Vaccination: Frequently Asked Questions (FAQs)

What are vaccines, and why do people need vaccinations?

Vaccines are medicines that boosts your ability to fight off certain diseases. Most of the vaccine-preventable diseases are highly contagious and even deadly in non-immunized individuals. Before the development of vaccines, these diseases killed or disabled millions of people. The successful use of vaccines has almost eliminated many of these infectious and fatal diseases that are still dangerous and may kill people who are not protected adequately from them.

What are the benefits of vaccinations?

Vaccines have proved to be highly effective and a vital form of primary prevention as they are designed to prevent diseases. Vaccinations have enabled us to control diseases that once threatened numerous lives, such as:

• Tetanus
• Small Pox
• Chicken Pox
• Polio
• Measles
• Pertussis (whooping cough)
• Tuberculosis

Other significant benefits include:

• Vaccines Save Lives: Over the years, vaccines prevented countless cases of disease, disability and saved millions of lives. For instance, vaccines helped eradicate diseases like smallpox and polio, which were one of the most dreaded childhood diseases of the 20th century. Each year, vaccines prevent more than 2.5 million deaths.

• Vaccines Prevent Disease Outbreaks: Vaccines prevent disease outbreaks (sudden surge in the frequency of disease). Vaccines do not just protect you, they protect people around you – especially those who are not well enough to be vaccinated. This prevents the outbreak of infectious diseases that can cause long-term health issues and deaths among thousands of people

• Vaccines are Cost-Saving: Vaccine-preventable diseases can be very costly resulting in doctor visits, hospitalizations, as well as premature deaths. Besides, outbreak responses take a lot of time, money and manpower. Through timely vaccinations, a country can save billions of rupees.

Who can take vaccines, and who cannot?

Vaccines help prevent deadly and disabling diseases that in the past would sicken innumerable people every year. However, these vaccines may not be right for everyone. The CDC recommends that some people should not get certain specific vaccines, Age, health conditions including other factors all combine to determine whether you can take or avoid certain vaccine.Talk to your doctor to understand what vaccines you need and what can be avoided.

How can vaccines help?

Your immune system is an efficient system that helps protect you against pathogens that cause infection. However, certain pathogens can overwhelm your immune system. When this happens, it may cause illness. The pathogens that cause problems are the ones that our body does not recognize. Vaccination helps train or teach your body’s immune system on how to identify and get rid of an organism; it has not come into contact with before. That way, your body is fully prepared if you are ever exposed.

How can people become immune (protected)?

Protection or immunity can occur in one of two ways:

Active immunity

The first way of becoming immune is by actually getting the disease naturally. For many organisms, this gives immunity for life. When an individual is exposed again to this organism, the immune system re-establishes protection rapidly.

The second way of becoming immune is through the use of a vaccine. The vaccine interacts with our immune system and creates the same kind of protection as if the individual had natural infection. This is done without getting exposed to the risks involved when getting a natural infection.

Passive immunity

Passive immunity is provided when someone is given antibodies to prevent a disease rather than producing them through his/her own immune system. Newborn babies receive passive immunity from their mothers which lasts only for just a few months. That’s why newborns have to start receiving immunizations shortly after the birth. For some sicknesses, some shots contain readymade antibodies against certain diseases (immune globulin). We have immune globulin for diseases like rabies and hepatitis. These are also examples of passive immunity.

How are vaccines administered?

Vaccines are administration using different routes. These routes include:

1. Oral route: administered by mouth
2. Intramuscular route: injected into muscle tissue
3. Subcutaneous route: injected into the area just beneath the skin into the fatty, connective tissue
4. Intradermal route: injected into layers of the skin
5. Intranasal route: administered into the nose

Note: Each vaccine has a recommended administration site and route. Deviation from the recommended route may reduce the efficacy of the vaccine or may increase local adverse reactions as well.

What precautions can be taken before and after vaccination?

Getting vaccinated is as important for adults as it is for children. Being prepared can help you go through the process smoothly.

