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Importance of vaccinations in newborns

July 29, 2024

This article has been written by Rakhi Das pursuing a Training program on Using AI for Business Growth from Skill Arbitrage.

This article has been edited and published by Shashwat Kaushik.

Table of Contents

Introduction

Vaccines are essential for protecting against diseases and saving lives. They are especially important for newborns and young children, who have weaker immune systems and are more vulnerable to infections and deadly killer diseases due to their low and still-developing immune systems. In the first few months, infants are highly vulnerable to infections because their natural defences are still developing. Vaccines act by introducing a tiny, harmless piece of the germ causing the illness into the body. This helps the immune system learn to fight the germ effectively. So, if children are exposed to the real disease, their bodies can protect them from getting sick. Vaccinating babies and kids is crucial for their health and well-being.

The immunity from vaccines can last a lifetime, providing long-term protection. Vaccination is a key public health measure that reduces the spread of contagious diseases and helps build community immunity, which protects those who can’t be vaccinated for medical reasons. Therefore, vaccinating newborns is vital; it ensures their health, prevents deadly diseases, and promotes a healthy start to life.

Crucial reasons signifying the importance of vaccination

Responsibility of every parent: As parents, our primary goal is to ensure our children’s health and safety from preventable diseases. Vaccination is the most effective way to achieve this protection.
Protection and effectiveness: Vaccinations are completely safe and effective. Each vaccine undergoes thorough and extensive reviews by scientists, doctors, and government authorities to ensure its safety.
Support from paediatric organisations: Major paediatric organisations, including the Indian Academy of Paediatrics and the Centres for Disease Control and Prevention, strongly endorse the protection of children through recommended vaccinations.
Sheild for serious illnesses: Vaccination shields children from severe illnesses and their complications. Without vaccines, diseases can lead to serious conditions such as limb paralysis, hearing loss, convulsions, limb amputation, brain damage, or even death.
Vaccine-preventable diseases still remain a global threat: Diseases like mumps, polio, and whooping cough are preventable by vaccines but still pose a global threat. Many children around the world still contract these diseases annually.
Risk from international travel: International travellers can introduce these diseases to other countries, putting unvaccinated children at risk of infection.
Potential outbreaks from low vaccination rates: If more people refuse or delay their children’s vaccination, it could lead to outbreaks of preventable diseases. Such epidemics could have devastating effects on child healthcare.
Protection to others: Unvaccinated children can serve as carriers and transmit diseases to other children, infants too young to be vaccinated, and people with weakened or low immune systems, such as with cancer or immunosuppressive therapy.

Importance of vaccination in the context of India

In India, vaccination holds immense importance. The country’s large population and varied socio-economic conditions create an environment where infectious diseases can spread rapidly. Newborns, with their immature immune systems, are particularly at risk. Vaccination programmes in India are crucial in shielding these infants from serious illnesses like mumps, diphtheria, polio, and measles. Vaccines enable infants to develop immunity without getting sick, which is crucial in a country where healthcare access may be limited and disease outbreaks can have devastating effects. Additionally, widespread vaccination contributes to community or herd immunity, decreasing the overall incidence of diseases and safeguarding those who cannot be vaccinated. Vaccination is a key public health strategy in India, ensuring healthier futures for countless children and supporting the nation’s overall health and economic stability.

Overview of the common vaccines recommended for newborns in India

In India, we have two kinds of immunisation schedules. The first one is known as National Immunization Schedule (NIS) which is given by the Government of India, supplied through all Government health sectors. It is free of charge all over the country and includes the bare minimum vaccines that every child in India must receive, keeping public health as a focus and also considering various factors such as cost involved, delivery chain feasibility, availability of vaccines, etc. The second comprehensive vaccination schedule is developed by the Indian Academy of Paediatrics (IAP) to ensure that newborns in India receive optimal protection against various diseases. With the IAP vaccination chart, it is easier to understand which are the specific vaccines recommended at a specific age and which vaccines require multiple doses at different intervals to provide complete immunity.

