IMMUNISATIONS

Below is the Nationl Immunisation Program Schedule for Australia:

Birth:  Hepatitis B, Vitamin K

2 months:  Diptheria/Tetanus/Whooping Cough, Hepatitis B, Hib, Polio, Pneumococcal

4 months:  Diptheria/Tetanus/Whooping Cough, Hepatitis B, Hib, Polio, Pneumococcal

6 months:  Diptheria/Tetanus/Whooping Cough, Hepatitis B (or at 12 months),Hib, Polio, Pneumococcal

12 months:  Hepatitis B (if not already given at 6 months), Hib, Measles/Mumps/Rubella, Meningococcal C

18 months:  Chickenpox

4 years:  Diptheria/Tetanus/Whooping Cough, Meales/Mumps/Rubella, Polio

WHAT IS IMMUNISATION?

Immunisation is a simple, safe and effective method of protecting children against certain diseases.  The risks from diseases are greater than the very small risk of side effects from immunising.

Immunisation protects a person against harmful infections before they come into contact with the germ that causes the disease in the community.  Immunisation uses the body’s natural defence mechanism called the immune response, to build a resistance to specific infections.

IMMUNISATION AND VACCINATION

Vaccination is a term used for giving a vaccine.  Immunisation is the term used for the process of both getting the vaccine and becoming immune to the disease, as a result of having received the vaccine.  Most people will use the terms interchangeably, even though their meanings are not exactly the same.  Immunity follows vaccination in most, but not in all cases.

HOW DOES IMMUNISATION WORK?

All forms of immunisation work in the same way.  When a vaccine is given, the persons body produces an immune response in the same way it would if the disease had been caught by the person.  If the immunised person then comes into contact with the disease that they have been immunised against, the body is able to make an immune response fast enough to prevent the person from developing the disease or from developing a severe form of the disease.    So in some cases, a mild form rather than a severe form of the disease will develop.

WHAT DO VACCINES CONTAIN?

Some vaccines contain a very small dose of a live but weakened form of a virus.  Some vaccines contain a very small dose of a killed inactive bacteria or small parts of bacteria.  Other vaccines contain a small dose of a modified toxin produced by bacteria.  Vaccines may also contain either a small amount of a preservative or a small amount f an antibiotic which preserves the vaccine.  Some vaccines will also contain a small amount of an aluminium salt, which helps to produce a better immune response.

HOW LONG DOES IT TAKE FOR AN IMMUNISATION TO WORK?

The normal immune response takes around two weeks to work.  This means that protection from an infection will not happen immediatel after immunisation.  Most immunisations will need to be given in several doses to build a long lasting protection, otherwise only partial protection will occur.

HOW LONG DO IMMUNISATIONS LAST?

The protective effect of immunisations is not always life long.  Some vaccines will last for years and others will need to be re administered every few years.

WHY DO BABIES NEED SO MANY IMMUNISATIONS?

A number of immunisations are required in the first few years of a child’s life to protect against the most serious of childhood infectious diseases.  The immune system in young childen does not work as well as the immune system in older children and adults, as it is still immature.

In the first months of life, a baby is protected from most infectious diseases by antibodies from his/her Mother, which are transfered to the baby during pregnancy.  When these antibodies wear off, the baby is at risk of serious infections and so the first immunisations are given before the antibodies have gone.

I’M BREASTFEEDING SO DOES MY BABY NEED TO BE IMMUNISED?

The answer is yes.  Breast fed babies should be immunised just the same as artificially fed babies.  Breast milk contains small amounts of antibodies,but this does not inerfere with the immunisation process.  Breast fed babies need to have vaccines because breast milk does not produce permanent protection, or specific protection against diseases.

