Sunday, May 31, 2009

STI: Vaccinate kids before travel and preschool

May 28, 2009

Raising healthy kids

Vaccinate kids before travel and preschool

Consequences of not immunising kids are severe and may even lead to death. HUANG HUIFEN reports


Passport? Check. Swimming costumes and goggles? Check. Two weeks' worth of diapers? Check. Influenza, hepatitis A and typhoid vaccinations? Huh?


While parents often have a checklist of what they need to pack for their children for the family vacation, vaccinations for their kids against common diseases such as influenza, hepatitis A and typhoid may slip their minds.


Paediatricians here say it is important to get kids vaccinated to prevent infections which may be caught from consuming contaminated food and water, or being in countries with high attack rates of a certain disease.


In countries where there is a lack of clean sterilised water and hygienic food, typhoid and hepatitis A vaccinations are recommended, said Dr Thoon Koh Cheng, an associate consultant of the Infectious Disease Service at the department of paediatric medicine at KK Women's and Children's Hospital. Places with a high incidence of typhoid fever include Indonesia, India, Pakistan and central Africa.


Dr Ang Ai Tin, a paediatrician from the Paediatric Centre at Thomson Medical Centre, recommends the influenza vaccine when travelling to a country during winter. This is because the influenza virus spreads more easily in cold and low-humidity climates.


'With the lack of sunlight, the low melatonin secretion and low vitamin D levels may lower one's immunity and increase one's risk of catching the flu virus. During winter, people also tend to stay indoors and the close proximity to other people increases the risk of the spread of the virus,' she said.


Vacations aside, many Singaporeans are now posted overseas for work together with their families. So, what vaccinations should parents get for their kids before the move?


'In addition to ensuring that all the nationally required vaccinations are given, other vaccines that should also be considered include hepatitis A, typhoid, Japanese encephalitis, rabies, yellow fever and the meningococcal vaccine,' said Dr Thoon.


He cautioned that young patients may react to the vaccines which include pain, swelling, redness and a sore arm. They may also develop a fever and feel lethargic or general weakness (malaise). He advised parents to plan vaccinations well ahead of departure dates.


'The last dose in a vaccine series should be given seven to 14 days prior to travel, both to watch for side effects and for maximal protection to set in,' he said.


Parents should also take note of what children should be immunised against before they start playschool at the age of three.


Dr Ang recommends that on top of the vaccinations listed in the National Immunisation Schedule, kids should be given the haemophilus influenza type B vaccine, rotarix against the rotavirus - the most common cause of intestinal viral infections resulting in diarrhoea and/or vomitting especially in kids aged five and below - prevenar against pneumococcal disease, chickenpox vaccine and other influenza vaccinations. Influenza jabs are especially important for children with asthma.


The consequences of not giving these vaccinations are severe and may even lead to death, warned Dr Thoon.


He added that when travelling abroad, everyone in the family can protect himself by using insect repellants, avoiding close contact with animals and watching what he eats. Avoid using tap water overseas even for activities like brushing teeth.


Lastly, always seek medical advice before travelling.




At birth: BCG against tuberculosis; first dose against hepatitis B


1 month: Second dose against hepatitis B


3 months: First dose against diphtheria, pertussis and tetanus (DPT/DT); first dose against poliomyelitis (Oral Sabin)


4 months: Second dose of DPT/DT; second dose of Oral Sabin


5 months: Third dose of DPT/DT; third dose of Oral Sabin


5-6 months: Third dose against hepatitis B


1-2 years: Primary dose against measles, mumps and rubella (MMR)


18 months: First DPT/DT booster; first Oral Sabin booster


6-7 years (Primary 1): Second Oral Sabin booster; MMR booster dose


10-11 years (Primary 5): Second booster of DT-containing vaccine; third Oral Sabin booster


Source: Health Promotion Board


The last dose in a vaccine series should be given 7 to 14 days prior to travel

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