Vaccination Chart India And Commonly Asked Questions About Vaccination

Why should you vaccinate your child?

Vaccines are the only way to prevent infection with some deadly viruses and bacteria that have the potential to cause death and disability.

In the last century millions of lives have been saved by vaccinating.

Some of the common diseases that used to claim the lives of thousands of children every year are now no longer seen or even heard of – thanks to effective vaccination programs that are running all over the country and the world.

Vaccinations increase the child’s immunity to particular infecting organism and thereby to the disease it causes.

The vaccines available have been tested for safety and have a very minimal rate of adverse reactions. In addition the adverse reactions are minor compared to the disease itself which can be fatal.

Our children are fortunate to be born in a time when vaccines are available to protect them from death and disability – and as responsible and affectionate parents it is our responsibility to protect them from these diseases. That is the reason we must vaccinate our children

How do vaccines work?

Vaccines work by teaching the immune how to fight against germs such as bacteria or viruses.

The vaccines contain the disease causing bacteria and viruses in their killed or inactive forms.

When a child is vaccinated – these killed or inactivated germs enter the child’s body. The child’s immune system is exposed to these germs and learns to fight them – without the child having to suffer from the disease.

Once a child’s immune system learns how to fight a germ – it remembers that for a long time and is able to fight the germs every time they try to enter the child’s body from the environment.

This means that the germ is never able to cause disease in the child.

Every vaccine works against a different germ – so every vaccine protects the child against a different disease.

 

Are vaccines safe?

Yes – vaccines are safe. Every vaccine is tested for 10 -15 years by scientists before it is licensed for use in children.

 

Do vaccines have side effects?

Yes. Just like any other medicine in the world – vaccines also have side effects. Most of the side effects however are mild.

The usual side effects are redness and swelling where the shot was given. Some shots may also cause fever. All these go away within a few days.

Serious side effects after vaccination, such as severe allergic reaction, are very rare. Vaccines are tested for several years before they are used routinely and if they have major side effects they are never approved for use in children.

Do not be afraid of the side effects of vaccines because the consequences of not taking the vaccine are deadly because most of the diseases that vaccines are designed to prevent cannot be cured.

Do vaccines cause autism?

No. Vaccines do not cause autism. Many scientists have studied and continue to study this possibility. But they all reach the same conclusion – which is that there is no connection between vaccines and autism.

What is a vaccination chart?

The vaccination chart is list of vaccines which children of a particular country must necessarily receive in order to protect them from the diseases which are a problem in their country.

 

WHO recommended immunization schedule? 

The WHO recommends different immunization schedules in different countries of the world. This depends on the diseases prevalent in these countries and the nutritional and immune status of the children there.

 

https://www.who.int/immunization/policy/immunization_tables/en/

 

http://apps.who.int/immunization_monitoring/globalsummary/schedules

 

UIP vaccination chart

The WHO or the World Health Organization recommends a list of vaccines under its EPI (Expanded Programme of Immunization). This list is modified into the UIP (Universal Immunization Program) in India to protect children from the diseases they are likely to suffer from in India. This avoids unnecessary vaccines.

The UIP which was launched in 1985 included vaccines against the 6 deadly childhood diseases – Tuberculosis, Polio, Diptheria, Pertussis, Tetanus, Measles.

This has subsequently been expanded to include other diseases of importance to the Indian population.

In India – it is important to follow the UIP vaccination chart because these are the vaccines that children need in our country. Also they are the vaccines that are likely to provide immunity when given in India at the specific intervals specified in the vaccination chart.

 

IAP Vaccination Chart

The UIP seeks to immunize each and every child in the country against the killer diseases and therefore these vaccines are given free.

Unfortunately – due to the lack of funds – some new vaccines can sometimes not be provided free to the entire population even though paediatricians may think that the children of India will be safer if they are immunized with them. These vaccines are included in the IAP (Indian Academy of Paediatrics) schedule. The IAP vaccination chart includes the vaccines of the UIP schedule but has a few additional vaccines that parents may need to pay for.

Why should I give my baby BCG vaccine?

The BCG vaccine protects your child against TB or Tuberculosis.

