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QUESTION: Dear Doctor,

My son is 45 days old and today we took vaccination for below items:
DTaP-IPV/HiB, DTaP/HiB & IPV, DTwP/HiB & IPV, Rotavirus and Pnemococcal conjugate vaccine.
There were 3 injections and one was oral input. Doctor told there won't be any pain and fever. It costed around Rs.7800. But they gave one more choice where total cost would have been Rs. 2850. But there will be a pain and fever. Sofar no fever came to my son. What is the actual difference between these?

We were told these would be repeated two times with one month interval. Can we mix these two choices and go for cheaper one for next two intervals. We were also told these injections are also available at government hospital for free. We are actually confused what is right?

What is precautionary actions to be taken after these vaccination?


Best Regards,
Dinesh
Chennai.

ANSWER: Hi Dinesh,

Recent research has found that DTwP is MORE EFFECTIVE than DTaP. Thus, Indian Academy of Pediatrics (IAP) which formulates immunization guidelines for the whole country has very recently (November 2013) recommended that only DTwP should be used, especially for first 3 doses (6, 10 and 14 weeks). You can see the latest immunization chart at: http://www.iapindia.org/IMM%20Schedule.pdf

Thus, I would recommend that you should go for DTwP only at 10 and 14 weeks (although it is likely to cause pain/ fever, unlike DTaP).

However, the cost mentioned by you does not seem OK...since Pneumocioccall conjugate vaccine (PCV vaccine) (Prevenar 13) itself costs Rs. 3801 per dose.

At Govt centers, only DTwP and Hep B is provided free. Hib has recently been started in a few states (including Tamil Nadu I suppose). IPV, Rota and PCV are not prvided free by Govt.


Best wishes,
Dr. Puneet Kumar,
Kumar Child Clinic, Dwarka,
New Delhi, India

www.KumarChildClinic.com

+91-9818356846


---------- FOLLOW-UP ----------

QUESTION: Dear Doctor,

Thanks for the quick reply.  

Doctor gave us 2 choices today. Really would like to know the differences between them. Should we always go for costliest one? Mentioned cost is less or high for the vaccination my son had today?

Can we go for less costlier injections next time? Regarding DTwP type I will discuss with my Doctor.

Best Regards,
Dinesh
Chennai

Answer
Hi Dinesh,

DTwP is MUCH LESS costly than DTaP: That is what I was mentioning. It is less costly but MORE EFFECTIVE. Hence you should switch to less costly vaccine (with DTwP) from next dose.

Regarding PCV, there are 2 brands: PREVENAR 13 and SYNFLORIX. PREVENAR 13 is costlier and BETTER. And considering the amount you have paid, most likely your son has been given PREVENAR 13 only. And in PCV vaccines, brand CANNOT BE changed. You should continue with the same brand.

Please feel free to ask if you still have any doubt.

Best wishes,
Dr. Puneet Kumar,
Kumar Child Clinic, Dwarka,
New Delhi, India

www.KumarChildClinic.com

+91-9818356846

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Dr. Puneet Kumar

Expertise

I would be happy to answer general queries on prevention and treatment of ailments in newborn, infant, toddler, child or an adolescent. Needless to say, it will not be possible to answer any query requiring specific diagnosis of a particular subject.

Experience

I have worked in various capacities (medical officer, resident, senior resident, consultant) in public as well as private sector in Pediatrics and Neonatology. Today, I have over 15 years of experience in the field.

Organizations
Currently, I am running my own clinic (Kumar Child Clinic) in Dwarka, New Delhi and am attached to Lifeline Hospital, Dwarka as consultant pediatrics and neonatology. I am also developing my clinic website into a comprehensive child health/ parenting website (http://www.kumarchildclinic.com)

Publications
(a) Chapter "National Immunization Schedule" in Frontiers of Social Pediatrics, Jaypee Publishers: 2nd edition, 2016. (b) Article, "All about Pertussis vaccines" in special issue of Indian Journal of Practical Pediatrics, July-Sept 2015 (c) Three chapters (DTP vaccines, Pneumococcal vaccines and Poliovirus vaccines) in "Textbook of Pediatrics for Post-graduates" First edition: 2015. (c) Chapter: "Alternative delivery methods of vaccines" in IAP textbook of Vaccines, First edition, 2014 (published by IAP/ Jaypee Brothers) (d) Special Article: "50 years of Immunization in India: Progress and Future" in January 2013 issue of Indian Pediatrics (e) Four chapters in "FAQ: Book on Vaccines and Immunization Practices" First edition, 2011 AND 2nd edition, 2015 published by Jaypee Brothers. (f) Three articles in special issue of Journal of Pediatric Sciences on “Controversies and Challenges in Pediatric Vaccination Today" in Sept, 2010. Co-edited the series also. http://www.pediatricsciences.com/issue/view/1050000010 (f) Regular column, “How do I treat” in Pediascene (www.pediascene.com) (g) Review article, “Role of Anti-Poliovirus Agents in Polio eradication and beyond” in Polio Pulse, April, 2008. (h) Chapter on “Acute Infectious Diarrhea” in Textbook of Infectious Diseases in Children. (An IAP Publication), 2007. 2nd edition in 2011. (i) Book-Review (IAP Pediatric Drug Formulary, 2004) in Pediascene, March 2005 (http://www.pediascene.com/page.php?cid=6&catid=9&id=132 ) (j) Case-report on Osteopetrosis. Jharkhand Journal of Pediatrics, Dec-2002.

Education/Credentials
After MBBS, I have done DNB residency in Pediatrics.

Awards and Honors
Winner of IAP practising pediatrician's quiz in 2001.

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