15 MONTH OLD. Proactive in your child s care. Empowering families for over 50 years.

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1 15 MONTH OLD Proactive in your child s care. Empowering families for over 50 years. Please take the time to read through this material. We provide this information because we see value in educating our patients.

2 15 Month Visit: Immunizations Your child is due to receive the following immunizations at this visit: HiB (Haemophilus influenza type B) DTaP (Diphtheria, Tetanus and Pertussis) We strongly recommend that all patients 6 months of age and older receive an annual Influenza (flu) vaccine. Please review the enclosed Vaccine Information Sheets (VISs) prior to your visit for more information. For our complete immunization schedule: wmpeds.com/topic/immunization-schedule

3 VIDEOS Let us help you be proactive and educated in your child s care! These following videos are just a few that we feel may help you and your child at this specific age. Please view our website at for these and many more. 15 Months Fever Ear Infections including information on Swimmer s Ear Rashes information on a Basic Rash, Diaper Rash, Fifth Disease, Hand - Foot and Mouth Disease and also Hives Cough/Croup information on when to worry and a demonstration on Croup and Stridor Vomiting and Diarrhea Colds Toddler Information on behavior, nutrition, toilet training and new siblings

4 Prevent Unnecessary ER Visits If you don t need to call 911 Please call us before you go to the ER! Each year hundreds of ER visits and expensive co-pays for WMPEDS patients might be avoided with phone consultation and office or home based treatment. Save your family the trop and the cost. Call us first, before you got to the ER. LACERATIONS: Many cuts can be closed in our office without stitches using special glue for the skin called dermabond. CALL US FIRST -- to help assess your child s laceration. BELLY PAIN: Serious causes of abdominal pain exist but are rare. Many children with pain are in fact constipated even with a daily BM. CALL US FIRST -- to discuss your child s symptoms. CROUP: A barking cough can often be calmed with steam, cold freezer or night air or a dose of Orapred according to the nighttime croup plan. CALL US FIRST -- to help decide which treatment your child needs. FINGER, WRIST & ANKLE INJURIES: Lots of sprains and strains can be treated with RICE (Rest, Ice, Compression and Elevation). CALL US FIRST - to help assess your child s injury. BUMPED HEADS: The majority of concussions do not need imaging and heal spontaneously over time with physical and cognitive rest. CALL US FIRST - to review your child s symptoms. FEVER: Fever helps the body fight infection and is rarely harmful. Refer to the fever fear manual for evaluation and treatment guidelines. CALL US FIRST - to discuss when to schedule a visit. EAR & THROAT PAIN: Both ear and throat pain is often soothed with ibuprofen. Most ear infections resolve without antibiotics and home strep tests can help determine if your child needs an office visit. CALL US FIRST - to help assess your child s pain. Worried about waking up a doctor at night? Don t be! Nurse triage service is available 24/7 to discuss your child s symptoms, to page a doctor when needed and to help decide whether a trip to the ER is needed. We are happy to take your phone call. Please visit for educational videos and more information.

5 My Spirited Child Oh my strong will child. Some feel you re so wild. You re so bright and can be so joyous. But your anger and frustration can really annoy us. We look to others for support. But if they have no such experience, Negative vibes is what they purport. We must prepare you for so many situations in advance. Anticipation is crucial for a peaceful daily dance. Sometimes I must speak-up and defend you. Sometimes I must set a limit. Yet my urge to blame and shame can get in the way, And I can t always dam it. Your spirit is so inspiring. Keep dreaming and aspiring. By: Dr. Hartman Follow Dr. Hartman on *Raising Your Spirited Child by Mary Sheedy Kurcinka. Excellent reference!

