Routine Child Vaccination in Corona Pandemic

Is this the right time for me to take my child for routine vaccination, given the COVID-19 pandemic?¹

 

In the current COVID-19 pandemic, you must make sure that you do not step out of your homes for non-essential activities – but do keep in mind that vaccination is important.

The Advisory Committee on Vaccines and Immunization Practices (ACVIP) recommends that all routine vaccinations be administered as scheduled, even during the COVID-19 pandemic as it is an essential health activity. The benefits of immunizations far outweigh the associated risks.

So, yes, it is still the right time for you to get your baby vaccinated for vaccine-preventable diseases.¹

It should be emphasized that “Immunization is a Core Health Service” that should be prioritized for the prevention of communicable diseases and safeguarded for continuity during the COVID-19 pandemic, where feasible.¹

Due to reasons mentioned above, immunizations should be continued during COVID-19 pandemic as immunization is an essential health activity.

Moreover, there is no documented risk of immunizing a well child during the COVID-19 pandemic.²

 

For my new-born baby, which vaccinations should I prioritize?1

  • Get newborns vaccinated in maternity set up before discharge: BCG, OPV and hepatitis B vaccines are to be administered.
  • Prioritize primary vaccination series: DTP, hepatitis B, Hib, OPV/IPV, Rotavirus vaccines and PCV.
  • Multiple vaccines can be administered in the same session without fear of any increased adverse effects.
  • Check your child’s paediatricians’ file and stay in touch with the doctor for any pending immunization.
  • If a child is in a healthcare facility for any reason, this opportunity should be utilized for administering any eligible vaccine.

 

 My child is 14 weeks old. Due to the COVID-19 pandemic,

I couldn’t give DTP vaccine second dose to my child. When should I give the missed dose?³

If either the start or the completion of the primary series has been delayed, the missing doses should be given at the earliest opportunity with an interval of at least 4 weeks between doses.

 

Due to the COVID-19 pandemic, my child’s DTP dose was missed? What should I do?3

For children whose vaccination series has been interrupted, the series should be resumed without repeating previous doses. Children aged 1 to <7 years who have not previously been vaccinated should receive 3 doses of vaccine following a 0, 1, 6-month schedule.

 

What are the next steps if any of my child’s routine vaccinations are delayed?2

This is a common situation in the COVID-19 pandemic. Owing to  restrictions on movement or public hesitancy, there will be times when your baby may miss a vaccination appointment. However, there is no reason to worry! There is a window period in which the vaccines could be given, and once given, it would have similar efficacy in future.

Following principles need to be followed:

  • The birth dose of hepatitis B vaccine should be administered within 24 hours of birth and OPV, and BCG vaccines should be given as early as possible after birth. If for any reason this is not done, these vaccines should be administered at the first contact with the healthcare facility.
  • The primary vaccination series and the vaccines for outbreak prone diseases should be prioritized, for example: DTP, hepatitis B, Hib, OPV/IPV, rotavirus, PCV, influenza, varicella, and MR/MMR. Postponing these vaccines is to be avoided.
  • The pneumococcal and influenza vaccine should also be given to the vulnerable groups.
  • The age specific recommendations of giving vaccines e.g., for pneumococcal, meningococcal and rotavirus vaccine should be followed.
  • Multiple vaccines can be administered in the same session without fear of any increased adverse effects.
  • Typhoid conjugate vaccines may be clubbed with the influenza vaccine at 6 months or MR/MMR at 9 months.
  • Inactivated JE vaccines (where applicable) can be administered at whenever possible if missed (because of the logistic issues of transport etc.), hepatitis A vaccines and HPV vaccines may be administered after the priority vaccines have been given.
  • When missed (because of the logistic issues of transport etc.), the booster dose(s) may be given at the next earliest available opportunity.
  • If a child is in a healthcare facility for any reason, and eligible for immunization, this opportunity should be utilized for administering eligible vaccines.
  • Check your child’s paediatricians’ file and stay in touch with the doctor for any pending immunization.

 

A family member is COVID-19 positive. When should I take my child for vaccination?1

Children from homes where COVID-19 confirmed or suspected are present, should be immunized only after the quarantine period is over.

 

My child has tested positive for COVID-19 a week ago and is due for routine vaccination after 2 weeks. How do I go about it?4

Routine immunization can be continued 2 weeks after child is asymptomatic (of COVID-19 infection). If the child needs some higher medications such as high-dose steroids or tocilizumab which suppresses the components of immunity of patient, immunization needs to be deferred for 3 months after the medication.

 

Does vaccination increase a child’s risk of becoming infected with SARS-CoV-2 or of developing COVID-19?2

In general, vaccination against one disease does not weaken the immune response to another disease. As of now, there is no evidence that vaccination would increase the risk of a child becoming infected with COVID-19 or affect the course of the disease in a child who has been inadvertently vaccinated during the asymptomatic phase or incubation period.

 

What precautions should I follow when visiting the vaccination clinic with my child?2

  • Any caretaker having cough, cold, or fever should be barred from entering the healthcare facility.
  • Senior citizens (more than 60 years of age) should be requested not to accompany the vaccinee.
  • Only 1-2 caretakers should be permitted with each child.
  • All caretakers and children, except infants, should wear a mask.
  • It is essential to always maintain social distancing.
  • Digital payment is to be encouraged.
  • Well-baby visits may be combined with immunizations.
  • Utilize every healthcare visit for immunization, provided there are no precautions/contraindications and the interval between vaccines are maintained as per published guidelines.

 

Are there any risks associated with immunizations during a pandemic?1

There is no documented risk of immunizing a well child during the COVID-19 pandemic. COVID-19 is an evolving disease and hence we need to monitor strictly for any increased adverse events following immunization.

 

Is it alright for my child to receive its annual flu vaccination during COVID-19 times?5

Vaccination is the most effective way to prevent infection and severe outcomes caused by influenza viruses. Vaccination is especially important for people at higher risk of serious influenza complications, and for people who live with or care for high-risk individuals.

 

During the COVID-19 pandemic, WHO recommends seasonal influenza vaccination for:

 

  1. Highest priority:
  • Health workers
  • Older adults

b.Priority (in no particular order):

  • Pregnant women
  • Individuals with specific chronic medical conditions
  • Children aged 6-59 months

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