Vaccination. The best gift to your child

Unless you are a parent or a newborn, your knowledge of immunization is likely to be very scant.

I dare say many parents walk into motherhood without a clue of which injection comes first and why. Yet we all have tell tale signs on parts of our bodies, especially near the elbow and on our shoulders, that suggest we were immunized against one disease or the other.

Why immunize? According to Dr. Carol Nguru, a paediatrician at the Kenyatta National Hospital, “Immunization is a guard against some diseases that can attack a child and change their lives forever like polio, which can cripple the child.

Some diseases like chicken pox, measles and meningitis can be fatal if left to chance. Yet some naysayers against immunization are against taking a baby through all the pain of injections, arguing that people should just be cleaner. However, those voices have been drowned by what appears more useful and that is immunization.

This is a welcome development as it has been observed that thanks to immunization, some common childhood diseases have been drastically reduced or eradicated altogether, leading to reduced child mortality in the country.

How does it work? These injections are given to the baby in different parts of the body, at different ages and to guard against different diseases.

The following is the schedule of immunization for children born in Kenya, according to the Ministry of Health’s Division of Vaccines and Immunization plan for 2006 to 2010.

• BCG (Tuberculosis) and OPV (Oral polio vaccine) are given at birth. OPV is followed up at six, 10 and 14 weeks.
• DPT (Diphtheria, Tetanus and Pertussiswhooping cough) together with HepB (Hepatitis B) and HiB (Heamophilus Influenza type B) are given at 6, 10 and 14 weeks.
• At nine months, the child is immunized against Measles, Mumps and Rubella as well as yellow fever. (Yellow Fever is only for the children living in high risk areas which are typically places with mosquitoes).

Because these injections are always subject to change with improvements in healthcare in the country, you should seek the advice of a doctor on how to go about it. However, one thing remains constant; your child must be immunized to enhance his quality of life. For instance, PCV (Pneumococcal Conjugate Vaccine) which guards against Pneumonia, a leading child killer, was introduced recently.

What if I forget about or delay immunizations?
Dr. Nguru advises against skipping a date with the doctors for immunization saying: ‘Should the immunization schedule be skipped for some reason, it may be resumed at any time. However , it is best that parents keep the schedule.

However, have the immunizations at the correct time, as the earlier the child is protected, the better. Some exceptions to this rule are:

• Pertussis Vaccine is not usually given to children over the age of seven years.
• Meningitis C Vaccine (MenC). If the child starts immunization over the age of 4 months, then only two doses of MenC are needed, four weeks apart. If the child is over 1 year old and has not had any previous doses of MenC then only one dose is needed.
• Hib vaccine. If the child is over 13 months but less than four years, and has not had any previous doses, then only one dose is needed. Hib is not given to children aged over four years, as the risk of infection from this bacterium is much less than in young children and babies.
• Pneumococcal Conjugate Vaccine (PCV). If a child between the ages of 1and 2 years has not had any previous dose of PCV, or only had one previous dose, then a single dose of PCV should be given. Children aged over two years and who are not in an at-risk group do not need to be immunized.

Who should NOT be immunized?
There are very few reasons why children should not receive their full course of immunizations. Immunizations are generally safe and effective. Some of them are:

• If the immune system is not working properly, then some vaccines are not given. For example, in children with HIV infection, children undergoing chemotherapy or who are receiving high doses of steroids.
• If a child has previously had a severe reaction to the same vaccine.
• See the separate leaflets on the individual immunizations for more details.

Which diseases are prevented with childhood immunizations?
Diphtheria is caused by the bacterium Corynebacterium diphtheriae. It causes a serious throat and chest infection. Since immunization was started in the 1950s, diphtheria has now become rare in the UK.

Haemophilus Influenzae type b (Hib) is a bacterium which can cause pneumonia and meningitis. Children under the age of 4 are most at risk. Before the introduction of the vaccine in 1992, 1 in 600 children developed some form of Hib disease before their 5th birthday. It is now rare.

Measles is caused by a virus. It causes a miserable feverish illness with a rash. Complications occur in some cases such as Pneumonia, convulsions or Encephalitis (brain inflammation). Before the introduction of a Measles vaccine in 1968, it was a common childhood illness. It is now rare in the UK although the incidence of measles is increasing in some areas due to some children not being immunized.

Mumps is caused by the mumps virus. The infection typically causes inflammation and swelling of the salivary glands.

Complications occur in some cases such as Pancreatitis, Orchitis (inflammation of the testes), Meningitis and Encephalitis (inflammation of the brain). Mumps may cause permanent deafness in one ear.

Rubella (German Measles) is caused by the rubella virus. It causes a mild illness with a rash. However, if a pregnant woman has Rubella, the virus is likely to cause serious damage to the unborn child. The child is likely to be born with multiple defects (Congenital Rubella Syndrome).

Meningococcus group C is a bacterium (germ) which is one of the causes of Meningitis and Septicaemia (severe blood poisoning). There are other types of Meningococcus, but cases of Meningitis and Septicaemia caused by group C have fallen since immunization was introduced.

Pertussis (Whooping Cough) is caused by a bacterium called Bordetella pertussis. This causes a prolonged and distressing cough. Some infected children develop complications such as Pneumonia or brain damage.

Pneumococcus is a bacterium which can cause Pneumonia, Meningitis and some other infections. Pneumococcal infection can affect anybody. However, young children, people aged 65 and over, and some other groups of people are at increased risk of pneumococcal infection.

Poliomyelitis (Polio) is an illness caused by the polio virus. The virus first infects the gut, but then travels to the nervous system and can cause a meningitis-like illness. This may damage some nerves. This may lead to wasting of muscles and sometimes paralysis of one or more of the limbs. The illness can seriously affect breathing in some people and may even lead to death.

Tetanus is an infection caused by a bacterium called Clostridium tetani which is found in the soil. It causes severe and agonizing muscle contractions and is often fatal.

Human Papillomavirus (HPV) is a virus that can affect the skin and mucosa (the moist membranes lining different parts of the body, including the mouth, throat and genital area). There are over 100 different types of HPV and about 40 of these can affect the genital area. Two types, HPV 16 and 18 are involved in the development of most of the cases of cancer of the cervix. The HPV vaccine is very effective in stopping cancer of the cervix from developing.

How does immunization work?
The body is given a vaccine which is a small dose of an inactive form of a bacterium or virus (germ) or a toxin (poison) made by the germ. As it is inactive it does not cause infection. However, the body makes antibodies and/or immune cells (white blood cells) against the germ or toxin. Antibodies are proteins in the bloodstream that attack infecting germs. Once we are immunized, the antibodies and/or immune cells are ready to attack the germ if it begins to invade our body. More antibodies can quickly be made from cells, which have previously made the particular antibody.

It has been difficult to produce a vaccine for some bacteria and viruses, but technology is advancing and new vaccines will be available in the future.

A newborn baby has passive immunity to several diseases such as Measles, Mumps and Rubella, from antibodies passed from its mother via the placenta. This passive immunity usually lasts for a few weeks or months. However, for Measles, Mumps and Rubella it lasts up to one year. Immunization with vaccines is called active immunity and provides long-term immunity. You may not think about it, but immunizing your child is probably one of the wisest investments you could make for your child.

END: BL 40 / 26-28