Why vaccinate your baby

Why vaccinate your baby?

All the diseases that your child is protected against are serious diseases and by immunising your child, you are also ensuring better protection for the population. 

How does Immunity Work? 

We get sick when our bodies are invaded by germs. For example the measles virus enters the body and gives us measles. Our immune system is meant to protect us from these germs. 

These germs enter our body and start to reproduce. Our immune system responds to these “invaders” by making proteins called antibodies. These antibodies help to destroy the germs that are making us sick. But as these germs are already in our body, we would already feel sick by the time our immune system has produced enough antibodies to destroy them. However by eliminating the attacking germs, antibodies then help us get well. 

Antibodies also have another job. They remain in our bloodstream, guarding us against future infections. So if the same germs ever try to infect us again even after many years, these antibodies will come to our defense. Now they can destroy the germs before they have a chance to make us sick. This process is called immunity. This is a very effective system to prevent future disease. 

How Do Vaccines Help? 

The idea behind vaccination is to give us immunity to a disease before it has a chance to make us sick. ​

​Vaccines are made from the same virus or bacterium (or parts of them) that cause disease. But in vaccines, they are altered so that they cannot cause illness. These vaccines containing the weakened or killed germs are introduced into our body, usually by injection. Our immune system reacts to the vaccine in the same way as to the disease, by making antibodies. Then they stay in our body, giving us immunity and hence afford protection against those diseases. 

This “immunologic memory” lasts longer for some vaccines than for others and sometimes re-vaccination is required to maintain protection. Immunisations therefore help the child’s immune system do its work. The child develops protection against future infections, the same as if he or she had been exposed to the natural disease. The good news is, with vaccines your child does not have to get sick first to get that protection. 

What are Some of the Diseases that are Preventable? 

  • ​Tuberculosis​ (TB) is caused by a bacteria that infects lungs, bones, brain, kidneys and intestines. We give the BCG at birth to protect against this disease. 
  • Hepatitis B​ is a virus that can lead to serious complications in adulthood, like chronic liver failure and even liver cancer. 
  • ​Diphtheria​ is a bacterial disease that starts in the throat and can cause obstruction to breathing and can also spread to the heart and nervous system. 
  • Tetanus is a bacterial disease that can get into the body from cuts in the skin. It produces a toxin in the body that begins with clamping together of the jaw, hence the old name “lockjaw”. It can also cause severe muscle spasms of any muscles including that of respiration and swallowing, leading to death in about 10% of cases. 
  • Pertussis​ (Whooping cough) is a bacterial infection that can cause coughing spasms that can result in vomiting, seizures, lung damage and even death in some cases. 
  • ​Poliomyelitis​ was the dreaded childhood disease of the 20th century. Polio is a viral infection that can be transmitted easily through consuming contaminated water or food. It typically affects young children with majority occurring under three years of age. Most have mild symptoms like fever, sore throat, but if the virus enters the brain and spinal cord, disease may result in paralysis and death. 
  • Hemophilus influenzae type B is a bacteria that can cause serious, often life threatening infections like bacterial meningitis, pneumonia or epiglottis which affects the windpipe, and can lead to brain damage or death.​ 
  • Measles is a virus that can cause chest infections, severe ear infections that can result in deafness, seizures and even permanent brain damage. 
  • Mumps is caused by a virus, which causes painful swellings of the salivary gland and fever. Its complications include meningitis, encephalitis, painful swelling of the testicles, deafness, and even death. 
  • ​Rubella is caused by a virus that is usually mild in adults but if it occurs in early pregnancy, can lead to miscarriage and congenital rubella syndrome. 
  • Chicken pox (Varicella zoster) is caused by a virus, which is spread by air-droplets and direct contact with fluid from blisters. It is contagious from 1–2 days before rash appears till 5–7 days later when it is totally dry. It is usually a mild irritating illness in the acute phase, but it can lead to serious complications like scarring, pneumonia, encephalitis and shingles. 
  • Streptococcus pneumoniae is a bacteria that is spread through respiratory droplets. It can cause pneumonia, bacteraemia and meningitis (especially in the <5 year olds). 
  • Rotavirus​ causes severe gastroenteritis (vomiting and diarrhea) in infants and young children worldwide. 

