Under lockdown, restricted movement and the genuine fear of visiting a hospital. Parents of newborns and young toddlers are worried about delayed immunisation and possible consequences. Already, reporting on immunisation is low and the drive has faced severe drawbacks due to the lockdown.
We reached out to Dr Rahul Nagpal, pediatrician with Fortis Hospitals to get your frequently asked questions answered.
Can we take the kids to clinics/hospitals for immunisation?
Where ever possible, avoid taking children to hospitals. Some vaccines need to be given within a time period and others are booster shots. There is a delay in immunisation due to lockdown. We try and talk to parents online and call them only for immediate vaccinations.
What precautions should parents take when visiting hospitals?
Only visit with appointment after consultation on phone to ensure there is no rush or crowds in the waiting area. Make sure only one attendant comes to the clinic. Anyone coming to the clinic should wear a mask, including children 2 years and above. Some clinics don’t allow footwear inside the clinic. Now, more and more vaccination cards are online, updating electronically is safest nowadays - to avoid using pens etc. We wear masks, gloves and take all precautions while we physically examine the child and vaccinate them. Earlier we used to have nurses and attendants in the room. Now we allow only one attendant (parent) and the doctor. ‘Minimal exposure, minimal touch, minimal intervention’ is our focus.
For how long can we delay certain vaccinations?
Vaccines that are given in the first 9 months are referred to as primary vaccines and these can’t be delayed beyond a time frame. Booster shots can still be delayed to beyond lockdown. BCG, polio, hepatitis are given at birth. In the first year 3 doses of DPT, polio are given. We start the first dose 6 months after birth - this can be delayed maximum upto 8 weeks. We have to keep a gap of one month between doses. This gap can be again increased maximum upto 2 weeks. Measles vaccine is given between 9 to 12 months. Flu vaccine is given six months after birth and should not be delayed beyond seven months. Rotavirus vaccine has to be given before seven months. Post seven months it doesn’t help.
After the baby turns one, we can be more flexible, but before that, we have to be very careful not to miss vaccines.
Can we given multiple shots together?
Basic vaccines are given at birth. Due to the lockdown, we are trying to offer combination vaccines to children coming to us, and we decide based on what is safe to be given in one setting.
What guidelines are being followed for delayed vaccination?
If vaccination gets delayed, we follow catch up immunisation schedule based on a chart prepared by the WHO. Doctors are following that schedule. Based on this, as we move forward we have to reduce the gap between shots, so if the requirement is a 6 week gap, we give them the shot in 4 weeks.
Experts world over have warned that delayed vaccine can lead to real fears of other diseases. The World Health Organisation released the following statement:
“Immunisation is an essential health service which may be affected by the current COVID-19 pandemic. Disruption of immunisation services, even for brief periods, will result in increased numbers of susceptible individuals and raise the likelihood of outbreak-prone vaccine preventable diseases (VPDs) such as measles.”
UNICEF pointed out to the vulnerabilities in the south Asia:
"Almost a quarter of the world’s unimmunised or partially immunised children—about 4.5 million children—live in South Asia. Almost all of them, or 97 per cent, live in India, Pakistan and Afghanistan. With lockdowns in place as a part of the novel coronavirus (COVID-19) response, routine immunisations have been severely disrupted."
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