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Immunisation FAQs

What is immunisation?

Immunisation is a way of protecting against serious infectious diseases. Once we have been immunised, our bodies are better able to fight those diseases if we come into contact with them.

How do vaccines work?

Vaccines contain a small part of the bacterium or virus that causes a disease, or tiny amounts of the chemicals that the bacterium produces. Vaccines work by causing the body’s immune system to make antibodies (substances that fight off infection and disease). If your child comes into contact with the infection, the antibodies will recognise it and be ready to protect him or her. Because vaccines have been used so successfully in the UK, diseases such as diphtheria have almost disappeared from this country.

There are some diseases that can kill children or cause lasting damage to their health. Immunisations are given to prepare your child’s immune system to fight off those diseases if they come into contact with them.

When should my child be immunised?

It is important that your child has their immunisations at the right age – the first ones are given at two months old.

They will be given further doses of these immunisations when they are three months old and four months old.

They will be given further doses of these immunisations when they are three months old and four months old. Other immunisations are given to children between 12 and 13 months of age, then to children at three years and four months of age or soon after (before your child starts school). 

Why are children vaccinated so early?

Diseases can be particularly serious in young children. It is important to make sure children are protected as early as possible to prevent them catching the diseases. 

Why does my child need more than one dose of vaccine?

Most immunisations have to be given more than once to prepare your child’s immunity. For example, three doses of DTaP/IPV/Hib vaccine are needed to provide protection in children. Booster doses are then given later in life to provide longer-term protection.

Won’t giving my child MMR, three vaccines at the same time overload their immune system?

No. From birth, childrens' immune systems protect them from the germs that surround them. Without this protection, children would not be able to cope with the tens of thousands of bacteria and viruses that cover their skin, nose, throat and intestines. This protection carries on throughout life.

In theory, a child could respond effectively to around 10,000 vaccines at any one time. The child's immune system can and does easily cope with vaccines at the same time.

A few years ago, some people said that the MMR vaccine could cause autism and bowel disease. How do I know that MMR is truly safe?

There have been many stories in the media suggesting a link between the MMR vaccine and autism and bowel disease.

Independent experts from around the world looked very carefully at this possibility and there is no credible scientific evidence of a link between MMR and autism or bowel disease – and there is a lot of research that shows there is no link. The MMR vaccine has been used in over 100 countries and it has an excellent safety record. 

Wouldn’t it be better for my child to have MMR in separate vaccines?

No. The World Health Organization advises against giving separate vaccines. No country in the world recommends single vaccines when MMR is available. Giving the vaccines separately leaves children at risk of catching measles, mumps or rubella between the three injections. There is no evidence that single immunisations are safer than the MMR vaccine

How will I know when my child's immunisations are due?

Your childs first immunisations are due at eight weeks of age. An appointment can be made by contacting your surgery. All childhood immunisations are free.

What happens at the appointment?

The doctor or practice nurse will explain the immunisation process to you, and answer any questions you have. The vaccine is injected into the muscle of the child’s thigh, or the upper arm after 12 months of age. Rotavirus vaccine is given as drops by mouth.

What if I missed the appointment?

If you missed the appointment or delayed the immunisation, make a new appointment. You can pick up the immunisation schedule where it stopped without having to start again. Rotavirus vaccine can be given at three and four months or at two and four months, if necessary.

If some diseases have disappeared from this country, why do we need to immunise against them?

In the UK, these diseases are kept at bay by high immunisation rates. Around the world, millions of people a year die from infectious diseases with more than 5 million of these being children under the age of five. Many of these deaths could be prevented by immunisation. As more people travel abroad and more people come to visit this country, there is a risk that they will bring these diseases into the UK. The diseases may spread to people who haven’t been immunised so your child is at greater risk if he or she has not been immunised. Immunisation doesn’t just protect your child, it also helps to protect your family and the whole community, especially those children who, for medical reasons, can’t be immunised.

Remember, it’s never too late to have your child immunised. Even if your child has missed an immunisation and is older than the recommended ages, talk to your doctor, practice nurse or health visitor to arrange for your child to be immunised.

How do we know that vaccines are safe?

Before they are allowed to be used, all medicines (including vaccines) are thoroughly tested to assess how safe and effective they are. After they have been licensed, the safety of vaccines continues to be monitored. Any rare side effects that are discovered can then be assessed further.

All medicines can cause side effects, but vaccines are among the very safest. Research from around the world shows that immunisation is the safest way to protect your child’s health.

I am worried that my child will be upset by having an injection

Your child may cry and be upset for a few minutes, but they will usually settle down after a cuddle. 

Will my child have any side effects from the injection?

Some children will have side effects.

They may:

  •      have redness, swelling or tenderness where they had the injection (this will slowly disappear on its own)
  •      be a bit irritable and feel unwell, or
  •      have a temperature (fever) see below.

