A guide to immunisations up to 13 months of age

Transcription

1 A guide to immuisatios up to 13 moths of age

2 The complete routie childhood immuisatio programme These booklets describe the immuisatios offered to your child durig the first 18 years of their life. A guide to immuisatios up to 13 moths of age Immuisatios betwee 12 ad 13 moths of age withi a moth of the first birthday Pre school immuisatios A guide to vacciatios at three years ad four moths of age Immuisatios at secodary school Your questios aswered about the HPV ad Td/IPV vacciatios give betwee 12 ad 18 years of age (school years 8 to 13) A guide to immuisatios up to 13 moths of age Covers all the immuisatios up to 13 moths but describes i detail those at 2, 3 ad 4 moths. 2 Immuisatios betwee 12 ad 13 moths of age withi a moth of the first birthday A remider leaflet to get your child immuised betwee 12 ad 13 moths of age. 3 Pre school immuisatios a guide to vacciatios at three years ad four moths of age Details of the immuisatios for your child at three years ad four moths of age before they start school. 4 Immuisatios at secodary school your questios aswered Describes the immuisatios betwee 12 ad 18 years of age. The complete immuisatio programme is show i detail o the back cover of this leaflet. Copies of these booklets are available from your cliic or doctor s surgery. See also

3 Cotets 4 Summary of immuisatios up to 13 moths of age 6 Commo questios about immuisatio 17 The childhood immuisatio programme 18 Immuisatios at 2, 3 ad 4 moths of age 18 DTaP/IPV/Hib vaccie 22 Peumococcal vaccie (PCV) 23 MeC vaccie 24 Immuisatios betwee 12 ad 13 moths of age withi a moth of the first birthday 24 Hib/MeC vaccie 25 MMR vaccie 30 Peumococcal vaccie (PCV) 31 Other immuisatios 32 BCG vaccie 33 Hepatitis B vaccie 35 Meigitis ad septicaemia 39 Travel advice for childre 42 Glossary of terms Back cover Childhood immuisatio programme a quick referece guide to your child s immuisatios. 3

4 Summary of immuisatios up to 13 moths of age Which immuisatios will my baby have at 2, 3 ad 4 moths? At 2 moths, your baby will have immuisatios agaist: diphtheria, tetaus, pertussis (whoopig cough), polio, Haemophilus ifluezae type b (Hib), ad peumococcal disease. At 3 moths, your baby will have immuisatios agaist: diphtheria, tetaus, pertussis (whoopig cough), polio, Haemophilus ifluezae type b (Hib), ad meigococcal group C disease (MeC). At 4 moths, your baby will have immuisatios agaist: diphtheria, tetaus, pertussis (whoopig cough), polio, Haemophilus ifluezae type b (Hib), peumococcal disease ad MeC. Which immuisatios will my baby have betwee 12 ad 13 moths of age? Your baby will have immuisatios agaist: Haemophilus ifluezae type b (Hib) ad MeC measles, mumps, rubella ad peumococcal disease. 4 For more iformatio visit

5 The two public health itervetios that have had the greatest impact o the world s health are clea water ad vaccies. World Health Orgaizatio 5

6 Commo questios about immuisatio

7 What is immuisatio? Immuisatio is a way of protectig agaist serious diseases. Oce we have bee immuised, our bodies are better able to fight those diseases if we come ito cotact with them. How do vaccies work? Vaccies cotai a small part of the bacterium or virus that causes a disease, or tiy amouts of the chemicals that the bacterium produces. Vaccies work by causig the body s immue system to make atibodies (substaces that fight off ifectio ad disease). If your child comes ito cotact with the ifectio, the atibodies will recogise it ad be ready to protect him or her. Because vaccies have bee used so successfully i the UK, diseases such as diphtheria have almost disappeared from this coutry. There are some diseases that ca kill childre or cause lastig damage to their health. Immuisatios are give to prepare your child s immue system to fight off those diseases if they come ito cotact with them. Whe should my baby be immuised? It is importat that your baby has their immuisatios at the right age the first oes are give at two moths old. They will be give further doses of these immuisatios whe they are three moths old ad four moths old. Other immuisatios are give betwee 12 ad 13 moths of age, the at three years ad four moths of age or soo after (before your child starts school), see the table o the back cover of this leaflet. Betwee 12 ad 18 years of age they will be offered further immuisatios. Commo questios about immuisatio 7

8 Why are babies vacciated so early? These diseases ca be particularly serious i youg babies. It is importat to make sure babies are protected as early as possible to prevet them catchig the diseases. Why does my baby eed more tha oe dose of vaccie? Most immuisatios have to be give more tha oce to prepare your child s immuity. For example, three doses of DTaP/IPV/Hib vaccie are eeded to provide protectio i babies. Booster doses are the give later i life to provide loger term protectio. How will I kow whe my baby s immuisatios are due? Your doctor s surgery or cliic will sed you a appoitmet for you to brig your baby for their immuisatio. Most surgeries ad health cetres ru special immuisatio or baby cliics. If you ca t get to the cliic, cotact the surgery to make aother appoitmet. All childhood immuisatios are free. What happes at the appoitmet? The doctor or urse will explai the immuisatio process to you, ad aswer ay questios you have. The vaccie is ijected ito the muscle of the child s thigh or the upper arm after 12 moths of age. What if I missed the appoitmet? If you missed the appoitmet or delayed the immuisatio, make a ew appoitmet. You ca pick up the immuisatio schedule where it stopped without havig to start agai. 8 For more iformatio visit