6 Family Life - Temper Tantrums What should I do when my child has a temper tantrum? It's hard for young children to hold strong feelings inside. When they feel frustrated or angry, they often cry, scream, or stomp up and down. This is a temper tantrum. Temper tantrums are a normal part of your child's development. They usually begin around age 12 to 18 months; get worse between 2 and 3 years, then taper off after that, once children are able to use words to communicate their wants and needs. How to handle tantrums What you can do? - Try to stay calm. If you shout or get angry, it can make things worse. If you can't stay calm, leave the room. Wait a minute or two, or until her crying stops, before returning. - Distract your child. Try a new game, book, or toy. Sometimes something as simple as changing locations can prevent a tantrum. For example, if you are indoors, try taking your child outside to distract her attention. - Give your child a time-out. Take your child away from the problem and give her time alone to calm down. A good rule of thumb for a time-out is 1 minute of time-out for every year of your child's age. For example, a 4-year-old would get a 4-minute time-out. After the time-out is over, talk with your child and make sure she understands why she got a time-out and how to deal with it next time. Don't use time-out too much or it won't work. - Ignore minor displays of anger such as crying, screaming, or kicking. Try touching or holding your child to calm her. Or try standing nearby without talking until she calms down. If your child is having a tantrum in a public place, take her home or to the car. - Some behaviors are not OK and should not be ignored, such as o Hitting or kicking people o Throwing things that might hurt someone or break something o Screaming or yelling for a long time If these things happen, take your child away from the problem. Say firmly, "No hitting" or "No throwing" to make sure your child knows these behaviors are not OK. What not to do Never punish your child for temper tantrums. She may start to keep her anger or frustration inside, which can be unhealthy. Keep in mind that as your child grows, she will learn to deal with her strong emotions. Do not give in to your child just to stop a tantrum. This teaches your child that temper tantrums get her what she wants. Also, don't feel guilty about saying no to your child. Set the rules and stick with them. When parents change the rules, it is harder for children to understand which rules are firm and which ones are not. Discuss with those who care for your child which rules are really needed and how to be firm about them.

7 KidsHealth.org The most-visited site devoted to children's health and development Disciplining Your Child How do you keep a 1-year-old from heading toward the DVD player? What should you do when your preschooler throws a fit? How can you get a teenager to respect your authority? Whatever the age of your child, it's important to be consistent when it comes to discipline. If parents don't stick to the rules and consequences they set up, their kids aren't likely to either. Here are some ideas about how to vary your approach to discipline to best fit your family. Ages 0 to 2 Babies and toddlers are naturally curious. So it's wise to eliminate temptations and no-nos items such as TVs and video equipment, stereos, jewelry, and especially cleaning supplies and medications should be kept well out of reach. When your crawling baby or roving toddler heads toward an unacceptable or dangerous play object, calmly say "No" and either remove your child from the area or distract him or her with an appropriate activity. Timeouts can be effective discipline for toddlers. A child who has been hitting, biting, or throwing food, for example, should be told why the behavior is unacceptable and taken to a designated timeout area a kitchen chair or bottom stair for a minute or two to calm down (longer timeouts are not effective for toddlers). It's important to not spank, hit, or slap a child of any age. Babies and toddlers are especially unlikely to be able to make any connection between their behavior and physical punishment. They will only feel the pain of the hit. And don't forget that kids learn by watching adults, particularly their parents. Make you re your behavior is role-model material. You'll make a much stronger impression by putting your own belongings away rather than just issuing orders to your child to pick up toys while your stuff is left strewn around. A Word About Spanking Perhaps no form of discipline is more controversial than spanking. Here are some reasons why the American Academy of Pediatrics (AAP) discourages spanking: Spanking teaches kids that it's OK to hit when they're angry. Spanking can physically harm children. Rather than teaching kids how to change their behavior, spanking makes them fearful of their parents and merely teaches them to avoid getting caught. For kids seeking attention by acting out, spanking may inadvertently "reward" them negative attention is better than no attention at all. Reviewed by: Jennifer Shroff Pendley, PhD Date reviewed: October 2008

8 10 tips Nutrition Education Series choose MyPlate 10 tips to a great plate Making food choices for a healthy lifestyle can be as simple as using these 10 Tips. Use the ideas in this list to balance your calories, to choose foods to eat more often, and to cut back on foods to eat less often. 1 balance calories Find out how many calories YOU need for a day as a first step in managing your weight. Go to to find your calorie level. Being physically active also helps you balance calories. 2 enjoy your food, but eat less Take the time to fully enjoy your food as you eat it. Eating too fast or when your attention is elsewhere may lead to eating too many calories. Pay attention to hunger and fullness cues before, during, and after meals. Use them to recognize when to eat and when you ve had enough. 3 avoid oversized portions Use a smaller plate, bowl, and glass. Portion out foods before you eat. When eating out, choose a smaller size option, share a dish, or take home part of your meal. 4 foods to eat more often Eat more vegetables, fruits, whole grains, and fat-free or 1% milk and dairy products. These foods have the nutrients you need for health including potassium, calcium, vitamin D, and fiber. Make them the basis for meals and snacks. 6 switch to fat-free or low-fat (1%) milk They have the same amount of calcium and other essential nutrients as whole milk, but fewer calories and less saturated fat. 7 make half your grains whole grains To eat more whole grains, substitute a whole-grain product for a refined product such as eating wholewheat bread instead of white bread or brown rice instead of white rice. 8 foods to eat less often Cut back on foods high in solid fats, added sugars, and salt. They include cakes, cookies, ice cream, candies, sweetened drinks, pizza, and fatty meats like ribs, sausages, bacon, and hot dogs. Use these foods as occasional treats, not everyday foods. 9 compare sodium in foods Use the Nutrition Facts label to choose lower sodium versions of foods like soup, bread, and frozen meals. Select canned foods labeled low sodium, reduced sodium, or no salt added. 5 make half your plate fruits and vegetables Choose red, orange, and dark-green vegetables like tomatoes, sweet potatoes, and broccoli, along with other vegetables for your meals. Add fruit to meals as part of main or side dishes or as dessert. Center for Nutrition Policy and Promotion 10 are a major source of added sugar, and calories, in American diets. Go to for more information. drink water instead of sugary drinks Cut calories by drinking water or unsweetened beverages. Soda, energy drinks, and sports drinks DG TipSheet No. 1 June 2011 USDA is an equal opportunity provider and employer.

