Childhood immunization

Immunizing your child from an early age helps protect them against the most serious childhood infections, some of which can be life-threatening. Routine childhood vaccines are usually given through national immunization programs, often free of charge, and a doctor or local health clinic can arrange them.

Some groups in the community are at higher risk than others and may need extra vaccinations. Talk to your doctor or immunization provider about whether this applies to your child.

How immunization protects babies#

In the first months of life, a baby may have some protection from infectious diseases that their mother has had or been immunized against. This is known as passive immunity, and it happens when antibodies pass from mother to baby during pregnancy.

This early protection is often low and wears off quickly, which leaves the baby at risk of diseases that can be prevented by vaccination. Immunization helps build the child’s own, longer-lasting protection.

What childhood immunization protects against#

National immunization schedules vary from place to place, but many programs protect children against a similar set of diseases, including:

• chickenpox (varicella)
• diphtheria
• Haemophilus influenzae type b (Hib)
• hepatitis B
• influenza (flu)
• measles
• meningococcal disease
• mumps
• pneumococcal disease
• polio
• rotavirus
• rubella (German measles)
• tetanus
• whooping cough (pertussis)

Most childhood vaccines are given as an injection into the arm or leg. The rotavirus vaccine is an exception and is given by mouth. A single dose may protect against one disease or several at once. Combination vaccines protect against several diseases in one injection, which reduces the number of injections a child needs.

The immunization schedule#

An immunization schedule sets out which vaccines are recommended and the age at which each one should be given, starting in the first weeks of life and continuing through early childhood. Schedules differ between countries, so follow the one used where you live and check it with your doctor or immunization provider. New vaccines continue to be developed, and schedules are updated over time.

To fully protect your child, it is best to immunize at the recommended ages. If you fall behind or miss a vaccine, the schedule can usually be safely continued as if there had been no delay. There is no need to repeat doses already received before having catch-up doses. Ask your doctor or immunization provider about catching up.

Additional vaccines are sometimes recommended for children with certain medical conditions that increase their risk of complications from vaccine-preventable diseases, such as chronic illnesses. Talk with your doctor to see whether your child should have any extra vaccines.

Before the appointment#

Bring your child’s personal health record booklet to each appointment so the doctor, nurse or health worker can record the visit. These records are a useful reminder of when the next immunizations are due and which children in the family are up to date.

Before immunization, tell the doctor or nurse if your child:

• is unwell, especially with a temperature over 38.5°C (101.3°F)
• has had a severe reaction following any vaccine
• has any severe allergies to medications or other substances
• has had any vaccine in the past month
• has had an injection of immunoglobulin, or received blood products or a whole blood transfusion, within the past year
• was born prematurely (for example before 32 weeks) or at a low birth weight
• has a chronic illness
• has a bleeding disorder
• does not have a working spleen
• has a condition that lowers immunity (such as leukemia, cancer, HIV or AIDS), or is having treatment that lowers immunity (such as oral steroids, radiotherapy or chemotherapy)
• lives with someone who has lowered immunity or is having treatment that lowers immunity
• was born to a parent who received highly immunosuppressive therapy, such as biological disease-modifying anti-rheumatic drugs (bDMARDs), during pregnancy

Side effects after immunization#

Vaccines are effective and safe, although, like all medicines, they can have unwanted side effects. In almost all cases, side effects are far milder than the illness the vaccine prevents. Common reactions are usually mild and temporary, often appearing one to two days after vaccination, and may include a mild fever and pain at the injection site.

Some vaccines have their own typical reactions. For example, certain vaccines such as MMR can cause, around 7 to 10 days after the dose, a mild fever (which can be over 39°C (102.2°F)), a faint red non-infectious rash, drowsiness, a runny nose, cough, puffy eyes or swollen salivary glands. Ask your doctor or healthcare professional about the side effects expected from each vaccine.

Meningococcal B vaccine and fever#

The meningococcal B vaccine commonly causes a fever in children under 2 years of age. For this age group, paracetamol (acetaminophen) should be given in the 30 minutes before vaccination, or as soon as practicable afterwards, followed by two more doses given 6 hours apart, whether or not the child has a fever. Check the label for the correct dose, or ask your pharmacist.

Managing common reactions#

Specific treatment is not usually needed. Helpful steps include:

• Managing fever by offering extra fluids and not overdressing the child.
• For injection-site soreness, redness, itching, swelling or burning, which may last one to two days, applying a cool compress.
• Routine use of paracetamol after vaccination is not generally recommended, but if pain or fever is present, or the baby is crying and unsettled, paracetamol can be given. Check the label for the correct dose for a child’s age and weight, or ask your pharmacist.

When to seek help#

If a side effect is unexpected, persistent or severe, or if you are worried about your child after a vaccination, see your doctor or immunization nurse as soon as possible, or go directly to a hospital. It is also important to seek medical advice if your child becomes unwell, as this may be due to another illness rather than the vaccine.

There is a very small risk of a serious allergic reaction (anaphylaxis) to any vaccine. This is why you are advised to stay at the clinic for at least 15 minutes after immunization, in case further treatment is needed. Serious reactions can be reported to a vaccine safety service; ask your immunization provider how to do this where you live.

Immunization through life#

The immunizations you may need depend on your health, age, lifestyle and occupation, sometimes summed up as HALO. Talk to your doctor or immunization provider if you think you or someone in your care has health, age, lifestyle or occupation factors that could mean extra immunization is recommended.

Key points#

• Some groups are more at risk than others and may need extra vaccinations.
• Early protection from a mother’s antibodies fades quickly, leaving babies at risk of diseases that vaccination can prevent.
• The meningococcal B vaccine commonly causes a fever in children under 2 years.
• Common side effects after immunization are usually mild and temporary, appearing one to two days after vaccination.
• Specific treatment is not usually required.

Where to get help and trusted information#

For evidence-based global health guidance, see Source: World Health Organization (WHO).