Information and History About Vaccination and Vaccines

A new version of Gardasil was recently approved by the FDA.
The Gardasil HPV vaccine is one of the newer vaccines approved for use in children.. Photo by Russell Kirk/Getty Images

Vaccines and Vaccination

When given a vaccination, most children develop antibodies that can help them resist specific viral infections, such as hepatitis B, polio, and measles, etc., or bacterial infections, including tetanus, pertussis (whooping cough), and diphtheria, etc.

Although there have always been some people who have been against vaccines, most people have thought of vaccines as one of the greatest health achievements of the 20th century.

History of Vaccines

  • Edward Jenner conducts experiments in 1796 that led to the creation of the first smallpox vaccine a few years later and replaces variolation as a preventative for smallpox
  • a vaccine for rabies is developed by Louis Pasteur in 1885
  • vaccines for cholera and typhoid were developed in 1896 and a plague vaccine in 1887
  • the first diphtheria vaccine is developed in about 1913 through the work of Emil Adolf Behring, William Hallock Park, and others
  • the first whole-cell pertussis vaccines is developed in 1914, although it will take several decades before they are more widely used
  • a tetanus vaccine is developed in 1927
  • 12 children die when a multi-use bottle of diphtheria vaccine that didn't contain a preservative became contaminated with bacteria in the Queensland Disaster in 1928
  • Max Theiler develops the first yellow fever vaccine in 1936
  • the AAP formally approves the use of a pertussis vaccine created by Pearl Kendrick and Grace Eldering in 1943
  • the first flu vaccine is licensed for use in the US in 1945
  • the individual diphtheria, tetanus, and pertussis vaccines become combined in a single DTP vaccine in 1948
  • the Salk inactivated polio vaccine (IPV) is introduced in 1955
  • about 200 children develop polio in 1955 from contaminated polio vaccines in what becomes known as the Cutter Incident
  • the live, oral Sabin polio vaccine (OPV) replaces the Salk polio vaccine in 1962
  • the first live measles vaccine was licensed in 1963 but was replaced with a further attenuated measles virus that caused fewer side effects in 1968
  • the MMR vaccine becomes available in 1971, combined the vaccines for measles, mumps (licensed in 1967), and rubella (1969), and was routinely given when toddlers were about 15 months old
  • routine vaccination with smallpox vaccines end in the US in 1972
  • Pneumovax, the first pneumococcal vaccine that protects kids and adults from certain types of Streptococcus pneumoniae bacteria is approved in 1971 and is given to high-risk kids
  • the Thirty-Third World Health Assembly declares that smallpox is eradicated in 1979
  • Menomune, the first meningococcal vaccine is licensed in 1981 and is recommended for high-risk kids until it is later replaced by Menactra
  • a plasma-derived hepatitis B vaccine is licensed in 1981
  • Vaccine Roulette, a controversial news segment, airs in 1982 and attempts to associate the DPT vaccine with permanent brain damage, downplays the risks of pertussis disease and helps start much of the modern anti-vaccine movement
  • a Haemophilus b capsular polysaccharide vaccine is licensed in 1985, but unfortunately does not provide good protection in kids younger than 18 to 24 months, who are most at risk for Haemophilus influenzae Type b disease
  • a recombinant hepatitis B vaccine (Recombivax HB) is approved in 1986 but is only recommended to be used in those at high risk for infection
  • another hepatitis B vaccine, Engerix-B, is approved in 1989
  • the first Haemophilus b conjugate vaccine (PRP-D) is approved in 1988 to provide protection against Haemophilus influenzae type b disease in all kids at least 18 months old, but in 1990, they are replaced with two improved Hib conjugate vaccines (PRP-HbOC and PRP-OMP) that can be given to infants as young as two months old
  • a booster dose of MMR is first recommended in 1989, but only for kids who live in counties that have at least 5 cases of measles. The routine 2 dose MMR schedule wasn't put into use for all kids until 1994.
  • the Vaccine Adverse Events Reporting System (VAERS) is established in 1990
  • the hepatitis B and Hib vaccines are recommended for all infants in 1991
  • the DTaP vaccine, which is supposed to have fewer side effects than DTP is licensed, and by 1997 replaces DTP for all required doses, although DTP is never actually shown to have caused seizures or brain damage, as was once claimed in Vaccine Roulette
