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Home > First Year > Immunisations in Paediatric Practice
 Immunisations in Paediatric Practice
The first course of vaccination starts from the age of 6 weeks to 2 months with the first dose of 5 in 1 or 6 in 1. The 5 in 1 vaccine consist of Diphtheria, Tetanus, acellular Pertussis, Poliomyelitis, Haemophilus influenzae type B (Hib) plus Hepatitis B vaccine in the 6 in 1. These shots are again boosted at 3 months, 4 months and eighteen months of age to complete the course.
Vaccination against Rotavirus gastroenteritis is available as Rotarix vaccine in the form of drops given in 2 doses before the 6th month of life. Another vaccine, Rotateq is given in the form of drops in 3 doses, ie : at 6 – 12 weeks, 10 – 12 weeks, and 14 – 26 weeks of age.
Synflorix and Prevenar are vaccines against pneumococcal disease which is caused by a bacterium called Streptococcus pneumoniae. This disease may take the form of pneumonia, meningitis, bacteraemia or septicaemia and middle ear infection, and the disease in itself can be severe and fatal, in some cases resulting in long – term neurological problems. The vaccines are indicated in children from 6 weeks up to 5 years of age in a specific schedule as recommended by the paediatrician.
Serogroup C Meningococcal Disease (Menigitec): Vaccination against this invasive disease giving rise to meningitis or septicaemia, is available from 2 months of age and consists of 2 doses with a booster in the 2nd year of life. Children starting the vaccine from the age of 1 year require only one dose.
At 1 year of age, children may have the Varilrix vaccine against Varicella diseae or better known as chicken – pox. The vaccine is again boosted at 4 years of age and may be combined with the MMR vaccine as one booster vaccine (Priorix – Tetra).
MMR (measles, mumps and rubella) Priorix vaccine is given from 13 or 15 months onwards and boosted at 4 years (priorix – tetra) as mentioned above. It is important that children having the MMR vaccine should have been exposed to egg protein and allergy or anaphylaxis to eggs is excluded prior to vaccination.
Children not having had the 6 in 1 vaccine but the 5 in1 vaccine may take the Twinrix vaccine (Hepatitis A and B) in 3 doses in 6 months, as hepatitis vaccine is absent in the 5 in 1 vaccine. The twinrix vaccine may be taken any time after 1 year of age, but especially before entering nursery school, where children may be exposed to the disease due to biting, sharing bottles and food items, toileting etc.
In secondary school age, the BCG (anti –TB) vaccine is given by the School Medical Service System (Health Department) after testing negative for the Heaf test.
Females from 12 - 13 years onwards, may have the vaccine against the Human Papilloma Virus (HPV) in 3 doses in a period of 6 months as Cervarix or Silgard vaccines. These vaccines offer protection against HPV which is associated with cervical cancer, genital warts and precancerous lesions.
At 16 years of age the primary course of immunisations are boosted again by administering the Tetanus, acellular Pertussis, half dose Diphtheria and polio vaccine.
Points of importance before vaccinating the infant with any of the above vaccines :
(1) Pre – Vaccination Consultation : The infant should be healthy and well enough to be vaccinated and especially free from fever. It is always advisable that infants and children should be examined medically by an experienced doctor in child health or a paediatrician, where the child’s neurological development and immune status is assessed. During this consultation, questions should be directed to the paediatrician by the parents regarding the vaccine itself, the disease associated with the infectious agent, any contraindications to vaccination, and tips of how to counteract possible side effects of the vaccine should also be addressed.
(2) Cold Chain : It is also never recommended to parents to purchase and transport the vaccines themselves before going to a health professional to administer the vaccines. In such cases the cold chain is highly likely to be broken and the vaccine would be ineffective. The cold chain should never be broken and vaccines should be given directly in a clinic where the vaccines have been stored by the pharmacist or health professional.
(3) Timing of Vaccine Course : In a proper vaccination schedule it is very important to stick as much as possible to the appointments given by the health professionals administering the vaccines as the course of certain vaccines need to be given in a specific time period. Excessive prolongation of the course of vaccination for a given vaccine will result in a lowering of immunity rendered by the vaccine itself and possible infection with the offending microbial agent.
Article thanks to Dr. Chris Sciberras
MD, MRCPCH, MRCP(UK), MSc.Comm.Paed.(warwick), DCH (Dublin), Cert.Dev.Paeds(London)
Dr. Sciberras can be found at 21, G.B.Pantalleresco Str. B'Kara and contacted on (00356) 99476462
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