Editors note: NDSC Board Member and Professional Advisory Council Co-Chair Laura Cifra-Bean, M.D., is a pediatrician and mother of a son with Down syndrome. She sees many children with special needs in her practice and one question she often hears is “My child always has an ear infection or constant runny nose if not on antibiotics. Is this common in children with Down syndrome?” Here is her response:
Vaccines and Antibodies
Recurrent ear infections and prolonged respiratory infections are common in children with Down syndrome. This is due to the small anatomy of their mid-face structures, including the nose, and the eustachian tubes, which drain the ears into the throat. These infections occur more commonly during the winter months and are usually not constant. Some children need tubes in their ears to prevent recurrent ear infections. When respiratory infections are chronic or ear infections persist despite tubes, one should proceed with further evaluation since the problem may not be confined to the ears, nose and throat. That further evaluation could include examining the immune system to make sure it is producing enough antibodies to fight off infections.
Some children with DS may not mount the usual immune response to vaccines or natural infections. After a vaccine is given, the immune system produces antibodies that will fight off infections when a child is exposed in the future to that particular bacteria or virus. A significant number of people with DS do not produce enough antibodies after receiving the vaccines against pneumococcal or haemophilus influenzae bacteria. A blood test can measure the antibody titer after the vaccines are completed at the one year check up. If the response to the vaccines is insufficient, then it would be a good idea for the child to see an immunologist. Vaccines would probably be repeated and the child may need preventive treatments to avoid recurrent infections.