Frequently Asked Questions

Common questions and answers about immunisation, vaccines and vaccine preventable diseases.

Diseases

Are the diseases that vaccines protect against serious?

They can be.

Each disease carries its own set of risks. Some are more serious at certain ages; whooping cough for example is most dangerous in very young babies. Some diseases are rare but very serious for most people who get them, such as tetanus. Some diseases, like measles, are very contagious although not everyone who gets it will be seriously ill. It is impossible to predict who will get seriously ill and who won’t.

Why does New Zealand still immunise against diphtheria?

New Zealand is generally free of diphtheria however there are still outbreaks in other countries and someone with the disease may travel to New Zealand. There was a single case of skin diphtheria in Wellington in November 2009, in a person travelling from overseas.

Does having a tetanus infection protect from getting tetanus again?

No. The amount of tetanus toxin able to cause disease is very small and not expected to induce immunity. Cases of tetanus relapse or recurrence have been reported because tetanus spores that haven't released toxin stayed in the body and released toxin later.

Why does New Zealand still immunise against polio?

New Zealand is a polio free country however there are still outbreaks in other countries. A person visiting New Zealand from one of these countries may have the virus in their gastrointestinal system/gut and infect someone who has not been immunised against polio.

Why are children at risk of getting hepatitis B?

The hepatitis B virus can be transferred from one person to another when an opening in the skin in one person comes in contact with blood, saliva, sexual fluids or even contact with weeping school sores of someone who has hepatitis B. Mothers who are hepatitis B positive can pass the infection onto their baby during the birth process, household members who are hepatitis B positive can pass the virus onto others, including children, living with them and children can pass the virus onto each other when they're playing, especially if they have an accident. 

The hepatitis B virus can also live outside the body in dried blood for at least seven days. If there is hepatitis B infected dried blood on playground equipment it is possible for another child to hurt themselves on the same equipment days later and become infected.

Can someone get chickenpox from shingles?

A person with shingles won't get chickenpox again but they can pass the chickenpox virus onto someone else who is not immune to chickenpox if that person comes in contact with weeping shingles blisters.

Vaccines

How do vaccines work?

When germs invade the body, the immune system deals with them by producing protective cells and small molecules called ‘antibodies’. When we come across a germ for the first time, our immune response is often slow and we get sick. After the infection, however, the immune system remembers how to make the antibody so if we come into contact with the same germ again the immune system responds quickly and usually deals with it before we get sick.

Vaccines work in the same way, but use a weakened, inactive form or fragment of the germ. In response to a vaccine, our natural immune system kicks in and produces the protective cells and antibodies to protect against the germ. Vaccines will not cause or give you the disease, but simply alert the immune system to recognise the invaders should they present again at a later stage.

How well do vaccines work?

Vaccines work very well to prevent a wide range of very serious diseases. Immunisation is one of the most extensively researched areas of medicine and has proved to be the most valuable health care measure ever developed by saving millions of lives worldwide. Over the years, immunisation has controlled or stopped many of the diseases that cause illness or death in children, it is the key driver behind the decline in debilitating diseases like polio, and has even managed to entirely eradicate smallpox.

You need to have all of the recommended doses of a vaccine to make sure it can do the best job of protection possible.

Vaccines don’t provide 100% protection to all people. In cases like this, we can get the disease, but usually don’t get as sick as we would if we weren’t immunised. If most people are immunised the spread of the germ is reduced so the chance of exposure to a disease is much lower. The people who are protected against the disease can protect those who aren’t.

Are vaccines safe?

As with any medicines, immunisations have risks as well as benefits. Serious side effects, such as severe allergic reactions (anaphylaxis), are very rare and vaccines are considerably safer than getting the diseases that they protect against.

Before any vaccine can be used it will have been through extensive scientific research and independent review, more than any other prescription medication. This is not only to show that they are safe, but also to prove that they work.

