Wednesday 22 August 2012

Immunization in Children:

  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.