Preventing Disease An ounce of prevention is worth a pound of cure.

A word so simple, yet difficult for any mother to see her child being poked right from their birth in the name of vaccination but yet so courageous to face the present and make her child fit for the future and boost them with strong immunity so that they can fight from their future sufferings in the name of disease — that’s what immunization/vaccination Is! Immunization protects children and adults against harmful infections before they come into contact with the infection in the community. Immunization uses the body’s natural defense mechanism - the immune response - to build resistance to specific infections. 

Infectious diseases

Infectious diseases are one of the leading causes of death in children especially below one year of age. It is estimated that at least two million children die each year from the disease that could have been prevented by already existing vaccines. In addition to this high death toll, millions more suffer disability and illness because they have not been immunized. This problem is most significant in low income countries with health disparity between the rich and the poor. Infectious disease includes large number of diseases that may produce various symptoms like fever, mild rashes, cold, cough, muscle weakness, jaundice but it may be severe at times producing life threatening complications like: pneumonia, meningitis, paralysis, septicemia, respiratory distress, liver failure, infertility and many more — hence, the introduction of the vaccine has revolutionized prevention of child health.

Immunization and Vaccines

Vaccines are the only public health tools available to prevent a vast majority of infectious disease. A vaccine is defined as a preparation used to prevent a particular disease by triggering an immune response to the disease without actually suffering from the disease. As a parent and a doctor we must be conscious of the fact that the immunization needs of the children are quite dynamic. There is always a need to update knowledge and concepts especially in the field of immunization. However, to get the most benefits for any vaccine in a community, adequate immunization coverage is required. Unfortunately, in countries like ours, the routine immunization coverage rate has slipped down, which is a major obstacle in any disease eradication programme. And this is a matter of great concern for all of us. A vaccine which may not be considered important today may become necessary in the future as more information about the epidemiology of the disease will
be known.

Vaccines were first introduced in 1974 to reduce morbidity and mortality caused by certain diseases. At that time there were only a few vaccines but with growing knowledge about diseases and their epidemiology, newer vaccines are coming up with the ultimate aim of controlling diseases in communities and if possible, eradicating them altogether. The future holds lots of promise as far as the prevention of disease through vaccination is concerned.

Step by step protection against childhood infection is what your child needs. So, follow the steps of vaccination your doctor advices you.

Immunization as per Nepal immunization programme

Age	Vaccine
At Birth	BCG Hep B1
6 Weeks	OPV1,DPT1,Hib1,Hep B2
10 Weeks	OPV2,DPT2,Hib2,
14 Weeks	OPV3,DPT3,Hib3,Hep B3
9 months	Measles

Optional Vaccination

Age	Vaccine
15 Months	MMR
18 Months	DPT  ,Hib,OPV Booster
>1 year	Varicella
>2 years	Hep A
6 months apart 2nd dose	Hep A
>2 years	Typhoid (Booster every 3 years)
>2 years	Pneumococcal  (Booster every 5 years)
>2 years	Meningococcal A+C(Booster every 3 years)
>1 years	JE Single Dose
>6 months	Influenza (Booster every year)
5 years	DPT Booster
10 years	dT/DT

Side effects

Side effects of vaccination in general are: fever, pain and swelling at the site of injection, mild rashes. Some severe but occasional side effects may be: inconsolable crying, fits, local abscess at the injection site, anaphylactic reaction, meningitis, BCG lymphadenitis. In such cases, see the doctor immediately or visit the nearby hospital. Still, remember that the benefits of protection against disease through vaccination far outweigh the very small risks of vaccination.

Contraindications (when vaccination should not be given)
1. Severe adverse reaction to the previous dose of vaccination like: seizures, hypotonic hypo responsive episode, incessant cry (pertusis)

2. Progressive neurological disease (DPT)

3. Immunodeficiency stat, HIV, Recent history of immunoglobulin transfusion (live vaccines: BCG.OPV,JE,)

4. Egg allergy (mumps, influenza, yellow fever)

5. Neomycin allergy (MMR,varicella, IPV)

Some do’s and don’t’s <br>
1. Inform your doctor if
Your child is suffering from some chronic disease or illness
Your child is on long term medication
Your child had received immunoglobulin transfusion within last 6 months

2. If immunization status of a child is unknown, there is no harm in giving appropriate vaccines again.

3. Lapse in the schedule of immunization does not necessitate reinstitution of the total course.

4. A minimum of 4 week interval is better between two types of vaccine administration.

5. Mild cold and cough are not contraindications for vaccination. 

Finally, many people have not yet realized the importance of other vaccines which are not supplied by the government. But it is important that such vaccines are made available so as to provide good vaccine coverage and decrease disease occurrence and suffering.

As a doctor, I want to ensure that all children have every opportunity to grow up healthy and are vaccinated against those diseases that can so easily be controlled.