Written by Eve Bandusena | Parents Avenue’s Editorial Assistant
However, how far do we go to protect them physiologically? It’s not only about avoiding a scraped knee, or a visit to the dentist to get that wiggly tooth extracted, but it goes internally as well.
In the earlier years of their lives, younger children are prone to encountering many infectious diseases from mild to severe forms such as colds, bronchitis, ear infections, and sinusitis. To prevent this from happening, parents can depend on one single word: “vaccinations”.
Parents Avenue sits with Dr Sharon Chan Pek Suan, KPJ Sabah’s Consultant Paediatrician on vaccinations for babies and young children.
During the start of the discussion, Dr Sharon lays down the groundwork for how vaccines work: “a vaccine basically works by giving a much weaker substance of an illness that you are trying to prevent in the child.
That antigen stimulates the body to build up an immune response to that particular virus, bacteria or disease that you are trying to avoid. Your body builds up a memory so that when the real thing comes, it can work fast and avoid you from getting that disease, and even if you do get it, it will be in a much milder form because you have primed your immune system with the vaccine ” she explains.
After establishing the science behind how vaccines work, she moves confidently onto a more pressing topic that has a large influence over parents: the importance of vaccinations.
According to Dr Sharon, a lot of parents see diseases as a rather minor matter and treat it with an attitude of you get it and you recover. “No, that’s not true, because some of the illnesses we get from infections can be very serious but parents don’t realize this”, she continues “That’s the whole point of doing vaccinations.
You want to give the baby and child protection and obviously any parent would want the best for their child. The best is to prevent them from getting diseases and to do that you need to so your vaccinations.”
With any jabs, there will sometimes be side effects but Dr Sharon puts our worries at ease, as the minor side effects are nothing to fret about, “ The very common side effects are fever, redness or swelling at the site of injection. The child may also feel a bit unwell for 1 or 2 days. You can expect all this within the first 48 hours of vaccination”.
She continues, “these are minor side effects which you can easily overcome by giving paracetamol to the baby or child. Uncommon and very rare side effects may be anaphylaxis. Common side effects are about 10%, and the very rare are about 1 in a million”.
With the importance of vaccines put aside, Dr Sharon goes on with providing advice on the appropriate age in which you baby or child should get vaccinated, “each vaccine has a different starting point. Babies are given the BCG and 1st Hepatitis B at day 1 of life.
Other vaccines like the ‘diphtheria, tetanus, whopping cough, polio and hemophilus influenza B’ vaccine is given from 2 months, the ‘mumps, measles and rubella’ vaccine are given from 9 months, chickenpox vaccine can be given from 1 years old.
However, if you are vaccinating your baby or child a little behind the recommended schedule, Dr Sharon reassures that it’s still alright, “Even if you didn’t start at the age you were supposed to get that vaccine, for instance because the child was sick then, or if the parent forgot to take the child then for the vaccine, you can still do it later.
It doesn’t mean that if you have missed coming say for example to do the 2nd month vaccine at 2 months, you can’t do it permanently. No, you can still do it even if you come a few months later. The important thing is to carry one with the vaccinations”.
For the scheduling of vaccinations, most countries follow roughly the same schedule, though there might be slight variations in the timings. At birth, the babies are given Hepatitis B and BCG.
At the government clinics/Klinik Kesihatan, the 2nd Hepatitis B is given at 2 months, then the 5 in 1 (combination of diphtheria, tetanus, whopping cough, polio and hemophilus influenza B are given at 2 ,3 and 5 months) and 3rd Hepatitis B at 6 months.
However in the private clinics and hospitals, most doctors don’t give the second Hepatitis B vaccine at 1 month because they will use the 6 in 1 ( combination of diphtheria, tetanus, whopping cough, polio, hemophilus influenza B and hepatitis B ) at 2, 3 and 5 months.
In Malaysia, the MMR vaccine will be given at 9 months and 1 year old followed by the combined 5 in 1 at 18 months.
Interestingly enough, there are quite a number of additional vaccinations that are not available from the Klinik Kesihatan. These are the extra vaccinations that you can and also should take from the private clinics, to give your child a wider coverage.
In other countries, these optional vaccinations are included in their routine immunization schedules. This is mainly because our country cannot afford to include all these extra vaccinations into our schedule, so they consider these extra vaccines are ‘optional’.
Dr Sharon says, “I strongly recommend the parents take all these optional ones as well, since it’s available, you might as well prevent rather than treat the illness”.
