Vaccines by Diseases

Influenza – flu

1. What is Influenza?

Influenza is a viral respiratory infection, which occurs globally and spreads from person to person. In India, influenza spreads throughout the year with peaks in the monsoon season and winter. The risk of flu complications is high in extremes of age (young and old), those with weak immune system and long-standing disorders of the heart, lungs, liver, kidneys and diabetes. Flu can result in complications such as pneumonia, bronchitis, sinus infections and ear infections. Vaccination is the most effective way to prevent infection and severe outcomes.

2. Who should get the flu shot?

All individuals should get yearly shot before the onset of monsoon or at any time of the year. Elderly, Pregnant and travellers are at high risk and should not forget to take their yearly shot.

3. What is the schedule of the Influenza vaccines?

One dose annually of 0.5ml by intramuscular injection on deltoid or anterolateral aspect of thigh.

4. Is it a safe vaccine?

Generally, it is a safe vaccine. Soreness, redness, and swelling at the site of the injection may be seen after the vaccination.

For more information, please contact your doctor.

Pneumococcal

1. What are the diseases caused by the Pneumococcus?

The pneumococcal vaccine protects from potentially serious, and even life-threatening infections caused by pneumococcus bacteria, which include (a) pneumococcal meningitis (an infection of the tissue covering the brain and spinal cord) and (b) pneumonia (lung infection). While pneumonia is a serious condition, meningitis can cause lifelong disability, or death. Pneumococcus is also a common cause of ear infections.

The disease spreads when an infected person coughs or sneezes. India has a very high burden of pneumococcal diseases.

2. What are the symptoms of pneumococcal disease?

The symptoms depend on the part of the body it affects.

Pneumococcal pneumonia (lung infection): Fever with chills, cough, rapid breathing or difficulty breathing, chest pain
Pneumococcal meningitis (infection of the covering of the brain and spinal cord): High fever, headache, fits, stiff neck, vomiting, are some of the symptoms of this dangerous condition.
Pneumococcal meningitis (infection of the covering of the brain and spinal cord): High fever, headache, fits, stiff neck, vomiting, are some of the symptoms of this dangerous condition.

3. Which are different types of Pneumococcal vaccines available for use in adults?

All individuals should get yearly shot before the onset of monsoon or at any time of the year. Elderly, Pregnant and travellers are at high risk and should not forget to take their yearly shot.

PCV13 1 dose followed > 8 weeks later by 1dose of PPSV23 and another dose of PPSV23, 5 years after the last dose for adults > 18 years with immunocompromised conditions; for those with CSF leak or cochlear implant and other high risk indications.

Healthy adults > 50 years, should receive the PPSV23 vaccine at least one year after receipt of PCV13.

In case PPSV23 is given earlier, PCV13 should be given after > 1 year.

4. Is it a safe vaccine?

Yes. The pneumococcal vaccines are safe. When side effects do occur, they are usually mild and transient and include redness, swelling, or soreness where the shot was given.

5. Who should receive this vaccine?

All senior citizens 50 years and above, under 50 years but with co morbidities like Diabetes, Asthma, chronic respiratory diseases, on dialysis, Chronic liver disease, immunosuppressed, malignancy on immunosuppressed drugs should receive the vaccine.

For more information, please contact your doctor.

Cervical Cancer

1. What are the diseases caused by the Human Papilloma Virus (HPV)?

Almost all cervical cancers are caused by the Human Papilloma Virus (HPV). HPV viruses are also responsible for vaginal, vulvar, anal, oral, throat and penile cancers. India alone accounts for one-quarter of the worldwide burden of cervical cancers. HPV infections are so common that nearly all sexually active men and women will get at least one type of HPV at some time in their lives. Most HPV infections go away by themselves within two years. Around 5% of them progress to a state of persistent infection, which can cause cancer. Cervical cancer is often detected late due to lack of any significant symptoms in the early stages of the disease. Of the more than 100 HPV types known, 13 types may cause cervical cancer or are associated with other cancers of the anus, penis, vulva, vagina and throat. Out of them, type 16 and 18 are the most common ones.

