Vaccination Schedule and Nutritional Concerns for Young Children

Vaccination

1.
The child is currently one year and nine months old (male).
He received the first dose of the influenza vaccine on October 6.
However, he still needs to receive the diphtheria, pertussis, and tetanus (DPT) combination vaccine, the oral polio vaccine, and the varicella (chickenpox) vaccine, which are due at one year and six months.
Besides knowing that the second dose of the influenza vaccine should be administered one month after the first dose, I would like to ask the physician how long the other vaccines should be spaced apart to avoid any conflicts.
Is it also not advisable to delay them for too long?
2.
The child is currently one year and nine months old (male), with a height of 80 cm and a weight of 11.5 kg.
Is he too short for his age, and does he need special nutritional supplements? (For reference: father’s height is 170 cm and mother’s height is 153 cm).
His usual diet consists of 180 cc of milk in the morning and before bed, along with two main meals (he does not like to eat vegetables).
3.
Another child is currently three years and eleven months old (female).
Does she need to pay out of pocket for the influenza vaccine? (She has not received it in previous years).
If she needs to get vaccinated, how many doses are required, and what is the cost?
4.
Do vaccines at general pediatric clinics tend to be older and may have slower turnover?

carol, 20~29 year old female. Ask Date: 2004/10/08

Dr. Lin Wenxian reply Pediatrics

Director Lin Wen-Hsien of the Pediatrics Department at Tainan Hospital, Ministry of Health and Welfare, responds to Carol:
Dear Parent,
I would like to address your questions in order:
A.
Regarding the sequence of influenza vaccination and other vaccines: they can be administered at any interval or even simultaneously without any interference, as the influenza vaccine is an inactivated vaccine.
B.
The oral polio vaccine and varicella vaccine are both live vaccines; they should either be administered together or spaced at least one month apart.
If the pentavalent vaccine is given, the polio component is an inactivated vaccine, so there are no concerns in this regard.
The oral live vaccine is generally considered safer and also provides immunity against Haemophilus influenzae type b.
The pentavalent vaccine at Tainan Hospital is on special for NT$1552 in October.
C.
Generally, in Taiwan, a maximum of two injections can be given at one time, administered at different sites.
Since your child has not yet received the measles, mumps, and rubella (MMR) vaccine or the varicella vaccine, I recommend administering both the MMR and varicella vaccines before the next influenza vaccination.
Delaying these vaccinations may hinder your child's ability to develop immunity against these diseases, which is not advisable.
For a 1 year and 9 months old boy with a height of 80 cm, he falls around the 10th percentile on the growth chart.
This growth chart is included in every child health handbook, usually in the early pages, and every parent should learn to plot and understand its significance.
The 10th percentile means that if there were 100 children of the same age in the world ranked by height, your child would be the 10th shortest.
Being below the 3rd percentile is considered too short, while being above the 97th percentile is too tall.
Therefore, a height at the 10th percentile and weight at the 25th percentile are both within the normal range.
Another function of the growth chart is to track development: if your child's height has consistently remained near the 10th percentile line from birth to now, then they are growing steadily, and there is no need for excessive concern.
While nutritional supplements are not necessary, it is important to avoid developing picky eating habits.
For a 3 year and 11 month old child who contracts influenza, although the risk of complications and hospitalization is lower than for children under 2 years old, they will still experience significant discomfort, high fever, fatigue, and inability to attend school, and they can also spread the virus to others.
Receiving the influenza vaccine can reduce these risks.
Since your child is over 2 years old, the vaccine will be out-of-pocket, so please consider this.
As for pricing, it may vary between hospitals and clinics, so parents are encouraged to inquire.
At Tainan Hospital, a public hospital, the out-of-pocket cost for the influenza vaccine in the pediatrics department, including the registration fee, is only NT$350.
For children under 9 years old receiving the vaccine for the first time (if they have never been vaccinated in previous years), two doses are required, spaced at least four weeks apart.
The influenza vaccines available this year are all freshly manufactured (as each year's vaccine differs), so there is no concern about them being outdated.
Wishing you good health and all the best from Tainan Hospital!

Reply Date: 2004/10/08

More Info

When it comes to the vaccination schedule and nutritional concerns for young children, it's essential to address both aspects comprehensively to ensure optimal health and development.

Vaccination Schedule
1. Vaccination Timing: For your 1 year and 9 months old boy, it is crucial to follow the recommended vaccination schedule. The DTaP (diphtheria, tetanus, and pertussis) and IPV (inactivated poliovirus) vaccines are typically administered at 2, 4, 6, and 15-18 months, with a booster at 4-6 years. The varicella (chickenpox) vaccine is usually given between 12-15 months and again at 4-6 years. Since he has already received the flu vaccine, the second dose should be given at least 4 weeks after the first dose. It’s advisable to consult your pediatrician to ensure that the vaccines are administered in a timely manner without any overlaps that could compromise their effectiveness.

2. Delay in Vaccination: While it is important to adhere to the vaccination schedule, delays can occur. However, prolonged delays may leave your child vulnerable to preventable diseases. It is best to catch up on missed vaccinations as soon as possible. Your healthcare provider can help create a catch-up schedule tailored to your child's needs.

3. Flu Vaccine for Other Child: For your 3 years and 11 months old daughter, if she has never received the flu vaccine before, she will need two doses if she is receiving it for the first time. These doses should be administered at least 4 weeks apart. The cost of the flu vaccine can vary depending on your location and the healthcare provider, so it’s best to check with your pediatrician or local health department for specific pricing.

4. Vaccine Storage and Efficacy: Regarding the concern about the vaccines at pediatric clinics being old or slow-moving, reputable clinics follow strict guidelines for vaccine storage and administration. Vaccines are typically stored in refrigerators or freezers at specific temperatures to maintain their efficacy. If you have concerns, you can ask your healthcare provider about their vaccine management practices.

Nutritional Concerns
1. Growth Assessment: Your son’s height of 80 cm and weight of 11.5 kg places him below the average growth percentile for his age, which could be a concern. Given that his parents have average heights (father at 170 cm and mother at 153 cm), it’s important to monitor his growth closely. Regular check-ups with a pediatrician can help assess whether he is growing appropriately for his genetic potential.

2. Nutritional Intake: His current diet includes milk and two meals a day, but if he is not consuming enough vegetables, he may be missing out on essential nutrients. Children at this age require a balanced diet rich in fruits, vegetables, whole grains, and protein sources. Since he is not fond of vegetables, consider incorporating them into meals in creative ways, such as blending them into smoothies or hiding them in sauces.
3. Nutritional Supplements: If his dietary intake is insufficient to meet his nutritional needs, a pediatrician may recommend a multivitamin or specific supplements. However, it’s essential to consult with a healthcare provider before introducing any supplements to ensure they are appropriate for his age and health status.

4. Encouraging Healthy Eating: To improve his nutritional intake, involve him in meal preparation, offer a variety of foods, and create a positive mealtime environment. Children often mimic their parents' eating habits, so modeling healthy eating can encourage better choices.

In conclusion, maintaining a proper vaccination schedule is crucial for your children’s health, and addressing their nutritional needs is equally important for their growth and development. Regular consultations with healthcare providers can provide personalized guidance tailored to your children’s specific needs.

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