9 MyPlate is part of a larger communications initiative based on 2010 Dietary Guidelines for Americans to help consumers make better food choices. ChooseMyPlate.gov The website features practical information and tips to help Americans build healthier diets. It features selected messages to help consumer focus on key behaviors. Selected messages include: Enjoy your food, but eat less. Avoid oversized portions. Make half your plate fruits and vegetables. Switch to fat-free or low-fat (1%) milk. Make at least half your grains whole grains. Compare sodium in foods like soup, bread, and frozen meals and choose foods with lower numbers. Drink water instead of sugary drinks. ChooseMyPlate.gov1 includes much of the consumer and professional information formerly found on MyPyramid.gov. Also on the web Sample Menus for a Week Food Group Based Recipes Historical Development of Food Guidance Nutrition Communicators Network for Partners Application Forms All print-ready content

10 Hib Vaccine What You Need to Know VACCINE INFORMATION STATEMENT ( Haemophilus Influenzae Type b) Many Vaccine Information Statements are available in Spanish and other languages. See Hojas de información sobre vacunas están disponibles en español y en muchos otros idiomas. Visite 1 Why get vaccinated? Haemophilus influenzae type b (Hib) disease is a serious disease caused by bacteria. It usually affects children under 5 years old. It can also affect adults with certain medical conditions. Your child can get Hib disease by being around other children or adults who may have the bacteria and not know it. The germs spread from person to person. If the germs stay in the child s nose and throat, the child probably will not get sick. But sometimes the germs spread into the lungs or the bloodstream, and then Hib can cause serious problems. This is called invasive Hib disease. Before Hib vaccine, Hib disease was the leading cause of bacterial meningitis among children under 5 years old in the United States. Meningitis is an infection of the lining of the brain and spinal cord. It can lead to brain damage and deafness. Hib disease can also cause: pneumonia severe swelling in the throat, making it hard to breathe infections of the blood, joints, bones, and covering of the heart death Before Hib vaccine, about 20,000 children in the United States under 5 years old got Hib disease each year, and about 3% - 6% of them died. Hib vaccine can prevent Hib disease. Since use of Hib vaccine began, the number of cases of invasive Hib disease has decreased by more than 99%. Many more children would get Hib disease if we stopped vaccinating. 2 Hib vaccine Several different brands of Hib vaccine are available. Your child will receive either 3 or 4 doses, depending on which vaccine is used. Doses of Hib vaccine are usually recommended at these ages: First Dose: 2 months of age Second Dose: Third Dose: 4 months of age 6 months of age (if needed, depending on brand of vaccine) Final/Booster Dose: months of age Hib vaccine may be given at the same time as other vaccines. Hib vaccine may be given as part of a combination vaccine. Combination vaccines are made when two or more types of vaccine are combined together into a single shot, so that one vaccination can protect against more than one disease. Children over 5 years old and adults usually do not need Hib vaccine. But it may be recommended for older children or adults with asplenia or sickle cell disease, before surgery to remove the spleen, or following a bone marrow transplant. It may also be recommended for people 5 to 18 years old with HIV. Ask your doctor for details. Your doctor or the person giving you the vaccine can give you more information.

