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A WonderBaba Guide to Childhood Vaccinations in Ireland!

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It has been announced that the HSE intend to roll out a new Primary Childhood Immunisation Programme this year which will mean that all babies who are born on or after the 1st of October 2016 will receive two new vaccines as part of the programme.  The two new vaccines include MenB (at 2,4 and 12 months) and Rotavirus (at 2 and 4 months). The timing  if the 1st MenC vaccine will also change from 4 to 6 months and the timing of the third PCV will change from 12 to 13 months.  Currently Hib and MenC are given as two separate vaccines but will now change to one injection which combines the two vaccinations at 13 months. The changes are best understood by looking at the following chart:

the new pci schedule

Reference : http://www.immunisation.ie

The vaccines which are shown in yellow text are new and the ones in green text in the chart have had changes to the timings as described above.  Children who have started on the ‘old schedule’ i.e those born before the 1st October 2016 will complete the ‘old schedule’.  As a parent of three I understand that vaccination schedules will change with time and that the most relevant vaccines at the time of my children’s birth have been offered to them.  There has to be a starting point for any new vaccination schedule and I suppose this is why there is no ‘catch up’ programme planned that I am aware of. Any parent of a child born before the 1st October 2016 who wishes to get their child vaccinated against MenB or the Rotavirus will have to discuss it with their GP who may prescribe it for them privately but the parent would need to pay for the vaccinations as they will not be covered under the child’s state funded immunisation schedule.

The changes to the Primary Immunisation Programme are very likely to go ahead but the HSE have yet to engage in negotiations with the Irish Medicines Organisation (who represent the GP’s who are responsible for administering the vaccines) to form an agreed framework for the implementation of the programme. Once that has been completed then the new vaccination programme should go ahead as planned.

The Primary Childhood Immunisation programme exists to help protect our babies and children from preventable diseases.  The more we vaccinate the more we move towards eradicating these diseases from Irish health. Whilst I strongly advise vaccination it is also only fair to point out that it is optional and you should always offer your consent before a vaccination takes place.  This article aims to allow you to make that decision in a more informed manner.  I hope for you to understand what vaccines your child is receiving and for what illnesses. I also hope you will find my ‘Parents Tips’ at the end useful for making the vaccination process less scary and intimidating for your child as a relaxed and prepared parent allows a child to be confident and relaxed in your care.

You will be given a vaccination record at the doctors to keep a note of all of the vaccines your child has received.  Your baby will receive two injections at each visit to the GP at two months, four months, six months, twelve months and thirteen months.  Vaccines are given at such a young age because that is when they are most vulnerable to theses diseases. It’s important to stress that some of the diseases detailed below can actually kill a child or adult – I hate to point that out but it is the core reason that us health care professionals urge vaccination. Your child is not fully vaccinated until they have received all of their vaccinations so it is important to complete the course.

Parents often have concerns about the mercury content of vaccines which is not an issue in this case as none of the vaccines in the primary schedule contain thiomersal (a mercury-containing product).

Here is a chart from the ‘old’ immunisation programme which shows what vaccines are currently being offered to parents and an explanation of each of them.  I will also explain the two new vaccines which will be offered to babies born on or after the 1st October 2016.

cropped schedule(https://www.hse.ie/eng/health/immunisation/infomaterials/pubs/introtoyourchildsimm.pdf)

bcg picA little bit more about each vaccine:

BCG

To read more about the BCG read my full BCG blog here!

Expect a small red pimple to appear at the injection about three to six weeks after the injection – this is completely normal and it often stays for a few weeks and then scabs over.  It will eventually heal and often leaves a small scar.  If you feel that the pimple or scab have excessive swelling, oozing or irritation around it then get it checked out with your GP or public health nurse.

There has been a shortage of the BCG since April 2015 – the situation remains the same as I described in this blog – https://wonderbaba.ie/2015/08/07/the-bcg-shortage-the-full-story/   Don’t worry about this delay affecting your child’s other vaccinations – it does not – you should continue with the vaccination programme as planned and at the recommended time intervals. You can also check the HSE’s website for further updates on supply of the BCG but they most recently updated their information in February 2016 (This is correct on 30/07/2016 when I wrote this blog).  http://www.hse.ie/eng/health/immunisation/news/BCG16.html

The 6 in 1 vaccine

This vaccine is given at two, four and six months and protects your child against six different diseases in one injection.