9 If some diseases have disappeared from this coutry, why do we eed to immuise agaist them? I the UK, these diseases are kept at bay by high immuisatio rates. Aroud the world, millios of people a year die from ifectious diseases with more tha 5 millio of these beig childre uder the age of five. May of these deaths could be preveted by immuisatio. As more people travel abroad ad more people come to visit this coutry, there is a risk that they will brig these diseases ito the UK. The diseases may spread to people who have t bee immuised so your baby is at greater risk if he or she has ot bee immuised. Immuisatio does t just protect your child, it also helps to protect your family ad the whole commuity, especially those childre who, for medical reasos, ca t be immuised. (See page 13 for details.) Remember, it s ever too late to have your child immuised. Eve if your child has missed a immuisatio ad is older tha the recommeded ages, talk to your doctor, practice urse or health visitor to arrage for your child to be immuised. How do we kow that vaccies are safe? Before they are allowed to be used, all medicies (icludig vaccies) are thoroughly tested to assess how safe ad effective they are. After they have bee licesed, the safety of vaccies cotiues to be moitored. Ay rare side effects that are discovered ca the be assessed further. All medicies ca cause side effects, but vaccies are amog the very safest. Research from aroud the world shows that immuisatio is the safest way to protect your child s health. Commo questios about immuisatio 9

10 I am worried that my baby will be upset by havig a ijectio. Your baby may cry ad be upset for a few miutes, but they will usually settle dow after a cuddle. Will my baby have ay side effects from the ijectio? Some babies will have side effects. They may: have redess, swellig or tederess where they had the ijectio (this will slowly disappear o its ow) be a bit irritable ad feel uwell, or have a temperature (fever). (See also page 21.) What is fever? A fever is a temperature over 37.5 C. Fevers are quite commo i youg childre, but are usually mild. If your child s face feels hot to the touch ad they look red or flushed, he or she may have a fever. You could check their temperature with a thermometer. 10 For more iformatio visit

11 How to treat a fever Keep your child cool by: makig sure they do t have too may layers of clothes or blakets o, ad givig them plety of cool driks. A dose of ifat paracetamol or ibuprofe liquid may help reduce your child s fever. Read the istructios o the bottle very carefully. You may eed to give a secod dose four to six hours later. It is ot recommeded that these medicies are give before or after vacciatio i aticipatio of a fever. Remember, ever give medicies that cotai aspiri to childre uder 16. If you are worried about your child, trust your isticts. Speak to your doctor or call NHS Direct o Call the doctor immediately if, at ay time, your child: has a temperature of 39 C or above, or has a fit. If the surgery is closed ad you ca t cotact your doctor, trust your isticts ad go to the emergecy departmet of your earest hospital. Commo questios about immuisatio 11

12 I m worried that my baby may have allergies. Ca he or she have the vaccie? Yes. Asthma, eczema, hay fever, food itoleraces ad allergies do ot prevet your child havig ay vaccie i the childhood immuisatio programme. If you have ay questios, speak to your doctor, practice urse or health visitor. Are some babies allergic to vaccies? Very rarely, childre ca have a allergic reactio soo after immuisatio. This reactio may be a rash or itchig affectig part or all of the body. The doctor or urse givig the vaccie will kow how to treat this. It does ot mea that your child should stop havig immuisatios. Eve more rarely, childre ca have a severe reactio, withi a few miutes of the immuisatio, which causes breathig difficulties ad ca cause the child to collapse. This is called a aaphylactic reactio. A recet study has show that there is oly oe aaphylactic reactio i about a millio immuisatios. The people who give immuisatios are traied to deal with aaphylactic reactios ad childre recover completely with treatmet. A aaphylactic reactio is a severe ad immediate allergic reactio that eeds urget medical attetio. Do these childhood vaccies cotai thiomersal? Noe of the routie vaccies described i this leaflet cotai thiomersal. 12 For more iformatio visit

13 Are there ay reasos why my baby should ot be immuised? There are very few reasos why babies caot be immuised. The vaccies should ot be give to babies who have had: a cofirmed aaphylactic reactio to a previous dose of the vaccie, or a cofirmed aaphylactic reactio to eomyci, streptomyci, or polymyxi B (atibiotics that may be added to vaccies i very tiy amouts). I geeral, childre who are immuosuppressed should ot receive live vaccies. Childre who are immuosuppressed iclude those: whose immue system does ot work properly because they are udergoig treatmet for a serious coditio such as a trasplat or cacer, or who have ay coditio which affects the immue system, such as severe primary immuodeficiecy. (Primary immuodeficiecies are very rare diseases that mea you are more likely to catch ifectios tha is ormal. They are usually caused by a faulty gee ad are usually diagosed soo after birth.) If this applies to your child, you must tell your doctor, practice urse or health visitor before the immuisatio. They will eed to get specialist advice o usig live vaccies such as MMR ad BCG. There are o other reasos why vaccies should defiitely ot be give. Commo questios about immuisatio 13