11 3 Some people should not get this vaccine Hib vaccine should not be given to infants younger than 6 weeks of age. A person who has ever had a life-threatening allergic reaction after a previous dose of Hib vaccine, OR has a severe allergy to any part of this vaccine, should not get Hib vaccine. Tell the person giving the vaccine about any severe allergies. People who are mildly ill can get Hib vaccine. People who are moderately or severely ill should probably wait until they recover. Talk to your healthcare provider if the person getting the vaccine isn t feeling well on the day the shot is scheduled. 4 Risks of a vaccine reaction With any medicine, including vaccines, there is a chance of side effects. These are usually mild and go away on their own. Serious reactions are also possible but are rare. Most people who get Hib vaccine do not have any problems with it. Mild Problems following Hib vaccine: redness, warmth, or swelling where the shot was given fever These problems are uncommon. If they occur, they usually begin soon after the shot and last 2 or 3 days. Problems that could happen after any vaccine: Any medication can cause a severe allergic reaction. Such reactions from a vaccine are very rare, estimated at fewer than 1 in a million doses, and would happen within a few minutes to a few hours after the vaccination. As with any medicine, there is a very remote chance of a vaccine causing a serious injury or death. Older children, adolescents, and adults might also experience these problems after any vaccine: People sometimes faint after a medical procedure, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting, and injuries caused by a fall. Tell your doctor if you feel dizzy, or have vision changes or ringing in the ears. Some people get severe pain in the shoulder and have difficulty moving the arm where a shot was given. This happens very rarely. The safety of vaccines is always being monitored. For more information, visit: 5 What if there is a serious reaction? What should I look for? Look for anything that concerns you, such as signs of a severe allergic reaction, very high fever, or unusual behavior. Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness. These would usually start a few minutes to a few hours after the vaccination. What should I do? If you think it is a severe allergic reaction or other emergency that can t wait, call or get the person to the nearest hospital. Otherwise, call your doctor. Afterward, the reaction should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your doctor might file this report, or you can do it yourself through the VAERS web site at or by calling VAERS does not give medical advice. 6 The National Vaccine Injury Compensation Program The National Vaccine Injury Compensation Program (VICP) is a federal program that was created to compensate people who may have been injured by certain vaccines. Persons who believe they may have been injured by a vaccine can learn about the program and about filing a claim by calling or visiting the VICP website at There is a time limit to file a claim for compensation. 7 How can I learn more? Ask your doctor. He or she can give you the vaccine package insert or suggest other sources of information. Call your local or state health department. Contact the Centers for Disease Control and Prevention (CDC): - Call (1-800-CDC-INFO) or - Visit CDC s website at Vaccine Information Statement Hib Vaccine 4/02/2015 Office Use Only 42 U.S.C. 300aa-26

12 DTaP Vaccine What You Need to Know VACCINE INFORMATION STATEMENT (Diphtheria, Tetanus and Pertussis) Many Vaccine Information Statements are available in Spanish and other languages. See Hojas de información sobre vacunas están disponibles en español y en muchos otros idiomas. Visite 1 Why get vaccinated? Diphtheria, tetanus, and pertussis are serious diseases caused by bacteria. Diphtheria and pertussis are spread from person to person. Tetanus enters the body through cuts or wounds. DIPHTHERIA causes a thick covering in the back of the throat. It can lead to breathing problems, paralysis, heart failure, and even death. TETANUS (Lockjaw) causes painful tightening of the muscles, usually all over the body. It can lead to locking of the jaw so the victim cannot open his mouth or swallow. Tetanus leads to death in up to 2 out of 10 cases. PERTUSSIS (Whooping Cough) causes coughing spells so bad that it is hard for infants to eat, drink, or breathe. These spells can last for weeks. It can lead to pneumonia, seizures (jerking and staring spells), brain damage, and death. Diphtheria, tetanus, and pertussis vaccine (DTaP) can help prevent these diseases. Most children who are vaccinated with DTaP will be protected throughout childhood. Many more children would get these diseases if we stopped vaccinating. DTaP is a safer version of an older vaccine called DTP. DTP is no longer used in the United States. 2 Who should get DTaP vaccine and when? Children should get 5 doses of DTaP vaccine, one dose at each of the following ages: 2 months 4 months 6 months months 4 6 years DTaP may be given at the same time as other vaccines. 3 Some children should not get DTaP vaccine or should wait Children with minor illnesses, such as a cold, may be vaccinated. But children who are moderately or severely ill should usually wait until they recover before getting DTaP vaccine. Any child who had a life-threatening allergic reaction after a dose of DTaP should not get another dose. Any child who suffered a brain or nervous system disease within 7 days after a dose of DTaP should not get another dose. Talk with your doctor if your child: - had a seizure or collapsed after a dose of DTaP, - cried non-stop for 3 hours or more after a dose of DTaP, - had a fever over 105 F after a dose of DTaP. Ask your doctor for more information. Some of these children should not get another dose of pertussis vaccine, but may get a vaccine without pertussis, called DT. 4 Older children and adults DTaP is not licensed for adolescents, adults, or children 7 years of age and older. But older people still need protection. A vaccine called Tdap is similar to DTaP. A single dose of Tdap is recommended for people 11 through 64 years of age. Another vaccine, called Td, protects against tetanus and diphtheria, but not pertussis. It is recommended every 10 years. There are separate Vaccine Information Statements for these vaccines.

