Diphtheria Tetanus and Pertussis
Diphtheria, tetanus and pertussis are serious diseases caused by bacteria.
Diphtheria and Pertusis spread from person to person and Tetanus enters the body through cuts or wounds.
DIPHTHERIA causes a thick covering in the back of the throat. It can lead to breathing problems, paralysis, heart failure and even death.
TETANUS (Lockjaw) causes painful tightening of the muscles, usually all over the body. It can lead to "locking" of the jaw so the victim cannot open his mouth or swallow. Tetanus leads to death in up to 2 out of 10 cases.
PERTUSSIS (Whooping Cough) causes coughing spells so bad that it is hard for infants to eat, drink or breathe. These spells can last for weeks. It can lead to pneumonia, seizures (jerking and staringspells), brain damage and death.
DPT vaccination is started at the age of 6-8 weeks. A total of 5 doses of DTP vaccine are administered to children at 6,10,14 weeks, 15 months, 4-5 years & 10 years.
DPT vaccine is available in two variants ie DTwp or the Whole Cell vaccine(normal DPT) and DTap or the Acellular(Painless) pertusis vaccine.
It has been seen that children who receive DTwP in First 3 doses have less chances of devloping Pertusis when they are adolescents. For this reason, DTwP vaccine is prefered over DTaP. Though DTaP causes much less pain, redness and fever as compared to DTwP vaccine.
Local Pain, redness, swelling and fever and irritability for 1-2 days.These effects are less with DTaP vaccine. A small pea-size nodule formation is seen at the injection site, more with DTwP vaccine, which takes months to disappear.
If your child has received any DPT dose in past 10 yrs then you do not need to give a Tetanus (TT) booster vaccine after every day to day injury. Giving repeated TT doses can rather be harmful for the immunity of the body.
HEPATITIS B (HEP B)
Its a Viral infection Caused By Hepatitis B Virus
Hepatitis B virus is transmitted through contact with the blood or other body fluids of an infected person, Use of contaminated Needles, from a mother to her baby during pregnancy.
A infected Mother can Breastfeed her baby without any risk of infecting as Hepatitis B cannot be transmitted in Breastmilk.
Risks with Hepatitis B infection
Hepatitis B can cause a short-term illness with loss of appetite, Vomiting, loose stools, jaundice. Such symptoms are common among adults.
Children who become infected usually do not have these symptoms but develop a long term infection
Chronic (long-term) infection which is more serious and can lead to liver damage, liver cancer and in few cases death. These patients can spread hepatitis B virus to others, even if they don't look or feel sick.
Babies normally get 3-4 doses of hepatitis B vaccine:
There are TWO schedules which can be followed, Both have equal efficacy
1st Dose: Birth
2nd Dose: 1-2 months of age
3rd Dose: 6-18 months of age
1st Dose: Birth
2nd Dose: 1-2 months of age
3rd Dose: 2-3 months of age
4th Dose: 4-6 months of age
No boosters are recommended after initial 3/4 doses
Hepatitis B vaccine is also available in combination of DPT/HIB/IPV vaccines and combination vaccines which are equally effective and can be used to save a separate prick to the child.
HEPATITIS A (HEP A)
Hepatitis A is caused by the hepatitis A virus (HAV).It is spread by eating food or drinking water containing HAV or by close personal contact of an Infected patient within the same household. Its the most common cause of Jaundice in Adolescents and Adults.
Hepatitis A Symptoms resemble a Flu like illness or a Viral illness initially associated with stomach pains, Nausea or vomits which is often followed by jaundice (yellow skin or eyes, dark urine). Jaundice can take upto 6 weeks to come back to normal. The illness causes significant weakness and often results in loss of many school days for the children. Almost 20 % of the people with hepatitis A would need a hospitalisation due to the severity of the illness. Most cases recover completely without any complications but few cases can have complications like internal bleeding, Jaundice affecting brain and causing loss of life or liver damage being too extensive and requiring a Liver transplant in long run.
There are two types of vaccines available for Hepatitis A. One is a Live vaccine other is attenuated vaccine. Both can be used in age more than 1 year.
A total of 2 doses of Hepatitis A are administered to children at and interval of at least 6 months apart starting at age 1 yr or above.Further boosters are not required.
Haemophilus Influenzae type B (HIB)
It is a bacteria whose infection usually causes serious disease in children under 5 years old. It can also affect adults but in adults, it causes less complications.
It is spread by air from person to person. Some persons, especially adults can carry these bacteria in their nose and throat, without getting sickness but they can very well spread to other people. Its only when the bacteria spread into the lungs or the bloodstream, then HIB can cause serious problems.
Disease caused by HIB:
It can cause meningitis. Meningitis is an infection of the lining of the brain and spinal cord. It can lead to brain damage and deafness. HIB can also cause Infection of Lungs(pneumonia), Ear Infections(Otitis media). Some times it can be a cause of serious infections of the blood, joints, bones, and covering of the heart.
Vaccination Schedule for HIB
A total of 4 doses of HIB vaccine are administered to children starting at 6 weeks of age and last dose at age 15 months plus after which no further boosters are required.
If some one has started late then dose schedule is little different.
HIB vaccine is commonly available as a combination vaccine with DPT and Hepatitis B so if iven on time it saves any extra pricks for the child later.
Injectable Polio Vaccine (IPV)/ Oral Polio Vaccine (OPV)
What is Polio?