In countries where the HPV vaccines are used in the national immunization programs, a significant reduction of diseases caused by HPV has been recorded within a few years of use.

2. Which are the vaccines available against the HPV and what is the schedule?

This vaccine is expected to broaden the protection against cervical cancer by ~15%.

In India, the Quadrivalent HPV vaccine (HPV 4) is expected to prevent ~ 83% of cervical cancers, whereas the Nonavalent vaccine (HPV 9) is expected to prevent ~ 98% of cervical cancers.

Schedule:

Gardacil – HPV4

Girls 9 to 14 years: Two doses to be administered at an interval of 6 months, 0–6 months.
Girls 15 years and older: Three doses recommended in the schedule 0–1–6 months

Gardacil – HPV9 is licensed in a 3-dose schedule of 0-2-6 months in females 9-26 years of age and males 9-15 years of age.

Cervavac – HPV4 can be given
9 to 14 years boys and girls: 2 dose 0–6 months.
15 to 26 years boys and girls: 3 dose 0-2-6 months.

The ideal age for starting the vaccine is 9-10 years.

HPV vaccines can be given at the same time as the Tdap vaccine.

3. Why is it essential to start the schedule at 9-10 years and not later?

There is no recommendation for any booster doses.

4. Are the HPV vaccines safe?

These vaccines are generally safe. Mild to moderate local side effects are pain, swelling or redness at the vaccine site.

5. Who should receive this vaccine?

All girls (>9 years, adolescents) and women up to 45 years should receive this vaccine.

Vaccination of males will offer some protection against other HPV related cancers penis, anus and oropharynx (mouth and throat). In India, Gardacil 9 and Cervavac is licensed in males up to 26 years of age.

For more information, please contact your doctor.

Herpes Zoster

1. What is Herpes Zoster (HZ)?

Herpes Zoster (HZ) or Shingles usually presents as painful skin rash with vesicles occurring in groups. This rash usually appears on one side of the face or body, generally does not cross the midline and lasts for 2 to 4 wks. Its main symptom is pain, which can be quite severe. Other symptoms can include fever, headache and burning sensation of rashes.

The most common complication of shingles is prolonged and recurrent pain, occurring at the site of rash, even after the rash clears up. This is called postherpetic neuralgia (PHN) and can last for months or years. The pain from PHN can be severe and debilitating.

Zoster is caused by the Varicella Zoster Virus (VZV), the same virus that causes chickenpox. Only someone who had chickenpox can develop zoster. The virus remains dormant in the body and many years later, when immunity is low due to old age or disease, can present as zoster.

Zoster is far more common in people 50 years of age and older. It is also more common in people whose immunity has declined.

2. Which are the vaccines available against HZ and who should receive the vaccine?

Recombinant vaccine (RZV) – Shingrix. This vaccine is recommended in individuals 50 years of age and older in a 2-dose schedule at 0 and 2-6 months.

The RZV vaccine can be administered to individuals who have had Herpes Zoster in the past and who have received the Live Zoster Vaccine in the past.
There is no maximum age for getting the RZV.

3. How safe are these vaccines?

Redness, soreness, swelling or itching at the site of the injection and fever can happen after shingles vaccine.

4. Who should receive this vaccine

All adults 50 years and above, irrespective of previous HZ infection or receipt of LZV.

For more information, please contact your doctor.

TdaP

1. Why should I receive the Tdap vaccine?

As a child we must have received D-T-P containing vaccines at 6, 10, 14 weeks and boosters at 16-18 months and at 4-6 years. However, the protection conferred by this vaccine starts reducing after the last dose at 4-6 years. Cases of Pertussis (whooping cough) and diphtheria are increasing among adolescents and young adults. Hence, there is a need for a booster dose of the D-T-P vaccine at 10-12 years.

Since full dose DPT cannot be given after the age of 7 years (because of risk of more side effects), we can only give a vaccine that contains reduced dose pertussis and diphtheria components along with full dose tetanus, i.e., Tdap vaccine.

2. What is the schedule?

Tdap should be used only for children 7 years and older, adolescents, and adults.