Tuberculosis is a deadly disease which is also highly infectious. Tuberculosis used to be the leading cause of death in the previous century. BCG vaccine has had a huge role in bringing down the number of deaths caused by Tuberculosis.

Many people believe that TB is a disease of the past – but that is not true. TB is serious disease that is highly prevalent in India. It can affect almost any organ in the body and if it is not treated can cause death.

It is important to take the BCG vaccine because although the vaccine cannot prevent the entry of the bacteria into your child’s body – it can protect the spread of the bacteria in the body and prevent the bacteria from getting into the bloodstream and affecting other organs.

Also read What is BCG vaccination for Babies?

Why should I give my baby Polio vaccine?

Polio is a deadly disease that may not show any symptoms at first but can cause paralysis and death

The infection is caused by a virus which is present in the air and in water and food. All children can get the disease if they have not been vaccinated.

The disease at first may have no symptoms and the child may just have sore throat fever nausea and headache.

When the virus enters the nerves – it can cause lifelong paralysis and death.

There is no medicine to cure Polio

How to protect your child from Polio

Vaccinate your child with OPV (oral polio vaccines) which are given as drops in the mouth or IPV (injectable polio vaccine which is given as an injection)

 

Why should I give my baby the Hepatitis B vaccine?

Hepatitis B is a deadly disease caused by the Hepatitis B virus.

Your child can get the disease by contact with blood or body fluids.

Babies are at risk of getting Hepatitis B as soon as they are born because they come out from the mother’s womb coated in body fluids.

This is why the Hepatitis B injection is given immediately after birth.

A child with Hepatitis B infection may have no symptoms or may have general symptoms like fever, headache, weakness, vomiting, jaundice, joint pain.

At a later stage however the virus can cause liver failure and liver cancer.

There is no medicine to cure Hepatitis B

How can you prevent Hepatitis B?

Vaccinate your child with Hepatitis B vaccine which is given as an injection.

Also read Hepatitis B vaccination ; all you need to know

Why Should I give my baby the DPT vaccine?

The DPT vaccine protects your child from three deadly diseases – Diptheria Pertussis and Tetanus

Diptheria

Diptheria is a deadly disease caused by a bacteria. The bacteria are present in the air and can be inhaled by the child. They can also be present on objects like pencils and books and can go into the body through the mouth.

The initial disease is difficult to tell apart from a routine fever. The child will just have sore throat mild fever weakness swollen glands in the neck etc.

When the disease actually manages to get a foot hold on the child’s body the bacteria can cause swelling of the heart muscle, heart failure coma paralysis and death

It is difficult to treat the infection once it begins because the toxin from the bacteria spreads through the child’s body very quickly – and even if the bacteria is killed with antibiotic – the toxin cannot be removed or stopped from causing death and damage.

The best thing to do is to prevent the infection all together by giving the DPT vaccine.

Pertussis

Pertussis is a deadly disease which is also called whooping cough.

The disease is caused by a bacteria which is caught by children from the air.

Initially the disease is just like any other cough and cold episode. But once the bacteria really gets hold of the child’s immune system the child can develop a severe cough. The cough may be severe enough to actually stop the child from breathing at certain points leading to death. The disease can go on to cause pneumonia.

It is possible to prevent the disease by giving children the DPT vaccine.

Tetanus

Tetanus is caused by a bacteria that enters the body through wounds in the skin. Once the bacteria is in the body it causes stiffness in the neck and abdominal muscles, difficulty in swallowing muscles spasms and fever. The bacteria secretes a toxin that quickly spreads through the body and causes spasm of the lungs which results in the child not being able to breathe and consequently death from lack of oxygen. Tetanus is deadly disease and the only good thing about the infection is that it can be easily prevented by vaccination.

The DPT vaccine can prevent Tetanus infection.

Also read DPT Vaccine ; All You Need To Know

Why should I give my child the MR/MMR vaccine?

The MR vaccine protects your child against Measles and Rubella and the MMR vaccine protects your child against Measles Mumps and Rubella

Measles

Measles is an infection caused by a virus. The virus is present in the air and can be inhaled by children at any time. Measles is a deadly disease and it is wrongly believed to be a mild self-limiting disease. If you have heard that measles is a harmless disease and it is better to suffer through it and acquire immunity that way – you have heard only half the story.

