Vaccine Myths shattered !

In this modern era of Internet and net savvy parents, many of these concerned parents have some queries / objections regarding vaccines.

These are increasing on a daily basis due to many factors, including increasing number of newer vaccines, newspaper / media reports (generally factually incorrect, I may say) regarding potential side-effects, and genuine concerns regarding the effect of so many vaccines on the child's immune system.

I would like to shatter a few of the common misconceptions regarding vaccinations using this forum.

Myth: it’s better to develop natural immunity then get vaccinated.

Fact: the difference between vaccination and natural infection is the price paid for immunity. The price paid for natural immunity (infection) is the physical economical & mental agony the entire family goes through after one suffers from a disease. In comparison price paid for vaccination is negligible. Also it is important to remember that many of the diseases that we getting protected against can actually cause a large number of complications including death of a child. In fact thousands of children die in India every year due to vaccine preventable diseases, hence getting a vaccination done is preferable to allowing 'natural immunity' for most diseases.

Myth: by relying on vaccines, my child’s immune system becomes weak or does not develop at all.

Fact: No, vaccine do not weaken immune system. People generally believe that vaccines offer ready made protection. This is NOT the case. In fact the vaccines work like a 'mini-disease'. The body acts on vaccine germs and produces antibodies, which fight against disease germs when the child comes in contact with disease any time in future.

Myth; vaccines are known to cause serious side effects.

Fact: In most cases, vaccines cause no side effects or only mild reactions such as fever or soreness at the injection site. Very rarely, people experience more serious side effects like allergic reactions. Be sure to tell your doctor if your child has had any severe reaction to previous vaccine, or has health problems or known allergies to medications or food.

“Vaccines”- Yes But how many ?

As you know, prevention is always better than cure. Fortunately, due to progress in vaccine science & technology, it is possible to protect children against several serious diseases through vaccination; normally a baby is exposed to millions of germs daily. It is much better to protect them against diseases through vaccination then let them be at risk & suffer.

Myth: My child does not require vaccines, as he/ she is healthy, active & eats well.

Facts: vaccination is intended to help keep kids healthy, because vaccines work by protecting the body before disease strikes. If you wait until your child gets sick, it will be too late for the vaccine to work. The best time to immunize kids is when they’re healthy.

Myth: Combination vaccines cause more side effects.

Fact: Combination vaccines are as safe & effective as individual vaccines there are two practical factor in favor of giving a child several vaccines during the same visit. First, to immunize children as early as possible to give protection during the vulnerable early months of their lives.

Second, giving several vaccines at the same time will mean fever clinic visits & fewer injections, which saves parents both time and money and may be less traumatic for the child. There are studies done that show that the discomfort caused is less with combination vaccines as compared to individual shots.

Just think - what would you want for yourself - 3 injections separately or a single injection containing all 3 vaccines ?

Myth: It’s OK to skip certain vaccine.

Fact: In general skipping vaccines is not a good idea. This can leave your child vulnerable to potentially serious disease that could otherwise be avoided. If you have reservations about any particular vaccine, discuss your concerns with your child’s doctor, if your child falls behind the standard vaccination schedule, catch-up vaccination is also available.

Myth: If I have missed a dose of any vaccine, it is no longer needed later

Fact: For most vaccines, if the dose is missed on the due date, you still need to take it at any later date (catch - up vaccination). Talk to your doctor regarding when these doses should be completed.

Myth: Vaccine may not be 100% effective; so why vaccinate?

Fact: Vaccines indeed are the most effective weapons we have against diseases. They work in 85% to 99% of cases. Smallpox has been eradicated from the face of earth & a dramatic reduction in the incidence of diseases like Polio, Diphtheria, Pertussis, Measles & Mumps are evidence of power of vaccines. Vaccine failure is rare & in such a case the disease is usually milder.

Myth: vaccines are for babies only. There is no need to vaccinate after 2 to 4 years of the age.

Fact; Diseases continue to affects school going children, adolescents & adults. It is always better to keep your child protected. Few vaccines (like DPT) do not provide life long protection. Protective efficacy of these vaccines wanes off over a period of time so regular boosters are required.

