In our previous blog on vaccination, we introduced the concept behind vaccination or immunization, need, benefits and what vaccinations are mandatory or optional for infants. Also, we addressed some common concerns most parents have around vaccination. In this blog, of the same series, we
- Debunk popular myths around vaccination
- Mandatory vaccines for kids between 1.5 -10 years
- Optional vaccines for kids between the same age group
- Considerations to take into account before going in, or not, for optional immunization.
It is normal to feel anxious before getting your child vaccinated given the many myths surrounding it. But most of these myths are just misconceptions and sometimes lead to parents doubting the safety and efficacy of this process.
Myth 1. Immunization is linked to long-term health issues like autism, diabetes or multiple sclerosis
Fact: All vaccines can have mild side effects like low fever, headache, fatigue, soreness near the injection area or slight pain. But even after several pieces of research, no conclusive evidence has been found of any connection between immunization and long-term health problems like autism, diabetes, or multiple sclerosis.
Since the first symptoms of Autism Spectrum Disorder may appear around the time children need to receive MMR and other vaccines, there is a common assumption that MMR is associated with autism. But when verifying this concern, researchers identified the symptoms of autism way before the children received MMR vaccine.
Myth 2. Children vaccines contain mercury or mercury-based preservatives
Fact: In earlier times, a mercury-based preservative called Thimerosal had been used in some of the vaccines. However, this use of chemical had no harmful effects except the normal redness or swelling near injection areas.
But, in 1999, the manufacturers of vaccine decided to eliminate the use of Thimerosal. Since then, the vaccines for children be are made without the use of this preservative. However, some of the adult vaccines may contain Thimerosal.
Myth 3. Vaccinating my child so early is not needed
Fact: The diseases that the scheduled vaccines prevent, can occur in the very early stages of life and their impact is most harmful during this young age.
So waiting for your child to grow up a bit can only result in making her more vulnerable to these diseases. On the contrary, vaccinating your baby at the right time will make her totally immune to some of the life-threatening diseases that were the significant reasons of infant death in the past like measles, whooping cough or diphtheria.
Myth 4. My child can get the disease from the vaccine that it is supposed to prevent
Fact: Most of the pathogens used as vaccine are inactivated (killed). In some vaccines, a live but weakened organism is used, but they are incapable of causing the actual infection. However, live organisms may cause mild illness. For example, if your child is given the chicken pox vaccine, she may develop a few rashes, but that is harmless. Hence, even if the vaccines are causing mild reactions, they will never cause the actual disease they are meant to prevent.
Global measles deaths have decreased by 84% from an estimated 5,50,000 deaths in 2000 to 89, 780 in 2016. Accelerated immunization activities have had a major impact on reducing measles deaths. — WHO
Myth 5. Diseases are part of childhood. Natural immunity is better than vaccine-induced immunity
Fact: There are pieces of evidence that, although natural immunity (actually catching the disease to get immune) may produce a better result than the vaccine-induced immunity, but catching the disease itself is not worth the risk. Vaccines can prevent many harmful viruses, and the effectiveness of these vaccines are as high as 90-99%.
But allowing your child to suffer from the vaccine-preventable diseases in order to generate natural immunity can end up in major health issues. For instance:
- Chickenpox can lead to more severe illness like pneumonia.
- Mumps often leads to permanent hearing loss in children.
- A natural Haemophilus influenza type b ( HiB) can cause permanent brain damage or even death.
Hence it is always recommended to vaccinate your child on time to avoid any severe health problem and not depend on the child catching the disease.
Myth 6. Multiple vaccinations over a short period of time confuse the immune system
Fact: There is this fear that injecting multiple pathogens over such a short period can actually confuse the system and lead to harmful diseases, even cancer. But this is not true.
Infants are born with the ability to respond to a considerable number of antigens from viruses and bacteria that they come in contact daily at the same point of time. Vaccines are made to stimulate that immune response and create antibodies. They contain the same antigens, that of natural infections, but in a weakened form. Hence, the weakened organisms cannot replicate and hence fail to cause the actual disease, but the immune system, in response to those antigens, produces the antibodies.
Although an infant receives multiple vaccines in the first year, the number of antigens that she is exposed to are only approximately 160. On the other hand, a single bacterium that she can come in contact with from the environment can contain up to 6,000 antigens. So the challenge the immune system faces from all the vaccines she gets is insignificantly low, compared to the naturally-contracted organisms (resulting from diseases.) In fact, considering the capability of the immune system, an infant can respond to 10,000 vaccines at a time.
Hence it is implausible that multiple vaccinations can confuse or weaken the immune system.
Myth 7. With so many people getting vaccinated, there’s no need to vaccinate my child as the infection rates are already low
Fact: With the decades-long immunization campaign, herd immunity has become a reality where the majority of the population is so immunised, that even an un-immunised person is protected or less likely to get the diseases. This is because the virus never gets a chance to spread, as the majority of the population is immunised. Herd immunity has been particularly beneficial for that minor population who are unable to receive vaccinations like pregnant women, or those with a weak immune system.
In spite of a low infection rate, if a number of people stop immunising their children, it will increase the risk of collective danger. This decision, if taken by a considerable number of parents, will leave more children vulnerable to the diseases and eventually increase the chance of spreading the infections at a higher rate.
Immunization process has succeeded in eliminating a few diseases like smallpox or Polio. Before immunization, it was a challenge to keep healthy, and sometimes alive too, because of the frequent outbreak of contagious fatal illnesses. Hence, immunising your child is not only your duty towards your baby but towards the whole community.
