Baby Vaccination Questions Answered — Painless vs Painful, Government vs Private, and Common Myths

Dr. Sandip Gupta

A podcast episode answering the vaccination questions and myths that worry new parents most. Painless vs painful vaccine. This concept applies only to the DTP vaccine. If you look at your vaccine card it says DTwP or DTaP. DTwP uses whole cell pertussis, which causes more reaction — more fever, more swelling, some pain, and in earlier times a small chance of seizures in some children. Science then removed the cell wall to make the acellular pertussis vaccine, DTaP, which in lay terms is called the painless vaccine, with less swelling, pain and fever. If a painful vaccine causes 100 units of reaction, the painless causes about 20. Cost: the painless (DTaP) is costlier; the painful is cheaper. Effectiveness: comparing a single dose, the painful DTwP's protection lasts longer. But since this vaccine is given repeatedly — at 6 weeks, 10 weeks, 14 weeks, around 1.5 years, between 4 and 6 years, and at 10 years — the difference does not matter much. Both are effective. Choose painless if you prefer less pain for the child or you are a nervous parent; the painful vaccine is also completely safe. For pain and swelling, give paracetamol drops and apply a little ice — it settles in a day or two. Government vs private centres. All essential life-saving vaccines — for diseases that threaten life, such as polio and tetanus — are provided free by the Indian government to every child. These are equally available privately. The additional vaccines available only privately are: influenza (flu), typhoid, chicken pox, hepatitis A (which causes jaundice and liver problems), and HPV / cervical cancer vaccine — five vaccines not currently available in government centres. Painless vaccines are available only privately, because their cost is high; the government provides the painful DTwP version. The doctor's practical advice on cost: Private vaccines cost more because private companies make and sell them and the doctor's charge is added, whereas the government buys in large quantity and bears the cost for public welfare. Both government and private vaccines are equally effective — there is no difference in quality. If the private cost is not affordable, take every vaccine available at the government centre, following the card date-wise at your nearest government or anganwadi centre; that protects your child from the serious, life-threatening diseases. If you can afford and wish to, take the additional vaccines privately from your nearby pediatrician. Can multiple vaccines be given in one day? Yes. Two or three vaccines in a day, as recommended on the vaccine card, cause no extra harm. Multiple vaccines in a day are as effective as a single vaccine. Parents get frightened seeing injections in both legs plus an oral vaccine, but there is no problem. Vaccinating when the child has a cold or fever. As per scientific guidelines, if there is a mild cough and cold and the child is not very unwell, the vaccine should be given — mild cold and cough makes no difference. Delay usually happens because parents are afraid, and a lot of time passes. Timely vaccination gives the best protection. If the child has a heavier cold or fever, you can keep a small buffer of two or three days, or give it within about a week once the child is stable — discuss with your doctor. Why polio vaccine continues though India is polio free. Polio was eradicated in India in 2014. But polio spreads through water contamination, and neighbouring countries such as Bangladesh, Pakistan and Afghanistan still detect it sometimes. If we stop vaccinating, herd immunity — the collective immunity of India's children against polio — will drop, and polio could spread again from outside. So a basic level of immunity is maintained by keeping polio vaccine in the schedule, though pulse polio activity has been strategically reduced compared to earlier. What happens after a vaccine. Most children have no serious problem. Fever for a day or two, usually not very high. Painful vaccines sometimes cause a bit more fever, which is why the doctor prescribes paracetamol along with the vaccine. The injection site may become red, swollen and a little painful — wrap ice in a cloth and apply lightly. Feed the child frequently and hold them in your lap to comfort them. Some vaccines occasionally cause a rash; if anything beyond fever, local swelling or pain appears, consult your doctor. Today's vaccines are quite safe. Myth — don't feed immediately after a vaccine. Not true. You can feed during and immediately after the vaccine; there is no restriction on feeding. Newborns must be fed, feeding maintains their nutrition, and it also settles the child. Milk is often given at the time of the injection so the child stays calm. Small children can be vaccinated