Dear Doctor,

I am a happy mother to a bubbly, healthy 22 months old girl. I have gone through all the necessary immunization processes but unfortunately, I missed the last bit, which was meant to have taken place when she was 15 months old.

I have been wondering what the risks are if one missed that particular immunisation and also if it’s too late to take her.

I am really worried.

Dinah

Dear Dinah,

Vaccines since their invention have been an advantage to protect children and even adults against several diseases. With advancement in medical science, range of diseases preventable by vaccination has increased. This has improved overall health status of children and prevented sickness and deaths among children, worldwide.

For example, polio a dreaded disease causing paralysis of a limb and lifelong handicap is now practically eradicated from many parts of the world.  This has been possible due to effective oral polio vaccination programs. Very few pockets remain, where people resisted polio vaccine due to misinformation linked to social, values. Small pox, again a deadly disease permanently disfiguring people has been eradicated in last century due to effective vaccination programs carried out extensively in the world. Now even small pox vaccination is not given. The immunization schedules vary from country to country, but basic pattern remains same.

Vaccines are brought in the field after extensive medical research. They are generally very safe and well tolerated. Adverse allergic reactions are very rare. The temporary discomfort of a prick and sometimes fever for 1-2 days is much less as compared to the discomfort and chronic sickness caused by the disease.  The time and money spent by the family in getting some disease treated in future is saved by regular vaccination. They are also important because of re-emergence of some diseases like pertussis, in the United States due to various reasons. Chicken pox which was previously regarded as a childhood illness is now seen to occur in adults, who were not vaccinated as children (since vaccine has been available in last 3 decades or so only). But those vaccinated will have a very low chance of contracting the disease any time.  

You have not specified as to what vaccine has been missed by your child. Usually at 15 months of age, a child is given 4th dose of DTaP (diphtheria, pertussis, tetanus) vaccine, 4th dose of pneumococcal vaccine (protects against pneumococcal pneumonia). Hepatitis A vaccine is also given around this age, which ensures against liver failure due to viral A hepatitis in future. Influenza vaccine is given as 3rd or 4th dose. Varicella vaccine is also given as single dose at this time, which protects against chicken pox in future.  Apart from these, any vaccine is not given earlier can be given at this age.  By not vaccinating her, she carries real risk of acquiring the disease, whenever exposed. Only condition which defers giving vaccination is, if the child is very sick at that moment. These vaccines contain killed or live microbes and act by building antibodies against the infectious microbe in the body. In a very sick child, it can be harmful. But as soon as the child recovers, he/she should be vaccinated. It is advisable for you to consult a child specialist and complete immunization schedule of your child.

 Dr Rachna is a specialist  in internal medicine                                                                  rachna212002@yahoo.co.uk