What must parents know about vaccines?
BCC VACCINE
This vaccine provides protection to the child against tuberculosis. A single injection of this vaccine is given in the left shoulder region. It does not cause any immediate reaction, such as fever or pain at the site of the injection. A small nodule usually appears about 4 to 6 weeks later at the injection site. It may have a little watery or creamy discharge and vary in its size intermittently over the next 6 to 8 weeks. This is normal. The nodule usually subsides by about 12 weeks leaving behind a permanent thin, light-coloured scar.
If your baby shows no local reaction after BCG vaccination, report it to your doctor. He may like to check whether the vaccine administration has been successful or not. It may, sometimes, need to be repeated.
If the child develops a swelling in his left armpit or in the neck, it may mean that a lymph gland in the area has become inflamed. Consult your doctor. Your child may need medication for a few weeks.
DTP (TRIPLE ANTIGEN)
This vaccine confers protection to the child against diphtheria, pertussis (whooping cough) and tetanus. The child may develop fever, irritability, pain and swelling over the site of injection which may last for one to two days.
These symptoms can be easily relieved by giving the child a dose of paracetamol syrup as and when required.
injection persist for more than three to four days. Very rarely, a baby may develop high fever (above 103 deg F to 39.5 deg C) or a persistent, unusual reaction (which are rare) seek advice from your doctor.
POLIO VACCINE
Most medical experts now recommend initial administration of a total of 5 doses of oral polio vaccine with the 5th dose to be given along with the hepatitis B vaccine between 6 to 9 months of age.
Polio vaccine does not cause diarrhea, fever or any other side effects.
MEASLES VACCINE
The measles vaccine is generally recommended to be given to children in India at the age of around 9 months. But if an epidemic of measles occurs in your area, the measles vaccine should be given even to younger babies who are between 6 and 9 months of age.
This should be followed by the MMR vaccine (measles, mumps, rubella) between 15 to 18 months of age in order to ensure that these babies develop adequate long-term protection against measles.
There is no fever or any other significant reaction soon after the administration of measles vaccine. The baby may however develop transient mild fever and rash over his face and body 5 to 7 days later, which subside on their own.
There is no upper age limit for giving the measles vaccine. If a child has not received measles or MMR vaccine, and if he has not already suffered from measles, the vaccine can be given to him at any age.
MMR (MEASLES, MUMPS, RUBELLA) VACCINE
The MMR vaccine confers protection against measles, mumps and rubella (German measles). Protection against rubella is particularly important for girls.
If a pregnant woman develops rubella, especially during the first four months of pregnancy, her baby becomes highly liable to suffer from serious birth defects involving his heart, brain, eyes, and other vital organs.
The MMR vaccine administration may occasionally be followed about 10 days later by transient swelling of the parotid glands (on the side of the face, and around ear lobes). No treatment is required and the swelling subsides on its own.
TYPHOID VACCINE
Typhoid is very common disease in India and many other developing countries.
Children over 2 years of age are more at risk of developing this disease than younger children due to the greater chances of their exposure to contaminated food and water outside the home.
It is, therefore, considered advisable to provide protection to children over two years against typhoid fever with the aid of typhoid vaccine along with the observance of other preventive measures. (for details refer to Typhoid fever in the section on common diseases in children.)
Three types of typhoid vaccine are now available, out of which two have to be given by injection, while the third is available in capsule form.
There is no significant difference in the efficacy of the three types of vaccines.
- The older type of typhoid vaccine is inexpensive. Initially, two doses of this vaccine are given by injection at an interval of four weeks. Booster doses may be given at 3 years interval.
- The new Vi typhoid vaccine is costly. A single injection is given to begin with and then repeat doses every three years, this vaccine is recommended for children at 2 years of age and above.
- An oral typhoid vaccine has recently become available for children above 6 years of age. One capsule of this vaccine has to be swallowed as a whole on alternate days for three days (three capsules in all) subsequently repeat doses are to be given every two three years.
MENINGOCOCCAL VACCINE (AGAINST ONE TYPE OF MENINGITIS)
Infection by a number of different bacteria and viruses can cause inflammation of the meninges, which is medically termed as ‘meningitis’.
Meninges are thin, sheet-like covering on the outer surface of the brain and spinal cord. Meningococci are one of the several organisms (bacteria and viruses) which can cause meningitis. The generally available meningitis caused by meningococci (strains A and C only.) it does not protect against all types of meningitis.
There Strictly speaking, its use should be restricted to situations of an epidemic of meningococcal meningitis caused by meningococci in your area, and should be administered under specific instructions of a paediatrician.
HEPATITIS B VACCINE
It is a new vaccine which protects against one type of jaundice caused by hepatitis B. the importance of hepatitis B disease in children is now being increasingly recognized. Besides being a cause of jaundice, it is now known to also produce chronic liver damage.
For prevention of this problem, routine prophylactic administration of three doses of hepatitis B vaccine to all children has been started in USA and some other Western countbries.
It is a very useful vaccine and is now freely available in India. You may discuss the matter in detail with your child. According to recent recommendations of an expert committee of the Indian academy of pediatrics, all children should be routinely immunized with hepatitis B vaccine.
The committee has recommended that the first dose of this vaccine should be given within 2 weeks of the baby’s birth (along with BCG and polio vaccine) followed by the second dose one month later (along with DTP and polio vaccine). The child should receive its third dose between 6 and 9 months of age.
Booster doses of this vaccine have been advised by some experts to be given at the age of 5 years and 15 years for maintenance of continued protection.
Although immunization with hepatitis B vaccine should preferably commerce soon after birth, it can, however, be started later in older children.
The first dose of the vaccine is then followed by the second and third dose after 1 month and 6 months of the first dose respectively.
If a pregnant mother during her routine antenatal checkup is found to be hepatitis B positive, protective vaccination of her birth. In this situation, the baby needs simultaneous administration of one dose of HBIG-Hepatitis B immunoglobulin (by intramuscular injection at a separate site) along with the first dose of Hepatitis B vaccine.
The second dose of Hepatitis vaccine is given 1 month later and the third dose 6 months after the first dose.
HIB VACCINE
Infection by Hib organisms (Haemophilus Influenzae type B) organism is responsible for causing pneumonia , meningitis and several other illness in many children below 5 years of age in the west.
To prevent this infection, hib vaccine is now being routinely administered to all infants and young children in America and Europe.
Recent research studies have shown significant incidence of this infection in India and suggested the desirability of giving protective hib vaccine to children in this country also.
Three doses of this vaccine are recommended to be given initially, one dose each along with DTP and polio vaccine at 6, 10, and 14 weeks of age, followed by a booster dose 12 months after the last injection.
When immunization with this vaccine gets delayed and is started between 6 and 12 months of age, only 2 doses are given 1 to 2 months apart. It is followed by a booster 12 months after the second dose.
For children between 1 and 5 years of age, only one dose of this vaccine is sufficient. The hib vaccine is safe and effective.
OTHER VACCINES
The usefulness and desirability of giving presently available cholera vaccine is very doubtful.
Hepatitis A vaccine (against another type of jaundice) is still under trial.
Rabies vaccine is employed for protection in the case of bites by animals suspected to be suffering from rabies or unprovoked bites by stray and possibly rabid animals.
Consult your doctor for specific instructions.