  • the WHO declares that polio has been eliminated from the Western Hemisphere in 1994
  • a vaccine to protect kids against chicken pox (Varivax) is licensed in 1995
  • VAQTA, the first hepatitis A vaccine is approved by the FDA in 1996 for kids who are at least two years old, but is mainly given to kids at high risk to get hepatitis A
  • the Salk inactivated polio vaccine (IPV) is once again recommended for kids and replaces the oral polio vaccine (OPV) in 1996 because of a small risk of vaccine-associated paralytic poliomyelitis (VAPP), beginning with a sequential IPV-OPV vaccine schedule and then going to an all IPV schedule in 2000
  • RotaShield, the first rotavirus vaccine is licensed in 1998 but is soon withdrawn from the market in 1999 after it is associated with an increased risk of intussusception, a form of bowel obstruction
  • LYMErix, a Lyme disease vaccine, is licensed in 1998
  • Dr. Andrew Wakefield publishes a report in the journal Lancet attempting to link the MMR and autism
  • Thimerosal removed from the vast majority of vaccines in the childhood immunization schedule in 1999 and 2000
  • endemic measles  is declared eliminated in the United States in 2000
  • Prevnar, a newer pneumococcal vaccine which never contained thimerosal, is licensed in 2000 and is added to the immunization schedule the next year
  • LYMErix goes off the market because of insufficient sales in 2002
  • Flumist, a live, intranasal flu vaccine, is approved in 2004
  • endemic rubella is declared eliminated in the United States in 2004
  • a flu shot for all healthy children between 6 and 23 months became a formal recommendation for the 2004-05 flu season.
  • beginning in the 2004-05 flu season, a flu shot is recommended for women who will be pregnant during flu season, in any trimester, which is different than previous recommendations for a flu vaccine if a women was going to be beyond the first trimester of pregnancy during flu season. Unfortunately, even though they are in a high-risk category, only about only 13% of pregnant women received a flu vaccine in 2003.
  • Havrix, another hepatitis A vaccine, is approved in 2005 and the age indication for both hepatitis A vaccines is lowered to 12 months.
  • Menactra, a vaccine to protect against certain types of meningococcal disease is licensed in 2005 and is added to the immunization schedule in 2006, being recommended for all at 11 to 12 years of age or when they enter high school
  • the Tdap vaccine (Boostrix or Adacel) is recommended for teens and adults to protect them from pertussis in 2006 and replaces the previous Td vaccine that only worked against tetanus and diphtheria
  • RotaTeq, another rotavirus vaccine, is licensed in 2006, and is added to the immunization schedule in 2007
  • the hepatitis A vaccine is added to the routine childhood immunization schedule in 2006
  • Gardasil, the first HPV vaccine, is approved in 2006
  • a 2nd booster dose of the chicken pox vaccine is added to the immunization schedule in 2007 to help prevent breakthrough infections
  • another rotavirus vaccine, RotaRix, is approved in 2008
  • another HPV vaccine, Cervarix, is approved in 2009
  • another meningococcal vaccine, Menveo, is approved in 2010
  • a newer version of Prevnar, which can provide coverage against 13 strains of the pneumococcal bacteria, is approved and replaces the older version (Prevnar 7) in 2010
  • Fluzone Intradermal and Fluzone High-Dose are two new flu vaccine options that became available in 2011
  • A combination vaccine that protects against both Haemophilus influenzae type b and Neisseria meningitidis serogroups C and Y was approved by the FDA in 2013. MenHibrix is recommended for infants at high risk for meningococcal disease.
  • Quadrivalent flu vaccines, which protect against four strains of flu, become available for the 2013-14 flu season
  • Trumenba, the first vaccine to protect against serogroup B Meningococcal disease is approved by the FDA (October 2014). Previously, Bexsero, a MenB vaccine that is approved in some other countries, was given to some college students during outbreaks under the FDA's expanded access program for investigational products. Both are now recommended by the ACIP for those at increased risk for meningococcal serogroup B infections.
  • Gardasil 9 is approved by the FDA (December 2014) to provide protection against five additional types of HPV.

