What is immunization and how does it work ?

Immunization is a way of protecting the human body against infectious diseases through vaccination. Immunisation prepares our bodies to fight against diseases in case we come into contact with them in the future.

Babies are born with some natural immunity which they get from their mother and through breast-feeding. This gradually wears off as the baby's own immune system starts to develop. Having your child immunized gives extra protection against illnesses which can kill.

The schedule recommends that the vaccinations should start when the baby is 1 1/2 months old. But what should be done if the baby is brought late for vaccinations? Should vaccination still be started?

Yes, definitely. Even if the baby is brought late for vaccinations, she should still receive all the vaccinations. While it is the best to follow the ideal immunization schedule, on no account should the baby be denied vaccinations, even if she is brought late for them. But every attempt must be made to complete full immunization, before the age of 1 year.

My friend's baby, who was given the B.C.G. injection about two months ago, has developed a small blister at the site of injection. Is this a cause for worry?

Please reassure your friend that there is no cause for worry. This is a normal reaction after the B.C.G. injection. About 4 to 6 weeks after B.C.G. injection a small lump called a papule appears at a site of the injection which may later break, giving out a whitish discharge. This will heal in about 10 to 12 weeks after the injection has been given and will leave a scar. Only if the discharge continues

without the wound drying up, should the doctor be consulted.

What are the side effects of vaccinations? Only very few infants and children develop side effects after a vaccination. We have already discussed the side effects of the B.C.G. After the D.P.T. injection, the infant may have pain at the site of the injection and may even develop fever. In that case the baby may be given 1/2 a table or 1/2 a tsp. of paracetamol.

After the measles injection, measles like rashes may appear. These are normal. Very rarely, children can have allergic reactions straight after immunization. Also if the baby develops high fever or loses consciousness, a doctor should be consulted immediately. People giving immunizations are trained to deal with allergic reactions and if the child is treated quickly, he or she will recover fully.

Sometimes it is not possible to take the baby for the second and third vaccinations after precisely a month. If so, should the whole course be repeated?

No, a slight delay does not matter. Continue the vaccinations as per the schedule and complete the course as soon as possible. The child will be fully protected only after she has received 1 B.C.G. injection. 3 D.P.T. injections, 3 O.P.V. doses and 1 measles injection. Hence it is very important to take the baby for the vaccination at the correct time and to make sure that all the vaccinations are given.

Are there any reasons why my child should not be immunized? There are very few reasons why a child should not be immunized. Ordinarily common illnesses like a cold or a diarrhea are not impediments against getting your child vaccinated.

There are certain situations though, where you must let your healthcare provider know of your childs conditions. Following are some of them:
y

The child has a high fever; He has had a bad reaction to another immunization; He has had a severe reaction after eating eggs; or Has had convulsions (fits) in the past. (With the right advice, children who have had fits in the past can be immunized.)

He has had, or is having, treatment for cancer; He has any illness which affects the immune system, for example, HIV or AIDS. He is taking any medicine which affects the immune system, for example, immunosuppressants (given after organ transplant or for malignant disease) or high-dose steroids. How do we know that vaccines are safe? Vaccines like all other medicines under go extensive and rigorous tests regarding their safety. Only after the have been found to be safe that they are introduced for general vaccination programs. Each vaccine is continually checked even after it has been introduced and action is taken if it is needed. If a vaccine is not safe it is not used.

IDEAL IMMUNIZATION SCHEDULE FOR THE INFANTS (Recommended by the Ministry of Health, Searchvt. of INDIA)

B.C.G. (injection)*

At 11/2 months D.P.T. - 1 (injection) and

O.P.V. - 1 (dose)

D.P.T. - 2 (injection) and At 21/2 months O.P.V. - 2 (dose)

D.P.T. - 3 (injection) and At 31/2 months O.P.V. - 3 (dose)

At 9 months

Measles (injection)

D.P.T. Booster (injection) and 16 to 24 months O.P.V. Booster (dose)

* If the infant has been delivered in a hospital/clinic, she should be given the B.C.G. injection at birth. * Even if you are late for an injection/dose, you must still get it. Consult your health worker regarding this. Q. What is the basic principle of Immunization? Ans. Basic principle of active immunization involves stimulating the host to produce its own antibodies to the agent that causes disease. This stimulation is done by introducing attenuated(weakened) strain of specific bacterias, viruses and killed bacterias.

Q. Why is Immunization recommended mostly in early childhood? Ans. Children are highly susceptible to develop infections, as they have never been exposed to it earlier. Aim of Immunization is to prevent the person from getting the disease when they are exposed to it for the first time in life as certain illness may be crippling or fatal.