14 What if my baby is ill o the day of the appoitmet? If your baby has a mior illess without a fever, such as a cold, they should have their immuisatios as ormal. If your baby is ill with a fever, put off the immuisatio util they have recovered. This is to avoid the fever beig associated with the vaccie, or the vaccie icreasig the fever your child already has. If your baby: has a bleedig disorder (for example haemophilia, i which the patiet s blood does ot clot properly), or has had a fit ot associated with fever speak to your doctor, practice urse or health visitor before your child has ay immuisatio. What are fits? Fits are also called seizures or covulsios. Some are associated with fever ad some are ot. Seizures associated with fever (which may be called a febrile seizure or febrile covulsio) are rare i the first six moths of life ad are most commo i the secod year of life. After this age, they become less frequet ad are rare after the age of five years. Most childre who have febrile seizures recover fully. Whe a child has a seizure withi a short time after immuisatio, it might ot have bee caused by the vaccie or the fever. It could be due to a uderlyig medical coditio. If your baby has a fit after a immuisatio, cotact your doctor. He or she may refer you to a specialist for advice about further ivestigatios ad future immuisatios. If the surgery is closed or if you ca t cotact your doctor, go straight to the emergecy departmet of your earest hospital. 14 For more iformatio visit

15 My baby was bor early. Whe should premature babies have their first immuisatio? Premature babies may be at greater risk of ifectio. They should be immuised i lie with the recommeded schedule from two moths after birth, o matter how premature they were. Does my baby have to be immuised? I the UK, parets ca decide whether or ot to have their childre immuised. Vacciatio is recommeded because it gives your baby protectio agaist serious diseases, most of which ca kill. Aroud the world, may childre are ow routiely protected with vaccies. Because of this, some of the world s most serious diseases may soo disappear. How log do I have to wait before I ca take my baby swimmig? Cotrary to popular belief, you ca take your baby swimmig at ay time before ad after their immuisatio. Are there other ways to immuise my baby? There is o other prove, effective way to immuise your child. The Faculty of Homeopathy (the registered orgaisatio for doctors qualified i homeopathy) follows the Departmet of Health guidelies ad advises parets to have their childre immuised with stadard vaccies, uless there are medical reasos for ot doig so. For more iformatio, visit Commo questios about immuisatio 15

16 Why is the immuisatio programme chaged from time to time? Immuisatio programmes are regularly reviewed to make sure that all childre are offered protectio agaist prevetable diseases. As ew vaccies become available, or research shows that givig existig vaccies at differet times improves protectio, the programme will be chaged. Recet chages to the UK programme have bee: replacig the puemocococcal vaccie (PCV) that provided protectio agaist seve strais of peumococcal bacteria with PCV that protects agaist a further six strais. givig the vacciatios previously give i two sessios at 12 ad 13 moths of age i oe sessio betwee 12 ad 13 moths of age. 16 For more iformatio visit

17 The childhood immuisatio programme

18 The childhood immuisatio programme Immuisatios are give to babies at two, three ad four moths of age, with further immuisatios give betwee 12 ad 13 moths of age. Immuisatios at two, three ad four moths of age You will be offered DTaP/IPV/Hib, MeC ad PCV for your baby durig the first four moths of their life see the table o page 19. The vaccies are described below, together with the diseases they protect agaist. DTaP/IPV/Hib vaccie Your baby should be immuised with DTaP/IPV/Hib vaccie whe they are two, three ad four moths old. The DTaP/IPV/Hib vaccie protects agaist five differet diseases diphtheria, tetaus, pertussis (whoopig cough), polio ad Haemophilus ifluezae type b (Hib). Your child should have a Hib booster (i combiatio with MeC) betwee 12 ad 13 moths of age; boosters agaist diphtheria, tetaus, pertussis ad polio before they start school; ad a further tetaus, diphtheria ad polio booster betwee the ages of 13 ad 18 years. How effective is the DTaP/IPV/Hib vaccie? Studies have show that DTaP/IPV/Hib vaccie is very effective i protectig your baby agaist these five serious diseases. Further doses are eeded to exted this protectio as your child grows up. 18 For more iformatio visit

19 The routie primary immuisatio programme for babies at two, three ad four moths of age Each vacciatio is give as a sigle ijectio ito the muscle of the child s thigh. At what age to immuise Diseases protected agaist Vaccie give Two moths old Three moths old Four moths old Diphtheria, tetaus, pertussis, polio, Haemophilus ifluezae type b (Hib) ad peumococcal disease Diphtheria, tetaus, pertussis, polio, Hib ad meigococcal group C disease (MeC) Diphtheria, tetaus, pertussis, polio, Hib, MeC ad peumococcal disease DTaP/IPV/Hib ad PCV DTaP/IPV/Hib ad MeC DTaP/IPV/Hib, MeC ad PCV What is diphtheria? Diphtheria is a serious disease that usually begis with a sore throat ad ca quickly cause breathig problems. It ca damage the heart ad ervous system ad, i severe cases, it ca kill. Before the diphtheria vaccie was itroduced i this coutry, there were up to 70,000 cases of diphtheria a year, causig up to 5000 deaths. What is tetaus? Tetaus is a disease affectig the ervous system which ca lead to muscle spasms, cause breathig problems ad ca kill. It is caused whe germs that are foud i soil ad maure get ito the body through ope cuts or burs. Tetaus caot be passed from perso to perso. Immuisatios at two, three ad four moths of age 19