HEPATITIS B

Hepatitis B is the very first disease that your baby will be immunised against.  It is given in the hospital soon after birth and then again at 2 months, 4 months and either 6 or 12 months.  Several doses of the vaccine are required to provide full protection.    The vaccine contains a modified part of the Hepatits B virus. Hepatitis B is a disease that can be contracted thoughout the lifespan.  Caused by a virus that will affect the liver.  Babies who have Hepatitis B may have no symptoms or may only have mild symptoms.  Babies are however at a much higher risk than adults of becoming a lifelong carrier of the virus.  Hepatitis B carriers may develop liver cancer or liver failure later in life.

POSSIBLE SIDE EFFECTS FROM THE HEPATITIS B IMMUNISATION

Soreness at the injection site, mild fever, nausea,  joint pain and an unwell feeling.

DIPHTHERIA, TETANUS AND WHOOPING COUGH (PERTUSSIS)

This immunisation DTPa  is a combination vaccine in which three vaccines are combined into one injection.  The injection consists of small amounts of diphtheria and tetanus toxins which are modified to render them harmless, small parts of the pertussis bacteria, aluminium hydroxide and a preservative called phenoxyethanol.

DIPHTHERIA

Diphtheria is caused by a bacteria found in the mouth, throat and nose of an infected person.  A membrane may grow around the inside of the throat which can lead to difficulty in swallowing, breathlessness and even suffocation.  A powerful toxin is produced by the diphtheria bacteria and can spread throughout the body.  The toxin can cause serious and life threatening complications.

TETANUS

Tetanus can be a fatal disease caused by a toxin made by bacteria found in soil and manure.  Tetanus cannot be caught from other people.  The bacteria would need to enter the body through a wound, even as small as a pin prick.  Tetanus attacks the nervous system and causes severe muscle spasms which would first be felt in the neck and jaw muscles.  The effects then spread and cause breathing difficulties, painful convulsions and abnormal heart rhythms.

WHOOPING COUGH (PERTUSSIS)

Whooping cough is a highly contagious disease caused by a bacteria which is spread by droplet infection by coughing or sneezing.  Whooping cough affects the breathing passages and causes difficulty breathing.  Severe coughing spasms occur with the infected person gasping for breath causing the characteristic WHOOP sound.  Vomiting will often follow a coughing spasm.  The cough can last for months.  Whooping cough is the most serious in babies under 12 months of age.  Complications of the disease can include convulsions, pneumonia, coma, inflammation of the brain, permanent brain damage and long term lund damage.

POSSIBLE SIDE EFFECTS FROM THE DTPa IMMUNISATION

Mild fever and redness, soreness and swelling in the area of the injection.  These local side effects will usually settle without any intervention.

POLIOMYELITIS (POLIO)

On 29th October, 2000, The World Health Organization (WHO), declared the Western Pacific Region which includes Australia to be polio free.  It is still important to immunise your child agains polio.  Polio can cause mild symptoms or very sever illnesss.  Polio is a gastrointestinal virus which causes fever, vomiting and musce stiffness and can affect the nerves causing permanent paralysis.

There are two types of vaccine available in  Australia: Inactivated Polio Vaccine (IPV) and Oral Polio Vaccine (OPV).  IPV is given as part of the combined vaccine with DTPa.

OPV

Oral Polio Vaccine (sabin) is given as drops into the mouth.  It will now only be used in Australia if there was to be an outbreak of the disease.  This vaccine contains small amounts of three types of live polio viruses which have been altered so they do not cause the disease, and a very small amount of neomycin, an antibiotic.

IPV

Inactivated Polio Vaccine contains small amounts of the killed polio virus.  In Australia, IPV is combined with other vaccines so it also contains very small amounts of preservatives and antibiotics.

POSSIBLE SIDE EFFECTS FROM THE POLIO IMMUNISATION

IPV or vaccines that contain IPV, can cause musce aches, soreness, swelling or localised redness at the injection site.  A low grade fever and possible loss of appetite.

