Category Archives: vaccination

What newer Vaccines are there for my child ?

Good day parents

As a parent u all must be aware of vaccines which u all must be giving to your child. There are various newer vaccines which keep coming in market after research and development. there are some painless vaccines too. It is your right to get information  regarding various new vaccines available for your child for better growth and prevention of infections.

traditionally following vaccines were given by govt of India in Delhi NCR:  BCG, polio drops , DwPT/DTwP (which causes pain and fever , usually lasting for 24 to 48 hours ),Hepatits B,  measles, MMR, typhoid.

Latest Immunization schedule as per Indian academy of pediatrics have added few more vaccines which are gentle DTaP along with Hib and IPV( Injectable polio vaccine) , Rotavirus, Pneumococcal, Hepatitis A, chicken pox . and in high risk children Flu, Meningococcal.

DTP:

One important thing which I wanted to emphasis that whether U give traditional DTP or gentle DTaP both has equal efficacy in Indian circumstance, only difference being in the side effects. So the huge amount of difference in cost is to prevent side effect only( these sypmtoms of fever and pain can be managed easily by giving crocin/ paracetamol). So its for u to decide which one to go for as medically both are equally potent. It all depends on your abilities to handle a baby who is cranky .

IPV:

injectable polio vaccine is the best option for complete protection of your baby in present circumstances. In countries where polio has been eradicated IPV is the only option available.

Rotavirus:

This vaccine helps in preventing against diarrhea / loose motion. But giving this vaccine does not mean that your baby will not have diarrhea ever in life. This vaccine only prevent against Rota Virus, which is a virus which causes serious diarrhea usually needing admission in hospital and IV fluids. .And this being a viral illness is difficult to prevent.

Hepatitis A:

Jaundice is very commonly seen in India through out calender year with peak in rainy season. This vaccine prevents against jaundice, as no matter how cautious you are, once in a while we all dine out and drink water from unreliable sources which can cause jaundice. So this vaccine is strongly recommended.

Chicken Pox:

regarding this disease you all know that it can cause rashes on face with permanent scaring. when this disease occurs in adult age group , it is much more severe, so this vaccine is also recommended by IAP.

Pneumococcal vaccine:

This organism causes , serious infections, which include ASOM (ear infection), Pneumonia, Meningitis (brain infection). And once child gets infection due to this pneumococcal , it invariably needs IV antibiotic ( ranging from 7 to 14 days). Some people promote this vaccine as vaccine against Pneumonia, but again it does not means that if U give this vaccine your child will never have Pneumonia (as there are many organism which can cause Pneumonia). The main problem with this vaccine is huge cost, if cost is not an issue then this vaccine must be given , atleast before your child starts going to play school.

 

Haemophilus influenzae type B:

This vaccine is being given along with DTP universally these days, now even govt of India has introduced this vaccine in pilot project in Delhi, so it is being given along with DTP and Hepatits B. A must vaccine for your child.

Flu:

Its a seasonal vaccine which needs to be given every year in high risk group. Flu keeps changing its structure every few year. eg you must have heard of Bird flu many years back, later swine flu few years back (latest vaccine covers against swine flu ) but few  year down the line some new virus will come.

Meningococcal :

Latest vaccine against this disease is Menactra, which is highly efficacious vaccine but the most expensive vaccine in children till date with MRP of 4500Rs. But this disease has very high mortality (can cause death within 24 hours), 2nd only to Rabies. Although incidence of this disease is low, but considering its high mortality , it can be given if cost is not an issue. Delhi had lots of cases in out break few years back.

you can send in your queries regarding any vaccine to me  and I will try to give you unbaised opinion about it.

Stay Healthy and prevent Diseases

Dr. Rahul

My newborn’s vaccination schedule. Why do infants need so many vaccines so quickly?