20 What is pertussis (whoopig cough)? Whoopig cough is a disease that ca cause log bouts of coughig ad chokig, makig it hard to breathe. Whoopig cough ca last for up to 10 weeks. Babies uder oe year of age are most at risk from whoopig cough. For these babies, the disease is very serious ad it ca kill. It is ot usually so serious i older childre. Before the pertussis vaccie was itroduced, the average umber of cases of whoopig cough reported each year i the UK was 120,000, ad 92 childre died i the year before the vaccie was itroduced. What is polio? Polio is a virus that attacks the ervous system ad ca cause permaet paralysis of muscles. If it affects the chest muscles or the brai, polio ca kill. Before the polio vaccie was itroduced, there were as may as 8000 cases of polio i the UK i epidemic years. Because of the cotiued success of the polio vacciatio, there have bee o cases of atural polio ifectio i the UK for over 20 years (the last case was i 1984). What is Hib? Hib is a ifectio caused by Haemophilus ifluezae type b bacteria. It ca lead to a umber of major illesses such as blood poisoig (septicaemia), peumoia ad meigitis. The Hib vaccie oly protects your baby agaist the type of meigitis caused by the Haemophilus ifluezae type b bacteria it does ot protect agaist ay other causes of meigitis. The illesses caused by Hib ca kill if they are ot treated quickly. Before the Hib vaccie was itroduced, there were about 800 cases of Hib i youg childre every year. Ad sice it's bee itroduced, the umber of childre uder five years of age with Hib has falle by 99%. 20 For more iformatio visit

21 Meigitis ca be caused by bacteria ad viruses (see the sectio o meigitis ad septicaemia). After immuisatio with DTaP/IPV/Hib Your baby might get some of the followig side effects, which are usually mild. Redess, swellig or tederess where they had the ijectio. It is quite ormal for your baby to be miserable for up to 48 hours after havig the ijectio. Your baby could develop a mild fever (see page 10). You might otice a small lump where your baby had the ijectio. This may last for a few weeks but will slowly disappear. If you thik your baby has had ay other reactio to the DTaP/IPV/Hib vaccie ad you are cocered about it, talk to your doctor, practice urse or health visitor. Parets ad carers ca also report suspected side effects of vaccies ad medicies through the Yellow Card Scheme. You ca do this olie by visitig or by callig the Yellow Card hotlie o Freephoe (available Moday to Friday from 10am to 2pm). Immuisatios at two, three ad four moths of age 21

22 Peumococcal vaccie (PCV) Your baby should be immuised with PCV whe they are two ad four moths old. What is peumococcal ifectio? Peumococcal (proouced ew mo cock al) ifectio is oe of the commoest causes of meigitis but it also causes ear ifectios (otitis media), peumoia ad some other serious illesses. PCV provides some protectio agaist oe of the commoest causes of meigitis, ad also agaist other coditios such as severe ear ifectios (otitis media), ad peumoia caused by peumococcal bacteria. This vaccie does ot protect agaist all types of peumococcal bacteria ad does ot protect agaist meigitis caused by other bacteria or viruses (see the meigitis ad septicaemia sectio o page 35). After immuisatio with PCV Out of every 10 babies immuised, oe or two may get swellig, redess or tederess at the ijectio site or get a mild fever (see also pages 10 ad 21). 22 For more iformatio visit

23 MeC vaccie Your baby should be immuised with MeC vaccie whe they are three ad four moths old. This vaccie protects agaist meigitis ad septicaemia (blood poisoig) caused by meigococcal group C bacteria. Before the vaccie was itroduced, this disease led to about 1500 cases ad 150 deaths each year. MeC vaccie does ot protect agaist meigitis caused by other bacteria or by viruses (see page 35). How effective is the MeC vaccie? Sice the vaccie was itroduced, the umber of babies uder the age of oe with group C disease has falle by about 99%. A booster dose of MeC i the secod year of life is eeded to provide loger term protectio. Both meigitis ad septicaemia are very serious. See page 35 for descriptios of the diseases, their sigs ad symptoms, ad what to do about them. After immuisatio with MeC vaccie Your baby may have redess, swellig or tederess where they had the ijectio. About half of all babies who have the vaccie may become irritable, ad about oe i 20 could get a mild fever (see also pages 10 ad 21). Immuisatios at two, three ad four moths of age 23