Initially measles is a mild disease where the child has a rash all over the body, fever and cough. However, the disease can take a deadly turn and cause swelling of the brain or encephalitis and infection of the lung or pneumonia which can result in death.

Death due to measles is not uncommon in small children and it is best to prevent the infection by taking the vaccine.

The government of India provides all children with the measles vaccine free of cost.

In the private set up – you can take the measles vaccine in combination with the vaccine for Rubella and Mumps. The vaccine is then called MMR (Measles Mumps Rubella).

Mumps

Mumps is caused by a virus that is present in the air and can be inhaled by children. It can also be acquired by children if they are in direct contact with a child who has mumps. The disease can cause death – but it more frequently causes sever disability. A child with mumps has swollen salivary glands – which causes severe pain during swallowing. The virus also causes fever, headache, tiredness, muscle pain. In severe cases – the infection may lead to deafness. It can also lead to inflammation of the testis and ovaries causing infertility. The disease can turn fatal when the infection causes meningitis (infection of the covering of the brain and spinal cord) and encephalitis (infection and swelling of the brain)

It is naïve to believe that it is OK to suffer through Mumps ad acquire immunity.

It is best to prevent infection by taking the MMR injection.

Rubella

Rubella is a mild disease in which the child may suffer from mild fever and rash for a few days. In many cases there may be no rash and the disease may not even be recognized as Rubella.

The problem with Rubella is when it occurs during pregnancy. When a pregnant woman gets infected with Rubella the baby she is carrying may suffer from Congenital Rubella syndrome which has serious implications. Babies with Congenital Rubella Syndrome may have catarct, deafness, heart and brain anomalies.

When children are vaccinated against Rubella girls who grow up to be women who will have babies will have safer healthier pregnancies. And boys who grow up to be men will not pass on the infection to the women in their vicinity. Also when all children are immunized the virus will no longer have a home to live and multiply in and will eventually be eliminated.

Immunizing your child against Rubella will ensure that you have a healthy next generation.

Why should I give my baby Hib (H.influenzae TypeB) vaccine?

H.influenzae B is a bacteria that can cause a deadly infection.

The bacteria is present in the air and can be inhaled by the child at any time. If the bacteria does not enter the blood stream it may not cause and visible disease. But if it does enter the bloodstream it can cause meningitis (Infection of the covering of the brain and spinal cord, intellectual disability, epiglottitis (where the wind pipe gets blocked and causes breathing problems, pneumonia (infection of the lungs) and death.

The infection can be prevented by giving the child the Hib vaccine.

Also read Should I give my child the Hib Vaccine and Meningococcal Vaccine?

Why should I give my baby the PCV (Pneumococcus) vaccine?

Pneumococcus is a bacteria that can cause serious infection in children leading to death.

The bacteria is present in the air and goes into the body when the child breathes or comes in contact with another child who has Pnuemococcus infection.

The disease may be mild at first – but can go on to become pneumonia.

If the bacteria enters the blood stream as it frequently does in children – it can cause deadly conditions like bacteraemia (infection of the blood) Meningitis (infection of the covering of the brain) and death.

Fortunately it is possible to prevent these serious complications of the disease by giving the child the PCV vaccine

 

Why should I give my child Varicella vaccine?

Chicken pox is caused by a virus that is present in the air.

Children can inhale the virus from the air or get the infection by contact with another child who has chicken pox. The standard symptoms of Chicken pox are rash, tiredness, headache, fever. Since most children have only these symptoms and recover – it is a mistaken belief that it is better to suffer through the infection and gain immunity.

What is not known to a lot of people is that when Chicken pox gets complicated it can result in bleeding disorders, brain swelling (encephalitis) and pneumonia (infection of the lungs)

Since a vaccine is available to prevent the disease. It is a good idea to use it.

 

Why should I give my child Hepatitis A vaccine?

Hepatitis A is virus that causes infection of the liver. The virus enters the body through contaminated food and water. Some children may not have any symptoms r may have mild fever, stomach pain, loss of appetite, fatigue, vomiting, jaundice and dark urine. In some cases the infection may lead to liver failure, joint pain, disorders of the kidney, pancreas and blood.

