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Medical Services

What is acute disease care?

Acute illnesses usually develop quickly and last a short amount of time (only a few days or weeks). Examples of acute diseases include:

  • Asthma attacks
  • Bronchitis
  • Burns
  • The common cold
  • The flu
  • Lacerations
  • Pneumonia
  • Strep throat
  • Respiratory infections
  • Simple broken bones

These conditions generally come on rapidly. In some cases, as with the common cold, symptoms will improve on their own. The recovery time is generally fast. Self-management can go a long way toward preventing acute diseases from occurring, but if they are unavoidable and severe, seek medical attention as quickly as possible.

What is chronic disease care?

Chronic diseases, on the other hand, develop slowly but will get worse over an extended period of time (months to years). Examples of chronic diseases include:

  • Alzheimer’s
  • Depression
  • Arthritis
  • Diabetes
  • Kidney disease
  • High blood pressure
  • Heart disease
  • High cholesterol
  • Osteoporosis
  • Obesity

These conditions take more time to develop than acute conditions and may progress over time. Certain chronic diseases have warning signs while others have none. Unfortunately, chronic health conditions can only be controlled, not cured. Managing symptoms usually requires a health care plan and regular visits to the doctor. Your healthcare provider can provide you with medication, healthy eating advice, occupational and/or physical therapy referral or other ancillary services as appropriate. In order to ward off certain chronic conditions, we recommend implementing healthy lifestyle habits. Staying physically active, maintaining a healthy weight, eating right, limiting sun exposure and refraining from drugs and excessive alcohol use are extremely beneficial.

What is chronic kidney disease?

Chronic kidney disease, or chronic kidney failure, is a gradual loss of kidney function. The kidneys are an essential organ that filter wastes and excess fluids from the blood, which leave the body when we urinate. When dangerous levels of waste, electrolytes and fluid build up in the body, chronic kidney disease has reached an advanced stage. During the early stages of chronic kidney failure, signs and symptoms may be small or undetectable. You may not realize that you have this disease until your kidney function is significantly impaired.

Many factors can contribute to this disease, including diabetes (type 1 or 2), high blood pressure, kidney inflammation, pyelonephritis (recurrent kidney infections), polycystic kidney disease, vesicoureteral reflux (a condition that causes urine to back up into the kidneys) and prolonged obstructions of the urinary tract. Smoking, obesity, old age, family history and abnormal kidney structure are all risk factors for chronic kidney failure.

What are the symptoms?

Signs and symptoms usually develop over time, especially if the kidney damage progresses slowly. You may experience:

  • Changes in the number of times you urinate
  • Nausea
  • Vomiting
  • Loss of appetite
  • High blood pressure
  • Chest pain
  • Shortness of breath
  • Itchiness
  • Swelling of the feet and ankles
  • Muscle cramps and twitches
  • Sleeplessness
  • Fatigue and weakness

The reason why these signs and symptoms may not be noticeable until irreversible damage has been done is because the kidneys are highly adaptable and are able to compensate for lost function. If you notice any of these signs or symptoms, schedule an appointment with one of our healthcare providers. If you have a medical condition that increases the risk of kidney disease, urine and blood tests can help to detect chronic kidney failure. Early detection is important, since chronic kidney disease can affect almost every part of your body.

How can I reduce the risk?

In order to reduce the risk, we recommend that you:

  • Avoid taking too many over-the-counter medications/pain relievers
  • Maintain a healthy weight
  • Avoid smoking
  • Work with your healthcare provider to manage your conditions or diseases that increase the risk of kidney disease

What are the treatments?

Certain types of kidney disease can be treated, but for the most part, chronic kidney disease does not have a cure. The treatments work to control the signs and symptoms as much as possible. In order to control the symptoms and make you feel more comfortable, your doctor may prescribe:

  • High blood pressure medication
  • Medicine to lower your cholesterol
  • Medicine to treat anemia (a condition in which the blood does not have enough healthy red blood cells)
  • Medicine to relieve any swelling you experience
  • Calcium and Vitamin D supplements to prevent weak bones

What is a circumcision?

circumcision is a surgical procedure that removes the skin (foreskin) covering the tip of the penis (the glans). In the United States, circumcisions are fairly common for newborn males. The procedure can be performed on teenagers and adults, but it is more complex.

Why is it done?