Before any vaccines are made available to the public or added to an immunisation schedule, the scientists have to be completely convinced that they’re not dangerous. This process can take ten years or more. Only vaccines with excellent safety profiles are licensed for use in New Zealand.

Even after a vaccine is made available its safety continues to be monitored both in New Zealand and overseas, to ensure it provides the safest, best possible protection possible.

What are vaccines made of?

All vaccines contain a component of a germ (the antigen) which activates the immune system, but without making you sick.

The other parts of a vaccine are included to keep the vaccine stable or improve the immune response. Sometimes people mistake these other components for toxins or poisons. In reality, we eat, drink and come into contact with these components in far greater quantities than the amount in a vaccine. Aluminium, for example, is in our drinking water, food and food packaging.

Why are combined immunisations given?

Most immunisations are now given in combinations, such as the DTaP-IPV-HepB/Hib which protects against diphtheria, tetanus, whooping cough, polio, hepatitis B and Haemophilus influenzae type b (Hib) disease. While a number of parents express concern that this could be overwhelming for small children, there is no evidence to suggest that children struggle to generate a response to the combined immunisations, with the benefit of there being fewer injections required.

The content of the vaccines given today is so well refined that children actually receive fewer germ-components than their parents would have, despite the combining of immunisations.

What is the difference between Infanrix®-hexa, Infanrix®-IPV and Boostrix® vaccines?

The infant vaccine Infanrix®-hexa (DTaP-IPV-HepB/Hib) protects against six diseases (diphtheria, tetanus, whooping cough, polio, hepatitis B and Haemophilus influenzae type b (Hib) disease), while Infanrix®-IPV (DTaP-IPV) protects against the first four of these diseases. The adolescent and adult vaccine Boostrix® (Tdap) boosts protection against diphtheria, tetanus and acellular pertussis (whooping cough) but is sometimes used in a primary vaccine course.

The infant and adult vaccines contain different volumes of some active ingredients, or antigens. Infanrix®-hexa and Infanrix®-IPV have a higher volume of tetanus, diphtheria and acellular pertussis antigens, which are needed to stimulate a strong immune response. Boostrix® contains smaller doses of tetanus, diphtheria and pertussis antigens, the immune response to these invaders already exists, so the vaccine is only required to "remind" the immune response about how to respond. Local site reactions to the tetanus, diphtheria and acellular pertussis vaccines increase after the fourth dose, so the smaller dose of these components also helps to avoid these reactions in adolescents.

Does the MMR vaccine cause autism?

No. A range of very large studies worldwide clearly demonstrate that MMR vaccine does not cause autism. The original paper suggesting some association has now been retracted from the public record by the Lancet, who originally published the paper. The lead author (Dr Andrew Wakefield) has been investigated in the UK for failure to disclose a conflict of interest, publishing fraudulent research and ethics breaches. He has been struck off the medical register after being found guilty of serious professional misconduct.

What is the difference between Prevenar®, Prevenar 13® or Synflorix® and Pneumovax® 23?

Prevenar®, Prevenar 13®, Synflorix® and Pneumovax® 23 are all vaccines against pneumococcal disease, a leading cause of serious illness in children and some adults, but there are differences in the way they are made.

Prevenar®, Prevenar 13® and Synflorix® are conjugate vaccines. The sugar molecules from the outside of the bacteria have been attached to a special protein to make them better at stimulating the immune system. Young infants respond well to this type of vaccine. Prevenar® offers protection against seven common types of pneumococcal bacteria, Prevenar 13® against 13 types and Synflorix® offers protection against 10 common strains of pneumococcal types.

Pneumovax® 23 is a polysaccharide vaccine. It is made using the sugar molecules from the outside of the bacteria. It is not very effective in infants under two years of age as their immune systems are too immature to generate a strong, protective response to this kind of vaccine. Older children and adults do respond to Pneumovax® 23 but not as well as they do to the conjugate vaccines. The advantage of Pneumovax® 23 is that it protects against 23 types of pneumococcal bacteria.

