A-Z of Baby Vaccination- Complete Infant Vaccine Schedule, Common Questions Answered

Baby Vaccination Schedule

So I thought instead of giving you a detailed description and a lot of theory about vaccines, I felt it would be more useful if I could answer most of the common questions that comes to most of our minds. In spite of being a doctor myself and having studied about the immunization process in detail, when I had to vaccinate my little one for the first time, my head was filled with so many queries. So let me share it with you so that it gets easier for you.

The National Immunization Schedule:

What is immunization?

Immunisation is a way to protect your child against a lot of disease which could be highly infectious. The immunisation could be either in the form of drops or injection and the number of doses can also vary from one to three.

How will immunization help my child?

Certain diseases can be very serious and fatal and can affect your child’s health .It could lead to a lot of mental stress, anxiety and worry in the family .The treatments could be expensive and can even put your child’s life at risk. By administering the vaccine, your child s body is protected against these specific serious diseases.

Won’t my child have a natural protection mechanism against these diseases?

Yes certainly baby’s have a natural protective mechanism. But remember it is only for the initial few months which they get from their mother during the process of breastfeeding. But as they grow up, this natural immunity starts to wane off making the child vulnerable to various diseases. By administering vaccines we can protect our child by enhancing their immunity to fight against various diseases

How does the vaccination work?

Vaccines mainly contain a weakened form or inactivated form or part of the disease causing agent which could be either a virus or bacteria. When the vaccine is injected into the body either through injectables or drops, it produces a protective substance in the body called antibodies. So whenever the infection attacks your child s body , these antibodies come into action and kill the disease causing organism , neutralise their effect and in certain cases protect you child from subsequent episodes of infections.

Will the immunization provide lifelong immunity?

No the vaccine does not provide lifelong immunity. But however it lasts for many years .It protects the child from most of the childhood illness that are extremely deadly and dangerous. In certain cases even if the child gets the disease, the symptoms are extremely mild and lasts for a shorter duration. In certain vaccines, a booster dose is given to improve the immunity level and further enhance the protection.

At what age should we start vaccination?

The immunisation process starts immediately after the birth of the child. The BCG vaccine, polio drops and Hepatitis B vaccine is given immediately after child birth. After this we follow the National Immunisation Schedule and each vaccine is given at a specific age and specific way.

Why is it important to give vaccines at the right time?

There are certain diseases that affect the body at a certain age and have a very dangerous impact on the body. Vaccines when given to the child at the right age and with the correct number of doses give maximum protection to the child. Let’s take for example Polio .Polio is very common among children below 5 years of age. Hence vaccination against polio is given in the routine immunisation as well as in the polio drive campaigns so that we can protect the child as much as possible.

Why are certain vaccines not recommended for children who have reached a certain age?

Certain vaccine when administered at a certain age with the correct number of doses cause maximum protection against those diseases. They also reduce the chances of being infected and

even the number of deaths. However after a certain age the child tends to acquire a natural protection to some of the disease like tuberculosis which could have been life threatening.

What should be done in case of delay of getting a particular vaccine?

I would suggest as much as possible to keep a chart / file for your child so that you can remember when the child is due for the next shot. But in case if you delay then the vaccine has to be given as early as possible. Say if the vaccine has 3 doses and the first 2 doses were taken as per schedule and there was a delay in the 3 rd dose. Then you don’t have to restart then entire schedule, but instead only the remaining dose has to be taken at the earliest possible.

How much does the vaccination cost?

Certainly most of the vaccines are costly. But the good part is our government spends money in acquiring it, sorting and transporting it at the right temperature. All the vaccines included in the national immunisation schedule, along with certain medicines and supplements like paracetamol ORS , zinc and vitamin A are given to all the children free of cost at the government facilities .even the vaccines required by pregnant women are given free of cost at the government health facilities.

Where the places where we can get our children vaccinated?

You can get your child vaccinated at any government health facility, government hospitals, private hospitals, medical colleges, urban dispensaries, primary health centres, community health centres, sub centres, anganwadi centres. In fact for your information in certain villages, the ANM’S organise certain immunisation programs for children who don’t have access to hospitals or health care centres. However though the government tries to make it easily accessible for most of them, house to house services are not provided. Certain special campaigns like the Oral polio drops for Pulse Polio Immunisation does house to house service.

Which vaccine is better –those given at private hospitals or those given at government hospitals?

Some of us have this notion that vaccines given at private hospitals could be of better quality and better for your child. Well it is not true. All the vaccines in the country are licensed by the Drug Controller General of India (DCGI). The government as well as the private hospitals procure these vaccines from the same government approved and licensed manufacturers. But the positive point is all theses vaccines are given to children and pregnant ladies free of cost at government sectors.