Children having the rotavirus vaccine may get mild diarrhoea. 

What is fever?

A fever is a temperature over 37.5°C. Fevers are quite common in young children, but are usually mild. If your child’s face feels hot to the touch and they look red or flushed, he or she may have a fever. You could check their temperature with a thermometer.

How to treat a fever

Keep your child cool by:

  • making sure they don’t have too many layers of clothes or blankets on, and give them plenty of cool drinks.

A dose of infant paracetamol or ibuprofen liquid may help reduce your child’s fever. Read the instructions on the bottle very carefully. You may need to give a second dose four to six hours later. It is not recommended that these medicines are given before or after vaccination in anticipation of a fever.  

Remember, never give medicines that contain aspirin to children under 16.

If you are worried about your child, trust your instincts. Speak to your Doctor or Practice Nurse.

Call the doctor immediately if, at any time, your child:

  •      has a temperature of 39°C or above, or
  •      has a fit.

If the surgery is closed and you can’t contact your doctor, trust your instincts and telephone your surgery as normal.  You will either get an answer phone service giving you the numbers of the out-of-hours service or your calls will be automatically diverted to the Manx Emergency Doctor Service.

I’m worried that my baby may have allergies. Can he or she have the vaccine?

Yes. Asthma, eczema, hay fever, food intolerances and allergies do not prevent your child having any vaccine in the childhood immunisation programme.

If you have any questions, speak to your doctor, practice nurse or health visitor. 

Are some babies allergic to vaccines?

Very rarely, children can have an allergic reaction soon after immunisation. This reaction may be a rash or itching affecting part or all of the body. The doctor or nurse giving the vaccine will know how to treat this. It does not mean that your child should stop having immunisations.

Even more rarely, children can have a severe reaction, within a few minutes of the immunisation, which causes breathing difficulties and can cause the child to collapse. This is called an anaphylactic reaction. A recent study has shown that there is only one anaphylactic reaction in about a million immunisations. The people who give immunisations are trained to deal with anaphylactic reactions and children recover completely with treatment.

An anaphylactic reaction is a severe and immediate allergic reaction that needs urgent medical attention. 

Do these childhood vaccines contain thiomersal?

None of the routine vaccines contain thiomersal or mercury.

Are there any reasons why my child should not be immunised?

There are very few reasons why children cannot be immunised.

The vaccines should not be given to children who have had:

  •      a confirmed anaphylactic reaction to a previous dose of the vaccine, or
  •      a confirmed anaphylactic reaction to neomycin, streptomycin, or polymyxin B (antibiotics that may be added to vaccines in very tiny amounts). 

In general, children who are ‘immunosuppressed’ should not receive live vaccines. Children who are immunosuppressed include those:

  •      whose immune system does not work properly because they are undergoing treatment for a serious condition such as a transplant or cancer, or
  •      who have any condition which affects the immune system, such as severe primary immunodeficiency. (Primary immune-deficiencies are very rare diseases that mean you are more likely to catch infections than is normal. They are usually caused by a faulty gene and are usually diagnosed soon after birth.)

If this applies to your child, you must tell your doctor, practice nurse or health visitor before the immunisation. They will need to get specialist advice on using live vaccines such as MMR and BCG

There are no other reasons why vaccines should definitely not be given.

What if my child is ill on the day of the appointment?

If your child has a minor illness without a fever, such as a cold, they should have their immunisations as normal. If your child is ill with a fever, put off the immunisation until they have recovered. This is to avoid the fever being associated with the vaccine, or the vaccine increasing the fever your child already has.

If your child:

  • has a bleeding disorder (for example haemophilia, in which the patient’s blood does not clot properly), or
  • has had a fit not associated with fever
  • speak to your doctor, practice nurse or health visitor before your child has any immunisation. 

What are fits?

Fits are also called seizures or convulsions. Some are associated with fever and some are not. Seizures associated with fever (which may be called a febrile seizure or febrile convulsion) are rare in the first six months of life and are most common in the second year of life. After this age, they become less frequent and are rare after the age of five years. Most children who have febrile seizures recover fully. When a child has a seizure within a short time after immunisation, it might not have been caused by the vaccine or the fever. It could be due to an underlying medical condition. If your child has a fit after an immunisation, contact your doctor. He or she may refer you to a specialist for advice about further investigations and future immunisations. If the surgery is closed or if you can’t contact your doctor, go straight to the emergency department of your nearest hospital.

My child was born early. When should premature babies have their first immunisation?

Premature children may be at greater risk of infection. They should be immunised in line with the recommended schedule from two months after birth, no matter how premature they were. 

Does my child have to be immunised?

In the UK, parents can decide whether or not to have their children immunised. Vaccination is recommended because it gives your baby protection against serious diseases, most of which can kill. Around the world, many children are now routinely protected with vaccines. Because of this, some of the world’s most serious diseases may soon disappear. 

