Immunisations are one of the success stories of modern medicine. Most children in the world today lead much healthier lives and parents live with much less anxiety and worry over infections during childhood thanks to immunisations . Vaccines are safe and they work. As a result of safe and effective vaccination programs, small pox has been eradicated form the face of the earth and polio is close to eradication. Vaccinations have reduced the number of diseases from vaccine preventable diseases by more than 90%.
Yet, parents question the safety of vaccines. Several factors contribute to parental concerns including:
- lack of information about the vaccines being given and about immunisation in general
- conflicting ideas from other sources like antivaccine organisations
- lack of appreciation of the severity of vaccine preventable illnesses
- relative infrequency of vaccine preventable diseases
What is immunisation?
It is the process of inducing immunity against a specific disease. Vaccination is one method of inducing immunity. It is one of the most beneficial and cost-effective disease prevention measures.
Are vaccines 100 % safe?
If the definition of safe is “harmless” it would imply that any negative consequence of a vaccine would make it unsafe. Using this definition, no vaccine is 100% safe. Almost all vaccines cause pain, redness or tenderness at the site of injection. Few things meet the definition of “harmless”. Even simple every day activities contain hidden dangers. The dangers of the disease is greater than the dangers of the vaccine used to protect against it.
Why should your child get vaccinated?
Vaccines can prevent infectious diseases that once killed or harmed many infants, children and adults. Without vaccines, your child is at risk of contracting serious illnesses like measles and whooping cough with much suffering, pain, disability and even death. It is always better to prevent a disease than to treat it after it occurs.
Why are some of these vaccines still needed if the diseases are not common?
Due to better nutrition, improved living conditions and most importantly vaccines, many diseases do not occur or spread at the same rate as they used to. But the bacteria and viruses that cause these diseases remain in the environment. Immunisations keep our children protected from these infections if they are reintroduced into our environment. For example, travellers from regions where some of these diseases are common, can bring them into your community.
What are the vaccinations every child should have?
All children should receive vaccinations against Tuberculosis, Hepatitis B, Diphtheria, Tetanus, Pertussis (whooping cough), Hemophilus influenza B, Poliomyelitis, Pneumococcal infection, Rotaviral diarrhoea, Measles, Mumps, Rubella and Chicken pox. In addition, there are other optional vaccines that are recommended based on the place of residence or travel.
How does a parent choose which vaccinations should be given to their child?
Every child should take the mandatory vaccines recommended by the national immunisation guidelines. UAE has a national vaccination schedule that is mandatory for all infants and children. Please discuss with your paediatrician regarding the mandatory and optional vaccines for further information.
What are the common ingredients in vaccines?
All vaccines contain antigens. Antigens make the vaccines work by stimulating the body to create an immune response to protect against infection.
Antigens in vaccines come in several forms:
- Weakened live viruses: They are too weak to cause disease, but still prompt an immune response, e.g. MMR and Chicken pox vaccines
- Inactivated or killed viruses: They do not cause even a mild form of the disease, but create an immune response, e.g. Hepatitis A vaccine
- Partial viruses: These are made up of specific parts of the virus that will stimulate a protective immune response, e.g. Hepatitis B vaccine
- Partial bacteria: They are made up of specific parts of the bacteria that produce a specific immune response to protect against the infection, e.g. DTP vaccine
In addition, vaccines also contain other ingredients to be keep it stable, preserve it in a sterile form and to enhance the immune response. Each of these ingredients have been studied and are safe for humans in the amounts used in vaccines. This amount is much less than what children encounter in their environment, food and water.
Is it OK to delay vaccines till my baby is older?
Firstly, of all age groups, young babies are hospitalised and die more often from the diseases that we are trying to prevent with vaccines, so it is important to vaccinate them according to the recommended schedule. Secondly, the schedule is designed to work best with a child’s immune system at certain ages and at specific time intervals between doses. There is no research to show that spreading out the vaccines would be safer. Any length of time without immunisations is a time with risk for infection from that particular vaccine preventable disease. If many parents decide to delay vaccinations or follow alternate or incomplete schedules, diseases will spread quickly in a community.
Is it safe to administer multiple vaccines simultaneously?
There are no contraindications to the simultaneous administration of multiple vaccines routinely recommended for infants and children. Immune response to one vaccine does not generally interfere with the immune response to other vaccines
Many parents worry that receiving too many vaccines especially early in life can overwhelm a baby’s immune system. From the moment of a baby’s birth, the immune system begins coping with microorganisms like bacteria, viruses and fungi. Our immune system is remarkably powerful to handle this load and the antigens presented through the vaccines are miniscule compared to the infections and allergens presented by the natural world. A single bacterium contains a large number of antigens than are found in all the recommended early childhood vaccines combined.
What are the advantages of combination vaccines?
Combination vaccines contain ingredients that protect against multiple infections in one dose, e.g. MMR vaccine, that protects against three illnesses namely measles, mumps and rubella. It helps to reduce the number of injections during the clinic visit, without compromising efficacy or safety of the vaccine.
My child has missed a few doses of vaccines. What should be done to complete the series?
A lapse in the immunisation schedule does not require restitution of the entire series. The subsequent dose should be given as if the usual interval has elapsed. Talk to your doctor if you have questions.
What is herd immunity?
Herd immunity is the concept that when most people in a community are protected, every one in the community is better protected. A highly vaccinated community means that fewer people are available to spread the disease. So the number of protected should be higher for a community to enjoy the effects of herd immunity.
What to expect after vaccinations?
After a vaccination, your baby may cry for a little while, that usually stops soon afterwards with a feed or a cuddle. Some children may have a reaction at the site of injection like redness, swelling or soreness. Apply a clean, cool wet wash cloth over the area. For pain or fever give paracetamol or ibuprofen as advised by your paediatrician.
Call you doctor if the redness or swelling increases after 24 hours, if fever is high or persistent, if your child is crying for more than three hours, if your child is noticeably less active or less responsive.
What about vaccines and autism?
There is no link between vaccines and autism. No one knows for certain what causes autism, though recent studies suggest a genetic component. Researchers have looked into the possibility that vaccines might cause autism. Dozens of studies have been conducted by different groups of scientists from around the world and they have failed to suggest vaccines as a cause of autism. The suggestion that too many vaccines given too early in life at the same time have also been dispelled. Parents often first notice the behaviours of autism when their child is 18 to 24 months old, the age by which most vaccines are given. Because of this, parents often incorrectly associate autism with vaccinations.
What is the status of COVID-19 vaccine?
There is currently no licensed vaccine to prevent corona virus disease 2019 (COVID 19). Research and development are underway around the world to develop a vaccine that is safe and effective.
Should I administer only high priority vaccines now, due to the current COVID pandemic?
It is important to administer all recommended vaccines simultaneously when no specific contraindications exist at the time of the visit. By doing so, you will reduce the number of health care encounters necessary for your child to be fully vaccinated. Please discuss with your doctor regarding the best course of action for your child and family.
Should I give influenza vaccine to my child during the coming flu season?
Influenza is not a simple cold; it can lead to hospitalisations and dangerous health outcomes. The illness is most severe in the very young children (aged between 6 months and 5 years, and children with other illnesses like asthma. The CDC (Centers for Disease control) recommends vaccinating everyone 6 months and older.
The influenza vaccine will not prevent COVID 19 infection, but it will reduce influenza related illness and in effect reduce the stress on people and health services during this pandemic. Consult with your doctor for any questions.