The Star Online: Lifestyle: Health
The Star Online: Lifestyle: Health |
| Posted: 08 May 2013 01:45 AM PDT Vaccines are undoubtedly one of modern medicine's greatest success stories. THE advent of vaccines in medicine has saved millions of lives all over the world. Diseases like smallpox have been eradicated, while other diseases such as polio are near being eradicated – Malaysia and the Western Pacific Region has been polio-free since October 2010. Not only are vaccines responsible for the control of many infectious diseases, they also protect both those who receive them and those whom they come into contact with. Vaccination plays a vital role in your child's health. Vaccines were developed to protect against dangerous and often fatal diseases. Although your child's body produces cells and antibodies to fight off viruses and bacteria, there are certain types of germs that are associated with an increase in morbidity or severity of the disease. Although getting your child vaccinated does not offer a 100% guarantee of avoiding the disease, it does greatly help to reduce your child's chances of contracting the disease. Furthermore, if your child does get infected, the symptoms are often milder and the chances are higher that he recovers faster. For example, the chickenpox vaccine will induce immunity such that if the child is exposed to an infected person, the ensuing symptoms will be mild. Looking at the larger picture, immunisation leads to lower healthcare spending for the treatment of infectious diseases. Immunisation is the most successful health intervention you can provide your child. It is also cost-effective as the cost of treating the disease itself would undoubtedly be more expensive. Vaccinating the younger generation means more community immunity against disease outbreaks. Even those who are not eligible for vaccination (such as infants, pregnant women, or immune-compromised individuals) are protected because the spread of a disease is contained. This is called "herd" immunity. In Malaysia, vaccines are divided into those grouped in the National Immunisation Programme (NIP) and those that are known as "optional" or recommended vaccines. Most parents have the misconception that if a vaccine is optional, it is therefore not as important or necessary as a vaccine given in the National Immunisation Programme. Vaccines were developed to protect against dangerous and often fatal diseases; recommended vaccines are no less important than the ones in the national programme. Are vaccines safe? Vaccines are very safe as they have been tested extensively for safety by the manufacturer and the US Food and Drug Administration (FDA). This process takes many years before the vaccine in question gains approval for commercial use. The phases of clinical development of any vaccine are: Phase I – small groups of people given the trial vaccine. Phase II – expanded group to include people with characteristics similar to those for whom the vaccine is intended. Phase III – given to thousands of people and tested for efficacy and safety. Phase IV – ongoing studies after the vaccine is approved and licensed. It normally takes several years before a vaccine can be licensed, and the rigorous tests conducted all work to ensure that vaccines that have been licensed are safe for use. In fact, once a vaccine is in use, the US Centers for Disease Control (CDC) and FDA will continue monitoring it for any adverse events via the Vaccine Adverse Event Reporting System (VAERS). If any potential problems are detected, both the CDC and FDA will initiate further investigations, and depending upon the severity of the problem, additional warnings may be printed on the vaccine's labels/packaging or the vaccine's licence could even be revoked. Examples of vaccines that have been revoked include the first rotavirus vaccine called "Rotashield" that was associated with increased incidences of intussusception (a form of intestinal obstruction in infants). This has been meticulously monitored in current vaccines. Like any medication, vaccines have been known to cause some side effects. Most of the effects are very minor (like soreness where the shot was given, irritability or a low-grade fever) and typically last for only a few days. Serious reactions to vaccines are very rare. What is the NIP? The World Health Organisation (WHO) has a list of vaccines that are required to be given by every country to its children, called the Expanded Programme on Immunisation (EPI). Every country has its own national programme based on affordability, and the Malaysian NIP is no different. However, the vaccines under the NIP exceed the EPI from WHO. What are mandatory/compulsory vaccines? The vaccines provided for under the NIP are mandatory vaccines that the Malaysian Health Ministry has introduced into its immunisation schedule to