  • Newborns need multiple vaccines because infectious diseases can cause more-serious problems in infants than in older children.
  • While maternal antibodies help protect newborns from many diseases, this immunity begins to disappear as quickly as one month after birth. In addition, children don’t receive maternal immunity from certain diseases, such as whooping cough. If a child isn’t vaccinated and is exposed to a disease, he or she might become sick and spread the illness.
  • Avoid altering your child’s recommended vaccination schedule. Research shows that it’s safe for infants and young children to receive multiple vaccines at the same time, as recommended by ( IAP) Indian Academy of Pediatrics and (CDC) the Centers for Disease Control and Prevention’s vaccination schedule.
  • Remember, newborns and young children can be exposed to diseases from family members, care providers and other close contacts, as well as during routine outings — such as trips to the grocery store, nearby park and family functions etc. Many vaccines can be given even if your child has a mild illness, such as a cold or mild fever. Consult your child’s doctor regularly to keep your child’s vaccination status up to date.

stay healthy and stop the spread of vaccine preventable disease

regards

Dr. Rahul Varma

Rotavirus vaccine: should we give to children?

Did you know? Rotavirus vaccines combat the leading cause of deadly diarrhoea among children.

Around the world, these vaccines keep kids happy, healthy and out of hospital!

 

https://www.facebook.com/GAVI/photos/a.126742141406.129029.92572781406/10153294291846407/?type=1&theater

 

There is significant reduction in cases of Diarrheal disease since the induction of rotavirus vaccine in National Immunization schedule of many countries.

Hopefully soon we too have this Vaccine in Govt. of India Vaccination schedule UIP (Universal immunization Programme).

Once the vaccine is built indigenously then it will lead to sharp reducing in pricing of this vaccine in private sector too.

 

Regards

Dr Rahul Varma

“Healthy kids, Happy Family”

How to reduce pain during Vaccination

Question: My baby cries a lot during vaccination. What can I do to decrease the pain and make the procedure less traumatic for my baby?

 

Answer:

It can be very painful experience not only for baby but for parents as well. But the benefits which child has due to this vaccination are worth it. Most of the pain is due to DPT vaccine only, 3 initial doses for which are given before 5 months of age usually.

There are few things which you can try in order to make it a less painful procedure.

 

These things might decrease the pain immediately after the vaccination shots (in small babies) are:

  • Swinging your baby gently in your arms
  • Swaddling immediately after vaccination has been given.
  • Making some sounds in her ear. (slow whistling sound or any pleasant sound in her ear will make baby comfortable sooner)
  • Breastfeed your baby
  • Keep baby in your arms and walk around near clinic in open air will make baby comfortable soon.

Basically you have to distract the child. And baby will soon forget the pain.

In case of adults or older children, pain is more because of anticipation and we make our mind think too much about the injection. Before reaching the vaccination clinic and even after leaving we sometimes perceive pain; more because of our thought process.

Luckily in younger children, they do not know where they are going and what is going to happen. So they have pain only for few moments when vaccination needle is inside the body and as soon as you distract them to other things they are comfortable. And you are able to calm them.

For older kids, try letting them sit on your lap during vaccination and give them something to distract them like a toys, play a song or use some picture book etc.

Most Important is you as a parent should be relaxed. Because if you are tense, your child can pick up your anxiety and they themselves become anxious.

After vaccination either Paracetamol or Ibuprofen may be given in children (but only after consulting your pediatrician regarding appropriate doses).

Also, don’t forget to praise your child afterward. Positive reinforcement will make next trip to doctor’s clinic easier.

Do something interesting after vaccination; so that child has pleasant memories associated with vaccination like a trip to playground, or doing some fun activities.

Do not scare your child into doing things in name of injection. It can induce lot of fear in their mind regarding vaccination.

Feel free to discuss with your child doctor in detail regarding precautions if any need to be taken.

 

Regards

Dr Rahul Varma

Vaccination reminder service for your baby via sms

http://www.immunizeindia.org/

Click on the above link for vaccine remider service

 

The world’s largest vaccination reminder service

IAP-Immunizeindia is the world’s largest vaccination reminder service, and is available free of cost to parents anywhere in India. It is a national non-profit initiative, promoted by Indian academy of Pediatrics.