Can the MMR vaccine cause measles?

No. In some cases, the vaccine can cause a mild, non-infectious rash 6-12 days after immunisation.

My child is allergic to egg. Can they still have the MMR vaccine?

Yes. All children with egg allergies can receive the MMR vaccine without increasing their risk of side effects/adverse reactions.

Does the MMR vaccine contain thiomersal (or mercury)?

No. National Immunisation Schedule vaccines used in New Zealand, including MMR, do not contain thiomersal (also known as thimerosal).

Thiomersal is mercury-based preservative used in some vaccines to prevent bacterial contamination. All of the scientific evidence available to date suggests that thiomersal in vaccines has never caused any harm.

Does the MMR vaccine cause mumps?

No. Historically there has been one report of transmission of the mumps vaccine virus after immunisation with a vaccine that is no longer made.

Does the rotavirus vaccine protect against all diarrhoea?

No. The vaccine only protects against severe diarrhoea and vomiting (gastroenteritis) caused by rotavirus. The vaccine does not protect against gastroenteritis caused by other viruses or bacteria.

Was the rotavirus vaccine associated with a bowel obstruction called 'intussusception'?

In the late 1990s a different rotavirus vaccine was associated with intussusception and removed from the market. The new vaccine has been tested in over 70,000 children and no link with intussusception was found. As part of ongoing vaccine safety monitoring a large study of Rotarix® in Mexico suggested there may be a small increase in the risk of developing intussusception following the first vaccine dose. 

The U.S. Centers for Disease Control and Prevention (CDC) reviewed all the information available. They recommended that as the increased risk of intussusception is extremely small and the benefits of rotavirus vaccination are great, Rotarix® continue to be used to prevent rotavirus disease.

What is the difference between Act-HIB® and Hiberix®?

These vaccines are very similar in their manufacture and safety profile. The body's immune response to both vaccines is also similar.

What is the difference between Prevenar®, Synflorix® and Prevenar 13®?

A pneumococcal conjugate vaccine called Synflorix® is replacing Prevenar® at the scheduled visits of 6 weeks, 3 months, 5 months and 15 months of age. Synflorix® covers the same seven pneumococcal types that Prevenar® does plus three more types.

From 1 July 2011 Prevenar 13® replaced Prevenar® for children with particular medical conditions eligible for the High Risk Pneumococcal Immunisation Programme. Prevenar 13® covers the same seven pneumococcal types that Prevenar® does plus six more types. Prevenar 13® is to be used in these children instead of Synflorix®. The safety profile for all three vaccines is similar.

The body’s immune responses to both Synflorix® and Prevenar 13® are comparable to the responses to Prevenar® for the pneumococcal bacteria types they have in common. Therefore, both Synflorix® and Prevenar 13® are expected to be as least as effective as Prevenar® in preventing serious infections. However, until Synflorix® and Prevenar 13® have been used for many years, like Prevenar® has, there will be no data to show how much more effective they may be. The new vaccines also generate a protective response against additional pneumococcal types not covered by Prevenar®.

A child who has started their course of pneumococcal protection with Prevenar® can complete their course with Synflorix®. When this occurs the child is expected to develop full protection for the seven types of pneumococcal bacteria in both vaccines. They may also develop partial protection for the extra three types in Synflorix®.

What if a child has already had four doses of polio vaccine?

In New Zealand the inactivated polio vaccine is usually administered in a three-dose series in the first year of life, followed by a booster dose around school entry age as part of the Infanrix®-IPV (DTaP-IPV) vaccine. A child having already had four polio vaccines is an uncommon situation but may occur for children vaccinated under an overseas schedule. 

It is safe to administer a fifth dose of polio vaccine.

Boostrix® (Tdap) is available for private purchase. It does not have a polio component however when administered to children less than 10 years of age it must be prescribed by a Doctor outside of its license.

Why isn't the MeNZB™ vaccine available anymore?

