WELCOME

 

IMMUNIZATIONS

 

Immunizations protect your child from serious or even life-threatening diseases. The American Academy of Pediatrics and Centers for Disease Control use the same schedule, updated yearly. It various somewhat from the current French schedule. The recommendations can be found at:

http://www.cdc.gov/vaccines/schedules. 

 

Should you come from another country, continuing your current schedule is rarely a problem.  Please be aware that in France, physicians do not stock vaccines, but rather you must obtain a prescription and fetch them directly from a pharmacy. 

 

The French immunization schedule may be different from your home country schedule. This may be a problem for you once you return home after your time in France. Feel free to discuss with Dr. Lovejoy.

 

Should you have concerns about vaccine safety or the number of vaccines given, please let Dr. Lovejoy know. You may also want to visit the following site: https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/Weighing-the-Risks-and-Benefits.aspx. There is, sadly, growing misinformation regarding vaccines on the internet, with the predictable result of increasing disease in non immunized children. 2025 promises to be a very challenging year for children!

 

DESCRIPTION OF IMMUNIZATIONS

 

RSV VACCINE

 

Beyfortus is a new vaccine--or, more accurately, monoclonal antibody, replacing the older Synagis injections. It is very effective against RSV, a major cause of hospitalization in the first year of life. It is available and free of charge in France. It is just one shot, and mostly for babies born in 2024, and those with certain risk factors entering their second winter. Feel free to ask Dr Lovejoy for a prescription. {Of note, there is a similar vaccine given to pregnant women between 32-36 weeks; if given, the newborn infant does not require Beyfortus.

 

COVID VACCINE

 

Each autumn, the FDA and CDC will approve an updated Covid vaccine, similar to influenza vaccine updates. Unfortunately it is not administered at the AHP, so please make an online appointment via Doctolib.fr--there is an age-based algorithm which will guide you to the appropriate center.

 

ROTAVIRUS VACCINE

 

This vaccine is designed to protect young children from a particularly severe form of diarrhea caused by the rotavirus. There are two vaccines in production, the Rotateq and Rotarix. The Rotateq was approved by the American Academy of Pediatrics on November 2, 2006 in the US; and is now an official recommendation. The Rotarix (an oral vaccine) is approved in Europe and, as of April 2008, also in the U.S. The two vaccines are of comparable safety and efficacy; however the Rotarix is two doses, and the Rotateq is three. Rotarix is usually given at 2 and 4 months of age; the final dose should be given by 8 months of age. 

The rotavirus vaccine is reimbursed in France since 2023, though not mandatory.

Both versions of the rotavirus vaccine are safe and recommended in the USA.

 

MEASLES, MUMPS AND RUBELLA (MMR) VACCINE 

 

The first shot is when your child is 12 to 15 months old and the second at age 4 to 6 years. The French schedule requires the second MMR shot at an earlier time, between 16-18 months. 

Due to the Covid shutdown and non-vaccination during that period, there has been a worldwide outbreak of measles since 2021. Amazingly, in 2023 over 100,000 people--mainly children--died worldwide from this disease.

 

Internet rumors abound linking the MMR vaccine to autism. There have been four major studies in the past decade showing no scientific link between this vaccine and future developmental problems. In addition, on February 6, 2010, the Lancet medical journal retracted the one scientific article linking MMR to autism. The author, Dr. Andrew Blakefield, falsified his data. He also had filed for a patent for a single-vaccine shot (measles only), hence his article served his own financial interest.

 

The folllowing article gives a very good, if somewhat technical summary: https://www.aafp.org/pubs/afp/issues/2010/0915/p586.html.

 

DIPHTHERIA, TETANUS AND PERTUSSIS (DTaP) VACCINE 

 

Pertussis, or whooping cough, is a dangerous disease for infants. Twenty years ago there were concerns raised about side effects of the vaccine, especially seizures. With the newer acellular vaccine, this risk is now very small; however the weaker vaccine has permitted a resurgence of the disease, worsened by the Covid-19 epidemic and consequent non-vaccination of children at the time.

