Health & Fitness

Antibiotics and Vaccine Effectiveness in Children

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Experts say parents should be careful about giving their young children antibiotics. Anna Tabakova/Stocksy United
  • New research shows that antibiotics can make childhood vaccines less effective.
  • This effect has been observed in adults and in mice, but this is the first study examining children.
  • Experts say, however, there are times when a young child should be given antibiotics.

The old saying tells us nothing’s certain in life but death and taxes. May we suggest adding childhood bacterial infections to the list?

Try as you might to explain it rationally, infants and toddlers have no appreciation for germ theory. They don’t cover when they cough or sneeze, they don’t wash their hands, and everything they grab ends up in their mouth.

It’s really no wonder that young children commonly get bacterial ailments such as strep throat, pink eye, and ear infections. Many times, these are treated with antibiotics.

However, a new study in the medical journal Pediatrics reports that the use of some antibiotics can negatively impact the effectiveness of vaccinations in children under the age of 2.

More specifically, the study authors stated that young children who received antibiotic prescriptions more frequently or for longer durations had lower levels of antibodies associated with childhood vaccines.

The vaccines in the study included:

  • DTaP (diphtheria-tetanus-acellular pertussis)
  • Hib (Haemophilus influenzae type B)
  • IPV (inactivated polio vaccine)
  • PCV (pneumococcal conjugate vaccine)

Having fewer antibodies means less protection against these diseases. In addition, because antibiotic overuse has been a concern for years, this could go beyond individual children by impacting community-wide herd immunity against these diseases.

While the researchers didn’t find the exact mechanism behind these results, they theorized that broad-spectrum antibiotics alter the gut microbiome for an extended period of time, thereby disrupting the mechanisms that allow vaccines to properly function.

Let’s not panic. To be clear, antibiotics still have their uses in young children.

Amoxicillin is one antibiotic that’s commonly used. The study authors found that it didn’t have a significant impact on antibody levels.

The antibiotics that negatively affected antibody levels were:

  • ceftriaxone
  • cefdinir
  • amoxicillin/clavulanate (amoxicillin combined with clavulanate)

Amoxicillin/clavulanate in particular was shown to have no significant effect on vaccine-induced immunity after a 5-day course, but a negative effect after a 10-day course. The researchers said this suggests that the duration of antibiotic use is an important consideration.

The researchers, advising pediatricians more than caregivers, recommended using narrow-spectrum antibiotics over broad-spectrum when possible, limiting the course duration, and prescribing antibiotics more judiciously overall.

Fair enough, but what are your options if you aren’t licensed to write prescriptions?

Dr. Gina Posner, a pediatrician at MemorialCare Orange Coast Medical Center in California, told Healthline that antibiotics are completely unnecessary for colds and other viral infections.

“Most infections are viral and a lot of times a doctor will feel pressured by a parent to give an antibiotic even though there is no need for it,” Posner said.

Advocating for your child’s health is important, but pressuring a doctor for a prescription is something else, and it can be more harmful in the end.

So if it’s not a bacterial infection, what can you do?

“Frequently, you can use saline nasal washes to help clear sinus infections,” Posner said.

“Oftentimes, time is what cures the infection. Just letting a virus run its course is important,” she added.

Dr. Danelle Fisher, FAAP, a pediatrician and the chair of pediatrics at Providence Saint John’s Health Center in Santa Monica, California, gave Healthline similar advice, saying “Children with obvious viral infections (such as the common cold) will not benefit from an antibiotic.”

Using antibiotics only to fight bacterial infections is a good start. Preventing bacterial infections in the first place is another practice that deserves more attention.

“Trying to prevent bacterial infections with good hygiene is important,” Fisher said. “Children can optimize their health by eating healthy foods, drinking lots of water, and getting a good amount of exercise and sleep on a regular basis.”

If your child still needs antibiotics, can they just get extra vaccine boosters to make up for it? Posner and Fisher both advised against this, citing a lack of supporting experimental evidence. Stick to the vaccine schedule, they advised.

However, they also both said you can give your child probiotics while they’re on antibiotics. This almost sounds paradoxical, but it can actually help to keep your child’s gut microbiome more intact.

Fisher added that probiotics can help prevent antibiotic-associated diarrhea, too.

If your child needs antibiotics, check with their pediatrician to see if probiotics are safe for your specific circumstances.

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