The MeNZB™ vaccine, given under the Meningococcal B Immunisation Programme, was designed to help control an epidemic of a specific strain of meningococcal disease. Disease rates are now at the lowest level in a decade, and the Ministry of Health received expert advice that there is no longer a need for immunisation.

What is the latest news about Dr Wakefield and autism?

The body of scientific research demonstrates clearly that the MMR vaccine does not cause autism. The original paper suggesting some association has now been retracted from the public record by the Lancet. The lead author (Dr Andrew Wakefield) has been investigated in the UK for failure to disclose a conflict of interest, publishing fraudulent research and ethics breaches. He has been struck off the medical register after being found guilty of serious professional misconduct.

What vaccines are available to those at increased risk of infection?

The annual influenza vaccine is now recommended for infants from six months of age, children and adults with certain chronic medical conditions that increase their risk of getting influenza or increase their risk of developing complications from influenza. Chronic conditions eligible for funded influenza vaccines include diabetes, heart, lung or kidney disease, asthma requiring regular preventer medication, cancer and conditions that suppress the immune system. The influenza vaccine is recommended and available free of charge for pregnant women and those aged 65 or over.

Children less than five years of age with certain medical conditions that increase their risk of invasive pneumococcal disease are eligible to start immunisations under the High Risk Pneumococcal Immunisation Programme. 

Children less than 16 years of age with functional asplenia or who are pre or post splenectomy and those aged 16 years and over are eligible for immunisations under the Pre/Post Splenectomy Immunisation Programme.

How many germs/antigens are infants exposed to in vaccines?

Since the year 2000 infants are exposed to about 50 antigens by immunisation. In 1980, children were vaccinated with 3041 antigens. Before the eradication of smallpox the smallpox vaccine alone contained 200 antigens! Children today are being exposed to far fewer antigens throughout an entire immunisation schedule than some of their parents and grandparents would have been exposed to in a single vaccine!

Do vaccines produce a different immune response to infections by bypassing the natural route of entry?

Many vaccine preventable infections enter through the respiratory route while in contrast most vaccines are injected directly into the arm or leg. Despite this major difference the same biological processes for inducing immunity occur. There are differences in that the immunity to vaccination is often less broad than that acquired from natural infection, but this is specific for each antigen. Some vaccines actually induce superior immunity than natural infection such as tetanus, Haemophilus influenzae type b and human papillomavirus (HPV) vaccines. Vaccines use the same pathways of the immune system as natural infection does, even if they do not always engage as broad a response as the natural infection.

Do current vaccines increase infections they are not targeted to prevent?

No. For most vaccines, including Prevenar®, the evidence shows that the use of some vaccines leads to a decrease in illness and death in those who receive the vaccine and those not targeted by that immunisation.

Years after the introduction of the pneumococcal conjugate vaccine (Prevenar®) in the US invasive pneumococcal disease caused by the types of bacteria in Prevenar® decreased in children who had received the vaccine, their peers who had not received the vaccine and the elderly who had not received the vaccine. However, the number of cases caused by one type of pneumococcal bacteria not in Prevenar® had also increased.

After all the evidence was reviewed the benefits of less disease caused by the bacteria types in the vaccine were much greater than the increase in disease from the type that was not in the vaccine. An increase in pneumococcal disease caused by a type not in the vaccine has not happened anywhere else in the world where Prevenar® is used.

Why do some vaccines have more than one dose?

Sometimes, just one exposure to the germ isn't enough to teach the immune system how to respond to it. In these cases, it is important to have repeated vaccines or "booster" vaccines, which use extra doses of the vaccine to remind the immune system about how it should respond. These reminders allow protection against the disease to last for a long time.

Some vaccines (such as the pneumococcal and Haemophilus influenzae type b vaccines) require infants to receive more doses than older children to get the same level of protection.

Immunisation

Why do the National Immunisation Schedules vaccines change?

