One of the most important things you can do as a parent to safeguard your child’s health, both now and in the future, is to ensure they receive all their routine childhood immunisations.
You’ll be protecting them against a wide range of different infectious diseases that were once common in childhood in the UK, and still result in death and disability for millions of children in the developing world today.
Routine primary vaccines are given at two, three and four months. At each visit a baby is offered the ‘five in one’: diphtheria, whooping cough, tetanus, polio and Hib as one injection. At two months they are also offered the pneumococcal vaccine, at three months the Meningitis C vaccine and at four months both of these. A Hib/Men C booster is given at 12 months, and at 13 months the first dose of measles, mumps and rubella vaccine (MMR) and a booster of pneumococcal vaccine. Just before starting school there’s a second dose of MMR (this can be earlier) and a booster of diphtheria, tetanus, polio and whooping cough. Before leaving school, teenagers are given a diphtheria, tetanus and polio booster.
Before routine childhood immunisations, nearly everyone would have had a number of these diseases and many would have died. Although some of these infections may now be quite rare in the UK, they still exist in other countries.
To keep the conditions from circulating again in the UK, and to prevent epidemics, a high proportion of children need to be immunised providing what’s known as herd immunity. This means children who cannot be immunised or are too young will be protected because the diseases become so uncommon. In countries where vaccine rates have fallen for one reason or another, the diseases have come back.
A young baby’s immune system is able to cope with many more antigens than is contained in the immunisation schedule. In fact it has been calculated that a baby could cope with thousands at any one time. Newer vaccines contain 50-60 times fewer antigens than vaccines used 10 or 20 years ago.
There isn’t much you can do to prepare your baby. A cuddle while your baby’s having the injection will provide comfort, but it’s very likely your baby will cry for a short time.
Older children can be prepared just before the injection by telling them what’s going to happen. You could read a story about going to the doctor’s. Be honest - if your child asks if the injection will hurt, say it will a bit, but the discomfort will be over very quickly. Recent research shows that the way parent or carer behaves when a child is being immunised is very important. Distracting them, taking a matter-of-fact approach and not being too apologetic for the fact the child is having an injection all help a child cope.
After any vaccine a baby or child may have a red, swollen area where the injection was given but this usually settles down on its own. After the primary vaccines it’s normal for some babies to have a fever and feel unwell for up to 48 hours. If this happens, a dose of infant paracetamol or ibuprofen can help reduce the fever.
If your child has a fever, it’s best to postpone a routine immunisation appointment until they’re better. If a child has had a very severe (anaphylactic) reaction to a vaccine, they should not receive a subsequent dose of the same vaccine. Anaphylaxis after immunisation is rare (about 1 in 100,000 to 1 million doses). It’s advised that children whose immune systems already do not work properly, such as those with leukaemia, should not have live vaccines.
Routine immunisation of school children against TB stopped in September 2005 on advice from the Department of Health. The vaccine is now only offered to children in high risk groups.
When BCG was introduced, TB was much commoner than it is now and affected all groups in the population. The pattern of infectious diseases changes over time. Although there has been a rise in the incidence of TB in the last 15-20 years, it is much less common overall than when the vaccine was introduced.
As with any vaccine, use of BCG has been kept under constant review and the decision to stop using it among school children was expected for a few years.
The vaccine is now given to those who are particularly at risk. This includes babies born in areas of the country where TB is common, children whose parents or grand parents were born in countries where TB is common, and people going to countries where TB is common.
Your first port of call should be your GP, practice nurse or health visitor who will be able to give you a schedule of recommended immunisations, and information on each. They would also be happy to discuss these with you, and answer any questions.
You may also feel you want to do some research yourself. The Internet is an obvious source of information but be aware that anyone can put information on the worldwide web - you need to know that what you are reading is accurate.
Check who the author is and whether they seem qualified to give information; look at the date the information was last updated (advice may change in the light of new knowledge); also where there may be significant alternative views does the author mention them?
Last reviewed by Great Ormond Street Hospital: May 2007
This information has been written by Great Ormond Street Hospital specialists and has also appeared in a different format on the website of The Times newspaper.