Circumcisions are performed for a number of reasons, including:

  • Religious or cultural rituals
  • Family tradition
  • Preventive health care
  • Personal hygiene

From a medical standpoint, sometimes the foreskin is too tight to retract or be pulled back over the glans. In other parts of the world, circumcisions are recommended to reduce the risk of some sexually transmitted infections (STIs/STDs). Circumcised men have a lower risk of STIs, HIV and urinary tract infections (UTIs) than uncircumcised men. Hygiene is also easier, as the penis is easier to wash without the foreskin. Circumcision does not affect fertility, nor should it have a large impact on sexual pleasure for men and their partners.

How is it done?

Newborn circumcisions are performed at the clinic when the baby is less than 10 lbs. and within the first 30 days after birth. The penis and surrounding areas are cleaned and an anesthetic is injected into the base of the penis. A special clamp is attached to the penis and the foreskin is removed. After the procedure is over, the penis is covered with a topical antibiotic and is wrapped with gauze. For patients 31 days and older, or newborns larger than 10 lbs., this procedure would be referred to a urologist.

Healing generally takes 10 days, and after the procedure, you may notice swelling, bruising, redness and even a small amount of yellow fluid on the tip of the penis.*

What is dermatology?

Dermatology is the branch of medicine concerned with the diagnosis and medicinal & surgical treatment of skin conditions. We treat people of all ages with benign and malignant (cancerous) disorders of the skin, nails, hair and the adjacent mucous membranes. At Jamison Family Medicine in Spokane, Washington, we can diagnose and treat:

  • Skin cancer*
  • Actinic keratosis*
  • Melanoma*
  • Moles*
  • Tumors*
  • Skin tags*
  • Dermatitis and other inflammatory skin disorders*

What is diabetes?

Diabetes refers to a group of diseases that affect your body’s use of blood sugar (glucose). Glucose is essential to your health because it is the brain’s main source of fuel and it provides energy to the cells that make up your tissues and muscles. There are 2 types of diabetes, but regardless of the type, these diseases result from excessive sugar in the blood. Type 1 usually develops at young age (though it can develop at any age) and occurs when the pancreas produces little to no insulin. Type 2 can also develop at any age, but it is more common among people who are 40 or older.

What are the symptoms?

Your symptoms will depend on how much your blood sugar is elevated. With type 1 diabetes, symptoms are known to develop quickly and are much more severe. Some of the most common symptoms for both types include:

  • Frequent urination
  • Increased thirst
  • Extreme hunger
  • Unexplained weight loss
  • Fatigue
  • Irritability
  • Blurred vision
  • Frequent infections (of the gums, skin or vagina)

If you or your child experiences any of these symptoms, see a doctor as soon as possible. The earlier this condition is diagnosed, the sooner the treatments can begin.

What are the treatments?

The best way to manage diabetes, as well as your overall health, is to eat healthy and get plenty of exercise. We recommend cutting down on saturated fats (red meat and dairy), refined carbohydrates and sweets. Exercise will lower your blood sugar level by moving sugar into your cells for energy and it increases your sensitivity to insulin.

Insulin pumps or injections, frequent blood sugar monitoring and carbohydrate counting can all help to treat diabetes. Other treatments may be recommended by your healthcare provider, including oral medications, a pancreas transplant or surgery.

FEELING FINE IN 29 Jumpstart

This 4-week program consists of a 14-day whole foods cleanse, beating physical and emotional cravings, metabolic make-over, fitness and learning a whole new way of eating. We focus on SMARTER GOALS so you feel 100% supported in every way.

  • 4 (30 min.) coaching sessions
  • Support emails throughout the month

90- Days to Reclaim Your Health and Body

This 3-month program includes a lifestyle and mindset makeover that is customized to your unique needs and challenges. Set SMARTER GOALS while understanding primary and secondary foods and how to navigate in a fast food world.

  • 6 (1 hour) one-on-one sessions
  • Support emails throughout the program
  • Control self-sabotaging behaviors
  • Guidance on health fat loss and reducing inflammation
  • Rid yourself of old beliefs and habits
  • Identify your personal exercise regime to get fit and toned

The 6-month Total Mind and Body Transformation

Designed for the growing population suffering from food sensitivities and those seeking to live your best life.