Q. Is natural immunity better than vaccine induced immunity? Ans. No, with natural disease, risk of serious illness, disability and death are high. Immunization is safer way to get immunity.

Q. Is it true that Immunized children still may contract one of the diseases? Ans.Yes, no immunization is 100% effective but if infection does occur, it will be mild.

Q. Can BCG, DPT and OPV vaccine may be administered simultaneously? Ans. Yes, BCG, DPT and OPV can be given on the same day.

Q. What are the contraindications to DPT vaccine? Ans. Progrinive murological disease, uncontrolled conculsick and severe reaction to first or subsequent close of DPT are contra indication to this vaccine.

Q. What are the side effects, complications of DPT vaccine? Ans. Fever and local pain are the common side effects of DPT vaccine but complication like convulsions, shock and encephalitis may also occur rarely.

Q. What are the contraindication to Polio vaccination? Ans. Contraindication to Polio are very few like immuno compromised host, severe diarrhoea and and acute febrile illness.

Q. What is pulse Polio Immunization? Ans. Pulse Polio Immunization means intermittent polio immunization drive inthe community or region to vaccinate all susceptible children irrespective of their previous immunization status. Pulse Polio immunization helps to replace the wild virus (disease causing virus) by vaccine virus in community. Many countries like Brazil, Cuba and Israel have eradicated polio disease by adapting pulse polio approach.

Q. Can breast-feeding can be given just before or soon after Polio vaccine administration?

Ans. Yes, Breast-feeding can be given just before or soon after administration of Polio vaccine.

Q. Can Polio vaccine be given to a child who has received Immunoglobin? Ans. The administration of Polio vaccine should be delayed by at least 6 weeks after administration of immunoglobin.

Q. Can Polio vaccine be given to a child who has recovered from Measles? Ans. Polio vaccine should be administered after one month of an attack of measles.

Q. MMR Vaccine protects from which diseases? Ans. MMR Vaccine provides protection against measles, mumps and Rubella. All three diseases are highly infectious and can lead to serious complications.

Q. Who should be given MMR Vaccine? Ans. Ideal age for MMR vaccine is between 15-18 months of age. However, it can be given upto 5 years of age if not given earlier.

Q. MMR Vaccine protects from which diseases? Ans. MMR Vaccine provides protection against measles, mumps and Rubella. All three diseases are highly infectious and can lead to serious complications.

Q. Can MMR vaccine be given along with other vaccines. Ans.Yes, MMR Vaccine can be given along with other vaccines like DPT, OPV etc. but at different sites.

Q. What are the side effects of MMR Vaccine? Ans. It is a very safe vaccine. Local tenderness may occur mild fever may occur

upto 5-6 days of vaccination some children may develop rash and lymphnode enlargement.

Q. MMR Vaccine protects from which diseases? Ans. MMR Vaccine provides protection against measles, mumps and Rubella. All three diseases are highly infectious and can lead to serious complications.

Q. What are the contraindication to MMR vaccine? Ans. MMR Vaccine is contraindicated for immunocompanised hosts. It is also contraindicated in children having severe (anaphylactic egg allergy).

Q. If a child is having cold, cough, fever or diarrhaea can he get MMR? Ans. Yes the child can get MMR vaccine.

Q A 3 months old infant is in contact with his elder sibling who is suffering from measles. Does this child prevention? Ans.No, infants upto 5-6 months of age have adequate level of maternally derived measles antibodies, which protect them against the disease.

Q. Can measles occur after measles Immunization? Ans. Yes, measles can occasionally occur after measles vaccination 10-15% children fail to seroconvert after measles vaccine given at 9 months of age.

Q. Can measles vaccine be given with Polio vaccine. Ans. Yes, Measles vaccine can be given Polio vaccine.

Q. A 3 months old infant is in contact with his elder sibling who is suffering from measles. Does this child prevention?

Ans. No, infants upto 5-6 months of age have adequate level of maternally derived measles antibodies, which protect them against the disease

Vaccination Schedule

Age of the child

Govt Schedule

IAP Schedule

BCG(Against Tuberculosis) At Birth OPV (Against Polio) This dose of vaccine at birth is called the zero dose.

BCG, OPV HB (Against heptitis B)

OPV (1st dose) OPV (first dose) 6 weeks DPT (Triple vaccine against diptheria, pertusis and tetanus) DPT (1st dose) HB (2nd dose)

OPV ( second dose) 10 weeks DPT (second dose)

OPV (2nd dose) DPT(2nd Dose)

OPV (third dose) 14 weeks DPT (third does)

OPV (3rd dose) DPT (3rd dose)

6-9 months

----------------------

HB ( 3rd dose)

9 months

Measles

Measles

OPV (4th dose) OPV (fourth dose) 15-18 months DPT (fourth dose) DPT (4th dose) MMR (vaccine against Measles, Mumps and German Measles (rubella)

5 years

DT (5th dose) (only for diptheria and tetanus)

OPV (5th dose) DPT (5th dose)

TT 10 years TT (against tetanus) HB

TT 16 years TT

RECOMMENDED IMMUNIZATION SCHEDULE FOLLOWED IN INDIA

Sl No.