1. Before vaccination, find your earlier vaccination record so that your doctor knows which vaccines you have already had. If you cannot find them, you can ask your parents or your family doctor if they have saved your vaccination records. Talk to your doctor before getting vaccinated. Some people may need to wait or may not be able to get vaccinated. Inform your doctor if you:
   1. Are sick
   1. Have any allergies
   1. Are pregnant or planning to get pregnant
   1. Have had severe side effects from a vaccine in the past
2. Stay calm while you are getting vaccinated. If you are feeling nervous about getting a shot, try the following tips to stay relaxed:
3. Avoid looking at the syringe
4. Take deep breaths
5. Relax your muscles (this will make the shot less painful)
6. After your vaccination: Although many people do not have any severe side effects from vaccines,  the most common, usually mild, side effects include:
7. Chills
8. Mild fever
9. Fatigue (feeling tired)
10. Headache
11. Swelling, pain, or redness where the injection was given
12. Muscle and joint aches

Steps to help feel better if you have mild side-effects include:

• Drinking lots of fluids.
• Putting a cool, wet washcloth on places where you have soreness
• If your arm is sore after getting the injection, try to move your arm around. This can help with pain, as well as swelling
• You can take a non-aspirin pain reliever, after checking with your doctor.

Although it is very unlikely that you may experience severe side effects, if you have any symptoms that may concern you after you get vaccinated, call your doctor immediately.

Is it safe to take vaccine during this pandemic?

The World Health Organization (WHO) advises that all routine vaccinations have to be administered as per the schedule, even during the COVID-19 pandemic. Currently, there is no evidence that the COVID-19 pandemic poses any specific risk linked to vaccination. WHO recommends that it is important especially for children to receive all vaccines as per schedule.  In addition, timely vaccination is key to protect both young and old from serious and even life-threatening infectious diseases, and also to avoid the accumulation of unvaccinated groups and potential loss of community immunity.

Some interesting facts on vaccines

• Each year, vaccines prevent more than 2.5 million deaths
• Vaccines save up to 3 million children a year from deadly diseases.
• Vaccines helped reduce measles deaths worldwide by 78 percent between 2000 and 2008. Deaths due to measles dropped by 92 percent in sub-Saharan Africa in the same period.
• Thanks to vaccination efforts, smallpox had been eradicated and the number of polio cases have dropped drastically and eradicated from several countries .
• The CDC reported a 99 percent reduction in the incidence of bacterial meningitis caused by Haemophilus influenzae since the introduction of the vaccination against this disease in 1988.
• Not all vaccines are given as shots. Some vaccines are given orally.
• Most diseases that were prevented by vaccines are no longer common now. If vaccines were not used, just a few cases could quickly turn into tens or hundreds of thousands.

Adult Vaccination – Frequently Asked Questions (FAQs)

1. Why do adults need vaccines?

Vaccinations are recommended throughout your life. Even if you were fully vaccinated earlier as a child, you may still be at risk for other diseases due to your age, lifestyle, job, travel or health conditions. Besides, protection from some vaccinations can wear off over time. All adults require vaccines to protect against serious illnesses that could lead to missed work, not being able to care for family due to severe disease needing medical treatment or even hospitalization.

2. Are there any potential risks from adult vaccines?

While there some mild side-effects from vaccination, the health risk involved in not being vaccinated is real and is evidently greater than that of being vaccinated. Side effects from vaccines are usually temporary, mild and limited to soreness or local reactions at the injection site, or slight fever that goes away in few days. A few may experience allergic reactions to some vaccines, but severe and long-term side effects are rare.

Anyone about to get vaccination should be fully educated about both the benefits and the risks involved with it. Discuss any concerns or questions with your doctor.

3. Can people with severe egg allergies get an annual influenza vaccination?

The American College of Allergy, Asthma, and Immunology had published an updated guideline in December 2017. This new guidelines recommended that people with egg allergy should receive the influenza vaccine. Although the vaccine is presently manufactured in eggs, there is only negligible egg protein in these vaccine. Therefore, there is a very low risk of reaction in patients with egg allergy.

4. What vaccines can women receive while pregnant?

Pregnant women should not receive the MMR, zoster vaccines, oral typhoid yellow fever, or varicella. These vaccines are developed from live attenuated viruses and can potentially cause a problem. Pregnant women can, however receive influenza and tetanus vaccines as required. It is also safe to receive meningococcal, pneumococcal and hepatitis A & B and vaccines.

5. Are vaccine-preventable diseases really a risk for adults, and what is the impact of the disease if vaccine is not taken?