How long do I have to wait before I can take my child swimming?

Contrary to popular belief, you can take your child swimming at any time before and after their immunisation.

Are there other ways to immunise my child?

There is no other proven, effective way to immunise your child. The Faculty of Homeopathy (the registered organisation for doctors qualified in homeopathy) follows the Department of Health guidelines and advises parents to have their children immunised with standard vaccines, unless there are medical reasons for not doing so. For more information, visit www.trusthomeopathy.org

Why is the immunisation programme changed from time to time?

Immunisation programmes are regularly reviewed to make sure that all children are offered the best protection against preventable diseases. As new vaccines become available, or research shows that giving existing vaccines at different times improves protection, the programme will be changed. Recent changes to the UK programme have been:

  • giving a booster dose of MenC vaccine in the early teenage years instead of at four months,
  • giving rotavirus vaccine at two and three months of age.

Watch out for meningitis and septicaemia

Both meningitis and septicaemia are very serious. It is important that you recognise the signs and symptoms and know what to do if you see them. Early symptoms of meningitis and septicaemia may be similar to a cold or flu (fever, vomiting, irritability and restlessness). However, people with meningitis or septicaemia can become seriously ill within hours, so it is important to know the signs and symptoms of these conditions. 

Watch out for meningitis and septicaemia

Both meningitis and septicaemia are very serious. It is important that you recognise the signs and symptoms and know what to do if you see them. Early symptoms of meningitis and septicaemia may be similar to a cold or flu (fever, vomiting, irritability and restlessness). However, people with meningitis or septicaemia can become seriously ill within hours, so it is important to know the signs and symptoms of these conditions. 

What is meningitis?

Meningitis is an infection of the lining of the brain. Meningitis can be caused by several types of bacteria or viruses.

Infection with meningococcal bacteria can cause meningitis, septicaemia (blood poisoning), pericarditis (inflammation of the lining of the sac that contains the heart) and arthritis (swelling of the joints).

What is septicaemia?

Septicaemia is a very serious condition when the bloodstream is infected. The signs are cold hands and feet, pale skin, vomiting and being very sleepy or finding it difficult to wake up, and these signs can come on quickly. If you suspect you or someone else has septicaemia, get help urgently.

In children, the main symptoms of meningitis may include:

  •      a high-pitched, moaning cry
  •      being irritable when picked up
  •      a bulging fontanelle (see the glossary on page 25)
  •      feeling drowsy and not responding to you, or being difficult to wake
  •      being floppy and having no energy or stiff with jerky movements
  •      refusing feeds and vomiting
  •      having skin that is pale, blotchy or turning blue, and
  •      a fever

The main symptoms of septicaemia may include:

  •      rapid or unusual patterns of breathing
  •      skin that is pale, blotchy or turning blue
  •      fever with cold hands and feet
  •      shivering
  •      vomiting and refusing feeds
  •      red or purple spots that do not fade under pressure (do
  •      the ‘glass test’ explained below)
  •      pain or irritability from muscle aches or severe limb or joint pain
  •      floppiness, and
  •      extreme tiredness

In older children, adolescents and adults, the main symptoms of meningitis may include:

  •      a stiff neck (check that they can kiss their knees or touch their forehead with their knees)
  •      a very bad headache (although this on its own is not a reason to get medical help)
  •      wanting to avoid bright lights
  •      vomiting
  •      a fever
  •      tiredness, being less responsive and confused, and
  •      a rash

The main symptoms of septicaemia may include:

  •      sleepiness, being less responsive, uninterested or confused (a late sign in septicaemia)
  •      severe pains and aches in the arms, legs and joints
  •      very cold hands and feet
  •      shivering
  •      rapid breathing
  •      red or purple spots that do not fade under pressure (do the ‘glass test’ explained below)
  •      vomiting
  •      a fever, and
  •      diarrhoea and stomach cramps.

It is important to remember that not everyone will develop all the symptoms listed. If an individual develops some of the symptoms listed, especially red or purple spots, get medical help urgently. If you can’t get in touch with your doctor, or you are still worried after getting advice, trust your instincts and take your child to the emergency department of your nearest hospital.

The ‘glass test’

  •      Press the side of a clear drinking glass firmly against the rash so you can see if the rash fades and loses colour under pressure. If it doesn’t change colour, contact your doctor immediately.

Where can I get more information?

The Meningitis Research Foundation and Meningitis Now both provide information on meningitis.

Phone the Meningitis Research Foundation’s free helpline on
+ 080 8800 3344 or visit the website at www.meningitis.org

Phone the Meningitis Now 24-hour helpline on + 0800 8010 388 or visit the website at www.meningitisnow.org

You can also ask your doctor, practice nurse or health visitor for advice.

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