Order of shots matters

Dr. Moshe Ipp of the Hospital for Sick Children in Toronto, realizing that some vaccines cause more pain than others because of their chemical makeup, tested whether changing the order in which they are given would make a difference. To do so, 120 healthy infants were randomly chosen to receive either the pneumococcal conjugate vaccine, known as PCV, first, or the combination vaccine for diptheria, polio, tetanus, pertussis, and Haemophilus influenzae Type B, or DPTaP-Hib.

Each infant was videotaped while getting the shots, one after the other in alternate thighs. Their pain was scored by a researcher based on their facial expression, crying, and movements. Parents also rated their children's reaction on a scale of zero to 10.

Infants given the less painful DPTaP-Hib vaccine first appeared to experience less overall distress than infants who got the PCV vaccine first.

BOTTOM LINE: The sequence of immunizations given at doctor's office visits can reduce the overall pain an infant experiences.

CAUTIONS: Results are based on a small trial at a single clinic.

WHAT'S NEXT: The researchers recommend that vaccine makers come up with formulations that are less painful.

WHERE TO FIND IT: Archives of Pediatric and Adolescent Medicine, May 4.

Job loss is unhealthy

Sociologist Kate W. Strully, now at the State University of New York at Albany, analyzed data from a national survey done in 1999, 2001, and 2003. More than 8,000 people were asked about their health, their occupation, and whether they had become unemployed in the previous year and a half.

People already in poor health were 40 percent more likely to be laid off or fired than healthy workers. And people who were fired or laid off had a 43 percent higher risk of new health problems.

To isolate job loss from individual factors that may have led to a firing or layoff, Strully studied only people who lost their jobs when an entire factory closed or a business went under. She found that laid-off workers without previous health problems had an 83 percent higher risk of developing health problems, including heart disease, diabetes, and arthritis, compared to people who remained employed.

And even if they became reemployed one or more times - called job churning - their risk rose to 97 percent higher than people who kept their original jobs, researchers found. The findings were consistent among both blue-collar and white-collar workers.

"People suffer significant health declines following job loss," said Strully, who completed the study while a postdoctoral fellow at the Harvard School of Public Health. "People who got reemployed quickly are still suffering worse health."

BOTTOM LINE: People who lose their jobs are more likely to develop health problems than people who remain employed, even if they quickly find new work.

CAUTIONS: The study did not explain why job loss might lead to such a variety of illnesses; other research links cardiovascular disease, diabetes, and arthritis to inflammation caused by stress.

WHERE TO FIND IT: Demography, May 2009.

ELIZABETH COONEY