24 Immuisatios betwee 12 ad 13 moths of age withi a moth of the first birthday Your child will eed a dose of the combied Hib/MeC vaccie betwee 12 ad 13 moths of age to boost their protectio agaist Haemophilus ifluezae type b (Hib) ad meigococcal C ifectios. This booster will protect your child through early childhood. Your child will also have their first dose of MMR vaccie at this time to protect agaist measles, mumps ad rubella, ad the PCV booster to provide loger term protectio agaist peumococcal disease see the table below. Your child will eed a secod dose of MMR vaccie before startig school. The routie primary immuisatios for babies betwee 12 ad 13 moths of age Each vacciatio is give as a sigle ijectio ito the muscle of the child s thigh or upper arm. At what age to immuise Betwee 12 ad 13 moths withi a moth of the first birthday Diseases protected agaist Haemophilus ifluezae type b (Hib), meigococcal group C disease (MeC) Measles, mumps ad rubella Peumococcal disease Vaccie give Hib/MeC booster MMR PCV booster Hib/MeC vaccie Your baby should be immuised with their booster dose of Hib/MeC vaccie whe they are betwee 12 ad 13 moths of age at the same time as their MMR ad booster PCV vacciatios. 24 For more iformatio visit

25 This booster dose provides loger term protectio agaist two causes of meigitis ad septicaemia. After immuisatio with Hib/MeC booster Your baby may have redess, swellig or tederess where they had the ijectio. About half of all babies who have the vaccie may become irritable, ad about oe i 20 could get a mild fever (see also pages 10 ad 21). MMR vaccie Your baby should be immuised with their first dose of MMR vaccie betwee 12 ad 13 moths of age at the same time as their Hib/MeC ad PCV vacciatios. MMR protects your child agaist measles, mumps ad rubella (Germa measles). What is the MMR vaccie? The MMR vaccie cotais weakeed versios of live measles, mumps ad rubella viruses. Because the viruses are weakeed, people who have had the vaccie caot ifect other people. How ad whe is the vaccie give? The vaccie is ijected ito the muscle of the child s thigh or upper arm. It is give to a child betwee 12 ad 13 moths of age after the immuity they got from their mother wears off. It should be give agai whe childre are three years ad four moths of age or soo after. How effective is the MMR vaccie? Sice it was itroduced i the UK i 1988, the MMR vaccie has almost wiped out the three diseases (measles, mumps, rubella) i youg childre. Immuisatios betwee 12 ad 13 moths of age 25

26 What is measles? Measles is caused by a very ifectious virus. Nearly everyoe who catches it will have a high fever, a rash ad geerally be uwell. Childre ofte have to sped about five days i bed ad could be off school for 10 days. Adults are likely to be ill for loger. It is ot possible to tell who will be seriously affected by measles. The complicatios of measles affect oe i every 15 childre. The complicatios iclude chest ifectios, fits, ecephalitis (ifectio of the brai), ad brai damage. I very serious cases, measles ca kill. I 1987 (the year before the MMR vaccie was itroduced i the UK), 86,000 childre caught measles ad 16 died. How is it spread? Measles is oe of the most ifectious diseases kow. A cough or a seeze ca spread the measles virus over a wide area. Because it s so ifectious, the chaces are your child will get measles if he or she is ot protected ad comes ito cotact with someoe who has measles. 26

27 What is mumps? Mumps is caused by a virus which ca lead to fever, headache, ad paiful, swolle glads i the face, eck ad jaw. It ca result i permaet deafess, viral meigitis (ifectio of the liig of the brai) ad ecephalitis. Rarely, it causes paiful swellig of the testicles i males ad the ovaries i females. Mumps lasts about seve to 10 days. Before the MMR vaccie was itroduced, about 1200 people a year i the UK wet ito hospital because of mumps. How is it spread? Mumps is spread i the same way as measles. It is about as ifectious as flu. What is rubella? Rubella (Germa measles) is also caused by a virus. I childre it is usually mild ad ca go uoticed. It causes a short lived rash, swolle glads ad a sore throat. Rubella is very serious for ubor babies. It ca seriously damage their sight, hearig, heart ad brai. This coditio is called cogeital rubella sydrome (CRS). Rubella ifectio i the first three moths of pregacy causes damage to the ubor baby i ie out of 10 cases. I may of the cases, pregat wome caught rubella from their ow, or their frieds, childre. I the five years before the MMR vaccie was itroduced, about 43 babies a year were bor i the UK with cogeital rubella sydrome. How is it spread? Rubella is spread i the same way as measles ad mumps. It is about as ifectious as flu. Immuisatios betwee 12 ad 13 moths of age 27

28 After vacciatio with MMR The three viruses i the vaccie act at differet times ad may produce the followig side effects after the first dose. Six to 10 days after the immuisatio, as the measles part of the vaccie starts to work, about oe i 10 childre may develop a fever ad some develop a measles like rash ad go off their food (for advice o treatig a fever, see page 11). About oe i every 1000 immuised childre may have a fit caused by a fever. This is called a febrile covulsio (see page 14). However, if a child who has ot bee immuised gets measles, they are five times more likely to have a fit. Rarely, childre may get mumps like symptoms (fever ad swolle glads) about three weeks after their immuisatio as the mumps part of the vaccie starts to work. Very rarely, childre may get a rash of small bruise like spots i the six weeks after the vacciatio. This is usually caused by the measles or rubella parts of the vaccie. If you see spots like these, take your child to the doctor to be checked. He or she will tell you how to deal with the rash. Fewer tha oe child i a millio develops ecephalitis (swellig of the brai) after the MMR vaccie, ad there is very little evidece that it is actually caused by the vaccie. However, if a child who has ot bee vacciated catches measles, the chace of developig ecephalitis is betwee oe i 200 ad oe i Side effects after the secod dose are eve less commo ad usually milder (see also page 21). 28 For more iformatio visit