  • Diphtheria – This can be a very serious bacterial illness which symptoms can vary from sore throat, fever, headache to breathing difficulties and problems with swallowing. Immunity is 97% after vaccination.
  • Hepatitis B – This is a viral infection which affects the liver and can cause serious health problems such as liver failure, cancer, cirrhosis and lifelong infection.  Immunity is 80-100% after vaccination
  • Hib – This is a bacterial infection which can cause meningitis, septicaemia and chest and ear infections. Immunity is 95-100% after vaccination.
  • Polio – This is a viral infection that can cause paralysis.  Immunity is 99% after vaccination.
  • Tetanus – This is a potentially fatal disease which can cause muscle spasm, convulsions and breathing problems.  Immunity is almost 100% after vaccination.
  • Whooping Cough – This is a bacterial infection which causes a characteristic ‘whoop’ sound during coughing episodes and can lead to difficulties breathing, pneumonia, heart and lung failure and brain damage.  Immunity is 75-90% after vaccination.

This vaccine is important.  Each time your baby gets the vaccine their level of immunity is increased and the vaccine becomes more effective.  Getting the vaccine at the recommended times means that your child will be immune to these illnesses as early as possible which reduces their risk of contracting illness.   As with all vaccines there is a very small risk (less than one in 100,000) of your child experiencing a severe anaphylactic reaction but these often occur within 15 minutes of vaccination and the nurses or doctors administering the vaccine are well-trained to manage these reactions.

Babies who should avoid this vaccine are ones who have previously had a severe allergic reaction to a previous dose or have a known allergy to other parts of the vaccine such as neomycin or polymixin B.

You can get your child vaccinated if they have a cough or a cold but not if they are sick with a fever.

PCV  (pneumoccocal vaccine)

This vaccine protects against pneumoccal infections such as pneumonia, septicaemia and meningitis caused by Streptococcus pneumoniae bacterium.  The PCV protects against 13 strains of the pneumococcal bacterium.  This vaccine is given at two, six and twelve months of age.  According to the HSE “If your child is under one year of age and has missed a dose of the PCV vaccine, they should receive the remaining doses that they need with two months between each dose.  If your child is over one and under two years of age and has missed a dose of the PCV vaccine, they should be given a single dose of the PCV vaccine.”  Immunity is 90% after vaccination. Possible side effects of the pneumococcal conjugate vaccine (PCV) include:

  • Discomfort, redness and swelling where the injection was given.
  • A slightly raised temperature
  • Irritability

As with all vaccines if you suspect your child is suffering from a more severe reaction then don’t hesitate to contact your healthcare provider.

meningitis hseMenC

This vaccine protects your baby against one type of meningitis and septicaemia – those caused by the meningococcal group C bacteria.  This vaccine cannot cause your baby to get meningitis and has been really successful at getting Men C bacterial meningitis levels reduced in Ireland.  It is currently given at four and thirteen months of age. However due to the changes expected to be implemeted this year it will now be given at six and thirteen months (in combination with Hib) to all children born on or after the 1st October 2016 receiving the new Immunisation Programme Children.  They will also receive it when they start secondary school. Immunity levels are 90% after vaccination.

MMR

The MMR is given at twelve months of age.  It is 95% effective at protecting against Measles, Mumps and Rubella.  Measles is a highly infections disease which is spread easily and there is a current out break in Ireland so the HSE are recommending anyone with young children who do not have their vaccines up to date contact their healthcare provider to arrange vaccination as soon as possible.

I would like to highlight that there is no link between the MMR and autism.  The MMR has been protecting children from these diseases since 1988.  Extensive research has been undertaken on the area.

Hib

This vaccine is 95-100% effective at protecting against Haemophilus influenzae b.  This vaccine is given as a part of the 6 in 1 and also then on its own at thirteen months of age.  The ‘new’ vaccination will combine the Hib and MenC in one injection at thirteen months instead of two separate ones. Hib is a bacterial infection which can cause meningitis, septicaemia and chest and ear infections. Immunity is 95-100% after vaccination.

new vaccines pic**  The New Vaccines **

Rotavirus

This is an oral vaccine (yippee not an injection!).  It will be given to your baby at 2 and 4 months of age.  It will be given before the injected vaccines and you will be able to feed your baby like normal before or after the vaccine.  The nurse or doctor giving your child their vaccines will use an oral applicator to put it into your childs mouth. Your child should not have this vaccine if they have a very high temperature or a bad dose of vomiting or diarrhoea.  Phone your GP’s surgery if you are in doubt over your child’s fitness to get their vaccines.  Your baby may experience some loose stools and irritability after this vaccine. If your child suffers from any other side effects such as severe abdominal pain or blood in the stools then they need urgent medical attention – This is extremely rare and will only effect 1 in 50,000 babies vaccinated.