One dose of Tdap should be given at the age of 10 to 12 years. People who did not get Tdap at that age should get it as soon as possible.

Tdap is especially important for anyone having close contact with a baby younger than 12 months of age as a part of cocooning strategy.

Pregnant women should get a dose of Tdap during every pregnancy between 27 and 36 weeks of pregnancy to protect mother and the newborn from pertussis. Infants are most at risk for severe, life-threatening complications from pertussis.

A similar vaccine, called Td, protects from tetanus and diphtheria, but not pertussis. A Td booster should be given every 10 years.

3. How safe is this vaccine?

The vaccine is safe. Pain, redness, or swelling at the site of administration, mild fever, headache, may be experienced after receiving this vaccine.

For more information, please contact your doctor

MMR

1. Why should I receive the MMR vaccine?

Measles presents as generalised rash, cough, and high-grade fever. It may predispose to pneumonia, ear infection or tuberculosis.

Mumps causes salivary gland enlargement and fever. Its complications include swelling of the brain and spinal cord and its covering, deafness or painful swelling of the testes.

Rubella presents as fever, sore throat, joint pains and rash. If Rubella occurs in a pregnant woman, for the first time, she may have a miscarriage or the child born may have serious congenital abnormalities.

MMR vaccine protects against above three illnesses.

2. What is the schedule?

MMR Vaccine is a combination vaccine which protects against Measles, Mumps and Rubella diseases.

MMR vaccine is given as two doses 4 to 8 weeks apart in adults.

3. How safe is MMR vaccine?

MMR vaccine is a safe vaccine. Soreness at the site of injection, generalised rash, fever and swelling of the glands in the neck may happen. Serious side effects are very rare.

4. Who should not receive the vaccine?

Individuals with a history of serious allergic reactions to a previous dose of the vaccine or known severe allergic reactions to any component of the vaccine.
Adults with a weakened immune system or if any family member has a history of immunodeficiency.
Pregnant women.
Adults who have received blood transfusion or blood products recently.

For more information, please contact your doctor.

Typhoid

1. What is Typhoid?

Typhoid is a potentially serious illness which spreads through contaminated food and water. India accounts for 30%-40% of all Typhoid cases in the world. The germ causing Typhoid is becoming increasingly resistant to the commonly used antibiotics, making Typhoid treatment complicated and expensive.

Typhoid generally presents with fever, stomach pain, loose stools, and cough. If undetected and untreated in the first week, Typhoid may need hospitalization for effective treatment.

There is an effective vaccine for prevention of Typhoid disease.

2. Which are the vaccines available against Typhoid?

Two types of vaccines against Typhoid are:

The TCV is the preferred vaccine because of better efficacy and only one dose is sufficient, whereas polysaccharide vaccine has suboptimal efficacy and requires boosters every 3 years.

3. What is the schedule of TCV?

A single dose of 0.5ml is administered intramuscular. The vaccine is licensed for use, till 45 years of age.
As of now, boosters are not recommended.

4. How safe is the TCV?

Side effects of the vaccine include fever, pain and swelling at the site of the injection. Generally, it is a safe vaccine.

5. Who should receive this vaccine?

All adults who are likely to get the disease should be protected. Adults who had Typhoid in the past, should also receive this vaccine as post disease immunity is subopitmal. Especially food handlers and travellers need to prioritize.

For more information, please contact your doctor.

Hepatitis A

1. What are the diseases caused by Hepatitis A?

Hepatitis A virus causes infection of the liver, which may cause jaundice. An individual can get this infection through water or contaminated food or by close contact with a person infected with Hepatitis A.

Symptoms include weakness, loss of appetite, fever, nausea, vomiting, pain in abdomen, dark yellow colour urine and jaundice (yellowish discoloration of eyes, and skin). Rarely, hepatitis A infection can lead to liver failure and death.

Adults have more severe disease. Till few years back, more than 90% of children acquired Hepatitis A infection by 10 years of age. With improvements in hygiene and sanitation, children become more susceptible to infections at a later age, when the infection causes more severe disease, with some complications.

