Vaccinations

We offer all CDC and guideline-recommended vaccinations, including vaccines against the following infections:

  • Hepatitis A and B

  • Haemophilus influenzae (Hib)

  • HPV (Gardasil)

  • Influenza (Oct 1 – Mar 31)

  • Meningitis

  • Measles, Mumps, Rubella (MMR) Pneumococcus (Prevnar and Pneumovax) Rabies

  • Shingles (Shingrix)

  • Tetanus

  • Varicella

importance of Vaccines

The gasping breath and distinctive sounds of the whooping cough; the iron lungs and braces designed for children paralyzed by polio; the devastating birth defects caused by rubella: and the highly contagious variola virus that causes smallpox resulting in small blisters that pop up over the body, accompanied by flu-like fatigue, body aches and sometimes vomiting; to most Americans, these infectious scourges simultaneously inspire dread and represent obscure maladies of years past.
Smallpox affected all levels of society. In the 18th century in Europe, 400,000 people died annually of smallpox, and one-third of the survivors went blind. Case fatality rates varied from 20% to 60% and left most survivors with disfiguring scars. Case fatality rates in infants were even higher, approaching 80% (London) and 98% (Berlin).


The practice of immunization dates back hundreds of years. Dr. Edward Jenner is considered the founder of vaccinology in the west in 1796. As a country doctor, Dr. Jenner relied extensively on knowledge of local customs of farming communities and the awareness that milkmaids infected with cowpox, visible as pustules on the hand and forearm, were immune to subsequent outbreaks of smallpox that periodically swept through the area. Dr. Jenner applied the scientific methods of observation and experimentation to this parochial wisdom, ultimately conducting one of the first world’s clinical trials. He inoculated a 13-year-old body with Vaccinia virus (cowpox) and demonstrated immunity to smallpox leading to the subsequent development of the smallpox vaccine. The mass implementation (immunization) and intense and internationally coordinated vaccination campaign of the smallpox vaccine over the 18th and 19th century culminated in the eradication of smallpox in 1979. A little more than a century ago, the U.S. infant mortality rate was a staggering 20 %. Not surprisingly, in an epoch before the existence of preventive methods and effective therapies, infectious diseases such as measles, Diptheria, smallpox, and pertussis topped the list of childhood killers. Fortunately, many of these devastating diseases have been contained, because of the development and widespread distribution of safe, effective, and affordable vaccines.
Millions of lives have been saved and microbes stopped in their tracks before they could have had a chance to wreak havoc. In short, vaccines represent the single greatest promise of biomedicine; disease prevention. The following tables illustrate the dramatic reduction in deaths due to diseases that are now vaccine-preventable.

Impact of Vaccines in the 20th & 21st Centuries

Table 1.  Comparison of 20th Century Annual Morbidity & Current Morbidity:

Vaccine-Preventable Diseases

Disease                
20th Century
Annual Morbidity*
2017 Reported
Cases**
%Decrease

Smallpox                                                 29,005                                          0                                          100%

Diphtheria                                               21,053                                           0                                          100%         

Pertussisi                                                200,752                                    18,975                                        91%

Tetanus                                                       580                                            33                                           94%

Polio (paralytic)                                      16,316                                           0                                           100%

Measles                                                   530,217                                       120                                         >99%
Mumps                                                    162,344                                     6,109                                         96%                           
Rubella                                                     47,745                                           7                                           >99%
CRS                                                               152                                             5                                             97%
Haemophilus                                       20,000 (est.)                                  33***                                      >99%
Influenzae

Haemophilus Influenzae type b (Hib) < 5 years of age

Table 2. Comparison of Pre-Vaccine Era Estimated Annual Morbidity with Current Estimate: 
Vaccine-Preventable Diseases
Disease
20th Century
Annual Morbidity
2017 Reported
Cases
% Decrease
Hepatitis B (acute)                   66,232                                            20,900                                       68%
Hepatitis A                                 117,333                                            4,000                                         97%
Pneumococcus                         63,067                                           30,400                                       52%
(invasive) All ages                           16,069                                             1,700                                        89% 
<5 years of age                        
Rotavirus                                     62,500                                           30,625                                        51%
(hospitalizations
<3 years of age)
Varicella                                   4,085,120                                        102,128                                       98%
*JAMA 2007; 298 (18): 2155-2163
**CDC National Notifiable Diseases Surveillance System, 2017 Annual Tables of Infectious Disease Data. Atlanta, GA, CDC Division of Health Informatics and Surveillance, 2018. Available at:  

You can read more about these tables and the impact/ importance of vaccines in the Journal of the American Medical Association 2007, Volume 298, Number 18 and the CDC. National Notifiable Diseases Surveillance system 2017.
During the 2017-18 flu season, 80,000 people in the U.S. died from influenza and 900,000 people were hospitalized, according to preliminary estimates from the CDC.
There are a multitude of reasons why people refuse to get vaccinated. While there is a consensus that vaccines are an excellent means to prevent infection, and despite the ubiquitous nature of public advertising and messaging, these messages appear to be diluted by a number of other factors. We respect each individual’s right to decline any treatment, nonetheless, it is important to address several misconceptions about vaccines.