One of the optional vaccines is the rotavirus vaccine. “Rotavirus is a very common virus that causes vomiting and diarrhoea, I usually advise then to take it as early as 2 months and it’s a vaccine that is given orally.
Depending on which brand the doctor uses, it is either drinking the vaccine on 2 different occasions, or 3 different occasions”. The other optional vaccination that she strongly recommends is the Pneumococcal vaccination.
“I feel this vaccination is very important because the pneumococcal bacteria can give rise to ear infections, pneumonia and the worst is if it goes into the brain and causes meningitis.
You can do it as early as 2 months, but it will have to be given at the same time as the 5 in 1 or 6 in 1 jab, and in Malaysia, most parents do not like to have to give their babies 2 jabs in a day, so than you can opt to have this pneumococcal vaccine done at 4 months of age, as there is no compulsory vaccine scheduled at 4 months.
Along with any type of medical procedure regardless of whether it is a jab or an operation, it is granted that parents will have their worries and concerns. Questions in mind could take the form of: Can baby’s body take so many vaccines at a single time? Can babies with allergies get vaccinated?
And quite frankly, how safe are vaccines? Dr Sharon has got these covered: “babies can handle many vaccinations at a time.
We have been vaccinating babies for years in the whole world and they have been given combination vaccines and surveillance has shown that they have not had serious side effects and these children have all grown up.
Parents are worried about doing vaccinations every month, but studies have proven that the baby’s immune system can cope with it and that it mounts a good response.”
For parents whose children have allergies, it is easy to understand why they would feel hesitant about getting vaccinated. Dr Sharon says indeed they can also get vaccinated, however precautions should be taken for those who are very allergic to eggs.
Yup! You heard it right. “As long as they are not very allergic to eggs as some vaccine contain a little bit of egg. But even then for those children, the vaccination can still be given in a controlled situation, whereby we admit the child, give the vaccine and watch for any severe reaction.
However, those situations are quite rare. General allergies like eczema, allergic rhinitis, asthma: these children can still get vaccinated”.
Next, sick babies can be vaccinated as long as it is only a minor illness like a slight flu or cough.
“In general, when babies have fever, we tend not to vaccinate and wait till they are better and have recovered, because if you vaccinate them when they have the fever, it may cause the fever to go higher”.
She adds that some parents prefer waiting for their child to be absolutely well before they have vaccinations. However, by right, if it is just a slight flu or cough with no fever, and nothing serious, the vaccination can still be carried out.
And lastly, she touches on a highly debatable topic. How safe are vaccines?
There’s a concern that the MMR vaccine causes autism. Dr Sharon elaborates, “There was a paper published in 1998 by Dr Andrew Wakefield who linked the MMR vaccine with autism.
This paper created a lot of anxiety and problems and resulted in a drastic drop in the uptake of MMR vaccine and caused a resurgence of measles worldwide. However this paper has been withdrawn as it was later proven that the results were falsified and Dr Wakefield was struck off the medical register.
Many more studies done since then have not shown any link between the MMR vaccine and autism. Despite this, this study has caused a huge hysteria all over the world and up till today there are still parents who associate MMR with Autism.
All vaccines need to undergo vigorous testing and many years of trials before they are licensed to be used. Even when they come in the market, there is active post surveillance going on.
Just think about it, millions of children have been and are being vaccinated yearly. The side effects of the vaccinations are much smaller compared to the side effects of getting that disease”.
“So if you are a parent, you would want the best for your child. You want to give them a great head start. The best you can do for them is to bring them to get their vaccinations done as per scheduled and follow what their doctors recommend, which ones to take and when to do them. Don’t think of the optional vaccinations as optional, just take them. Do all the vaccines”.
She readdresses that it’s okay if parents are busy and have forgotten their appointments, but to reschedule and do it even if it is late. “For my patients who get their shots at government clinics, I tell them about the optional vaccinations available and encouraged them to think about it so that they can make an informed decision and go to the private doctors to get the extra vaccinations”.
Dr Sharon Chan Pek Suan is a Consultant Paediatrician with KPJ Sabah Specialist Hospital. With over 22 years of experience as a paediatrician, she did her medical training in Ireland and worked both in Ireland and UK before returning to Kota Kinabalu to work at Queen Elizabeth Hospital. She then joined KPJ Damai Specialist Hospital and in the past one year is now at KPJ Sabah Specialist Hospital.
For further information or any enquiry, you may contact KPJ Sabah Specialist Hospital at 088- 322000 or visit www.kpjsabah.com to book your appointment on line. You can also follow KPJ Sabah Specialist Hospital on social media @kpjsabah for your daily healthcase updates.
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