Apart from maintaining good hygiene and sanitation, vaccination of susceptible children and adults is the most effective way to prevent this disease.

2. What are the vaccines available against Hepatitis A and the schedules?

Two types of vaccines are available:

Minimum age of administration of this vaccine is 12 months.

The inactivated vaccine is administered intramuscularly in a two-dose schedule with the second dose administered at least 6 months after the first dose.

The live, weakened vaccine, is administered subcutaneously as a single dose after the age of 12 months.

3. Is it a safe vaccine?

Adverse reactions are minor and may include local pain and swelling and low grade fever.

4. Who should receive this vaccine?

All children > 12 months of age should receive this vaccine.

If not taken, all susceptible adults should receive at any age. It is also recommended for chronic liver disease patients and travellers and people in food industry.

5. Who should not receive this vaccine?

The live, attenuated vaccine should not be given to immunocompromised individuals.

For more information, please contact your doctor

Hepatitis B

1. What is Hepatitis B Infection and disease?

Hepatitis B virus causes carrier state without any symptoms, acute jaundice (infection of liver), chronic progressive liver damage and cancer of the liver. In India, 1.6% to 4% of the population carry this virus in their blood.

This virus has many ways of spreading from one to another:

1. From the infected mother to the newborn - This is the most common mode of spread and without appropriate preventive measures, a good number of infected infants go on to develop liver disease and liver cancers. This is called “Vertical transmission” and is eminently preventable with timely vaccination, beginning in the newborn period
2. From infected family members or close contacts - by sharing of articles like toothbrushes and razors
3. By sexual spread from an infected partner.

By using Hepatitis B vaccine appropriately, Hepatitis B infection can be prevented very effectively

2. What is the schedule of the Hepatitis B vaccine?

For children and adults, the vaccine is administered in a schedule of 0-1 month –6 months.
There is no need for booster doses of this vaccine as the initial 3 doses confer almost life-long protection.

In health care workers, a blood test is required to check immunity and an extra dose may be required.

3. Is it a safe vaccine?

Yes, except for some reactions at the site of vaccination and low-grade fever, the vaccine is safe.

4. Who should receive this vaccine?

All infants and children should receive this vaccine.
It’s an important vaccines for health care professionals, travellers, on dialysis and those with chronic liver disease.

For more information, please contact your doctor.

Chickenpox

1. Why do I need Varicella (Chicken pox) Vaccine?

Varicella is a highly contagious disease, which in absence of vaccination, is likely to affect almost all persons. Generally, chickenpox is mild and does not require any treatment but it may be of a serious nature in neonates, very young infants, pregnant women, and people with decreased immunity. Rarely, hospitalization may be required. When it occurs in pregnancy, it may lead to serious developmental abnormalities in the newborn.

Chicken pox usually present with rashes, some of which appear as red dots, some as red bumps, some with clear fluid and some with scabs. The illness may last for 5-10 days. Rarely, it may be complicated by skin infections, pneumonia, and inflammation of the various parts of brain and/or spinal cord. Later in life, herpes zoster may also develop following chickenpox.

Varicella vaccine can prevent chickenpox and also reduce the chances of developing herpes zoster in future.
Varicella vaccine can also reduce the chances of developing varicella if given within 72 hour of exposure to a case of varicella.

2. Which are the chicken pox vaccines available and what is the schedule?

Many brands of the vaccine are available. They may vary in the quantity of the weakened virus. Generally, all the brands are equipotent.

Two doses of varicella vaccine are recommended for adequate protection at an interval not less than 4 weeks.

Despite giving full schedule (2 doses) of the varicella vaccine, varicella may occur in 1% of children, but the disease is generally very mild.

3. Is it a safe vaccine?

Varicella is a safe vaccine. Pain, redness, or swelling may occur in occasional cases. Few persons may also develop a rash which is milder in nature as compared to the disease. If this happens, the varicella vaccine virus could spread to an unprotected person.

Anyone who gets a rash should stay away from people with a weakened immune system and infants until the rash goes away.

