A shot of confusion for parents

The first 18 months since her daughter, Drea's birth, Kandivli resident Mansi Sheth would dread the paediatrician visits to Princess Street in Marine Lines. It wasn't the distance that was daunting but the mention of expensive vaccines. The recommendation would often be followed by the six words that seal the deal for most parents: It's what's best for your baby. "He was a good doctor," Sheth says, "But subconsciously, he made us question our reluctance to use optional vaccines that are not on the national programme. Some others, like pneumococcal conjugate vaccine cost us R8,000 at the time of Drea's birth."

The national programme or the Universal Immunisation Programme is a Ministry of Health and Family Welfare initiative that provides important vaccines to infants, children and pregnant women. Vaccinations against life-threatening diseases have been one of the greatest public health achievements. Millions of child deaths have been prevented, and several others have been saved from illness that could leave one disfigured for life. However, factors like misinformation, fear and costs often keep some parents from getting their child vaccinated.

Dr Samir Dalwai

Management consultant Sharanya Shriram also faced a similar predicament with the paediatrician that the hospital had assigned her. "She made us anxious about everything, including birth weight and vaccines. As a first-time parent, the last thing you want is someone pressing the panic buttons. She asked us to use only a certain private brand of vaccine claiming it was better. But my husband is a doctor, so we know that the ones administered by the government are just as good," she adds.

Shriram stopped visiting the pediatrician within a month. Of her current doctor, she says, "He doesn't force us to take a particular brand. In fact, he recommends that we go for the painful variant, saying that the painless vaccines contain fewer antigens," says Shriram, whose daughter is now ten months old.

Dr Nitin Shah

Dr Nitin K Shah, consultant pediatric haemato-oncologist, PD Hinduja Hospital, Mahim, explains, "Some vaccines introduced in the private market take decades before their effectiveness to be seen and are put onto the national programme. For instance, the Rotavirus vaccine has been in the private market for 10 years but introduced in the national programme only last year. That's also the case with the pneumococcal conjugate vaccine (PCV). You cannot dismiss their importance just because they are not on the national
programme."

Developmental paediatrician and spokesperson for the Indian Association of Paediatrics, Dr Samir Dalwai, clarifies, "All vaccines are helpful but there is a cost component involved. The national programme has vaccines that the government subsidies. Others aren't. So it's up to the parents to pay. The word 'optional' means parents have an option to pay. In no way does it imply that these vaccines are of a poorer quality than the government subsidised ones. It's best to study the literature about the disease and the vaccine that protects against it so your decision is an informed one."

The common side effects of vaccines include mild reactions like fever, swelling or soreness at the injection site. Dr Shah says, "These reactions indicate that the vaccine is working. Vaccines introduce a disabled antigen into the body so the immune system can produce antibodies against it and create immunity to the disease. While no vaccine is 100 per cent effective, the overall effectiveness to the health of our population outweighs the tiny number of ineffectiveness. It's best to be on the safe side."

Cut-and-keep
1. BCG (Bacillus Calmette Guerin) prevents Tuberculosis
2. OPV (Oral Polio Vaccine) prevents Polio
3. Hepatitis B prevents Hepatitis B virus that can cause liver infections

At 1.5 months
1. DPT 1 prevents Diphtheria, Pertussis (Whooping Cough) and Tetanus.

Optional but recommended
1. HiB 1 (Influenza Type B) prevent brain and spine damage
2. Rotavirus 1 prevents rotavirus infection which causes severe diarrhoea and vomiting in young infants.
3. PCV 1 (Pneumococcal Conjugate Vaccine)prevents bacteria from causing blood and ear infections.
4. Hepatitis B

At 2.5 months
DPT 2 second dose
Optional, but recommended
Second dose of
1. IPV 2 (Inactivated Polio Vaccine)
2. HiB 2
3. Rotavirus 2, PCV 2

At 3.5 months
Optional but recommended
IPV 3 prevents polio
DPT 3
HiB 3
Rotavirus 3
PCV 3

At 6 months
Optional but recommended
Hepatitis B 3
OPV 1 (Oral Polio Vaccine)
Prevents Poliomyelitis
(Polio)

At 9 Months
OPV 2
MMR 1 prevents Measles, Mumps and Rubella
TCV 1 prevents Typhoid

At 12 Months
Hepatitis A prevents Hep A, liver disease

At 15 Months
Second dose of MMR 2
Varicella Prevents Chicken Pox
Optional, but recommended
PCV Booster prevents ear and blood infections

At 18 Months
Hepatitis A 2
DPT B 1 (The booster of the DPT Vaccine).

At 2 Years
TCV Booster

At 4 Years
MMR 3

At 5 Years
DPT B 2

Sources: National immunisation schedule by Government of India

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