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This text is designed for an International readership at Dr Ashutosh Jindal’s  Website       www.healthybaccha.com While we have tried to keep the content  international in application – the prime readership is designed towards India. Hence , some phrases and ideas may be unfamiliar for some regions of the World.For clarifications please feel free to e mail Dr Jindal. Printouts may be taken but the copyright rests with the Site and misuse is prohibited. The Site owns no responsibility for any mishap occurring out of application as such or from misinterpretation of the information. You are advised to meet your local Pediatrician for endorsement of the information before application. UPDATE # 2   VACCINES – CONTINUED Vaccine failure : It may be not too uncommon for you to see Typhoid developing in a child who has duly been vaccinated for it.Similarly for Measles ,Polio and the rest. This naturally raises the question “ why then vaccinate at all “.   The broad fundamentals are : No vaccine claims 100 % protection  Generally speaking , the breakthrough illness ( i.e. disease despite vaccination) shall be less severe than the situation in which the child was not vaccinated at all – some solace A variety of factors influence the efficacy of the vaccine: properly stored and administered vaccine if the child is in the incubation period of a disease ( this is a window period when the child has already contacted the germ from some other person but is not yet  manifesting the disease outwardly ) – the vaccine is very likely to be ineffective. And there is no way either you or the Pediatrician can make out a clue to the illnesses in this incubation period. Anytime the child’s immunity gets grossly suppressed ( mostly during viral infections ) – the body gets unduly susceptible to infections in general – this period is one of risk of acquiring infection in prior vaccinated child. On the whole , there are a variety of unknowns that my produce vaccine failure.It is almost a duty at your part to follow the vaccine schedule – and then keep your fingers crossed. The happy thing is that vaccine failure is rather uncommon – please do not lose sleep over it ! What if I have missed a dose or delayed a vaccine ? The golden rule is simple – take the first opportunity to take the shot. Also , whatever may be the length of delay – it does NOT call for a repetition of the course all over again ( this applies to those vaccines which are taken as multiple injections i.e. DPT & Hepatitis B).  Rubella ( German Measles ) vaccine Booster for adolescent girls : This is one important vaccine that gets usually ( almost always , I daresay) missed since by that age the family has got over the vaccine business. Rubella is a subtle infection that comes and goes un-noticed ( usually as a day or two of fever with or without a rash and tends to get ignored as a “ viral” ). What it leaves behind in the girl’s circulation is a lurking Rubella infection.This infection, if passed on to the developing fetus, can produce devastating consequences to the fetus and real bad malformations may result. This vaccine is usually taken at some 15 months of age as MMR vaccine ( M=Measles ; M=Mumps; R=Rubella ( German Measles) but the immunity to Rubella generally wanes off by teenage. Hence the need for this additional dose. It may be taken as a monovalent Rubella (Pure Rubella) vaccine. On occasions, the availability of this is difficult – you may then take MMR in its place.  My child is unwell – should I take the scheduled vaccine or not ? A fairly common situation. A very simple answer – minor coughs,colds,fevers do not entitle you to delay the vaccine.   In any case, your Pediatrician shall first examine the baby and only then give him the shot.In case he feels that the child is really sick , he shall anyway defer the scheduled vaccine.   BUT DO NOT DECIDE FOR YOURSELF THAT YOUR CHILD IS UNWELL – HENCE I AM NOT GOING TO MY PEDIATRICIAN. Tetanus shots at every injury : It is a common practice for you as a parent to rush to your nearby Doctor or your Pediatrician and ask for a Tetanus shot since your child has had an injury. The simple rule is that if you have followed the proper schedule of 3 initial DPTs ( T = Tetanus) starting at some 1.5 months and have followed by a Booster ( this also contains Tetanus) at 1.5 years of age and then you have taken the 5 year Second Booster ( this again contains Tetanus) your child is fully immune to tetanus disease. Do remember to take the final Booster ( this shall also contain Tetanus ) at 10 years of age. If you are in doubt about the schedule followed by you , then go about it in a proper FRESH schedule :                         Take one shot within 24 hours of injury                         Take a repeat shot after 6 weeks                         Take a repeat shot 6 months                         Now your child is immune for the next 5 years – NO NEED FOR                         TETANUS SHOTS FOR ANY INJURY FOR THE NEXT 5 YEARS.   There shall be more coming from us soon – till then good luck and happy parenting.   Dr Jindal and team Healthybaccha.com

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