Your introduction to immunisations

What is an immunisation?

An immunisation is a powerful way of protecting your child against a disease.

It works by prompting your child’s immune system to produce antibodies against a particular disease, so that if they are exposed to that disease in the future, their body can more effectively fight it off.

Your child will be offered immunisations against a wide range of dangerous diseases while they are young, to make sure they are protected before they come into contact with them.

The latest immunisation schedule
(October 2016)

The schedule below is only valid for babies born on or after the 1st October 2016.

Please refer to https://www.hse.ie/eng/health/immunisation/ for information on the vaccination schedule for babies born on or before the 30th September 2016

What to expect at your child's immunisation appointment

The nurse or doctor will check:

• your child's general health, and what medicines they may be taking

• which vaccines your child is going to have

• that you know which diseases the vaccinations protect against

• that you understand what side effects may occur and how to treat them

• that you're happy to go ahead

It is a good idea to make past experiences known before the injection. Tell the nurse about any reactions your child has had after any previous vaccinations. Although children rarely faint after a vaccination, if your child is prone to fainting, you can ask if they can have the vaccination lying down.

The vaccine will be administered (either by injection, oral administration, or a nasal spray).

If your baby is receiving the Meningitis B vaccine along with their other routine immunisations at 2 or 4 months old, you should be asked if you have a supply of liquid infant paracetamol at home. If you do not, you may be offered a syringe of CALPOL^®. You should then get some liquid infant paracetamol from your local pharmacy or supermarket on your way home. This is because post-immunisation fever is more common when the Meningitis B vaccine is given with the other routine vaccinations at 2 and 4 months.

Read more about post-immunisation fever

What to expect after the immunisation

What happens directly afterwards?

Just in case your baby reacts to the injection, you may be asked to stay in the surgery for about 15 minutes after the immunisation. It’s normal for babies and young children to be upset for a little while after an immunisation by injection and they may be a little irritable or off-colour that evening.

What about side effects?

Usually, any side effects will occur where the injection was given, including:

• Swelling

• Redness

• A small hard lump

Though it may be sore to touch, these symptoms will pass in 2-3 days and you don't have to worry about them.

Fever is also quite common in young children, but is usually mild – see page 9 for more information on post-immunisation fever.

What about febrile seizures (fits)?

Most febrile seizures occur when a child has fever caused by a common infection (like flu, chickenpox or tonsillitis), but in very rare cases they can occur after a child has a vaccination.

Although febrile seizures can be frightening, they aren't usually a cause for concern. If the seizure lasts for less than five minutes, phone your GP or GP out of hours service. In very rare cases, a seizure can be a sign of a more serious condition, which could require emergency medical treatment. Dial 999 immediately to request an ambulance if your child:

• is having a seizure that's lasting longer than five minutes and showing no signs of stopping

• has a blotchy red rash that doesn't fade or change colour when a glass is placed against it (in some cases a rash isn't always present)

• is having breathing difficulties

What temperature constitutes a fever?

• Fever in children is usually defined as a temperature of over 37.5°C.

• You should contact your GP, health visitor or practice nurse if your child is:

• Under 3 months old and has a temperature of 38°C (101°F) or higher

• 3 to 6 months old and has a temperature of 39°C (102°F) or higher

• Any age, and, as well as fever, has other signs of being unwell such as floppiness and drowsiness

Helping your child feel more comfortable when they have a fever

• Give your child plenty of fluids

• Cover them with a lightweight sheet if necessary

• Keep the room well aired and at a comfortable temperature (about 18°C or 65°F) by adjusting the radiators or opening a window.

• If your child is distressed and uncomfortable, them liquid infant paracetamol or infant ibuprofen (paracetamol can be used from 2 months of age (weighing over 4kg and not premature) and ibuprofen from 3 months (weighing over 5kg)). This helps bring their temperature down. Always read the label to find out correct dose and frequency for your child's age.

Specific advice for after the Meningococcal B vaccine

The Men B vaccine is usually given at your baby’s first and third immunisation appointments at 2 months and 4 months of age, and a booster at 12 months.

Fever is particularly common with Men B vaccine at 2 and 4
months:

Although fever can be expected after any vaccination, it is more common when the Men B vaccine is given with the other routine vaccines at two and four months. The fever tends to peak around six hours after vaccination and is nearly always gone completely within two days.

The fever shows your baby’s body is responding to the vaccine (but don’t worry - not getting a fever doesn’t mean it hasn’t worked). The level of fever depends on the individual child and does not indicate how well the vaccine has worked.

How can I reduce the risk of fever after MenB Vaccine?

Giving paracetamol soon after vaccination – and not waiting for a fever to develop – will reduce the risk of your child having a fever. This will also reduce the chance of your baby being irritable or suffering discomfort (such as pain at the site of the injection).

You should give the first dose as soon as possible after your two month vaccination visit. If necessary you should then give a second dose 4-6 hours later. Do not give more than 2 doses unless your doctor or nurse has advised otherwise.

After your four month vaccination visit give the first dose as soon as possible after your vaccination visit. If necessary you should then give a second dose 4-6 hours later and if necessary a third dose 4-6 hours after that. Do not give more than four doses in any 24 hour period.

Current advice states that paracetamol should be used to treat postimmunisation fever in babies after their Men B injections at 2 and 4 months. Your nurse will give you more information about paracetamol at your vaccination appointment and you may be given a leaflet to take away with you with written instructions.