4. Who should receive this vaccine?

All who have not had documented varicella, should receive this vaccine.

5. Who should not receive the Chickenpox vaccine?

Severe allergic reaction after a previous dose of varicella vaccine, known allergy to any vaccine component
During Pregnancy
Has a weakened immune system due to drugs or disease
Has a parent, brother, or sister with a history of hereditary or congenital problems with their immunity.
Is taking salicylates (such as aspirin).
Vaccination should be postponed in those who: have recently had a blood transfusion or received other blood products.

For more information, please contact your doctor

Rabies

1. What is Rabies?

Rabies is a disease that is transmitted to humans by bites of affected animals (mammals). It almost always results in death of the affected individual.

2. Which animal bites can cause Rabies and require anti-Rabies vaccines?

Rabies can be transmitted to humans by mammalian bites. Over 90% are caused by dog bites, followed by cat bites and bites by monkeys, horses, cows and other large mammals.

Domestic rodent (rat) bites and bites by small mammals (e.g. rabbits, squirrels) usually do not cause Rabies and do not warrant rabies vaccination.

Any bites by known or unknown animals in the wild can cause Rabies.

In India, exposure to bats have not been reported to cause Rabies.

3. What steps are essential, at home, for wound management, following an exposure to an animal?

Consult your doctor for vaccination advice as soon as possible.

4. What types of exposure need anti-Rabies vaccine?

Category 1. Touching or feeding animals, animal licks on intact skin (no exposure): no vaccines required

Category 2. Nibbling of uncovered skin, minor scratches or abrasions without bleeding (exposure): only anti-Rabies vaccine required.

Category 3. Single or multiple bites or scratches (with blood oozing), contamination of mucous membrane or broken skin with saliva from animal licks: anti-Rabies vaccine and the Rabies immunoglobulin / monoclonal antibody preparations, which is injected at the site of the bite (exposure).

5. What is the schedule for the anti-Rabies vaccine?

For those who have never received any anti-Rabies vaccine in the past [Post-exposure prophylaxis (PEP)], the schedule consists of 4 doses on day 0-3-7-14 to 28 days, day 0 is the day the 1st dose of the vaccine is administered.

For those who have received the full schedule of PEP, anytime in the past and if the exposure has occurred more than 3 months after the completion of the schedule, 2 doses on days 0-3 is recommended. If the re-exposure has occurred within 3 months, vaccine is not necessary.

In the Govt. sector, anti-Rabies vaccine is administered within the layers of the skin (intradermal) in a different schedule. This is also equally effective.

6. Are the anti-Rabies vaccines safe?

The anti-Rabies vaccines presently in use have been shown to be safe and well tolerated. Minor and transient erythema, pain and/or swelling may occur at the site of injection.

7. Is it correct to just observe the biting dog or cat for 10 days without starting treatment justified?

No. In a country like India, where rabies is prevalent in a large population of dogs and cats, it is necessary to start treatment and keep the biting dog/cat under observation for 10 days.

8. Can you receive the vaccine before exposure and what is the schedule?

Yes. The vaccine can be given before exposure: pre-exposure prophylaxis (PrEP), in select groups e.g. people at high risk of exposure to rabies, such as veterinarians, animal handlers, rabies laboratory workers and rabies biologics production workers.

The Indian Academy of Pediatrics also recommends PrEP to children at high risk of rabies exposure e.g residents in boarding schools, children with pets at home.
The schedule is 2 doses on 0-7 days.

9. Should my child receive the vaccine if bitten by a vaccinated, pet dog?

Vaccinated animals may also transmit Rabies if the vaccination of the animal was ineffective due to any reason. A history of rabies vaccination in an animal is not always a guarantee that the biting animal is not rabid. Animal vaccine failures may occur because of improper administration, improper storage with a consequent sub-optimal immune response of the vaccine or poor health status of the animal. Hence, the category of bite should be the decisive factor in deciding the treatment schedule.

10. Who should not receive the anti-rabies vaccine?

Anti-rabies vaccine is a necessity after exposure to mammalian bites. Everyone should receive it, young and old, ill and healthy and pregnant women as well.

