Dr Wong Poh Chen Petrina
Vaccines are a form of disease prevention. Infants build up their natural immunity against diseases from their mother and through breastfeeding. This immunity tends to fade by the age of 6 months. Vaccines help to stimulate your child's immune system by teaching it to recognise and respond to a disease. Exposure to vaccines will help your child's body develop antibodies to fight off germs when they are next exposed to them.
Our immune system is made up of different organs, cells and proteins. The 'innate' immune system is what we are born with, and the 'acquired' immune system is developed when our body produces antibodies in response to vaccinations or exposure to viruses, bacteria and other disease-causing pathogens.
These antibodies remain in us so that, the next time we are exposed to those pathogens, our body has the 'armour' to protect us against those specific diseases.
Vaccine–induced immunity (which is a form of acquired immunity) is achieved by introducing a 'killed' or 'weakened' form of the germ to our bodies in a 'safe' way by vaccinations.
Vaccines usually consist of a 'safe' form of the disease-causing germ, where the germ is weakened or killed. Some vaccines are in the form of a toxoid. 'Adjuvants' are used in some vaccines to help increase the immune response in the body.
Vaccinations are not only important for the health of an individual, they also help in community or national disease prevention.
The National Childhood Immunisation Programme (NCIP) in Singapore includes a variety of vaccinations that protect against several diseases. These diseases are:
Other diseases that can be prevented by vaccinations include:
Do consult your paediatrician to find out more.
Although it is recommended to get as much protection against diseases as possible, only vaccinations against diphtheria and measles are compulsory by law in Singapore.
For the other vaccinations that aren't compulsory, parental consent is required. Data from the Ministry of Health show that close to 100% of children in Singapore have been vaccinated in the last decade.
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These are some additional vaccines that parents should consider as they can provide useful protection for your children against common infectious diseases:
Rotavirus is a highly contagious disease which can cause severe diarrhoea (gastroenteritis) in babies and young children. It is sometimes accompanied by fever and vomiting. Children who get a rotavirus infection may experience dehydration require hospitalisation. The rotavirus vaccine is administered orally in 2 or 3 doses, depending on the type of vaccine that is used.
Chickenpox, caused by the varicella-zoster virus, is a common childhood disease that also affects adults. Infected individuals experience small fluid-filled blisters that are very itchy. The virus remains in the nerve cells and can reactivate years later as shingles, which can be very painful. Getting the varicella vaccine can help to prevent both chickenpox and shingles and since November 2020, it has been included in Singapore's National Childhood Immunisation Schedule.
The influenza or flu virus circulates the globe. In temperate climates it is seasonal but in tropical countries like Singapore, influenza occurs throughout the year. It can lead to serious illness or complications like pneumonia and ear infections, and could make existing conditions like asthma worse. While the vaccine will not completely protect against all strains of the influenza virus, those who are vaccinated often experience less severe illness. The influenza vaccine has been included in Singapore's National Childhood Immunisation Schedule since November 2020.
Some illnesses are more common in certain parts of the world hence it is often advisable to protect yourself prior to your trip. Some common recommended vaccines include influenza and tetanus, among others, while some parts of the world require specific vaccinations such as Japanese encephalitis and meningococcal disease. It is best for you to speak to your doctor and the relevant travel authorities to see which ones you should take.
As its name suggests, combination vaccines offer protection against two or more diseases. This helps to reduce the number of injections a child takes. Common combination vaccines available in Singapore include MMR (measles, mumps and rubella), MMRV (measles, mumps, rubella and varicella), DTP or DTaP (diphtheria, tetanus and pertussis). Others include the 5-in-1 (diphtheria, tetanus, pertussis, polio and haemophilus influenzae B) and 6-in-1 (diphtheria, tetanus, pertussis, polio, haemophilus influenzae B and hepatitis B).
Because of the high acceptance of vaccines in Singapore, the incidence rates of several diseases have drastically decreased over the years.
Vaccinations are administered to infants soon after birth and throughout childhood. Most vaccines require more than one dose for adequate coverage.
|Recommended age for vaccination||Vaccine|
|Birth||* Hepatitis B (1st dose)
* Bacillus Calmette-Guerin (BCG, for tuberculosis)
|2 months||* Hepatitis B (2nd dose)
* Diphtheria, tetanus, and pertussis (DTaP) (1st dose)
* Inactivated polio (IPV) (1st dose)
* Haemophilus influenzae type b (Hib) (1st dose)
|4 months||* Diphtheria, tetanus, and pertussis (DTaP) (2nd dose)
* Inactivated polio (IPV) (2nd dose)
* Haemophilus influenzae type b (Hib) (2nd dose)
* Pneumococcal conjugate (PCV10 or PCV13) (1st dose)
|6 months||* Hepatitis B (3rd dose)
* Diphtheria, tetanus, and pertussis (DTaP) (3rd dose)
* Inactivated polio (IPV) (3rd dose)
* Haemophilus influenzae type b (Hib) (3rd dose)
* Pneumococcal conjugate (PCV10 or PCV13) (2nd dose)
|6 months – < 5 years
(Annually or every season)
|12 months||* Pneumococcal conjugate (PCV10 or PCV13) (1st booster)
* Measles, mumps and rubella (MMR) (1st dose)
* Varicella (chickenpox) (1st dose)
|15 months||* Measles, mumps and rubella (MMR) (2nd dose)
* Varicella (chickenpox) (2nd dose)
|18 months||* Diphtheria, tetanus, and pertussis (DTaP) (1st booster)
* Inactivated polio (IPV) (1st booster)
* Haemophilus influenzae type b (Hib) (1st booster)
|2 – 17 years
(For children with specific medical condition or indication)
|* Pneumococcal polysaccharide (PPSV23)|
|5 – 17 years
(Annually or every season for children and adolescents with specific medical condition or indication)
|10 – 11 years||* Tetanus, reduced diphtheria and acellular pertussis (Tdap) (2nd booster)
* Inactivated polio (2nd booster)
|12 – 13 years
(For females only)
|* Human papillomavirus (HPV2 or HPV4) (1st and 2nd dose)|
Vaccines are safe, as they are rigorously tested before they are certified ready for use. The benefits of vaccines far outweigh their risks.
Like any medicine, your child may experience some vaccine-related side effects. Most of these are mild and temporary.
Rarely, serious adverse effects like allergic reactions may occur.
Do consult your doctor first if your child has a weak or suppressed immune system, or if there is a family or personal history of vaccine reactions.
If your child experiences mild vaccine reactions such as pain at the injection site, a rash, or a fever; here are some steps you can take at home:
Discuss more with your child's doctor regarding the specific side-effects for each vaccine. Call your doctor if you notice anything unusual with your child.