  • 2-week customized cleanse
    • Food sensitivities
    • Superfoods for brain health and overall vitality
  • 12 (1 hour) one-on-one sessions
  • Goal setting (and monitoring)
    • Stress reduction
    • Improved sleep
    • Superfoods for optimizing brain health
  • Control self-sabotaging behaviors
  • Guidance on health fat loss and reducing inflammation
  • Rid yourself of old beliefs and habits
  • Identify your personal exercise regime to get fit and toned

What are implantable contraceptives?

Implantable contraceptives, also known as birth control implants, are tiny rods (roughly the size of a match) that are inserted into the body to prevent pregnancy. Once implanted into the arm, these contraceptives release hormones to protect you from pregnancy for several years.*

How does it work?

The rod of birth control, also known as Nexplanon or Implanon, is implanted under the skin of the upper arm. The implant releases the hormone, progestin, which will stop you from getting pregnant.* Progestin works by thickening the mucus on the cervix, which will prevent sperm from reaching an egg.* It can also stop eggs from leaving the ovaries, so that there are no eggs to fertilize.* When your eggs aren’t released, you cannot get pregnant. The implant is said to work up to 4 years, but it is not a permanent form of birth control.*

If you decide that you do not want your implant anymore, your doctor can remove it for you. After the implant is removed, you should be able to get pregnant shortly after.* Implantable contraception does not prevent sexually transmitted diseases. Wearing condoms during intercourse will lower your chances of contracting or spreading an STD.

How is the implant inserted?

Your doctor will determine if birth control implants are right for you before the procedure. If you are a candidate, you will be given a shot to numb a small area on your arm during your appointment. Next, a special inserter tool will be used to slide the implant under your skin. The procedure only takes a few minutes. Most patients feel a pinch or sting when they receive the numbing shot. After that, you shouldn’t feel any pain or discomfort. After the numbing agent wears off, your arm may ache.* You might also experience swelling and tenderness, but this will pass after a week or two.* Your doctor will give you instructions on how to wash and take care of the skin around your implant for the first few days.

How effective is it?

Birth control implants are 99% effective.* Since it is in your arm, you will not have to worry about taking birth control incorrectly or at all. If you get Nexplanon during the first 5 days of your period, you are protected right away.* If you get the implant at any other time during your cycle, it is recommended that you use a second form of birth control to prevent pregnancy.*

What is a no-scalpel vasectomy?

A vasectomy is a simple surgery for male sterilization. During a no-scalpel vasectomy, the skin of the scrotum is not cut with a scalpel. Instead, one tiny hole puncture is made to reach both vas deferens tubes. The vas deferens tubes are then tied off, blocked or cauterized (closed with an electrical current). The procedure is done to permanently protect against pregnancy. During the surgery, the small tubes that carry sperm in the scrotum (vas deferens) are blocked off so that it cannot leave the body and cause pregnancy. No-scalpel procedures see reduced bleeding and a lower risk of bruising, infections and other complications.* There’s no scarring with this method and you will not need stitches.*

The alternative to this procedure is an incision vasectomy. During an incision vasectomy, one or two small cuts are made in the skin of scrotum. The vas deferens tubes are then tied, cauterized or blocked with surgical clips. The entire procedure can take 20 minutes and then the cut will be stitched up. You will be able to go home the same day with either method.*

How safe is the procedure?

No-scalpel vasectomies are routine and extremely safe.* Very few people experience complications and the risks are minor and treatable.* Additionally, we use Nitronox, a N2O and O2 pain relief system, during the procedure. Nitronox delivers 50% nitrous oxide and 50% oxygen directly to you on an “as needed” basis. You will be in control of the handheld supply valve in order to self-administer your own pain relief. To learn more about the procedure, please schedule a consultation at Jamison Family Medicine.

How effective is it?

Vasectomies are one of the most effective forms of birth control. Its success rate is close to 100% for preventing pregnancy, though not right away.* It can take a few months for your semen to become sperm-free.* Your doctor will do a semen analysis test after your surgery to confirm this. You should not have unprotected sex until the results come back from this test. This procedure is meant to be permanent, and should be performed on men who no longer want to have any children. Vasectomies will not protect you from sexually transmitted diseases.

What is osteopathic manipulation?

Osteopathic manipulation, or osteopathic manipulative treatment (OMT), involves the use of hands to diagnose, treat and prevent injuries and illnesses. Osteopathic physicians conduct these treatments and during your appointment, a physician will move your joints and muscles using stretching techniques, resistance and gentle pressure.

