Friday, 30 May 2008

Vaccinations - A Study

Arjun was born in Denmark and travelled to India and then relocated to Sweden.
I was greatly confused about his vaccination schedules. And I have been receiving questions from my friends, who are new mothers, whose children are born abroad, and travelling/relocating to India or the other way, about the same. I have been questioned by a fellow traveller in the flight also about this. I have discussed quite a lot with doctors in India, Denmark and Sweden and also read about this in the web and I capture my learnings here for the betterment of fellow mothers and also my future reference.

The vaccinations are more or less similar in India, Sweden and Denmark except that there are some extra ones in India. Also the age at which they vaccinate in India is different.

Let me state the abbreviations the doctors use.

D - diphtheria
P - wooping cough
T - Tetanus
OPV/IPV - Oral Polio Vaccine / injectable Polio Vaccine
Hib - Influenza Type B(Known as meningitis in the Europe, which is actually the name of the disease)
MMR - Mums, Measels, Rubella
Hep B - Hepatitis B

A child born in India is given BCG at birth.This is a vaccination against tuberculosis, commonly known T.B and also she is given the first dosage of hep B vaccination at 2 weeks.

In India, there are two types of injections available.
Easy four and Easy five.

Easy four: DPT+Hib
Easy five: DPT+Hib+Hep B

Its so easy that one need not receive too many pricks, but just one prick but all the four/five vaccines. In our childhood, it was known as 'Triple Antigen-Muthaduppu oosi' which was DPT.

Ideally a kid must receive three doses of DPT, Hep B and Hib,by one year.

So a kid that received BCG and Hep B respectively at birth and 2 weeks, will receive one easy five when 45days old, one more easy five at 75 days and one easy four at 105days old, which makes 3 doses of DPT, Hep B and Hib. And each vaccination is also associated with a OPV.Now a days they recommend one dosage of IPV atleast.The doctors make sure each vaccine is given at one month interval at the least.

The same scenario is handled a bit differently in Denmark and Sweden.They dont give the vaccinations at such young age.The first vaccine itself start when the child becomes three months old. In Denmark they claim that there is no Hep B virus and so there is no vaccination for that. But they dont have this easy four, easy five concepts. They prick twice, once for DPT+IPV and once for Hib, I mean meningitis.
And if you want to order Hep B yourself, then one more prick. And there is no BCG vaccine also.You need to order it yourself, if you want. And this DPT+IPV,Hib are repeated at 6 months and 1 year.
In Sweden also the vaccinations are given at 3 months, 6 months and one year but sweet people, just one prick for all the six, DPT+IPV+Hib+Hep B.
In Sweden, they also have BCG vaccine at 6 months old.

Now coming to MMR, in India they recommend a vaccination only for 'measels' at 9 months and a MMR vaccine at 15 months. But in Denmark and Sweden, they give only MMR at 18 months.

Say a child is travelling to India for a vacation before she is given MMR and she is older than 9 months, then its better she gets a measles vaccine as soon as she lands in India.

There are optional vaccinations for chicken pox at one year, typhoid and Hep A at 2 years in India.

So depending on where are you at what age, we must plan the vaccinations for our children.

I would like to add two things.
A reiteration that Hib and meningitis are one and the same. Why I reiterate, is because a friend of mine relocated from India to UK, when her son was one year old, that means he received 3 doses of Hib already, did not know they are the same, ended up giving three more doses of meningitis in UK.Ideally repeating the vaccine must not cause any issue, however it costs our kids one more prick and lots of pain.

And since all the three doses of DPT+OPV are given at so young age for Indian children, its recommended that they receive a DPT booster dose(triple antigen-muthaduppu oosi)+OPV at 18months and another booster of DPT at 5 years. But in Denmark and Sweden they give the DPT booster at 5years, as the children have received the third DPT+IPV dose itself at 1 year. Now, a case, which ideally triggered me to write this post, a friend of mine who is living in Denmark, who may probably relocate to India, who has a one year old son, she asked me about what all vaccinations she would have to give in India.
Since her son has received the third DPT dose itself at one year unlike kids in India who would receive the third dose when 105 days old, she has to discuss about whether to give a booster at 18 months or the booster is enough at 5 years old itself.

No comments: