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Pharmamum’s Ultimate Guide: Immunisation
There has been a lot of discussion recently regarding immunisation. In Australia, over 90% of children are fully vaccinated, so we are doing a great job, however we need to ensure that we continue to maintain high levels of vaccination in order to eradicate serious diseases. In this post, I want to answer a lot of questions regarding vaccines and allay some common myths to put your minds at rest. If you have any questions please don’t hesitate to ask.
Firstly, congratulations for being committed to your child and community’s health because going to the health centre or GP at 2 months, 4 months, 6 months, 1 year and 18 months of your child’s life can be painful (literally). It seems like we are forever taking our child to get another vaccination, where your child screams the place down, and looks at you like you are torturing them. However once you collect your thoughts you realise you are saving your child’s life from serious diseases and for a little discomfort, the benefits of immunisation far outweigh the negatives.
1. My baby is so young, won’t I be over stimulating their immune system by vaccinating them?
Healthy people have the ability to mount a response to every infection they encounter. Vaccines stimulate our defence mechanism that provide protection against specific diseases. Children’s immune system begin developing inside their mother’s womb and continue to mature after birth. Whilst our newborn’s immune system is developing they are being protected by the circulating antibodies from their mothers, against many, but not all serious infections. The protection usually lasts for approximately four months and that’s why the national immunisation programs stagger the vaccines after birth to cater for our baby’s developing immune system. In comparison to what babies encounter everyday, putting their hands in the mouths, picking up toys and putting them in the mouths, older siblings coughing and sneezing over babies all stimulates their immune system much more than the small number of antigens found in vaccines.
2. What are the side effects I should expect after each childhood vaccination?
The most common side effect from each vaccine include fever and pain at the injection site, these usually occur for 2-3 days after the vaccine however, some vaccines can cause side effects that can occur even up to three weeks after a vaccine ie the MMR (Measles,Mumps,Rubella) vaccine can potentially cause for 7 to 10 days after vaccination: fever (can be over 39°C), faint red non-infectious rash, drowsiness, runny nose, cough or puffy eyes and swollen salivary glands. The MMRV (Measles,Mumps,Rubella,Varicella-chickenpox) vaccine can also cause the above, as well as a mild rash like chickenpox for about 5 to 26 days after the vaccination. If you notice your child has a papular rash after the varicella (chickenpox) vaccine, which typically consist of 2 to 5 lesion or commonly at the injection site, this can occur in 5% of babies and typically 8 days after the vaccination. Those spots should be covered by a band-aid to reduce the risk of transmission.
Many vaccine injections may result in soreness, redness, itching, swelling or burning at the injection site for one to two days. Paracetamol might be required to ease the discomfort.
I remember with my eldest daughter at her 2 month old vaccination, my friends in my mother’s group told me their child slept for a couple of hours after the vaccine whereas with my daughter she had a very short unsettled sleep following the vaccine and it wasn’t until I gave her a dose of Paracetamol that she settled calmly. My personal experience with both my daughters I noticed that each vaccination was received differently. Sometimes you wouldn’t have known that they had a vaccination that day and other times it was really evident ie fever, irritability, redness and soreness around the site, and ‘flu like symptoms’ with a rash occurring a week or so after.
If the side effect following immunisation is unexpected, persistent or severe or if you are worried about your child after a vaccination, see your doctor or immunisation nurse as soon as possible or go directly to a hospital.
3. Should I give my baby/child Paracetamol before the vaccine?
Routine use of paracetamol before each vaccination is not recommended, if fever is present after the vaccination paracetamol can be given. However, there is always an exception to the rule and that is:
i) with a new vaccine called Bexsero. Bexsero is a new Meningococcal group B vaccine available on the private market since March 2014. ( I will discuss this new vaccine in more detail later)
ii) routine use of Paracetamol to prevent fever at the time of vaccination, is recommended for children with a history of febrile seizures.
With both of my girls, I noticed with some vaccinations, they needed Paracetamol a few hours later when they became warm with a fever and irritable, and other times, the vaccine may have caused them to feel warm but not bothered and so I held off giving them Paracetamol and they were fine.
4. I heard there are additives like aluminium and preservatives that contain mercury in our vaccines, is this true?
With regards to Aluminium, aluminium salts are added to enhance the immune response to vaccines and the amount of aluminium is lower than everyday intake from diet.
In the past preservatives were required to prevent bacterial and fungal growth if the vaccine was produced in a multidose vial for mass vaccination and often the preservative used was a mercury based product called thiomersal. In practice preservatives are no longer used in Australia because the vaccines are now produced in single-use sealed vials, so to answer your question, there is no mercury in vaccines.
5. I believe getting my child vaccinated is unnatural and I’d rather my child catch the viruses to build an optimal protection against them. Do you agree?
The truth is, catching some of these diseases can have some very serious consequences that being, losing a limb, paralysis or even death. Fortunately we live in a society that we haven’t been subjected to epidemics or pandemics of diseases that kill off millions of people. If you speak to parents and grandparents they will know somebody that suffered with polio or diptheria and witnessed their peers with legs in braces or brain damage from measles etc. They saw first hand, how devastating these diseases could be. Diseases like meningitis and tetanus kill, whereas a vaccine may give minor side effects that mainly being, sore and hot around the injection site and mild fever or even ‘cold like’ symptoms.
Choosing to vaccinate uses a persons natural response to stimulate their immune system so that if a child comes in contact with disease they have been vaccinated against, their bodies ‘will remember’ that virus/bacteria and mount an effective response to stop the diseases or if it does develop, suffer with a much milder case.