Detailed explanation of each vaccine

The chart may seem overwhelming, but the shots are far easier. After an institutional delivery, the newborn receives its first vaccine within 72 hours of birth in the same medical facility itself. The vaccines include Bacillus Calmette-Guérin (BCG), Oral Polio Vaccine (OPV) and Hepatitis B (Hep-B). A single shot of BCG gives a lifelong immune system against primary tuberculosis and is given only once as per schedule, intradermally in the upper left arm. A small wheal formation with a series of blisters can be noted but it is completely normal and expected. Hepatitis B (birth dose) 0.5 mL is given intramuscularly at birth or as early as possible within 72 hours after birth to prevent Hepatitis B. OPV (first dose) is a vaccine for poliomyelitis prevention that is given orally in two drops at birth or as early as possible within the first 15 days. OPV -1,2 and 3rd doses are given at 6 weeks, 10 weeks & 14 weeks and can be repeated up until 5 years of age

The 6 vaccines, namely Hepatitis B (Hep – B), Inactivated Polio Vaccine (IPV), Haemophilus Influenzae Type B, Diphtheria, Tetanus, And Pertussis Vaccine (DTP), are available in 1 vial known as “Hexavaccine” in the Middle East and Western countries. In India, it is 5-in-1 vaccine vial known as “Pentavalent,” excluding IPV, thus providing immunity to the baby in one single shot of 0.5ml intramuscularly. This vaccine is given three times at 4 weeks, 10 weeks and 14 weeks of age, respectively. The booster dose is repeated every Booster 16-18 months.

Rotavirus is given orally 5 drops and helps to gain immunity against rotavirus, which can cause deadly diarrhoea.

The next schedule comes at the age of 9 months for Measles, Mumps, and Rubella (MMR) given Subcutaneously on the Upper arm and repeated at 15 months of age. It can also be given up to 5 years if not received at 9 – 12 months

Vitamin A (1st dose) in 1 mL is given orally at 9 months and given up to 2 years of age at a 6 months interval. This is given to prevent vitamin A deficiency. If doses are missed, the vaccine can be given up to 5 years of age.

Hepatitis A (Hep – A) and influenza vaccines are scheduled for 12 & 18 months of age and given intramuscularly, helps to get immunity against the Hepatitis A virus.

Vaccines that do not come under the Government of India schedule but are recommended by the IAP are available in the private sector and considered optional vaccines; these include the Japanese Encephalitis, Typhoid and varicella vaccines.

Under the Pulse Polio Immunisation Programme, a once OPV campaign is organised by GOI to vaccinate all the children under 5 years of age, irrespective of the immediate vaccines they would have received according to their age and immunisation schedule. Although India was already declared a “Polio – free country” in 2014, the campaign is still ongoing, and the Polio vaccine is an integral part in the vaccination schedule as a preventive measure for the vulnerable population of India.

Vaccination schedule in India

Given here is a condensed summary of the vaccination schedule by IAP, GOI and Health & Welfare Ministry of India for Children:

Vaccine	Age	Site	Benefits/Diseases Prevented
Bacillus Calmette-Guérin (BCG)	At Birth	Intradermal – Upper arm	Tuberculosis (TB)
Oral Polio Vaccine (OPV 0, 1, 2, 3, Booster)	At Birth,	Oral	Polio
Hepatitis B (Hep – B)	At Birth, 6, 10 & 14 Weeks	Intramuscular – Anterolateral thigh	Hepatitis B
Diphtheria, Tetanus, And Pertussis Vaccine (DTP)	6, 10 & 14 WeeksBooster 16-18 Months	Intramuscular – Anterolateral thigh	Diphtheria, Tetanus, Pertussis (Whooping Cough)
Inactivated Polio Vaccine (IPV)	6, 10 & 14 WeeksBooster 16-18 Months	Intramuscular – Anterolateral thigh	Polio
Rotavirus	6, 10 & 14 Weeks	Oral	Rotavirus gastroenteritis
Pneumococcal Conjugate Vaccine (PCV)	6, 10 & 14 WeeksBooster 16-18 Months	Intramuscular – Anterolateral thigh	Pneumococcal diseases like pneumonia, meningitis
Haemophilus Influenzae Type B (HiB)	6, 10 & 14 WeeksBooster 16-18 Months	Intramuscular – Anterolateral thigh	Haemophilus influenzae type B infections
Typhoid Conjugate Vaccine (TCV) *	6 Months	Intramuscular – Anterolateral thigh	Typhoid fever
Measles, Mumps, And Rubella (MMR)	9 Months, 15 Months4-6 Years*	Subcutaneous – Upper arm	Measles, Mumps, Rubella
Hepatitis A (Hep – A)	12 Months, 16-18 Months	Intramuscular – Anterolateral thigh	Hepatitis A
Influenza (Yearly)	12 Months, 15 Months	Intramuscular – Anterolateral thigh	Influenza (Flu)
Varicella *	15 Months, 4-6 Years	Subcutaneous – Upper arm	Chickenpox (Varicella)

