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Childhood immunisations

DTP-Hib vaccine

This is given when your child is two, three and four months old. (The DT part is also given at age three to five years as a booster.) 

The DTP-Hib vaccine protects against three different diseases: diphtheria, tetanus and pertussis (whooping cough) and against infection by the bacteria called Haemophilus influenzae type b (Hib).

Your child will receive a further tetanus and diphtheria booster at age 13 to 18 years.

What is diphtheria?

This disease begins with a sore throat and can progress rapidly to cause problems with breathing. It can damage the heart and the nervous system and in severe cases it can kill. Diphtheria has almost been wiped out in the UK, but it still exists in other parts of the world and it is on the increase in parts of Eastern Europe.

What is tetanus?

Tetanus germs are found in soil. They enter the body through a cut or burn. Tetanus is a painful disease that affects the muscles and can cause breathing problems. If it is not treated, it can kill.

And what about whooping cough (pertussis)?

Whooping cough can be very distressing. In young children it can last for several weeks. Children become exhausted by long bouts of coughing which often cause vomiting and choking. In severe cases pertussis can kill.

I hadn’t heard of Hib before, what is it? 

 Hib is an infection that can cause a number of serious illnesses including blood poisoning, pneumonia and meningitis. All of these diseases can be dangerous if not treated quickly. The Hib vaccine protects your child against this one specific type of meningitis. The Hib vaccine does not protect against any other type of meningitis.

How effective is the Hib vaccine?

Before the Hib vaccine became part of the childhood immunisation programme in 1992, over 60 children a year died as a result of Hib infection. And more than twice that number were left with permanent brain damage. Since immunisation began, the number of children with Hib meningitis has dropped by more than 95%.

What are the side-effects of the DTP-Hib vaccine?

It is quite normal for your baby to be miserable within 48 hours of the injection. Some babies develop a fever in the way described earlier. Sometimes a small lump develops where the injection was given. This lump can last for several weeks. 

If your child has a worse reaction to the DTP-Hib vaccine – for example, some form of fit – your doctor may not give your child any more doses of the vaccine. If this happens, talk to the doctor, nurse or health visitor.

If a baby has a fit in the first 48 hours after being given the DTP-Hib vaccine at two, three and four months, it is no more common than at any other time for young babies. But if you delay the immunisation, it increases the chances of fits after DTP -Hib. So, it’s important to make sure your child gets vaccinated on time.

Is it true that the whooping cough vaccine can cause brain damage?

In the 1970s a study was done which seemed to show a link between the whooping cough vaccine and a few babies who suffered brain damage. More recent and reliable studies have not confirmed this theory. But the actual whooping cough disease can cause brain damage.

Polio vaccine

This is given when your child is two, three and four months. The first booster is given when your child is between three and five years. The second booster is given when your child is between 13 and 18. Polio vaccine protects against the disease poliomyelitis.

What is polio?
Polio is a virus that attacks the nervous system and can cause permanent muscle paralysis. If it affects the chest muscles it can kill. The virus is passed in the faeces (poo) of infected people or those who have just been immunised against polio. Routine immunisation has meant that the natural virus no longer causes cases of polio in the UK. But polio is still around in other parts of the world, especially in India. 

How is it given?
Unlike other immunisations, you take the polio vaccine by swallowing it. The doctor or nurse drops the liquid into your child’s mouth.

Are there any side-effects?
There is an extremely small chance of developing polio from the immunisation – the risk is of one case in more than 1.5 million doses used.

The nurse at the clinic told me to be careful about changing my child’s nappy after the immunisation. Why is this?
The polio vaccine is passed into your child’s nappies for up to six weeks after the vaccine is given. If someone who has not been immunised against polio changes your child’s nappy, it is possible for them to be affected by the virus. There is about one case each year. This works out at about one case for every 1.5 million doses used. You must wash your hands thoroughly to prevent this happening.

If you think you have not had the polio immunisation, contact your doctor. You can arrange to have it at the same time as your child. This also goes for anyone else in the family who looks after your child.

What about children who are allergic to eggs?

