How do vaccines work?
A.A vaccine is a preparation that contains a weakened form or a part of the germ (pathogen) that causes an infection. When injected into the body, they stimulate the defence mechanism of the body to produce antibodies to fight the pathogen or ‘enemy’. The body then stores the memory of this enemy and how it had carried out this successful operation. So the next time the body’s immune system encounters this type of germ, it immediately identifies it as an invader and rapidly acts to fend off this infection before the person falls sick.
I feel terrible about pricking my baby’s delicate skin. Is it necessary?
A.Your baby is most precious to you. As a parent you have a natural desire to protect her from all pain including that of a needle prick. But remember that this little moment of pain will soon pass whereas, it will arm your little angel with a lifetime of protection. Vaccination may give a little distress now but this is nothing as compared to the discomfort of the symptoms and the complications of a severe infection like mumps or measles in the future. So, if you want to do everything possible to safeguard the health and happiness of your baby…vaccination is very important as it can protect your child against serious infections and complications. Moreover, vaccination is your public duty too as it can check the spread of an epidemic or an outbreak of a preventable disease.
What are the Recommended vaccinations for children aged 0-18 years?
Some of the common vaccines given to children are
- Tuberculosis (BCG)
- IPV (inactivated poliovirus vaccine)
- Varicella(Chicken Pox)
- Hepatitis B
- Hepatitis A
- Pneumococcal vaccine
- Gastroenteritis (rotavirus)
- Haemophillus influenza B
Are there any other vaccines apart from the ones mentioned above, which are meant for children?
Yes, these are known as “Vaccines recommended in certain high-risk groups”. These are those vaccines that are not included in the normal immunization programme and can be given to certain high risk groups of children. These vaccines include:
- Influenza Vaccine
- Meningococcal Vaccine
- Japanese Encephalitis Vaccine
- Cholera Vaccine
- Rabies Vaccine
- Yellow Fever Vaccine
- Pneumococcal Polysaccharide vaccine (PPSV 23)
- HPV (Human papillomavirus)
High-risk category of children includes:1
The definition of High-risk category groups includes:1
- Children with immunocompromised conditions like cancer or HIV (PPSV23).
- Children with diseases like sickle cell anemia (PPSV23).
- Children with serious conditions like chronic heart disease like congenital heart disease or heart failure. (PPSV23).
- Children with lung conditions like asthma. ( PPSV23).
- During outbreaks (Meningococcal vaccine, cholera)
- Children planning on international travel (Meningococcal vaccine.)
- Children planning to travel to areas where the disease in endemic(cholera)
Definition for ‘high-risk category of children’ for rabies vaccination includes:
- Those with pets at home
- Those with higher threat of being bitten by dogs such as hostellers, risk of stray dog menace while going outdoor.
Will the vaccine give my baby the disease it is supposed to prevent?
A.Vaccines are the best line of defence that you can provide your baby against common childhood infections. They are preparations that contain weakened or harmless parts of germs to teach your baby’s immune system how to recognize some common germs and how to overpower them if and when they attack. A common concern among parents is whether these vaccines which contain weakened or dead germs can themselves cause infections.
Vaccines which contain only parts of organisms or dead organisms are highly unlikely to give that disease to your baby. In very rare cases, if the vaccine contains an inactive or a weakened form of the organism like in the measles it may result in a much milder form of that infection. But it will be nowhere close to a full-blown bout of that infection. 2
My baby is ill. Can she be vaccinated?
A.If the baby’s illness coincides with the time of her vaccination, the parents are in a dilemma of whether she should be subjected to the additional discomfort of inoculation. Actually, whether or not your baby can be vaccinated in illness depends upon how ill the child is. This can only be determined by your baby’s pediatrician. If your baby just has cold and sniffles, your doctor may proceed with the vaccination. But if she has high fever or some other serious symptoms, your pediatrician may decide to postpone the vaccination.
Why are the vaccinations for some diseases repeated?
A.Some vaccinations need to be administered in multiple doses to ensure optimal protection against an infection. A single dose may prove ineffective and leave your baby vulnerable to that infection. Hence, it is essential that the immunization schedule advised by your pediatrician is strictly adhered to. You should thus ensure that your baby does not miss any booster or repeat doses.
Is it possible to vaccinate my child once she grows up a little, instead of now?.
A.Most parents wish that the pain of vaccinations could be postponed till their sweet little one grows up. But, remember, most vaccinations have a fixed schedule and they must be strictly administered as per the protocol to prevent the risk of infection. If your child misses a dose, it is possible to get her shot later on your pediatrician’s advice, but waiting till she grows up is reckless and unadvisable as it can make her vulnerable to a serious vaccine-preventable infection till then. The pain and the discomfort of the needle prick is certainly much more bearable than the distress of the symptoms and the complications of a severe infection which can make your baby lose out on valuable moments of childhood.
Be sure to consult your pediatrician about your baby’s vaccination schedule and stick to it strictly.