 

The risk of suffering and death caused by whooping cough is far greater than the possible side effects of the vaccine. A child who has not been immunized against pertussis has a chance of 1 in 3000 of getting whooping cough. In contrast, a child who got the vaccine has a chance of 1 in 2 million of having neurological damage with the vaccine. The risk of children getting pertussis increases if fewer children are immunized. 

 

This vaccine is mandatory for entry into French schools. 

France and the USA recommend that adult women receive a pertussis booster with every pregnancy.

 

HEAMOPHILUS INFLUENZAE TYPE b (Hib) VACCINE

 

Haemophilus influenzae is a type of bacteria that causes several life-threatening diseases in young children (such as meningitis, epiglottitis, and pneumonia). Before the vaccine was available, over 10,000 children in the U.S. developed haemophilus meningitis each year. About 500 of them died and 3800 became mentally retarded, blind or deaf, or got cerebral palsy as a result of the disease. Because of the vaccine, haemophilus influenzae type B is now uncommon in the U.S. The Hib vaccine does not protect against flu and meningitis caused by viruses. 

 

POLIO VACCINE

The polio vaccine protects children from this now rare but crippling disease. The polio vaccine schedule issued in 2000 recommends inactivated polio vaccine (IPV) for all polio doses. In France, your child needs to have more polio shots than in the U.S: every five years until age 16-18, and every ten years thereafter. 

 

PNEUMOCOCCAL VACCINE

The Pneumococcus is a bacterium which, similar to Haemophilus type B, can cause serious blood infections, meningitis, bone and joint infections, but also ear infections. The vaccine available for babies has been offered in the US since the year 2000. It is given along with the basic series of shots, a total of 4 times in the first 15 months of life (but just 3 times in France). The older Prevenar 13 has been replaced with the 15-strain Vaxneuvance, or the 20-strain Prevenar 20. The former has not yet been approved in France for infants, though it has been in the USA.

 

HEPATITIS B VACCINE (HEP B)

 

Your child needs a total of 3 hepatitis shots. Vaccination against hepatitis B prevents this type of hepatitis and the severe liver damage that can occur 20 or 30 years after a person is first infected. More than 5000 adults die each year in the U.S. from hepatitis-related liver cancer or cirrhosis. The younger the age when the infection occurs, the greater the risk of serious problems. 

If you have an older child who was not vaccinated against hepatitis B as an infant, ask your doctor whether he or she should have the shots.

 

CHICKENPOX (VARICELLA) VACCINE 

 

The chickenpox vaccine is usually given at 12 months of age, but it can be given to older children if they have not had the vaccine or the disease yet. Booster doses are given in the USA at age 4 years, but I recommend between 15-18 months in France, since French children are not vaccinated--full protection also protects in adult years against shingles.

 

Children age 13 or older should get 2 doses at least 4 weeks apart; disease is more aggressive the older one is.

 

HEPATITIS A VACCINE

 

This vaccine is universally recommended in the USA.

In France it is recommended for high-risk patients, including people traveling to developing countries. Hepatitis A is a common illness in the developing world, which one can catch from contaminated water or food. It consists of two shots given at least 6 months apart. It can be given after 12 months of age, but to minimize the number of shots at any one visit, Dr. Lovejoy usually gives it at 18 and 24 months. It can also be combined with the Hepatitis B vaccine (just one needle stick).

 

MENINGOCOCCAL VACCINE

 

There are several meningoccal (one of several types of bacteria which can cause meningitis) vaccines on the market in France. The US recommendations are that the combination A,C,Y, W135 should be given to children at the 11-12 year visit, and again at 15-16 years.

 

France will require this vaccine as of 2025 for infants and for adolescents who have never received the vaccine.

 

Meningoccocus B vaccine (Bexsero) will be required in France as of 2025 for babies. It is an option in the USA>

 

HPV VACCINE

 

This vaccine, called Gardasil, is designed to prevent infection with the Human Papilloma Virus, the leading cause of cervical cancer. It is also protective for HPV-related esophageal cancer (boys & girls).

It is the first cancer vaccine in history. It is recommended at 11-12 years of age, before any sexual activity has started. It is somewhat more efficacious when given at this age than during the later teen years; it is not effective when given after significant sexual activity.