Every year, thousands of adults across the world suffer serious health problems, are hospitalized and even die from illnesses that could be prevented by vaccines. There are various diseases that cripple the health system of India and vaccine-preventable diseases are amongst them. Deaths due to infectious diseases in India is still high. For example, a 2017 study published in GAVIN Journal reveals:

Around 40-45% of women in the childbearing age are susceptible to Rubella and over 2 lakh babies are born with birth defects owing to Rubella infection during pregnancy in India. Congenital Rubella syndrome (CRS) accounts for 10-15% of pediatric cataract. 10-50% of children with congenital anomalies have laboratory evidence of CRS.

About 1, 32, 000 women in India are detected with cervical cancer annually and 74,000 of them die.

India has a high endemicity with 300,000 new Hepatitis cases occurring each year.

The burden of influenza (or simply flu) in adults is unimaginable. Around 40,000 deaths occur due to Influenza annually and the situation is grimmer when an epidemic or outbreak occurs.

Several major epidemics of meningococcal disease have been reported, predominantly from the major cities, and particularly from New Delhi.

6. What vaccines do adults need?

The vaccines a person may need depends on their age, medical conditions, occupation, vaccines they have received in the past,  including other factors. All people 6 months and above are recommended to take flu vaccine every year, with some rare exceptions. Flu vaccination is important especially for those who are at a greater risk of serious flu-linked complications, including adults 65 years and above, pregnant women as well as people with certain chronic conditions like diabetes, heart disease or asthma. In addition, vaccination of healthcare workers (caregivers) is essential to protect those who are at high risk.

All adults should also get a one-time dose of DPT vaccine to protect against diphtheria, pertussis (whooping cough) and tetanus, if they have not receive the vaccine in their preteens or teens.  Td booster, every 10 years, is also important for all adults. This will help them in protecting themselves against tetanus and diphtheria. Women are recommended to take DPT shot during the third trimester of their pregnancy to protect themselves and their newborn infants against whooping cough. It is important for pregnant women to get Tdap even if they have had a prior Tdap shot.

Other vaccines needed for adults are determined by factors including age, job, lifestyle health condition and vaccines received in the past. Vaccines that may be recommended for adults include those that protect against pneumococcal disease, human papillomavirus (that can cause certain cancers), shingles, hepatitis A and B, and MMR (measles, mumps and rubella).

Adults may need additional vaccines if they are travelling abroad. Check with your doctor for more information on what you should do to prepare for travel, based on where you are travelling.

7. Are vaccines safe people who take prescription medications or for people with certain health conditions?

Vaccination is even more important for people with certain chronic health conditions like heart disease, diabetes, or asthma, as they are at a greater risk for complications from some vaccine-preventable diseases like pneumonia and flu. For example, diabetes can make the immune system less capable of fighting infections. In addition, flu sickness can make it harder for a person with diabetes to control his/her blood sugars. Such complications may put diabetic people at higher risk of flu-linked complications, including sickness that may result in hospitalization. That is why it is important especially for people with diabetes and some other high risk factors to get flu vaccine every year.

It is safe for people who are taking prescription medicines to take vaccines. However, there are other factors that may make some vaccines unsafe for some people, such as allergy to certain vaccine ingredients or allergy to a vaccine itself. Additionally, live vaccines should not be given to pregnant women and people with weakened immune systems. Talk to your doctor to determine which vaccines are recommended for you.

8. What are some invalid reasons for postponing vaccination?

Do not postpone vaccination for any of the following reasons:

1. Mild sickness: colds, low-grade fever, mild diarrhea and upper respiratory-tract infections are not reasons to postpone vaccination.
2. General allergies: People (including children) with allergies with no history of reactions to vaccine components, should receive vaccines as recommended
3. Antibiotics: Ongoing administration of antibiotics is not a valid reason to put off the vaccination.
4. Household contacts of immunosuppressed patients or pregnant women: Living in a house with an immunosuppressed patient or a pregnant woman is also not a valid reason to put off the vaccination. Two exceptions are the smallpox vaccine and the live attenuated nasal influenza vaccine .
5. Breastfeeding: Breastfeeding should not be the reason for either the mother or the baby to put off the vaccination.
6. Preterm birth: Preterm birth is not a valid reason to put off vaccination
7. Family history: Having a family member who had an adverse reaction to a vaccine is also not a reason to postpone or put off the vaccination.

The bottom line

Adults who are not up-to-date on their vaccines are at higher risk of getting and spreading certain vaccine-preventable diseases. It is important, especially for older adults and those with chronic health conditions to get vaccinated as they are at a raised risk for complications from diseases. We encourage all adults to talk to their doctor about which vaccines are right for them – and get vaccinated.