Other vaccines that are recommended but have to be purchased, i.e. they are not supplied free of cost, are described below.
1. Hepatitis-B vaccine: It is a killed viral vaccine having excellent protection against Hepatitis-B virus. There are 5 common hepatitis viruses; A to E. Out of these, at present, vaccines are only available against Hepatitis A & B. Hepatitis-A causes only acute (lasting for a brief time say 1-2 weeks) liver disease while Hepatitis-B may cause a chronic liver disease which may ultimately lead to liver failure. It has also been known to cause liver cancer. That’s why one should get oneself immunised against it.
• In an infant (i.e. till the age ofl year), it is given as 3 doses at 1 month interval and the injection is given in the thigh. Ideally the first dose should be given at birth, the second dose at the age of 1.5 months and the 3rd dose at the age of 2.5 months.
• In older children including adults it is given as a 3 dose schedule at 0, 1 and 6 months and the injection is given in the arm. No booster doses are recommended.
• The dose after the age of 10 years is considered as adult dose and is 1 cc. below the age ofl year, the dose is 0.5 cc.
• You should also get your child immunised against Hepatitis-A.
2. MMR vaccine: This is a triple vaccine, which affords protection against Measles, Mumps and Rubella. It is given as a single dose intramuscularly at the age of 15 months. Even if your child has got Measles vaccine at the age of 9 months, it should be given.
3. Typhoid vaccine: It is available in two forms. One is injectable, given i.m. to children above the age of 2 years and repeated every 3 years thereafter. The second one is in the form of capsules (3 capsules given as a single capsule every alternate day). The oral form is recommended only for children above 6 years; so initially you have to vaccinate them with the injectable form. Due to the poor sanitation and water supply, Typhoid is quite common in India and therefore it is better to vaccinate your child against this disease.
4. H.Influenza vaccine: H.Influenza is a bacterium that may cause serious disease in the child including meningitis (brain fever) and pneumonia. It is given i.m. The vaccination schedule parallels that of DTP; excepting that the 5-year dose is not given. It is the only vaccine in which the number of doses is reduced depending upon the age.
• Below 6 months: 3 doses at 1 month interval + 1 booster at 18 months.
• 6-12 months: 2 doses at 1 month interval + booster at the age of 15-18 months.
• 12-15 months: 1 dose +1 booster.
• Above 15 months-5 years: only single dose.
• Above the age of 5 years: not required.
It is a relatively costly vaccine, 1 dose being priced approximately Rs. 450/-, though highly recommended due to the serious nature of the disease.
5. Hepatitis-A vaccine: It is a killedvaccine given as a 2 dose schedule 6 months apart. The adult dose (i.e. above the age of 19 years is double that of child’s dose). It can be started above the age of 1 year, though some manufacturers recommend it to be given after the age of 2 years. It is a costly vaccine, the cost of 1 injection being approximately Rs.1000. It protects against the water-borne type of jaundice and is much commoner than Hepatitis-B. In India, it is estimated that adults usually don’t require the vaccine as they are already immunised due to this infection being contracted by them during childhood.
6. Chickenpox vaccine: This is a live attenuated vaccine. A single dose is recommended below the age of 13 years and after that 2 doses at 1 month interval is recommended. It protects against chickenpox, a viral rash associated with fever, pain and itching at the site of the rash. It is a costly vaccine, priced at approximately Rs. 1500.
7. Pneumococcal vaccine: It is recommended above the age of 2 years as a single dose. The protection lasts for 5 years after which it has to be given again. It prevents against infection due to Pneumococcal bacteria, serious infections being pneumonia and meningitis. Pneumococcus along with H.Influenza-B (and staphylococcal aureus against which no vaccine is available presently) are 3 bacteria which are common causes of infection in childhood and all 3 of them can cause serious, life threatening infections.
Therefore it is strongly recommended that one should protect the child against these infections. H-Influenza-B is dangerous till the age of 5 years only and thus is not given above the age of 5 years. Pneumococcal infections are common even in adults and therefore can be given at any age. It is currently recommended for patients with underlying diseases, which weaken the immune (defence) system of the body.
Apart from the 4 vaccines (BCG, Measles, DPT and Polio) given to protect against the 6 major killer diseases, as per the national health policy of Govt, of India, parents should also get the child immunised with the other seven vaccines mentioned above.
Influenza vaccine: This is a special vaccine which is not given as a routine but only to high risk cases. It protects against influenza, a viral infection chiefly affecting the respiratory system. It is recommended in asthmatics, those with heart diseases, diabetes, chronic lung diseases, chronic renal disease etc. For the use of this vaccine, consult your doctor. Just remember that it is not given to healthy children, but to children who are having an underlying disease, e.g. asthma which can become severe due to the child getting influenza.