HAEMOPHILUS INFLUENZAE TYPE B (Hib)

Despite the name, Hib is not related in any way to influenza.  Hib may cause pneumonia, joint infection or infection of the tissue under the skin, usually on the face in the form of cellulitis.  Meningitis, an infection and inflammation of the membranes covering the brain and epiglottitis, swelling in the throat which can block breathing can both develop quickly and untreated will cause rapid death.

Several doses of Hib vaccine are required to protect against the disease.  There are two types of Hib vaccine in Australia.  They are Hib PRP-T and Hib PRP-OMP.  Both vaccines contain a small amount of a part of the Hib bacteria ttached to a protein which stimulates the immune system.  The vaccines differ from each other in which protein the Hib bacteria is attached to.  Hib PRP-OMP gives earlier protection and requires less doses to complete a primary course.  This is the only type of Hib vaccine that should be given to Indigenous children living in Queensland, The Northern Territory, Western Australia and South Australia.

POSSIBLE SIDE EFFECTS FROM  THE Hib IMMUNISATION

Mild swelling, redness and pain at the injection site.  Fever and irritability are uncommon.

PNEUMOCOCCAL DISEASE

Pneumococcal Disease is a group of potentially life threatening infections that occur  most frequently in the under 2 years age group and the over 65 year age group.  The forms of infection are meningitis, an infection around the brain, septicaemia, a blood poisoning and pneumonia, an infection of the lungs.  In children, the most common less serious side effect would be a middle ear infection.

Pneumococcal disease is spread by droplet infection through coughing or sneezing.  There are two types of pneumococcal vaccine avaiable.  They are conjugate vaccine (Prevenar) and polysaccharide vaccine (PneumoVax23).  The conjugate vaccine works well in babies and young children and covers the seven types of pneumococcal bacteria that most commonly cause disease in children.  The polysaccharide vaccine covers 23 different types of pneumococcal bacteria but it does not work well in young children.

Both vaccines are made of small parts of different strains of the bacteria, attached to a protein which stimulates the immune system.

POSSIBLE SIDE EFFECTS FROM THE PNEUMOCOCCAL IMMUNISATION

There may be some swelling, redness and soreness at the site of the injection.  Low grade fever, sleepiness, restlessness and irritability are commone side effects.  Uncommon side effects may include vomiting, decreased appetite or diarrhoea.  A severe allergic reaction is a rare side effect.

MEASLES, MUMPS AND RUBELLA

Measles is a highly contagious viral disease which causes fever, a runny nose, cough and sore red eyes followed by a skin rash.  Measles can lead to dangerous complications.  Measles is caught through coughing and sneezing through droplet infection by an infected person before they realise they are sick.

Mumps causes a fever, headache and inflammation of the salivary glands.  It can sometimes cause an infection of the membrane covering the brain, but permanent sid effects are rare.  Mumps can also be the cause of permanent deafness.

Rubella otherwise known as German Measles, is a mild childhood disease but can also affect teenagers and adults.  Symptms include swollen glands,  joint pain and a rash of the face and neck which lasts two to three days.  Rubella is very dangerous when a pregnant woman contracts the disease in the first 20 weeks of pregnancy.  This can result in devastating effects on the fetus such as deafness, blindness, heart defects and intellectual disability.  Rubella is caught from droplet infection through coughing and sneezing before the infected person realises they are sick.

Pregnancy should be avoided for one month following immunisation against the disease.

This combination immunisation provides protection against all three diseases.  The first immunisation is at 12 months of age and again at 4 years.  The MMR vaccine contains small amounts of reduced strength live measles, mumps and rubella viruses, and a small amount of an antibiotic called neomycin.

POSSIBLE SIDE EFFECTS FROM THE MMR IMMUNISATION

The most common reaction to the MMR immunisation is the feeling of being unwell, perhaps with a low grade fever and possibly a skin rash which may occur 7 – 10 dayss after the immunisation and lasting for 2-3 days.  Children who develop this rash will not be infectious to others.  Due to the Mumps component of the vaccine, occasionally a mild swelling of the salivary glands may occur about 3 weeks after the immunisation.  More serious reactions are rare.