Rotavirus is the leading cause of gastroenteritis in children and it can cause diarrhoea and vomiting.  It can cause a high temperature and can lead to dehydration.

MenB

Meningitis describes an infection of the meninges. The meninges are the protective membranes surrounding the brain and spinal cord. The infection can be viral or bacterial.
According to the Health Protective Surveillance Centre Group B meningococcal bacteria accounts for almost 80% of all cases of meningitis in. In 2014, out of a total of 82 notifications of all meningococcal disease notifications, 64 (78%) cases were caused by serogroup B. The Bexsero information leaflet is available here :
(http://www.medicines.ie/medicine/15903/SPC/Bexsero+Meningococcal+Group+B+vaccine+suspension+for+injection+in+pre-filled+syringe/)

This is a very safe and effective vaccine which is NOT a live vaccine.  It is common for babies to suffer from a fever after this vaccine and so it is recommended to give your baby 2.5mls (60mg) of liquid infant paracetamol (120mg/5mls) e.g Calpol at the time of the injection, again 4-6 hours after the first dose, and then once again 4-6 hours after the second dose of paracetamol.  This is a total of three doses of paracetamol after each MenB vaccine.  The first MenB vaccine is at two months of age and the second is at four months of age.   Calpol is recommended NOT Ibuprofen (nurofen).  If your baby continues to have a temperature or seems unwell then you should seek medical advise.  There is no recommendation in place to give Paracetamol after the 12 month dose of MenB as the risk of fever after this vaccine is less.

breastfeeding Tips for parents

  • Offering  breastfeed or bottle just before and after immunisations can reduce upset and crying in babies and infants.
  • If your baby develops a temperature after a vaccine try not to be alarmed as it is a common side effect to vaccination and paracetamol can be offered if the fever rises above 39.5C.  It is not currently recommended to give a preventative dose of medication before any vaccine other than MenB.
  • It’s a good idea to give your baby plenty of fluids before and after vaccination.
  • Your babies arm or leg may be sore after the vaccination at the injection site – this is normal. Some redness and a little swelling are also normal but if you are concerned about the amount of swelling then contact your GP or public health nurse for further advice.
  • Try to get your vaccines on time other wise your child will not be adequately protected when they are at their most vulnerable.  If you have fallen behind with the vaccination schedule just contact your child’s GP and they will arrange for you to get back on track! It’s never too late!
  • Occasionally side effects can occur – generally within 48 hours and so you can expect a little pain, redness or swelling at the injection site.  Your baby may become irritable and so may cry a little more than usual.  They may develop a minor fever.  If you feel your child is very uncomfortable or has a high fever (over 39.5) you can treat them with paracetamol or ibuprofen if appropriate.  If you are at all concerned with the side effects your child is experiencing seek medical attention.
  • From personal experience….cuddles, lots and lots of cuddles!

You can read more about vaccinations at:

www.hse.ie

www.hpra.ie

www.immunisation.ie

http://www.hse.ie/eng/health/immunisation/pubinfo/babychildimm/commonqs/beforeimm/#before immunisation

cropped-cropped-feet1.pngI hope you have found this article helpful and if you have any questions at all please don’t hesitate to contact me by sending a private message to the WonderBaba facebook page (www.facebook.com/wonderbabacare) or by calling me (Sheena) at Milltown totalhealth Pharmacy in Dublin 6 on 012600262. I’m always happy to help!

 

 

 

This blog was updated on 30/7/16 – all information was accurate at that time.  New information may become available at the above refernces should be checked to ensure you are completely up to date.  I will always update it as soon as is reasonably possible for me but if in any doubt please refer to the above websites. Thanks, Sheena 🙂

 

Author: WonderBaba Blog

My name is Sheena Mitchell and I'm a pharmacist with my own business Milltown totalhealth Pharmacy in Dublin 6. From working in the pharmacy I've realised that there are a lot of first time and experienced moms who might benefit from hints and tips from a pharmacist who can balance healthcare advice with real hands on experience from my important work as a mother of two! I hope to bring you regular advice and information and answer questions that you have! Being a mother and pharmacist are my two favorite things and I'm delighted to have this way of bringing my two worlds together! All questions and queries are gratefully received but otherwise sit back, relax, and let the solutions come to you!

One thought on “A WonderBaba Guide to Childhood Vaccinations in Ireland!

  1. Pingback: Measles | WonderBaba

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