Primed with tissues for the tears, lollipops for bravery and promises of television for the guilt of putting their children through the pain of a needle, most parents these days are well prepared for their children's regular immunisations. But understanding exactly what diseases your child is being vaccinated against is not always easy with the National Immunisation Program Schedule constantly under review. As part of the schedule to be updated on July 1 this year, children under five can expect to receive 13 injections and numerous oral courses, making up a total of 45 vaccine doses.
Every year the Federal Government spends almost $300 million funding vaccines so that families can access them for free. Therefore, the only vaccines that make it onto the schedule are those that cause significant illness and that have been proven to be safe and effective, explains Professor Peter McIntyre, Director of the National Centre for Immunisation Research. "Only diseases that cause a substantial burden in the community, substantial discomfort or illness or in some cases death and a range of long-term handicaps … make it onto the nationally funded immunisation schedule."
Ensuring your child is up-to-date with their vaccinations is important for two reasons, explains Professor McIntyre. Having your child vaccinated not only protects them from significant illness, but also helps to protect the rest of the community. "There are some people in the community who can't be protected because they have a disease or they have had to have treatment for a disease which means their immune system is not working properly. For those people the only way to protect them from disease is to have high levels of immunisation in the community," says Professor McIntyre. He adds that in the case of very young babies, who can die if they contract whooping cough, the only way to protect them is for the community to have a high level of immunisation against the disease.
Current trends show that about 95 percent of children are up-to-date with their vaccinations by age two. The five percent that aren't vaccinated are largely made up of families with significant difficulties who find it tough simply to keep up with their immunisations and those who follow a life philosophy that disagrees with immunisation.
Professor McIntyre explains that the most important vaccinations to have on time are the earliest ones. "It is a balance between getting protection from as early as possible and the response that you get from the immune system on the other," he says. "If there is a delay with a third dose at six months that is not as much of a problem because by the time you have had two doses you usually have a substantial degree of protection and you'll get a nice boosting of that when you have the third dose."
What's free and what's not
Every few years new vaccines for diseases become available and some of them make it onto the schedule. While this means young children and babies are getting the newest vaccines, it does create gaps within the community. For example, on July 1 this year, babies aged two, four and six months will be eligible to receive a vaccine preventing the rotavirus under the schedule. Unfortunately, that means children over six months old miss out. Their parents either have to pay for the vaccine themselves or choose not to have them immunised against the rotavirus.
Babies don't have the first of their three doses of whooping cough until they are two months old. For this reason, says Professor McIntyre, it is recommended people planning to have children or who have had a baby recently and who haven't been protected against whooping cough get the vaccination. Because whooping cough is only on the schedule for young children and teenagers, however, adults will have to pay for this vaccine.
The prices for all vaccines vary dramatically but some of the newest varieties can cost as much as $120 to $150 per dose, explains Professor McIntyre.
What's on the schedule
Birth
Two months
- Hepatitis B
- Diphtheria, tetanus and whooping cough
- Haemophilus influenzae type b
- Polio
- Pneumococcal conjugate
Four months
- Hepatitis B
- Diphtheria, tetanus and whooping cough
- Haemophilus influenzae type b
- Polio
- Pneumococcal conjugate
Six months
- Hepatitis B
- Diphtheria, tetanus and whooping cough
- Haemophilus influenzae type b
- Polio
- Pneumococcal conjugate
12 months
- Hepatitis B
- Haemophilus influenzae type b
- Measles, mumps and German measles
- Meningococcal C
12-24 months
- Hepatitis A (Aboriginal and Torres Strait Islander children in high-risk areas)
18 months
18-24 months
- Pneumococcal polysaccharide (Aboriginal and Torres Strait Islander children in high-risk areas)
- Hepatitis A (Aboriginal and Torres Strait Islander children in high-risk areas)
Four years
- Diphtheria, tetanus and whooping cough
- Measles, mumps and German measles
- Polio
10-13 years
15-17 years
- Diphtheria, tetanus and whooping cough
*From July 1, 2007, the rotavirus vaccine will be given as a two-dose oral course at two and four months, or as a three-dose oral course at two, four and six months of age. A vaccine to prevent several Human Papillomavirus (HPV) types has also recently been added to the schedule as a three-dose course to young women aged 12-18 years (school-based program) or 18-26 years (community-based catch-up program). HPV causes up to 70 percent of cervical cancers.
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