Big fight: Protecting the young from diseases

By Elma M Sandoval

Following last year’s measles outbreak, the Philippine Pediatric Society (PPS), Pediatric Infectious Disease Society of the Philippines (PIDSP), and the Philippine Foundation for Vaccination developed the 2019 Schedule of Childhood Immunization in the Philippines. Pediatricians are now recommending that the first measles vaccine be given at six months old for earlier protection considering the outbreak. Previously, this was administered when babies were nine months old.

As in the past, the Bacillus Calmette-Guerin (BCG) vaccine for anti-tuberculosis, as well as the Hepatitis B vaccine (HBV), should still be given right after birth. Multivalent vaccines, such as Diphtheria-pertussis-tetanus(DPT) shots, the polio vaccine (OPV) and PCV against pneumococcal infections, to be given starting at six weeks of age.

From six months onwards, vaccines against the flu, Japanese encephalitis, mumps, rubella, chickenpox, hepatitis A, and human papillomavirus (HPV) are also recommended under the 2019 schedule. Under government’s expanded National Immunization Program, BCG, HBV, DPT, OPV, and the measles vaccine, are given free in health centers.
Pediatricians shared the Department of Health’s (DOH) concern over the declining vaccination coverage rate, which is presently at 55%, far below the 95% rate necessary to be declared disease-free.

In the Philippines, a child is considered fully immunized when he has completed the routine infant vaccination schedule that includes BCG, DPT, OPV, HBV and measles vaccine before turning a year old.

Raising the rate of coverage

PIDSP President Dr. Anna Ong-Lim echoed the DOH’s declaration that vaccines are safe, adding that they are “the most basic medical intervention” for children to grow into healthy adults. In the case of the Philippines, it’s the best means of protection against infectious diseases, particularly vaccine-preventable ones.

Factors cited for low collective immunity include not adhering to the scheduled follow-up vaccine doses, or missing the next in the routine immunization. Accessibility to healthcare facilities and personnel can be a challenge as well as keeping track of vaccination schedules, especially for working parents.

While booklets listing all immunization shots or doses might work for a conscientious parent, the busyness of raising children, keeping house, and holding down a job can result in delays for succeeding doses or missing out on the prescribed time for getting immunized. Fortunately for tech-savvy parents or caregivers, there are now mobile apps that can be of help, at least when it comes to reminding them of their children’s next vaccination schedule. Vaccine reminder app systems are simple as entering a child’s name, the date when the next shot is due, and reminding parents that it’s time to visit the doctor. Taking advantage of technology, this way should help the government’s campaign to raise the demand for routine immunization, increase the rate of herd immunity in the country, and prevent the recurrence of disease outbreaks.

Catching up

Meanwhile, polyvalent vaccines are there in case of an oversight in the vaccination schedule to help catch up. Locally, they’re available in forms like the 4-in-1 (DPT with polio); and the 6-in-1 for diphtheria, hepatitis B, haemophilus influenzae type b (Hib), pertussis (whooping cough), polio and tetanus. Polyvalent vaccines spare the child multiple injections while being able to provide protection against multiple diseases.
The most common mode of vaccine administration is through injection, whether intramuscular, intradermal, or subcutaneous. The other methods are oral and inhalation, the former used for the polio vaccine. The flu vaccine is at present the only type given via inhalation, although in the Philippines, this is given as a shot. Healthcare professionals admit the intradermal mode, used solely for BCG vaccine, is the most difficult because it’s used on newborns, whose arms are so small.

Dealing with side effects

Fear of needles is what makes vaccination terrifying for young children. But with a competent healthcare professional, any discomfort may be negligible.

It’s not unusual to feel pain or soreness in the area where the shot is given, but parents are still advised to be mindful of accidentally touching or holding the injection site to avoid swelling. Mild fever is to be expected but should resolve in a day or two. Babies also tend to fuss after receiving a vaccine shot. These common side effects are merely a sign that the body is starting to build immunity against a disease.
What parents must guard against are adverse reactions, although these rarely occur. It includes severe rashes and itching, chills, difficulty breathing, and fever of more than three days. Immediate medical attention is required if any of these symptoms are present.
It’s advisable not to give children 12 weeks and younger fever medicine until seen by a physician.

While routine vaccines are generally safe and protect against vaccine-preventable diseases, severe allergic reactions could occur, so it’s always best to observe a child after immunization.

Vaccination still remains to be the best way to protect ourselves and our loved ones from deadly infectious diseases. Make sure your family’s vaccines are up-to-date, and do have a conversation on vaccination with your doctor. HT