Immunisation in children

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 vaccine.

Immunisation should be done with potent immunising agents to have expected results. These immunising agents may be as following:

1.     Killed suspension. For an example, cholera vaccine.

2.     Live attenuated vaccines. For an example. Measles,

3.     Mumps, and Rubella (MMR) vaccines

4.     Toxoid. For an example. Tetanus toxoid.

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

plastic bag in the icebox. The vaccines should be arranged according to their expiry dates for the better use.

Contraindications for the immunisation:

1.     An acute illness with fever.

2.     When the child is on immuno-suppresive drugs or on radiation.

A child suffering from leukemia, lymphoma or malignancy.

Precautions:

Immunisation with live vaccines should not be repeated before three weeks. A special care should be taken as advised for specific vaccination as follows:

1. B.C.G. vaccine:

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 injection.

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.):

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.

D. Typhoid Vaccine:

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 10 days.

E. Cholera Vaccine:

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.