When it comes to baby vaccinations it's hard to know who feels the greatest pain - the baby who gets the jab or the parent who holds her.
Most parents dread taking their baby to be vaccinated - and that includes doctors, however much they talk about how lucky we are to be able to protect our children from infectious diseases. The dread is linked to a natural fear that by vaccinating your healthy baby you will harm her.
It feels unnatural to inject your baby with a cocktail of vaccines to kick-start her immune system. How can a tiny baby cope with such an assault? Surely it's more natural to expose your baby to the disease itself? And now that we're so well-nourished and healthy, a dose of whooping cough would surely be no match for a strapping toddler?
"Both my parents nearly died from measles as children, so why people take this illness lightly, I don't know." Beansprout
These arguments appear persuasive, but the scientific evidence is firmly on the side of vaccinating your baby. Children are very, very rarely damaged by vaccines (although to be fair, proving a vaccine caused a child to become brain damaged is not easy).
The trouble with any successful immunisation programme that has largely eradicated childhood infectious diseases is that we have all forgotten the harm these diseases can do. We think of them almost affectionately - dear old measles, funny old mumps (even the names are cute). Our generation can't recall the iron lungs that people with polio spent their lives in.
There are risks and benefits to anything in life and especially in medicine. Because vaccinations have worked and so few people get the diseases any more we only see the risks. But parents must be informed by doctors about the risks as well as the benefits. Any doctor who doesn't have the time to discuss a parent's worries had better get out their old textbooks and start learning what these infectious diseases look like. Because it doesn't take much of a fall in immunisation levels for epidemics to flare up.
FAQs about baby vaccinations
The infectious diseases of childhood have been largely wiped out so why do we need to vaccinate our babies?
Improvements in socio-economic conditions have helped reduce the rate of transmission of infections and made it more likely that children will survive any infections they do get. But the real falls in rates of infections occurred when vaccines were introduced. Meningococcal C vaccine, introduced in November 1999, which immunises against a form of meningitis common in babies under one year and teenagers between 15 to 17 reduced infection rates by 75%.
"You get MMR, that has its own risks. You get singles, they have risks (and costs). You get no jabs at all, that option has risks. Get away from the idea that there is an obvious safe option better than all the others." alardi
When immunisation rates fell after a scare about whooping cough vaccine in Britain in 1974, the effect was devastating - 100,000 children caught whooping cough and 36 died within the next four years.
Immunisation rates have to be high - sometimes over 90% - to avoid disease epidemics. Before vaccinations against diphtheria, one child died every five hours from the disease.
Also remember that your child might like to go abroad for holidays - where rates of infectious diseases are often higher than in the UK. Beware of bringing back a rash with the suntan.
Vaccinations don't always work so why have them?
They don't always work but most have over 90% success rates, with many over 95 percent. What's more, if you have been vaccinated and get the infection you generally have a less serious form of the illness.
Isn't it safer to have the natural form of the infection than a vaccine?
No. Rates of complications from all the diseases in their natural forms are far higher than those from vaccinations. For example:
- The risk of inflammation of the brain (acute encephalopathy) after measles, mumps and rubella is one in a million - for mumps infection it is one in 300
- One in 2,000 children who catch measles will have inflammation of the brain - 25% of those will have brain damage and one in 3,000 children who get measles will die
- One in 20 children who gets whooping cough may get inflammation of the brain compared with five in a million with the vaccine
Mumps can cause sterility in men in later life, German measles can cause deafness, and you don't have to be unhealthy to start with to suffer the complications of these diseases.
Millions and millions of babies worldwide have been vaccinated and followed up for side effects. Medical opinion is that the benefits outweigh the risks many hundreds of thousands time over - but no one can decide for you. And, of course, all this is no comfort to the mother of the child who is the one in a million damaged by a vaccine.
By vaccinating your baby, can't you overload its immune system?
It's an understandable concern but the vaccines work to the same principle as when your baby is exposed to any infection - it makes antibodies. When the infection comes round again it has learnt to recognise that particular enemy and can make antibodies so quickly that the infectious agent is defeated at the doorstep. Babies are exposed to many foreign agents each day - an ordinary cold may expose your baby to between four and ten of them.
Vaccines are made to act by exposing your baby to a tiny proportion of the foreign agent so she can learn how to fight off the disease without having to suffer it. We're talking tiny bits of the foreign agent, some of which have been killed, others which have been modified to make them harmless. Babies can cope.
It's worth saying that homeopathy cannot immunise children against infectious diseases. Many homeopaths are happy to admit this and support immunisation.
Why can't my baby be let off being vaccinated if everyone else is having their baby vaccinated?
Herd immunity - as it's attractively called - means that it's right to some extent to think: "I'm alright Jack - everyone else is making sure my child's safe by getting their children immunised." Most parents do get their children immunised, but there will be some children who cannot be immunised because they have no immune systems to speak of and couldn't cope with the vaccination.
"I believe there's a social responsibility involved to protect the tinies and the children who have compromised immune systems and can't have immunisations.
People who choose not to immunise their children are relying on those of us who do to protect their children from illness." midnightexpress
There will always be people who won't have had vaccinations or will have had them but they might not have worked completely.
No one would want to give a pregnant woman (your neighbour, for instance) who wasn't immune to German measles a dose of an infection that could damage or even kill her unborn child.
Also, if you travel to some other countries you can't be sure they have herd immunity.
What about the links with autism and inflammatory bowel disease
There was lots of media coverage of research published in the Lancet linking autism and inflammatory bowel disease with measles, mumps and rubella vaccine.
Government groups in the UK and US both found no evidence for these assumptions, criticising the way the studies were carried out and citing bigger studies that did not show a link.
Autism is often diagnosed at a time when babies will have recently been immunised and so it's understandable parents should link the two events. But this does not mean that one causes the other.
Finland has very thorough records of immunisations and for inflammatory bowel disease and has found no link between the two after studying hundreds of records. Other studies from Sweden and North London have shown no risk of autism.
The Lancet study suggested that people might separate out the vaccines and give them separately, thus meaning more visits and more jabs and more risk of catching the diseases in between. Most doctors don't think this is a good idea.
What vaccinations should my baby have and when?
If you have been convinced or even slightly reassured by reading the above you are obviously a very reasonable person and will visit your GP (your health visitor will tell you anyway) for a baby vaccination schedule.
Be honest with your child without freaking them out - say what it involves, that it hurts like a bee sting but is soon over. Try to be calm yourself.
What will happen to my baby after her jab?
Children often have sore lumps from the vaccination and may be fractious and a bit warm. Squirting a tiny amount of paracetamol (Calpol) into their mouths with a syringe (please read the dosage instructions) will make you feel as if you're doing something (but it will probably come straight out again).
Some children are completely fine, others cry pitifully and won't sleep. Give them plenty of skin-to-skin contact.
The reaction, if there is one, mimics the onset time for the disease, so for measles, for example, it will take about ten days for symptoms to develop and again these may mimic the disease, with a fever and cough.
When children get older it's easier for them to take paracetamol but don't overdose them. Never give your child aspirin as it can cause brain damage in children. If you're worried about your child phone your GP.