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QUESTION: hello doctor,
my baby is five months old. she was given pentaxim, hepB, rotarix and opv together after 7 weeks of her birth then after 23 days she was given prevenar again after 14 days of vaccination she was given second dose of pentaxim and rotarix together then we came to know that minimum 4 weeks of gap is necessary between two vaccinations now i am worried that if it may harm my daughter in future or dose will not be effective.

she has now given all three dose of pentaxim and prevenar.
please doctor give suggession.


ANSWER: Hi Vartika,

Relax! There is nothing to worry. The gap of 4 weeks is required between 2 doses of the same vaccine (eg., 2 doses of Pentaxim or 2 doses of Prevenar 13). So there is no problem the way the vaccines have been given in your baby's case. However, in general, we prefer to give vaccines on the same day, just to reduce no. of visits and no of uncomfortable days for the baby.

Also p[lease note that after certain vaccines ("live" injectable vaccines like Measles vaccine, MMR vaccine and Chicken Pox/ Varicella vaccine), there has to be gap of 4 weeks before ANY other vaccine is given.

In addition, I would like to inform you that new research has found that "painless"/ "Gentle" DTP (DTaP) vaccine is not as effective as "normal"DTP vaccine in the long run. New guidelines have clearly stated that normal DTP vaccine is always to be preferred. Pentaxim has DTaP.

You can see the new immunization chart (published in November 2013) at:

Please feel free to ask for any further clarification

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


[an error occurred while processing this directive]---------- FOLLOW-UP ----------

QUESTION: hello dr.,
thanks a lot for ur suggession but as you told that new research has found that "painless"/ "Gentle" DTP (DTaP) vaccine is not as effective as "normal"DTP vaccine in the long run and Pentaxim has DTaP.
my daughter has already been given all three dose of pentaxim.

Q.what should i can do now?

my another question is... dr. has suggested some drops like
mashyne(calciferio oral drops)
visyneral (zinc drops)
tobacin eye drop when needed.

Q.are these medicines safe for my baby and for how long i should go with these medicines?

plz have a look on my baby's vaccination schedule:

1.BCG, OPV, HepB day of birth on 29 aug 2013.

2.Pentaxim, rotarix, OPV, Hep B.......18 oct 2013.
prevenar......10  nov 2013.

3.Pentaxim, rotarix.....24 nov 2013.

4.Pentaxim, Prevenar....24 dec 2013.

5.Prevenar....3 feb 2014.

6.HepB, OPV and Influenza(1st dose) on 3 march 2014

Q. am i following right schedule? u prefer to give influenza and HepB vaccines on same day?

i know dr. that i am asking a lot but please give me ur fruitfull suggession.
i would be highly thankful.


ANSWER: Hi Vartika,

Here are the answers:

1. You should prefer "normal" ("whole-cell") DTP for subsequent boosters (to be given at 16-18 months and 4-6 years of age).

2. Almost every breastfed baby needs Calciferol drops, as breastmilk is a poor source of Vitamin D (The best source is sunshine: If you can ensure sun exposure of 0.5-1 hour to your baby every day, then these drops may not be needed). These are to be given for a very long time.
   I can't say whether your baby needs vi-syneral drops and tobacin eye drops: Your doctor is the best judge. However, I must tell you that tobacin eye drops are antibiotic drops and should be taken only when specifically prescribed for specified duration. They can't be take "when needed"

3. It is OK: except that Influenza vaccine is NOT recommended routinely. It is needed only during epidemics of flu or in special cases (e.g., asthmatic children). I had given you the link earlier: You can see the last page on opening that link for latest immunization chart.

Please feel free to ask for any further clarification

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


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

QUESTION: As u told Dr.that tobacin is an antibiotic so it should not be given when needed so suggest me what should I do whenssometimes my baby rub her eyes because of itching.


Hi Vartika,

Babies NORMALLY rub their eyes. Tobacin should NOT be used just for that. Usually no treatment is required. Please consult another doctor in your area, if you feel that her eyes are not OK.

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



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Dr. Puneet Kumar


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 that requires diagnosing, since it is not possible to examine a child online.


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 17 years of experience in the field.

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 (

(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. (f) Regular column, “How do I treat” in Pediascene ( (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 ( ) (j) Case-report on Osteopetrosis. Jharkhand Journal of Pediatrics, Dec-2002.

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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