6 May 2012

Childhood immunisations (Medical students)

National immunisation schedule
  • Infancy - "five-in-one" - diphteria, tetanus, polio, pertussis, HiB
  • 1-2 years - MMR (measles, mumps, rubella) and hepatitis B
  • Later - HPV (human papilloma virus)
Others (available in private sector)
  • Conjugated pneumococcal
  • Meningococcus B
  • Meningococcus A, C, W, Y
  • Rotavirus
  • Hepatitis B
  • Varicella
Common side effects – fever, pain, swelling within 24 hours for most vaccines; MMR may give fever and rash after 5 days.

Rare, serious side effects – febrile convulsions, anaphylaxis (adrenaline should be available when giving vaccines).

Give paracetamol to control symptoms (fever or pain) (not prophylactically), as paracetamol has been shown to decrease the immune response to the vaccine and most vaccines do not give any side effects anyway.

MMR and Varicella are live vaccines. Can be given safely if the child has egg allergy. Can be given on the same day or after an interval of at least 4 weeks.

Can you identify the diseases/complications shown in the picture below, all of which are preventable by vaccines? (answers below).

  • Top: Diphtheria, tetanus, polio, pertussis.
  • Middle: Hib epiglottitis (Haemophilus influenzae also causes meningitis), mumples, measles (SSPE), congenital cataract in congenital rubella syndrome.
  • Bottom: Pneumococcal lobar pneumonia (Strep pneumoniae is also a cause of meningitis and otitis media), chickenpox, meningococcal septicaemia (Neisseria meningitidis is also a cause of meningitis), rotavirus GE.