this is a page of information about vaccines, compiled from my own learning and the resources linked below. this is not a substitute for medical advice from your own family doctor; it is merely a page of information for me and my patients to quickly reference. you should always seek care with YOUR family doctor if you have questions or concerns about vaccination.

Vaccine Information Sheets (CDC provided)

CDC Immunization Schedules (2025)

books I have read, and suggest for further reading

Please note, these books are for INFORMATION and are not RECOMMENDATIONS or SUBSTITUTION for care. Your family doctor should answer any and all questions you have about vaccines; these books could be helpful in addressing some of those questions or help you think more deeply about this topic.

Between a Shot and a Hard Place by Joel Warsh, MD, MSC

The Vaccine Friendly Plan by Paul Thomas MD

what's a contraindication? what's a precaution?

contraindications are medical conditions or risk factors that make it INAPPROPRIATE to administer a vaccine to a person. an example is giving a live vaccine to a pregnant person.

contraindication = do NOT VACCINATE.

precautions are medical conditions or risk factors that could slightly increase the risk of adverse events, might compromise the efficacy of the vaccine (i.e. make it not effective for the person receiving it), or might confuse the vaccine with other problems. examples include a child who has an illness who is due for vaccines - the parents and/or doctor might choose to delay that child's vaccines to the following week or two when the child is healthy again, because it would be unclear if continued illness/fever was due to the vaccine or due to the pre-existing illness.

precautions = ok to give vaccines, but: think twice and have further conversation about risks and benefits before administering

Measles, Mumps, Rubella (MMR)

  • vaccination introduced in 1963
  • MMR II - Merck vaccine (usually given in US); ingredients:
    • live attenuated (or weakened) viruses
    • sodium phosphate
    • sucrose
    • recombinant human albumin
    • neomycin (antibiotic)

MEASLES (measles virus)

    • spread: respiratory droplets/direct contact
      • prior to introduction, 3-4 million cases per year, with ~48,000 annual hospitalizations; 400-500 deaths per year
      • one infected person infects 18 other people ON AVERAGE! this is a very contagious disease!
    • potential complications from infection: pneumonia (6% of children), encephalitis (1 in 1000; potentially causes permanent brain damage or death); SSPE (subacute sclerosing panencephalitis – rare but FATAL and occurs years after measles infection, 4-11 out of 100,000 cases); immune amnesia (impaired immune function after infection with measles, affects up to 50% of people infected with measles)

MUMPS (mumps virus)

    • spread: respiratory droplets or direct contact
    • complications: orchitis (testicular inflammation; can cause infertility), pancreatitis (inflammation of the pancreas, which can cause type I diabetes), encephalitis (inflammation/infection of the brain), hearing loss

RUBELLA (German measles)

    • causes congenital rubella syndrome in fetuses, if pregnant women become ill. this can cause: miscarriage, stillbirth, or severe birth defects including hearing loss, heart defects, intellectual disabilities

RSV (respiratory syncytial virus)

The RSV vaccine is recommended for moms at 32-36 weeks of pregnancy. An antibody is available for infants whose moms did not receive the vaccine. Sometimes, I meet moms who aren't interested in this vaccine because they see it as a risk for their pregnancy. I try to invite people to look at it as a way to take the vaccine FOR your baby, so your immune system can do the work that theirs can't yet. RSV, similarly to whooping cough (pertussis), lands a lot of babies in the hospital each year – tens of thousands each year, to be exact!

How effective is it? Real world effectiveness estimates: RSV vaccine prevents about 70-80% of hospitalizations related to RSV.

Why is it important? RSV causes between 58,000-80,000 hospitalizations each year, and 100-300 deaths each year in the US for infants and children under the age of 5.

Getting this vaccine or the antibody can prevent a hospitalization for your child. If you live in a rural area, hospitalization for your child might mean a transfer to a larger hospital by helicopter or ambulance, which is costly and stressful for families.

HEPATITIS B

As of late 2025, guidelines have changed for hepatitis B vaccine at birth in the United States. But family doctors still recommend you get your baby this dose at birth. Let's talk about why.

Hepatitis B is an infection of the liver that can cause chronic disease in infants. It is an infection that can be passed from mom to baby during pregnancy, and also from other humans to baby after birth. Most people know that hepatitis B is transmitted through blood, and wonder why babies need this vaccine if they are not using intravenous drugs, having sex, shaving, or otherwise engaging in behaviors that lead to blood-to-blood contact with strangers. But the truth is, your baby can also get hepatitis B from other bodily fluids from strangers. Studies have shown that there are some cases of hepatitis B that babies develop where we are not sure how they got infected, and this is especially true for babies who are in daycare where they are exposed to saliva and sometimes other bodily fluids of other infants. In these situations, it's easy to see why vaccination is strongly recommended for ALL babies - so they can protect each other!

If you choose not to give your baby the hepatitis B vaccine at birth, it's important to discuss this with your family doctor. It will be REALLY important for you to consider the vaccine before your baby goes to daycare or has childcare from other relatives. Even if you can't imagine your baby becoming sexually active or using IV drugs, right now - I bet you can picture your child being bitten or slobbered on by another child in day care.

why is hepatitis B a risk to my baby?

  • HepB is MUCH more contagious than HIV or hepatitis C and can be transmitted in a childcare setting through saliva
  • you might KNOW your baby isn't at risk at birth because you know you and your family members are vaccinated/not infected, but you do NOT know what other families have chosen to do!
  • if babies get infected with hepatitis B, the risk of chronic infection (lifetime infection) is very high - this causes cirrhosis and death because you cannot survive without a functioning liver

real stories about hepatitis B infection