Preventive medicine and the role of immunization are immense to keep children safe. So it’s important to always check the authenticity and avoid misconceptions.

Therefore, I decided to write about the less-painful vaccine.

Many parents think there are special procedures or facilities to make vaccination less painful for children. While your doctor will always give you tips to make your child comfortable during and after vaccination, you must know this.

Injections given with expertise can reduce pain. But the needle prick is not entirely painless.

Dr.Amrita Basu
healthwealthbridge.com

So, what is the talk about the less painful vaccine?

One -The less-painful vaccine is an option only for DPT/DTwP or DTaP based combination vaccines, but not other vaccines.

The whole-cell Pertussis (Bordetella Pertussis) containing DPT is often called a painful vaccine or DPT. The less painful vaccine, also known as DTaP with acellular Pertussis vaccine. It is the nature of the P or Pertussis component, which makes it less painful.

Pertussis (whooping cough), the P component of DPT /DTaP, is an infectious disease and a significant cause of infant disease and death. It is still a public health concern even after high vaccination coverage.

In infants and children less than five years worldwide, it is an important preventable cause of death. Since both types of vaccines give good coverage in the age group (who are susceptible), WHO stresses on discretion in choosing the vaccine. So it’s a conversation you will need to start with your Paediatrician before starting the primary immunization schedule.

But why does it even matter? The confusion parents feel while choosing for their little ones is common across the globe. You want the best.

This is why you must understand the critical aim of Pertussis vaccination. It is to decrease the risk of severe Pertussis in infants and young children. All children worldwide, including HIV-positive individuals, should be immunized against Pertussis. You can’t do away with the P part of the vaccine!

Two -Always Vaccinate your child as recommended

Vaccination coverage is most important to protect children. You must do it on time and complete it too. This is something everyone agrees on. The coverage should in no way be hampered. Every country tries to achieve early and timely immunization. Universal immunization (vaccination for all) is a must to protect your children, improve community coverage, and also protect future generations.

Remember: What you decide today has a long-term effect.

Three-Efficacy of the less painful vaccine

Now this one was tricky. The decision was about efficacy as well as acceptability. As an adult, you can be brave, but still you want medicines and vaccines to work.

WHO, IAP, AAP recommendations about the less painful vaccine

IAP mentions this German study about the 88.7% efficacy rate [1] of painless acellular vaccine for Pertussis and reading this, I took to heart. Even though the painful vaccine is recommended in terms of long-term efficacy, even more, important is the coverage of immunization in infancy and childhood when the risk of Pertussis is highest.

In fact, in the early years of life, the protection is found to be similar. The immunity decreases faster with the acellular or less painful vaccine. [2,3,4]
In Government healthcare setup, NGOs the whole-cell vaccine is often given for free. In a private set up, parents may reduce discomfort as well as provide adequate protection.

Acellular vaccine or less painful vaccine is comparatively less immunogenic. But it also causes less reaction; this is more acceptable to many parents. Over a 6 to 12 years period, the immunogenicity has been seen to be lowered in developed nations. But WHO recommends that we continue vaccination for complete vaccination coverage first.
Either type of vaccines needs to be used for primary immunization 3 doses [5,6]

Given the anxiety related to the whole-cell vaccine and the popularity of combination vaccination, the less painful vaccine can be used even in the primary series.

The exact efficacy and immunogenicity have more reviews going on. Additional boosters and vaccination of mothers can also be done is what WHO says.

Four-Talk to your Paediatrician for a personalized recommendation

Now my husband is the person who is my child’s Paediatrician too. But we discuss a lot about the pros and cons of every health decision as a family. You should consult your own doctor before making any decision regarding immunization. It’s important your child gets vaccinated with what is available and the final decision rests with the parent.

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References:

1) Schmitt HAJ, von König CH, Neisse A, Bogaerts H, Bock HL,
Schulte-Wissermann H, et al. Efficacy of acellular pertussis
vaccine in early childhood after household exposure. JAMA.
1996;275:37-41.

2. Winter K, Harriman K, Zipprich J, Schechter R, Talarico J,
   Watt J, et al. California pertussis epidemic, 2010. J Pediatr.
   2012;161:1091-6.
3. Centers for Disease Control and Prevention (CDC).
   Pertussis epidemic—Washington, 2012. Morb Mortal
   Wkly Rep. 2012;61:517-22.
4. Pertussis vaccines: WHO Position Paper – August 2015
   No. 35. World Health Organization. Weekly
   Epidemiological Record. 2015;90:433-60.
   5) World Health Organization. Pertussis Vaccine Evidence to
   Recommendations (WHO). Available from: http://
   www.who.int/immunization/position_papers/Pertussis
   GradeTable3.pdf. Accessed November 6, 2018.
   6) WHO Position paper on Pertusis Vaccine, 2005. World
   Health Organization. Weekly Epidemiological Record.
   2005;4:29-40.