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Home › Articles › Health Issues › A Double Shot

A Double Shot

Combined Vaccines: The Latest in Immunization

By Katherine Bontrager

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At the forefront of the new surge of combined pediatric vaccines is Pediarix™, which is produced by GlaxoSmithKline. The vaccine protects children against five diseases: diphtheria, tetanus, pertussis (whooping cough), hepatitis B and polio. Administered in a set of three shots (at the 2-, 4- and 6-month office visits), Pediarix™ can reduce the number of injections in a baby's first year by six. In February of 2003, the Centers for Disease Control and Prevention's advisory committee voted to include Pediarix™ in its "Vaccines for Children" program.

The vaccine Comvax®, by Merck & Co. Inc., combines the hepatitis B and Haemophilus influenza type b (Hib) vaccine into one shot. Given as a three-dose series (at 2, 4 and 12 to 15 months of age), it can amount to four fewer shots than when receiving the shots separately (three hepatitis B shots and four Hib shots).

Another vaccine, though not yet licensed in the United States, is being produced by Aventis. The vaccine, approved for use in Europe in 2000, protects against six diseases: diphtheria, tetanus, pertussis (whooping cough), polio, hepatitis B and Haemophilus influenza type b (Hib).

Easing Parent Anxiety
Dr. Richard Judelsohn is a clinical associate professor of pediatrics at the School of Medicine, State University of New York in Buffalo, N.Y., who also serves as the medical director of the Erie County Department of Health in Buffalo. As a practicing pediatrician, Dr. Judelsohn has been administering vaccinations for more than 30 years. "Immunization schedules are complicated, which can be challenging to both health practitioners and parents, and for some parents, it makes them uneasy," Dr. Judelsohn says. "They wonder, 'Are all these vaccines a good thing? I've never heard of some of these...'"

Although Dr. Judelsohn maintains there is no basis for such concerns, he does admit that for nervous new parents, the number of recommended pediatric immunizations can be a little traumatic. Combined childhood vaccinations are a great answer to these concerns. "It optimizes what we do," he says. "The more things that can be included in a single or short series of injections, the better for optimal disease prevention. There are a reduced number of injected sites in the baby, so there are fewer places for pain, swelling and possible reactions ... Crying is of shorter duration when there are fewer injections."

Although Aventis has not yet submitted its application to get a license in the United States for its vaccine, which can take about two years, Dr. Judelsohn says he is very familiar with the use of Pediarix™. "Pediarix™ has had sizable effect on the immunization program, reducing by 33 percent the number of vaccinations a child has to get," he says. And in the long run, Pediarix™ and other similar vaccines still under development could save both patients and doctors money.

"I've been having a lot of opportunity over the past four months to speak with colleagues about Pediarix™," Dr. Judelsohn says. "In many, many different communities what we're finding is the reimbursement by insurance companies is about equal or even higher for the combined vaccines than what the physicians were getting when giving the single, separate shots."

Combined Benefits

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