Key points to remember about immunisation

• immunisation protects your child against a range of serious and sometimes fatal diseases
• immunisation on time is the most effective way to protect pregnant mums, babies and children from preventable disease
• immunisations begin when your child is 6 weeks old
• immunisations on the National Immunisation Schedule are free in New Zealand for babies, children and young people until their 18th birthday
• the benefits of immunisation far outweigh the risks

Why does my child need immunisation?

In the past, diseases such as diphtheria, tetanus and whooping cough killed many children. Today, we use vaccines to immunise children against these and other diseases.

Immunisation has wiped out some of the killer diseases of childhood in New Zealand.

• tetanus is very rare - although it still happens in children who haven't been immunised
• New Zealand is free of polio and diphtheria

But, these diseases still exist in other countries.

Watch this video jointly produced by Auckland District Health Board (DHB), Northland DHB, Waitemata DHB and Counties Manukau DHB. A paediatrician briefly talks about the importance of immunisation. The video also features a family talking about their experience of immunisation.

Watch a series of 10 short videos answering your questions about immunisation [2]

Watch some short videos about protecting your child from serious diseases [3]

Current and recent epidemics in New Zealand

There have been epidemics or outbreaks of some diseases in recent years in New Zealand, including:

• whooping cough (pertussis)
• measles
• mumps

The following diseases have also been having a significant impact in our communities:

• pneumococcal disease
• chickenpox

Funded vaccines against the following diseases are available for children in New Zealand

• chickenpox (varicella)
• diphtheria
• hepatitis B
• Haemophilus influenzae type b (Hib)
• measles
• mumps
• pneumococcal disease
• polio
• rotavirus
• rubella
• tetanus
• whooping cough (also known as pertussis)
• human papillomavirus (HPV)

We immunise against these diseases because they can cause serious (and sometimes fatal) illnesses to our children, or cancers later in life, and we have effective immunisations available against them.

Immunisation protects your child. It also protects those most at risk from these diseases. This includes babies who are too young for immunisation or children with weakened immune systems. These babies and children rely on those around them being immunised.

For information on these diseases, see:

• available immunisations [4] at the Immunisation Advisory Centre (IMAC) website
• call IMAC on 0800 IMMUNE (0800 466 863), weekdays 9am - 4.30pm

Where to go for immunisation

The practice nurse at your family doctor's surgery can immunise your child.

The National Immunisation Schedule

[5]

[6]

The National Immunisation Schedule is the series of immunisations that are free for babies, children and teens (and adults). The Schedule lists the immunisations and the age your child can have them.

You can see the current schedule on the Ministry of Health website. [7]

It is important that your child has their full course to ensure continuing strong protection. Children need immunisations on time as delaying them leaves them at unnecessary risk of infection.

Some children may have special requirements. For example, some babies with specific risk factors may be offered:

• hepatitis B immunisation at birth - for all babies whose mothers have hepatitis B
• BCG immunisation to protect against tuberculosis
• meningococcal immunisation for those at increased risk

Discuss your own child's needs with your doctor.

Be there for your baby during immunisations - if you are confident, your baby will be too

After the immunisation, your child may cry for a brief time. This is their way of coping - comfort and hold your child, and talk supportively.

Parents can help decrease anxiety about immunisations in a number of ways.

• start immunising on time at 6 weeks of age
• remain calm and relaxed, even when your child becomes upset
• breastfeeding reduces baby's pain
• book your appointment early in the day before everyone is tired
• plan a calm day
• bring along a stuffed toy or blanket for your child to hold during the immunisation, or use them yourself as a tool for distraction
• hold your child firmly during the procedure, talking calmly and gently stroking your child's arm or back
• after the immunisation, your child may cry for a brief time but this is their way of coping - comfort and hold your child, and talk supportively
• you will need to remain in your doctor's clinic for 20 minutes after the immunisation
• rather than leave immediately, stay in the clinic until your child has calmed down - this will help your child to remember the clinic as a nice place and will help to make the next visit easier
• for babies, book your appointment to allow you to feed your child immediately after they have had their immunisation

After immunisation

Reactions to immunisation

Around 1 in 10 children can expect a reaction to an immunisation. The vast majority of these are mild, such as redness on the arm or a grizzly child for a day or two. A reaction is an expected sign that the immune response is building and the vaccine is working. Occasionally, more concerning reactions occur like prolonged crying. Although worrying at the time, research shows there are no long-term problems following such reactions. However, if you are concerned, contact your nurse or doctor.

Very rarely, a serious allergic reaction (anaphylaxis) can happen. This is treatable and occurs very shortly after the injection. This is why you must wait at the clinic for 20 minutes after immunisation. If you are concerned, contact your practice nurse or doctor straightaway.

Paracetamol and immunisation

You don't need to give babies and children paracetamol before immunisation. If your child is miserable or distressed with a fever after immunisation, you can give a dose of paracetamol. You must follow the dosage instructions on the bottle. It is dangerous to give more than the recommended dose.

Using paracetamol around the time of immunisation reduces the immune system response to immunisation when measured in a laboratory. But, there is no evidence that the reduced response decreases protection in children aganist the diseases they were immunised against.

Informed choice

Immunisation is not compulsory in New Zealand but it is a wise parenting choice. There is a lot of information on immunisation and this can be confusing. It's important to check out the source of the material before accepting the conclusions offered. Question critically:

• is it based on sound evidence?
• is it up to date information taking the latest research into consideration?
• does it relate to New Zealand?

Discuss any questions or concerns with your family doctor or practice nurse.