Where There Is No Doctor 2011 147
VACCINATIONS (IMMUNIZATIONS)—SIMPLE, SURE PROTECTION
Vaccines protect against many dangerous diseases. Each country has a schedule
of vaccinations, usually given for free. It is better to take your children to the nearest
health center to be vaccinated while they are healthy than to take them for treatment
when they are sick or dying. The most important vaccines are:
1. DPT, for diphtheria, whooping cough (pertussis), and tetanus. A child
needs 4 or 5 injections usually given at 2 months, 4 months, 6 months, and 18
months old. Sometimes one more injection is given between 4 and 6 years old.
2. POLIO (infantile paralysis). The child needs drops in the mouth 4 or 5 times.
In some countries the first vaccination is given at birth and the other 3 doses are
given at the same time as the DPT injections. In other countries, the first 3 doses
are given at the same time as the DPT injections, the fourth dose is given between
12 and 18 months of age, and a fifth dose is given when the child is 4 years old. In a
family where someone has HIV, do not use drops, use injections only.
3. BCG, for tuberculosis. A single injection is given under the skin of the left
arm. Children can be vaccinated at birth or anytime afterwards. If any member of the
household has tuberculosis, it is important to vaccinate babies in the first few weeks
or months after birth. The vaccine makes a sore and leaves a scar.
4. MEASLES. A child needs 1 injection given no younger than 9 months of age,
and often a second injection at 15 months or older. In many countries a ‘3 in 1’
vaccine called MMR is given for measles, mumps, and rubella (German measles).
One injection is given between 12 and 15 months old, and a second is given
between 4 and 6 years of age. Do not give measles vaccinations to a child with HIV.
5. HepB (Hepatitis B). This vaccine is given in a series of 3 injections, at the same
time as DPT injections. In some countries the first HepB is given at birth, the second
at 2 months old, and the third at 6 months old. Make sure there are at least 4 weeks
between the first and second injection, and 8 weeks between the second and third.
6. Hib (for Haemophilus influenza type b, which is a germ that causes
meningitis and pneumonia in young children). Generally this vaccine is given in a
series of 3 injections together with the first 3 DPT injections.
7. Td or TT (Tetanus toxoid), for tetanus (lockjaw) for adults and children
over 12 years old. Throughout the world, tetanus vaccination is recommended with
1 injection every 10 years. In some countries a Td injection is given between 9 and
11 years of age (5 years after the last DPT vaccination), and then every 10 years.
Pregnant women should be vaccinated during each pregnancy so that their babies
will be protected against tetanus of the newborn (see p. 182 and 250).
8. Rotavirus. Give the oral vaccine 2 or 3 times (depending on the manufacturer)
at 2 months, 4 months, and (if needed) 6 months old. It prevents this diarrhea
disease, a leading cause of death for young children.
Vaccines for measles, polio, and tuberculosis must be kept frozen or very cold
(under 8° C). The vaccines for Hepatitis B, tetanus, and the DPT must be kept very
cold (under 8° C) but never frozen. Vaccine that has been prepared but not used
should be thrown away. DPT is still good and useable if it remains cloudy 1 hour after
preparing it. If it becomes clear or has white flecks in it, it is spoiled and will not work.
For ways to keep vaccines cold, see Helping Health Workers Learn, Chapter 16.
Vaccinate your children on time.
Be sure they get the complete series of each vaccine they need.