Immunisation in children:
The important aspect in the child care, is to protect
children against specific preventable diseases. There are a few common
dangerous infections in the childhood which are preventable by immunisation,
such as, poliomyelitis, diphtheria, pertussis, measles, rubella, and hepatitis
B. The immunisations against these diseases stimulate the child's body to
produce immunity against specific infections.
The children with malnutrition have
low resistance to fight against the infection, therefore, children need timely
immunisation. All children have a right to get vaccines, protection against
preventable diseases. Extremely malnourished children may show severe reaction
to certain vaccines because they have low antibodies. For an example, measles
Immunisation should be done with
potent immunising agents to have expected results. These immunising agents may
be as following:
Killed suspension. For an example,
Live attenuated vaccines. For an
Mumps, and Rubella (MMR) vaccines
Toxoid. For an example. Tetanus
Maintaining a cold chain:
It is essential to maintain the
favourable temperature, with cold storage, to maintain the potency of vaccines.
The temperature should be around 2 o C to 8 o C. The vaccines should be kept
under me freezing compartment. The thermometer should be placed in the freeze
to confirm the validity. The door of the refrigerator should be opened as
minimum as possible.
During the transportation, the vaccines should be kept in a
container maintaining the cited temperature or may be kept in a
bag in the icebox. The vaccines should be arranged according to their expiry
dates for the better use.
Contraindications for the
An acute illness with fever.
When the child is on
immuno-suppresive drugs or on radiation.
A child suffering from leukemia, lymphoma or malignancy.
Immunisation with live vaccines should not be repeated
before three weeks. A special care should be taken as advised for specific
vaccination as follows:
B.C.G. vaccine is prepared in a powder form and can be
stored for six months. Before the use, it is dissolved with
normal saline. After dissolving it is used within 24 hours.
The usual dose is 0.1 ml. It is given on the left upper arm, intra dermal. Two
to three weeks after the vaccination, a papule appears. It may heal and a scar
may be fanned. Parents should be instructed not to put any thing on the site on
2. Polio vaccine:
Oral polio vaccine is prepared with the three types of live
attenuated polio viruses. Potency of this vaccine should be maintained by the
cold chain. Three doses are administered. The interval between two consequent
doses should be four to six weeks.
It is advisable to instruct the parents not to give any
thing by mouth, to the child about 30 minutes before and after the
administration of polio vaccine.
It is necessary to give polio vaccine to those children who
have suffered from the poliomyelitis, to protect them from the other two
viruses, against which they may not possess an immunity.
3. Diphtheria, Pertussis and Tetanus Vaccine
DPT. Vaccine contains toxoid of diphtheria and Tetanus
bacilli and dead bacilli of pertussis. It should be used within 10 days if kept
at the room temperature. The usual dose is 0.5 ml. It is administered deep
intramuscularly. The site for administration for the infants is best at upper
and outer middle one third of the thigh.
Pertussis vaccine is contraindicated, if the children have a
history of a convulsion. After the DPT. vaccination, children may experience
pain at the site of vaccination and may have moderate to high fever. The pain
and fever may be treated with the paracetamol. It is stored at 2 o C to 8 o C.
MAR. Vaccine is administered intramuscularly.
It is prepared with salmonella typhi and organism of
paratyphoid A and B. It is administered during the epidemic. The usual dose of
administration is 0.5 ml. and 1.0 ml. subcutaneously, at the interval of 7 to
It is prepared in a saline suspension of killed vibrio
cholera. It is administered in two doses of 0.5 ml. and 1.0 ml. epidermal at
the interval of three weeks.