The National Immunisation Schedule is reviewed every three years. Changes occur if more effective vaccines have been licensed in New Zealand, if disease patterns change or if new research provides insights into how and when immunisations should be given. Revision of the schedule allows New Zealand health services to remain up to date and relevant.

Why is it important to immunise my child?

Immunisation helps our children avoid many diseases that can seriously harm them. When a child is immunised the vaccines teach their immune system to respond to parts of germs that aren’t dangerous, or to weakened or inactive viruses that can’t cause disease. After immunisation the immune system can generate specialised cells to fight the infection if they are exposed to the disease, preventing them from getting sick.

Some parents focus more on the (rare) side effects of immunisation than on the diseases that immunisation protects against. The risk of serious side effects from immunisation is very low compared to the risk of complications or death should a child contract one of the vaccine-preventable diseases.

Immunisation is an important way to actively protect your child from these dangerous diseases.

Why immunise on time?

Young infants are particularly at risk of serious complications from some diseases such as whooping cough, pneumococcal disease and Haemophilus influenzae type b (Hib disease). Starting immunisation at six weeks begins to provide protection during the most vulnerable periods of childhood. Delaying or missing immunisations increases the risk of getting a disease and reduces the protection when it’s needed most.

Will immunisation be too much for my baby’s immune system?

No. Scientific research does not support the idea that multiple vaccines overwhelm, weaken, or "use up" the immune system. On the contrary, young infants have an enormous capacity to respond to multiple vaccines, as well as to the many other challenges present in the environment.  Contact with the millions of germs that babies come into contact with every day, from the air, surfaces, and people around them, strengthen an infant’s immune system by teaching it to respond to germs. Immunisation teaches your baby’s immune system the same thing; vaccines use safe components of dangerous diseases to stop babies from getting sick if they come into contact with the real germ.

Generally, how well does immunisation work?

Immunisation works very well to prevent a wide range of very serious diseases. It is one of the most extensively researched areas of medicine and has proved to be the most valuable health care measure ever developed by saving millions of lives worldwide. Over the years, immunisation has controlled or stopped many of the diseases that cause illness or death in children, it is the key driver behind the decline in debilitating diseases like polio, and has even managed to entirely eradicate smallpox.

Sometimes immunisation doesn’t provide complete protection. In cases like this, we can get the disease, but usually don’t get as sick as we would if we weren’t immunised. While vaccines can’t provide 100% protection to all people, the more people that are immunised, the less the diseases will spread through the population. The people who are protected against the disease can protect those who aren’t by reducing the risk of exposure to the germs.

Does my child need all of the recommended immunisations?

Yes. The vaccines on the National Immunisation Schedule have been chosen to provide your child with the best possible protection against some very dangerous diseases. It is very important to follow the schedule. Not immunising your child on time slows them getting the protection that the immunisation can provide and the risk that they will get the disease lasts longer.

For some diseases more than one immunisation is needed because just one exposure to the germ isn’t enough to teach the immune system how to respond to it. Sometimes a “booster” immunisation is also needed to remind the immune system about how it should respond and allow protection against the disease to last for a long time.

What if my child has allergies or asthma?

Children with allergies, asthma, eczema and hay fever can have all the recommended immunisations unless they have a specific, severe allergic reaction, called anaphylaxis, to the vaccine or a component of the vaccine being offered. Vaccinators are trained to ask questions about any allergies that may exclude your child from being vaccinated.

Scientific research has identified that immunisation with some vaccines can decrease a baby's risk of developing allergies and eczema when they are older.

When should I delay my child's immunisations? What if they have a cold or a fever?

It is generally not recommended to delay immunisations. However, if your child has a fever above 38°C, the immunisation should be postponed so that vaccine responses, like fever, sleepiness or irritability, don't make it harder to work out if your child's illness is getting better or worse.
If your child has an ordinary cough, cold, runny nose or another mild illness, but their temperature is normal or only slightly raised, they can receive their immunisations.