What would happen if we stopped vaccinations?
A.If we stopped vaccinations, diseases which have been almost eliminated or have become rare would stage a comeback. There would be outbreaks or even epidemics of certain diseases and the lives of many would be lost.
One example of this was seen in Japan in 1974 when pertussis vaccinations were stopped due to low occurrence of the disease. This wrong decision boomeranged into an outbreak in 1979 that claimed 41 lives. It is vital to remember that vaccinations not only protect our children but also the generations to come by eradication of certain diseases.
Is the pain of vaccines worth the protection it offers?
A.Yes, surely. As a parent, it is natural that you feel the pain when your baby is pricked, but remember that these shots serve to enhance your child’s immune defences against several infectious diseases. If you try to avoid these vaccinations, there are chances that your baby falls prey to one of these vaccine-preventable diseases. The symptoms and the complications of these diseases are much more difficult to bear than the pain of the pricks. Severe infections can cause delay in milestones, hinder your baby’s academic and physical performance and steal priceless moments of childhood. So be sure to get your baby vaccinated as per the schedule as advised by your pediatrician.
Can vaccination have any serious side-effects?
A.Being a parent it is natural that you may be concerned about the side-effects that vaccination may cause. Like any medicine, vaccination can give your baby certain side-effects but these are usually very minor like redness or swelling at the site where the shot was given. The arm or the thigh is likely to be sore for a couple of days. Your baby may develop a slight fever and may be movement of that limb will cause pain for some time. In some babies, there is a swelling in the lymph nodes of the thighs or the arm-pits. These side-effects usually clear out within a few days. Serious side effects following vaccination, such as allergic reaction, are very rare. 3 Always observe your baby closely for a few days after his/ her vaccination.
If the fever persists even after a few days and your baby seems agitated and unwell, please do not hesitate to consult your pediatrician.
What does a vaccine contain?
A.Vaccines contain the weakened form or the inactive form of the germ either the bacterium or the virus that causes the infection. They stimulate or instigate your child’s immune system to produce antibodies which are defense responses.4
How do I remember which vaccine is due and when?
A.Every pediatrician usually provides parents with a vaccination schedule. Be sure to refer to this periodically. Also, maintain a record of your child's immunization to keep track of the vaccination due dates and any missed doses. You can even install vaccine reminder apps for easy recall. Your Pediatrician can suggest the same to you.
Will my baby’s immune system become weak because of vaccination?
A.Vaccines are a method of providing your baby with a defense strategy to overpower a particular infection. Vaccines equip your baby’s immune system with a plan of attack in case it faces threat from a particular pathogen (germ like a virus or a bacterium). Being vaccinated against one disease does not mean that your baby’s immune response to another disease will weaken. 5
What are combination vaccines? Are they safe?
A.Combination vaccines merge protection against two or more diseases into a single injection. E.g. MMR or measles, mumps, and rubella vaccine (MMR). This means that combination vaccines contain two or more antigens that are either combined by the manufacturer or mixed immediately before administration. Such vaccines allow simultaneous administration of multiple antigens. Your child is spared the pain and distress of extra pricks and clinic visits. Combination vaccines are as effective as single shots. Ask your pediatrician about combination shots.
My baby was ill. I am so worried as he missed his shot!.
A.Are you worried that your baby has missed a dose because he was ill? Don’t be. For most vaccines, missed shots can be administered immediately once the baby is fine which is most of the time after a few days. Be sure to consult your pediatrician to get your children up to date on their vaccination schedule. It is important to remember that you should not purposely postpone your baby’s vaccinations thinking that he can catch up later. This is because till he gets his shot he will be vulnerable to that vaccine-preventable illness.
I have just shifted to another city. Is there anything that I should tell my new pediatrician before getting my baby vaccinated?
A.Go armed with your vaccination schedule to prevent missing a dose or getting unnecessary extra shots.
These are a few things your new doctor needs to know before giving your baby the vaccination.
1. Is your baby ill today? (if she has something more than common cold)
2. Has she had any reaction to a vaccination?
3. Does she suffer from any allergies?
4. Is she on any medicines like steroids?
5. Is her immune system weakened due to any other health condition?
My doctor recommends that I nurse my baby when she gives him a shot. She also says that I should feed him more often for a few days after the vaccination. Why?
A.There may be slight pain and swelling at the site of the shot for a couple of days. So your baby may be a bit cranky and refuse feeds. Nursing at the time of vaccination gives a sense of comfort and security. Your baby feels the safest in your protective arms. It will also keep him nourished and well- hydrated in this situation.
How do I reduce the stress of vaccination?
A.While vaccination can protect your baby from several common infections, the slight pain experienced during the needle prick can be distressful for the baby. You can reduce this discomfort by following these simple steps:
1. Nurse your baby during the shot
2. Reassure your child that you are there by holding him/her close.
3. Distract your child using a favourite toy or by blowing bubbles or a balloon.
4. Sing his favourite song or hum a lullaby.
My toddler is very fearful of his shots. Is there any way I can ease his anxiety.