What can I expect during treatments?

During your appointment, your osteopathic physician will implement a number of different techniques. A soft tissue massage puts pressure on your muscles and stretches them out. With a muscle energy technique, you will move your muscles in one direction while your physician moves them in an opposite direction. Myofascial release therapy works to put gentle, firm pressure to release the tension in the layer of connective tissue around your muscles, organs and bones (the fascia). With osteopathic cranial manipulative medicine, your osteopathic physician will apply light pressure to your cranium (skull) to stimulate healing.*

Who benefits from osteopathic manipulative treatments?

OMT can be helpful for everyone. Many people schedule sessions to ease their pain, increase overall mobility and promote healing.* It can be used to help patients who suffer from:

  • Muscle pain*
  • Carpal tunnel syndrome*
  • Sinus disorders*
  • Asthma*
  • Migraines*
  • Neck pain*
  • Shoulder pain*
  • Knee pain*
  • Menstrual pain*

Some people have also found that OMT can compliment or replace surgery and medicine.* Not everyone benefits equally from these treatments, but if you do find it to be helpful for you, it can be an important compliment to standard medical care.* Research shows that many people have benefited from OMT.* If you suffer from lower back pain, you may find that you’ll need less pain killers and time off from work.*

What is a Pap test?

A Pap test, or Pap smear, is one of the most important screenings for gynecologic cancers. Pap tests can save lives by detecting cancers and precancers in a woman’s cervix. Precancers are cell changes that could potentially become cancer if they are not properly treated. These tests are covered by most health insurance plans and they should be scheduled every three years between the ages of 21 and 65. Women with weakened immune systems may need to schedule tests more frequently.

If you have had a hysterectomy or your cervix has been removed and you do not have a history of cervical cancer or abnormal Pap results, you do not need to schedule a Pap smear. If you are 65 or older and your last three tests were normal, with no abnormal test results within the past 10 years, you will no longer need to schedule Pap smears.

What can I expect during my appointment?

During the exam, a speculum is used to open the vagina so that the cervix is visible. A stick or brush will then be used to swipe a few cells from the inside and surface of the cervix. The cells are sent away to a lab for testing. Pap tests may be mildly uncomfortable but you should not experience any pain. The results usually take 1-3 weeks to come in.* Most of the time, the results are normal, but should you get abnormal results, it does not always mean that you have cancer. Regardless of the results, your doctor will discuss the next steps with you.

What are physicals?

Physicals are medical examinations of the body, conducted by medical professionals. During this check-up, your doctor will investigate the body in order to identify signs of disease. Your medical history will be taken into account and you should disclose any symptoms that you are feeling. With this information, your doctor can determine your overall health & wellness. This new data will become a part of your medical record. There are several different kinds of physicals, and they may cover different areas of your body.

What kind of physicals does Jamison Family Medicine provide?

At Jamison Family Medicine in Spokane, Washington, we provide complete physical examinations, routine well child examinations and physicals for athletes (including pre-participation sports) and scouts.

General

Complete physicals are performed for medical screening purposes and to check up on the overall health of a patient. They are performed by family doctors and physician assistants. During your appointment, your vitals (body temperature, pulse, respiration rate) and blood pressure will be checked and recorded. You will also be given a HEENT exam (head, ears, eyes, nose and throat). A complete physical examination can include any of the following: lab tests, chest X-rays, pulmonary function testing, audiograms, EKGs, heart stress tests, vascular age tests, urinalysis, and mammograms or prostate exams. It is an in-depth review of your health to screen for underlying diseases and abnormalities that could lead to serious health problems. Your healthcare provider will discuss and order any appropriate testing.

Routine well child examination

Routine well child examinations are performed at:

  • Newborn
  • 2 months
  • 4 months
  • 6 months
  • 9 months
  • 12 months
  • 15 months
  • 18 months
  • 24 months
  • Annually

During a well child visit, your healthcare provider will check your child’s growth and development in order to find or prevent problems. They will record your child’s height, weight, and other pertinent information. They will also talk about other wellness topics such as family relationship issues, school, and behaviors. The will ensure that vaccinations are all current and administer those needed.

