When
are live viral vaccines (like Polio or MMR) not to be given?
- Immunodeficiency: Babies infected with HIV should
receive MMR vaccine, as the risk of measles far outweighs the risks of the vaccine.
Immunodeficient children living with immunodeficient persons can be given killed polio
vaccine (IPV). Hospitalized children should not be given OPV because of possibility of
transmission of the vaccine virus to an immunosuppressed infant.
- Immunosuppressed children: those receiving radiation,
steroids or cancer chemotherapy. However children on alternate day steroids, low or
moderate doses or those on short-term steroid usage (asthmatics) can be immunized in the
routine way.
- Pregnancy: Pregnant women should not receive live viral vaccines. However it is
permissible to give the same to their household contacts.
Common side-effects of Vaccines:
The
incidence and severity of side effects is far exceeded by the risks and damages of the
diseases against which vaccines afford protection. Some of the common vaccines that
manifest side-effects are -
- Pertussis (DPT/ DT): Symptoms occur within 48-72 hours of
injection.
- mild fever
- irritability
- persistent screaming
- collapse
- MMR: Temperature of 39.40C (1030F) or
more may develop between 6th and 10th day of injection and last for
1-2 days. Transient rashes and arthralgias may occur.
- Haemophilus influenzae type B (HiB): Mild local reactions
(erythema, swelling) may occur and usually resolve within 24 hours. Systemic reactions are
rare.
- OPV: Minute risk of producing poliomyelitis
- IPV: Mild local reactions only
Natural Immunity:
Natural
immunity is what a child gets either through the mother or by exposure to the organism
concerned. Children who have incurred the natural disease of Pertussis (whooping cough),
Measles, Mumps, Rubella develop lifelong immunity and need not be given the vaccine.
However, it must be kept in mind that receipt of the vaccine will cause no harm.
Simultaneous
administration:
Most mothers wonder which vaccines can be given with
others and which can not be? DPT, OPV/IPV, MMR, HiB can be given simultaneously without
any problem but they should be given at different sites. Hepatitis B vaccine can also be
given together with OPV/ DPT
The use of the HiB vaccine alongwith diphtheria toxoid does
not reduce immunity to diphtheria
BCG vaccine: (Baccile - Calmette - Guerin)
This is a live attenuated vaccine, to be given at birth as protection against Tuberculosis. It is given intradermally in the deltoid
region of the left arm.
You may forget that your baby was given the vaccine as the reaction to it comes up
after 6 wks. This is in the form of a swelling, which will burst with another 8-10 days.
This heals slowly leaving behind a permanent, tiny, round scar upto 8mm in diameter,
indicating successful vaccination. Boosters are generally not given. If BCG does not take
with 1st attempt, re-vaccination is indicated. Generally given at Government or
Municipal dispensaries.
Do's & Don'ts:
- Do not rub the site of vaccination
- Do not apply hot fomentation at the site
- Report to your doctor in case swelling appears in armpit or neck.
There had been some controversy regarding effectiveness of BCG. The controversy has
ended and all of you must give BCG.
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