All About Child Immunisation

[autumnbronze]

tankee:

:idea: Thinking of extracting these informative sharing into a thread under Health. But what should the topic title be? :?

All about Vaccines????

Vaccines???

Compulsory vaccines??

Queries on vaccines????

All you ever wanted to know about vaccines????

Sorli sorli, 2nd cup of nespresso, so quite overloaded with caffeine liao



edited: Opppps, just realized suggestions have already been given :oops:

[Mrs Ang]

duriz:

Mrs Ang:

My DD born in 2009 and she has the first Pneumococcal at 3 mth old. Nurse said norm infant have this jab at 6 mth but since mine is in CCC so better take earlier. I didn't know this jab is compulsory for 2010 child.


Doc said I should have give DD Rotavirus then she won't have stomach flu now. It is too late now as this jab must be given before 6mth old.

I think our DDs are the same age Mrs Ang :celebrate:
My DD born in Oct (I'd wanted my KSP nick to be Octomum
Anyhoo, she had her pneumococcal shots 5-in-one (2x), and 6-in-one (1x with Hep B), the next one will be MMR (mumps measles and rubella) when she turns 15 months. DD didn't have the rotavirus shot and thankfully she didn't have the flu either

Yup...yup... :celebrate: My DD also born in Oct.
Who is helping u to take care of your DD?

[Mrs Ang]

Have anyone heard that a new Pneumococcal vaccine will be out around end Oct or early dec?

The standard Polyclinic is give 3 jabs but private is 4 jabs. Can I check how many Pneumococcal jabs did you give your child?

[duriz]

Mrs Ang:

Have anyone heard that a new Pneumococcal vaccine will be out around end Oct or early dec?

The standard Polyclinic is give 3 jabs but private is 4 jabs. Can I check how many Pneumococcal jabs did you give your child?

Hi Mrs Ang,

I brought DD for the 6-in-1 @ NHG Polyclinic (total 2 jabs, one booster to follow at 15 months).
They gave her new pneumococcal vaccine known as Synflorix.
I think the fees are about $290 (for 5-in1) and $326 (for 6-in-1).

The vaccines are for: Diphtheria, Tetanus, Pertussis, Polio and Haemophilus Influenzae Type b (5-in-1) and additional Hepatitis B (6-in-1).

You are able to use your Medisave to pay for Hepatitis B and Pneumoccocal vaccines. You can also pay for your child’s immunisation using your child's Baby Bonus cash gift or savings in the CDA.

If you require more information on the Baby Bonus and its approved healthcare institutions, please go to http://www.babybonus.gov.sg.

[duriz]

PNEUMOCOCCAL VACCINATION


What is it ?
Pneumococcal disease is a group of illnesses caused by the bacterium Streptococcus pneumoniae, also known as pneumococcus.

They include meningitis, bacteraemia (blood infection ), pneumonia (lung infection ), otitis media (ear infection) and sinusitis

Pneumcoccal disease may thus lead to brain damage, permanent hearing loss, paralysis or severe disability, mental retardation, speech delay and in the worst case scenario, death.

About 15 per 100 000 children less than 5 years old are infected with pneumococcal disease each year in Singapore. A total of 144 cases of invasive pneumococcal disease were notified from January to June 2009

In serious cases, about 25% will suffer from complications and about 6% will die.

The pneumococcus bug can be passed easily via respiratory droplets through sneezing, coughing or close contact.

Currently, the available pneumococcal conjugate vaccine (PCV) is known as Prevenar. From 2010, a new pneumococcal vaccine known as SynflorixNEW will be available. MOH's Expert Committee on Immunisation (ECI) has recommended that PCV be included into the National Childhood Immunisation Programme from 2009 (see article). The target population groups are infants and children aged 6 weeks to 5 years.

