Why you need to vaccinate your child?

National Immunization Schedule (NIS) for Infants, Children and Formaldehyde and Aluminum are added to the vaccine to make it more
1. Vaccination prevents diseases which may be very serious and life Pregnant Women effective. These are added in micrograms and as per the recommendation of
threatening. World Health Organization. Please remember that what you read on internet is
Age Vaccine
2. Timely age specific vaccination is essential to provide immunity before not always true. Each vaccine batch is tested for its safety and then marketed.
Birth BCG, OPV0, HepB
your child is exposed to the disease. Read in newspapers and in Whatsapp group messages that certain vaccines
6 wk DPT- HepB-Hib1(pentavalent 1), OPV1, fIPV1,
3. Vaccines are tested for efficacy and safety before they are marketed. were incriminated for deaths or severe adverse reactions. Can you explain?
Rota1, PCV1
4. Millions of lives are being saved every year by vaccination. 10 wk Pentavalent2, OPV2, Rota2 Vaccines can cause some minor or major adverse reactions. However, all these
5. Eradication of small pox and polio free world has been possible because 14 wk Pentavalent3, OPV3, fIPV2, Rota3, PCV2 reactions are treatable and if it occurs, preventive actions for the subsequent
of vaccines. 9-12 mo Measles-Rubella (MR), PCV3 doses are decided. However, the deaths reported following administration of
16-24 mo DPT Booster 1, OPV4, measles 2nd dose or vaccines are not to be believed. If proper technique and right vaccines are
Protect your child at every age from birth till 18 years of age:
MR/MMR and JE vaccine in select districts administered, the chances of serious adverse reactions can be minimized. The
1. Govt. of India is providing vaccines through all health centres and reports of death following Polio and Rota vaccines are myths and not real.
5-6 y DPT 2nd booster
hospitals free of cost and anybody can avail the facility. However, it is recommended that infants and children should be observed for
10 y TT
2. Vaccination schedule as per Govt. of India is the minimum that should be at least 15-20 minutes after vaccination for any untoward adverse reaction and
16 y TT
taken by all infants and children in the country. immediate treatment should be given for any serious reactions.
Pregnant women TT1 (early in pregnancy)
3. Timely vaccination shall prevent against ten life-threatening diseases that TT2 (1 mo later) I have missed one dose of vaccine due to illness of my baby. What should be
are included in Govt. of India’s immunization schedule. In addition,
TT booster (if vaccinated in past 3 y) done?
certain vaccines are given in highly endemic region, e.g., Japanese
encephalitis vaccine in 268 districts of the country. Rabies vaccine is Frequently asked questions by the parents: Please consult your doctor/nurse/immunization center. There is no need to
recommended after dog bites as post- exposure prophylaxis. restart the vaccine series again even if there is a lapse of time. The remaining
Isn’t vaccination an unnatural way of producing immunity? doses should be given and they shall have equal effectiveness.
4. Most of the dreaded diseases that cause serious illness, disability and
death are covered under National immunization schedule as shown in Vaccination produces immunity exactly in the same mechanism as the natural Can my child get the disease from the vaccine administered?
the following table disease process. The natural disease can be life-threatening and fatal at times.
The answer is almost never. Inactivated vaccines cannot give rise to a disease.
Diseases that are included in National immunization schedule for prevention Therefore, without suffering from the disease, the body’s immune mechanism
Live attenuated vaccines can sometime produce mild illness e.g., Measles
by vaccines: produces antibodies to protect from the illness.
vaccine can cause mild disease and that would be an excellent demonstration
1. Tuberculosis (BCG vaccine) Won’t so many vaccines produce overwhelming response to the body’s that immunity shall surely develop.
2. Hepatitis B (HBV) immune mechanism? Can a child get disease even after full course of vaccination?
3. Poliomyelitis [Oral polio vaccine (OPV) & Inactivated polio vaccine A baby after birth is exposed to a wide variety of innumerable germs and the It depends on the type of vaccine as well as the timing when the vaccine was
(IPV)] immune system responds to the exposure. Although one is not sure about how given. In the first instance, we know that Measles vaccine given at 9 months of
4. Diphtheria many hundreds or thousands of germs a baby’s immune system can handle age would be effective in 85% cases and Typhoid vaccine’s efficacy is
simultaneously, the number of vaccines that are given to an infant has been approximately 70%. Following DPT primary and two booster doses,
5. Whooping cough (Pertussis) (As DPT, containing diphtheria, pertu- found to produce enough protective antibodies without creating any adverse
ssis and tetanus) Whooping cough can occur about three times in a life time unless the
effects. adolescent booster dose is taken. However, even if disease occurs, it is mild in
6. Tetanus nature. In some situations, one may be harboring an infection e.g., Flu but the
Why some vaccines require many doses while others only single or two
7. Hemophilus Influenzae b (Hib) [DPT & Hib as pentavalent vaccine] doses? symptoms have not started and if the vaccine has been given during the
8. Rota virus There are mainly two types of vaccines namely, inactivated and live. Most of prodromal period, it may not be effective at all.
9. Pneumococcal (PCV—Pneumococcal conjugate vaccine) the inactivated vaccines like DPT require several doses to have booster effect What are the precautions that need to be taken after vaccination?
10. Measles whereas most of the live attenuated vaccines require less number of doses. Follow the instructions given by the nurse or doctor who has administered the
However, exceptions are there even with live vaccines e.g, Polio and Rota vaccine to your child. If there is high fever, irritability or excessive crying, give
11. Rubella (Measles & Rubella as MR vaccine) which require more doses. paracetamol as per the dose recommended. Do not rub or massage the
12. Japanese encephalitis (JE vaccine) in selected districts injection site. If the child has very high grade fever, inconsolable crying
Is there any painless injectable vaccine?
episode, any convulsions, drowsiness, lethargy, rashes in the body, is not
5. Indian Academy of Pediatrics has recommended some additional It is a myth and not true. All injections would cause some pain. In routine
accepting feeds or any unusual symptoms, take him immediately to the doctor
vaccines e.g., Hepatitis A, Inactivated Polio, Chicken pox, Typhoid and vaccination, syringe with needle is used and proper technique with
for advice. Many reactions are normal response of the vaccine e.g., following
Human papilloma virus (HPV). Consult your pediatrician for these appropriate size of the needle and certain additional steps like distracting the
BCG vaccine, there may be a vesicle formation or ulceration at the site of
vaccines and their timings. baby, putting the baby in mother’s lap, breastfeeding the baby and giving
injection.
sucrose water have been found to be helpful.
6. All pulse polio vaccine doses, as recommended, should be taken. MR
Why vaccinate adult population?
(Measles and Rubella) vaccine has been introduced in the National Read that certain ingredients in the vaccines are toxic, what are these ?
• Successful universal immunization has resulted in decrease in mortality
schedule at 9 months of age and for catch up vaccination, all children from Vaccines are made of several substances in order to make them effective. The
and morbidity in children.
9 mo till 15 years of age should be given vaccination. MR is a safe and main ingredient is the antigen which causes the disease but this is in killed
• Adolescents and adults have become more susceptible and prone to get
effective vaccine. form or a very small amount is taken. Other substances e.g., Mercury,
vaccine preventable diseases (VPD).
 • Hepatitis B virus (HBV) is 100 times more infectious than HIV, Mumps Human Papilloma virus (HPV) Two to three doses depending upon initial vaccination
and Varicella in adults – Serious complications are more. from 19 till 26 years of age in both females and males
• In our National schedule only Tetanus toxoid (TT) vaccine is included at Pneumococcal conjugate vaccine One dose is indicated in high risk groups but one dose
10 and 16 years and the coverage is extremely poor. is essential after the age of 60 years
• Adults are not routinely given any preventive vaccination. Pneumococcal polysaccharide 1-2 doses depending upon the indication in high risk
vaccine group but one dose is indicated 6-12 months after
• Adolescents and adults constitute > 70 % population in India. PCV in > 60 years
• Vaccination in adults boosts the immunity that is decreasing and Hepatitis B 2-3 doses depending on previous vaccination status
prevents specific diseases. Hepatitis A 2-3 doses depending upon vaccination status but is
• Adults with chronic diseases like diabetes, heart disease, chronic not given routinely
obstructive pulmonary disease and conditions causing immune Meningococcal ACWY 1-2 doses depending upon previous vaccination
suppression always would be benefitted by appropriate vaccination. status; high risk individuals may require booster
every 5 years
• Vaccinating adults with vaccines like Pertussis vaccine prevents
Meningococcal B vaccine 2 -3 doses depending upon vaccine and indication

