VACCINES RECOMMENDED FOR ALL CHILDREN GLOBALLY

• BCG (Bacille-Calmette-Guerin) vaccine,whichofferspartialprotectionagainstsomeformsoftuberculosisandleprosy

• DTP vaccine (alsoknownasDPTvaccine).Diphteriacausesinfectionoftheupperrespiratorytract, which in severe cases may lead to breathing difficulties and death. Pertussis, orwhoopingcough,affectstherespiratorytractandcancauseacoughthatlastsfourtoeightweeks.Thediseaseisverydangerousininfants.Tetanuscausesrigidmusclesandpainfulmusclespasmsandcanbedeadly.Allpregnantwomenandinfantsneedtobeimmunizedagainst tetanus. Immunizing awomanwith at least twodoses of tetanus toxoid beforeorduringpregnancyprotectsthenewbornforthefirstfewweeksoflifeandprotectsthemother.At6weeksold,ababyneedsthefirstdoseofthetetanustoxoid(thetetanuscomponentoftheDTPvaccine)toextendtheprotectionreceivedfromthemotheragainsttetanus.

• Measles vaccine isneededasmeaslescanbeamajorcauseofmalnutrition,poormentaldevelopment,andhearingandvisualimpairments.Thesignsthatachildhasmeaslesareafeverandrash,togetherwithacough,arunnynoseorredeyes.Achildcandiefrommeasles.

In countrieswhere vitaminA deficiency is common, high dose vitaminA capsules aregiventochildrenaged6monthsto5years,everyfourtosixmonths.VitaminAisalsoanimportantpartofmeaslestreatment.

• Polio vaccine protectsagainstpoliowhichcausesdisability.Thesignsofpolioareafloppylimbortheinabilitytomove.

Facts for Lifeaimstoprovidefamiliesandcommunitieswiththeinformationtheyneedtosaveandimprovethelivesofchildren.Parents,grandparents,other caregivers and young people can refer to this practical source ofinformation for answers to their questions related to childbearing andgettingchildrenofftothebeststartinlife.ThemessagescontainedinFactsforLifearebasedonthelatestscientificfindingsbymedical andchilddevelopmentexpertsaround theworld.Themessagescontainedarealsobasedonhumanrights,particularlytheConventionontheRightsoftheChildandontheEliminationofAllFormsofDiscriminationagainstWomen.Thisinformationempowerspeopletofulfilltherightsoftheirchildren.Theyarealsoaimedatenablingwomen,youngpeopleandchildrentoexerciseandspeakoutinfavoroftheirrights.Thedifferentdigestsyou’llgetthroughouttheyeararefilledwithpractical informationabout how to ensure children’s rights to survival, growth,development and well-being. The topics address pregnancy,childbirth, major childhood illnesses, child development, earlylearning,parenting,protection,andcareandsupportofchildren.

FactsforLifeFourthEditionisproducedbyUNICEF,WHO,UNESCO,UNFPA,UNDP,UNAIDS,WFPandtheWorldBank,FactsforLifecanbefoundatwww.factsforlifeglobal.org.

Thewebsitewillbeupdatedregularlyandincludesalinktoaninteractivesiteforpostingcomments,sharingexperiencesandmaterialsanddiscussingrelevantissues.

VACCINES WHICH MAY BE INCLUDED IN NATIONAL IMMUNIZATION PROGRAMMES

• Hepatitis B vaccine -IncountrieswherehepatitisBisaproblem,upto10outofevery100childrenwillharbortheinfectionforlifeiftheyarenotimmunizedagainstHepatitisB.UptoonequarterofchildreninfectedwithheapatitisBmatydevelopseriousliverconditionssuchascancerwhentheyareolder.

• Haemophilus influenzae type B (Hib) and pneumococoal conjugate (PCV) vaccines–Inmanycountries,pneumoniacausedbypneumococcusbacteriaorHaemophilusinfluenzaetypeB(Hib)bacteriaiscommonandkillsmanyyoungchildren.Eitherofthesebacteriacanalsocausechildhoodmeningitisandotherseriousinfections.Thesebacteriaareamongthemostdangerousforchildren.Particularlythoseunder5yearsold.VaccinationwithHaemophilusinfluenzaetypeBvaccine(Hibvaccine)andpneumococcal(conjugate)vaccine(PCV)canpreventthesedeaths.

