Immunisation and Vaccine Advice

Childhood vaccines are the preventive measures given under medical supervision to protect a child against certain diseases. Immunisation follow-up means following them in a planned way, completing anything missing and reviewing how a child is after each dose. Vaccine advice is where a family's questions are discussed with the doctor.

This page sets out how childhood vaccines are planned, how follow-up works, what may be seen after a vaccine and how to handle a child's fear of injections. The most common misunderstanding is that the subject is only a matter of dates on a calendar, when every decision concerns the child in front of you.

Why childhood vaccines are given

A vaccine allows the body to recognise and remember a disease before meeting it. The immune system can then respond more quickly and in a controlled way when the same disease comes along. A vaccine is not a way of treating an illness, but a way of preparing for it in advance.

Vaccination also has a role at the level of the community. As the number of people with immunity in an area rises, so does the protection available to small children or children with weak immunity who cannot be vaccinated. Immunisation is not only a personal decision; it concerns the children around you.

That said, a vaccine is not the same for every child. The plans for babies born prematurely, for children with a chronic illness and for children with an immune system condition are considered differently, and the decision follows from the doctor's knowledge of the child.

How immunisation follow-up is kept

Follow-up runs on three sets of records: the vaccination card, the record system of the health provider and the doctor's own notebook. The card is the most practical record for the family, showing which vaccines were given, when, and what is outstanding. The record system makes missed doses easier to notice.

Consistency matters. Because one dose shapes the plan for the doses that follow, a gap in the middle creates a picture that is harder to correct later. A catch-up plan is made for whatever is missing, and the doctor sets that plan according to the child's situation. Records also need reviewing when a new vaccine is added to the schedule or when a child arrives from another country.

What vaccine advice covers

Vaccine advice gathers a few headings together. The first is the schedule: which vaccines are due at this age, which have been given and which are outstanding. The second is the child's health history. Recent infections, fever, reactions to earlier vaccines and the medicines in use can all affect the plan.

The third heading is the child's particular situation. The vaccine plan of a premature baby, of a child with a chronic illness or of a child who has had surgery recently is considered separately. The fourth is the family context: travel plans, the vaccination status of relatives, what the school asks for and the child's own fears.

The visit usually ends with a written plan. It shows which vaccine comes next and when, in which situations the doctor should be contacted and what will be followed up. It also reduces the “did we miss a vaccine?” question that arises later.

What may be seen after a vaccine

The response to a vaccine varies from child to child. The most common are redness at the injection site, mild swelling and tenderness, a slight fever, restlessness and temporary changes in appetite. These usually settle on their own within a short time.

Some signs, however, are not an ordinary reaction and should be reported the same day: an area at the injection site that quickly grows or swells, a high fever, prolonged crying, a rash over the body, marked lethargy. Difficulty in breathing, swelling of the face or lips, a seizure or loss of consciousness is an emergency: call 112 or go to the nearest emergency department immediately. These are uncommon, but when they occur they need a prompt assessment.

If your child has a fever before the appointment, or has had an infection recently, tell the doctor during the examination. Whether the vaccine goes ahead is a decision for the doctor who has seen the child.

What parents can do after a vaccine

• Keep fluids up: Frequent feeding for breastfed babies and frequent drinks for older children make the day easier.
• Allow the arm to move normally: Letting the injected arm move as usual can ease the local soreness.
• Write down the complaint: When the fever started, how long it lasted and any change at the injection site are the most valuable things to tell the doctor.
• Ask the doctor about fever reducers: How and when one is used is the doctor's decision, settled at the appointment.
• Do not put off the next vaccine: A short period of tiredness after a vaccine is not a reason to move the schedule.

Handling a child's fear of injections

Fear of injections is common and usually related to age. In younger children the worry is rarely about the needle itself, but about being in an unfamiliar place and about losing control. Sometimes the pain of an earlier dose produces a more resistant reaction the next time round.

The first step is a calm explanation before the appointment. Describing what will happen in simple words, not lying about it and answering the child's questions calmly all build trust. Continuing with play or conversation while waiting, and keeping the procedure short, also help.

Holding the child's hand firmly, taking them on your lap and offering praise afterwards are widely used approaches. They do not necessarily make the procedure easier, but they make the experience manageable. Postponing the procedure when a child starts to cry is often the right choice too, since learning to cope with the discomfort works better than allowing the fear to continue.

How vaccine decisions are made

Every decision about a vaccine is made by the doctor who knows the child's condition. There are situations in which a dose is deferred; these are assessed according to the child's health at that moment, a recent infection and earlier reactions to vaccines. A deferral is completed once the circumstances allow.

If you have doubts about vaccines, it is better to voice them than to keep them to yourself. The source of the worry is often a previous experience with a different vaccine, or information that has been misread. An open conversation prevents the record from being left half-finished.

Common questions

Should the family keep track of the schedule?

The schedule is held on the vaccination card, in the provider's record system and in the doctor's notebook. The family should know it too. Bringing the card to the appointment shows which dose is outstanding and when the next one falls due.

Is a slight fever after a vaccine normal?

A slight fever, redness at the injection site or a little restlessness are common reactions that usually settle within a few days. A high fever, prolonged crying or a rash means the doctor should be contacted the same day; if there is swelling of the face or difficulty in breathing, call 112 or go to the nearest emergency department immediately. Knowing the difference helps you call at the right moment.

Can a child catch up if a vaccine was missed?

A catch-up plan is made for missed doses, and the doctor draws it up according to the child's age and condition. Leaving vaccines pending is not the point; identifying what is missing and completing it is. Keeping the record up to date makes the gap easier to notice.

My child is frightened of injections. What can I do?

Not dismissing the fear and giving a simple explanation before the appointment are the steps that work best. Staying close during the procedure, holding the child's hand and offering calm praise afterwards are often enough. Postponing the procedure when the child begins to cry is also reasonable.

My child is ill at the moment. Should the vaccine go ahead?

When a child has a fever, or has recently had an infection, the doctor decides how the vaccination plan should proceed. It is enough to share that information during the examination; the decision does not rest with you.

Immunisation follow-up and vaccine advice are carried out by Dr. Murat Palabıyık, a paediatrician and neonatologist, at Elit Istanbul Medical Center in Florya, Bakırköy. The contact page holds the appointment options.