Childhood vaccinations

Table of Contents

Immunisation schedule

2 months: 6 in 1, rotavirus, meningitis B
3 months: 6 in 1, rotavirus, pneumococcal
4 months: 6 in 1, meningitis B
1 year: MMR, pneumococcal, meningitis B, Haemophilus influenzae type B/meningitis C
Preschool (3 years 4 months): MMR, 4 in 1 (diphtheria, polio, tetanus, pertussis)
12-13 years: HPV (two injections 6-12 months apart)
14 years: 3 in 1 (diphtheria, tetanus, polio), meningitis ACWY

6 in 1: diphtheria, tetanus, polio, pertussis, Haemophilus influenzae type B, hepatitis B

MMR = measles, mumps, rubella NB: influenza annual nasal vaccine is also offered to 2-10 year olds

Reference: NHS ‘NHS vaccinations and when to have them’ 2019

Possible stations

Parent wants to find out more about childhood vaccinations
Parent disagrees with vaccinating their child
Parent has heard something on the news, e.g. MMR causes autism (it doesn’t!)

Aims of the station

Empathise and be non-judgemental
Address the patient’s concerns and pick up on their cues
Explore their beliefs
Explain how the benefits of getting vaccinated outweigh the risks of the vaccines
Convey the importance of vaccinations

Overview of diseases vaccinated against

6 in 1 childhood vaccine

Diphtheria
- Illness: fever, sore throat, grey membrane on tonsils can narrow lumen
- Complications: cardiomyopathy, kidney injury
Tetanus
- Illness: muscle spasm in jaw and other muscles (including respiratory muscles)
- Complications: respiratory muscle impairment
Polio
- Illness: destruction of nerves resulting in muscle weakness and paralysis
- Complications: paralysis
Pertussis
- Illness: whooping cough (‘hundred day cough’)
- Complications: pneumonia, convulsions, bronchiectasis
Haemophilus influenzae type B
- Illnesses: can cause epiglottitis, meningitis, pneumonia
Hepatitis B
- Complications: liver cirrhosis

Rotavirus

Illness: diarrhoea and vomiting
Complications: extreme dehydration

Pneumococcal

Illnesses: meningitis, pneumonia

Meningitis vaccines B/C/ACWY

Illness: different strains of meningitis
Complications: deafness, cerebral oedema, memory difficulty, learning disability

MMR

Measles (M)
- Illness: high fever, cough, conjunctivitis, coryza, rash
- Complications: encephalitis, corneal ulcer/scar
Mumps (M)
- Illness: mild illness with gland swelling and headache
- Complications: orchitis (and infertility), unilateral deafness, encephalitis, meningitis
Rubella (R)
- Illness: flu-like illness with rash
- Complication in pregnant women: congenital rubella syndrome

NB: A paper, published in 1998, linked the MMR vaccine to autism. This research has since been discredited and the author has been struck off the medical register for serious misconduct. Further detailed studies have shown there is no link between the MMR vaccine and autism.

Human papillomavirus (HPV)

Risks: cervical cancer, oral cancer, anal cancer, vaginal cancer
Given as 2 injections, 6 months apart

Risks vs. benefits of vaccinations

Benefits
- Prevent serious diseases with severe consequences
- To maintain eradication of diseases that can kill and disable millions of children
- It’s much safer to have the vaccines than not have them
Safety
- Vaccines are extremely safe
- Continually monitored
Risks
- As with all medications, vaccines can have side effects (below)
- However, they are rarely serious and generally only last a couple of days

Contraindications to vaccination

If your child is ill with a fever, the vaccine should be postponed
Avoid live vaccines (MMR, BCG, Varicella, nasal flu vaccine) in immunocompromised
Avoid if known anaphylactic reaction to vaccine or any ingredient
MMR and flu vaccines contain egg
- Egg in MMR is from chick embryos and does not trigger allergy
- Flu vaccine may cause reaction in patients allergic to eggs – use egg-free alternative