Vaccinations/Immunization schedule for infants and children

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What is Immunization/Vaccination?

Immunization is the production of immunity by artificial means which may be passive with antisera or active vaccine whereas Vaccination is the use of antigens to stimulate the body to produce its own antibodies. When your baby receives Immunization, he/she will be able to fight the infection that the vaccine prevents whenever the infection enters the babys body. If your child gets vaccine for Measles, Mumps and Rubella (MMR), it means that any time after the vaccination that the baby happens to get infected by measles virus, the baby would have developed antibodies already that would fight the measles virus and hence the infection will not manifest.

How Immunization works: the antibodies that serve as soldiers in the body are very specific; this means that an antibody that fights measles cannot fight Hepatitis B virus infection and vaccine for Polio virus infection cannot fight infection for Tuberculosis; all because the antibodies produced by each vaccine are very specific for infection that are supposed to fight, this is the reason why every woman needs to ensure that the baby takes the complete vaccines according to the age of the baby. Therefore, knowing the immunization schedule is important in order to take your child for immunization. There are different vaccines required at different ages, hence it is not a one-time process and it starts from birth to when the baby is weeks old, months and years. There are some diseases that may affect the type of immunization a baby is required to have.

The type of immunization varies according to the country even though there is a schedule by Center for Disease Control (CDC) and UNICEF, not all immunizations listed by CDC are applicable to all countries. What may work in the United States of America may not be required in Nigeria and what may work in England may not be needed in India. I am using the immunization Schedule according to National Program on Immunization (NPI) in Nigeria.

Immunization Schedule Chart in Nigeria
Immunization Schedule Chart in Nigeria

 

NPI Immunization Schedule according to age of a child.

Each age, the type of vaccine need and the route of administration of the vaccine including the dosage will be explained. Vaccines having just a single dose can offer protection for a very long time or for life but those that are more than one only offers protection for a short period of time and needs a booster dose or doses to increase the time of protection. This is important because by just having your child immunized against Hepatitis B or Oral polio with the first dose does not mean you should not comply to the full doses because if you do, your baby can still get infected by these diseases. Immunization card is normally given to mothers to keep records of the immunization schedule of the baby; that can serve as evidence that a child has been fully immunized for age even if the mother forgets.

Immunization at Birth

  • Bacillus Calmette-Gurin (BCG)
  • Hepatitis B Virus Vaccine, 1st dose (HBV-1)
  • Oral Polio Vaccine, starter dose (OPV-0)

This means the baby needs to take 3 vaccines at birth and this is the reason why giving birth in the hospital is important because the child gets vaccinated before the mother is discharged from the hospital. A woman who delivers at home still needs to go to the hospital for her child to be vaccinated against the mentioned diseases.

Bacillus Calmette-Gurin (BCG)

The BCG Vaccine helps to prevent Tuberculosis; failure to immunize your baby makes the baby stands the risk of having tuberculosis infection. It is normally given at the left arm, and usually leaves a scar known as BCG scar that can still be seen even when the child becomes an adult. About 0.05 mls of the vaccine is given to the baby.

Hepatitis B Virus Vaccine, 1st dose (HBV-1)

This is the first dose of the 3 doses a child needs. It helps prevent the baby from having Hepatitis B Virus infection. It is usually given on the thigh and about 0.5 mls of the vaccine is given. The second dose is given at 6 weeks of age and the third at 14 weeks

Oral Polio Vaccine, starter dose (OPV-0)

There are 4 doses for the oral polio vaccine and the starter dose is given at birth, the second dose at 6 weeks, the third dose at 10 weeks of age of the baby and the last dose (4th dose at 14 weeks of age). 2 to 3 drops are given by mouth.

Immunization chart showing the routes of administration of Vaccines, the types of vaccines and dosages for Babies of less than 1 year
Immunization chart showing the routes of administration of Vaccines, the types of vaccines and dosages for Babies of less than 1 year

 

Immunization at 6 weeks of babys age

  • Diphtheria, Pertussis and Tetanus vaccines (DPT)
  • HBV-2
  • OPV-1

Diphtheria, Pertussis, and Tetanus Vaccine

Three vaccines are combined and given at the same time on the thigh, 0.5 ml given as injection.

Together, DPT, HBV and Hib are known as Pentavalent vaccines. Hib means Haemophilus influenza B vaccine. Pentavalent vaccine is given intramuscularly on the outer thigh.

Immunization at 10 weeks of babys age

  • Diphtheria, Pertussis and Tetanus vaccines (DPT)
  • HBV-2
  • OPV-1

Immunization at 14 weeks of babys age

  • Diphtheria, Pertussis and Tetanus vaccines (DPT-3)
  • HBV-3
  • OPV-3

Immunization at 9 months of babys age

  • Yellow fever
  • Measles
  • Vitamin A

Yellow Fever Vaccine

This is given at the upper right arm and about 0.5 mls injection given. It offers protection from Yellow fever virus.

Measles Vaccine

0.5 mls injection given at the right upper arm at 9 months of age against Measles virus infection

Vitamin A

Vitamin A is not a vaccine but it is given as a supplement to help boost the ability of the body to fight infections. During disease conditions such as Tuberculosis or Measles, the rate at which the body uses Vitamin A increases and if it is not treated, it can lead to Night blindness and even total blindness. 100,000 IU are given at 9 months of age by mouth (orally).

List of Vaccines needed by a Baby from birth to 9 months of age in Nigeria

  1. BCG
  2. Oral Polio Virus vaccine
  3. Hepatitis B vaccine
  4. Diphtheria vaccine
  5. Pertussis (Whooping cough) vaccine
  6. Tetanus vaccine
  7. Yellow fever vaccine
  8. Measles vaccine

Vitamin A is usually given to boost the immune system of the child as a form of nutritional supplement; hence it is included in the NPI Immunization Schedule.

Missed Opportunity of Immunization

Whenever a child comes in contact with a health facility and missed being immunized even when the child has reached the appropriate age for the said vaccine, then this is referred to as Missed Opportunity.

Table showing Routine Immunization Schedule for Children less than 1 year in Nigeria

VaccineNo of DosesAgeMinimum interval between dosesRoute of AdministrationDoseVaccination site
BCG1At birth or as soon as possible after birthIntradermal0.05mlUpper left arm
OPV4At birth and at 6,10,and 14 weeks of age4weeksOral2dropsMouth
DPT3At 6,10,and 14 weeks of age4weeksIntramuscular0.5mlOuter part of thigh
Hepatitis B3At birth,6 and 14 weeks of age4weeksIntramuscular0.5mlOuter part of thigh
Measles1at 9months of ageSubcutaneous0.5mlUpper right arm
Yellow fever1at 9months of ageSubcutaneous0.5mlUpper right arm
Vitamin A2at 9 months and 15 months of age6 monthsOral100,000 IU

200,000IU

Mouth

Intradermal-into the skin

Intramuscular-into muscle

Subcutaneous-under the skin

There are other recommended vaccines for children greater than 1 year and also for those with special conditions who are at risk of developing Meningitis or Cholera such as the Meningitis vaccine and Cholera and are given from 12 months above.

 

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