 

 

INFLUENZA VACCINE

 

[PLEASE SEE SEPARATE LINK ON INFLUENZA FOR CURRENT INFORMATION]

 

Influenza can affect anyone, and epidemics of influenza occur during the winter months nearly every year. Influenza is spread through coughing and sneezing, and is highly contagious, especially in childcare centers, schools, and nursing homes. Influenza generally comes on suddenly, and symptoms include muscle aches, fever, chills, headache, cough, and runny nose. Young infants may develop croup. The most frequent complication of influenza is pneumonia. Myocarditis (inflammation of the heart) and worsening of chronic lung diseases also may occur. 

The vaccine is given every year due to the changing of strains seen every year. For children under age 8 years, the first year they must receive the vaccine twice. For children under age 3 years, a half-dose is given each time. The vaccine is available in France without a prescription, usually as of mid-October. Unless there is an ongoing epidemic, we usually stop vaccinating at the end of January, but it can be given through April. Egg-allergic children should generally not receive the vaccine. The American Academy of Pediatrics broadened their recommendation in August 2008 to include all children ages 6 months to 18 years. In France it is not universally recommended due to financial constraints, but is so for children with a history of wheezing or cardiac disease, and as of November, 2008 they recommend that the °family° living with infants under 6 months of age be vaccinated. The American Academy of Pediatrics also recommends the entire family be vaccinated if you have a high-risk child, or a child under 5 years of age. Should one of your children have asthma or bronchiolitis, it is strongly recommended to vaccinate him/her every year regardless of age, and the entire family as well.

 

BCG

 

This vaccine has never been recommended in the U.S. It does not prevent a person from catching tuberculosis, but is fairly effective in preventing severe TB disease in young children. Once vaccinated, there is a risk that any future skin test (PPD) done upon return to the US will be positive, which entails taking medication for 9 months.

As of July, 2007, the BCG is no longer mandatory in France, but is still recommended for at-risk children. Feel free to discuss the pros and cons of this vaccine with Dr. Lovejoy.

 

REASONS NOT TO VACCINATE

If any of the following conditions apply to your child, talk to your doctor before getting your child vaccinated. 

1. Your child had an allergic reaction to a previous vaccination. 

2. Your child has seizures or serious neurological disease. 

The pertussis vaccine (DTaP) should not be given if a child has seizures or serious neurological disease. You can still give your child the tetanus and diphtheria (Td) vaccine without the pertussis vaccine. 

3. Your child has poor immunity. 

Children with weak immune systems should not get live vaccines (for example, chickenpox, MMR or the Rotavirus vaccine). These children should be vaccinated with the inactivated polio vaccine (IPV) for all 4 doses. This is because the live oral polio vaccine (OPV) carries a small risk that children who have poor immunity, or who are living with adults who have poor immunity (for example, people who have AIDS), will get or pass on polio from the vaccine. 

 

 

UNWARRANTED REASONS NOT TO VACCINATE

Many children have not received all of the recommended immunizations. Unnecessary precautions have led parents to postpone or cancel scheduled immunizations. In April 1989, the U.S. Public Health Service published the following list of conditions that are NOT routine reasons for postponing or canceling immunization. That is, a child can still be immunized even if one or more of the following conditions is true: 

The child had soreness, redness, or swelling at the injection site after a previous DTaP shot. 

The child had a fever of less than 105°F (40.5°C) after a previous DTaP shot. 

The child has a mild illness such as a cold, cough, or diarrhea without a fever. 

The child is recovering from an mild illness such as a cold, cough, or diarrhea. 

The child has recently been exposed to an infectious disease. 

The child is taking antibiotics. 

The child was premature. 

The child's mother is pregnant. 

The child is breast-feeding. 

The child has allergies (unless it is an egg allergy). 

The child's family has a history of convulsions or sudden infant death syndrome (SIDS). 

 

 

CONCERNS ABOUT VACCINE SAFETY ?

Ask Dr. Lovejoy for links to several internet sites, or purchase the book, “Do Vaccines Cause That?” A Guide For Evaluating Vaccine Safety Concerns, by Martin Meyers and Diego Pineda.