National Immunization Awareness Month

National Immunization Awareness Month (NIAM) is an annual observance in August to highlight the importance of vaccines for people of all ages and how they help to prevent and protect us from serious, sometimes deadly, diseases and illness. 

Vaccines play a key role in keeping you, your family and your community healthy. They not only protect the person receiving the vaccine but also help to keep diseases from spreading to others and protect people who are the most vulnerable to illness, such as infants, elders and those with weakened immune systems. 

It’s important to know the facts about vaccines, immunizations and vaccine-preventable diseases. In this blog, we speak to Vibitha Mani, M.D., a pediatrician at INTEGRIS Health Medical Group Council Crossing, to get answers to common questions about vaccination.

Vaccine basics

• A vaccine is made from very small amounts of weak or dead germs that can cause diseases and prepares your body to fight the disease faster and more effectively. 
• Immunization is the process of getting vaccinated and becoming immune to, or protected against, a disease. 
  
  

Immunity 

Immunity is the body’s way of defending against diseases. Children are born with an immune system that can recognize germs as antigens, or foreign invaders, and produce antibodies to serve as a defense mechanism. 

When a specific antigen first infects a child, their body slowly produces antibodies to fight the disease. Because this process takes time, they’ll usually develop symptoms that are sometimes severe. If they get sick again in the future, the body remembers the antigen and produces antibodies more quickly, so your child may not get sick the next time.

“Imagine if our body could remember these invaders and produce antibodies without getting sick? That’s a vaccine,” Mani says. “Vaccines contain these antigens, or parts of antigens of specific diseases, in a form that doesn’t cause the disease. It instead allows the body to create antibodies so that the body can ‘remember’ and produce immunity.”

Children may not have a strong enough immune system if they are unvaccinated and become exposed to bacteria or viruses. This happened before vaccines when many children died from diseases such as smallpox, measles, mumps, polio or whooping cough. The development of safe and effective vaccination is a primary reason we do not see these diseases as often. 

• Data from the Centers for Disease Control and Prevention (CDC) comparing annual morbidity before vaccines with more recent data after vaccines shows a large decrease in cases, with some diseases nearly eradicated. For example, 20th century morbidity totals for smallpox and diphtheria decreased from 29,005 and 21,053, respectively, to zero. Polio also decreased from 16,316 to zero during that same time. As the result of vaccination against polio, more than 20 million people are able to walk today who would otherwise have been paralyzed due to the illness.
• According to the World Health Organization (WHO), from 1974 to 2024, mass vaccinations have saved an estimated 154 million lives. That’s over three million per year, or six people every minute for five decades.
• The vast majority of lives saved by vaccination programs globally are infants. 

“Vaccinating our children also helps protect the health of our community, especially those people who can’t receive vaccines, such as newborns and people with compromised immune systems. As these diseases still exist, by keeping the vaccination rates high, we prevent epidemics of these diseases,” Mani says.

Vaccination by the numbers

Population immunity requires high levels of vaccine uptake to limit the number of unvaccinated people and the opportunity for pathogen transmission between them. 

States and local districts set vaccination requirements for school attendance and conditions and procedures for exemptions from these requirements. For most states, the goal is for at least 95% of the student population to be vaccinated.

During the COVID pandemic, children missed their shots and vaccination rates fell due to disruptions in health care services, logistical challenges and inequities in access to services. In the last four years, however, more parents have opted their children out of vaccination requirements through the use of nonmedical religious exemption. 

• The CDC collects annual data from states on the number of children in kindergarten who meet, are exempt from, or are in the process of meeting requirements. According to this data, during the 2022-23 school year, vaccine exemption rates rose in 41 states, exceeding 5% in 10 states.
• In Oklahoma, more parents have requested non-medical exemption in recent years. According to state and federal data, the CDC reported that Oklahoma had the highest vaccine exemption rate in a seven-state region for the 2021-22 school year (excluding COVID vaccines). 

“Scientists have developed our current immunization schedule based on our national infectious disease data so that we can give children the best chance of developing full immunity for these diseases,” Mani says. “Missing vaccines puts children at risk of developing these vaccine-preventable diseases, such as measles and polio. Children don’t receive any known benefits from delaying vaccines or skipping vaccines.”

Although measles was eliminated in the U.S. over two decades ago, widening gaps in immunization coverage are driving outbreaks of measles and other diseases and compounding an historic drop-off in vaccination rates. 

• In 2019, the largest measles outbreak in the U.S. since 1992 occurred in a New York City community with a cluster of unvaccinated children.
• Last year, 18 jurisdictions reported measles cases, including a significant outbreak in Ohio.
• In January 2024, the CDC issued an alert stating 23 confirmed cases of measles had been detected since Dec. 1, 2023. They said most of the cases were children and adolescents who had not received a measles (MMR or MMRV) vaccine, even if age eligible.
• About 1 in 5 unvaccinated people who get measles are hospitalized in the U.S.