*Optional vaccines

For the original chart and details, please visit IAP and GOI websites.

Importance of following the vaccination schedule

Timely vaccination plays a crucial role in safeguarding public health by reducing hospital stays and preventing the spread of infectious diseases. Vaccines are designed to stimulate the immune system to produce antibodies that protect against specific diseases. When administered according to the recommended schedule, vaccines provide optimal protection, ensuring that individuals have sufficient immunity to combat potential infections.

Skipping vaccines or not vaccinating on time can have severe consequences. Children who are not fully vaccinated are more vulnerable to contracting serious illnesses, such as measles, mumps, and rubella. These diseases can lead to complications, including pneumonia, encephalitis, and permanent disabilities. Moreover, incomplete vaccination rates undermine herd immunity, which is the indirect protection provided to unvaccinated individuals when a large portion of the population is vaccinated. This puts the entire community at risk, as it allows infectious diseases to spread more easily.

Timely vaccination is especially important for protecting those who cannot be vaccinated, such as infants and immune-compromised individuals. Infants have immature immune systems and are particularly susceptible to infections. Immune-compromised individuals, such as those undergoing chemotherapy or organ transplant recipients, have weakened immune systems and may not be able to mount an effective response to vaccines. By vaccinating on time, we can provide indirect protection to these vulnerable groups and help prevent the spread of diseases.

In conclusion, timely vaccination is essential for reducing hospital stays, preventing the spread of infectious diseases, and protecting both individuals and the community as a whole. By adhering to the recommended vaccination schedule, we can ensure that everyone, including those who cannot be vaccinated, is safeguarded from preventable illnesses.

Common concerns that may lead to improper execution of the immunisation schedule

Concerns that can lead to not adhering to the immunisation schedule properly include:

Health care provider barriers

Lack of knowledge: Insufficient understanding of the indications for and contraindications to immunisations can lead to improper execution of vaccination.
Inadequate training: Poorly trained medical staff who may not effectively administer vaccines or educate parents is a matter of concern.
Absence of reminder systems: Lack of systems to remind parents and providers about missed vaccinations.
Discomfort with vaccine schedule: Medical staff and parents are uncomfortable with the number of recommended immunisations during well-child visits in the first year of life.
Communication issues: Failure of physicians to clearly communicate the importance of timely vaccinations according to guidelines may create fear and anxiety in parents.

Logistical barriers

Expense of vaccines: High cost of vaccines, can make them less accessible to some facilities and patients.
Storage requirements: Strict storage requirements for certain vaccines like MMR, OPV, Influenza vaccine, and rotavirus vaccine are needed.
Lack of vaccination records: Absence or incompleteness of vaccination records hinders proper tracking of immunisations and can cause errors, missing or duplication of vaccines.
Missed visits: Patients missing scheduled visits can lead to an incomplete vaccination.

Technological barriers

Lack of Electronic Health Records (EHR): Many facilities are not utilising EHR systems, which could standardise record-keeping and track missed visits and immunisations accurately.

