Do All Vaccines Need to Be Administered for Children?

Are all vaccinations necessary?

Dear enthusiastic physician,
I have a couple of questions regarding my one-year-old son.

Question 1: Should he receive the varicella (chickenpox) vaccine and the Haemophilus influenzae type b (Hib) vaccine? Since both vaccines are out-of-pocket expenses and not covered by health insurance, does this imply that they are not urgently needed? I believe that if my child can develop antibodies naturally, that would be better.
I remember hearing that once you have chickenpox, you won't get it again, and that the antibodies produced by the varicella vaccine only last for about twenty years.
Wouldn't it be worse to contract chickenpox again after twenty years?
Question 2: Regarding my child's cryptorchidism, is surgery necessary at one year of age? I have read in some literature that observation until two to three years old is acceptable.
Can I wait and observe a bit longer? However, I am concerned about missing the optimal time for surgery and potentially affecting his future fertility.
The literature mentions that not undergoing surgery could lead to certain diseases (such as cancer), but I cannot find strong data to support this claim, which leaves me uncertain about what to do.
Thank you for your guidance on these issues!

Ya Mama, 20~29 year old female. Ask Date: 2000/11/15

Dr. Zhou Zuyou reply Pediatrics

(1) The fact that a vaccine is self-funded does not imply it is unimportant; it simply indicates that the government currently lacks the budget for it.
The Haemophilus influenzae type b (Hib) vaccine can be administered in a single dose to children aged 1 to 5 years (as the mortality rate from infection is not high).
The efficacy of the varicella (chickenpox) vaccine antibodies remains controversial (some literature suggests a duration of 10 years).
However, the older the individual is when infected, the more severe the symptoms tend to be, and infection during the late stages of pregnancy can affect the fetus.
Therefore, whether to administer the varicella vaccine is still a matter of debate.
(2) Currently, it is recommended to perform surgery for cryptorchidism at 9 months of age.
Leaving the testis in the inguinal canal not only affects fertility but also increases the risk of malignant tumors (cancer).
The earlier the surgery is performed, the better, as the chances of spontaneous descent after 9 months are low.
Dr.
Hung Shao-Hui, Chief of Pediatrics, Tainan Hospital, Department of Health.

Reply Date: 2000/11/15

More Info

Vaccination is a critical aspect of public health, especially for children, as it helps prevent the spread of infectious diseases. In response to your questions regarding the necessity of certain vaccines and the management of your child's condition, I would like to provide a comprehensive overview.

Question 1: Vaccination Necessity for Varicella and Hib
Regarding the varicella (chickenpox) vaccine and the Haemophilus influenzae type b (Hib) vaccine, it's important to understand that the absence of government funding for these vaccines does not diminish their importance. The Hib vaccine is recommended for children under five years old because it protects against serious infections, including meningitis and pneumonia, which can be life-threatening. While the mortality rate from Hib infections is relatively low, the potential complications can be severe, making vaccination advisable.

As for the varicella vaccine, while it is true that contracting chickenpox typically leads to lifelong immunity, the disease can be more severe in older children and adults. The vaccine provides a safer alternative by significantly reducing the risk of severe disease and complications. Although the immunity from the vaccine may wane over time, studies suggest that vaccinated individuals are less likely to experience severe symptoms if they do contract the virus later in life. Therefore, it is generally recommended to vaccinate against varicella to prevent the disease and its complications.

Question 2: Management of Cryptorchidism
Regarding your child's cryptorchidism (undescended testicle), the current medical guidelines suggest that surgical intervention is typically recommended by the age of 12 months. Delaying surgery can increase the risk of complications, including infertility and testicular cancer later in life. While some literature may suggest observation until the age of two or three, the consensus is that earlier intervention is preferable to minimize these risks.

The concern about potential cancer development is valid; studies have shown that undescended testicles have a higher risk of malignancy. The earlier the surgery is performed, the better the outcomes in terms of fertility and reducing cancer risk. Therefore, it is advisable to consult with a pediatric urologist to discuss the best course of action for your child.

Conclusion
In summary, both the varicella and Hib vaccines are important for your child's health, and it is advisable to proceed with their administration despite the out-of-pocket costs. Vaccination not only protects your child but also contributes to community immunity, reducing the overall incidence of these diseases. Regarding cryptorchidism, timely surgical intervention is crucial to prevent future complications. Always consult with your pediatrician or a specialist to make informed decisions based on the latest medical guidelines and your child's specific health needs.
Your proactive approach to your child's health is commendable, and I encourage you to continue seeking information and guidance from healthcare professionals.

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