Episode No. 10 
IMMUNIZATION – II 

Here are a few frequently asked questions about immunization and certain precautions to be taken for vaccination.  Also some information about newer vaccines, and their schedules.

Q: My baby had a cold on the day his vaccination was due, so we didn’t get him vaccinated. Now do we have to repeat the whole course?
A: No, minor cold and cough is not a contraindication for vaccination. But if your child is seriously ill, or due to any other reason, you couldn’t get your child immunized, you don’t have to repeat the course, just give the dose that is due. If immunization status of a child is unknown, there is no harm in giving appropriate vaccine again.

[Active immunoprophylaxis is after exposure to disease is recommended for rabies, measles (within 3 days of exposure) hepatitis and tetanus].

Q:  Does the child have to be kept on an empty stomach before giving the oral polio vaccine?
A: No, this was the older concept, which has changed now.  The child can be fed before giving the O.P.V.

Q: What should be applied on the swelling that may occur after DPT?
A: Don’t apply any ointment or any material over the mild swelling and tenderness after this vaccine.

Q: Children keep getting hurt while playing and have minor injuries. Should they be given TT (Tetanus Toxoid) each time?
A: A fully immunized child does not require TT for minor injuries. TT protects a child for 5 years. However, if he gets hurt when his DPT booster is due, give him the dose.

Q: Are there any other precautions to be taken before vaccination?
A: The government provides facilities for sterilization of immunizing agents, storage and transport of vaccines through a system called the ‘cold chain’. All parents should be aware of the fact that the vaccines are not effective if they are not preserved properly in the refrigerator or in an icebox. They should be careful about the same while carrying the vaccines and also should check that the personnel are taking care to maintain the required temperature of the vaccines. Do keep record of all the vaccines given to your child so that he completes the course as per schedule.

Q: What is the MMR vaccine for?
A:: MMR is given to a child between the ages of 15-18 months. It gives protection against measles, mumps and rubella. It acts as a booster dose for measles vaccine.

Q: What is hepatitis?
A: Hepatitis, meaning inflammation of the liver, commonly presents as jaundice, and is caused mainly by 2 viruses, Hepatitis A virus and Hepatitis B virus. Hepatitis A is spread through contaminated food and water. Hepatitis B occurs mainly through blood (parenteral). It passes from an infected mother to her baby. Other modes are contaminated needles or surgical instruments.

Q: Are vaccines available for both these diseases?
A: Yes. Hepatitis B is the more dangerous of these two diseases.  Hepatitis B vaccine is given at birth, as soon as the baby is born, or within 24 hrs, to prevent vertical transmission from the mother to the newborn. The second dose is given a month later and the third at 6 months of age. 

At any age, Hepatitis B vaccine can be given in 3 doses, 2^nd being 1 month apart from the 1^st dose and 3^rd dose after 6 months. Hepatitis A vaccine is also given in three doses like Hepatitis B vaccine.

Q: What are the vaccines available for typhoid?
A: Three types of vaccines are available for typhoid, 2 are injectable and 1 is oral.

The first type (TA) is given after 6 months of age. This is cheaper but has many side effects like local pains and swelling. This vaccine is required to be repeated every year.

The 2^nd type (VI) can be given after 2 years of age and has to be repeated every 3 years.

Oral vaccine is given when the child is able to swallow the capsule i.e. usually at 6 years of age and has to be repeated every 3-5 years of interval. The latter two have minimal side effects. 

Q: Is there a vaccine against brain fever?
A: An organism called Haemophilus influenzae can cause a variety of infection in children, including meningitis i.e. infection of the coverings of brain and spinal cord. Children less than 5 years of age, especially those between 6-18 months of age are especially at risk for this meningitis.

Taking HiB vaccine at 1¹/₂, 2¹/₂ and 3¹/₂ months of age with DPT and OPV in 3 doses, can prevent this contagious disease. Between the age of 15 months and 5 years only one dose of this vaccine is administered.

Q: Can chicken pox be prevented by vaccination?
A: Chickenpox is another viral disease, presenting as fever and itchy blistering rashes and is also highly contagious and can be prevented by vaccine. This vaccine is given as a single dose for below 12-year-olds and as two doses (one month apart) for those above 12 years of age.

Q: Is it compulsory to give all these vaccines?
A: Vaccines help the body in fighting disease. You can discuss the merits and demerits of these vaccines with your physician and decide to take the vaccines. The vaccines included in the National Immunization Schedule are however mandatory.

Q: What other steps can be taken to prevent disease?
A: We recommend hygienic precautions to prevent water and food borne diseases. Maintaining personal hygiene, eating well-cooked, fresh food, drinking boiled water and proper sewage disposal are a few measures, which help avoid these illnesses. Taking all the vaccines alone does not protect you from all the diseases. Vaccines provide protection against various diseases and not the permission to live life in your own way, and besides, there are so many diseases like giardiasis and amoebiasis against which we don’t have a vaccine. Vaccination is an important step towards a healthy life, but general principles of hygiene and healthy life style is the path you have to walk on.