The MMR vaccine is prepared in egg but it can be given to children who are allergic to eggs. If your child has had a serious reaction to eating eggs, or food containing egg, then talk to your doctor. The usual signs of a serious allergic reaction are a rash that covers the face and body, a swollen mouth and throat, breathing difficulties and shock. In these cases your doctor can make special arrangements for the immunisation to be given safely.

MMR vaccine 

This is given when your child is between 12 and 15 months and then again when your child is three to five years. The MMR vaccine protects your child against measles, mumps and rubella (German measles).

What is measles?

The measles virus is very infectious. It causes a high fever and a rash. About one in 15 children who gets measles is at risk of complications which may include chest infections, fits and brain damage. In severe cases measles can kill.

What is mumps?

The mumps virus causes swollen glands in the face. Before immunisation was introduced, mumps as the commonest cause of viral meningitis in children under 15. It can also cause deafness, and swelling of the testicles in boys and ovaries in girls.

What is rubella?

Rubella, German measles, is usually very mild and isn’t likely to cause your child any problems. However, if a pregnant woman catches it in her early pregnancy, it can harm the unborn baby.

Do children really need protection against these illnesses? I’ve heard they’re usually mild. Yes, they can be mild. In some children the illness may pass almost unnoticed, but others can be very ill. The most dangerous thing about these illnesses is that they can cause complications. 

Before the vaccine was introduced, about 90 children a year in the UK died from measles. Because of immunisation, children no longer die of measles.

Why are two doses of MMR given?

Your child will receive two doses because measles, mumps and rubella vaccines don’t always work well enough on the first go. The second MMR immunisation makes sure that your child gets the best protection against these three diseases. This also gives a second chance for those children who missed out the first time around. So, you can be sure your child is well protected before he or she starts school. Giving a second dose of MMR is a recent improvement to children’s immunisation in the UK. Two doses are already used in this way in many countries including the USA and Canada.

Are there any side-effects of the MMR vaccine?

About a week to ten days after the MMR immunisation some children become feverish, develop a measles-like rash and go off their food for two or three days. Very rarely, a child will get a mild form of mumps about three weeks after the injection. Your child will not be infectious at this time, so he or she can mix with other people as normal.

Occasionally, children do have a bad reaction to the MMR vaccine. About one child in 1000 will have a fit. A child who actually has measles is ten times more likely to have a fit as a result of the illness.

Although encephalitis (inflammation of the brain) has been reported very rarely after immunisation, the risk of children developing encephalitis after the measles immunisation is no higher than the risk of children developing encephalitis without the vaccine. But the risk of a child developing encephalitis after having measles is about one in 5000. And a third of these children will be left with permanent brain damage. 

A study of British children shows that ten years after the measles immunisation, children had no more illnesses than children who had not been immunised – and actually had fewer because they were protected against measles and did not suffer its complications. 

Your child may get a rash of small bruise-like spots after the MMR, but this is very rare. This rash is linked with the rubella part of the immunisation. If you see spots like this, show them to your doctor.

Side-effects from the second MMR vaccine are even rarer than after the first. Those that do happen are most likely in children who did not respond to the first vaccine. These are the children who need the immunisation most. There are no new side-effects of a second MMR vaccine.

If you want more information about MMR, your GP or health visitor should have a leaflet, MMR – the facts, and can answer any additional questions you may have.

What about reports of links between autism and MMR? Is this really a risk?

No. Autism was well-known long before MMR was ever used in this country. Although autism is recognised more often now than in the past, the increases were going on long before MMR was introduced. Parents often first notice signs of autism in children after their first birthday, and MMR is usually given when children are 12 to 15 months old, so it’s possible to see how people might think that there is a link with MMR. But, there is no evidence, other than coincidence, to link MMR with autism.

What about reports of links between measles, MMR and Crohn’s disease?

It has been suggested that measles viruses, either from the natural disease or the vaccine, might stay in the bowel and cause a bowel disorder called Crohn’s disease. Careful independent studies in this country and abroad, using the most sensitive tests, have not found measles viruses in the bowel of people with Crohn’s disease. Also, Crohn’s disease is no more common in immunised people than in people who have not been immunised.

The conclusion of experts from all over the world, including the World Health Organization, is that the evidence is firmly against any link between measles and MMR vaccines and Crohn’s disease.

We are indebted to Health Promotion England for their help in compiling this section.