In Singapore, the National Childhood Immunisation Programme is based on recommendations from Singapore’s National Vaccine advisory committee and the World Health Organization. It is made up of the Childhood Vaccination Programme, which is conducted by the Family Health Service, hospitals and clinics; and the School Vaccination Programme which is conducted by the School Health Service. ​​​

​Childhood Vaccination Program​ 

​TIME OF VACCINATION ​VACCINE
​Birth​​- Hep B (Hepatitis B) 1st dose​
- ​BCG (Bacillus Calmette-Guerin)
​1 month​Hep B 2nd dose
​3 months​DTP-Polio (Diphtheria, Tetanus, Pertussis-Polio) 1st dose
​4 months​DTP-Polio 2nd dose
​5 months​DTP-Polio 3rd dose
​6 months​Hep B 3rd dose
​12–24 months​​MMR (Measles, Mumps, Rubella) 1st dose
​18 months​ DTP-Polio 1st booster


​School Health Program​ 

TIME OF VACCINATION​
 VACCINE​
​6–7 yrs
 ​– oral polio – 2nd booster
– MMR – booster
10–11 yrs ​– DT – 2nd booster
​– oral polio – 3rd booster​​


​Currently, some of these vaccines have been combined into a single vaccine so your baby can get the benefit of all these vaccines, and yet not require multiple injections. In other words, your child still gains the same protection from the vaccines, but there are fewer injections involved to achieve the same protection. 

There are also additional vaccines that are available, these include vaccines against chicken-pox, Haemophilus Influenzae B (Hib) bacterial infection, Streptococcus Pneumoniae and Rotavirus.

Common Types of Combination Vaccines Available in Singapore

​Diphtheria, Tetanus, Pertussis​Infanrix (GSK)
Diphtheria, Tetanus, acellular Pertussis​Boostrix (GSK)
aka 3-in-1
Diphtheria, Tetanus, acellular Pertussis, Polio,
H. influenzae
​Infanrix-IPV+HiB (GSK)
aka 5-in-1
Diphtheria, Tetanus, acellular Pertussis, Polio,
H. influenzae, Hepatitis B
​Infanrix Hexa (GSK)
aka 6-in-1

​

​Well Baby Vaccination Schedule Available in KK Hospital

​At birth
​BCG, Hepatitis B
​2 months​Diphtheria, Tetanus, acellular Pertussis, Polio, H. Influenzae, Hepatitis B (Hexa)
​4 months​Diphtheria, Tetanus, acellular Pertussis, Polio, H. Influenzae (5-in-1)
​6 months​Diphtheria, Tetanus, acellular Pertussis, Polio, H. Influenzae, Hepatitis B (Hexa)
​15 months​Measles, Mumps, Rubella (MMR), Varicella (Chicken pox)
​18 months​Diphtheria, Tetanus, acellular Pertussis, Polio, H. Influenzae (5-in-1)
​Optional​Pneumococcus Vaccine, Rotavirus Vaccine


​If you have any concerns/queries about immunizations, please discuss this with your doctor. 

When to delay immunization 

  • When your baby is born prematurely and weighs less than 2 kg. 
  • When the child is unwell, for example a high fever, then delay the immunization till the child is better. 
  • If the child is being assessed for a neurological problem, is being treated for cancer​ or has any disease that weakens the immune system, discuss this with your child’s doctor. 
  • Speak with your doctor if your child has had a serious reaction to any previous injection or has an allergy to eggs or anything else. 

Side effects of Vaccines 

The needle does cause brief pain, so it is normal for your baby to cry a little. Often this is just for a few seconds after the injection. Soreness, a slight redness and even a small lump are common, but this usually resolves on its own. 

It is also normal for a child to be a little more irritable for a few hours or even a day or so after the injection and there may also be a slight fever (<38°C) that tends to last usually 1–2 days. Your doctor may prescribe a small dose of paracetamol for pain or fever. 


Acknowledgement

Source: Dr TAN Thiam Chye, Dr TAN Kim Teng, Dr TAN Heng Hao, Dr TEE Chee Seng John, The New Art and Science of Pregnancy and Childbirth, World Scientific 2008.