• A pentavalent vaccine (five vaccines in one), combining the DTP , hepatits B and Hibvaccines,isincreasinglybeingusedbynationalimmunizationprogramsinmanycountries.

• Yellow fever vaccine–Insomecountries,yellowfeverputsthelviesofmanyyoungchildrenandadultsatrisk.Vaccinationcanpreventthisdisease.

• Rotavirus vaccine–Diarrheacausedbyrotavirusiscommonandcanbesevere.Itaffectsnearlyeverychildunderage5.Severe rotavirusdiarrhea ismorecommon indevelopingcountrieswherehealthcarecanbemoredifficult toaccess, resulting inmanydeaths inchildren under 5 years old, especially in children under 2. Vaccination against rotaviruspreventsdiarrheacausedbythisvirus.However,diarrheaduetootherbacteriaorvirusescanstilloccurinchildrenwhoreceivetherotavirusvaccine.

©UNICEFPhilippines/2011/Palasi

COVERPHOTO©UNICEFPhilippines/2011/Palasi

Eachyear,millionsofchildrendiefromdiseasesthatarepreventablewithreadilyavailablevaccines.Thesediseasesincludemeasles,meningitiscausedbyHaemophilus influenzatypeB(Hib),diphtheria,tetanus,pertussis(whoopingcough),yellowfever,polioandHepatitisB.Newvaccinesagainstotherillnesses,suchaspneumoniaanddiarrheacausedbyrotativirus,havebeendevelopedandarenowmorewidelyused.

Immunizationprotectschildren from thesedeadlydiseases.All children have the right to this protection.

Earlyprotectionthroughimmunizationiscritical.Theimmunizationsinthechild’sfirstandsecondyearsareespeciallyimportant.Itisalsoessentialthatpregnantwomenareimmunizedagainsttetanustoprotectthemselvesaswellastheirnewborns.

Itissafetoimmunizeachildwhohasaminorillnessoradisabilityorissufferingfrommalnutrition.

In the Philippines, all public health centers offer free immunization all year longfor therecommendedvaccinesshown inTable1. Inaddition, theDepartmentofHealthconductsanoutreachimmunizationprogramtwiceayear,inordertoboostimmunization coverage amongst children. UNICEF supports the Department ofHealthintheprocurementofvaccinesusedinitsimmunizationprogram.

THE 7 FACTS ON IMMUNIZATION

1 Immunization is urgent. Every child should complete the recommended series of immunizations. Early protection is critical; the immunizations in the first two years are particularly important.

Children must be immunized earlyin life. It is essential for infants to get allrecommended vaccines at the right time.Some vaccines require multiple doses forfull protection. It is important for everychild tocomplete the fullnumberof theseimmunizations.Toprotect the child duringand beyond the first year of life, theimmunizations in the following chart arenecessary.Thesearemosteffectivewhengivenat theagesspecified,orasclose tothoseagesaspossible. Ifachilddoesnotcompletethefullseriesofimmunizationsinthe first two years of life, it is extremelyimportanttohavethechildfullyimmunizedassoonaspossible.

As new vaccines become available, morevaccinesare recommendedforallcountries.Butsomevaccinesareonlyneeded incountrieswherecertaindiseasesarepresent.

Parentsandhealthpractitionersshouldfollowthelocallyrecommendedimmunizationschedule.InsomecountrieslikethePhilippines,additionalvaccinedoses,called‘boostershots’,areofferedafterthefirstyearoflife.Thesehelpsustaintheeffectivenessofthevaccinessothechildisprotectedlonger.

Immunization protects against dangerous diseases. A child who is not immunized is more likely to become sick, permanently disabled or undernourished, and could possibly die.

Immunization protects children against some of the most dangerous diseases ofchildhood.Achildisimmunizedbyvaccines,whichareinjectedorgivenbymouth.Thevaccinesworkbybuildingup thechild’sdefensesagainstdiseases. Immunizationonlyworks ifgivenbeforethediseasestrikes.