A.Vaccinations can be distressful for your child and stressful for you but remember your nervousness can be transmitted to your child, so be calm and patient. Here are some tips to deal with the fear of vaccination:
• Never threaten children with injections for disobedience or naughtiness. This will increase their fear of vaccinations.
• Deal with your toddler’s fears with patience. If you become stressful, the child will realize it and this will magnify his fears.
• Carry along his favourite toy or game. It can distract him during the shot.
• A sweet taste can pacify pain. Giving your child some sweet juice can help in soothing your child during the shot.
• Read out his favourite story or ask him to sing along during the shot.
• Encourage him/ her to breathe in and out deeply during a shot.
• Tell older toddlers that vaccines can help him fight germs: Make an interesting story around how his body needs his help to kick away bad germs and injections are his weapons.
What care do I take after the vaccination?
Your baby may get a little restless for a couple of days after the vaccination. He or she may develop a slight fever or redness or pain at the site. This may make you anxious and worried. But don’t worry this pain will give your baby the gain of immunity. You can deal with the distress of vaccination with a few simple tips
• Apply cold compress or ice wrapped in a towel at the site of vaccination.
• Nurse your baby more frequently for a few days following the vaccination.
• Do not force your baby to move his/ her thigh or arm.
• Spend a lot of time with him/ her.
• Touch therapy works…give him/her more caresses, pats and hugs and hold him/her close.
Do we have to take vaccinations before travelling abroad?
A.Traveling to foreign locales for business and leisure has become common today, however traveling may entail exposure to illnesses. Rather than falling ill and missing out on the enjoyment and the thrill of your vacation, it is better to protect yourself with vaccination. Many vaccine-preventable diseases may be uncommon in your country but may be still prevalent in other parts of the world.
Visit your doctor at least two months in advance to ask about any specific immunizations recommended for travel to the region of the world you will be visiting. No matter where you plan to go, you should get recommended vaccines to lower the chances for getting and spreading disease.
It is important to plan your vaccinations atleast 4 to 6 weeks prior to travel as that will give you enough time to complete a vaccination series and your body enough time to develop immunity.
The vaccinations depend on a number of things including:
• Where you are traveling
• Your activities while traveling
• Length of visit
• Season of stay
Also ensure that you are up-to-date on routine vaccines before every trip. These vaccines include measles-mumps-rubella (MMR) vaccine, diphtheria-tetanus-pertussis vaccine, varicella (chickenpox) vaccine, polio vaccine, and your annual influenza shot.
Some examples of vaccines that may be recommended include the following:
Typhoid: Typhoid can be contracted through contaminated drinking water and food or by eating food handled by an infected person.
Japanese Encephalitis: This disease is transmitted through the bite of an infected mosquito.
Hepatitis A: Hepatitis A is a water-borne disease that spreads through contaminated food and water.
Be sure to get vaccinated to avoid making illnesses a part of your take-home luggage.
I am 35 years old. Do I need to get vaccinated?
A.You may be thinking that vaccination is only for kids, however adults too need the protection of immunization to prevent the risks of certain serious illnesses. The vaccines you need as an adult depend on many factors including your age, your health status, your travel plans, and your vaccination history.
Sometimes, you may need a booster dose even if you have been vaccinated when you were a child. Some vaccines may not have been available in your growing up years, so you need to be vaccinated now. You may also need vaccination if you have a medical condition that makes you more vulnerable to a particular infection. E.g. Asthmatics need to take the flu vaccine every year as influenza may be risky for them and pet owners and people who work with animals need to take rabies vaccine. Some vaccines like that of herpes must be taken after the age of 60 as the risk for herpes increases at this age. 6
However vaccines should only be taken after discussing with your Doctor as there are certain co-existing health conditions that need to be informed to the Doctor before being vaccinated.
I am 40 years old. Do I need the chicken pox vaccination?
A.It is wrong to say that chicken pox strikes only at children. In fact when it occurs in adults, it is more severe and is frequently accompanied by complications like encephalitis, bronchitis and pneumonia etc.7 The risk of mortality due to chicken pox also increases post-childhood. Hence it is better to vaccinate yourself to protect yourself from this common illness. Adults who work closely with children like school teachers, day care workers or parents and adults who are at high risk of transmission including physicians, health care workers and nurses should get themselves immunized against chicken pox without fail. 8
However, it is best to discuss with your Doctor before you decide to get vaccinated.
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1. IAP Recommended immunization schedule for children aged 0-18 years (with range), 2016 page 28 – 48
2. Trop Med Int Health. 2001 Sep;6(9):694-8.
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6. Aging health. 2010 Apr 1; 6(2): 169–176.
7. Postgrad Med J. 2006 May; 82(967): 351–352.
8. J Clin Virol. 2013 Jun;57(2):109-14,