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Immunization


                        

Why do children need immunization?

Our immune system is a natural defense against disease. The immune system produces substances called antibodies which usually fight off infection and prevent disease. In some cases, though, our immune system need a bit of help. Vaccines are given to strengthen your child’s immune system to fight off diseases that could cause lasting damage to their health or even kill them.
Remember, its never too late to have your child immunized.
Even if your child has missed an immunization and is well above the recommended age for the vaccine, its probably still worth getting it done. Ask your doctor or health worker for advice.


Routine Immunizations

Your doctor will usually give you the immunization schedule and you will need to follow this schedule. Its important to follow the schedule and get your baby immunized at the right age, to keep the risk of disease and any potential side effects as low as possible. The doctor will also explain the immunization process to you. The vaccine will be given by injection to your baby’s thigh or upper arm.


Immunization Schedule:

As per the Indian Academy of Pediatrics (IAP), following immunization schedule is to be followed for the newborns in India

   Age
           Vaccines
                Note
  Birth
BCG


Oral Polio Vaccine


Hepatitis B-1




 6 weeks
OPV-1+IPV-1/OPV-1
OPV alone if IPV cannot be given

DTPw-1/DTPa-1


Hepatitis B-2


Hib-1




10 weeks
OPV-2+IPV-2/OPV-2
OPV alone if IPV cannot be given

DTPw-2/DTPa-2


Hib-2




14 weeks
OPV-3+IPV-3/OPV-3
OPV alone if IPV cannot be given

DTPw-3/DTPa-3


Hepatitis B-3
Third dose of Hepaptitis B can be given at 6 months of age

Hib-3




9 months
Measles




15-18 months
OPV-4+IPV-B1/OPV-4
OPV alone if IPV cannot be given

DTPw booster-1 or DTPa booster-1


Hib booster


MMR-1




  2 years
Typhoid
Revaccination every 3-4 years



 5 years
OPV-5


DTPw booster-2 or DTPa booster-2


MMR-2
The second dose of MMR vaccine can be given at any time 8 weeks after the first dose



 10 years
Tdap


HPV
Only girls, three doses at 0, 1-2 and 6 months




Vaccines that can be given after discussion with parents

More than 6 weeks
Pneumococcal conjugate
3 primary doses at 6, 10, and 14 weeks, followed by a booster at 15-18 months



More than 6 weeks
Rotavirus vaccine
2/3 doses (depending on brand) at 4-8 weeks interval



After 15 months
Varicella
Age less than 13 years: one dose
Age more than 13 years: 2doses at 4-8 weeks interval



After 18 months
Hepatitis A
2 doses at 6-12 months interval








1.    The IAP endorses the continued use of whole cell pertussis vaccine because of its proven efficacy and safety. Acellular pertussis vaccines may undoubtedly have fewer side-effects (like fever, local reactions at injection site and irritability), but this minor advantage does not justify the inordinate cost involved in the routine use of this vaccine.
 
2.    If the mother is known to be HBsAg negative, HB vaccine can be given along with DTP at 6, 10, 14 weeks/ 6 months. If the mother's HBsAg status is not known, it is advisable to start vaccination soon after birth to prevent perinatal transmission of the disease. If the mother is HBsAg positive (and especially HBeAg positive), the baby should be given Hepatitis B Immune Globulin (HBIG) within 24 hours of birth, along with HB vaccine.
 
3.    Varicella, Hepatitis A and Pneumococcal Conjugate vaccines should be offered only after one to one discussion with parents. Also refer to the individual vaccines notes for recommendations.
 
4.    Combination vaccines can be used to decrease the number of pricks being given to the baby and to decrease the number of clinic visits. The manufacturer's instructions should be followed strictly whenever "mixing" vaccines in the same syringe prior to injection.
 
5.    At present, the only typhoid vaccine available in our country is the Vi polysaccharide vaccine. Revaccination may be carried out every 3- 4 years.
 
6.    Under special circumstances (e.g. epidemics), measles vaccine may be given earlier than 9 months followed by MMR at 12-15 months.
 
7.    During pregnancy, the interval between the two doses of TT should be at least one month.
 
8.    We should continue to use OPV till we achieve polio eradication in India. IPV can be used additionally for individual protection.
 
9.    OPV must be given to children less than 5 years of age at the time of each supplementary immunisation activity.


 

 



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