Vaccinations

A to Z Resource Guide

Vaccinations

Our Vaccine Policy

We believe in the effectiveness of vaccines to prevent serious illness and to save lives.

We believe in the safety of our vaccines.

We believe that all children and young adults should receive all of the recommended vaccines according to the schedule published by the Centers for Disease Control and Prevention and the American Academy of Pediatrics.

We believe, based on all available literature, evidence, and current studies, that vaccines do not cause autism or other developmental disabilities.

We believe that thimerosal, a preservative that has been in vaccines for decades and remains in some vaccines, does not cause autism or other developmental disabilities.

We believe that vaccinating children and young adults may be the single most important health-promoting intervention we perform as health care providers, and that you perform as parents/caregivers.  The recommended vaccines and their schedule are the results of years and years of scientific study and research, with data gathered on millions of children by thousands of our brightest scientists and physicians.

These things being said, we recognize that there has always been and will likely always be controversy surrounding vaccination.

The vaccine campaign is a victim of its own success.  It’s precisely because vaccines are so effective at preventing illness that we even discuss whether or not they should be given.  Because of the safety and effectiveness of vaccines, many of you have never seen a child with polio, tetanus, whooping cough, bacterial meningitis, or even chickenpox.

Over the past several years, some people have chosen not to vaccinate their children with the MMR vaccine after publication in Europe of an unfounded suspicion that the vaccine caused autism.  This claim was later discredited and retracted.  Unfortunately, decreased vaccination rates have resulted in a rise in the number of measles cases across Europe.

Please understand that delaying or “breaking up” vaccines to give one or two at a time over several visits goes against expert recommendations and can put your child at risk for serious illness or even death.  Doing these things also goes against our medical advice.

As medical professionals entrusted with the lives of children we believe strongly that vaccinating children on schedule with currently available vaccines is the right thing to do.  With rising rates of pertussis being seen in this country we have made the decision here at Cary, Fuquay, and Apex Pediatrics to require our patients to meet certain vaccine standards to be part of the practice.  This is to protect the health of your child, our patients, and our community.

Finally, if you should refuse to vaccinate your child despite all our efforts and recommendations, we will ask you to find another health care provider who shares your views.

We write this statement not to scare you, nor to coerce you, but to make you aware of the facts, and to emphasize the importance of vaccinating your child.

Please feel free to discuss any questions or concerns you have about vaccines with any one of our providers.  Please also recognize that we will do everything we can to convince you that vaccinating your child according to the recommended schedule is the right thing to do.  It is our job to advocate for children and their health is our priority.

TYPICAL VACCINE ADMINISTRATION SCHEDULE:

Birth/2-Weeks: Hep B

2 month series (3 shots):  Pentacel (DtaP, IPV, HiB), Prevnar, Hep B, and oral Rotateq

4 month series (3 shots):  Pentacel (DtaP, IPV, HiB), Prevnar, Hep B, and oral Rotateq

6 month series (3 shots):  Pentacel (DtaP, IPV, HiB), Prevnar, Hep B, and oral Rotateq

1 year series (4 shots):  MMR, Varivax, Hep A, and Prevnar

15 month series (2 shots): DTaP, HiB (Prevnar if not administered at 1 year)

18 month or 2 year (1 shot): Hep A

4-6 years old (2-4 shots depending on combination used): MMR, Varivax, DTaP, IPV

11-12 years old:  Tdap, MCV4, HPV (2 doses needed)

16-17 years old:  MCV4, Meningitis B (2 doses needed)

To meet our practice standards, the following are required:

1 year standard:  Each infant should have 3 doses each of DTaP, IPV, HiB, and Prevnar by 1 year of age.

2 year standard:  Each toddler should have the 1 year standard + 1 dose each of MMR, Varivax + boosters of DTaP, HiB, and Prevnar (total of 4 each) by 2 years of age.

6 year standard:  Each child should have the 2 year standard + boosters of MMR, Varivax, DTaP and IPV. Note that Hep B is required for Kindergarten entry.

12 year standard:  Each child should have the 6 year standard, + Tdap booster and MCV4.