Patient and parent barriers

Lack of knowledge: Parents may not be well-informed about the importance and schedule of vaccination.
Fears about vaccine safety: Unreasonable fears and misconceptions or myths about vaccine safety.
Transportation issues: Lack of transportation makes it difficult for parents to bring children to vaccination points.
Awareness of disease
Threats: Parents may not be aware of the risks posed by vaccine-preventable diseases and the availability of safe and effective vaccines.

Clinic operational arriers

Supportive Staff: Clinics lack supportive staff who encourage and facilitate immunisations.
Office Hours and Wait Times: Inconvenient office hours and long wait times for immunisations can discourage parents from adhering to schedules.

By addressing these concerns through proper education, improved communication, technological integration, and logistical support; adherence to immunisation schedules can be significantly improved.

Addressing the common concerns

Health care provider solutions

Enhanced training programs

Ministry of Health and Welfare is regularly planning and implementing various trainings and workshops for healthcare providers to ensure they are knowledgeable about vaccination guidelines and schedules.
Healthcare providers are encouraged to utilise digital platforms and mobile applications for continuous medical education (CME) and short-term certified training courses.

Reminder systems

Government of India has introduced electronic reminder systems for healthcare providers to track and notify about upcoming and missed vaccinations.
Leverage of the government’s eVIN (Electronic Vaccine Intelligence Network) to monitor vaccine stocks and usage in various urban and rural sectors have improvised the miss-outs.
Mobile phone registration system is introduced where the parent can register the child’s name and date of birth. A reminder SMS is automated when the vaccine is due for the particular child at the parent’s registered phone number.

Effective communication

State and District authorities conduct awareness programmes to educate healthcare providers on the importance of clear communication with parents. Nursing students and institutions also play an important role in communication and awareness by conducting outreach community programmes
Distribution of educational materials that outline the vaccination schedule and address common concerns. Parents are provided with a “Baby Immunisation Chart,” which contains all the demographic details of the child, vaccine schedule and developmental red flags.

Logistical solutions

Financial support

Increase government subsidies for vaccines to reduce costs for healthcare facilities.

Utilise schemes like Mission Indradhanush which provides free vaccines to underprivileged populations.

Improved storage solutions

Enhance cold chain infrastructure through initiatives like eVIN to ensure proper vaccine storage and reduce wastage.
Provide grants or financial assistance for clinics to upgrade their storage facilities.

Complete vaccination records

Government can customise and promote child vaccination using an identical web platform like CoWIN, which helps in maintaining accurate vaccination records.
Health care workers should be encouraged to integrate immunisation records with national health databases.

Utilising opportunistic immunisation

Train healthcare providers to take every opportunity, such as during other clinic visits, to find out and administer vaccines. ASHA workers and Anganwadi teachers are trained for this data collection role.

Technological solutions

Adoption of Electronic Health Records (EHR) system through government incentives and training can be encouraged.
Implement user-friendly EHR systems that integrate seamlessly with existing health IT infrastructure.

Patient and parent solutions

Public awareness campaigns

Launch nationwide campaigns, similar to the Pulse Polio Program, to educate parents about the importance and safety of vaccines.
Use mass media, social media, and community health workers to disseminate information.

Addressing safety concerns

Provide factual, easy-to-understand information about vaccine safety and efficacy through trusted sources.
Set up helplines and mobile apps where parents can get their questions answered by medical professionals.

Transportation solutions

Implementation of mobile vaccination units to reach remote areas.
Provide transportation support through community health programmes for those who lack access to health facilities.

Enhancing awareness of disease threats

Conduct local workshops and seminars to highlight the risks of vaccine-preventable diseases.
Collaborate with community leaders to spread awareness and promote vaccinations.

Clinic operational solutions

Supportive staff

Train staff to be more supportive and proactive in promoting vaccinations.
Recognise and reward clinics with high immunisation rates to motivate staff.

Convenient office hours and reduced wait times

Extend clinic hours to evenings and weekends to accommodate working parents.
Streamline the vaccination process to minimise wait times, possibly through appointment systems.

By implementing these solutions and leveraging existing government initiatives, India can significantly improve adherence to immunisation schedules and enhance overall public health outcomes.