Polio is a disease caused by a virus which is spread by feco-oral route, which means that virus is spread in community stools of the infected person and can be transmitted to a healthy person by consumption of food or water contaminated by same and it enters the body through the mouth.
Most of the times, it may result in a mild viral like illness with vague symptoms like fever, body aches, loose stools but sometimes it causes paralysis (can't move arm or leg), and it can cause meningitis (irritation of the lining of the brain). It can cause serious complications if paralysis involves the muscles that help us breathe.
Oral Polio Vaccine(OPV)
OPV are drops, given to swallow. It may be given at the same time as other vaccines. Children get multiple doses of OPV, depending on whether they have got Injectable Polio Vaccine or not.
OPV is recommended for children who are receiving IPV also, as by giving OPV to all children, it helps to spread a Herd Immunity means preventing an out-break of Polio in community.
Injectable Polio Vaccine(IPV)
Its a much better vaccine as compared to Oral Polio Vaccine(OPV) drops in terms of immunity and protection against Polio disease but still OPV is used along with IPV because of many operational challenges and Polio Eradication not being declared and OPV doses help to prevent an outbreak of disease in community(Herd Immunity)
Parents should note that Pulse Polio Drops are not to be confused with the regular vaccination whether its IPV or OPV and pulse polio drops are recommended for every child upto the age of 5 years irrespective of having received OPV or IPV.
Vaccination Schedule for IPV
A total of 4 doses of IPV are given starting 6-8 weeks of age - First 3 doses in first 6 months, then a booster at 15-18 months
It is available as a combination vaccine with DPT/HIB/Hepatitis B and does not usually require a separate prick for administration. At times due to poor availability of IPV containing vaccines, one has to follow different schedules for a particular case.
Rotavirus(RV) causes diarrhea, mostly in babies and young children and it spreads by oral route (by mouth). The virus can easily get transmitted even by by hands, diapers or objects like toys, changing tables or doorknobs.
The diarrhea can be severe, and lead to dehydration. Vomiting and fever are also common in babies with rotavirus. Most of the unvaccinated children with Rotaviral Infection get sick enough and invariably land up in a hospital with severe dehydration. Vaccinated children are much less likely to fall sick and usually have a milder course of disease, if at all get infected.
A total of 2 or 3 doses(2 doses of Rotarix or 3 doses of Others brands)of Rotavirus vaccine are administered to children starting at 6 weeks followed by repeat doses.
Rotavirus vaccine cannot be used if age at the time of first dose is more than 14 weeks, 5 days(approx 3 months plus). And the last dose of the Rotavirus vaccine cannot be given later than 8 months of age.
Pneumococcal Conjugate Vaccine (PCV)
Pneumococcal disease is caused by Streptococcus pneumoniae bacteria that can spread from person to person through air. It most commonly causes ear infections and in some cases it can also lead to more serious infections of the Lungs (Pneumonia)or Blood(Septicaemia)or brain and spinal cord (meningitis).
Ear infections are commonly seen in children while pneumonia is common among adults. Pneumococcal meningitis can cause deafness and brain damage and life threatening complications in 10% of cases.
Because of rising incidence of resistance of these bacteria to routinely used antibiotics, prevention of the disease through vaccination is even more important.
PCV is given as 3 primary doses in first 6 months starting at 6 weeks of age and then a booster at 12-15 months of age.
Dose schedule would vary if vaccination is started after 6 months of age.
This vaccine is routinely not recommended at age more than 5 years.
Pneumococcal conjugate vaccine is available in two variants in India, i.e. PCV 10 by the name of Synflorix and PCV 13 by the name of Prevnar
PCV 13 offers a little broader coverage as it covers 13 types of bacteria while PCV 10 covers 10 types of the bacteria. However, studies do not show a very significant difference in efficacy of both the vaccines and so both type of vaccines are equally recommended for pneumococcal vaccination.
Measles, mumps and rubella – all are serious diseases. After increase in routine vaccinations, they are less commonly seen now a days. These diseases are highly contagious and easily spread from person to person via droplets through the air.
Rubella (German Measles)
All Children should get 3 doses of MMR vaccine:
Recent Changes in Vaccination Schedule of MMR
About Typhoid Disease
Typhoid (typhoid fever) is a bacterial infection caused by bacteria called Salmonella Typhi.
It spreads by contaminated food or water. Milk products like cake icings, cream, cheese, milk-shakes, curds, etc are more notorious to spread these bacteria.
Typhoid causes a high fever, fatigue, weakness, stomach pains, headache, loss of appetite, and sometimes a rash. If it is not treated, it can cause serious complications in upto 30% of people, especially if they are not vaccinated.
Another bacteria known as Salmonella paratyphi A and Samonella paratyphi B also cause a similar illness, called as paratyphoid fever, which also spreads through food and water contamination. However, paratyphoid fever causes less complications as compared to typhoid.
About Typhoid Vaccines
Vaccines are available for Typhoid only and these do not protect from Partyphoid infection.
There are 2 types of vaccines available for typhoid- One is a Polysaccharide Vaccine, also known as Vi antigen vaccine another is Typhoid Conjugate Vaccine(TCV).
None of them are 100% protective against getting a typhoid infection.
Vi antigen vaccine offers a 40-60 % protection and its effect decreases after 2 years and is almost nil at end of 3 years. This vaccine cannot be used in children less than 2 years.
On the otherhand, TCV offers a 70-80% protection and does offer some protection beyond three years also. This vaccine can be used to protect children as young as 9 months of age.