29 Egg allergies The MMR vaccie ca safely be give to childre who have had a severe allergy (aaphylactic reactio) to egg. This is because MMR vaccie is grow o chick cells, ot the egg white or yolk. If you have ay cocers, talk to your health visitor, practice urse or doctor. MMR ad autism There have bee may stories i the media likig MMR with autism. Some parets delayed their child s MMR immuisatio or did t have it at all, which led to outbreaks of measles. However, idepedet experts from aroud the world have foud o scietific evidece for such a lik. I fact, there is ow a large amout of evidece showig that there is o lik. MMR is the safest way to protect your child agaist measles, mumps ad rubella. Immuisatios betwee 12 ad 13 moths of age 29

30 Peumococcal vaccie (PCV) Your child should be immuised with their booster dose of PCV betwee 12 ad 13 moths of age at the same time as their Hib/MeC ad MMR vacciatios. This vacciatio provides loger term protectio agaist peumococcal ifectio. After immuisatio with the PCV booster Out of 10 babies immuised, oe or two may get swellig, redess or tederess where they had the ijectio, or they may have a mild fever (see also page 21). Wo t givig my baby MMR, PCV ad Hib/MeC at the same time overload their immue system? No. From birth, babies immue systems protect them from the germs that surroud them. Without this protectio, babies would ot be able to cope with the tes of thousads of bacteria ad viruses that cover their ski, ose, throat ad itesties. This protectio carries o throughout life. I theory, a baby could respod effectively to aroud 10,000 vaccies at ay oe time. The baby s immue system ca ad does easily cope with the MMR, peumococcal ad Hib/MeC vaccies at the same time. 30 For more iformatio visit

31 Other immuisatios

32 BCG vaccie Protectig babies agaist tuberculosis (TB) The BCG vaccie is ot part of the immuisatio programme for all childre. The BCG vaccie is offered to those babies who are more likely tha others to come ito close ad prologed cotact with someoe with TB. If the vacciatio is offered, it is usually while you ad your baby are still i hospital, but it ca be give later. What is TB? TB is a ifectio that usually affects the lugs. It ca also affect other parts of the body, such as the lymph glads, boes, joits ad kideys. Most cases ca be cured with treatmet. TB ca also cause a very serious form of meigitis. After immuisatio A blister or sore may appear where the ijectio is give. If it does appear, it will heal gradually, ad it is best if you do ot cover it up. The sore may leave a small scar. If you are worried or thik the sore has become ifected, see your doctor (see also page 21). Although TB is o loger as commo i the UK, worldwide it kills aroud two millio people a year. 32 For more iformatio visit

33 Hepatitis B vaccie Protectig babies agaist hepatitis B The hepatitis B vaccie is ot part of the routie childhood immuisatio programme. The vaccie is curretly give to babies whose mothers have hepatitis B to prevet the babies developig the disease. The first dose is give shortly after birth. A secod dose is give whe the baby is oe moth old. A third dose is give at two moths old. A booster dose is give whe the baby is 12 moths old to provide loger term protectio. A blood test is take at 12 moths to check that the baby has ot developed hepatitis B. What is hepatitis? Hepatitis is a ifectio of the liver caused by hepatitis viruses. Hepatitis B vaccie protects agaist the B type of the virus, but it does ot protect agaist hepatitis caused by other types of the virus. The hepatitis B virus is passed through ifected blood from mothers to their babies. If you are pregat ad have hepatitis B, or if you get the disease durig your pregacy, you could pass it o to your baby. Your baby may ot be ill immediately after birth but they have a high chace of becomig a carrier ad developig serious liver disease later i life. Some people carry the virus i their blood without kowig it. Other immuisatios 33

34 Pregat wome i the UK are offered a hepatitis B test durig their ateatal care. If you have hepatitis B, you should have your baby vacciated after birth to prevet them from becomig ifected. It is safe to breastfeed your baby as log as they receive their vaccies o time. After immuisatio The side effects of the hepatitis B vaccie are usually quite mild. There could be some redess, soreess or tederess where the ijectio is give. This lasts for a few days (see also page 21). For more iformatio, visit ad type hepatitis B i the search box. 34