Parent FAQs about vaccination

What are vaccines?

Vaccines are products given to children to protect against serious, often deadly diseases. They stimulate the body’s immune response to prepare it to fight infections more effectively in the future (UNICEF)

How do vaccines work?

Vaccines help the immune system recognise and combat pathogens. They train the immune system to recognise and destroy specific viruses or bacteria if they ever invade the body. (UNICEF)

Are vaccines safe?

Vaccines are rigorously tested for safety and effectiveness before being approved. The risk of serious side effects is extremely low compared to the risks associated with the diseases they prevent (UNICEF) (Kids Health) (CDC).

Why should I vaccinate my child?

Vaccination protects children from serious diseases, prevents outbreaks, and contributes to herd immunity, protecting those who cannot be vaccinated (UNICEF)

Can my baby handle multiple vaccines at once?

Yes, a baby’s immune system can handle many more antigens than are present in vaccines. Receiving multiple vaccines at one visit is safe and effective (UNICEF) (Kids Health)

What are the common side effects of vaccines?

Common side effects include redness and swelling at the injection site, mild fever, and soreness. Serious side effects are rare (Kids Health) (CDC)

Do vaccines cause autism?

Extensive research has found no link between vaccines and autism. The study that initially suggested this link was found to be fraudulent and has been discredited (NCBI)

What diseases do vaccines prevent?

Vaccines protect against diseases like polio, measles, tetanus, diphtheria, whooping cough, and more. These diseases can cause serious health issues and even death (UNICEF)

Can I delay my child’s vaccine schedule?

It is recommended to follow the established vaccine schedule to ensure timely protection against diseases. Delaying vaccines increases the risk of contracting vaccine-preventable diseases (UNICEF) (Kids Health) (CDC) (AAP).

Why do healthy children need vaccines?

Vaccines help keep healthy children protected before they are exposed to diseases. Immunising healthy children prevents them from becoming carriers and spreading diseases to others. (NCBI)(UNICEF)

What is herd immunity?

Herd immunity occurs when a significant portion of the population is vaccinated, reducing the overall amount of disease and providing indirect protection to those who are not immune (UNICEF)

Why do boys need HPV vaccinations?

HPV vaccination prevents infections that can lead to cancers of the penis, anus, and throat in men. Vaccinating boys also helps reduce the spread of HPV, contributing to overall community health (UNICEF)(CDC).

How do you treat a baby’s fever after vaccination?

In case an infant develops a high fever after vaccination, they should drink plenty of water. Liquid paracetamol can be administered to lower the temperature and soothe pain and discomfort.

Can I bathe my baby after vaccination?

It is safe to bathe the baby after vaccination, as usual. But it is advisable to wait at least 24 hours to avoid chills. If the injection area is red and warm, a cool, wet towel can be used around the site. Avoid using an ice pack.

Can I feed the baby before and after vaccination?

Yes, breastfeeding both before and after vaccination can help alleviate pain in babies up to 1 year old. Most children tend to feel tired and may eat very little after being vaccinated, so feeding the baby beforehand is usually recommended.

Do’s and don’t’s during and after vaccination

Do’s

Carry health records: A child’s vaccination health card should be carried during each appointment to keep it updated.
Comfortable clothing: Babies should be dressed in comfortable, easily removable clothes, as infants under 12 months receive shots in the thighs. Older children should wear short sleeves or off-shoulder tops, as injections are usually administered in the arm.
Distraction techniques: Using distractions such as sounds, cuddling, or soft singing can comfort the baby during the injection.
Reschedule missed vaccinations: If a scheduled vaccination is missed, it should be rescheduled with the healthcare provider as soon as possible.
Proper positioning: The child should be held securely on the knees during the injection to help them feel safe and reduce movement.
Managing fever: If a high temperature develops after vaccination, the child should be given plenty of fluids. Liquid paracetamol or ibuprofen should be administered as recommended to manage the fever.

