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Immunization

1. The Schedule
The following schedule is recommended by the Indian Academy of Pediatrics

AGE
VACCINE
Birth BCG,
OPV -1st dose,
Hepatitis B Vaccine - 1st dose
6 weeks DPT - 1st Dose,
OPV - 2nd Dose,
Hepatitis B Vaccine - 2nd dose
10 weeks DPT - 2nd Dose,
OPV - 3rd Dose
14 weeks DPT - 3rd Dose,
OPV - 4th Dose,
6 - 9 months OPV - 5th Dose,
Hepatitis B Vaccine - 3rd dose,
9 months Measles vaccine
15 -18 months MMR(Measles, Mumps, Rubella),
DPT -1st Booster dose,
OPV -1st Booster dose
5 years DPT - 2nd Booster,
OPV - 2nd Booster
10 years TT(Tetanus Toxoid) - 3rd Booster dose,
Hepatitis B Vaccine - Booster dose
15 - 16 years TT - 4th Booster dose.

Note : Thought the gap recommended between first 3 OPV-DPT doses is 4 weeks, some delay(even upto 1 month) over this period should not cause any anxiety.

2. Diseases prevented by vaccines

Vaccine
Disease Prevented
BCG Tuberculosis
OPV (Oral Polio Vaccine) Poliomyelitis
DPT (Triple Vaccine) D: Diphtheria, P:Pertusis(Whooping Cough), T: Tetanus
Hepatitis-B Vaccine Hepatitis B
Measles Vaccine Measles
MMR Vaccine M:Mumps, M:Measles, R:Rubella
(German Measles)

3. BCG
Within 3-6 weeks (sometimes a few months) of giving BCG a small lump/redness will be seen at the site of injection (left shoulder). The lump may soften and subsequently rupture discharging pus. It may take few weeks for this ulcer to heal, leaving behind a scar. The ulcer should be kept clean with soap and water and kept dry. No ointment application is required. There may be an associated lump in the armpit or in some cases above the shoulder. If this lump increases more than 1 cm in diameter or becomes red or soft or attached to the overlying skin it would demand your doctor's attention. The lump may persist for months or years. If no reaction, or mark is seen at BCG injection site after 3 months, consult your doctor. BCG significantly decreases the risk of tuberculous meningitis(Brain TB) and other disseminated (widespread) forms of tuberculosis.

4.OPV
OPV given soon after birth is called zero polio. However it is counted as the first polio. Total of maximum 5 polio doses are administered in the first year of life. Over and above that 'pulse polio' doses are administered atleast twice in each winter to all children below 5 years of age, irrespective of number and time of previous polio doses. Additional doses of polio may be given in a particular area if a case of polio is found. Children should be given these doses when approached by municipal authorities.

5. DPT
Swelling and pain at the injection site and fever for upto 72 hours with irritability and \ or excessive crying is common. Paracetamol for 48-72 hours after DPT significantly reduces chance and severity of these reactions. Fomentation with ice wrapped in handkerchief helps to reduce swelling and pain to some extent.

6. Measles
Fever between 5-12 days, measles like rash, cough and cold are commonly seen post vaccination. These may occur singly or in combination. These do not need any treatment except paracetamol to control fever. A child may not experience any side effects at all.

7. MMR
Apart from side effects like those with measles vaccine, mumps like swelling of parotid and other salivary glands may be seen. However these are not the rule.

8. Typhoid
Considering the high incidence of typhoid in our country it would be worthwhile to administer this vaccine. Newer vaccines now available are administered as a single dose after two years of age. Boosters are necessary every 3 years. After the child is more than 8 years old a capsule preparation is available. This oral vaccine also needs to be taken every 3 years for continued protection. When whole cell killed typhoid vaccine becomes available in our country, it would be a much cheaper and effective alternative.

9. New Vaccines
Vaccines for meningitis, chicken pox and Hepatitis A are now available. Discussion on these vaccines is outside the scope of this booklet. Kindly discuss the need of administering these vaccines with your doctor.



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Disclaimer: All material provided at Breastfeedingindia.org is provided for educational and informational purposes only. Consult with your doctor regarding the advisability of any opinions or recommendations with respect to your individual situation.