while held in the parent's lap — the doctor prefers this in his clinic so the child is less frightened and cries less than when laid on a bed. Myth — MMR vaccine causes autism. Some years ago a fraudulent research created this concept. That research has been completely disproved and discarded, and no one accepts it now. Extensive subsequent research has made it absolutely clear that MMR does not cause autism — there is no doubt left, and MMR is totally safe. Crores of children receive it every year in India, in both government and private settings. Autism's causes are largely genetic and social — for example, excessive screen time is causing virtual autism these days — but MMR has nothing to do with autism. BCG vaccine and the mark it leaves. BCG protects against tuberculosis, particularly its severe forms such as TB in the brain or TB spreading through the body. In India it is given to every child right after birth, before hospital discharge, in the left upper arm — which is why most people have a scar there. Its natural course: no reaction for the first two weeks; between two and four weeks a small red bump forms; at four to six weeks the bump swells and may burst or slowly dry up; and between six weeks and three months a scar forms. This happens in all children and is nothing to panic about. When the ulcer forms there may be slight discharge — this is not a new infection, it is due to the BCG bacteria given into the skin. No antiseptic and no antibiotic are needed; just clean it with clean water and cotton gauze, and it does not need to be covered. Many mothers are never told this, which is why they get frightened, and most anxiety happens simply because information does not reach parents properly. Flu vaccine — will the child never get a cold again? No. Common cold is caused by some 100 to 200 viruses already in the environment; flu (influenza) is just one of them, and a more serious one. Like the COVID vaccine, which prevents serious illness and hospitalisation rather than all infection, the flu vaccine prevents serious illness from influenza. Other viruses like RSV and rhinovirus can still cause ordinary cold and cough. So the child can still catch a cold — but the flu vaccine protects against the serious cold, cough and fever. JE and MCV vaccines — both optional. JE is Japanese encephalitis, a brain fever caused by a virus, present in many districts and parts of India — Karnataka has 10 identified districts, and belts in Bengal, Jharkhand and Odisha have a high burden. It is a very serious disease with chances of paralysis, permanent brain damage and death. Government guidelines make JE vaccination essential in affected areas, where the government includes it free in its schedule. The doctor often gives it after asking parents, since it has few side effects and its cost is not high. MCV is the meningococcal vaccine — meningococcus is a bacteria that causes brain fever. It is not mandatory in India, is quite costly, and has somewhat more swelling as a side effect. It is recommended for immunodeficient children whose immunity is weak due to some illness, for people travelling to the USA or cold countries where the disease is more common, and often for Haj pilgrims. Discuss with your doctor; take it if your doctor advises it. Missed vaccines — catch-up schedule. If you didn't know about the additional vaccines and your child is now three or four years old, you can still get them. This is called a catch-up schedule, and it has rules that your pediatrician knows. Catch-up does not mean starting again from scratch — the doses already given are counted, and only the remaining ones are given. This works whether the missed doses were government or private. Relevant for: parents choosing between painless and painful vaccination; parents asking whether government vaccines are as effective as private ones; parents asking which vaccines are free and which are only available privately; parents worried about two or three injections in one day; parents wondering whether to vaccinate when the child has a cold or fever; parents asking why polio drops continue in a polio-free India; parents dealing with fever, swelling or redness after a vaccine; parents told not to feed after a vaccine; parents worried the MMR vaccine causes autism; parents frightened by the red bump, ulcer or discharge at the BCG site; parents asking whether the flu vaccine stops all colds; parents asking about JE and meningococcal vaccines; and parents whose child has missed vaccines and want to know about catch-up. Disclaimer: This video is for general information and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Every child is different — please consult your pediatrician about your child's vaccination schedule, which optional vaccines are suitable, and the correct medicine and dose for fever after vaccination.