IAP-Immunizeindia aims to prevent half a million child deaths and disabilities by 2018.

IAP-Immunizeindia is supported by Vodafone, which is the national telecom partner. IAP-Immunizeindia’s national press campaign, promotional posters in hospitals and clinics and promotional pamphlets are funded by an education grant from another leading Fortune 50 multinational corporation.

How to register for the service

Parents opt-in to the service by sending a text message by SMS to the national shortcode 566778 from any mobile phone in India, in the following format*** :

Immunize <Space> <Baby’s pet name> < Space> <Baby’s date of birth>

Example : Immunize Rekha 04-11-2013

The phone will immediately receive a confirmation message.

Text message reminders** will  be sent to the phone for 12 years, following the IAPCOI Immunization schedule.

3 reminders are sent, at 2 day intervals, for each vaccination that is due. An example of a reminder is – “Rekha is due for a vaccination this week, please do not forget to visit your doctor”**

Reason for the service

Over 2 Million children under the age of 5 die every year in India* and another 1 Million or more are disabled for life. ??

A major cause is that parents often forget to vaccinate the child on time, as most parents in India do not maintain a vaccination calendar for their child in a disciplined manner. Other reasons are-

            – parents’ misplaced priorities
– low awareness
– busy lifestyles
– forgetfulness
– social and cultural causes

Vaccination reminder services in several countries have been effective in increasing compliance by 20%. There are over 40 published scientific studies that prove the effectiveness of vaccination reminders.

India has 700 million mobile phones which support Text Message Service or SMS (every family has a phone). A well promoted, national, Text Message reminder service will be the the most cost effective method of  reminding parents that a vaccination is due.

Contact – For clarifications and support please send an email to info@immunizeindia.org

*     Source- Global Immunization Vision and Strategy (GIVS). 2006-2015, World Health Organization
**    Reminders do not advertise, recommend or promote any vaccine brands or products.
***   Service not available for phones outside India

 

Feel free to contact your pediatrician or contact us at our website www.mayaclinic.in

 

Regards

Dr Rahul varma

Newer Guidelines with few changes in IAP Immunization Schedule, October 2014

travel_clinic_vaccinations

“Few Changes in Immunization schedule for 2014″

1. at 9 months MMR in place of Measles, 2nd dose @ 15 months, no dose @ 5 years
2. Live Hep A single dose only , Killed to have 2 doses
3. Rotavirus, DTP vaccine , same stand as before
4. Typhioid-TCV cojugate can be started @ 9months with booster @ 2 years (No need to re vaccinate every 3 years).
5. Cervical Vaccination in 9-14 years, only 2 doses 6 months apart.

New IAP Vaccination Guidelines as per october 2014

For Parents , it is best to discuss with your child specialist. Your doctor is in best position to prepare vaccination schedule for your child as per latest recommendation.
 http://indianpediatrics.net/oct2014/785.pdf

Regards

Dr Rahul varma

 

WIW banner Google plus

Immunize for a healthy future: know, check, protect.

Immunization week 2014

 WIW banner Google plus

 

World Immunization Week – celebrated in the last week of April (24-30) – aims to promote one of the world’s most powerful tools for health – the use of vaccines to protect people of all ages against disease.

The theme of the World Immunization Week 2014 campaign is “Are you up-to-date?”. The slogan and calls to action to be used on global materials are “Immunize for a healthy future – Know. Check. Protect.”

all

Know, Check, Protect

 

know

Know

  • why you need to get vaccinated
  • which vaccines you need
  • how, where and when you should get vaccinated
  • where you can go to find out more

check final

Check

  • whether you and family have had all the vaccines you need
  • when you need booster doses
  • whether you need any vaccines before travelling

 

protect 

Protect

  • yourself and your family: get vaccinated

 

Details regarding latest Immunization schedule in INDIA.

http://www.iapindia.org/IMM%20Schedule.pdf

IMM-33-1

 

Regards

Dr Rahul Varma

“Healthy kids, Happy Family”

 

Myths and facts about Vaccination

Vaccination-cartoon

A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe, its toxins or one of its surface proteins. The agent stimulates the body’s immune system to recognize the agent as foreign, destroy it, and “remember” it, so that the immune system can more easily recognize and destroy any of these microorganisms that it later encounters.