There are some new vaccines (like HPV) for adolescent girls to prevent Cervical Cancer. Some vaccines (like Flu) need regular vaccination as the virus keeps changing. For most of the vaccines age is not a barrier. Ask your doctor if you have missed any vaccine as you can always catch-up.

A friendly reminder for parents:

Adults need vaccination too! Check with your doctor to know what vaccines you might need. Your baby is counting on you.

Source:

Vaccination Information Pamphlet by GSK

Vaccination health news from India - Depressing Statistics, Innovative solutions

That India ranks low globally in its rate of vaccinating its population probably comes as no surprise. In 2010, only 72% of Indian babies received the three doses of the DPT vaccine against diphtheria, tetanus and whooping cough. This was quite poor when compared to 95% for Bangladesh and 83% for Indonesia. The reason for this dismal statistic has been attributed to weak, decentralized public health infrastructure and inadequate monitoring. And so, in a bid to make sure that there is extensive coverage of babies that would require vaccination, India's health minister has come out with a new initiative. This would involve collecting mobile phone numbers of all pregnant mothers to monitor their babies' vaccinations. While this project has already begun, the quantum of funds invested for this project is not known. That said, one wonders whether this plan will really solve the problem that confronts India. For starters, there could be discrepancies in the mobile numbers themselve s, a problem that the health ministry is also facing. What India could probably do is make healthcare a priority at the Centre rather than relegating it to states.

What's new in the latest 2011 Immunization Schedule for Indian Children by the Indian Academy of Pediatrics?

The Indian Academy of Pediatrics (IAP) is the parent body of more than 16,500 pediatricians (as of 2007) in India, and is responsible for establishing standardized guidelines for various childcare issues. The latest guide-lines provide some important changes that child specialists and parents need to be aware about, regarding vaccination of their children.

Here is a list of altered recommendations in the 2011 guidelines

1. Hepatitis A has been rightfully preponed to age 1 year (from 1.5 years previously) for the first dose. The second dose is 6 months after the first dose.
2. An additional dose of Chicken Pox vaccine (Booster) is recommended at 5 years age. This is probably as per the US guidelines, and due to the fact that lots of breakthrough cases were being witnessed after CP vaccination. For children who have not taken CP vaccination, two doses can be given at three months interval. Adults above the age of 13 years can take two doses at a month gap.
3. MMR booster is now clearly recommended at 5 years. While this is the same recommendation as before, the fact that soon a combination vaccination of CP & MMR is likely to be made available in India, would make this a more convenient option.
4. The confusing recommendation of some (newer, more expensive) vaccinations to be given after"one to one" discussion with parents has been removed. This makes it easier for pediatricians to recommend the vaccines, and the parents to decide as per their paying capacity (since we do not have Insurance cover for vaccines in India yet), about the decision to take the vaccine or not.

This appears to be a well thought out, comprehensive and scientific set of recommendations that have simplified the Immunization guidelines for Indian Children. Parents should take printouts of this guideline and encourage their pediatricians to follow the same, since vaccination schedules tend to vary across India.

The guidelines are not only less confusing, but also have moved towards International standards now, making it easier to vaccinate children in this era of global movement.

Suggested Reading

IAP 2011 Immunization Boooklet

What are some good Internet Resources for Information about Newer Vaccines?

I understand the need for getting the latest unbiased information about the newer vaccines, since many mass media (like newspapers, TV channels etc.) are filled with horror stories regarding drugs and vaccines. Most of these reports, at least in the Indian media, are sensationalized, over simplified and have inaccurate conclusions with the intention of boosting sales. These lead to avoidable panic, and sometimes serious delays in providing appropriate vaccinations to children.

However since the internet is a very democratic medium, and virtually anyone can (& does) provide their opinion online, it can be tough for a parent to search for accurate information online. Here are a few websites that provide excellent, well researched and peer -reviewed information (checked by experts) online.