16 – 17 year standard: Each child should have the 12 year standard + MCV4 booster

Vaccination Facts from the Centers for Disease Control

Bear in mind that diseases we vaccinate are not gone.  The number of cases of measles last year was more than any single year since the 1990’s; most of the cases in children who have not been vaccinated either because of age or by choice.

See the Downloads list below for fact sheets about each vaccine.

Downloads

Reliable Web Sites

Recommended Reading

  • Vaccinating Your Child, Humiston and Good
  • What Every Parent Should Know About Vaccines, Offitt & Bell

Contraception

A to Z Resource Guide

Contraception

At Cary, Fuquay and Apex Pediatrics, we are proud to be following the latest recommendations from the AAP for the most effective adolescent contraception. We offer traditional guidance for birth control, including but not limited to abstinence, condoms, oral contraceptives and Depo Provera.

Nexplanon

Our providers are trained in the insertion of Nexplanon, which is a small, soft, and flexible birth control implant that is just 4 centimeters in length.  It is inserted directly and discretely under the skin on the inside of the arm.  The procedure is quick with minor discomfort and Nexplanon provides up to 3 years of continuous pregnancy prevention.  No daily pills, sticky patches or injections.

Once it is inserted, Nexplanon is over 99% effective.  If you or your teen are interested in Nexplanon or any other form of contraception, ask to schedule a consult with one of our trained providers in ANY of our locations.  We can tell you all about it!

Circumcisions

A to Z Resource Guide

Circumcisions

We are now able to perform circumcisions on your newborn boy.  The procedure is performed in our Cary office by Dr. Villareal.  Here is what he has to say about the procedure.

“There are three different ways that a circumcision can be performed.  I was trained in the most common method using a Gomco clamp.  I feel comfortable performing circumcisions on newborns up to two weeks of age.

One of the most common concerns for a parent is how much pain their son will experience.  I take great care to numb the area and ensure that your son is numb prior to starting the circumcision.  I also have the baby suck on some sugar water throughout the procedure.  With these two soothing mechanisms, evidence and my experience shows that most babies are very comfortable, and I have a high percentage that will sleep through most of the procedure.

The worst part of the procedure is that they have to have their legs strapped down to the table so that they do not interfere with the sterile area, which can make kids a little cranky after the procedure.  The whole procedure takes about 25-30 minutes.  After the procedure, I have the parents wait in the office for about 15 minutes so that I can check the penis and ensure that everything looks appropriate.”

If you have any additional questions please do not hesitate to contact our Cary office with more questions.

Nutrition

A to Z Resource Guide

Nutrition

Eating disorders, obesity, picky toddlers, and vegetarianism are just a few of the topics our registered dietitians can cover.  We are excited to have Caitlin Ashley, MPH, RD, LDN as part of our practice. Caitlin’s areas of interests are disordered eating, eating disorders, intuitive eating and sports nutrition. She is currently seeing patients via Telehealth. An appointment can be made at any time. Please discuss this service with your provider.

Downloads

Reliable Web Sites

Recommended Reading

  • AAP Guide to Your Child’s Nutrition, Dietz and Stern

ADHD

A to Z Resource Guide

ADHD

Our office performs ADHD screening for our families and helps them navigate the confusing landscape of ‘attention’ in school and at home. Please call to set up a consult with one of our providers if you or the school has concerns.

Reliable Web Sites

  • ADDitude
    Strategies and support for ADHD and LD

Child Development

A to Z Resource Guide

Child Development

Developmental Screenings

We are using CHADIS developmental screens in our office at many checkups to make sure we don’t miss any subtle problems.

Recommended Reading

  • Babyhood, Leach
  • The First Three Years of Life, White
  • Infants and Mothers, Brazelton
  • Caring for Your Young Baby and Young Child-Birth to Age 5, Shelov, MD and Henneman, MD
  • Your Baby’s First Year, Shelov
  • What to Expect the First Year, Eisenberg, Markoff and Hathaway
  • AAP Guide to Your Child’s Sleep, AAP
  • It’s Potty Time (video), Duke Family Series
  • How to Get Your Kids to Eat, but not too Much, Ellyn Sutter
  • Guide to Toilet Training, AAP
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