesicular skin rash on the trunk, face and head. The varicella vaccine has been available in the US since 1995. The immunization is given at age 12 months with a booster at age 4 years. The common side effects are redness, swelling, or soreness at the injection site. In under 5% of patients, a localized or generalized varicella-like rash may develop 1-3 weeks following the vaccine.

Measles, Mumps, and Rubella (MMR)

• Measles is prevalent worldwide. Several measles outbreaks have occurred in the US due to decreased immunization rates. The measles virus causes rash, cough, runny nose, eye irritation, and fever. It can lead to ear infection, pneumonia, seizures, brain damage, and even death.
• Mumps is also a viral illness. Mumps infection in adolescent and adult males can cause orchitis (testicular inflammation) that can lead to infertility.
• Rubella infection poses major risks during pregnancy. If a pregnant woman is infected, her fetus may contract congenital rubella that can cause significant birth defects.

All three diseases are highly contagious. The MMR vaccine is an immunization against measles, mumps, and rubella. It is a live attenuated virus vaccine. This immunization is given at age 12 months and 4 years. The vaccine may cause a fever and/or rash 7-10 following the administration.

Hepatitis A (Havrix) Hepatitis A is an acute infectious disease of the liver. Symptoms include nausea, vomiting, diarrhea, jaundice (yellowing of the skin and the eyes), fever, and abdominal pain. Hepatitis A is spread by ingesting food or water contaminated with the virus. The transmission is fecal-oral. Shellfish that has not been sufficiently cooked is a relatively common source. The vaccine provides protection from the virus for at least fifteen years. The immunization is administered at the 15 month and 2 year old visit. This vaccine does not cause fever or any other significant side effects.

Meningococcus (Menactra) Neisseria meningitidis (meningococcus), is a bacteria that causes meningitis and other serious illnesses. It is the leading cause of bacterial meningitis in teenagers and young adults. Six serogroups, A, B, C, Y, W-135, and X are responsible for virtually all cases of the disease in humans. Menactra is a vaccine that protects from serogroups A, C, Y, and W-135. The immunization is administered at age 11 years and again between ages 16-18 years. The common side effects are soreness at the injection site and mild fever.

Influenza The most common symptoms of influenza, “the flu,” are chills, fever, runny nose,sore throat, muscle pains, headache (often severe), coughing, and weakness/fatigue. Seasonal flu vaccine is recommended for all children six months of age and older. Children in the 6-36 month age group are considered at highest risk for complications of influenza. Other high risk groups include those children with cardiac disease, pulmonary disease (asthma), diabetes, immunosuppression, or other chronic illnesses. This vaccine is administered annually and targets the most common circulating strains for the upcoming season. The Flu vaccine is an inactivated vaccine and does not cause the Flu. The common side effects are soreness, redness, or swelling where the shot was given, fever, cough, headache and fatigue.

Human Papilloma Virus (Gardasil) Human papilloma virus (HPV) is the most common sexually transmitted infection in the US. More than half of all sexually active people are infected with HPV at some time in their lives. Chronic HPV infection can lead to cervical cancer in women, penile cancer in men, and oral and anal cancers, and genital warts in both women and men. Gardasil protects against four different strains of the virus. The vaccine is approved for ages 9 through 26 years. Pediatric Associates typically begins giving this vaccine at 13 years of age. It is recommended for both girls and boys. If administered before 15 years of age, only 2 doses are needed, separated by a period of 6 months. If given at 15 years of age or older, it is given as a three dose series: the initial dose, the 2nd dose two months later, and a final dose six months from the initial dose. The most common side effect is injection site pain and fever.

Meningitis B (Trumemba)