Newborn Vaccinations: What's The Cost And Are They Covered?

Vaccinations are crucial for protecting newborns from harmful and potentially deadly diseases. In the first few months of life, newborns are given a series of vaccinations, with the first dose of the hepatitis B (HepB) vaccine typically administered shortly after birth. This vaccine helps prevent liver damage caused by the hepatitis B virus. Following this initial vaccination, newborns receive a combination of vaccines over the next few months, including the diphtheria-tetanus-pertussis (DTaP) vaccine, the Haemophilus influenzae type B (Hib) vaccine, the inactivated poliovirus (IPV) vaccine, and the pneumococcal conjugate (PCV13) vaccine. These vaccines protect against serious illnesses such as diphtheria, tetanus, pertussis (whooping cough), Haemophilus influenzae type b infections, polio, and pneumococcal disease. The cost of these vaccinations can vary depending on location and healthcare provider, but they are typically recommended by organizations such as the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP).

Hepatitis B vaccine

The Hepatitis B vaccine is given to prevent the severe liver disease that can develop when children or adults are infected with the hepatitis B virus. Hepatitis B is a serious liver infection that can cause liver cancer, the second leading cause of cancer deaths worldwide. It is typically transmitted through direct contact with blood, semen, or other bodily fluids that carry the virus.

The hepatitis B vaccine is typically given to newborns within the first 24 hours of birth. If a newborn's mother carries the hepatitis B virus, the baby must get the vaccine within 12 hours of birth, in addition to another shot of hepatitis B immune globulin (HBIG) to provide immediate protection. If the mother does not have the virus, the baby can get the vaccine within 24 hours after birth. If the baby has a low birth weight, they will receive their first dose when they are one month old or when they are discharged from the hospital.

The hepatitis B vaccine is typically given as a series of three shots. The second dose is given one to two months after the first, and the third dose is given between six and 18 months of age. The vaccine is also recommended for those up to 60 years old who have not previously received it and those 60 and older who are at increased risk or who wish to be protected from the virus.

The hepatitis B vaccine is considered safe and effective by experts. It cannot cause hepatitis B because, although parts of the hepatitis B virus are used to create the vaccine, these parts are inactive and only serve to train the body to fight against the virus. The vaccine is constantly monitored for safety during production and administration, and any signs of a potentially dangerous response would result in an immediate recall.

Possible side effects of the hepatitis B vaccine include fussiness, soreness, redness, or swelling at the injection site, and low-grade fever. These side effects are usually mild and go away within 72 hours. In rare cases, the vaccine can cause a severe allergic reaction, but this is very unlikely to occur.

Rotavirus vaccine

The rotavirus vaccine protects young children from rotavirus infections, which are the leading cause of severe diarrhoea. Rotavirus is a common infection that can cause severe diarrhoea, vomiting, fever, and belly pain in infants. It can also lead to dehydration, which is particularly dangerous for newborns. The rotavirus vaccine is recommended at 2 and 4 months of age.

The two internationally licensed rotavirus vaccines are Rotarix® (GlaxoSmithKline Biologicals) and RotaTeq® (Merck & Co.). These vaccines have been proven safe and effective in large-scale clinical trials and post-licensure studies. However, they are more expensive than most traditional childhood vaccines. For example, in 2006, Rotarix® was approximately 132 times more expensive per dose than the cheapest traditional vaccine, while RotaTeq® was 90 times more expensive. Despite the high cost, the rotavirus vaccine is considered a cost-effective intervention. In the United States, routine rotavirus vaccinations cost US$138 per case averted and US$197,190 per life year saved from a societal perspective.

To address the issue of affordability, the pharmaceutical companies behind Rotarix® and RotaTeq® have offered to provide their vaccines at reduced prices to low-income countries. GlaxoSmithKline has offered their vaccine at US$2.50 per dose, a 67% reduction, while Merck & Co. has offered their vaccine at US$3.50 per dose for purchases over 30 million doses. However, even at these reduced prices, the rotavirus vaccines are still more expensive than most traditional childhood vaccines.

The introduction of rotavirus vaccines has had a significant impact on reducing the burden of rotavirus-associated diarrhoea. At least 43% of the 527,000 child deaths and 51% of the 27 million annual medical visits due to rotavirus diarrhoea could be prevented with universal vaccination. As a result, the World Health Organization (WHO) has recommended including the rotavirus vaccine in national immunisation programmes worldwide. However, as of 2012, only 14 countries in Latin America and one African country have routinely used the vaccine.

Diphtheria, tetanus, and pertussis (DTaP) vaccine

The DTaP vaccine protects against three serious bacterial infections: diphtheria, tetanus, and pertussis (whooping cough).