Below mentioned link will give you relevant knowledge .

http://www.who.int/features/qa/84/en/

Vaccination: Myths and Facts

vaccine

“Healthy kids, Happy Family”

Regards

Dr. Rahul Varma

 

Rabies vaccination after dog bite/monkey bite

rabies    

rabies

Rabies vaccination after dog bite/monkey bite

Dog bite/ Monkey bite is very scary situation for young kids and their parents. We need to consult doctor immediately as treatment has to be started within 24 hours.  Dog bites can lead to rabies disease.

Rabies disease can be prevented with vaccination, but if it occurs it is 100% fatal worldwide.

Rabies can occur with dog bite, monkey bite or any other domestic or wild animals.

Specially if dog bite is unprovoked, chances of dog being rabied is high. Beside as we know the illness is 100% fatal, so whenever in doubt its better to vaccinate the child.

 

Category of bite:

 

Table 1: Type of contact, exposure and recommended post-exposure prophylaxis

 

Category Type of contact Type of exposure Recommended post-exposure prophylaxis
I  Touching or feeding of animals Licks on intact skin  None 
  • None, if reliable case history is available

 

II  Nibbling of uncovered skinMinor scratches or abrasions without bleeding Minor
  • Wound management
  • Anti-rabies vaccine

 

III Single or multiple transdermal bites or scratches, licks on broken skinContamination of mucous membrane with saliva (i.e. licks) Severe • Wound management• Rabies immunoglobulin

•Anti-rabies vaccine

 

 

Management:

  • Keep a watch on dog for 10 days if possible.
  • Wound cleaning
  • If needed Rabies Immunoglobulin
  • Anti rabies vaccines (as per protocol)

Not previously vaccinated:

  • Wound cleansing:  All post exposure prophylaxis (PEP) should begin with immediate thorough cleansing of all wounds with soap and water. If available, a virucidal agent (e.g., povidine-iodine solution) should be used to irrigate the wounds.
  • Human rabies immune globulin (HRIG): Administer 20 IU/kg body weight. If anatomically feasible, the full dose should be infiltrated around and into the wound(s), and any remaining volume should be administered at an anatomical site (intramuscular [IM]) distant from vaccine administration. Also, HRIG should not be administered in the same syringe as vaccine. Because RIG might partially suppress active production of rabies virus antibody, no more than the recommended dose should be administered. The dose of equine rabies immunoglobulin  is 40 IU per kg body weight of patient and is given after testing for sensitivity
  • Vaccine:  Human diploid cell vaccine (HDCV) or purified chick embryo cell vaccine (PCECV)
    • IM (deltoid area): 1ml dose, on days 0, 3, 7, 14, 28.
    • ID (intradermal): 0.1ml in both arms, on 0, 3, 7, 28.

Previously vaccinated:

  • Wound cleansing:  All PEP should begin with immediate thorough cleansing of all wounds with soap and water. If available, a virucidal agent such as povidine-iodine solution should be used to irrigate the wounds.
  • HRIG: HRIG should not be administered.
  • Vaccine: HDCV or PCECV 1.0 mL, IM (deltoid area†), 1 each on days 0 and 3

For further reading, click on the below link. It will tell you regarding Rabies treatment in details as per govt of India.

http://www.ncdc.gov.in/Rabies_Guidelines.pdf

Or you can get in touch with Maya Clinic or your Child specialist / Pediatrician for queries.

Stay healthy and stay away from stray dogs.

Regards

Dr Rahul varma

 

Your baby: birth to 3 months

baby

Once the shock, relief and exhaustion of delivery have worn off a bit, you will probably find that caring for your new baby is a lot of work; wonderful, but still work.

