Dr Michelle O'Driscoll: What you need to know about Childhood vaccinations

Dr Michelle O'Driscoll: What you need to know about Childhood vaccinations

"Vaccination prevents your child from picking up a variety of serious illnesses, and also protects society as a whole by halting the spread of these diseases." Picture: Stock

AS a parent to a new baby, the list of things you should be doing and need to remember can feel overwhelming.

The vaccination schedule for your little one in particular can be very daunting, and feel like you’re going blindly from visit to visit. This article breaks down exactly what vaccinations are recommended, what to expect, and how to prepare for them.

Background to your baby’s vaccines

The HSE Childhood Immunisation Schedule runs from two months to 13 months of age. It’s followed up with further vaccinations as part of the School Immunisation Schedule in later years.

Vaccination prevents your child from picking up a variety of serious illnesses, and also protects society as a whole by halting the spread of these diseases.

When your child is given a vaccine, their body responds by making antibodies, in the same way as if they had caught the disease but without getting sick. The antibodies that your child’s body makes then stay in their body to protect them against the disease. Most childhood immunisations protect up to 99% of the children who get them, but sometimes a child will not respond to certain vaccines.

When are the vaccines due?

As part of the childhood immunisation schedule, vaccinations are due for your baby at two, four, six, 12 and 13 months of age. They are given free of charge by your GP or nurse. The BCG vaccine for tuberculosis was provided at birth in maternity hospitals until 2015, but there has been a global shortage of supply since then.

It has since been recommended by The National Immunisation Advisory Committee (NIAC) and the Health Information and Quality Authority (HIQA) that the BCG vaccine does not now need to be given routinely to all children.

What vaccines are given?

The number and types of vaccines given at each visit vary, and are detailed here.

2 months: three injections, one oral vaccine:

6-in-1 injection (diphtheria, haemophilus influenzae b (Hib), hepatitis B, pertussis (whooping cough), polio and tetanus) MenB injection PCV injection Rotavirus oral drops

4 months: two injections, one oral vaccine:

6-in-1 injection (same as 2 months) MenB injection (same as 2 months) Rotavirus oral drops (same as 2 months)

6 months: three injections:

6in1 injection (same as 2 and 4 months) PCV injection (same as 2 months) MenC injection (new vaccine) 12 months: two injections.

MMR injection (new vaccine) MenB injection (same as 2 and 4 months)

13 months: 2 injections:

The Hib/MenC injection (Hib was part of the 6-in-1 vaccine at 2, 4, 6 months. MenC was given at 6 months) PCV injection (same as 2 and 6 months).

The side effects of any of these vaccines are usually mild and self-limiting. Picture: Stock
The side effects of any of these vaccines are usually mild and self-limiting. Picture: Stock

Side effects of vaccines and how to deal with them

The side effects of any of these vaccines are usually mild and self-limiting. Your child may experience a sore leg or fever, and this can be a particular issue with the MenB injection at two and four months. For this reason, it is recommended you routinely give three doses of liquid infant paracetamol after each of these visits.

You should give one 2.5ml dose of infant paracetamol (60mg) immediately after receiving the injections, a second dose four to six hours after the first dose, and a third dose four to six hours after the second dose. You have the option of giving a fourth dose four to six hours after the third dose if you feel your baby needs it. For subsequent visits at six, 12 and 13 months you are no longer routinely advised to give three doses of paracetamol because your child either doesn’t receive the MenB, or they’re older and less prone to its side effects.

If they have a high fever over 39C, or seem distressed after these visits you can give them paracetamol or ibuprofen according to their dosing instructions on the package for their age, and keep them hydrated with milk or cooled boiled water.

For the MMR vaccine (measles, mumps and rubella) at 12 months, your child may present with “mini-measles” in the form of a rash six to 10 days after the injection, or “mini-mumps” in the form of swollen glands three weeks after the injection. These are nothing to worry about, and are signs that the body is responding to and remembering the vaccines. They are not contagious and can’t be passed onto others.

The rotavirus oral vaccination can cause loose stools and upset tummy, and it’s advised to be extra thorough with your handwashing technique after changing and disposing of these nappies.

If your child becomes very unwell at any point post-vaccination and you’re worried about them, make sure to contact your GP.

How important is the timing of these vaccines?

The closer you stick to this vaccination schedule, the better protection your child will have. There are very few reasons to delay vaccination. Even in this ongoing COVID19 pandemic, doctors are urging parents to adhere to vaccination schedules to prevent outbreaks of these diseases.

If your child has a high fever it is advised wait until your child is better before attending for vaccination. However, infants and children with minor coughs and colds, or those on antibiotics, can go ahead with immunisation.

The MMR vaccine at 12 months should be delayed if your child is on high-dose steroids, is having chemotherapy or radiotherapy, or has an illness or disease that affects their immune system.

For vaccines that are delayed, most can be given at a later stage, with some exceptions eg. the rotavirus oral vaccine cannot be given after eight months of age, due to an increased risk of a blocked gut.

A child who misses one injection in a course of injections does not have to start again. Talk to your doctor in these cases about the best course of action.

Things to remember on the day

So you’ve educated yourself about the vaccination process, and the day has come. How do you prepare?

Dress your child in loose comfortable clothing, with easy access to their thighs — a baby-gro for younger babies is ideal.

Buy infant liquid paracetamol in advance, and bring it with you with an oral syringe for those initial doses at two and four months. You can feed your baby as normal before and after vaccination, and during if you wish!

At their first vaccination visit, your child will be issued with an immunisation passport to document details of all vaccinations received. Keep this in a safe place, and remember to bring it to each subsequent visit.

And finally, be prepared for a few tears (from parent and baby!) but while you’ll remember it, they won’t! And they usually stop as quickly as they start, so don’t worry!

The vaccination schedule for your little one in particular can be very daunting, and feel like you’re going blindly from visit to visit.

ABOUT THE AUTHOR

  Dr Michelle O’Driscoll is a Lecturer of Clinical Pharmacy in UCC, while continuing to work in the community pharmacy setting.

Her research lies in the area of mental health education, and through her company InTuition she delivers health promotion workshops to corporate and academic organisations nationally

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