For more information, please contact your doctor.

Polio

1. What is Polio?

Polio is a very serious and a highly infectious viral disease that can cause paralysis of the limbs or other body parts.

It is caused by any of three poliovirus serotypes (types 1, 2 or 3). It primarily affects children under five years of age. The last reported case of wild polio in India was in West Bengal on 13 January 2011. However, two neighbouring countries, Pakistan and Afghanistan, are still reporting cases of Polio. Hence continued polio immunization is necessary to maintain high vaccination coverage in the community to protect against this deadly disease.

2. Which are the vaccines available against Polio and what are the schedules?

There are two types of vaccines:

1. Inactivated (Injectable) Polio Vaccine (IPV) –IPV is given by injection and contains all the three virus serotypes PV1, PV2 and PV3.
2. Oral Polio vaccine (OPV) –given orally as drops and available as a bivalent formulation, containing serotypes 1 and 3. Monovalent (containing only 1 type) OPVs are also available but not used routinely. They are reserved by Govt. for handling outbreak situations. OPV is administered as 2 drops directly into the mouth.
3. The wound should not be covered with any bandage or sutures unless profusely bleeding.

3. Are these vaccines safe?

OPV is a safe vaccine. Very rarely, it might cause paralysis, a condition known as Vaccine-associated paralytic polio (VAPP) either in the vaccinated or in close contacts. The vaccine virus may revert to a disease-causing state and spread through the environment. This is known as Vaccine-derived polioviruses (VDPVs).

IPV is considered very safe, whether given alone or in combination with other vaccines. Minor adverse events are transient and include local redness (0.5%–1%), swelling (3%–11%) and pain (14%–29%)

3. Are these vaccines safe?

4. Who should receive this vaccine?

Polio (bOPV/IPV) – For Hajj travel and for travellers from Countries where polio is endemic (Pakistan and Afghanistan) or are having outbreaks.

5. What are recommendation about polio vaccine by Ministry of Health and Family Welfare, India for inbound travellers to India?

The vaccination requirements for inbound travellers to India from countries with ongoing polio transmission are as follows:

Resident nationals of the polio infected countries are required to receive a dose of OPV regardless of age and vaccination status at least 4 weeks prior to departure to India.

The certificate of vaccination should accompany other documents when applying for visa for India and during travel.

6. What are recommendation about polio vaccine by Ministry of Health and Family Welfare, India for outbound travellers from India?

The vaccination requirements for outbound travellers from India to countries with ongoing poliovirus transmission is to receive a dose of OPV at least 4 weeks prior to departure regardless of age and vaccination status.

7. Who should not receive the vaccines?

OPV should not be given to individuals with weakened immune systems caused by diseases (incl. HIV) or medications (prolonged high dose steroids/immunosuppressive therapies) and to individuals who had a severe allergic reaction to a previous dose of the vaccine like anaphylaxis or a known, severe allergy to any vaccine components.

For more information, please contact your doctor

Cholera

1. What is Cholera?

Cholera is an acute illness, which is spread through contaminated food or water. It causes severe diarrhea and vomiting and if not treated properly, it can lead to severe dehydration and even death.

Cholera is usually seen during the aftermath of natural calamities or when there is a congregation of large numbers of persons for religious festivals and other functions.

2. Which are the vaccines against Cholera, who should receive it and what is the schedule?

Only one anti-cholera vaccine is marketed in India. It is made from killed cholera germs.

Vaccine is recommended in two doses two weeks apart to individuals above one year of age.
Immunity starts after 7-10 days after second dose.

It is given to residents of highly endemic areas and in areas where there is risk of an outbreak such as during pilgrimages like Kumbh Mela, etc.

Where there is continued risk of V. cholerae infection, revaccination is recommended after 3 years.

3. Is it a safe vaccine?

This is a very safe vaccine with practically no reported side effects.

For more information, please contact your doctor.

JE

1. What is Japanese Encephalitis (JE)?

Japanese encephalitis (JE) is a viral infection which is spread by bites of an infected mosquito. It does not spread from person to person.