Since a vaccine is available to prevent Hepatitis A infection it is a good idea to vaccinate children with Hepatitis A injection and prevent these problems.

 

Why should I give my child Rotavirus vaccine?

Rotavirus is a virus that causes diarrhoea fever and vomiting in small children. This may lead to severe dehydration, intestinal complications and death due to dehydration in very severe cases. The virus enters the child’s body through contaminated food and water.

The Rotavirus injection may be given to prevent diarrhoea and dehydration.

 

Why should I give my child Influenza vaccine?

Influenza is caused by a virus that is present in the air and can cause infection when the child inhales the virus from the air or comes into direct contact with a patient who has influenza. The typical symptoms of influenza are fever, muscle pain, sore throat, cough and extreme fatigue. Complicated influenza can result in pneumonia which can sometimes be fatal.

The Influenza vaccine must only be taken when recommended by the pediatrician – primarily because the Influenza virus keeps changing – and the old vaccine may not be useful. Also vaccines are useful only for a limited period of time. They do not protect the child life long.

 

Latest recommendations by the Indian Academy of Pediatricians on vaccination

1. Hepatitis B vaccine must be given within 24 hours of birth
2. All babies must receive OPV at birth. They must also receive OPV when the Pulse Polio drives are organised – every time. If possible children should be given the injectable Polio vaccine (IPV) in place of the Oral Polio vaccine (OPV) when they are being immunized at 6 – 10 and 14 weeks. If IPV is not available the child must receive bOPV at 6- 10 and 14 weeks
3. MMR/MR vaccine must be given only after 9 months of age. During the national campaigns the MR vaccine must be given to all children irrespective of immunization status
4. The immunity from the painful DTwP vaccine is much more than the immunity from the painless DTaP vaccine and the immunity also lasts longer. However either of them can be given to the child during the first immunization. The children taking DTaP may require boosters at a later stage.
5. It is best to give the Varicella vaccine after 15 months of age.

 

Can I delay the vaccination dose?

It is best not to delay the vaccination doses because the age at which a particular vaccine is given is decided based on two factors –

1. The vaccine is given at the age at which the immune system will work best
2. The vaccine is given as early as possible to protect the child from the disease as soon as possible

It is best to stick to the prescribed vaccination schedule as closely as possible to ensure maximum protection for the child from diseases at the earliest age.

 

Starting the vaccines later in life has no benefits. On the other hand it can have the following problems –

1. The child may get the disease. Younger children are more likely to get the disease than older children
2. Older children remember the pain from vaccination much more clearly than babies. Babies forget fast. It is best to get the painful procedures over with as early in life as possible.

 

Why are so many doses of the same vaccine given?

Several doses of vaccines are given for two reasons

1. In case the first shot did not build your child’s immunity – the second shot definitely will.
2. The immunity from many of the vaccines fades over time. Repeated injections called boosters are given to ensure that the immunity remains high

 

When a live vaccine is given – the child develops immunity to the disease immediately and the purpose of the repeat vaccine is just to ensure 100% immunity. For example the Measles vaccine.

When an inactivated vaccine is given however, there is almost no immunity from the first shot. It is only after the second or third shot that the child acquires some degree of immunity. For example the DPT vaccine. This why the DPT vaccine is started early in the first year 3 doses are repeated at 4 week intervals so that by the time the child is exposed to other children from whom they may get the infection – they have good immunity

For some vaccines the body has poor immunological memory and the immunity drops drastically after the first few years. These vaccines must be repeated on schedule eg DPT. Other vaccines like Hib and Hepatitis B have long memory so their initial repeat doses work well.

 

Can vaccination be given before due date?

When vaccines including boosters are given with lesser and greater interval than what is recommended by the immunization schedule – the immune response to the vaccine is lesser than what is expected or desirable.

This means that the number of antibodies produced in response to the vaccine in that child is less than the number of antibodies produced in other children (who are following the schedule exactly)

There are various schedules that have been created for children who for one reason or the other miss out on the regular doses of the vaccines. The immunity provided by these schedules is definitely not as good as the immunity provided by the regular immunization schedule.