Age

Disease

Vaccination

Remarks

AT BIRTH HEPATITIS B

HEP B VACCINE -I

AT BIRTH POLIO

ORAL PV 0 DOSE

BIRTH TO 6 WK

TUBERCULOSIS

BCG

4 -6 WEEKS

HEPATITIS B

HEP B VACCINE -II

DIPHTHERIA 5 6 WEEKS PERTUSIS TETANUS POLIO DPT-I OPV -I

DIPHTHERIA PERTUSIS 6 10 WK TETANUS POLIO HEPATITIS B

DPT-II OPV-II HEP B VACCINE III* *DELHI GOVT RECOMMENDATION

14

DIPHTHERIA

DPT-III

*DELHI GOVT

WEEKS

PERTUSIS TETANUS POLIO

OPV- III HEP B VACCINE IV*

RECOMMENDATION

24 WEEKS

HEPATITIS B

HEP B VACCINE III*

*IAP RECOMMENDATION

9-

POLIO

OPV-IV MEASLES

12MTHS MEASLES

10

15-18 MTHS

MUMPS MEASELES RUBELLA MMR*

DIPHTHERIA 11 18 MTHS PERTUSIS TETANUS POLIO

DPT BOOSTER I OPV V

*RECOMMENDED BY DELHI GOVT & IAP ONLY

12

24 MTHS TYPHOID

TYPHOID*

*IAP RECOMMENDATION

DIPHTHERIA 13 4-5 YR PERTUSIS TETANUS POLIO

DPT BOOSTER II OPV -VI

OTHER AVAILABLE VACCINES

14

6 WEEKS

H influenza B

HiB

*IAP RECOMMENDATION

15 10 WK

H influenza B

HiB

16 14 WK

H influenza B

HiB

*IAP RECOMMENDATION

17

18 MTHS

H influenza B

HiB

*IAP RECOMMENDATION

18

24 MTHS

HEPATITIS A

H A VACCINE-I

SUGGESTED VACCINATION

19

30 MTHS

HEPATITIS A

H A VACCINE -II

SUGGESTED VACCINATION

20

12 MTHS

CHICKENPOX

VARICELLA VACCINE

SUGGESTED VACCINATION

21

24 MTHS

MENINGOCOCCAL A&C

MENINGOCOCCAL VACCINE

SUGGESTED VACCINATION

22 12

PNEUMOCOCCAL

PNEUMOCOCCAL

IN SPECIAL

MTHS

VACCINE

CIRCUMSTANCES

23

12 MTHS

INFLUENZA

INFLUENZA VACCINE

IN SPECIAL CIRCUMSTANCES

ON GOING VACCINATIONS

24 10 YEARS TETANUS

TT

EVERY FIVE YEARS

25 5 YEARS

TYPHOID

TYPHOID

EVERY THREE YEARS

26 5 YEARS

MENINGOCOCCAL A&C

MENINGOCOCCAL VACCINE

EVERY THREE YEARS

27

NIDS & SNIDS

POLIO ERADICATION PULSE POLIO

AS PER GOVT DIRECTIVES

IMPORTANT:

I.

NO VACCINE IS 100 % EFFECTIVE; PLEASE CHECK THE EFFICACY OF INDIVDUAL VACCINES BEFORE IMMUNIZATION.

II.

MINOR UPPER RESPIRATORY INFECTIONS ARE NO CONTRAINDICATIONS OF IMMUNIZATIONS.

III.

TWO LIVE VACCINES SHOULD BE GIVEN EITHER

SIMULTANEOUSLY AT DIFFERENT SITE AT THE SAME SITTING OR AT LEAST ONE MONTH APART. IV. VACCINATION SCHEDULES DIFFER IN DIFFERENT COUNTRIES ACCORDING TO THEIR NEEDS. V. PULSE POLIO VACCINATIONS / OTHER IMMUNIZATIONS ON NATIONAL IMMUNIZATION DAYS ARE DIFFERENT FROM ROUTINE VACCINATIONS AND SHOULD BE FOLLOWED AS PER THE INSTRUCTIONS IN THE NATIONAL INTEREST. VI. FOLLOW POST VACCINATION INSTRUCTIONS AS ADVISED, AND REPORT ADVERSE REACTIONS IF ANY, IMMEDIATELY.