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A Double Shot
Combined Vaccines: The Latest in Immunization
By Katherine Bontrager
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).
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."
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