Why do some private hospitals give vaccines that are not mentioned in the government programme?

The government gives vaccines according to Universal Immunisation Programme which is implemented by the Ministry of Health and Family welfare. The government aims at ensuring protection for children and pregnant mothers against diseases that are highly infectious, fatal and infect a large number of children and pregnant woman. However in private hospitals, they cater to a smaller section of people and have a personalised approach which is chargeable.

Which vaccines are to be given to a new born?

It is important and mandatory to give one dose of OPV, BCG and Hepatitis B to all new borns irrespective to if they are born in private or government health care set up. This is in accordance to the National Immunisation Schedule.

In spite of taking the vaccine, some children still get the disease. How effective is the vaccine then?

No medicine is 100 % effective. Similarly no vaccine can be 100 % effective. The levels of protection can certainly vary from one child to another depending on the immune system of the child, the heath status of the child. Children generally who are malnourished, who get repeated diarrhoeas have a reduced protection level .But let me make one thing very clear. Make sure you get your child vaccinated because even if your child gets the disease, the severity of the disease will be much lesser and the recovery rate also will be much higher.

Why are certain vaccines seen only in certain states?

Whenever a new vaccine is been rolled out, it is important to first try it out in some states and then gradually expand to the other states and districts. Take for example the Rotavirus and PCV. It was started in a few states initially and then expanded.

Secondly some organisms may not be present everywhere. So in that case vaccines are given in those states or districts where that particular disease causing agent causing that disease is seen. Just like how JE vaccine is given only in certain states to protect Japanese encephalitis.

What are the vaccines that can be given to pregnant ladies?

Only tetanus toxoid vaccine can be given to pregnant ladies.

What is the schedule to follow?

2 doses of this vaccine should be given. The first dose is given as soon as pregnancy is confirmed and the second dose is given 4 weeks after the first dose. In case if they have not received while they were pregnant, then one dose of TT vaccine can be given at the time of delivery.

In case if the previous pregnancy happened within 3 years of the current pregnancy and the mother has received 2 doses of TT during the precious pregnancy, then in the current pregnancy only 1 dose of TT is required. But if the previous pregnancy happened more than 3 years ago, then in the current pregnancy 2 doses of TT has to be taken.

Why do pregnant ladies require vaccination?

All pregnant ladies are given only tetanus vaccine. This is to protect them and their children from tetanus. Tetanus is also called lockjaw disease and is a life threatening condition. It can cause seizures, muscle spasms, respiratory failure and even death of the baby.

Is having a scar after BCG injection normal?

Yes it is an absolutely normal reaction to have a scar after BCG injection.

BCG injection is given at birth. 2 weeks after the injection, the area usually becomes red and hard. This will cause an elevation of the skin and increase to its maximum size by the fourth week. The lesion later on cracks, with mild discharge of pus/ watery fluid and gradually changes into a crust by 5 to 6 weeks. Finally it leaves a scar by 8 weeks. Please don’t apply any medicine, lotion or herbs on that area. Do not even press or rub that area. However if the child starts developing a swelling in that area and has fever then please consult your doctor.

What should be done if the child does not develop a BCG scar?

Most of us develop a scar after the BCG injection. However in some individuals no scar develops after the injection. You don’t have to re- vaccinate the child. The child would have already developed protection against the disease.

What is pentavalent vaccine? How will it help my child?

Yes I am sure all you moms must have heard about it. Pentavalent vaccine was recently introduced into the National Immunization Schedule. This single vaccine provides protection against 5 severe forms of diseases. Diphtheria, Pertussis, tetanus, Hemophilus influenza type B infection and Hepatitis B. 3 doses of this vaccine is given to the child at 6 , 10 and 14 weeks.

To protect a child from hepatitis B infection which vaccine should be given?

To protect the baby from hepatitis B infection that gets transferred from the mother to the baby during delivery, one dose of HepB vaccine is given at birth. Apart from those, 3 doses of the pentavalent vaccine is given at 6, 10 and 14 weeks,

Can IPV be given along with OPV at 6 and 14 weeks?

Absolutely yes! You can give both IPV and OPV together on the same day. OPV is given orally whereas IPV is given by injection. In fact it is safe to give two vaccines against the same disease. It only ensures additional protection against polio infection.

Why is polio vaccine given and pulse polio campaigns still going on in India, if India is declared polio free country?

Yes certainly India is declared as a polio free nation. But there is a very high risk if a person travels to India from a country where polio is still present. It can certainly spread the polio infection. Hence it is important to protect the lives of our children till polio is completely eradicated from the world.

Why is it important to have a vaccine against rubella?