Early feelings of parents are of mixed emotions:

They are happy, a bit scared, it takes time for the feeling of being mom /dad to sink in. Most of first time parents are scared of holding on to baby in their lap, just relax, Babies are not frail and enjoy your baby. Babies thrive on touch, so early contact and bonding is important. Lots of mothers are working these days, due to financial necessity and demanding careers and it puts huge pressure on them. But as a mother you should remember that’s it’s the quality time you spend with your child that will matter.

All of your baby`s senses are working:

  • Touch , motion:  baby calms done when holding, swaddling and rocking movement
  •  Smell: they prefer smell of their mother`s body.
  • Hearing: Baby prefers speech that is slow and musical- the way parents seem to naturally talk to them.
  •  Vision: baby can see at birth, but are they are near sighted. And their eyes are very sensitive, so they tend to keep them closed in normal light but open them when lights go down.

Individual Personality:

harperasleep

Every baby has his own personality. Some are calm, other are more excitable. Some are regular in their eating, sleeping and bowel habits: others are more erratic. Some can handle lots of stimulation: others need a quieter environment.

Feeding: 

Breast feeding is best possible option for baby; on demand feeding, day and night. Sucking is important pleasurable activity of baby along with getting nourishment for growth. Baby sometimes make sucking movement while in sleep also, it`s absolutely fine and does not mean that baby is necessarily hungry.

Bowel movement (potty):

Baby`s bowel pattern is very variable. At birth baby passes black to dark greenish motion (also called meconium) which changes to normal yellow color by day 3 to 4 of life. Baby can pass semi -loose motions, 10 to 12 times per day during 1st few weeks of life (also called transition stool). After around 4 to 6 weeks; pattern of motion again change. You will realize that same baby during his/her 1st year of life will have very variable motions; some time loose watery 8 to 10 times per day and sometimes well formed stool after 4 to 5 days even. So whole range is normal, and for all practical purpose forget about stool, if your baby is sucking well on breast and passing urine more than 10 times per day.

Many times baby cry during or just before passing motion or urine: this is mostly normal and do not warrant any cause of concern.

Sleeping:

images (3)

On an average baby can sleep from 12 to 18 hours. Practically speaking in initial few months, baby wakes up when hungry, passed urine or motion and goes to sleep again. Mostly awake in night and sleeping in day. Baby do not have orientation regarding day or night, they are least bothered when sun is going to rise. The main reason why your newborn baby is giving you sleepless nights for 1st few months; is when child was inside mother`s womb, she was surrounded by water (amniotic fluid), so when mother was doing her routine activity during day, that fluid used to move and give rocking movement to baby; whereas when in night mother lie down to sleep, that water become still and baby wakes up.  Every baby has different sleeping pattern (just like adults), so it`s best not to compare your child with anyone else.

Crying:   

Baby has virtually all the emotions which we have; they feel sad, happy, angry, frustrated, they want your attention; but they have only one way of communicating with you and that is crying. If the baby cries the moment you put her to bed but calms down in your arms or in your lap; then in all probability baby is fine. Because if baby is seriously hungry, no matter what you do, she will not stop crying unless feeding is given.

images (4)

Tips for comforting a crying baby

  • Offer a feeding.
  • Change the diaper (look for urine and motion, whether baby is wet).
  • Hold, swaddle and rock the baby (NEVER SHAKE the baby). Sometime baby just want to be in your arms and seeking your attention.
  • Change the noise level of surrounding i.e. if quiet room can play some music.
  • Darken the room and reduce stimulation.
  • Just take the child to open area for fresh air i.e. balcony or for a walk.
  • If baby still does not calm done and crying, better take the child in your car for a drive (most of the kids of this generation love the long drive); but if still baby is crying, change the direction of your car and drive to hospital and meet pediatrician/ child specialist in hospital.
  • Most important thing is to try to relax, it happens with absolutely every parents once in a while that baby give you sleepless night.

Other issues of regarding baby`s health will be dealt over next few articles. For any queries feel free to contact us.

Stay healthy and happy

Regards

DR. Rahul Varma