ROTAVIRUS

Rotavirus disease is the most common cause of severe gastroenteritis in infants and young children.  Children may be infected by the virus several times during their lives.  It is very easily spread from one child to another.  Symptoms range from mild, watery diarrhoea to severe dehydrating diarrhoea with vomiting, fever and shock.  To confirm a rotavirus infection, laboratory testing of faecal speciman is required.  The oral rotavirus vaccine is the best way to protect infants and children against the disease.

The RotaTeq vaccine is a live weakened virus vaccine.  The vaccine will not protect against diarrhoea and vomiting caused by other infections, but is very good at preventing severe diarrhoea and vomiting caused by rotavirus.  There are three doses of RotaTeq in a course of vaccine, and is given at 2, 4 & 6 months of age.

Even after having a course of RotTeq vaccine, there is still a very small chance of catching a rotavirus infection.  If this was to occur, the illness would be a much milder version than if your child had not been immunised.

POSSIBLE SIDE EFFECTS FROM THE ROTAVIRUS VACCINE

Fever, vomiting and diarrhoea in the week after the vaccine is given.  An extremely rare side effect is anaphylaxis, a severe allergic reaction.

MENINGOCOCCAL C

Meningococcal disease is an uncommon life threatening infection, caused by bacteria that live at the back of the throat or in the nose in about 10% of people.  The onset of the disease is often sudden and can rapidly cause brain infection caled meningitis or blood poisoning called septicaemia, or a combination of both.  Meningococcal most often occurs in children less than 5 years of age.  Winter and Spring are the most common seasons when this disease presents.  There are different strains of the disease, with strains B and C the most common here in Australia.

The bacteria is spread through droplet infection from coughing and sneezing.  Many hours of close personal contact are usually required to transmit the bacteria between people.  The bacteria does not survive for very long outside of the body.  The symptoms can be a mixture of a sudden onset of fever, severe headache, drowsiness, confusion or coma, neck stiffness and joint pains, a skin rash or a red/purple spots or bruises, a dislike of bright lights and vomiting.

The Meningococcal C vaccine is a single dose given at 12 months of age.  This vaccine is very safe and does not contain live bacteria, and does not cause the disease.  The vaccine contains a small amount of part of the bacteria attached to a protein which stimulates the immune system.  It also contains aluminum salt.  There is no effective vaccine in Australia for Meningococcal B.

POSSIBLE SIDE EFFECTS OF THE MENINGOCOCCAL C VACCINE

Mild side effects such as pain, redness and swelling at the injection site.  Fever, irritability, headache and a decreased appetite for a few hours.  Seizures are a more serious but uncommon side effect.

CHICKENPOX (VARICELLA)

Chickenpox is a highly contagious infection caused by the varicella-zoster virus.  This infection is spread through droplet infection by coughing and sneezing and through direct contact with the fluid in the blisters of the skin rash.  This infection is usually a mild disease of a short duration in otherwise healthy children, it can however develop into a more serious illness and in adults it can be more severe than in children.

Chickenpox can be a risk factor to an unborn baby if contracted during pregnancy.  The incubation period for chickenpox is 10 to 21 days which is then followed by the appearance of a red spotty rash which then turns into blisters.  A fever is often present and the infected person will feel unwell and may experience severe itching.

The chickenpox vaccine contains modified live virus at a reduced strength, and a small amount of an antibiotic called neomycin.  Once single dose of vaccine is given at 18 months of age.

POSSIBLE SIDE EFFECTS OF THE CHICKENPOX VACCINE

Side effects are usually uncommon but may include pain, redness or swelling at the injection site and a fever.  Serious side effects are very rare.  This vaccine should not be administered to pregnant women.

Source:  Understanding Childhood Immunisation. (2005). Australian Government Department Of Health And Ageing.

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