Generally, most infected people do not have any illness. About 1 in 200 infected persons may develop symptoms, which may include fever, headache, fits and loss of consciousness (caused by swelling of the brain).

Almost 25% of people with brain involvement may die and about half are left with residual neurological deficits.

2. Which are the vaccines are available against Japanese encephalitis and what is their schedule?

Three vaccines are available in India:

1) SA 14-14-2 vaccine: This is made from live, weakened virus. This vaccine is available only in the national immunization schedule of the Government of India. It is administered in a 2-dose schedule at 9 months and 16-24 months, to children 9 months of age onwards.
2) JEEV: This is made from the dead virus. It is administered in a 2-dose schedule to children 1 year of age onwards. The second dose is given at least 4 weeks after the first dose.
3) JENVAC: This is made from the dead virus. It is administered in a 2-dose schedule to children 1 year of age onwards. The second dose is given at least 4 weeks after the first dose.

At present, there is no recommendation for booster doses.

3. Who should receive the JE vaccine?

All children above the age of 9 months, residing in districts declared as endemic, by the Govt. of India. In certain hyperendemic districts, the vaccine is also being given to adults. The vaccine is recommended for all the children residing in both, rural and urban areas in the endemic districts.

This vaccine may be offered to travellers to endemic areas, during the transmission season (monsoon) and for travellers intending to stay for long periods, in endemic areas.

It is also recommended for short term (less than a month) travellers, who will visit rural areas and have an increased risk for mosquito bites, or are not sure of their travel plans.
Please ask your doctor regarding the need of JE vaccines for your child.

4. How safe are the JE vaccines?

The vaccines are safe. Common reactions include pain, tenderness, redness, or swelling at the site of the vaccination. Fever, headache, muscle aches, flu-like illness can occur.

5. Who should not receive the vaccine?

The vaccines should not be given to children who have had an allergic reaction after a previous dose of JE vaccine, or has any known, severe, life-threatening allergies to any vaccine component.

For more information, please contact your doctor

Yellow Fever

1. What is Yellow Fever (YF)?

Yellow fever is a serious viral infection found in certain parts of Africa and South America. It spreads through the bites of infected mosquitoes.

Yellow fever can present with fever, jaundice and bleeding from multiple body sites.

It is a dangerous illness with 20-50% of serious cases resulting in death.

Yellow fever cases have not been reported from India.

2. Which are the YF vaccines available and what is the schedule?

YF vaccine is made from live, weakened virus.

YF vaccine is administered subcutaneously as a single dose for those between 9 months and 60 years. The vaccine results in more side effects if administered to those above 60 years of age.

YF vaccine should not be administered to pregnant women and mothers who are breast feeding their infants.

A single dose results in lifelong protection.

3. Who needs to take the Yellow Fever vaccine?

This vaccine is necessary for people travelling to Yellow fever endemic countries. The list of Yellow fever endemic countries is periodically updated by the World Health Organization (WHO) and should be checked on the WHO website at least 2 weeks before the travel date.

It is also required for people living in YF endemic countries and laboratory persons working in laboratories wherein fluids from suspected YF patients is handled.

4. Where can I get the YF vaccine?

Vaccine is given only at designated vaccination centres. After vaccination the details are to be entered on the
“International Certificate of Vaccination or Prophylaxis” (yellow card) and signed by the authorities at the vaccination center.

This certificate becomes valid 10 days after vaccination and is valid throughout life.

No boosters are necessary.

5. What is the importance of the “International Certificate of Vaccination or Prophylaxis”?

This valid card is necessary for entry to YF endemic countries. Failure to produce a valid certificate will result in refusal of entry into the YF endemic country or quarantine for a period up to 2 weeks.

6. Who should not get this vaccine?

Infants younger than 6 months of age
Those with severe (life-threatening) allergy to eggs, chicken proteins and gelatin.
This vaccine is avoided in pregnant women and mothers who are breast feeding their infants.
This vaccine is avoided in people with weakened immune systems e.g. people with cancers or on drugs which suppress the immune system.

For more information, please contact your doctor