Vaccinations - How Do They Help Prevent Diseases?

Hi,

I am Dr. Suresh Keshan, Pediatrician. Today I will be talking on vaccinations as a modality of prevention for childhood diseases. I will address the common concerns the parents have regarding the vaccinations. One of the things parents ask, are the vaccines really effective? Are they really prevent diseases? The answer to this the evidence-based medicines which show medicines have reduced the disease burden in the society a lot. 10 years ago, we use to see a lot of cases of polio mellitus. And people who are working on this with paralysis. Now, with the medications, polio has been eradicated. And hardly, we are seeing any child who is affected due to polio. Similarly, if you see the cases which are pertaining to infectious diseases like measles etc, also decreased a lot. That is the reason, vaccines are must for prevention. The problem is there are a lot of charts are available for vaccines. Each and every hospital has got its own chart. Parents are a little bit confused about the exact list of vaccination. This list is definitely available on the website. But that doesn't mean that one vaccination is mentioned on one chart but not on another one, so you will not go for that vaccine. So, it has to be discussed with your doctor. Some of the parents have a complaint, in spite of the vaccination, their child has got the disease. For eg, the child is vaccinated for typhoid and later on, the child got the same. So, the vaccines are not 100% efficacy. So, the preventive rate of efficacy differs.

This education should be given by doctor to the parent. Because once the organism is there in the body, but the disease has not yet come is known as the incubation period of the disease. So, in that case, also parent may label the vaccine failure while actually, it is not a failure as organisms were already there in the body. Another thing that there is no cut off age for vaccines. Sometimes parents ask that my child has to get the vaccine within 1 year but now he is 2 years. so, should it be given or not. So, yes, the vaccine has to be given. All the vaccines have no cut off age. You can give the vaccine in adulthood also. And the age which is prescribed in the chart for eg 6 weeks then it is an indicative age. So, you can't give medicines before 6 weeks. Another thing I would like to highlight is pain or painless vaccines. Only one vaccine is there which has got pain or painless and i.e. DPT. So, what is the difference between the 2? The difference is not giving the vaccine. The vaccine is pricked and injection has to be given to the child. Injection needle will definitely give pain and discomfort to the child.

The side-effect can be fever, there maybe pain at the local side, redness, irritability. So, all these side-effects are not present in the painless variety. They are most likely going to happen in the pain variety or the one vaccine which is with the side-effect. There is a cost difference but we will talk about efficacy wise. So, all 3 doses cannot be painless. Now other thing parents feel about the brand of the vaccine. So, vaccines are interchangeable. So, if you get a vaccine for A brand and another doctor is giving B brand, it is perfectly OK. One thing parents need to ensure that the vaccines are made to prevent diseases. So, companies are not going to make vaccines of the illnesses which are mild or which are infrequent in nature. Vaccines are made to prevent a particular virus or bacteria. It will not prevent the disease or symptoms. For eg, diarrhea, now there is rotavirus to prevent. Similarly, you can say about polio. If I have given the vaccine for polio then my child will not get paralysis. But paralysis can happen because of so many causes. So, this concept has to be clear in the parent's mind.

Then parents will think that some vaccines are there which are compulsory or optional. I do not know where this concept has come. Vaccines are the prevention of disease. It is like an assurance. So, if you do not take the vaccine, your child is at risk. So, all the vaccines which are recommended are to be given. The problem is the cost part. For eg, one vaccine cost 4000/-. Because of economic thought, it becomes optional in a parent's mind. So, irrespective of the price, vaccines have to be given. Affordability is a separate thing. There are certain vaccines which have to be given in teenage and adulthood. These are flu vaccine which has to be administered yearly. If one is prone to any infection then the flu vaccine has to be given. Hepatitis-B, typhoid, chickenpox, cervical cancer vaccines have to be given. I hope I have answered day today query which we also face in our clinic when we vaccinate the child.

Now we will talk about some myths or misconceptions which are there in the parent's mind. Just want to educate the parents about fact and reality. One thing parents have them in mind that teething causes a lot of problems like diarrhea, fever. So, most of the parents think that teething is related to some or the other problem. Teething is a natural process. It may cause some irritation of the gums. Therefore, the child may feel irritation and start biting hard things in the mouth. But it is a benign given by nature. It does not lead to any fever or infection. Because the child starts biting a lot of things and that is the reason infection goes inside the child's mouth and may result in diarrhea. Another myth is drinking cool things like juices, cold water, these kinds of things actually cause infection, therefore, these should be avoided. Infections are caused by viruses or bacteria. Some parents think ki curd thandi hai and bacha bimar ho sakta hai, so there is nothing of that sort. Whatever things the child loves, can be given to the child. For diarrhea, most of the parents think that milk is the culprit.

Therefore, they tend to avoid milk. Obviously, there is no rationale for holding milk from a child who is suffering from diarrhea. There is no evidence behind this thing. If diarrhea lasts for 5-7 days then maybe lactose intolerance may occur. So, after certain tests, milk can be avoided. Parents also complain about the liver. A healthy liver means a healthy body. But if parents are thinking that all the problems are happening because of the liver then it is not like that. In the vast majority of cases, the liver is perfectly healthy. So, there is no concern related to loss of weight, poor eating. Liver infections are not that common. In case it occurs, they will cause, nausea, vomiting, yellow colored urine. And parents also think that some liver tonic has to be given. It doesn't make any sense to give liver tonic. Another concern parents think that the child's immunity is low because my child is having a frequent cold and cough.

What should be done to boost immunity? The immunity of any child is healthy. There is nothing wrong with child immunity. There are very rare chances when immunodeficiency is there in the child or the child is severely malnourished. That particular time, the immune system may be compromised. So, decreased immunity is not the correct way of thinking. Infection does occur in the child because they get to expose to so many things. And they get multiple infections but this is very much normal for a child. Another thing which we see that kids are more prone to bronchitis which means they are having recurrent cough without any fever. There may be wheezing in the chest also. This has to be blamed on our lifestyle partially and the environmental changes which occur. The children are prone to allergies. So, in result, the child can have recurrent cough and cold.

The last point I will talk about is allergies. With the change in the lifestyle, the incidences have gone up. Therefore, the child has got a skin allergy. There is hardly any food substance which is causing allergy. Because of this, a lot of other tests are coming into the market today. Quite a few of them are commercial. Ultimately the results which are coming out, they have positive and negative results. So, there may be the substances which are not causing allergies or may turn out to be positive in the test. Or the substance which is actually causing the problem may turn out negative into that. Allergy testing by and large do not need the expectation of the parents which is there. It is better to have a clinical association between the allergen and the symptom. So, if you eliminate the allergen, then the symptom should go away. Thank you all for listening to this video. I really hope this will be helpful to all of you.

Thanks!