6. I breastfeed, won’t my baby be getting my immunity through breast milk?
The protection a child gets from their mother is not sufficient to protect a baby from getting all infections. It does also depend on the mothers exposure to the actual disease or whether the mother’s vaccinations are all up to date. So for example pertussis (whooping cough), generally only passes on minimal protection to the baby and the low amount that is transferred rapidly declines during the first few weeks leaving the infant vulnerable to infection if they are exposed to it. That is why we are seeing babies contracting this illness more frequently these days and its very important that parent and grandparents who are going to have close contact with their newborn child/grandchild be immunised against this particular disease. Whereas another disease like measles, the antibodies transferred to a baby from their mother may have enough protection for the first year of their childs life.
7. Will vaccines make my childs eczema or asthma worse?
Usually the contrary, it is highly recommended that an asthmatic child be given all vaccines, as catching a disease like whooping cough or influenza can severely exacerbate asthma.
In some people vaccines or their components can cause an allergic reaction, the risk is low, approximately 1 in a million. However components of vaccines which can trigger an allergic reaction are gelatin,yeast, egg protein. If your child is highly allergic to these things, it is important to contact a specialist immunisation clinic, pediatrician or infectious disease specialist.
8. My child has an egg allergy, can they still be vaccinated?
There are two vaccines that are thought to contain traces of eggs that is the Measles, Mumps and Rubella vaccines and flu vaccines. However the measles and mumps viruses for vaccines are grown in chick embryo cell lines not in eggs. It is now recognised that measles and mumps containing vaccines ie MMR and MMRV contain negligible amounts of egg protein and can be given to children with egg allergy even with anaphylaxis to eggs.
The majority of influenza vaccine in use in Australia have only trace amounts of egg protein (less than 1 microgram per dose) and can safely be given to most people with egg allergy. However individuals with a severe allergy to eggs ie anaphylaxis should seek specialist advice.
9. Is it true that the mercury in vaccines cause autism?
This has drawn a lot of attention in the media recently and it has finally been put to rest.The first systematic international review of childhood vaccinations led by researchers from the University of Sydney has found no evidence of a link to the development of autism or autism spectrum disorders (ASDs).The comprehensive review involving more than 1.25 million children, revealed no statistical data to support a relationship between childhood vaccination for the commonly-used vaccines for measles, mumps, rubella, diphtheria, tetanus and whooping cough and the development of autism or ASDs.There has been on-going talk of the MMR vaccine being linked to Autism. This was due to one published study that has since been retracted due to the data being fraudulent.
Since 2000, vaccines available on the national immunisation program in Australia have not contained the mercury containing preservative called thiomersal. Some vaccines like pneumococcal, MMR and other live vaccines never contained Thiomersal.
10. Is it true that vaccinations in young children cause seizures?
Febrile convulsions are a fairly common response to fever (Febrile convulsions are pretty common, occurring in about 4% of children between the ages of six months and five years). Since fever is a well documented side effect of vaccines it is not unexpected that febrile convulsions may occur following a vaccine. The risk is higher following certain vaccines ie influenza, MMR, MMRV and Meningococcal group B.
Latest information regarding vaccinations:
i)Meningococcal group B
In Australia the therapeutics goods of Australia (TGA) registered a vaccine called Bexsero, for prevention of Meningococcal group B in March 2014. It is available through the private market ( ie available from your GP) but not funded as yet on the National Immunisation Program (NIP). The two most common strains of meningococcal disease in Australia are strain B and C. (Globally there are 13 strains, most common ones are: A,B,C, W135, and Y.) Vaccination for Meningococcal C together with haemophilus influenzae type B is given as part of the national immunisation program at 12 months of age.
There has been a continual decline in meningococcal C disease since the introduction of the meningococcal C vaccine in 2003. Meningococcal disease can occur in any age group, but a large proportion of cases occur in those <5 years of age, with a secondary peak seen in the 15–24 years age group.In Australia, meningococcal disease in the <5 years age group,( particularly infants aged <1) is due predominantly to infection with meningococcal B, very few cases of meningococcal C disease are now seen in this age group.
Bexsero- (Meningococcal Group B vaccine) is registered for use in babies from 2 months. For infants less than 6 months, 3 doses of Bexsero are recommended 2 months apart plus a booster at 12 months. For babies less than 12 months, 2 doses of Bexsero are recommended plus a booster 2 months after the second dose. For children over 2 years old 2 doses are recommended with no booster required.
Bexsero can be given at the same time as the other vaccines recommended in the National Immunisation Program, however it is more common to suffer with fever therefore it is recommended to have a dose of paracetamol half an hour prior to having the vaccine.
ii)Varicella (Chickenpox) vaccine
In Australia at 18 months of age, babies get one dose of Varicella in combination with MMR. This is covered in the national immunisation program. Research is now showing that two doses of the Varicella vaccine will minimise the risk of breakthrough varicella, which is a milder case of chicken pox with fewer lesions than natural infection however, is still contagious. I do recommend speaking to your GP about a second dose of Varicella (chickenpox vaccine) as two doses are recommended for full coverage. You do need to wait 4 weeks after the first dose to have the second dose.
iii) In July, 2013, the scheduling of the national immunisation program changed slightly. Previously the chicken pox vaccine (Varicella) was the only vaccine given to children at 18 months, but since July 2013, at 18 months, a child will be given one injection containing the chickenpox vaccine together with the MMR (measles, mumps and rubella) vaccine. This means that the MMR booster has been brought forward from 4 years to 18 months. When it comes to your child getting their 4 year old vaccinations, they will only receive one injection (instead of two) that will contain Diphtheria/Tetanus/Pertussis/Inactivated Polio 4 from December 2015.
Please feel free to leave comments on this blog and if there are any questions I am more than happy to answer them. Also if you tried a remedy that worked well for your children that was or wasn’t mentioned above, let me know. I hope this information does help.