13 5 What are the risks from DTaP vaccine? Getting diphtheria, tetanus, or pertussis disease is much riskier than getting DTaP vaccine. However, a vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of DTaP vaccine causing serious harm, or death, is extremely small. Mild problems (common) Fever (up to about 1 child in 4) Redness or swelling where the shot was given (up to about 1 child in 4) Soreness or tenderness where the shot was given (up to about 1 child in 4) These problems occur more often after the 4th and 5th doses of the DTaP series than after earlier doses. Sometimes the 4th or 5th dose of DTaP vaccine is followed by swelling of the entire arm or leg in which the shot was given, lasting 1 7 days (up to about 1 child in 30). Other mild problems include: Fussiness (up to about 1 child in 3) Tiredness or poor appetite (up to about 1 child in 10) Vomiting (up to about 1 child in 50) These problems generally occur 1 3 days after the shot. Moderate problems (uncommon) Seizure (jerking or staring) (about 1 child out of 14,000) Non-stop crying, for 3 hours or more (up to about 1 child out of 1,000) High fever, over 105 F (about 1 child out of 16,000) Severe problems (very rare) Serious allergic reaction (less than 1 out of a million doses) Several other severe problems have been reported after DTaP vaccine. These include: - Long-term seizures, coma, or lowered consciousness - Permanent brain damage. These are so rare it is hard to tell if they are caused by the vaccine. 6 What if there is a serious reaction? What should I look for? Look for anything that concerns you, such as signs of a severe allergic reaction, very high fever, or behavior changes. Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness. These would start a few minutes to a few hours after the vaccination. What should I do? If you think it is a severe allergic reaction or other emergency that can t wait, call or get the person to the nearest hospital. Otherwise, call your doctor. Afterward, the reaction should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your doctor might file this report, or you can do it yourself through the VAERS web site at or by calling VAERS is only for reporting reactions. They do not give medical advice. 7 The National Vaccine Injury Compensation Program The National Vaccine Injury Compensation Program (VICP) is a federal program that was created to compensate people who may have been injured by certain vaccines. Persons who believe they may have been injured by a vaccine can learn about the program and about filing a claim by calling or visiting the VICP website at 8 How can I learn more? Ask your doctor. Call your local or state health department. Contact the Centers for Disease Control and Prevention (CDC): - Call (1-800-CDC-INFO) or - Visit CDC s website at Controlling fever is especially important for children who have had seizures, for any reason. It is also important if another family member has had seizures. You can reduce fever and pain by giving your child an aspirin-free pain reliever when the shot is given, and for the next 24 hours, following the package instructions. Vaccine Information Statement DTaP Vaccine 5/17/ U.S.C. 300aa-26 Office Use Only

14 Influenza (Flu) Vaccine (Inactivated or Recombinant): What you need to know 1 Why get vaccinated? Influenza ( flu ) is a contagious disease that spreads around the United States every year, usually between October and May. Flu is caused by influenza viruses, and is spread mainly by coughing, sneezing, and close contact. Anyone can get flu. Flu strikes suddenly and can last several days. Symptoms vary by age, but can include: fever/chills sore throat muscle aches fatigue cough headache runny or stuffy nose Flu can also lead to pneumonia and blood infections, and cause diarrhea and seizures in children. If you have a medical condition, such as heart or lung disease, flu can make it worse. Flu is more dangerous for some people. Infants and young children, people 65 years of age and older, pregnant women, and people with VACCINE INFORMATION STATEMENT Many Vaccine Information Statements are available in Spanish and other languages. See Hojas de información sobre vacunas están disponibles en español y en muchos otros idiomas. Visite certain health conditions or a weakened immune system are at greatest risk. Each year thousands of people in the United States die from flu, and many more are hospitalized. Flu vaccine can: keep you from getting flu, make flu less severe if you do get it, and keep you from spreading flu to your family and other people. 2 Inactivated and recombinant flu vaccines A dose of flu vaccine is recommended every flu season. Children 6 months through 8 years of age may need two doses during the same flu season. Everyone else needs only one dose each flu season. Some inactivated flu vaccines contain a very small amount of a mercury-based preservative called thimerosal. Studies have not shown U.S. Department of Health and Human Services Centers for Disease Control and Prevention