Rubella is a viral and a life threatening disease. Infection with rubella during pregnancy can cause abortion or still birth. It can cause various birth defects in the new born like blindness, deafness, heart defects, developmental delay. The rubella vaccine is introduced as measles rubella vaccine (MR). The MR vaccination campaign is a campaign which aims to vaccinate all children between 9 months to less than 15 years of age with an additional booster dose. The aim is to stop the transmission of this deadly virus from one person to another.

Is the MR vaccine used for children in the campaign safe and effective?

Certainly the MR vaccine that is used during the MR campaigns and routine immunization is extremely safe and highly effective. The vaccine is pre qualified by the WHO, manufactured in India and is also used in countries like Bangladesh, Sri Lanka, Myanmar, Nepal.

Why is there often pain and swelling at the injection site? How do we manage it?

This is a very common concern I totally agree with. Injectable vaccines like Hepatitis B , pentavalent , DPT, IPV will cause redness, minimal pain and swelling at the injection site. This pain and swelling usually persists for 1 to3 days and then gradually subsides. This cannot be related to the quality, safety or efficacy of the vaccine.

To provide relief to the child I would recommend you to put a clean cloth dipped in cold water on the injection site. In some cases the doctor would advise you to give the baby paracetamol syrup. However if the baby has fever even after 3 days, then please consult your pediatrician.

Why kids do get fever after taking the vaccination?

Most of the kids get fever especially after pentavalent and DPT vaccine. This is a very normal reaction and mechanism of the body. It is a response of the body to foreign substance. The fever is usually mild and goes away in 2 to 3 days. Generally kids feel better with paracetamol syrup given by the paediatrician or health care worker. However in certain kids they might not have any fever or reaction. That is also normal. You do not have revaccinate your child

Can my child be vaccinated when the child is sick?

If the child has mild illness like cough, cold or mild fever then it is safe to vaccinate the child with injectable or oral vaccines. But if the child is having serious illness with high grade fever, severe diarrhoea then kindly postpone till the child feels better. Personally I would always wait till my child is completely normal before I take him for vaccination.

What are the protocols I must follow after my child is vaccinated?

Once the session is over, kindly wait at least for half hour. This is to ensure that the baby gets immediate care if any immediate adverse reactions are noticed. Continue to breast feed or give formula feed even after the vaccination. Make sure you don’t apply any medicines or herbs on the injection site. It will heal by itself.

Another common question is if the child is born by C- section and is born before 9 months, can the baby receive vaccination?

Every child must be vaccinated according to the National Immunization Schedule. It does not depend on :

  • If the baby was born by normal or caesarian.
  • If they were born in a private hospital or a government hospital or at home
  • If they were delivered before 9 months of age
  • If the baby has a low birth weight
  • If the mother is suffering from any medical condition.

Have heard this notion that OPV can cause impotency and MR vaccine can cause autism. Is it true or is it just a myth

Would you think if the vaccine caused autism and impotency it would be added in the universal immunization program? Certainly it is not true. All the vaccines used in the universal immunization program are tested and are safe, effective with good quality.

Can vaccines cause an allergic reaction?

Most vaccines don’t cause any allergic reactions but however certain children may be allergic to the vaccine or to the components of the vaccine – may be the antibiotic or the preservative that can cause an allergic reaction. The child may get appearance of a red spots on the body, itching , swelling of the face, vomiting. If you know that child has any history of allergy, it has to be told to the doctor before administering the vaccine.

On a particular day can more than one vaccine be given?

Yes certainly more than once vaccine can be given to your child on a particular day. It does not have any adverse effect or reduce the effectiveness of the individual vaccine. In fact giving your child more than one vaccine as per the vaccination schedule reduces the number of visit to the hospital, reduces the extra time and travel required.

Why are certain vaccines given in the thigh while certain others in the arm? It would have been so convenient if all vaccines could be given orally.

I know this is a very genuine question. Each time when I took my child for vaccination I had the same question in my head. Well on the other side being a doctor I know that each vaccine, if it needs to give maximum protection against a particular pathogen it needs to be administered in a particular way. Certain vaccines when given intramuscularly will have a better efficacy rather than giving the same vaccine orally, and hence they are given by different routes.

Is vitamin A also a vaccine?

Certainly not!! Vitamin A is not a vaccine. Vitamin A is an essential nutrient that is mandatory for the child’s growth and development. It is important to enhance the child’s immunity to fight against diseases. Nine doses of vitamin A are given to all children. First dose is 1 ml or half the spoon (spoon that comes along with the bottle), second to ninth dose is 2 ml or full spoon.

Can Vitamin A be given along with other orally administered vaccines?

Yes. Vitamin A can be given safely along with other orally administered vaccines, like OPV and rotavirus vaccines.

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