Dosage and Administration

AGE DOSE
3 months old 1st Dose
5 months old 2nd Dose
12 - 24 months old 1st Booster Dose
12 - 59 months and (previously not vaccinated) 1 Dose unless asplenic or immunocompromised

Side effects: In clinical trials, the pneumococcal vaccine, prevenar , was found to be generally well tolerated. Most reactions to the vaccine, such as local irritations and fever, were mild, resolved spontaneously and were comparable to those commonly observed with other vaccines.

[duriz]

NATIONAL IMMUNISATION PROGRAM IN SINGAPORE


At Birth
(First 2 days of birth)
1. BCG for tuberculosis (TB)
2. Hepatitis B (1st dose)
Usually given at the hospital after consent is given by the parents

1 month old
Hepatitis B (2nd dose)

3 months old
Diptheria/Tetanus/Pertussis (DTaP) (1st dose)
Poliomyelitis Vaccine - (1st dose)
Pneumococcal Conjugate Vaccine (1st dose)*New

4 months old
Diptheria/Tetanus/Pertussis (DTaP) (2nd dose)
Poliomyelitis Vaccine - (2nd dose)

5 months old
Diptheria/Tetanus/Pertussis (DTaP) (3rd dose)
Poliomyelitis Vaccine - (3rd dose)
Pneumococcal Conjugate Vaccine (2nd dose)*New

5 - 6 months old
Hepatitis B (3rd dose)

1 - 2 years old
Measles, Mumps, Rubella (MMR)
Pneumococcal Conjugate Vaccine (Booster dose)*New Usually given at 15 months

18 months old
Diptheria/Pertussis/Tetanus (DTaP)(1st booster)
Poliomyelitis vaccine (1st booster) Usually given as 5-in-1

6 - 7 years old*
Measles, Mumps, Rubella (Booster dose)
Poliomyelitis vaccine (2nd booster dose)
As recommended in 2007 MOH guidelines

10 - 11 years old **
Diptheria, Tetanus (DT) - 2nd booster
Poliomyelitis vaccine (3rd booster)
As recommended in 2007 MOH guidelines

* With effect from Januaary 2008, all students in Primary 1 ie 6 to 7 years old will be administered the 2nd dose (booster dose) of MMR. Any child who is in Primary 2 to 6 from 2008 onwards who have not received the 2nd dose of MMR should be given the 2nd dose of MMR.

**For children already given 2nd booster of Diptheria-Tetanus containing vaccine in Primary 1 (prior to 2008), they would be given the 3rd booster of the Diptheria Tetanus-containing vaccine when they are in Primary 5.

[autumnbronze]

Mrs Ang:

Have anyone heard that a new Pneumococcal vaccine will be out around end Oct or early dec?

According to DS's PD, sometime in Oct.

She also mentioned that its v v painful.

To date, DS hasn't gone for it.

I may just decide to opt for this vaccine as PD is now recommending it.

[Mrs Ang]

duriz:

Mrs Ang:

Have anyone heard that a new Pneumococcal vaccine will be out around end Oct or early dec?

The standard Polyclinic is give 3 jabs but private is 4 jabs. Can I check how many Pneumococcal jabs did you give your child?

Hi Mrs Ang,

I brought DD for the 6-in-1 @ NHG Polyclinic (total 2 jabs, one booster to follow at 15 months).
They gave her new pneumococcal vaccine known as Synflorix.
I think the fees are about $290 (for 5-in1) and $326 (for 6-in-1).

The vaccines are for: Diphtheria, Tetanus, Pertussis, Polio and Haemophilus Influenzae Type b (5-in-1) and additional Hepatitis B (6-in-1).

You are able to use your Medisave to pay for Hepatitis B and Pneumoccocal vaccines. You can also pay for your child’s immunisation using your child's Baby Bonus cash gift or savings in the CDA.

If you require more information on the Baby Bonus and its approved healthcare institutions, please go to http://www.babybonus.gov.sg.