Immunization schedule for 1.5 – 10 years old
At 15 – 18 months
Varicella: This vaccine prevents children from contracting chicken pox (hyperlink to the chicken pox blog). It contains weakened live strain of Varicella-Zoster virus. A child should be first vaccinated at the age of 15-18 months and the second dose should be given at 4-6 years.
DTP Booster: This vaccine creates immunity against Diphtheria, Tetanus, and Pertussis (commonly known as Whooping Cough) and is a mandatory vaccine. It produces antibodies to battle against these diseases by inserting a combination of three inactivated antigens named Diphtheria Toxoid, Tetanus Toxoid, and Pertussis. The first dose should be given at 6 weeks, 2nd at 10 weeks and the third at 14 weeks which is followed by three booster doses one at 15-18 months, the second one at 5 years, and the 3rd one at 10 years.
IPV Booster: Inactivated Polio Vaccine is given to prevent Polio that can cause permanent paralysis. Polio vaccine is mandatory for all children. It is made from the wild-type polio virus strains that have been inactivated by formalin. The first dose is given at 6 weeks, 2nd at 10 weeks, 3rd at 14 weeks, and a booster at 15-18 months. This vaccine is usually given with DTP vaccine.
HiB Booster: This is a vaccine to prevent bacteria named Haemophilus Influenza Type B that causes diseases like Meningitis, Pneumonia, Epiglottitis. Inactivated bacteria components are introduced to the body during this immunization. The first dose is given at 6 weeks, 2nd at 10 weeks, and the third at 14 weeks, followed by a booster given at 15-18 months.
PCV Booster: Pneumococcal Conjugate Vaccine protects the body against Pneumococcal bacteria that causes pneumonia, blood infections, ear infections and brain meningitis which can be spread from person to person. The vaccine contains no live pneumococcal bacteria and is inactivated. The first dose is given at 6 weeks, 2nd at 10 weeks, and the third at 14 weeks, followed by a booster given at 15-18 months.
MMR Booster: The MMR is a mandatory vaccine to prevent Measles, Mumps, and Rubella (MMR). The vaccine contains live and weakened viruses to make our body immune to these viruses. The first dose should be given at 9 months and followed by a booster at 15 months.
HepA2: Hepatitis A vaccination is to prevent Hepatitis A virus that can cause chronic liver infections. It is a severe contagious liver disease. The vaccine contains inactivated virus. The first dose should be given at 1 year and a second dose should be given at 18 months.
At 2 Years:
Typhoid Booster: The Typhoid Conjugate Vaccine (TCV) protects against the typhoid virus. The first dose should be given at 1 year age followed by a booster given at 2 years. Re-vaccination should be done every 3 years.
At 5 Years:
DTP 2nd Booster Dose
MMR 2nd Booster Dose
At 10 Years :
DTP 3rd Booster
HPV1 : Human Papilloma Virus vaccine prevents the virus of the same name. It is estimated that it may prevent 70% of cervical, 80% of anal, 60% of vaginal, 40% of vulvar, and some of the mouth cancers. In addition, it may prevent genital warts by providing greater protection. This is an optional vaccine only meant for girls. The first dose should be given at 10 years, the second dose for children aged 9-14 years should be given after 6 months of the first dose and for 15 or more years old, it should be given 1 month after 1st dose and the third dose should be given to children aged 15 or more after 5 months of the second dose.
At 10 Years 6 months:
HPV2 : The second dose of Human Papilloma Virus vaccine is given at this age.
Vaccines can help limit the spread of antibiotic resistant diseases. Vaccinating humans and animals is a very effective way to stop them from getting infected and thereby preventing the need for antibiotics. — WHO
Price of Vaccines
Price of the vaccine may vary depending on the location or the brand. Here is an approximate rate of the vaccines that children of this age group should receive: Varicella : 1900
DTP +HiB : Rs. 600/- IPV : Rs. 700/- PCV : Rs. 3800/- MMR Booster : Rs. 500/- HepA : Rs. 1400/- Typhoid : Rs. 300/- HPV : Rs. 3200/-
Mandatory Vaccines for children of this age group:
Even if you’ve immunised your baby in the first year of her life, there are still a number of serious diseases that can be potentially harmful to her.
For many of these life-threatening diseases, prevention is better than cure.Considering these fatal or highly contagious illnesses, Government of India has declared the following vaccines as mandatory for the age group of 1-10 Years old children:
- Highly recommended
Though not mandatory as per the immunization schedule, the following vaccines are highly recommended:
- PCV: as Pneumococcal Conjugate Vaccine, it can prevent troublesome infections like pneumonia, blood or ear infection, etc.—major causes of illness and death in children. Around 2 million children die from pneumonia around the world, while 19% of the world’s death from pneumonia occur in India.
- Typhoid: as it causes high fever, weakness, stomach pain, and if left untreated, it can be fatal. Around 21 million people catch typhoid across the world in a year of who nearly 2 lakhs succumb to death.
- Chickenpox (Varicella): as the illness is highly contagious
- HPV: HPV causes cervical cancer. 1/3rd of the world’s cervical cancer death happen in India.
Can I skip the Optional Vaccines?
By classifying some of the vaccines as optional, the govt. has left it to your physician and you to decide if these are needed or not.
Although these vaccines are safe and effectively prevent diseases, the govt. has kept them out of the schedule due to the lack of their availability or affordability.
However, it is always better to prevent vaccine-preventable diseases through immunization than to risk catching the diseases. Before taking a call to skip an optional vaccine or not, consider the following conditions:
- The mortality rate of the disease
- How prevalent the disease or the infection is in the country
- Morbidity of the disease
Thinking through your decisions well can not only save your child from a debilitating disease but also help the world deal better with these diseases.