Diphtheria

Diphtheria is a serious infection of the throat that can block the airway and cause severe breathing problems. It is an extremely contagious infection that spreads from person to person. In severe cases, it can cause heart and nerve damage and even lead to death.

Tetanus

Tetanus is an infection that affects the nerves all over the body, causing severe muscle spasms. It is often referred to as "lockjaw" as jaw spasms can make it impossible for the infected person to open their mouth. Tetanus enters the body through cuts or wounds in the skin.

Pertussis

Pertussis, or whooping cough, is a respiratory infection that causes cold-like symptoms and can lead to intense coughing spells and severe breathing problems. The characteristic "whoop" noise is heard when an infected person tries to take a breath after a coughing fit. This infection is particularly dangerous for infants and young children, who may experience pneumonia, convulsions, brain damage, or even death.

DTaP Vaccine Schedule

The DTaP vaccine is given as a series of five shots to children under the age of seven. The recommended schedule is as follows:

• First dose at 2 months old
• Second dose at 4 months old
• Third dose at 6 months old
• Fourth dose between 15 and 18 months old
• Fifth dose between 4 and 6 years old

Tdap Booster Vaccine

As children grow older, they receive a booster shot called Tdap, which is first administered when they are 11 or 12 years old. This booster is then given every 10 years throughout adulthood.

Pregnant women should also receive the Tdap vaccine, preferably in the second half of their pregnancy, to pass on antibodies to their newborn. This is crucial as whooping cough can be fatal for newborns.

Side Effects

The DTaP and Tdap vaccines are generally safe, but they can cause mild side effects such as fever, crankiness, tiredness, loss of appetite, vomiting, and pain, redness, or swelling at the injection site.

Rarely, more severe side effects such as seizures, very high fevers, or uncontrollable crying may occur. In older children, there is a rare risk of swelling in the entire arm or leg where the shot was given. As with any vaccine, there is a small risk of fainting and a very slim chance of a severe allergic reaction.

Cost

Under the Affordable Care Act, marketplace health plans and insurance typically cover the cost of the Tdap vaccine. Additionally, the Tdap vaccine is covered under Medicaid and Medicare with prescription coverage.

For those without insurance, the U.S. Department of Health and Human Services website provides information on federally funded centres and state health departments where free or low-cost vaccines may be available.

Haemophilus influenzae type B (Hib) vaccine

Haemophilus influenzae type B (Hib) is a bacterial infection that can cause serious illness and even death in babies and young children. It is highly contagious and can lead to infections in different parts of the body, such as the brain and lungs.

Vaccine Details

The Hib vaccine is recommended for all children under 5 years of age in the United States. It is typically given in four doses at 2 months, 4 months, 6 months, and between 12 and 15 months. The vaccine is safe and highly effective, with more than 95% of infants developing protective antibody levels after receiving the primary series of shots.

Cost

In the United States, the cost of the Hib vaccine is typically covered by private health insurance plans. For those without insurance, the Vaccines for Children (VFC) program provides vaccines at no cost for children from low-income families.

In other countries, the cost of the Hib vaccine can vary. For example, in China, the four doses of the Hib single-component vaccine can cost up to US$40, which is unaffordable for many parents.

Side Effects

Side effects from the Hib vaccine are usually mild and may include redness, soreness, or swelling at the injection site, or fever. These side effects typically go away within a few days.

Effectiveness

The Hib vaccine has been highly effective in reducing the incidence of Hib disease. In the United States, serious cases of Hib infections have dropped by more than 99% since the vaccine became available in 1987.

Risks

While the vaccine is generally safe, as with any medicine, there is a very small chance of a severe allergic reaction. However, the risks associated with getting the Hib disease far outweigh the risks of the vaccine. Hib meningitis, for example, can cause brain damage or hearing loss in 1 in 5 children who survive it.

Pneumococcal vaccine

The Pneumococcal vaccine protects against Streptococcus pneumoniae, which causes meningitis, pneumonia, and some ear infections. It is recommended that children receive four doses in total: one dose at 2 months, 4 months, 6 months, and 12 to 15 months.

The CDC recommends pneumococcal vaccination for all children younger than 5 years old. In the United States, there are two types of pneumococcal vaccines recommended to help prevent pneumococcal disease in children: Pneumococcal Conjugate Vaccines (PCVs) and the Pneumococcal Polysaccharide Vaccine. The CDC recommends PCV15 or PCV20 for children younger than 5 years old.

The cost of the Pneumococcal 15-valent vaccine is $79.15 per dose, while the Pneumococcal 20-valent vaccine costs $95.15 per dose.

Pneumococcal vaccination is safe and well-tolerated, even when given shortly after birth. It stimulates effective antibody concentrations and primes immunological memory for sustained infant protection.

Frequently asked questions