Thanks duriz,
My DD has her immunisation at SingHealth Polyclinics and taken the same 6-in-1 as your DD. The cost of Pneumoccocal vaccines is $165 per dose. Is it the same for NHG Polyclinic?
Children age from 1 to 12 years old need 1 dose for chicken pox vaccination so what is the usual age people send their children for this jab?

[duriz]

Hi Mrs Ang,


We paid $326 for the pneumococcal vaccine package (2 jabs + 1 booster) using Medisave.

[duriz]

OPTIONAL VACCINATIONS


1. Rotavirus vaccination for below 6 months old
2. Haemophilus influenzae b (Hib) vaccine
3. Influenza vaccine
4. Varicella (Chickenpox) vaccine at 15-18 months
5. Hepatitis A vaccination
6. Human Papilloma Virus vaccine
7. Meningococcal Vaccine

1. ROTAVIRUS
What is it ?
Rotavirus causes acute severe diarrhoea and vomiting in young children which lasts 4-8 days but occasionally persists up to 3 weeks. In general, the younger the child, the higher is the risk of hospitalization for severe diarrhoea, fever and vomiting. In Singapore, rotavirus infection is one of the most common causes of hospitalization for diarrhoea.

There is no specific treatment for rotaviral infection. Hospitalisation becomes necessary when child is dehydrated or unable to retain fluids.

Dosage and Administration: Two oral vaccines are available. 2 doses of Rotarix vaccine are given during first 6 months of life with 1st dose given between 6 to 14 weeks and the second dose given between 14 and 24 weeks. Rotateq is a pentavalent vaccine that consists of 3 doses.

Side Effects: Both vaccines are well tolerated with no serious side effects.

Estimated Cost: 2 doses of Rotarix at $180-$200; 3 doses of Rotateq at $190-$220

2. Haemophilus Influenzae b (HIb) Vaccine
What is it?
Haemophilus influenzae b infections can lead to serious complications such as meningitis (brain infection), pneumonia(lung infection), acute epiglottitis (life threatening throat infection), septic arthritis (joint infection) and pericarditis(heart infection). It used to be the leading cause of meningitis in the States until the introduction of the vaccine.

Dosage and administration: Usually given as part of combined vaccine preparations 5- in- 1 or 6- in-1.

Side Effects and Cost: As for 5-in-1 and 6-in-1

3. INFLUENZA ( “FLU”) VACCINATION
What is it?
Influenza, commonly known as the flu, is an extremely contagious viral infection that causes high fever, chills, muscle aches, sore throat and cough. Elderly patients age 50 and above and children aged 6 months to 5 years are at higher risk for influenza related complications such as otitis media (ear infection) and death(rare). Anyone with chronic lung diseases such as asthma should also be vaccinated against influenza. Children who are receiving long term aspirin therapy are advised to be vaccinated against influenza as well. Anyone with chronic metabolic diseases such as diabetes should also be vaccinated against influenza.

Dosage and administration: The flu vaccine should be given for children above 6 months old and have no egg allergy. For children less than 9 years old who were previously not vaccinated against influenza, a booster dose one month later is recommended. The flu vaccine is given as an injection once a year.

Side effects: Low grade fever, flu like symptoms and pain at injection site may occur.

Estimated Cost: $25- $40

4. CHICKENPOX VACCINATION
What is it ?
The chickenpox virus is a highly infectious disease caused by the varicella-zoster virus. Your child can be infected by breathing in the virus through respiratory droplets or by contact with fluid from the blister like skin rashes. Infected person is able to spread the virus until all the skin blisters turn to crusts. Outbreaks in child care centres are common. Symptoms maybe mild in children and include fever, fatigue, muscle pain, loss of appetite, pain in joints and irritability. Prevention is recommended still as possible complication though rare maybe serious and life threatening eg pneumonia and encephalitis (brain lining infection). As children with chickenpox will usually not be allowed to attend school for about 2 weeks, it maybe more practical to vaccinate them especially if both parents are working and taking leave to look after the child for 2 weeks is difficult. There is a break through rate of 2-20% even after the vaccination. However a child who has received the vaccination usually has milder symptoms and they last for a shorter time.

