Below are some common questions parents may have about vaccines. For more information and to find expert's answers to the questions you may have, links to additional resources are available throughout this section, or you may call the San Diego Immunization Branch at (866) 358-2966 for more information.
Q: Immunizations, vaccinations, inoculations or shots?
A: It is easy to get confused over the terms we hear when people are talking about shots. Some people call them immunizations. Others call them vaccinations, or inoculations. Some just call them shots. Don't be confused. These words all mean the same thing. If a doctor or nurse tells you to bring in your baby for immunizations or vaccinations, or to be vaccinated or immunized, they are asking you to bring the baby in for shots.
Q: Why are baby shots so important?
A: These shots protect your baby from fourteen diseases; Measles, Mumps, Rubella (German Measles), Diphtheria, Tetanus, Pertussis (whooping cough), Polio, Haemophilus Influenzae type b (Hib Disease), Hepatitis B, Varicella (Chickenpox), Pneumococcal, Hepatitis A, Influenza and Rotavirus. It is important to have the recommended doses on schedule, to establish protection while the baby is small and especially vulnerable.
Q: Are these diseases very serious?
A: Although we might not think these diseases are very serious because we don't see them in our communities, they do still exist and can be very deadly. Before the MMR vaccine, measles used to kill hundreds--sometimes thousands--of people a year. In the 1920's over 10,000 people a year died from diphtheria. And in the 1940's and 50's tens of thousands of children were crippled and killed by polio. Even today these diseases can lead to pneumonia, choking, brain damage, heart problems, and blindness in children who are not protected. And they still kill children every year. In San Diego County during 2003, pertussis was responsible for 145 hospital days, mostly among infants, at a cost of $362,500. We cannot measure the cost to parents of watching their babies struggle to breathe. In 2005, 371 cases of whooping cough were reported in the County, the highest number in many years.
Q: What will happen if my child doesn't get these shots?
A: Maybe nothing, if your child is never exposed to disease. But children ARE exposed to diseases through their everyday activities. Most of these fourteen diseases are spread easily from person to person. If your child has not had her shots, and she is around someone who has measles, whooping cough, or one of the other childhood diseases, he/she may get sick, too. It's also important to remember that there are children who can't get their shots due to health problems. As a community, it is our responsibility to protect all of our children. Healthy children don't spread disease, so by protecting your child, you will be protecting others as well. Also, if an outbreak of one of these diseases occurs in a school or child care facility, all children who are not immunized may be kept out of school or child care until the outbreak is ended. 2008 saw the first outbreak of measles in San Diego since 1991. Twelve cases were reported and some 70 people were quarantined at their homes to interrupt the spread of the disease.
Q: Are shots safe?
A: YES! Immunizations are given to people who are not sick to keep them well so they are held to the highest standards of safety. Due to constant review and medical research they are getting even safer and more effective all the time. Vaccines, like all medicines, do have possible side effects. Most side effects are mild, such as pain or tenderness where the shot is given. Serious reactions are rare, but they can happen. Your doctor or nurse will discuss these with you before giving the shots. Make sure they also give you a vaccine information sheet (VIS) for each shot with information for you to take home about the vaccine.
Q: If vaccines cause side effects, wouldn't it be "safer" to just avoid vaccines?
A: No. Unfortunately, choosing to avoid vaccines is simply a choice to take a different (and greater) risk. Unvaccinated children are at risk from many diseases including meningitis caused by Hib, bloodstream infections caused by pneumococcus, pneumonia caused by measles, deafness caused by mumps, and liver cancer caused by hepatitis B virus. When you compare the risk of vaccines and the risk of diseases, vaccines are the safer choice.
Q: If vaccine-preventable diseases are almost gone from the United States, why do our children need to get any shots at all?
A: Many of these diseases may someday be eliminated, but outbreaks of diphtheria, measles, and other vaccine-preventable diseases still occur (see the answer to “What will happen if my child doesn’t get these shots?” above). Without vaccines, the diseases we are now protected from will return. Thousands of children will become sick, some will have long-lasting health problems, and some will die. Other countries do not have the same levels of immunization that we benefit from in the United States. We must all remain protected with vaccines because dangerous diseases, though largely under control in the United States are still only a plane ride away.
Q: How many shots does my child need? And when?
A: Your child should get the first shots at 2 months of age (or in some cases before leaving the hospital after birth), then at 4 months, 6 months and 12-15 months of age. Remember, each of these visits is important! Your child must complete the series to be fully protected. More immunizations are recommended at 2 years and before school entry. Adolescents also need immunizations at 11-12 years of age, before entering 7th grade. For more information, review the current 2012 Recommended Immunization Schedules:
Q: Does my child need a TB test to enter school or child care?
A: The TB skin test is not a vaccine, so it is not part of the California School Immunization Law. Some schools and child care facilities may require the TB test for admission, so check before you enroll your child. For more information, please contact San Diego County's Tuberculosis Control Program at (619) 692-8627 or visit their website at:
To view or download more information on TB screening guidelines, click on the link below:
Q: Is it safe to give my child so many shots?