Don’ts

Avoid aspirin: Aspirin should not be given to children under 16 years unless prescribed by a healthcare professional.
Appropriate clothing during fever: Overdressing the child should be avoided if they have a fever to prevent overheating.
Adhere to the vaccination schedule: Vaccinations should not be skipped, and the recommended immunisation schedule should be strictly followed. There should be at least a 4 weeks gap between vaccine schedules, so if any delay happens for a vaccine, the schedule for next vaccine should be after 4 weeks, irrespective of age.
Stick to recommended vaccines: Vaccinations that are not recommended for the child’s age or health condition should be avoided.
Adequate planning: Sufficient time should be allowed for vaccination appointments to avoid rushing and minimise stress for both the child and the caregiver.

Debunking myths and misconceptions about vaccine safety

Myth: Vaccines are unnecessary because diseases have been eradicated.

Fact: Vaccines have significantly reduced the prevalence of many diseases, but they have not been eradicated. Also, vaccine-preventable diseases still exist and can return if vaccination rates drop. Travel and immigration can bring these diseases back into areas where they were previously rare.

Myth: Vaccines contain harmful ingredients that can cause health problems.

Fact: Vaccines are rigorously tested for safety and efficacy. Ingredients in vaccines are carefully selected and present in very small, safe quantities. They are intended to protect, not to harm.

Myth: Vaccines can overload a child’s immune system.

Fact: Vaccines contain only a tiny fraction of the antigens encountered naturally. Research shows that the recommended vaccine schedule is safe and does not overwhelm the immune system.

Myth: Natural immunity is better than vaccine-induced immunity.

Fact: Natural immunity from disease can come with severe complications, hospitalisation, or death. Vaccination provides immunity without the risks associated with natural infections.

Myth: Most diseases for which vaccines are given are not serious.

Fact: All vaccine-preventable diseases can cause serious illness, complications, and death. Diseases like measles, whooping cough, and tetanus have severe outcomes and can be fatal.

Myth: If many people are vaccinated, my child doesn’t need vaccines.

Fact: Herd immunity only works if a large portion of the population is vaccinated. Unvaccinated children rely on others’ vaccinations for protection, but if too many are unvaccinated, diseases can spread.

Myth: It’s better to get vaccines one at a time.

Fact: Combination vaccines, like MMR, DTP, and Pentavalent are safe and effective. They provide timely protection and reduce the number of medical visits and injections.

Myth: There will be fewer side effects if baby’s vaccinations are delayed.

Fact: Delaying vaccines increases the risk of serious illness, not delay the rare side effects.

Myth: Vaccines are not adequately tested for safety.

Fact: Vaccines undergo extensive testing before approval and continuous monitoring for safety once in use. Serious side effects are very rare.

Myth: The MMR vaccine causes autism.

Fact: There is no scientific evidence linking the MMR vaccine to autism. The controversy originated from a fraudulent study, and extensive research has shown no connection.

Myth: Breastfeeding protects babies from infections, so vaccines are unnecessary.

Fact: Breastfeeding provides some protection but is not a substitute for vaccines. Vaccines offer complete and long-lasting protection against specific diseases.

Myth: Natural is better; vaccines are unnatural.

Fact: The germs that vaccines protect against are natural but harmful. Vaccines are made from natural sources and are designed to safely stimulate the immune system without causing illness.

Conclusion

In conclusion, vaccinating newborns is a vital public health step that protects them from deadly diseases. This article has highlighted the importance of vaccination for newborns and children, initiatives by the Government of India, essential do’s and don’ts for healthcare workers and parents, as well as a collection of FAQs, myths and facts worldwide. Vaccines help the immune system learn to fight infections, providing lifelong protection. Following the recommended vaccination schedule is crucial for timely and effective immunity, reducing hospital visits, and preventing the spread of diseases. India’s immunisation programmes, supported by IAP and MFW, offer thorough protection for children. To improve vaccination rates and public health, we need to address barriers like lack of knowledge, logistical issues, and misconceptions about vaccine safety. Educational efforts, technology, and support systems are essential to overcoming these obstacles. By sticking to the vaccination schedule and addressing concerns, parents and healthcare providers can ensure children’s health and contribute to a healthier future for everyone.