Sports

A sports physical is done to determine if your body is health enough for organized sports. This exam focuses on your ability to perform a certain type of activity, instead of focusing on your overall health. It is not as comprehensive as other physicals and it should not be used to replace your yearly physical. Your appointment will start off very similar to a general physical, but your healthcare provider will also record your height and weight. A basic vision exam may also be ordered. Once this information has been collected (all of your health information, including the results of any lab work,) the paperwork can be completed and you may be medically cleared to participate. Many sports organizations require that this be completed in the pre-participation phase, before the league or games have started. 

What is sports medicine?

Sports medicine is a branch of medicine that focuses on physical fitness and the prevention of injuries that result from sports and exercise. If you or your child have suffered an injury during exercise, a sport or any physical activity, schedule an appointment at Jamison Family Medicine for treatment.

As family medicine providers, we are trained to restore function to an injured patient so that they can get back out on the court or field.* We can also help with injury and illness prevention, given our extensive knowledge on the subject.* Sports medicine doctors work with professional athletes extensively, but they can also help children, teens and adults who are involved in recreational leagues. Even construction workers and other professionals who have physically demanding jobs can benefit from these services.

What does Jamison Family Medicine treat?

We provide treatments for simple fractures, tendonitis, concussions, cartilage injures, ankle sprains, shoulder and knee injuries, asthma, dehydration, heat illness and eating disorders. In addition to addressing eating disorders, we can provide advice on nutritional supplements.

When should I seek treatment?

If you or your child sustains an injury during sports or exercise that is significant, we encourage you to go to the emergency room as soon as possible. Severe pain, numbness, swelling or an inability to put weight on an injured area are all grounds for a trip to the ER. For minor to moderate sporting injuries, rest up at home and give us a call for guidance and a referral.

What are stem cells?

Stem cells are unique, primitive cells capable of making copies of themselves and becoming different, more specialized types of cell. Adult stem cells were once thought to be more limited than embryonic stem cells. The belief was that adult cells could only give rise to the same type of tissue from which they originated. But decades of research have shown that the adult stem cells found in bone marrow (or mesenchymal stem cells) are capable of becoming multiple different kinds of cells including bone, cartilage, and connective tissue. These mesenchymal stem cells are also capable of decreasing inflammation and promoting healing in the cells around them.

Adult stem cells can help to create new cells in existing tissue to help repair structures that are damaged or injured. When mesenchymal stem cells are applied to a damaged or inflamed tissue, they are able to help in multiple ways. First, they control inflammation and help prevent it from becoming a destructive, rather than reparative, process. Second, mesenchymal stem cells can become cells with more specialized functions, like cartilage and bone. Third, mesenchymal stem cells affect the cells around them, helping them to behave more like healthy cells instead of malfunctioning cells.

There is some data to support the use of mesenchymal stem cells in some chronic diseases, like rheumatoid arthritis, chronic obstructive pulmonary disease (COPD), and multiple sclerosis. While this data is exciting, there is not yet enough evidence to warrant offering stem cell treatment for these types of diseases outside of a clinical trial.

On the other hand, there are mountains of data, published over decades by physicians and researchers all over the world, demonstrating that mesenchymal stem cells can be safely and effectively used in orthopedic treatments, often allowing patients to avoid invasive surgeries like total knee and hip replacements. In one study in elderly patients, Dr. Phillippe Hernigou showed that patients treated with both their own mesenchymal stem cells in one knee and a total knee replacement in the other overwhelmingly chose the mesenchymal stem cell treatment as their preferred treatment for both pain relief and ease of recovery.

How does stem cell therapy work?

Other healthcare providers may offer “stem cell therapy,” by utilizing stem cell proteins derived from umbilical cord blood. While this process can help patients experiencing pain, live cells are not used. If they were live cells, you would have to be blood-typed and cross-matched to make sure that your body does not reject the stem cell treatments. What makes Jamison Family Medicine different is that we use your OWN stem cells, which are alive and ready to help you heal.

We can provide injectable treatments to the joints, hip and spine. We use FDA-approved technology to separate the bone marrow-derived stem cells that come directly from you. This procedure can be done in one sitting, lasting about an hour from start to finish. Treatments are done by Dr. Jamison and Dr. Dibble, if injections are made in the spine or hip. They are both board certified doctors with 18+ years of experience.

Stem cell therapy is an exciting and effective treatment that uses the patient’s own ability to heal; which to us, is the best medicine.

What is bone marrow aspiration?

