Vaccinations for Children: Everything You Should Know

What are vaccines?

Vaccines are a form of disease prevention. Infants build up their natural immunity against diseases from their mother and through breastfeeding. This immunity tends to fade by the age of 6 months. Vaccines help to stimulate your child's immune system by teaching it to recognise and respond to a disease. Exposure to vaccines will help your child's body develop antibodies to fight off germs when they are next exposed to them.

How does immunity work?

Our immune system is made up of different organs, cells and proteins. The 'innate' immune system is what we are born with, and the 'acquired' immune system is developed when our body produces antibodies in response to vaccinations or exposure to viruses, bacteria and other disease-causing pathogens.

These antibodies remain in us so that, the next time we are exposed to those pathogens, our body has the 'armour' to protect us against those specific diseases.

Vaccine–induced immunity (which is a form of acquired immunity) is achieved by introducing a 'killed' or 'weakened' form of the germ to our bodies in a 'safe' way by vaccinations.

What are vaccines made of?

Vaccines usually consist of a 'safe' form of the disease-causing germ, where the germ is weakened or killed. Some vaccines are in the form of a toxoid. 'Adjuvants' are used in some vaccines to help increase the immune response in the body.

What do vaccines protect against?

Vaccinations are not only important for the health of an individual, they also help in community or national disease prevention.

The National Childhood Immunisation Programme (NCIP) in Singapore includes a variety of vaccinations that protect against several diseases. These diseases are:

• Diptheria
• Haemophilus Influenzae Type B
• Hepatitis B
• Human Papillomavirus
• Measles
• Mumps
• Pertussis
• Pneumococcal Disease
• Poliovirus
• Rubella
• Tetanus
• Tuberculosis

Other diseases that can be prevented by vaccinations include:

• Hepatitis A
• Influenza
• Meningococcus
• Rotavirus
• Varicella (chickenpox)

Do consult your paediatrician to find out more.

Mandatory vaccines for children in Singapore

Although it is recommended to get as much protection against diseases as possible, only vaccinations against diphtheria and measles are compulsory by law in Singapore.

For the other vaccinations that aren't compulsory, parental consent is required. Data from the Ministry of Health show that close to 100% of children in Singapore have been vaccinated in the last decade.

Learn about caring for your children and family at Gleneagles hospital.

Additional vaccines for children

These are some additional vaccines that parents should consider as they can provide useful protection for your children against common infectious diseases:

Rotavirus

Rotavirus is a highly contagious disease which can cause severe diarrhoea (gastroenteritis) in babies and young children. It is sometimes accompanied by fever and vomiting. Children who get a rotavirus infection may experience dehydration require hospitalisation. The rotavirus vaccine is administered orally in 2 or 3 doses, depending on the type of vaccine that is used.

Varicella (chickenpox)

Chickenpox, caused by the varicella-zoster virus, is a common childhood disease that also affects adults. Infected individuals experience small fluid-filled blisters that are very itchy. The virus remains in the nerve cells and can reactivate years later as shingles, which can be very painful. Getting the varicella vaccine can help to prevent both chickenpox and shingles and since November 2020, it has been included in Singapore's National Childhood Immunisation Schedule.

Influenza

The influenza or flu virus circulates the globe. In temperate climates it is seasonal but in tropical countries like Singapore, influenza occurs throughout the year. It can lead to serious illness or complications like pneumonia and ear infections, and could make existing conditions like asthma worse. While the vaccine will not completely protect against all strains of the influenza virus, those who are vaccinated often experience less severe illness. The influenza vaccine has been included in Singapore's National Childhood Immunisation Schedule since November 2020.

Travel vaccinations

Some illnesses are more common in certain parts of the world hence it is often advisable to protect yourself prior to your trip. Some common recommended vaccines include influenza and tetanus, among others, while some parts of the world require specific vaccinations such as Japanese encephalitis and meningococcal disease. It is best for you to speak to your doctor and the relevant travel authorities to see which ones you should take.

Combination vaccines

As its name suggests, combination vaccines offer protection against two or more diseases. This helps to reduce the number of injections a child takes. Common combination vaccines available in Singapore include MMR (measles, mumps and rubella), MMRV (measles, mumps, rubella and varicella), DTP or DTaP (diphtheria, tetanus and pertussis). Others include the 5-in-1 (diphtheria, tetanus, pertussis, polio and haemophilus influenzae B) and 6-in-1 (diphtheria, tetanus, pertussis, polio, haemophilus influenzae B and hepatitis B).

The results of an effective immunisation programme

Because of the high acceptance of vaccines in Singapore, the incidence rates of several diseases have drastically decreased over the years.

Cases of:

• Measles decreased from 1,413 cases in 1997, to only 136 in 2017
• Rubella decreased from 48 cases in 2013 to just 12 cases in 2016
• Acute hepatitis B for all age groups declined from 243 in 1985 to 47 cases in 2016

Childhood Vaccination Schedule

Vaccinations are administered to infants soon after birth and throughout childhood. Most vaccines require more than one dose for adequate coverage.

Side effects of vaccines

Vaccines are safe, as they are rigorously tested before they are certified ready for use. The benefits of vaccines far outweigh their risks.

Like any medicine, your child may experience some vaccine-related side effects. Most of these are mild and temporary.

They include:

• Fever
• Muscle aches
• Soreness and redness near the injection site

Rarely, serious adverse effects like allergic reactions may occur.

Do consult your doctor first if your child has a weak or suppressed immune system, or if there is a family or personal history of vaccine reactions.

How do I care for my child after the vaccination?

If your child experiences mild vaccine reactions such as pain at the injection site, a rash, or a fever; here are some steps you can take at home:

• Give your child a cool sponge bath to reduce any fever. Antipyretics like paracetamol can also be given (after approval by your child's doctor).
• Ensure your child stays hydrated with lots of fluids.
• Use a cool, wet cloth to reduce any redness and swelling at the injection site.

Discuss more with your child's doctor regarding the specific side-effects for each vaccine. Call your doctor if you notice anything unusual with your child.