Routine Immunisation
Know about Vaccines
Immunisation is the most important and cost effective strategy against vaccine preventable diseases. The immunisation schedule is country specific and depends on disease epidemiology, socio-economic condition and health infrastructure. All vaccines are useful; we need to make an informed choice.
BCG Vaccine
BCG vaccine is given at birth or in first few days of life on the left shoulder and is against Tuberculosis. This vaccine should be given to all children. It can be given at birth to children born to HIV positive mothers.
The reaction to the vaccines may vary. From no reaction to a small nodule, to a bigger swelling that ruptures and some fluid oozes out, forming an ulcer, which heals with a scar formation. The whole process takes few weeks and is painless. It does not require any treatment.
Children less than 5 years may be given BCG if the parents deny h/o vaccination or are not sure of BCG vaccine. Also absent scar does not indicate no protection but since this is the only clinically observed sign BCG can be repeated once.
If any glands develop in axilla or neck on the same side following the vaccination, it could be due to BCG vaccination. It regresses in most children spontaneously. In case it persists, one needs to consult Pediatrician. Antitubercular therapy is not recommended.
Hepatitis B Vaccine
Hepatitis B vaccine is given in three doses starting at birth. The vaccine should be given to all children. It can be given later in the life also. Children upto eighteen years of age are given pediatric dose.
The vaccine is available as combination with other vaccines too. In some situations your Pediatrician may give four doses of the vaccine. Mild fever may be observed for a day or two.
Children born to Hepatitis B positive mothers need Hepatitis B Immunoglobulin at birth and additional dose of Hepatitis B vaccine. You need to consult your Pediatrician for the same.
DTP Vaccine
This vaccine is against three diseases viz. Diphtheria, Whooping Cough and Tetanus. The vaccine should be given to all children. It is given in three doses starting from six weeks of age and given at monthly interval. Two booster doses are given at eighteen months of age and four and a half year of age.
The vaccine causes pain and swelling at the site of the injection and fever for two to three days. There is a choice between painful and painless vaccine. Your Pediatrician will guide you.
Hib Vaccine
This vaccine is against the bug Haemophilus influenza B. This is known to cause meningitis, respiratory infections etc. The vaccine should be given to all children. It is given with DPT vaccine at the same time as three primary doses in first year and a booster at eighteen months of age. Your Pediatrician may suggest giving less number of doses if you start giving this vaccine at a later age. The vaccine may cause soreness at the site of injection and mild fever for couple of days.
Injectable Polio Vaccine (IPV)
This vaccine is given with DPT at the same time as three primary doses in first year and a booster at eighteen months of age. The vaccine should be given to all children. It is important to give atleast two doses of IPV to every child.
Oral Polio Vaccine (OPV)
Oral Polio Vaccine is given at birth, nine months of age and at the time of second DPT booster to all children. More doses can be given. In addition to routine immunisation OPV is also given at all National Immunisation Days (Pulse Polio Days).
Tetanus Vaccine (TT)
Tetanus vaccine is given at ten years of age to all children and should be given every five years after that. It is also given to mothers during pregnancy.
Tdap vaccine can be given at ten years of age instead of Tetanus vaccine. Please ask your Pediatrician about it. This can also be given at earlier age (after seven years of age) or at a later age (upto eighteen years of age) for catch up vaccination.
Pneumococcal Vaccine
There are couple of types of Pneumococcal vaccines available. It is against the pneumococcal bug. This bug is known to cause infections like pneumonia, meningitis, ear infection and sepsis.
The vaccine is given as three primary doses at monthly interval in first year and a booster dose at eighteen months of age. You can take guidance from your pediatrician about choosing a particular pneumococcal vaccine. The vaccine causes soreness at the site of injection and mild fever for couple of days.
Rota Virus Vaccine
The vaccine is against Rota virus which causes diarrhoea. It is given orally as two or three doses at monthly interval between six weeks and six months of age.
There are two types of Rota Virus vaccines available and based on which vaccine we give the number of doses varies between two and three. Your pediatrician will guide you about it. The vaccine should be rescheduled if child has diarrhoea.
Influenza Vaccine
Influenza vaccine is against Influenza virus. It can be given to infants above six months of age. There are two types of vaccines available. The schedule of both vaccines is same.
The schedule and dose of the vaccine depends on the age of the child. It is given as two doses in first year to all children below nine years of age and a single dose after nine years of age, followed by a dose every year. Children upto three years of age are given pediatric dose of the vaccine, after that adult dose is given.
The vaccine is especially useful for those children who gets respiratory infection very often and during Swine Flu outbreak. The vaccine causes soreness at the site of injection and mild fever for couple of days.
Hepatitis A Vaccine
Hepatitis A vaccine can be given to children above twelve months of age. It is given as two doses six months apart. Indian Academy of Pediatrics recommends giving this vaccine above eighteen months of age. The pediatric dose is advised to children below fifteen years of age. The vaccine can cause mild fever for couple of days.
Your pediatrician will guide you when to give this vaccine.
Varicella (Chicken Pox) Vaccine
Varicella (Chicken pox) vaccine can be given to children above fifteen months of age. The second dose can be given between four and six years of age. During an outbreak this vaccine can be given at twelve months of age. Children above twelve years of age are given two doses eight weeks apart.
The vaccine can cause mild fever more than a week after the vaccination. Your pediatrician will guide you for the schedule in case the child wasn’t given the vaccine at the age mentioned above.
The vaccine can help if it is given within 72 hours of exposure to the child who is above twelve months of age and is exposed to a patient suffering from chicken pox.
Typhoid Vaccine
Typhoid vaccine is for the protection against typhoid fever. Typhoid conjugated vaccine can be given after nine months of age. Your pediatrician will guide you about other type of typhoid vaccine and future doses.
The vaccine can cause soreness at the site of injection and mild fever for couple of days.
Meningococcal Vaccine
Meningococcal vaccine is against Meningococcal disease. This bug can cause meningitis or shock. The conjugated vaccine can be given to children above nine months of age. The vaccine can cause soreness at the site of injection and mild fever for couple of days. The vaccine is very useful during outbreaks.
Human Papilloma Virus (HPV) Vaccine
HPV vaccine can be given to girl children above nine years of age. There are two types of vaccines available. Both vaccines are given in three doses in a span of six months. The schedule is different for both vaccines which your pediatrician will guide you.
In India this vaccine can be given upto forty five years of age. In most other countries the vaccine is advised between nine and twenty six years of age.
Anti-Rabies Vaccine
Anti-Rabies vaccine is to protect against Rabies. This vaccine can be advised to children for routine immunisation also. Three doses are given on 0, 7 and 28 days in case of pre exposure prophylaxis. If a child has received pre exposure prophylaxis, in case of a dog or cat or monkey bite will need only two doses. One dose is given on the day of bite and second after three days.
In case the child hasn’t received any anti-rabies vaccine in the past and is exposed to a potentially infected animal, he would need five doses, starting on the day of bite and then on 3, 7, 14 and 28 days. Such a child if is exposed again, will need only two doses on the day of bite and three days later.
Your pediatrician will decide about additional Rabies Immunoglobulin in category three bites.
Japanese Encephalitis Vaccine
This vaccine is given to children only in endemic area of the country. Your pediatrician will guide you about the schedule of this vaccine.