From the time when your baby is two months old through to her secondary school years there is a planned NHS programme of regular immunisations to protect her against a number of diseases. Here we look at the illnesses and diseases that these vaccines protect against, how you can make the injections less of an ordeal for your baby and whether you need to protect yourself as a parent. To find out more about the schedule of injections and whether you need to have your baby vaccinated see our introduction to immunisations.
What the vaccines are for and at which age they are given
The 5-in-one (DTaP/IPV/Hib) vaccine PLUS the PCV vaccine
The 5-in-one vaccine was introduced in the UK in 2004, but has been used in Canada since 1997. The single injection is given to babies at 2, 3 and 4 months and then repeated sometime between 3 and 5 years. At the same time as the two-month and four-month appointments the PCV injection is also given. At the three-month appointment, the MenC injection is given as well as the 5-in-one. (For PCV and MenC, see below.)
- Diptheria – Now rare in the UK because of a programme of childhood immunisations since the 1940s, the highly contagious disease is still a problem in other parts of the world, with several recent epidemics, and is most often picked up when travelling. The disease begins with a sore throat and affects the upper respiratory tract (nose, throat, voice box and upper windpipe), the heart and nervous systems and, sometimes, the skin. It’s a very serious disease that affects all ages and can be fatal.
- Tetanus – Tetanus-causing bacteria usually enter the body through a wound such as a cut or animal bite, and are often found in soil or on plants. If you are not immune to the illness it affects your nerves and muscles and can be fatal. Immunisation is the only way to protect against tetanus and the immunisation programme has been very successful in making it a rare illness. A full course of tetanus immunisation consists of five doses of vaccine, which your child will have completed by the time he or she leaves school.
- Pertussis (Whooping cough) – Pertussis is a serious disease for babies under six months, and can be fatal, which is why babies are immunised very early on. For older children and adults the illness is less serious, but still unpleasant with long periods of coughing followed by vomiting and choking, that can last for several weeks. Thanks to a widespread programme of immunisation the disease is no longer very common in the UK, but it still poses a risk to your baby if s/he is not immunised.
- Polio – Polio is a virus that attacks the nervous system, it used to be the most common cause of paralysis in young people and can be fatal. The long-running vaccination programme has meant that polio is now extremely rare in the UK, however, it is still a problem in several developing countries, such as India.
- Hib (‘Haemophilus Influenzae’) – Hib is a highly infectious bacteria that can lead to several serious illnesses such as epiglottitis, blood poisoning, pneumonia and meningitis.
Pneumococcal conjugate vaccine (PCV) – A flu vaccination is offered to elderly people, those in at-risk groups and to babies. This injection was introduced in 2006 and has been offered to all children under two who might have missed it. Beyond two years the risk of suffering from the infection is greatly reduced.
Meningitis C (MenC) – Protection from the meningococcal group C infection. This is given as a single injection at three months and then in a booster with Hib later. (see below)
The MMR vaccine
The MMR – Measles, Mumps and Rubella injection – was introduced in the UK in 1998. It’s given at between 12 and 15 months, and again at three to five years. Given a certain amount of controversy about a possible link to autism of the injection, some parents prefer to have their children immunised for these diseases separately, which is not available on the NHS, or to not immunise them at all. The decision by some parents not to have their children vaccinated against these diseases has led to an increase in cases of all three in recent years.
- Measles – Measles is a highly contagious virus that causes a rash, high fever and respiratory problems and can lead to serious, even fatal, complications. The illness can be caught at any age, but mostly affects young children. While the immunisation programme did successfully make the disease relatively rare in the UK, controversy over the MMR vaccine has led some parents to decide against vaccination, and there have been a number of recent outbreaks among those not immunised.
- Mumps – Mumps is a contagious virus that infects the parotid salivary glands and used to be the most common cause of childhood meningitis. Although usually a mild illness, serious complications such as meningitis, deafness and swelling of the testicles or ovaries can occur in a minority of infections.
- Rubella – Also known as German Measles, rubella is a mild, although highly contagious, illness causing a rash and raised temperature. While there is little danger from the illness to your children, it can cause very serious birth defects if contracted by a pregnant woman.
Other injections beyond 12 months
In the early years, there is a series of other booster injections offered. These schedules vary from time to time, and sometimes you will get a letter about a new vaccination for your child if it has been decided that key groups need a catch-up with a jab that has been added to the regular schedule for younger children.
The Hib/MenC booster vaccine – This is one injection for Hib and MenC (see above) given at around 12 months.
PCV vaccine – This is one injection given at around 13 months. (It may be given at the same time as the MMR.)
MMR and DTaP/IPV boosters – Between the ages of 3 and 5 years, though usually just before your child starts full-time school, they will be given boosters of the MMR and the DTaP/IPV injections. For there is one injection for MMR (see above) and one for DTaP/IPV (see above, but without the Hib part of the ‘5-in-one’).
Td/IPV – This is one injection given between 13 and 18 years, for diphtheria, tetanus and polio.
How to lessen your baby’s suffering
Few people like needles and injections and your small baby won’t be any different. But there are things that you can do to limit the distress felt by your baby from injections and to try and prevent him or her associating a trip to the doctor’s office with all things terrible.
- Stay calm – Your baby will react to your emotions, so if you are tense and anxious the likelihood is that he will be too. If you dislike needles then it’s important not to pass your fear along to your baby: take deep breaths and look at your baby’s eyes, rather than the needle, as the injection is being given.
- Comfort your baby – Your baby will probably feel more secure if you hold and comfort him during the injection, maintaining eye contact and talking to him as much as you can. Perhaps there’s a particular song that he finds comforting, or at least distracting.
- Take along a distraction – If your baby is attached to a particular toy or blanket then take that along with you.
- After care – Some vaccinations may cause a slight sore reaction at the site of the injection, a mild temperature or leave your baby irritable. An ice pack will help with any swelling or redness and you can talk to your doctor about how to lower a temperature. If you think your baby has a more severe reaction to a vaccination then speak to your doctor.
In most cases your baby’s injections will pose no risk to you as a parent at all. However, in the case of polio, where the virus is passed on through human faeces, it is possible for a parent to catch the virus through handling dirty nappies if your baby has been given the polio vaccine orally, via a sugar cube. Since 2004 the oral vaccine has been largely replaced with the 5-in-one (DTaP/IPV/Hib) vaccine in the UK, which doesn’t carry this risk. If your baby is given an oral polio vaccine then speak to your doctor about whether or not you have been immunised and be sure to wash your hands thoroughly and carefully after handling dirty nappies.
UPDATED JULY 2008