Vaccinations are a rite of passage for every Singaporean child, but what if your kid is sick before an appointment, or misses a booster dose? Find out the answers to these and other pressing questions.
Are vaccines safe? Why did my child develop a fever after a shot?
Vaccines work by stimulating a child’s immunity to produce antibodies against certain infectious diseases, so she can ﬁght them if she comes into contact with them, explains Dr Flordeliza Yong, deputy director of School Health Service at the Health Promotion Board.
In Singapore, vaccines are assessed to be safe for use by the Health Sciences Authority.
Minor side effects, such as a low-grade fever and soreness at the injection site, are possible reactions to some shots. But serious allergic reactions, such breathing difﬁculty, wheezing, hives, a fast heartbeat or dizziness, are “extremely rare”, according to the World Health Organization (WHO).
In fact, your child is more likely to be seriously injured by a vaccine-preventable disease such as polio, which can cause paralysis, than by a vaccine, the WHO says.
After your child’s injection, remain in the clinic’s waiting area for 15 minutes so that she can be observed for any abnormal post-vaccination reactions, says Dr Predeebha Kannan, deputy director of Primary Care Academy at National Healthcare Group Polyclinics.
Most clinics provide fever medication – to be used when necessary – and post-vaccine advice to parents. See a doctor immediately if your child’s fever persists after 24 hours or if she experiences continuous crying, ﬁts or other serious reactions.
I’ve made an appointment for my baby’s vaccinations, but he’s running a fever and has a runny nose. Should I still go ahead?
If your child is sick with a fever, then delay the immunisation. But go ahead if he has a simple cold or other minor illness, says Dr Ratna Sridjaja, paediatrician at SBCC Baby & Child Clinic at Gleneagles.
Another instance where he should avoid going is when he has had a previous allergic reaction to that particular immunisation. For instance, kids who are severely allergic to eggs should skip the ﬂu vaccine because the ingredients are grown inside eggs.
If your child’s immune system is suppressed due to reasons such as cancer treatment, avoid live vaccines like polio and MMR (Measles, Mumps and Rubella), Dr Ratna adds.
What happens if he misses a vaccination shot or booster jab?
It is recommended to stick closely to the National Childhood Immunisation Schedule (visit www.tinyurl.com/VaccineSG for details). Every month that your little one goes without her scheduled immunisation puts her at risk of vaccine-preventable diseases, Dr Yong says.
But if you’ve missed certain doses, you will get a reminder letter from the National Immunisation Registry. It maintains the immunisation records for all Singapore residents aged 18 years and below. Take your child to the clinic for advice on how to get up-to-date on those shots so she continues to be protected, the experts say.
“Children who miss their ﬁrst doses at three months of age can start later. Those who have gotten some of their doses and fallen behind schedule can catch up without having to start over,” Dr Yong says.
If your child is unwell, her shots may be given at a later date as immunisation is only given when she is found to be ﬁt, says Dr Predeebha.
I’m concerned about the MMR jab, which has been linked to autism. Should I delay this until she is older?
There is no evidence to support the link between the measles- mumps-rubella (MMR) vaccine and autism, Dr Predeebha says.
The initial 1998 study by Dr Andrew Wakeﬁeld raised concerns about the possible link and set off widespread panic among parents, but was later found to be seriously ﬂawed.
An investigation published by British medical journal BMJ concluded that the study’s author misrepresented or altered the medical histories of all 12 of the patients studied.
Isn’t it better to build my child’s immunity naturally, by letting her go through a chicken pox infection, for example?
A natural chicken pox infection could lead to serious complications, such as pneumonia, brain damage or even death.
Vaccines interact with the immune system to produce an immune response similar to that produced by the natural infection. They work in 85 to 99 per cent of cases, and greatly reduce your child’s risk of serious illness and the risk of a disease outbreak, Dr Yong says.
“Vaccination is the best and safest way for children to develop immunity to protect them against diseases like chicken pox and its complications,” she adds.
Besides the chicken pox vaccine, are there other optional shots that I should consider for my child?
Your kid may be well covered by the vaccinations under the National Childhood Immunisation Schedule, but they may not cover other nasty infections that he may pick up beyond our shores.
For example, developing countries around the region still have cases of typhoid fever, and Hepatitis A and E infections, says Dr Christelle Tan, a specialist in paediatrics at Rafﬂes Specialists at Rafﬂes Holland V, which runs a travel medicine service.
Outbreaks of chickenpox and measles have also been reported on cruise ships, where it is easy for infections to spread, Dr Tan adds.
Before your trip, check that your kid’s vaccinations are up-to-date. You should also ﬁnd out the required or recommended shots for your travel destination, Dr Tan advises.
Check out the United States’ Centres for Disease Control (CDC) and Prevention destination list (www.cdc. gov/travel) which provides information on each country’s recommended vaccines, as well as travel health notices and what to do if you fall ill.
Plan your vaccination schedule at least a month in advance by consulting a doctor who is experienced in travel medicine, Dr Tan says.
Did you know that you can tap into your Medisave, Baby Bonus, or your kid’s CDA to pay for childhood vaccinations?
You may use your Medisave to cover all vaccinations recommended in the NCIS, up to $400 per account per year, at Medisave-accredited health-care institutions, including private clinics.
According to the Health Ministry, you may also use the Baby Bonus cash gift and/or savings in the Child Development Account (CDA) to pay for all vaccinations, including against pneumococcal disease, at Baby Bonus- approved medical institutions. These can be used to offset the bills for your other kids’ shots, as well.
If your child is a Singapore citizen, these vaccines are free at the polyclinics:
• BCG (tuberculosis)
• Hib and IPV in the form of a 5-in-1 combination vaccine (together with vaccination against diphtheria, tetanus, and pertussis (whooping cough)
• Hepatitis B
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