Mani says vaccines are the single most important thing parents and guardians can do for their children to boost immunity and protect them against deadly diseases and even certain types of cancer. 

“Immunization is an especially important preventive health measure especially for children. They directly benefit the immunized child against vaccine-preventable illnesses,” says Mani. “They also indirectly protect other children, such as infants too young for immunizations and those with immunodeficiencies or contraindications to vaccines, through community immunity which occurs when a significant part of the community is immune to the infection leading to decreased risk of transmission.”

In the event your child isn’t fully immunized, you should know your child can become infected by outbreaks or exposures, even from people who are asymptomatic. If exposed, Mani says to isolate your child from others, including family members, especially infants and people with weakened immune systems.

Getting back on track

We encourage you to talk to your doctor, nurse or health care professional to ensure that you and your family are protected against serious diseases by getting caught up on routine vaccinations. 

“Vaccine-preventable diseases are more severe in infants and young children which is why most of these immunizations are given at a young age to reduce duration of vulnerability,” says Mani.

Children can receive vaccinations as part of routine wellness visits. They’re also available at the state and county health department, some pharmacies (check with the pharmacy about age restrictions) and sometimes even at schools.

Here is a vaccination schedule by age: 

• Birth – Hep B
• 2 months – DTaP, Hep B, IPV, PCV, HIB, typically also given with rotavirus vaccine.
• 4 months – DTaP, Hep B, IPV, PCV, HIB, Rotavirus
• 6 months – DTaP, Hep B, IPV, PCV; Rota and HIB based on which brand administered.
• 12 months – MMR, Varicella, Hep A
• 15 months – DTaP, HIB, PCV
• 18 months – Hep A
• 4 years – MMR, Varicella, DTaP, IPV
• 9 to 11 years – HPV
• 11 years – DTaP, MCV4
• 16 years – MCV4, MenB

Many states have immunization information systems (IIS) to keep track of vaccination records. In Oklahoma, the Oklahoma State Immunization Information System (OSIIS) collects and maintains accurate and current immunization records for Oklahomans of all ages. Your doctor’s office can access this database and print a record for you. 

Once you start, it is essential to keep up with the correct schedule of vaccine doses. There are risks associated with missing or skipping vaccinations. Mani says to notify your doctor’s office, urgent care facility or emergency room staff if your child doesn’t have certain vaccinations.

Vaccinations required for Oklahoma children in school

Here's a list of what vaccinations are required in Oklahoma by each school grade. Some vaccinations will require multiple doses. 

Vaccines required to enter childcare:

• 4 x DTaP (diphtheria, tetanus, pertussis)
• 1 - 4 x PCV (pneumococcal)
• 1 - 4 x Hib (Haemophilus influenza type B)
• 1 x MMR (measles, mumps, rubella)
• 1 x Varicella (chickenpox)
• 3 x IPV (polio)
• 2 x Hep A (hepatitis A)
• 3 x Hep B (hepatitis B)
• A seasonal influenza (flu) vaccination is recommended.

Preschool: 

• 4 x DTaP
• 1 x MMR
• 1 x Varicella
• 3 x IPV
• 2 x Hep A
• 3 x Hep B
• A seasonal influenza, second Varicella dose and IPV vaccine on or after the fourth birthday is recommended. 

Kindergarten to 6th grade:

• 5 x DTaP
• 2 x MMR
• 1 x Varicella
• 4 x IPV
• 2 x Hep A
• 3 x Hep B

7th to 12th grade:

• 1 x Tdap
• 5 x DTaP
• 2 x MMR
• 1 x Varicella
• 4 x IPV
• 2 x Hep A
• 3 x Hep B
• A seasonal influenza, 2-3 x HPV, 1-2 x MCV4 and 2-3 x Men B are recommended for this age group. 

Students four through six years old are required to have their final doses of DTaP, IPV, MMR and Varicella vaccines prior to kindergarten entry. All students attending an institute of higher learning provide proof of immunity to measles, mumps and rubella diseases. New college and university students living in student housing must review and sign the Meningococcal Disease Information Sheet. For more information, visit the Oklahoma State Department of Health's immunization service.  

Side effects

While vaccines will prevent your child from becoming infected with deadly viruses and diseases, you should still be aware of common side effects. Mani says these include localized tenderness, redness or swelling, rash or fever. She adds, “Allergic reactions to vaccines or vaccine constituents may include symptoms such as hives, itching, facial swelling, wheezing, coughing, shortness of breath, stridor, palpitations and/or decreased blood pressure within 30-60 minutes after vaccines. Vasovagal syncope may occur in some patients but does not indicate vaccine allergy.” 

Still, side effects from vaccines are rare. For example, if one million doses of a vaccine are given, only one to two people may have a severe allergic reaction. While side effects are scary, especially with a child, keep in mind this is a sign the body is building immunity. Contact your doctor if you have any specific questions or concerns.