Combination Vaccines

In addition to these new vaccines, several new combination vaccines have been introduced over the years too, including:

  • Tetramune, a combination of DTP and Hib, 1993
  • Comvax, a combination of Hib and Hepatitis B, in 1996
  • Pediarix, a combination of DTaP, IPV, and the hepatitis B vaccine, in 2004
  • ProQuad, a combination of MMR and Varivax, in 2006
  • Pentacel, a combination of DTaP, IPV, and Hib, in 2008
  • Kinrix, a combination of DTaP and IPV, in 2008

Although they don't change the number of vaccines your kids get, combination vaccines can reduce the number of shots he gets at each visit. For example, instead of three separate DTaP, IPV, and Hib shots at his two, four, and six month well child visits, your child could get single Pentacel shot each time.

Immunization Schedule History

The current form of the childhood immunization schedule, which is put out each year by the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP), was first published in 1995. At that time, recommended vaccines included hepatitis B, DTP, although DTaP was available for the booster doses at 15 to 18 months and 4 to 6 years, Td, OPV (oral polio virus vaccine), and MMR.

Before 1995, the ACIP published vaccine schedules whenever new recommendations were made that changed the schedule, such as happened in:

  • 1994 - Hib and hepatitis B vaccines recommended for all infants and booster MMR for all kids
  • 1989 - Hib vaccine recommended for all toddlers at 18 months of age and booster MMR recommended for many toddlers
  • 1983 - in this schedule, kids got DTP (5 doses), OPV (4 doses), MMR (1 dose), and Td

Although some parents would like to go back to these earlier schedules, when kids got fewer vaccines, it is important to remember another part of history, as this was also a time when, each year, people (mainly kids) still got:

  • pneumonia, meningitis, and blood infections from the Streptococcus pneumoniae bacteria - 63,067 cases and 6500 deaths
  • meningitis, epiglottitis, and other serious infections from the Haemophilus influenzae type b (Hib) bacteria - 20,000 cases and 1,000 deaths
  • meningococcemia and meningococcal meningitis
  • hepatitis A - 117,333 cases, 6863 hospitalizations, and 137 deaths
  • hepatitis B - 66, 232 cases, 7,348 hospitalizations, and 237 deaths
  • rotavirus gastroenteritis - 3 million cases, 70 hospitalizations, and 20 to 60 deaths
  • chicken pox - just over 4 million cases, 10,000 hospitalizations, and 100 deaths
  • the most common forms of HPV that can cause cervical cancer

And since vaccines were introduced for these and the other vaccine preventable infections, cases for most have decreased 99 to 100 percent.

As more and more is done to reassure parents about the safety of vaccines, including that the efforts to link autism and vaccines have been disproved and thimerosal has been removed from all vaccines in the childhood immunization schedule, it would be unfortunate to let vaccination levels drop and these diseases return.



Long: Principles and Practice of Pediatric Infectious Diseases Revised Reprint, 3rd ed. - 2009.

American Academy of Pediatrics Committee Report: American Pediatrics: Milestones at the Millennium. Pediatrics, Jun 2001; 107: 1482 - 1491.

Shapiro-Shapin CG. Pearl Kendrick, Grace Eldering, and the pertussis vaccine. Emerg Infect Dis. Volume 16, Number 8-August 2010.

Mandell: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 7th ed.

Poliomyelitis Prevention in the United States. Updated Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. May 19, 2000 / 49(RR05);1-22.

Haemophilus b Conjugate Vaccines for Prevention of Haemophilus influenzae Type b Disease Among Infants and Children Two Months of Age and Older Recommendations of the ACIP. MMWR. January 11, 1991 / 40(RR01);1-7

Achievements in Public Health, 1900-1999 Impact of Vaccines Universally Recommended for Children -- United States, 1990-1998. MMWR. April 02, 1999 / 48(12);243-248

Roush SW. Historical comparisons of morbidity and mortality for vaccine-preventable diseases in the United States. JAMA. 14-NOV-2007; 298(18): 2155-63

Evan J. Anderson. Impact of Rotavirus Vaccination on Hospital-Acquired Rotavirus Gastroenteritis in Children. Pediatrics 2011; 127: e264-e270.

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