Essential Vaccination Guidance for Your 1-Year-Old Child

Vaccination

Hello Dr.
Hsiao,
I have the following questions regarding my baby who is currently 1 year and 2 months old:
1.
Are the vaccines provided in hospitals, health centers, or clinics, whether self-paid or government-subsidized, standardized and safe? Do vaccines also differ by manufacturer? For example, if the first three doses of the 7-valent pneumococcal vaccine (Prevnar) were administered at the hospital, is it safe and acceptable to receive the fourth dose at a clinic?
2.
Could you please advise on the order of vaccinations for my baby: varicella, influenza (first dose), and pneumococcal (fourth dose)? Should the interval between these vaccinations be one month?
3.
Previously, my baby received the hexavalent vaccine, and at 1 year and 1 month, the hospital mentioned that two additional doses of oral polio vaccine are needed.
Why is that? Is the interval for the second dose two months?
Thank you, Dr.
Hsiao, for your assistance.

Xuan Mami, 20~29 year old female. Ask Date: 2008/10/20

Dr. Xiao Kaiwen reply Pediatrics

1.
In principle, vaccination sites approved by local health bureaus are safe (the health bureau conducts regular inspections, including storage methods).
Some vaccines have different brands, and some can be used interchangeably (in case of shortages), while others cannot.
Please consult a pediatrician (it is generally better to use vaccines from the same brand, as the antigens are the same).
In Taiwan, there is only one brand of the 7-valent pneumococcal vaccine.

2.
Varicella, influenza (first dose), and pneumococcal (fourth dose) can be spaced 1-2 weeks apart (they can also be administered simultaneously).
However, varicella should be spaced one month apart from measles, rubella, and mumps, and pneumococcal should be spaced one month apart from Japanese encephalitis.
3.
The health department recommends that inactivated poliovirus vaccines (such as the pentavalent or hexavalent vaccines) may not generate long-lasting gastrointestinal immunity against poliovirus (since poliovirus is a type of enterovirus absorbed through the gastrointestinal tract).
Therefore, it is advised that those who receive the inactivated poliovirus vaccine should subsequently receive two doses of oral poliovirus vaccine (spaced 2 months apart).

Reply Date: 2008/10/20

More Info

Hello! Thank you for your questions regarding vaccination guidance for your 1-year-old child. Vaccination is a crucial aspect of pediatric healthcare, and understanding the nuances can help ensure your child is protected against various diseases. Let’s address your queries one by one.

1. Uniformity and Safety of Vaccines: Vaccines administered in hospitals, health centers, or clinics are generally standardized and regulated by health authorities to ensure their safety and efficacy. In the United States, for example, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) oversee vaccine approval and monitoring. While different brands may produce the same type of vaccine (like the 7-valent pneumococcal vaccine), they are required to meet the same safety and efficacy standards. Therefore, if your child received the 7-valent pneumococcal vaccine (like Prevnar) in the hospital, it is safe to receive the same vaccine from a different provider, such as a clinic. However, it is always best to keep a record of the vaccines received, including the brand and lot number, to ensure continuity of care.

2. Vaccination Schedule and Intervals: For your child, the recommended vaccination schedule typically includes the following:
- Varicella (Chickenpox) Vaccine: This is usually given at 12-15 months of age, with a second dose at 4-6 years.

- Influenza Vaccine: The first dose can be given starting at 6 months of age, and if it’s the first time your child is receiving it, two doses are recommended, spaced at least 4 weeks apart.

- Pneumococcal Vaccine: The fourth dose is usually given between 12-15 months of age.
In terms of intervals, it is generally recommended to space vaccines at least 4 weeks apart, but specific guidelines may vary based on the vaccine type and the child’s health status. It’s essential to consult your pediatrician for personalized advice.

3. Oral Polio Vaccine (OPV) Doses: The reason your child was advised to receive two additional doses of the oral polio vaccine (OPV) is likely due to the need for a complete immunization series. The standard schedule for polio vaccination includes a series of doses at 2 months, 4 months, 6-18 months, and a booster at 4-6 years. If your child received the combination vaccine (like the DTaP-Hib-IPV) but missed the oral doses, the pediatrician may recommend catching up to ensure full protection. The interval between doses is typically 4-8 weeks, but again, your healthcare provider will give the best guidance based on your child’s vaccination history.

In summary, it’s crucial to follow the recommended vaccination schedule to protect your child from preventable diseases. Always consult with your pediatrician regarding any specific concerns or questions about your child’s vaccinations. They can provide tailored advice based on your child’s health history and the latest guidelines. Keeping a vaccination record is also essential for tracking what has been administered and what is still needed.
I hope this information helps clarify your questions regarding your child's vaccinations! If you have any further inquiries, feel free to ask.

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