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Unlike the other pages on this site, the vaccination pages are country specific -- oriented to India.
Combination vaccines Combination vaccines are, well, combinations of more than one vaccinating agent in a single injection.  They're in the news right now because of the increasing number of vaccines available for children.  Combination vaccines reduce the number of needle pricks suffered by a child, and also the infection hazards, clinic visits, and discomfort associated with vaccination. The DTP vaccine  is an example of a combination vaccine.  It includes toxoids against tetanus and diphtheria, and killed pertussis bacteria, allowing a single needle prick to protect against all three.  This has now been combined with hepatitis B vaccine to give a four disease vaccine, and the addition of the hemophilus influenzae type b vaccine makes a pentavalent vaccine. Making combination vaccines is not as simple as adding antigens and stirring them.  The components have to get along, physically, chemically, and biologically.  This needs some doing in the laboratory.  Then there is animal testing, followed by testing on human volunteer adults, then in children, then collecting proof of efficacy and safety, and getting approval for use from medicine control agencies in each country.

Optional Childhood Vaccines

All vaccines are meant to protect against disease.  Parents would like their children to be disease free, so shouldn't all vaccines be given to all children?

The number of vaccines has increased greatly in the last decade, and the child of today probably feels like a pincushion by the first birthday.  While combination vaccines do reduce the number of pricks given, there is still some reluctance to subject babies to so many injections.  Apart from this, some diseases are mild and self limiting, some vaccines are expensive, and some diseases are of uncertain importance in India.

For different reasons, some vaccines are classified as optional vaccines.  Parents should think about each one and make a careful decision about whether to give it to their child.

Mumps.  
Rubella.  

These are viral diseases which are usually mild.  However, they can cause dangerous complications.  The MMR vaccine protects against both these diseases, and provides a second dose of measles vaccine.  Only a single dose is given, usually after the age of fifteen months.

Hepatitis B

The Hepatitis B virus causes jaundice.  However, it can also cause severe disease leading to unconsciousness and death.  Even after apparent recovery, the virus can produce slow destruction of the liver and cause chronic hepatitis, liver cirrhosis, and liver cancer.  The Hepatitis B vaccine offers good protection against this disease.  Three doses are needed, and should be started soon after birth.

Hepatitis A.

A vaccine has recently become available against the hepatitis A virus.  Two doses are needed to protect against this usually mild sickness.  It can be given after the age of one year.
In children, hepatitis A is often asymptomatic, i.e., the child gets the disease without anyone being aware of it.  This mild infection passes unnoticed within a few days, and the child then has lifelong immunity to the disease.  The majority of Indian children acquire immunity to this disease in this way by the time they are ten years old.

Hemophilus influenzae type b

This germ causes  meningitis , pneumonia,  epiglottitis and other life-threatening illnesses.  The Hib vaccine can protect your child against these.  One to four doses are needed, depending on the age at which the first dose is given.

Chicken Pox (Varicella)

This is another viral illness which almost all children suffer.  It is usually a mild disease, but causes school absenteeism and scarring.  A Varicella vaccine is available to prevent this troublesome disease in your child.  Only a single dose is needed, given after the age of 1 year.  If delayed beyond thirteen years, two doses will be needed.

Typhoid fever

This disease causes high fever for several days, and often needs hospitalisation. Increasing drug resistance has made this disease difficult and expensive to treat.  Injectable and oral typhoid vaccines offer some protection against this prolonged and sometimes dangerous illness.

Too many vaccines?

Perhaps.  The progress of medical science is making protection available against more and more diseases.  Many of these diseases were considered unavoidable in earlier times.  However, not all vaccines need be given to your child.

Poliomyelitis, Diphtheria, Whooping cough, Tetanus, Tuberculosis and Measles are so wide spread, and so dangerous, that every child must be vaccinated against them.  The MMR vaccine protects against 2 additional diseases, but its most important role may be the additional protection it offers against measles.

Typhoid Fever is common in our country, and the currently available vaccines are quite safe, though not a hundred percent effective.  Children over the age of two years should receive this vaccine.

Hepatitis B is another illness that is fairly common in our country, and has some serious forms.  Since there is no good treatment available for it, the Indian Academy of Pediatrics recommends that the Hepatitis B vaccine be given to all children.

Last revision: September 30, 2006

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