Myths and Fallacies About the Flu Vaccine

“I never get the flu each season so I don’t need a flu vaccination”

You may have a good history, but that does not mean you can’t get the flu. The flu shot is considered the best protection against the flu. Vaccine effectiveness varies from year to year, however, recent studies suggest that during seasons plagued by the predominant flu strains, flu vaccination reduces the risk of flu illness 40% to 60% among the overall population.
Also, it only takes getting the flu once to land yourself in the hospital, or worse, so please take this virus seriously. Over the past 8 years, between 12,000 and 56,000 people died each year from complications related to influenza infection. In 2017-18, over 700,000 people were hospitalized due to influenza; among the pediatric population, 180 children died, 80% of whom were not vaccinated.


“When I receive the flu vaccine, I come down with the flu”
It is impossible to get the flu from the influenza vaccine. All but one influenza vaccine is made with protein derived from the virus, which means there is no live virus present. The only live influenza vaccine is the live attenuated intranasal influenza vaccine (LAIV), which contains an inactivated strain of influenza that is not capable of causing illness.
It takes approximately 2 weeks for the body to build up enough immune defense to be protected against the flu. During that time, if you are exposed to influenza virus, you could still get the flu. Also, influenza vaccines do not protect against the far more common cold viruses that circulate during the winter months, including some severe viruses like parainfluenza and metapneumovirus that can mimic influenza illness. Finally, sometimes a new or modified strain of flu circulates, such as the 2009 H1N1 outbreak, which the seasonal influenza vaccine may not fully protect against, enabling some people who receive the flu shot to still get the flu.

“I am allergic to eggs and cannot receive the flu shot”

Egg allergies affect about 1.3% of all children and 0.2% of all adults. The CDC now advises that anyone with an egg allergy – no matter how severe – can safely receive the influenza vaccine that is otherwise appropriate for your age and health status. Individuals who have a history of severe allergic reactions to eggs (any symptom other than hives) are advised to receive the influenza vaccine in a hospital, clinic, health department or physician offices under the direct supervision of a health care provider.
Flu vaccines and nasal spray flu vaccines are manufactured with a negligible amount of egg protein (ovalbumin). CDC studies have found that allergic reactions in people with egg allergies are unlikely as the risk of having a life-threatening allergic reaction to any vaccine is about 1 in one million.

 

“I got the flu already this season, so I will not get it again this season”
Different strains of the flu circulate each season. Yes, it is possible to get the flu twice in one flu season. There are two types of influenza viruses that circulate each year - type A and B each conferring its own unique symptoms depending on which virus the person catches. There are many variants of Influenza A & B. Depending on what is circulating in the season, a person can catch type A virus first and catch type B virus next, or catch yet another variant of the influenza A virus. However, having had a particular influenza virus confers immunity from catching that specific one again.
You should still make it a priority to receive the flu vaccine if you already had the flu this season.

 

“It's too early or too late to get the vaccine”
The CDC recommends getting the flu shot as soon as it is available, preferably before October. Even if you have put off the flu vaccine, January is still not too late to get it, if influenza is active in your community. Getting it late is better than not getting it at all. Keep in mind, seasonal flu disease peaks between December and March and may occur as late as May.

We offer the following vaccinations to protect you while you are abroad:
 

  • Hepatitis A

  • Hepatitis B

  • Poliomyelitis

  • Twinrix (Combination Hep A & Hep B)

  • Influenza

  • Measles-Mumps-Rubella

  • Meningococcal

  • Pneumococcal

  • Tetanus/Diphtheria/Pertussis

  • Typhoid Fever

  • Yellow Fever

  • Varicella (Chickenpox)

  • Zoster (Shingles)


Prompt evaluation and, if needed, treatment upon your return.

We offer medications and advice on the following conditions:

 

  • Traveler’s Diarrhea

  • Malaria

  • Dengue Fever

  • Motion sickness

We offer vaccinations for specific travel destinations as well:

  • Brazil

  • China

  • Kenya

  • Tanzania

  • Thailand Peru

The CDC issues travel health advisories here:


http://wwwnc.cdc.gov/travel/notices

The US State Department issues international travel safety alerts regarding a range of issues, including health issues, here: http://travel.state.gov/content/passports/english/alertswarnings.html

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2020 Apex Physicians