While most people are convinced about necessity and the safety of the vaccine, revaccinations are under heated debate. I believe that it is essential to revaccinate children who are already vaccinated because of programmatic considerations to stop transmission of the viruses. Additional doses do not mean additional risk.
It is true that adverse events can follow vaccination though they are rare. I have listed the possible reactions and how they can be managed:
• Reactions because of vaccine: In this case the vaccine is a live attenuated one. It has the virus contained in it but attenuation takes an infectious agent and alters it so that it becomes harmless. Some children with immunosuppressive conditions may develop a mild form of the disease in consideration. If this is the concern and the child is nine months of age getting the first dose I urge that the vaccine be administered by the child’s paediatrician. If there have been no reactions previously it is very unlikely to happen.
• Allergic reaction to the components of a vaccine: Incidence is estimated to be 1-3/million for MR vaccine. The odds are the same as for any drug or food item. The personnel involved in the programme are trained to identify and manage such situations effectively. It is advised to be present at the site for thirty minutes following vaccination. Most allergic reactions are likely to happen within this time. Children allergic to eggs can be vaccinated. Do not vaccinate if the child has had a reaction to medications or gelatine or if there is previous history of allergies to vaccine components. High fever or any serious disease (such as tuberculosis) are conditions under which vaccination is not advised.
• Reactions because of errors in preparation, handling and administration: These vaccinations are supervised at several levels and the personnel are trained to monitor them. A vaccination team will have one or two vaccinators – Auxiliary Nurse Midwifes or Male Health Workers, Lady Health Visitors or retired nurses or Pharmacists and Doctors. All the medical officers in each district have been trained in management of adverse events and all the session sites have a specially prepared Adverse Event Management kit. Parents can opt for private practitioners but will have to show the duly filled vaccination card for the MR campaign to the MR campaign team.
• Events such as fainting because of pain after injection – the vaccinators and the supervisors at the vaccination site will provide support.