35 Watch out for meigitis ad septicaemia Both meigitis ad septicaemia are very serious. It is importat that you recogise the sigs ad symptoms ad kow what to do if you see them. Early symptoms of meigitis ad septicaemia may be similar to a cold or flu (fever, vomitig, irritability ad restlessess). However, people with meigitis or septicaemia ca become seriously ill withi hours, so it is importat to kow the sigs ad symptoms of these coditios. What is meigitis? Meigitis is a ifectio of the liig of the brai. Meigitis ca be caused by several types of bacteria or viruses. Ifectio with meigococcal bacteria ca cause meigitis, septicaemia (blood poisoig), pericarditis (iflammatio of the liig of the sac that cotais the heart) ad arthritis (swellig of the joits). What is septicaemia? Septicaemia is a very serious coditio whe the bloodstream is ifected. The sigs are cold hads ad feet, pale ski, vomitig ad beig very sleepy or fidig it difficult to wake up, ad these sigs ca come o quickly. If you suspect you or someoe else has septicaemia, get help urgetly. Watch out for meigitis ad septicaemia 35

36 I babies, the mai symptoms of meigitis may iclude: a high pitched, moaig cry beig irritable whe picked up a bulgig fotaelle (see the glossary o page 42) feelig drowsy ad ot respodig to you, or beig difficult to wake beig floppy ad havig o eergy or stiff with jerky movemets refusig feeds ad vomitig havig ski that is pale, blotchy or turig blue, ad a fever. The mai symptoms of septicaemia may iclude: rapid or uusual patters of breathig ski that is pale, blotchy or turig blue fever with cold hads ad feet shiverig vomitig ad refusig feeds red or purple spots that do ot fade uder pressure (do the glass test explaied o page 38) pai or irritability from muscle aches or severe limb or joit pai floppiess, ad extreme tiredess. 36 For more iformatio visit

37 I older childre, adolescets ad adults, the mai symptoms of meigitis may iclude: a stiff eck (check that they ca kiss their kees or touch their forehead with their kees) a very bad headache (although this o its ow is ot a reaso to get medical help) watig to avoid bright lights vomitig a fever tiredess, beig less resposive ad cofused, ad a rash. The mai symptoms of septicaemia may iclude: sleepiess, beig less resposive, uiterested or cofused (a late sig i septicaemia) severe pais ad aches i the arms, legs ad joits very cold hads ad feet shiverig rapid breathig red or purple spots that do ot fade uder pressure (do the glass test explaied o page 38) vomitig a fever, ad diarrhoea ad stomach cramps. Watch out for meigitis ad septicaemia 37

38 The sigs ad symptoms of meigitis ad septicaemia are listed o the previous pages. It is importat to remember that ot everyoe will develop all the symptoms listed. If a idividual develops some of the symptoms listed, especially red or purple spots, get medical help urgetly. If you ca t get i touch with your doctor, or you are still worried after gettig advice, trust your isticts ad take your child to the emergecy departmet of your earest hospital. The glass test Press the side of a clear drikig glass firmly agaist the rash so you ca see if the rash fades ad loses colour uder pressure. If it does t chage colour, cotact your doctor immediately. Where ca I get more iformatio? The Meigitis Research Foudatio ad the Meigitis Trust both provide iformatio o meigitis. Phoe the Meigitis Research Foudatio s free 24 hour helplie o or visit the website at Phoe the Meigitis Trust s 24 hour helplie o or visit the website at trust.org. You ca also ask your doctor, practice urse or health visitor for advice, or call NHS Direct o For more iformatio visit

39 Travel advice for childre

40 If your child is goig abroad, make sure their routie immuisatios are up to date. Your child may also eed extra immuisatios. Cotact your doctor s surgery or a travel cliic well i advace for up to date iformatio o the immuisatios your child may eed. Courses of most travel vaccies ca be give over a fourweek period, but you will eed to allow more time if your child has ot yet had their primary (first) course of the DTaP/IPV/Hib vaccie. If you fid that you have less time before goig abroad, it is still worth attedig a cliic to make sure your child gets as much protectio as possible, as well as gettig iformatio about reducig the risks of ill health abroad. Depedig o where you are goig, your child may eed to be immuised agaist other diseases such as yellow fever, ad have a vacciatio certificate as proof, before they ca eter some coutries. The yellow fever vacciatio certificate becomes valid ad effective 10 days after the vacciatio is give. Watch out for malaria Malaria is a serious ifectio that you ca catch from mosquito bites. It is a major problem i tropical coutries. If you are travellig to a area where there is malaria, your child will eed protectio. 40 For more iformatio visit

41 Avoidig mosquito bites You should do all you ca to prevet your child from gettig bitte by mosquitoes. Durig the day ad ight, dress your child i clothes that cover the arms ad legs. Use isect repellet o the ski ad a mosquito et soaked i isecticide over the bed or cot at ight. Use a isect repellet that is suitable for childre. Ask your pharmacist for advice. There is t a immuisatio agaist malaria, but your doctor will be able to give you advice o ati malarial drugs. Ati malarial drugs do ot provide complete protectio but they are importat whe you are travellig to some parts of the world. They ca be quite difficult to take but there are some especially for childre. For more iformatio You ca get Access to healthcare abroad (product code umber ), a iformatio leaflet produced by the Departmet of Health, by visitig the DH Publicatios Orderlie at You ca also get more iformatio o the Departmet of Health website at or NHS Choices at Travel advice for childre 41