prevent most of the major childhood diseases (like tuberculosis, hepatitis B, diphtheria, pertussis, tetanus, measles, Haemophilus influenzae infections and congenital rubella syndrome). These vaccinations are provided for free by the government to children at different ages. What are recommended (optional) vaccines? Optional or recommended vaccines are not mandatory in Malaysia as they are not part of the NIP. However, these vaccines have been proven to be highly effective and can help prevent potentially fatal infections of diseases that they protect against. Some examples of infections include those caused by the pneumococcus bacteria and rotavirus, which have been known to lead to severe complications that can be fatal. These recommended vaccines are readily available in private practices all over the country. Recommended vaccines that are available include vaccines that protect against: > chickenpox > invasive pneumococcal disease > influenza > hepatitis A > meningitis (caused by meningococcus and pneumococcus) > cholera > rotavirus > typhoid fever > Japanese encephalitis What are combination vaccines, and are they safe for children? Combination vaccines are vaccines that protect against many diseases in a single injection. There are a few different types of combination vaccines. These include MMR (Measles, Mumps, and Rubella) and DTaP-IPV-Hib (Diphteria, Tetanus, acellular Pertussis – Inactivated Polio Vaccine – Haemophilus influenzae type b) under the immunisation schedule, as well as MMRV (Measles, Mumps, Rubella, and Varicella) and DTaP-IPV-Hib-HepB (Diphteria, Tetanus, acellular Pertussis – Inactivated Polio Vaccine – Haemophilus influenzae type b – Hepatitis B), which are available in private practices. Many parents are worried that their children may not be able to handle the high dosage of antigens given in a single shot. However, studies have shown that children's immune systems are capable of handling even more antigens than those introduced by combination vaccines. With the combination vaccines, the total number of injections and number of visits for vaccination are reduced. Can vaccines cause autism? No! Scientific studies and reviews continue to show no relationship between vaccines and autism. Some people have suggested that thimerosal (a compound that contains mercury) in vaccines given to infants and young children might be a cause of autism, and others have suggested that the MMR (measles- mumps-rubella) vaccine may be linked to autism. However, numerous scientists and researchers have studied and continue to study the MMR vaccine and thimerosal, and have reached the same conclusion: there is no link with autism. The link between the MMR vaccine and autism started from a study in 1998 in Britain which claimed that the MMR vaccine contributed to the development of autism; this study has since been discredited, with 10 of the study's authors withdrawing their support of the study. The journal that it appeared in had also retracted the paper from its archive. Do vaccines contain contaminants like cow pus, horse urine, etc? This myth can be traced back to its origins in 1796 when Edward Jenner made the first smallpox vaccine using biological material from cowpox. Modern vaccine production methods have improved tremendously since the 18th century and such contaminants have been eliminated. Furthermore, since most vaccines are given by injection into the muscle/subcutaneous tissue, they need to be sterile so as not to cause a reaction. It is impossible for vaccines to have contaminants without causing serious side effects. Are vaccines causing an increase in asthma and skin diseases? There are many factors associated with asthma, eczema, and atopy. Among them are hereditary (asthma runs in the family), environmental pollution (both outdoor and indoor), secondary and tertiary smoking, respiratory infections (especially in early infancy), and many more. There is no study that links vaccinations with asthma or allergies. To isolate vaccines as a cause of these related disorders without taking into account the above variables is an unfavourable bias towards vaccination. All vaccines have been shown to be a safe and effective way of protecting children and adults from potentially serious illnesses. Young children and the elderly are especially vulnerable as they have a relatively weaker immune system and may run the risk of suffering complications should they contract any of these diseases. It is thus much better to prevent these diseases than to regret the consequences that could follow. Choosing not to vaccinate puts your children, and other people, at risk of getting vaccine-preventable diseases. Datuk Dr Zulkifli Ismail is a consultant paediatrician and paediatric cardiologist. This article is courtesy of the Positive Parenting Programme by the Malaysian Paediatric Association, supported by an educational grant from GlaxoSmithKline. The opinion expressed in the article is the views of the author. For further information, please visit www.myposi tiveparenting.org. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader's own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. |