•
diseases in small children at home.
Influenza and invasive Pneumococcal disease in high risk adults are the
two most important diseases that kills many adults.
Hemophilus influenzae b vaccine 1-3 doses depending upon indication
INFORMATION ABOUT
VACCINATION
• Vaccination in pregnant females with Pertussis-diphtheria-tetanus
(Tdap) vaccine prevents all the three diseases not only in the mother but
also prevents the newborn from getting the disease in early infancy
before the infant immunization starts its effect.
Successful immunization in high risk adults prevents morbidity and
mortality.
• There is no National schedule of vaccination in adults in India except
for Td (tetanus-diphtheria) in pregnant women. Risk group

High risk adults for Influenza and Pneumococcal disease are as follows:
• Pregnancy
• Some adults 19 through 64 years old are also at an increased
risk, including those:
• With chronic illnesses (lung, heart, liver, or kidney
disease; asthma; diabetes; or alcoholism)
• With conditions that weaken the immune system
(HIV/AIDS, cancer, or damaged/absent spleen)
• With cochlear implants or cerebrospinal fluid (CSF) leaks
• Who smoke cigarettes
Following tables show the adult vaccination schedule in USA by
Center for Disease Control (CDC) 2019 and Association of Physicians
in India 2014 respectively and any of the schedule may be followed in
practice. In addition, Federation of Obstetrics and Gynecology in India
recommends routine use of Influenza and Tdap vaccines during Prepared by
pregnancy.
Dr. A.K. Dutta
Recommended Immunization Schedule for Adults (CDC–2019)
Emeritus Consultant,
Vaccine Age group 19 to > 65 years
Influenza vaccine, inactivated or Yearly vaccination one dose (any one vaccine) from Indraprastha Apollo Hospital, Sarita Vihar,
live attenuated nasal spray 19 to > 65 years
Tetanus-diphtheria-pertusssis One dose of Tdap, if not given earlier at 10 years
New Delhi
(Tdap) or Tetanus-diphtheria (Td) followed by Td every ten years for all adults and in
each pregnancy, one dose of Tdap injection
&
Measles-Mumps-Rubella (MMR) 1 or 2 doses from 19-60 years of age depending upon Printed by
the previous doses
Varicella (Chicken pox) Two doses at 3 month interval from 19-35 year if not Indian Journal of Pediatrics,
vaccinated earlier
Zoster recombinant /Zoster live Two doses from 50 to > 65 years/ New Delhi
one dose from 55 to > 65 years