When a child has an evolving neurological condition the risks of disease from delaying whooping cough immunisation should be considered on an individual basis along with any possible benefits from delaying immunisation until the condition stabilises.

There has been significant media attention given to delaying the start of immunisation in the belief that the infant’s immune system may “cope better” with the dose of pathogen in vaccines when they are older. An infant is born with an immune system that is capable of responding to immunisations but it does need training. Vaccines are recommended early in life in order to protect infants from developing dangerous diseases while they are most vulnerable. Recent research from New Zealand has found that infants whose immunisations were delayed for 30 or more days were 4-6 times more likely to be hospitalised with whooping cough than infants the same age that had been immunised on time.

The best protection for your child can be provided by on time administration of the recommended vaccines.

How long will the protection last?

The length of protection against disease after immunisation depends on the age of the person receiving the vaccine, the type of vaccine available/used and the disease the vaccine is to protect from. Some vaccines can only protect people for 2-3 years e.g. the meningococcal A, C, Y, W135 polysaccharide vaccine, some for at least 4-6 years e.g. the whooping cough vaccines and some provide lifelong protection e.g. polio vaccines.

What are the side effects of immunisation?

As with any medicines, immunisations have risks as well as benefits. Serious side effects, such as severe allergic reactions (anaphylaxis), are very rare.

Most children experience no adverse effects following immunisation but some minor effects include being unsettled, irritable, grumpy or crying, a mild fever, redness and tenderness or swelling at the injection site, being sleepy or slow to feed or vomiting. These could start within 6 hours of your baby receiving their immunisations and last for 24-48 hours.

If you are worried about your child's response to an immunisation contact your Doctor or Practice Nurse.

Why do different countries have different immunisation schedules?

There are some differences internationally in both the timing and availability of vaccines. Recommendations are based on national decisions, economics and local disease risks. For example, following the large rubella epidemics in 2003 in Samoa, Tonga and the Tokelau Islands a free rubella containing vaccine was introduced onto their immunisation schedules. In the UK immunisations start at eight weeks old as this coincides with their first funded Well Child visit. In Australia chicken pox vaccine is offered free as this was considered a cost-effective public health measure for their country.

Should pre-term Infants be immunised?

Yes. Pre-term infants should be immunised by their actual (chronological) age i.e. the number of weeks or months since their birth. Pre-term infants have a higher risk of diseases including whooping cough, Haemophilus influenzae type b, pneumococcal disease and influenza. They may also experience serious complications and/or develop long-term problems if they contract these diseases.

Being born starts the maturing of the infant's immune system. Pre-term infants can develop an immune response to immunisations. There is some evidence that low birth weight infants (less than 2000g) may not build sufficient antibodies against hepatitis B immunisation at birth. However, infants born to mothers with hepatitis B should still be given a birth hepatitis B vaccine, as well as hepatitis B immunoglobulin. By six weeks of age almost all low birth weight infants will have an immune response to hepatitis B equivalent to heavier infants.

No scientific evidence supports the myth that immunisation can “overwhelm” an infant's immune system.

Pre-term infants do not have any more side effects from immunisation than infants born at full-term. There is no evidence of a risk of apnoea (pauses in breathing) after immunisation of babies born less than 1000g or 31 weeks gestation with the acellular pertussis (whooping cough) vaccine. However, it is recommended that these infants are monitored for apnoeic episodes for 72 hours after immunisation until further data can confirm this pattern of safety. 

Should immune compromised children be immunised?

It is very important to consider vaccinations for these children and, where possible, their immediate family, as they may be at very high risk of vaccine preventable disease. Important considerations to be taken into account before recommending immunisation for these children include: the level of immune deficiency, the expected duration of the deficiency and the likelihood of exposure to disease.

These children may not develop a protective immune response to immunisation. There is also a risk that live vaccines may cause disease in immune compromised children. Live attenuated (weakened) vaccines such as measles, mumps and rubella (MMR) and chicken pox must not be given to severely immune compromised people. 