Dosage and Administration: One dose is generally recommended for children below 12 years old. The dose must be given after 1 year old. Currently, a second dose may be recommended by your doctor at 4 to 6 years old if first dose is given between one to two years old.

Side effects: Low grade fever and rash may occur but is rare.

Estimated Cost: $70- $90

5. HEPATITIS A VACCINATION
What is it ?
Hepatitis A is often transmitted through consumption of contaminated raw seafood or water. It causes fever, jaundice (yellowing of eyes/skin), lethargy,diarrhoea , vomiting and on rare occasions death. Although hepatitis A disease is usually asymptomatic in children below 8 years of age, outbreaks may occur at child care centers. Hence, Hepatitis A vaccination is recommended for children attending child care centers, children who travel to countries where hepatitis A is endemic and children who are hepatitis B carriers.

Dosage and administration: Hepatitis A vaccine is given to children above 12 months of age. For children 1-15 years old, 2 doses of injection are given with second dose given 6 months later.

Side effect: rare

Estimated Cost: $60-90

6. Human Papilloma Virus (HPV) Vaccine
What is it ?
The human papilloma viruses are responsible for cervical cancer, precancerous stages known as cervical intraepithelial neoplasia and vulvar intraepithelial neoplasia and genital warts

Is it recommended for all ladies?
HPV vaccination will set the stage for prevention of cervical cancer. It is hence recommended by the US Advisory Committee on Immunisation Practices to include HPV vaccine in adolescent /adult immunization program for those in the age group of 9-26 years old who lack immunity. Cervical cancer is one of the top 6 cancers in female Singaporeans.

What is the benefit then of having a HPV vaccination?
Early vaccination in developed countries has resulted in reduced cancer rate by as much as 75% and shifted the burden of managing cervical cancer to managing pre-malignant lesions.

Protection against HPV will also help to reduce incidence of genital warts.

Currently two HPV vaccines, Gardasil and Cervarix, are available locally. Please discuss with your doctor with regards to each vaccine and their immunization schedule.

Dosage and Administration: The vaccine is injected over the upper arm or thigh with three doses given over a 6 month period. The second dose is administered 1 to 2 months after the first dose and the third dose is given 6 months after the first dose.

Who should get this vaccine?
Girls between the ages of 9 and 26 should be vaccinated against the human papilloma virus. Currently, ladies older than 26 years old may want to check with their doctors for this vaccination as approval from Health Science Authority is pending.

Ideally the vaccine should be administered before potential exposure to HPV through sexual activity; however, women who are sexually active should still be vaccinated.

Vaccination is not recommended during pregnancy. If a woman is found to be pregnant after initiating the vaccination series, the remainder of the three-dose regimen should be delayed until after the completion of the pregnancy.

Side Effects: Common side effects as with most other immunizations include fever, pain and swelling over injection sites.

Do I still need to be screened for cervical cancer after the vaccination?
Yes, routine PAP smear is still advised even after vaccination. This is because there are many strains of the HPV and vaccines available currently are directed against the few main HPV types that account for the majority of the cervical cancers, but not all. Hence, cervical cancer screening is still recommended ie PAP smears is still important.

Estimated Cost: $150-$200 per dose (Cost of this vaccine has been reduced to about $100 per injection in some clinics.)

7. Meningococcal Vaccine
What is it ?
Travellers going to countries with meningococcal epidemics and those pilgrims on Haj should be given this vaccine which protects against brain infection. It is available locally as the quadrivalent ACWY polysaccharide vaccine

Dosage and Administration: Vaccine is for children above 2 years old.

Side Effect: Pain and redness over injection site.

Estimated Cost: $52-$75