Available in India since 1999. Important vaccine as Chicken Pox usually strikes in Feb/March. Many students have jeopardized their career plans due to Chicken pox just before their board exams. It is a live attenuated vaccine, which can be given from the age of 12 mths onwards.

From age of 1-12 yrs, only one dose is required; above this age two doses are given at an interval of 6-10 wks. The vaccine is given sub-cutaneously. A measles virus containing vaccine can be given at the same time, if not then an interval of atleast one month should be kept between the two.

Side effects: Fever, rash, headache, fatigue, paresthesia.

Meningococcal meningitis most commonly occurs under 5 yrs of age.

This vaccine is recommended for children above 2 yrs of age as it can't produce an adequate immune response in children below that age. Immunity with this vaccine lasts for 3 yrs and boosters are advised every 3 yrs.

MMR:

It is a live attenuated vaccine, which simultaneously gives protection against Mumps, Measles, and Rubella.

The vaccine is first diluted with sterile water and given sub- cutaneously on the upper part of arm or anterior thigh.

This vaccine can be given between 18-24 mths of age and is generally given 6 months after the 1^st Measles dose given, where it acts as a booster.

Rubella:

It is a live attenuated vaccine.

Age: 15 months.

It is given in a single dose of 0.5-ml sub- cutaneously. It is strongly recommended in pre-pubertal girls as Rubella is one of the commonest cause of 1^st trimester abortions.

Measles - the largest killer of children in 1-3 age group before the advent of vaccine. It took us a long time to convince our patients (of all religions) about the need for Measles vaccine as the all-powerful myth associating Measles as ‘darshan’ of Goddess Durga. It is a live attenuated vaccine.

The reconstituted (available as powder) vaccine is administered in a single dose of 0.5 ml. Injection is given sub-cutaneously.

Age: It should be given as close to the age of 9 months as possible, as before this age the vaccine is rendered ineffective due to maternal antibodies in the infant’s circulation and after this age many children will have been exposed to the risk of infection. However if the child is malnourished the vaccine can be given at 6-8 months as the risk of infection in such children is very high. The child should then receive a second dose at 15-18 months of age.

Immunity develops 11-12 days after vaccination.

Even though not a part of Universal Immunisation Programme, the child must be protected against Typhoid. You may ask why? Many a children have missed their final exams or fared badly as Typhoid commonly strikes between Jan to March. Also the Typhoid causing bacteria is becoming resistant to the commonly used antibiotics.

The vaccine is available in injectable and oral form.

The INJECTABLE vaccine cannot be given below two years of age because of low immune response. It is given intramuscularly or sub-cutaneously. Two doses are required at an interval of 4-6 wks. Booster doses should be taken every 3 yrs.

The ORAL vaccine is a live vaccine available as capsules. It is recommended after 6 yrs of age. 3 capsules have to be taken on days 1,3 and 5, one hour before meals with cold or lukewarm water or milk. Boosters are required every 3 yrs.

Rabies Vaccine:

Three types of vaccine are available:

1. Nervous tissue vaccines - These are derived from nervous tissue of animals. These are not used nowadays due to their side effects - paralysis.
2. Duck embryo vaccines - These do not have the side effects like above.
3. Cell culture vaccines - These are of two types:
1. Human diploid cell vaccine (HDCV)
2. Purified chick embryo vaccine (PCEV)

The vaccine most commonly used is the PCEV. One ml of the vaccine is given intramuscularly in the arm (under no circumstances should it be given in the buttocks). The schedule depends upon the grade of exposure.