Immunisation of household and other close contacts is recommended to reduce the risk the child will be exposed to disease. Immunising contacts with the measles, mumps and rubella (MMR) vaccine is safe. Caution is required with regard to immunising contacts with the chicken pox vaccine, as the virus in the vaccine can theoretically be transferred if the vaccine recipient develops a rash.

Should pregnant women be immunised?

Pregnant women can be immunised with inactive (non-live) vaccines. There is no evidence of a safety risk for the mother or her fetus. In some countries regular contact with a woman during pregnancy is used to ensure she is up to date with her tetanus and diphtheria immunisations and also reduce the risk of neonatal tetanus.

Pregnant women are at high risk for influenza and in New Zealand immunisation against this disease is not only recommended but also funded for a pregnant woman at any time during her pregnancy. There is also evidence that an influenza immunisation in the late stages of pregnancy can also provide protection against influenza in the newborn infant.

A free  whooping cough booster immunisation, with a combined tetanus, diphtheria, pertussis vaccine, is free for women between 28-38 weeks of pregnancy to reduce their risk of getting the disease and passing it onto their newborn baby. When the booster immunisation is given before 36 weeks of pregnancy some protection will cross the placenta and may reduce the severity of whopping cough in babies for up to six weeks after they are born.

It is also important for pregnant women, who are at risk of be infected with hepatitis B, receive the course of hepatis B immunisations as soon as their risk is identified.

Live vaccines, e.g. measles/mumps/rubella (MMR) and chicken pox vaccines, are not intentionally administered to pregnant women. Although overseas research has not found any cases of injury to the unborn child when the MMR vaccine was inadvertently given just before or during pregnancy it is recommended that women delay becoming pregnant for one month after receiving a live vaccine.

It is recommended that close contacts of pregnant women are immune to measles and rubella. They can receive the MMR vaccine without risk to the pregnant woman or her fetus.

The chicken pox vaccine can also be administered to close contacts of pregnant women. However, if the vaccine recipient develops a vaccine related rash and the woman is not immune to chicken pox there is an extremely small risk that the vaccine virus could be transmitted to the pregnant woman from the liquid in the rash blisters.

Can breast-feeding women be immunised?

Breast-feeding women can have immunisations without risk for the baby or the mother.

The rubella vaccine virus may be secreted in breast milk; however research has shown that this is not a risk for the infant.

Is it safe to immunise babies as young as six weeks of age?

Yes. Infants have no more risk of side effects/adverse events than older children.

Do vaccines work in young babies?

Yes. Contact with the millions of germs that babies come into contact with every day, from the air, surfaces, and people around them and immunisation strengthen an infant’s immune system by teaching it to respond to germs. Vaccines on the childhood schedule have been proven both safe and effective in six week old infants.  It is important that all the scheduled doses are received, as best protection does not occur after only one dose. Some vaccines (such as the pneumococcal and Haemophilus influenzae type b vaccines) require infants to receive more doses than older children to get the same level of protection.

Does it matter if we delay vaccination until our baby is older?

Delayed vaccines will still teach the infant’s immune system how to recognise the diseases. However, delayed immunisation means the infant has a higher risk of vaccine-preventable disease for longer. It is important that infants start their immunisations on time to receive the best protection they can while they are at their most vulnerable, for many diseases this is during the first year of life.

An infant will not have the best protection from the vaccine-preventable diseases until they have received all the recommended vaccine doses, usually given at 6 weeks, 3 months and 5 months of age.

New Zealand research has shown that infants who receive their immunisations late are 4-6 times more likely to be admitted to hospital with whooping cough than those who have been immunised on time.

How many germs/antigens could the immune system respond to at once?

An infant has more immune cells to respond to germs per millilitres (mLs) of blood than an adult. This means that infants have an enormous capacity to respond to a very large number of antigens.