Achildwhoisnotimmunizedisverylikelytogetmeasles,whoopingcoughandmanyotherdiseasesthatcankill.Childrenwhosurvivethesediseasesareweakenedandmaynotgrowwell.Theymaybepermanentlydisabled.Theymaydielaterfrommalnutritionandotherillnesses.

It is safe to immunize a child who has a minor illness or a disability or is malnourished.

Manyparentsdonottakeachildtobeimmunizedbecausethechildhasafever,cough,cold,diarrhea,orsomeotherillness.However,itissafetoimmunizeachildwhohas

aminorillness.Afteraninjection,thechildmaycryordevelopafever,aminorrashorasmallsore.This isnormalandshowsthatthevaccine isworking.Childrenunder6monthsofageshouldbreastfeedfrequently;olderchildrenshouldbegivenplentyofliquidsandfoods.Ifthechilddevelopsahighfever(over38degreesCelsius)thechildshouldbetakentoatrainedhealthpractitioner.

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Measlescanbeextremelydangerousformalnourishedchildren,sotheyshouldbeimmunizedagainstmeasles,especiallyifthemalnutritionissevere.

All pregnant women and their newborns need to be protected against tetanus.

Inmanypartsoftheworld, includingsomeareasinthePhilippines,mothersstillgivebirthinunhygienicconditions.Thisputsboththemotherandthechildatriskofgetting

tetanus,amajorkillerofnewborninfants.Ifapregnantwomanisnotimmunizedagainsttetanus,andtetanusbacteriasporesenterherbody,herlifewillalsobeatrisk.

It issafe forapregnantwomantobe immunizedagainst tetanus.Sheshouldbe immunizedaccordingtothisschedule:

Afterfiveproperlyspaceddoses,themotherisprotectedforlifeandherchildrenareprotectedforthefirstfewweeksoflifeagainsttetanus.

A new syringe must be used for every person being immunized.

Sharingsyringesandneedles,evenamongfamilymembers,canspreadlife-threateningdiseases.Anewsyringemustbeused foreveryperson.Syringesmustbediscardedproperlyandsafelyafteruse.

Disease can spread quickly when people are crowded together.

Allchildrenlivingincongestedconditions,particularlyinrefugeeordisastersituations,shouldbeimmunizedimmediately,especiallyagainstmeasles.Emergenciesthatmakepeople flee their homes often lead to the spread of

communicablediseases.Asafirstpriority,alldisplacedchildrenunder15yearsofageshouldbeimmediatelyimmunized,especiallyformeasles,atthefirstpointofcontactorsettlement.Measlesisevenmoreseriouswhenchildrenaremalnourishedorlivinginconditionsofpoorsanitation.Ifachild’svaccinationrecordislostandtheparentsdonotrememberwhichvaccinesthechildhasreceived,itissafetorepeatdoses.

The vaccination card of a child (or an adult) should be presented to the health practitioner before every immunization.

It is important to follow the vaccination schedule inaccordance with national guidelines. Children should beimmunizedattherecommendedagesandshouldreceivesubsequentdosesatrecommendedintervals.

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Did you know?Breastmilkandcolostrum,thethickyellowmilkproducedduringthefirstfewdaysafterawomangivesbirth,provideprotectionagainstdiarrhea,pneumoniaandotherdiseases.Colostrumissometimesreferredtoasanewborn’s‘firstvaccine,’helpingtobuildthechild’simmunitytodisease.

AntigenAGE

Atbirth 6W 10W 14W 9M 12M

BCG X

HepB X

DPT-HepB-Hib X X X

OPV X X X

Rota* X X

Measles X

MMR X

TABLE 1: Immunization Schedule for Infants in the Philippines

Source: Department of Health (April 2013)

Firstdose Assoonassheknowssheispregnant.

Seconddose Onemonthafterthefirstdose,andnolaterthantwoweeksbeforeherduedate.

Thirddose Sixmonthstooneyearaftertheseconddose,orduringthenextpregnancy.

Fourthdose Oneyearafterthethirddose,orduringasubsequentpregnancy.

Fifthdose Oneyearafterthefourthdose,orduringasubsequentpregnancy.

What we need to know about IMMUNIZATION©UNICEFPhilippines/2011/Palasi