| Milk allergy and lactose intolerance Posted: 08 May 2013 01:52 AM PDT Do not confuse milk allergy with lactose intolerance; they are very dissimilar conditions. I AM extremely worried about my newborn baby. I fed her some formula milk and she started to vomit. I took her to a paediatrician and the doctor said that it is possible my daughter has milk allergy. What is milk allergy? Milk allergy is one of the most common food allergies to be found, occurring especially in children. Luckily, most of them outgrow this allergy by age three. As you grow older, your digestive tract matures, and you are less likely to react to milk. Milk allergy is actually an abnormal response mounted by the body's immune system – as most allergies are – to milk and products containing milk. The latter may include cheese and butter. The usual cause of milk allergy is cow's milk. That is why all doctors advocate mother's breast milk for babies. Milk allergy can also stem from goat's milk, sheep's milk and buffalo milk. Some children are allergic to cow's milk as well as soy milk. Is milk allergy the same as lactose intolerance? My whole family, from my father and mother, have lactose intolerance. No. Milk allergy is not the same as lactose intolerance. Milk allergy is a true allergy, mediated by immune factors. Lactose intolerance is the inability to digest lactose, which is a type of sugar found in milk and dairy products. It is a genetic condition. Lactose intolerant individuals have a deficiency of the enzyme lactase, which hydrolyses lactose into glucose and galactose. This results in cramps, abdominal bloating, gas, flatulence, diarrhoea, rumbling stomach and sometimes vomiting after consuming these milk and milk products. What causes milk allergy? In milk allergy, your child's immune system happens to be hypersensitive to certain milk proteins like casein and whey. These proteins trigger the release of Immunoglobulin E (IgE), and the resultant immune response involves the release of histamine. Casein is the curd, which is actually the solid part of the milk which appears when it is curdled. Whey is the liquid part of the milk that remains after it is curdled. You may be allergic to one or both. How do I recognise the symptoms of milk allergy? My baby would not be able to tell me anything that is bothering her because she's too young. The symptoms will vary from child to child. Some will occur within minutes to hours of ingesting the milk or eating the milk products. Look out immediately for: > Weals or raised reddish patches (urticaria or hives) on your child's skin. > Vomiting. > Wheezing or hoarse breathing. Then there are signs and symptoms that may take a bit more time to manifest: > Diarrhoea or loose, soft stools which may or may not contain some blood. > Stomach cramps or colic (for babies). > Coughing. > Wheezing: this may also occur later rather than earlier. > Skin rash, sometimes itchy, around the mouth area. > Runny nose. > Watery eyes. A very bad complication to look out for is anaphylaxis, which is a life-threatening allergic reaction that may result in severe constriction of lung airways, flushing, itching, and worse of all, anaphylactic shock resulting in a drop in blood pressure. For milk allergies, whether your child's symptoms are mild, moderate or severe, it's always best to consult a doctor immediately. Go as early as you can because of the possible complications. Are certain children more prone to developing milk allergy? Yes. A child who is allergic to other things is also more prone to develop milk allergy. However, it is usually the milk allergy that develops first. If your child has atopic dermatitis (inflammation of the skin), a family history of food allergy (such as one or both parents have food allergy, hay fever, asthma, eczema or any other type of allergic diseases), he is at greater risk of developing milk allergy. What can I do to treat my child's milk allergy? The only way is to make sure that your child avoids milk and milk products completely, which can be difficult sometimes. Medications that help include antihistamines, or in case of anaphylactic shock, epinephrine injections. Some parents even have epinephrine and some syringes at home as an emergency measure just in case they can't get to the hospital in time. Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health advice, computers and entertainment. For further information, e-mail starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. |
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