42 Glossary of terms This glossary describes some of the terms relevat to your child s immuisatios. Acellular pertussis vaccie Whoopig cough vaccie cotaiig oly parts of the pertussis bacterial cells which ca produce immuity i the perso receivig the vaccie. Aaphylactic reactio A immediate ad severe allergic reactio which eeds urget medical attetio. DTaP/IPV vaccie A combied vaccie that protects agaist four diseases diphtheria, tetaus, pertussis (whoopig cough) ad polio. It cotais acellular pertussis vaccie ad iactivated polio vaccie. It is give to youg childre aged three years four moths to five years as a pre school immuisatio. dtap/ipv vaccie A combied vaccie that protects agaist four diseases diphtheria, tetaus, pertussis (whoopig cough) ad polio. It cotais low dose diphtheria vaccie, acellular pertussis vaccie ad iactivated polio vaccie. It is a alterative to the DTaP/IPV vaccie that is give to pre school childre aged three years four moths to five years. DTaP/IPV/Hib vaccie A combied vaccie that protects agaist five diseases diphtheria, tetaus, pertussis (whoopig cough), polio ad Haemophilus ifluezae type b (Hib). It cotais acellular pertussis vaccie ad iactivated polio vaccie. Fotaelle Space betwee the boes at the top of a baby s skull. Hib/MeC vaccie A combied vaccie that protects agaist Haemophilus ifluezae type b ifectios ad meigococcal C ifectios. 42 For more iformatio visit

43 Iactivated polio vaccie (IPV) Polio vaccie made from viruses that have bee killed. MeC vaccie A sigle vaccie that protects agaist meigococcal C ifectios. Neomyci A atibiotic put ito vaccies to prevet cotamiatio by bacteria. Peumococcal cojugate vaccie (PCV) A vaccie that protects agaist ifectios caused by seve types of peumococcal bacteria. Polymyxi B A atibiotic put ito vaccies to prevet cotamiatio by bacteria. Streptomyci A atibiotic put ito vaccies to prevet cotamiatio by bacteria. Td/IPV vaccie A combied vaccie that protects agaist three diseases tetaus, diphtheria ad polio. It cotais tetaus, low dose diphtheria ad iactivated polio vaccie. It is give to youg people aged 13 to 18 years to top up their levels of protectio agaist the three diseases. Thiomersal A mercury based preservative used i some vaccies durig the productio process or to prevet cotamiatio. Glossary 43

44 Vaccie Damage Paymet Scheme Most immuisatios are give without ay trouble at all, but very rarely there may be problems. The Vaccie Damage Paymet Scheme is desiged to help with the preset ad future fiacial burdes of the perso affected by the vacciatio ad their family. It covers all the vaccies described i this booklet except hepatitis B vaccie. There are several coditios that eed to be met before a paymet ca be made. If you eed more iformatio, please cotact: Vaccie Damage Paymets Uit Departmet for Work ad Pesios Palatie House Lacaster Road Presto PR1 1HB Phoe: E mail: CAU VDPU@dwp.gsi.gov.uk 44 For more iformatio visit

45 If you wat more advice o immuisatio, speak to your doctor, practice urse or health visitor, or call NHS Direct o For more iformatio or to ask questios, visit 45

46 Crow copyright ap 164k Feb11 (AHP) (404921) Produced by COI for the Departmet of Health First published Jauary 2011 The text of this documet may be reproduced without formal permissio or charge for persoal or i house use. If you eed more copies of this booklet, please visit ad quote /A guide to immuisatios up to 13 moths of age or cotact DH Publicatios Orderlie Phoe: Miicom: (8am to 6pm, Moday to Friday)

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48 Routie childhood immuisatio programme Each vacciatio is give as a sigle ijectio ito the muscle of the thigh or upper arm. At what age to immuise Two moths old Three moths old Diseases protected agaist Diphtheria, tetaus, pertussis (whoopig cough), polio ad Haemophilus ifluezae type b (Hib) Peumococcal disease Diphtheria, tetaus, pertussis, polio ad Hib Meigococcal group C disease (MeC) Vaccie give DTaP/IPV/Hib ad Peumococcal cojugate vaccie (PCV) DTaP/IPV/Hib ad MeC Four moths old Betwee 12 ad 13 moths old withi a moth of the first birthday Three years ad four moths or soo after Girls aged 12 to 13 years Diphtheria, tetaus, pertussis, polio ad Hib MeC Peumococcal disease Hib MeC Peumococcal disease Measles, mumps ad rubella (Germa measles) Diphtheria, tetaus, pertussis ad polio Measles, mumps ad rubella Cervical cacer caused by huma papillomavirus types 16 ad 18 DTaP/IPV/Hib ad MeC ad PCV Hib/MeC, PCV ad MMR DTaP/IPV or dtap/ipv ad MMR HPV 13 to 18 years old Tetaus, diphtheria ad polio Td/IPV No routie immuisatios for at risk babies At what age to immuise At birth (to babies who are more likely to come ito cotact with TB tha the geeral populatio) At birth (to babies whose mothers have hepatitis B) Diseases protected agaist Tuberculosis Hepatitis B Vaccie give BCG Hep B Immuisatio Iformatio