How many germs/antigens is a baby exposed to at birth?

During the birth process most infants come into contact with about 18 types of genital and 400 types of faecal (poo) bacteria. Breast milk also contains about eight types of bacteria. Each type of bacteria encountered contains 3,000 – 6,000 proteins that stimulate an immune response in the infant. This means that infants are exposed to more than a million bacterial proteins at and shortly after birth!

How many germs/antigens is a baby exposed to with immunisation?

Since the year 2000, infants are exposed to about 50 antigens by immunisation. In 1980, children were vaccinated with 3041 antigens. Before the eradication of smallpox the smallpox vaccine alone contained 200 antigens! Children today are being exposed to far fewer antigens throughout an entire immunisation schedule than some of their parents and grandparents would have been exposed to in a single vaccine!

Are all the vaccine doses needed to get protection?

Yes. It is important that all the scheduled doses are received because best protection does not occur after only one dose.  Some vaccines (such as the pneumococcal and Haemophilus influenzae type b vaccines) require infants to receive more doses than older children to get the same level of protection.

Missing immunisations increases the risk of getting a disease and reduces the protection when it’s needed most.

Why does New Zealand start immunisation at six weeks of age?

New Zealand brought forward the first dose of the Childhood Immunisation Schedule from three months of age to six weeks of age in 1984 following an outbreak of whooping cough (pertussis) which affected those under three months most severely so infants could start developing pertussis protection sooner.

Many countries start their immunisation schedule at four weeks of age but in New Zealand six weeks of age, as opposed to four weeks, coincides with the six week post-natal check for both mothers and babies.

How long do I delay getting pregnant after immunisation?

Weakened live vaccines, e.g. meales/mumps/rubella (MMR) and chickenpox vaccines, are not intentionally given during pregnancy because there is a theoretical risk that a live vaccine could affect the fetus. Although research in the US, Germany and the UK found no injury to the unborn child when the MMR vaccine was inadvertently given just before or during pregnancy women are advised to delay becoming pregnant for one month after having a live vaccine.

There is no need to delay pregnancy after receiving non-live/inactive vaccines, e.g. influenza, tetanus/diphtheria/pertussis, hepatitis B, human papillomavirus (HPV) vaccines.

Other

I'm moving to/from New Zealand. What does this mean for my child's immunisations?

In general, holiday visits to other countries require little more than the routine travel recommendations. We do not provide travel vaccine advice and recommend that you contact your GP or a clinic that specialises in travel medicine.

If you are moving to another country we recommend that you and your children follow the immunisation schedule of that country because it will include immunisations for the diseases their children are most at risk of.

Ex-pats and immigrants coming to New Zealand may need some catch-up vaccines. Practice Nurses and General Practitioners can advise on any immunisation gaps and an accelerated catch up immunisation schedule can be provided if needed.

Where do children get immunisations in New Zealand?

Immunisations are given at local Doctor/General Practitioner (GP) practices or medical centres. They may be administered by the Doctor or by the Practice Nurse. Parents or guardians usually need to make an appointment for their child to have immunisations. It is advisable to ring the medical centre you want to attend and ask what they prefer.

Do I have to pay for immunisations for my child?

All children under 18 years of age can have National Immunisation Schedule immunisations for free, including catch up doses of vaccines they have missed, whether or not they are New Zealand residents. This includes children who are in New Zealand for a holiday, with a parent or guardian here on a short term or temporary visa, or who are here on a student visa.

However, for the human papillomavirus vaccine, Gardasil®, a girl who is a non-resident must be less than 18 years of age and be living in New Zealand for eight months or more after starting the vaccine course to be eligible to receive the vaccine for free.

How do I find a local Doctor/General Practitioner (GP)?

We suggest that you ask your friends, relatives or neighbours, other parents at playgroups, the local pharmacy or the local Citizens Advice Bureau who they know of and recommend. There is also a list of Doctors and medical centres in the front of the telephone book.