Bone marrow aspiration is a procedure that is performed to take a sample from the soft tissue inside the bones, and it can also be used to extract stem cells. Bone marrow is spongy tissue found inside our bones. It contains cells that produce red blood cells, white blood cells and platelets inside the skull, spine, ribs, breastbone and hips. Since red blood cells carry oxygen and nutrients, white blood cells help fight infections and platelets enable your blood to clot, it is very serious if our bodies experience abnormally high or low levels of one or all three. Stem cells are a class of undifferentiated cells that are able to become differentiated, specialized cell types (e.g. bone, muscle, skin, etc.).

We use bone marrow aspiration to prepare concentrated stem cell therapy for joint and spine pain reduction and rejuvenation.* Results vary, but live bone marrow derived stem cells from your own body are uniquely suited to heal the area they are placed.* When stem cells are concentrated in this way, the results can seem miraculous.* If you have pain in your knees, hips, shoulders or spine and you do not want to endure the pain and downtime of joint replacement or spinal surgery, this would be a great treatment option for you. Bone marrow derived live stem cells from your own body will never be rejected or cause harm.* Treatments can help with the:

  • Knees
  • Back/neck (or spine pain)
  • Shoulders
  • Hips
  • Feet/ankles
  • Hands/wrists

How is it performed?

During the procedure, you will lie down on your side or stomach and you will be covered with a cloth so that only the treated area will be visible. Your doctor will then check your blood pressure and heart rate.

Next, you will be given local anesthesia to numb the site of the aspiration. This is usually the top ridge of the back of the hipbone. In other cases, it may be taken from the chest bone. A small incision will be made to make it easier for a hollow needle to go into your skin. The needle will go into the bone, and with a syringe, your doctor will draw out fluid and stem cells from your bone marrow. After the fluid and stem cells are collected, the needle is removed and you will be bandaged up.

A trained nurse or technician then uses specifically designed equipment to concentrate the adult stem cells and growth factors present in the bone marrow, and provides the cells back to the physician for implantation into the targeted area.

What are vaccinations?

Vaccinations (immunizations) are small amounts of weakened or killed virus/bacteria, or a lab-made protein that imitate a virus that are injected into patients in order to prevent that same virus/bacteria. When your child gets a vaccine, they are being injected with a weakened form or small amount of a disease. This triggers their body’s immune response, causing it to produce antibodies to fight that virus or it will induce other processes that help their immune system. Going forward, their body will either be prepared to fight that same disease in the future or the vaccine will reduce its severity.

Should my child get vaccinated?

Yes. It is much easier and much more cost-effective to prevent diseases than it is to treat them. Immunizations can help to prevent the spread of serious diseases and viruses such as the mumps, the measles and whooping cough. Thanks to vaccines, we have also been able to eliminate cases of smallpox and polio. Certain vaccines only need to be given once, but some require boosters to maintain their successful immunization.

Which immunizations should my child get?

Many schools and daycares require proof of immunization, and aside from that fact, it is very important to keep your children up-to-date on their vaccines. Protecting children from disease and serious problems is paramount. The recommended vaccines for children from birth to the age of 18 include:

  • Tetanus (painful muscle spasms that start in the jaw and can lead to death)
  • Poliovirus (infects one’s brain and spinal cord, leading to paralysis)
  • Rotavirus (causes an inflammation of the stomach and intestines)
  • Hepatitis A (a highly contagious infection of the liver)
  • Hepatitis B (a life-threatening infection of the liver)
  • Pneumococcal (infections can lead to ear and sinus infections, pneumonia and bloodstream infections)
  • Influenza (the flu)
  • Measles (symptoms include a cough, runny nose, inflamed eyes, fever, a sore throat and a red, blotchy skin rash)
  • Mumps (a viral infection that affects the salivary glands)
  • Rubella (symptoms include a low-grade fever, sore throat and a rash that starts on the face and spreads to the rest of the body)
  • Varicella (chickenpox)
  • Diphtheria (affects the mucous membranes of the nose and throat and can be deadly)
  • Meningococcal (infections of the brain and spinal cord and bloodstream)
  • Pertussis (whooping cough)
  • Haemophilus influenzae type B (can cause pneumonia and make it hard for people to breathe)
  • Human Papillomavirus (can cause cervical, vaginal, anal, throat, or penile cancer or genital warts in adolescents)