15 thimerosal in vaccines to be harmful, but flu vaccines that do not contain thimerosal are available. There is no live flu virus in flu shots. They cannot cause the flu. There are many flu viruses, and they are always changing. Each year a new flu vaccine is made to protect against three or four viruses that are likely to cause disease in the upcoming flu season. But even when the vaccine doesn t exactly match these viruses, it may still provide some protection. Flu vaccine cannot prevent: flu that is caused by a virus not covered by the vaccine, or illnesses that look like flu but are not. It takes about 2 weeks for protection to develop after vaccination, and protection lasts through the flu season. 3 Some people should not get this vaccine Tell the person who is giving you the vaccine: If you have any severe, lifethreatening allergies. If you ever had a life-threatening allergic reaction after a dose of flu vaccine, or have a severe allergy to any part of this vaccine, you may be advised not to get vaccinated. Most, but not all, types of flu vaccine contain a small amount of egg protein. If you ever had Guillain-Barré Syndrome (also called GBS). Some people with a history of GBS should not get this vaccine. This should be discussed with your doctor. If you are not feeling well. It is usually okay to get flu vaccine when you have a mild illness, but you might be asked to come back when you feel better. 4 Risks of a vaccine reaction With any medicine, including vaccines, there is a chance of reactions. These are usually mild and go away on their own, but serious reactions are also possible. Most people who get a flu shot do not have any problems with it.

16 Minor problems following a flu shot include: soreness, redness, or swelling where the shot was given hoarseness sore, red or itchy eyes cough fever aches headache itching fatigue If these problems occur, they usually begin soon after the shot and last 1 or 2 days. More serious problems following a flu shot can include the following: There may be a small increased risk of Guillain-Barré Syndrome (GBS) after inactivated flu vaccine. This risk has been estimated at 1 or 2 additional cases per million people vaccinated. This is much lower than the risk of severe complications from flu, which can be prevented by flu vaccine. Young children who get the flu shot along with pneumococcal vaccine (PCV13) and/or DTaP vaccine at the same time might be slightly more likely to have a seizure caused by fever. Ask your doctor for more information. Tell your doctor if a child who is getting flu vaccine has ever had a seizure. Problems that could happen after any injected vaccine: People sometimes faint after a medical procedure, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting, and injuries caused by a fall. Tell your doctor if you feel dizzy, or have vision changes or ringing in the ears. Some people get severe pain in the shoulder and have difficulty moving the arm where a shot was given. This happens very rarely. Any medication can cause a severe allergic reaction. Such reactions from a vaccine are very rare, estimated at about 1 in a million doses, and would happen within a few minutes to a few hours after the vaccination. As with any medicine, there is a very remote chance of a vaccine causing a serious injury or death. The safety of vaccines is always being monitored. For more information, visit: vaccinesafety/

17 5 What if there is a serious reaction? What should I look for? Look for anything that concerns you, such as signs of a severe allergic reaction, very high fever, or unusual behavior. Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness. These would start a few minutes to a few hours after the vaccination. What should I do? If you think it is a severe allergic reaction or other emergency that can t wait, call and get the person to the nearest hospital. Otherwise, call your doctor. Reactions should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your doctor should file this report, or you can do it yourself through the VAERS web site at or by calling VAERS does not give medical advice. 6 The National Vaccine Injury Compensation Program The National Vaccine Injury Compensation Program (VICP) is a federal program that was created to compensate people who may have been injured by certain vaccines. Persons who believe they may have been injured by a vaccine can learn about the program and about filing a claim by calling or visiting the VICP website at www. hrsa.gov/vaccinecompensation. There is a time limit to file a claim for compensation. 7 How can I learn more? Ask your healthcare provider. He or she can give you the vaccine package insert or suggest other sources of information. Call your local or state health department. Contact the Centers for Disease Control and Prevention (CDC): - Call (1-800-CDC-INFO) or - Visit CDC s website at Vaccine Information Statement Inactivated Influenza Vaccine 08/07/2015 Office Use Only 42 U.S.C. 300aa-26