當馬克遇上莎莉

Diphtheria

Immunisation has dramatically cut the number of diphtheria cases in this country. The disease is extremely rare in the UK now, whereas in 1940 nearly 50,000 cases were reported. However, cases of diphtheria are still seen in other countries.

Diphtheria immunisation works by stimulating the body to produce an anti-toxin to the diphtheria toxin. This is done by using an inactivated form of the toxin. Mild swelling and redness at the injection site are common, but more severe reactions to diphtheria immunisation are rare.

Haemophilus influenzae type b (Hib)

Meningitis C

This vaccine is made in the same way as the Hib vaccine and the complications are rare. The most common reactions are redness and swelling at the site of the injection, mild fevers, irritability and headaches.

Measles, mumps and rubella (MMR)

You may find that your child has a short reaction to this immunisation seven to ten days after the injection. This may consist of a mild fever and a rash.

There have been concerns that the vaccine may be responsible for causing a few cases of encephalitis each year. Research has shown that the numbers of cases which may be linked to the vaccine are tiny in comparison to the numbers caused by measles and mumps themselves. Meningitis and encephalitis resulting from measles itself is roughly one per 1000 notifications and from mumps it is one per 200-5000 notifications (it can vary from one outbreak to the next).

A research paper published in February 1998 raised concerns about a possible link between the MMR vaccine and autism and Crohn's disease, which causes inflammation in the bowel. Large studies have been done and are continuing to be done, but as yet there is no conclusive proof of a link.

Pneumococcal infection (PCV)

Some swelling and redness at the injection site and a mild fever are among the most commonly reported reactions. Other mild side effects such as a slightly raised temperature, irritability, sickness, diarrhoea and loss of appetite may also occur.

Experience of using PCV in other countries has shown this vaccine to have an excellent safety record. In the US, PCV has been part of the universal childhood immunisation programme since 2000. Since its introduction, the incidence of invasive pneumococcal disease (the most serious form of the infection) has fallen by 94% in children under five years. Estimates vary but at least 16 and as many as 53 children under the age of two die from invasive pneumococcal disease in England and Wales each year.

Polio

Adverse reactions are rare with this vaccine.

Tetanus

The tetanus vaccine contains an inactivated toxin from the organism. It is common to see swelling and redness around the injection site and, occasionally, the child will be off colour and mildly feverish. More severe reactions are rare.

Whooping cough (pertussis)

There have been concerns in the past about the safety of this immunisation. They originated in 1974 after the publication of a paper which suggested a relationship between the whooping cough immunisation and serious conditions of the nervous system, such as epilepsy and learning disorders. As a result of the anxiety, uptake of the immunisation dropped to between 30% and 40% for a number of years. Subsequently, there were whooping cough epidemics between 1977 and 1979, and 1981 and 1983.

In response to this, the National Childhood Encephalopathy Study was set up. It concluded that the risk of a previously normal child developing a serious problem of the nervous system due to whooping cough immunisation was one in 110,000, and the risk of suffering permanent brain damage was one in 310,000. Intensive research in this country and abroad has failed to find a definite link. Also, these complications are complications of whooping cough itself and are more common after the disease than after the immunisation.

There has also been a link suggested between the whooping cough immunisation and asthma. However, there is no conclusive evidence of this.

In the past, children with epilepsy or a family history of epilepsy were not given the immunisation. However recent studies have shown that it can be given with no adverse effects. However, if the child has a history of febrile convulsions or there is a family history, there seems to be an increased risk of developing a febrile convulsion after the immunisation, so it is vital that parents know how to treat a fever.

There may be swelling and redness at the site of the injection and babies may be quite irritable, feverish or, occasionally, distressed after the injection.

Can my child have the immunisations separately?

Doctors generally agree that there is no increased risk associated with giving certain immunisations, such as the DTaP/IPV/Hib, together. There are also difficulties with giving the vaccines separately. Firstly, some vaccines may not be available separately in this country (the rubella vaccine on its own is not licensed in the UK for children under 10, for example). Secondly, some vaccines have to be given at least four weeks apart, so giving them to your child separately would significantly delay and prolong her immunisation schedule.

Why does my baby have to have the immunisations so young?

Babies are given their first round of routine vaccinations at eight weeks to ensure that they are protected at a time when they are most vulnerable to the effects of infectious diseases. Plus, studies have shown that babies immunised at this age are less likely to have reactions to the injections. For doctors, early immunisations also mean higher compliance by parents, so more babies are immunised.

Reviewed May 2006