Which vaccines do children need in Israel?

Health

The rate of unvaccinated children is reaching a peak in Israel, resulting in outbreaks of diseases previously unknown to the medical world.

A five-week-old infant died of whooping cough last week, and a child contracted tetanus—both were not protected by the routine vaccinations provided by Tipat Halav.

Vaccinations are especially critical among the child population because they are considered the first link in the chain of infection: toddlers infect their parents and siblings, who then infect their friends, colleagues at work, and others in both near and far environments.

The vaccine is given as part of the routine immunization schedule in a combination shot, and it provides protection for about ten years. (Illustrative). (credit: INGIMAGE)

What do the vaccines given in Israel protect against, when are they administered, and how long does the immunity last?

Polio

The polio virus belongs to the family of enteroviruses. Although most people infected with the virus experience mild and transient illness characterized by fever, headaches, sore throat, vomiting, and diarrhea, about 2% of those infected will develop the disease and suffer from muscle paralysis, which often does not resolve. Following the introduction of the vaccine in 1957, the incidence of the disease significantly decreased. Since 1989, there have been no cases of polio in Israel.

Haemophilus influenzae type B (Hib)

Before the Hib vaccine was developed, the Haemophilus influenzae bacterium was one of the main causes of pneumonia, blood infections, and meningitis in infants and children. Since the vaccine was introduced in December 1987, infection rates have dropped by 98%. Today, the disease is almost never seen in the medical world, and even new pediatricians are unfamiliar with it. The vaccine is part of the routine immunization schedule and is known to provide long-lasting protection.

Whooping Cough (Pertussis)

Whooping cough is significantly on the rise in Israel. It is caused by the bacterium Bordetella pertussis and is also known as the “100-day cough.” The disease manifests as severe coughing fits, accompanied by reddening and a choking sensation, and it can last for several months. Antibiotic treatment with macrolides does not cure the disease but prevents transmission from the patient to others. In infants, it is a life-threatening disease that can cause death. The vaccine is part of the routine immunizations provided by Tipat Halav and provides protection for five to ten years. The vaccine is also given to pregnant women because the antibodies produced in the mother’s body are transferred to the fetus and protect the baby during the first few months of life, a time in which the disease is considered life-threatening.

Rubella

While Rubella is a mild disease in children and adults, over 90% of babies born to mothers who contracted Rubella during the first trimester of pregnancy will suffer from congenital rubella syndrome, which causes heart defects, cataracts, intellectual disabilities, and deafness. Since 1973, the vaccine has been part of the routine childhood immunization program. Since 1994, it has been recommended that every child receive two doses of the vaccine. From that year, the number of cases dropped to less than ten per year. No cases of congenital Rubella have been reported in Israel since 1993. If rubella vaccinations were to stop, immunity to Rubella would decline, and the disease would once again infect pregnant women, leading to babies born with congenital rubella syndrome. This would result in tens of thousands of cases of deafness, intellectual disabilities, blindness, or fetal death in every country.

Measles

Measles is a serious infectious disease characterized by cough, runny nose, high fever, a distinctive rash, mouth lesions, and conjunctivitis. Children under the age of 5 and adults over the age of 20 are at significant risk if they contract the disease. The primary cause of death from measles is pneumonia, resulting from bacterial infections that attack the lungs and cause secondary infection. The most deadly complication is a chronic encephalitis that almost always ends in death. This inflammation occurs 7-13 years after infection when the virus, through an unclear process, becomes particularly virulent, destroying brain cells and leading to death in all affected patients. There is no cure for measles. The MMR vaccine, which protects against mumps, measles, and Rubella, is part of the routine immunizations provided by Tipat Halav.

Chickenpox

Until 2008, chickenpox was one of the more dangerous diseases, causing a high rate of complications including encephalitis and death. The mortality rate then stood at 1 per 100,000 infected individuals. With the introduction of the chickenpox vaccine into Israel’s routine immunization schedule that same year, the disease became one of the milder ones. From over 500 lesions covering the entire body, some infected, the disease now causes around 20 lesions only, without complications.

Tetanus

Tetanus is one of the deadliest diseases, as seen in the case of the child infected last week. The bacterium Clostridium tetani is widespread in soil, dust, and even in animal feces. It is highly resistant to heat and disinfectants. The disease, caused by a wound from objects like nails or glass, or even animal bites, leads to muscle stiffness and spasms. The jaw locks shut, and the result is choking, spasms, fractures, and even coma. About 30% of patients will die. There is no cure for tetanus, and the only way to protect oneself is through vaccination, which provides immunity for about ten years.

Mumps

Before the era of vaccinations, mumps was one of the leading causes of deafness in children, with one in every 20,000 infected losing their hearing. Mumps is typically a mild viral disease, but in certain cases, it can lead to orchitis (inflammation of the testicles) and infertility, encephalitis (inflammation of the brain), meningitis (inflammation of the nervous system), paralysis, seizures, and brain damage. In pregnant women, the virus can also cause miscarriages. The mumps vaccine is also part of the routine immunizations provided by Tipat Halav, and it provides long-lasting protection.

Diphtheria

Diphtheria, caused by the bacterium Corynebacterium diphtheriae, is an extremely severe disease. The bacterium colonizes the throat, tonsils, nose, and primarily the pharynx, where it forms an open sore covered by dead cells that resemble a grayish membrane. Inflammation and swelling around the membrane can cause choking. The bacterium produces a toxin that affects the heart muscle and the brain.

The entire process is accompanied by severe throat pain and high fever. The bacterium is transmitted from person to person through respiratory droplets during coughing, sneezing, or contact with nasal discharge and saliva. The risk to an unvaccinated person exposed to the bacterium is very high, and the mortality rate from the disease is high.

The vaccine is given as part of the routine immunization schedule in a combination shot, and it provides protection for about ten years.

Hepatitis B and A

Hepatitis B and A are viral liver inflammations. Hepatitis B is transmitted through sexual contact or contact with infected blood, while Hepatitis A is spread through contaminated food or drink touched by feces. The liver is essential for the body’s detoxification processes, and without it, life would not be possible. Hepatitis can develop into chronic liver disease, and in some cases, even liver cancer, with treatment often requiring liver transplantation. The hepatitis vaccine is administered in multiple doses during infancy as part of routine immunization, and also during military enlistment. Its protection lasts for about five to seven years.

Pneumococcus

Pneumococcus is a bacterium causing pneumonia and bloodstream infections. There are numerous strains, some of which the vaccine protects against. It is given via muscle injection to infants as part of the vaccination schedule, to at-risk populations, and adults over 65. In the United States, it is also recommended for smokers over 19 due to their increased risk of severe pneumonia. The vaccine provides protection for approximately ten years.

Meningococcus

Meningococcus is a highly virulent bacterium causing high mortality rates. It has several strains, with strain B being the most common in infants, while strains A, C, Y, and W139 affect young adults and older individuals more. The vaccine against strain B was approved in Israel about a decade ago and can be administered to infants at two months old through a pediatrician’s prescription, though it is not yet included in the national vaccine program due to budgetary considerations. Vaccines for other strains are usually given to soldiers or travelers to affected regions through travel clinics.

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