1. Indian Academy of Pediatrics - Committee on Immunization - provides latest recommendations for vaccinating children in India.
2. WHO - Immunization - WHO Position papers on vaccines
3. CDC - Vaccination
4. Immunization Action Coalition - Educational material for parents
5. Children's Hospital of Philadelphia - Information for parents, especially regarding vaccine safety
6. PATH - Excellent updated information about vaccination from different resources
7. National Network for Immunization Information

Suggested Reading

IAP Guide book on Immunization 2011 (Page 161)

Latest Indian Academy of Pediatrics (IAP) recommendations 2011 for vaccinating children in India

Iap Guide Book on Immunization Iap Immunization Time Table 2011

Finally we have the latest guidelines from the Indian Academy of Pediatrics, the official & the largest body of Pediatricians in India.

Unfortunately, in India a lot of Pediatricians, especially from the smaller cities and towns seem to be following somewhat random schedules, that are not only outdated but may lead to decreased vaccine efficacy.

I would encourage parents to download this chart, and use this as a guide for getting their children vaccinated in India

Hepatitis A - the common Jaundice

Most of us in India are aware of and have probably been vaccinated against hepatitis B. Given the fact that so many of us are protected from hepatitis B, have you ever wondered why we still have so many cases of jaundice especially in the months of summers and monsoons?
The reason is jaundice due to poor food, water and sanitation, meaning hepatitis A and hepatitis E virus.

The most important thing to realize that taking hepatitis B vaccination will not protect you against these forms of jaundice since they are caused by a different virus.

Today we are going to talk in some more details about Hepatitis A.
Hepatitis means inflammation (swelling) of the liver. While there are many infections that can cause this, in India the commonest cause in children and one of the most common causes in adults is Hepatitis A. Hepatitis A virus is spread from person to person by putting something in the mouth that has been contaminated with the stool of a person with hepatitis A. This type of transmission is called fecal-oral. For this reason, the virus is more easily spread in areas where there are poor sanitary conditions or where good personal hygiene is not observed. Casual contact, as in the usual office, factory, or school setting, does not spread the virus. Persons with hepatitis A virus infection may or may not have any signs or symptoms of the disease. Older persons are more likely to have symptoms than children. If symptoms are present, they usually occur abruptly and may include
• fever,
• tiredness,
• loss of appetite,
• nausea,
• abdominal discomfort,
• dark urine, and
• jaundice (yellowing of the skin and eyes).
Symptoms usually last less than 2 months; a few persons are ill for as long as 6 months. The average incubation period (i.e., time taken from transmission from one person to the other) for hepatitis A is 28 days (range: 15–50 days).
The diagnosis cannot be made without doing a blood test (IgM Hepatitis A antibody- cost approx. Rs. 600/-), since the symptoms of all types of hepatitis are the same. Other tests like the liver function tests are useful in finding out the extent of the disease. The good news is that once you have the disease, you develop antibodies that provide life-long protection from future infections. After recovering from hepatitis A, you will never get it again and you cannot transmit the virus to others.
Treatment is essentially supportive, and with adequate rest and minimum use of anti-fever and anti – vomiting medicines a patient should generally recover within 15- 30 days. However 15 % of patients (mostly adults) may have a prolonged course of illness lasting even as long as 6-9 months!
Prevention rests on maintaining a good personal hygiene. Always wash your hands after using the bathroom, changing a diaper, or before preparing or eating food. Avoid outside food and water especially food that is undercooked/ uncooked (like salad etc.). Since proper food and water in India is still a pipe-dream, a more feasible way is to take the Hepatitis A vaccine. This is a very safe and highly effective vaccine (more than 90 % effective) with no major side-effects. It can be given to anyone above 1 year of age. Two doses are needed for life long protection and these need to be given 6 months apart. The vaccine is effective a month after the first dose is given.
With proper cooking habits, care about water and outside food and proper vaccination at the right time, we can ensure that we do not have to suffer Hepatitis A disease.
Dr. Gaurav Gupta, Consultant Pediatrician, practicing in Charak Clinics, Phase 7, Mohali.

