Is your child's vaccination schedule up-to-date?

Expatriates residing in Southeast Asia need to comply with their home country vaccine programme as well as consider some recommended immunisations particular to the Asian region.

Vaccination is one of the most effective measures in preventing several infectious diseases or at least minimising their complications. It is also an effective approach to controlling the spread of a contagious illness and may lead to worldwide eradication, an example being smallpox in 1977. 

While controversies remain regarding the safety of certain vaccines, it is generally accepted that most vaccines have a positive benefit to risk ratio. 

Vaccination consists of injecting into the body some killed (or attenuated) bacteria or virus or their toxins, which cannot induce the disease but rather triggers an immune reaction from the body’s defence system. Specific proteins called antibodies are then synthesized by the white blood cells to eliminate the germs. These white blood cells retain the memory of producing antibodies for a rather long period and in case of actual infection, are able to release large quantity of antibodies that will prevent or lessen the severity of the illness. To maintain lifelong protection, the complete first set of vaccination shots must be completed at the defined intervals and followed by regular boosters. 

Vaccinations for adults and young people are recommended on the basis of several criteria including place of residence, age, health background, occupation, lifestyle and travel to foreign countries. Immunisation of young children against several diseases is required because infants have immature immunity making them more vulnerable to infection.

Health authorities in most countries implement a compulsory immunisation scheme for children to better control the propagation of the diseases concerned. Vaccines against diphtheria, tetanus, poliomyelitis, and measles as well as yellow fever (in some territories) are often required by law. 

As a common rule, starting from the first days and months of life, almost all children need to get the following vaccines. The hepatitis B vaccine, often given at birth; the diphtheria–pertussis (whooping cough)–tetanus vaccine, which is given in a combined shot called DTP; the Poliovirus vaccine, which comes in oral form; and the Haemophilus influenzae type B vaccine (this bacterium is responsible for meningitis). Today, the “5-in-1 vaccine” or DTaP/IPV/Hib vaccine conveniently combines DTP, haemophilus influenzae B and hepatitis B in one vial. The MMR vaccine, which protects against measles, mumps and rubella is also routinely given and requires only 2 injections. 

Many countries may also recommend other immunisations. These include pneumoccocal vaccines against invasive pneumococcal disease, which induces severe bacterial lung infection; rotavirus vaccine against a common viral cause of diarrhoea, now available in oral form, and meningococcal vaccines to protect against meningococcal disease that leads to meningitis. 

In addition, the Human Papillomavirus – a virus implicated in genital and oral cancers – is now widely recommended for girls above nine years of age and is also proposed to boys aged 9 to 26. The vaccine against influenza (or seasonal flu) is often recommended for children older than 6 months. In Asia, physicians may also recommend the addition of the BCG, the vaccine against tuberculosis, the hepatitis A vaccine, the varicella vaccine, the Japanese encephalitis vaccine (a viral disease causing brain infection) and the typhoid vaccine. 

Expatriates with children are encouraged to consult a family physician or a pediatrician in their new country of residence to learn about the most updated recommendations regarding the immunisation schedule.

 

Dr Gerard Lalande is Managing Director of CEO-HEALTH, which|provides medical referrals for expatriates and customised executive |medical check-ups in Thailand. He can be contacted at [email protected].