A: Children can now receive as many as 26 shots by the time they are 2 years old and sometimes as many as six shots in a single visit. That's a lot of shots! The number of recommended immunizations has increased because we are now able to safely protect children from more serious diseases than ever before. At birth, newborns immediately face a host of different challenges to their immune system. But babies are capable of responding to millions of different viruses and bacteria because they have billions of immunologic cells circulating in their bodies. Therefore, the vaccines given in the first two years of life are literally a raindrop in the ocean of what infants' immune systems successfully encounter in their environment every day. Immunizations work naturally by using the body's own immune system, making it stronger and teaching it to fight diseases. Children who have not been immunized are at far greater risk of becoming infected with serious diseases because their body hasn't been taught how to fight off the harmful bacteria and viruses. A recent study showed that children who had not received the measles vaccine were 35 times more likely to get the disease. The consequences from a harmful and sometimes even fatal vaccine-preventable disease are much more damaging to your child's body than the shots that they receive to protect themselves.
Q: What happens if my child misses a shot, or I haven't had time to bring him/her into the doctor on time to get the shots?
A: Many shots are given as a series over a period of time. However, if a shot is missed, you do NOT need to start the series all over again (as long as you have a record of previous shots)! The series can be continued as usual, simply picking up where you left off. Remember, your child must complete the series to be protected, so check your child's record, then call your doctor, nurse, or clinic right away if more doses are needed to help your child stay healthy.
Q: Are all these shots expensive? Where can I go?
A: If you don't have a regular doctor you can take your child to one of the free or low-cost clinics (view here in English or Spanish) nearby. In San Diego County, if you can't afford to pay for the shots, and your child is under 2 years of age, the shots will be given to your child at no cost. If your child is over 2 years, they can still get the shots even if you can not pay.
Q: I know my child's immunization record is important but what happens if I lose it?
A: Your child's immunization record is very important! It will be needed for entry to family child care homes, child care centers, Head Start, pre-schools, schools and even college. If you lose your child's record, ask your health care provider to give you a new copy, with all immunizations recorded and properly documented. If you cannot get the information re-documented by your providers, your child may have to get the shots all over again. So keep his/her record in a safe place with other important documents.
Click on the link below for tips.
Q: Will it hurt my child to get the shots over again?
A: Your child is at no added risk from getting his/her shots again. They will just suffer the discomfort that is involved with getting another shot. No one wants to have to "retake" their shots, so make sure that your child is protected and you have a record of it.
Q: How do I evaluate all the information I find on the internet about immunizations?
A: With the large amount of information on the internet now, it can be confusing to determine what is accurate and valid information. The National Network for Immunization Information has a good answer to this question. You can find it here:
Also, the Centers for Disease Control and Prevent has more information here:
Most importantly, the health information that you find on the web should be discussed with your doctor or health professional. Information from the web should add to rather than replace the information or advice given to you by your doctor.
Q: Does the MMR vaccine cause autism?
A: Many carefully performed studies say no. For the latest information on this topic, please see the sources listed below: American Academy of Pediatrics (AAP)’s web pages with information about vaccines and autism:
The Federal Centers for Disease Control and Prevention has a wealth of information on vaccine safety:
Q: Why is hepatitis B so serious in pregnant women?
A: Pregnant women who are infected with HBV can transmit the disease to their babies. Many of these babies develop lifelong HBV infections, and as many as 1 in 4 will develop liver failure or liver cancer. All pregnant women should be tested early in pregnancy to determine if they are infected with hepatitis B virus. If the blood test is positive, the baby should be vaccinated at birth with two shots, one of hepatitis B immune globulin and one of hepatitis B vaccine. The infant will need additional doses of hepatitis B vaccine at one and six months of age. If you are thinking about becoming pregnant, talk with your doctor about the recommended immunizations you should have to protect your unborn child. For more information about hepatitis, go to the Immunization Action Coalition website at:
Q: Will my child still be protected against chickenpox as an adult if he or she gets the vaccine now?
A: For the latest information on this subject, please see the following websites:
Q: Can the varicella vaccine cause chickenpox? Can other children or adults get chickenpox from being exposed to a child who has recently received the vaccine?
A: The varicella vaccine may cause chicken pox since it is a live, weakened virus. About 1% of recipients per year develop a chickenpox rash, which is much milder than the naturally occurring chickenpox, and is usually without fever. The few children who develop a rash after receiving the chickenpox vaccine may be contagious for a short period of time. Should this occur, they will spread the weakened vaccine virus, not the wild virus.
Q: Can the varicella vaccine cause shingles?
A: Yes, but this happens much less often among people who have been immunized than among those who were naturally infected with the chickenpox. Shingles is a rash with painful blisters that occurs in some people who previously had chickenpox. This is because after a person is exposed to the varicella virus, it can continue to live silently for many years in that individual's nerve cells. Later in life, the virus can become reactivated, moving from nerve cells to the skin, causing the painful condition as the virus multiplies. Shingles is less common among people exposed to varicella virus through the vaccine. About 0.2% of the people who had chickenpox earlier in life (20 cases per 10,000 people who had chickenpox) will develop shingles each year. Only 0.003% of people (.03 cases per 10,000 doses, or 3 cases per million doses) who have been given the varicella vaccine have developed shingles. When it develops, shingles in vaccine recipients is much milder than in people who had chickenpox disease.
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