In general it is less harmful to increase the interval between the same vaccines than to decrease the interval

So DPT vaccines which are supposed to be given 4 weeks apart may have much less efficacy when they are given less than 4 weeks apart. The earliest they can be given if at all is 4 days before the date on which they should have been given.

 

Can we give vaccine after due date ?

Very few studies have been done on children in whom the vaccine repeat doses have been increased beyond what is recommended. A few days beyond the recommended interval may not do too much damage. However delaying the vaccine for more than a week beyond the date recommended may result in the antibody response dipping so far that it may not be boosted at all by the booster. Which means that the booster will not push up the immunity as expected.

 

What is the maximum interval between vaccines?

The immunization schedule is designed with the maximum interval between vaccines in place. So the ideal maximum interval between vaccines are the intervals mentioned in the schedule.

The intervals are decided upon such that before the immunity from the previous shot wanes – the next shot can boost the immunity and take it to a higher level.

When the interval between the vaccines is increased beyond the recommended intervals – the immunity from the previous vaccine may fall to such a low level that

1. The child may get the disease
2. The immunity becomes so low that it cannot be boosted by the next dose any more.

 

What vaccines cannot be given together? 

There are various kinds of vaccines. Live vaccines, killed vaccines, conjugate vaccines, sub-unit vaccines and so on.

The immune response to all these vaccines are different in a child’s body and the immunization schedule is designed to club vaccines that can be given together on the same day.

It is not advisable to give any other combination of vaccines as that may result in weak protection or no protection.

Multiple vaccines – that are part of the schedule – can and should be given together. There is no chance of any harm.

 

Is there a problem if many vaccines are given on the same day?

No. Many vaccines can easily be given on the same day without any problem.

The reason for giving many vaccines on the same day is

1. To ensure that the child becomes immune to as many diseases as possible as rapidly as possible
2. To reduce the number of times the parents have to come to the doctor.

Giving multiple vaccines on the same day has been seen to be safe in various studies.

Right from birth babies are constantly exposed to many bacteria and viruses. Even safe activities like eating food introduces new bacteria into the body. And when children play – they touch various objects around them and get thousands of germs into their mouth and nose every hour. Even very young babies are used to having their immune system bombarded with millions of germs all the time.  In comparison a child who receives all the recommended vaccines in the 2018 childhood immunization schedule may be exposed to a maximum of 320 antigens through vaccination by the age of 2 years. This is unlikely to be problematic in any way.

 

Can vaccination be given during cough?  

Yes vaccination can be given if the child has a mild cough if the doctor in charge certifies that the cough is just a mild cough and not due to a serious illness like TB Tuberculosis or pneumonia.

Children with mild childhood illnesses should be vaccinated on time unless otherwise contraindicated.

It is most important to consult a doctor to differentiate between a mild illness and a serious illness before taking a vaccine. In other words – sick children must receive vaccines only if the doctor says that it is alright for them to receive vaccines.

Check with the doctor and ask for the doctor’s opinion before giving your child a vaccine in the following cases –

1. Your child is sick
2. Your child is on antibiotics
3. Your child has been exposed to a disease or is recovering from a disease
4. There is a pregnant or immunosuppressed person at home
5. Your child is preterm
6. Your child has allergies
7. People in your family have had reactions to vaccines in the past
8. Your child has had an adverse reaction to a vaccine in the past
9. Your child has had a seizure, brain or nerve problem
10. Your child has a serious illness like asthma, heart disease, lung disease, cancer and so on
11. If your child has received steroids or blood transfusion in the past year.
12. Your child has had a live vaccination in the past 4 weeks.

What is the best time of the day to get the baby Vaccines?

It is ideal to vaccinate during the day time – as the baby can be kept under observation by the parents more easily and for longer hours when immunization is given in the day time. Some studies say babies are more comfortable when vaccinated after 1:30 pm but there is not sufficient evidence of that.

As parents what we want more than anything else is to keep our children safe. And one of the most effective ways to keep children safe is to vaccinate them against the deadly diseases. If you are a parent – vaccinate your child on time on priority