Influenza Vaccine - Now Available for season 2009 -2010 in India - FAQs

Influenza (also called "the flu") is a viral infection in the nose, throat and lungs. About 10 to 20 percent people get the flu each year. Some people get very sick. Tens of thousands die every year in India because of the flu and complications.

What are the Symptoms of FLU?

The flu may cause fever, cough, sore throat, a runny or a stuffy nose, headache, muscle aches and tiredness. Some people describe the flu as the worst cold of their life. If you get the flu, you should feel better after one or two weeks. But in some people, the flu leads to serious, even life-threatening diseases, like pneumonia. Some people are more likely to get the serious complications. A vaccine (the flu shot) is recommended for these high-risk people to protect them from the flu.

Who is at higher risk?

You have a higher risk of flu complications if you:

• Less than 5 years age
• Are 60 years of age or older
• Are a doctor, nurse or working in a hospital
• Have a lung problem, such as asthma or emphysema
• Have Diabetes
• Have a suppressed immune system
• Have a problem with your kidneys
• Have heart disease or other long-term health problems

If you are in any of these risk groups, you should get the flu vaccine every year.

Even if you're not at higher risk, you may want to get the flu vaccine so you don't get sick with the flu.

What is the flu vaccine?

The flu vaccine is an injection. It contains killed viruses. You can't get the flu from the vaccine because the viruses are dead. Instead, the vaccine protects you from the flu. When a "live" virus shows up, your defenses are ready. These defenses keep you from getting the flu. Because flu viruses change from year to year, you must get the shot each year to be protected.

When should I get the vaccine?

You should get the vaccine at the beginning of the flu season, sometime in September onwards. You can get the shot later in the year too, but because flu season usually begins in the winter months, it would be best to be protected before that time.

If I get a flu shot, can I still get the flu?

Yes. Even with a flu shot, you aren't 100 percent protected. Each year, the flu vaccine contains three different strains (kinds) of the virus. Depending on the strains used, the Flu vaccine is 70 to 90 percent effective in preventing the flu in healthy people under 65 years of age. If you're older than 65, the vaccine is less likely to prevent the flu. Even if you get the flu after the vaccine, your flu symptoms should be milder than if you didn't get the vaccine. You'll also be less likely to get complications from the flu.

Is the vaccine safe?

Yes. The flu vaccine is safe for all age groups over six months of age. There are very few side effects too. Your arm may be sore for a few days. You may have a fever, feel tired or have sore muscles for a short time. If you have a severe allergy to eggs, you shouldn't get the shot.

Do you take the FLU vaccine?

Yes, I have personally been taking the FLU vaccine for the last 3 years, ever since it was made available in India.

Will the vaccine be effective against swine flu?

As of now we do not really know, however we must remember that Seasonal Flu kills far more people than Swine Flu, and it is as serious a disease. For the high risk people mentioned above, taking this vaccine is a great way to reduce complications from this common disease.

Dr Gaurav Gupta

Child Specialist,

Charak Clinics, Phase VII, Mohali

91-172-5092585, 91-172-4663775

Rotavirus presentation

This weekend I had a interesting presentation on Rotavirus presentation in our local IAP (Indian Academy of Pediatrics) meet of Pediatricians of Chandigarh, Panchkula & Mohali tri-city.


What is the rotavirus? Just the commonest cause of diarrhea in children, killing more than 1 lakh children in India alone!


You can get the entire presentation here. It was fun to read up this disease, since in office practice I tend to not get in a lot of academic reading about specific illnesses. While I am using the presently only available Rotavirus vaccine (Rotarix by GSK), there were still a few surprises for me. The large number of deaths worldwide caused by this virus were astounding, more so the fact (as you can read in the presentation ) that India has the largest number of deaths by far.


Since the presentation, I would probably be a bit more aggressive in suggesting this vaccine to affording parents with children under the age of 6 months. While the vaccination is at present slightly expensive (around INR 1,000 - 1,500 per dose), since it is imported and being marketed by a multinational, an Indian Rotavirus Vaccine is likely in the next few years, making a serious dent to the large number of preventable deaths due to rotavirus.

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