Nurture Article | The Portland Hospital Parenting Magazine
Winter Issue 2011 | Lucy Elkins
Watching as the GP injects your precious baby not once but twice, giving them protection against six different diseases, is enough to bring a tear to most mothers’ eyes. Suddenly, your baby’s face crumples and giant tears start tumbling down their cheeks, as they wonder what on Earth is going on. Yet deciding whether to vaccinate is one of the first and most important decisions parents must make about the health of their child.
“The idea of vaccinations is to protect children against diseases that could be extremely dangerous to them,” explains Dr Ahmed Massoud, a consultant paediatrician at the Portland Hospital.
“So the time they are given is designed to strike a balance between protecting children and waiting until their immune system can cope with the vaccines.
“You don’t want to give the vaccines too late as the children may then be exposed to diseases which could prove fatal to them.
“However, giving some vaccines earlier than eight weeks is also not practical because a newborn baby’s immune system is not mature enough to produce antibodies in response to certain vaccines.
“That would mean that the vaccine may not lead to adequate protection.”
Diseases such as polio are now virtually unheard of in this country thanks to vaccination programmes, and parents used to take their children along for their jabs without a second thought.
However, that changed after The Lancet published a study in 1998 suggesting that there may be a link between the MMR (measles, mumps, rubella) vaccine and autism and inflammatory bowel disease.
The study examined the outcomes of just 14 children and was later discredited but the damage was done. Uptake of vaccinations plummeted so much that in some areas only one in four children was having them.
However, recently the Health Protection Agency has appealed to parents to get their children vaccinated as outbreaks of diseases such as measles have become increasingly common.
The MMR jab is left a little later, until after a child’s first birthday, because unlike the vaccines given earlier
it contains live viruses.
“A baby is born with some antibodies from its mother and these antibodies would stop the work of the vaccine,” says Helen Bedford, a senior lecturer in children’s health at the Institute of Child Health in London.
“However these antibodies start to die off after around six months which is why the MMR is given later.”
Some people think that giving children so many jabs – in this country they receive vaccinations against ten different diseases before the age of two – will overburden their system, but this is not the case says Helen Bedford.
“Every time you breathe, eat or drink you take in numerous things that challenge the immune system,” she explains.
“The amount given in a vaccine is tiny in comparison.”
If children are not vaccinated, then they face a bigger threat from diseases that they would otherwise stand little chance of exposure to.
“In order to eradicate an infection you need to protect individuals and the community as a whole,” says Dr Massoud.
“You need to have around 95 percent of children vaccinated to achieve what is known as herd immunity.
“Otherwise, with a large number of the population not vaccinated, it makes the chance of outbreaks of these diseases more likely.”
All vaccinations are available free on the NHS, but some parents opt to have their children immunised privately as it gives them more control and choice.
It is also possible to get vaccinations privately such as chicken pox which are not available on the NHS, but are routinely given in other countries such as the United States.
Chicken pox is one of a number of conditions the NHS may offer childhood vaccinations for in the future.
However, there are concerns that if children are vaccinated against chicken pox, adults will be more likely to pick it up as their vaccine immunity wears off – and it can be a really nasty illness for adults.
Others under consideration or development include meningococcal B, a cause of bacterial meningitis and Hepatitis B.
“We are one of the only countries in the world not to vaccinate against that,” adds Helen Bedford.
“At the moment pregnant women are screened for it and if they are infected then their babies will be vaccinated against it but that might change.”
Q My baby has a cold, should I postpone their scheduled vaccination?
A No, children can still be vaccinated when they have a minor infection such as a cold. It is, however, advisable to delay a vaccine if your child has a fever. This is because vaccines can also cause a fever and this may confuse the diagnosis.
Q My child was underweight or premature at birth, should I delay vaccinating?
A No. Their immune system should be mature enough to cope with the vaccine at eight weeks irrespective of birth weight. The only children not advised to have a vaccine are those who have had an anaphylactic reaction to that specific vaccine. MMR is not recommended to those with immune-suppressant conditions as the vaccine contains live virus.
Q I am concerned about the MMR. Is it safer to have the injections separately?
A Scientifically, there is no valid reason not to have the MMR, says Dr Massoud. Separate vaccines can only be given privately (and cost around £100 each). At the moment there is no single mumps vaccine available.
Q Will vaccinations make my child’s immune system weaker?
A No the reverse is true. Studies have found that vaccinated children generally get fewer infections than children who have not been vaccinated, according to Helen Bedford.
Q Is it ever too late to vaccinate a child?
A No, although there are some exceptions. Hib is not normally given to those over ten because it is uncommon in anyone over the age of five. Whooping cough is also not normally given to those over ten because beyond that age it is not normally life threatening. Women who are hoping to have a family should ensure they have had the rubella vaccine as rubella can cause serious birth defects.
VACCINE TIMELINE CHECKLIST
5-in-one jab (Diphtheria, tetanus, whooping cough, polio and heamophilus influenza type b or Hib)Pneumococcal infection
5-in-one second dose Meningitis C
5-in-one third dose
Meningitis C second dose
Pneumococcal infection second dose
BETWEEN 12 MONTHS AND 13 MONTHS
Meningitis C third dose and Hib fourth dose
MMR (measles, mumps, rubella) Pneumococcal infection, third dose
3 YEARS AND FOUR MONTHS
MMR second jab
4-in-one pre school booster: Diphtheria, tetanus, whooping cough and polio
Cervical cancer vaccine
Diphtheria, tetanus and polio booster