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VACCINES USED IN KENYA AND THEIR SIDE EFFECTS

A vaccine is a substance derived from a pathogen or synthetically made and is administered in order to provide immunity against diseases. A vaccine is antigenic substance as opposed to being pathogenic. This confers artificial or active immunity to the individual. Artificial immunity can last from a few months to many years and booster doses can be administered to boost the immunity even further. Vaccination in Kenya usually lasts from 0 weeks in children to 18 months.

TYPES OF IMMUNIZING AGENTS

Immunizing agents are in three major groups, vaccines immunoglobulins and antisera

·         Live attenuated vaccines

·         DNA vaccines

·         Recombinant factor vaccines

·         Conjugate vaccines    

·         Inactivated vaccines which include, whole or fractional

Vaccines also contain active and inactive materials. Inactive materials include, adjuvants, preservatives, salts, stabilizers and diluents.

Vaccines used in Kenya for children include, BCG, polio, diphtheria, yellow fever HEB, pneumococcal tetanus, measles and pertussis.

BCG

BCG stands for Bacillus Calmette–Guérin. It is a live attenuated vaccine of the Bacillus Calmette–Guérin of mycobacterium bovis. It is usually administered within two weeks of birth and repeated if scar doesn’t form. The dosage is 0.05 mls. BCG gives immunity against tuberculosis. However it should not be administered to immunocompromised children or where immunosuppression is anticipated as in organ transplant. BCG is given as an intradermal injection to the right upper third of the hand.

SIDE EFFECTS

·         Axillary and cervical lymphadenopathy

·         Suppurative lymphadenitis

·         Fever

·         Anorexia

·         Myalgia

·         neuralgia

Management of side effects is usually symptomatically. If symptoms are severe the child can be admitted for specialized care.

POLIO VACCINE

It is a live attenuated polio virus. It administered at first contact with the child or within two weeks of birth, six weeks and ten weeks. The three doses are usually adequate to stimulate seroconversion. Polio vaccine is given orally.

SIDE EFFECTS

·         Irritability

·         Tiredness

·         Tenderness

·         Persistent crying

·         Loss of appetite

Management is asymptomatically. Paracetamol is usually prescribed for pain and fever and irritability.

PNEUMOCCCAL VACCINE (PCV 10)

Is usually administered during 6, 10 and 14 weeks. It’s a dead vaccine. Children are usually given pneumococcal conjugate vaccine. PCV 10 protects against 13 strains of pneumococcal viruses. PCV 10 is given as an injection to the left outer aspect of the thigh. The dose is usually 0.5 ml of the vaccine.

SIDE EFFECTS

·         Irritability

·         Fever

·         Reduced appetite

·         Persistent crying

·         Redness at the site of injection

·         Not sleeping well

·         Severe adverse reactions include severe allergic reactions and febrile convulsions.

Management of unwanted effects is usually symptomatically. If there is pain and fever, oral paracetamol is given. For reduced appetite, small frequent feeds is administered.

Dpt Hep A, Hep B

Two doses of 0.5 mls are given at 6weeks, 10 weeks and 14 weeks of child’s life. This vaccine provides immunity against tetanus, diphtheria, hepatitis A and B and pertussis It is usually given as a deep intramuscular injection to the outer aspect of the thigh. This is a toxoid vaccine which makes the body produce antibodies against the real toxins.

SIDE EFFECTS

·         Lymphadenopathy

·         Pain and swelling at the site of injection

·         Headache

·         Muscle pain

·         Stomach upsets

Management of side effects is symptomatically but adverse events may need admission for specialized care.

ROTA 2

Is a live vaccine. It is given orally to children and provides immunity against rotavirus which causes diarrhea in children. It is given in two doses of 1.5 mls orally at 6 and ten weeks. It is contracted in immune suppressed children.

SIDE EFFECTS

Unusual tiredness

·         Nausea

·         Headache

·         Irritability

·         Muscle weakness

·         Sore throat and stuffy nose

·         diarrhea

Management of unwanted effects is symptomatically. Adverse events require admission for specialized care.

MEASLES VACCINE

This is a type of live attenuated virus. The dosage is 0.5 mls given subcutaneously into the deltoid muscle of the right hand. It is given at 9 and 18 months. It provides protection against measles, mumps and rubella.

·         redness, pain and swelling at injection site

·         headache

·          dizziness;

·         mild fever;

·         joint or muscle pain

·         diarrhea

more serious unwanted effects include problems with hearing or seeing problems, extreme drowsiness and seizures. These require immediate attention in a hospital.

YELLOW FEVER VACCINE

This is another example of live attenuated vaccine given at nine months in yellow fever endemic areas. It is given as an injection to the subcutaneous region of the deltoid muscle of the left arm. The dosage is 0.5 mls. It is contraindicated in immunodeficiency’s and malignancies and in instances where organ transplantation is anticipated.

SIDE EFFECTS

·         Headache

·         Soreness and reddening of injection site

·         Low grade fever

·         Muscle pain

Management of unwanted effects is symptomatically with more serious ones requiring admission.

References

USAID.immunization Essentials:A Practictial guide. 2003 U.S Agency for International Development

Min. of Health Report on KEPI program Review, 27 January to 13 February, 1986, pg.2-28 A MOH/DANIDA Document, 1986