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For Parents

Vaccines and common side effects

Comparison of effects of vaccine-preventable diseases and vaccines

Commonly asked questions about immunisation

For Parents ~ About immunisation and Australian Childhood Immunisation Register

• What is immunisation?

• Immunisation and vaccination

• How does immunisation work?

• What is in vaccines?

• How long do immunisations take to work?

• How long do immunisations last?

• Is everyone protected from disease by immunisation?

• Why do children get so many immunisations?

• What are the side effects of immunisation?

• Why should I have my child immunised?

• Are all immunisations free?

• What to tell the doctor or nurse when taking your child for an immunisation

• Common misconceptions for missing immunisation

• Tell me about the Immunisation Register and how it can benefit me?

• How do I enrol my child on the Immunisation Register?

• How is information recorded on the Immunisation Register?

• How will the Immunisation Register help me keep track of my child's vaccinations?

• Will my child's immunisation status affect child care payments?

• Where can I get more information on the Immunisation Register?

• Requesting my child’s immunisation history online

• Immunisation and your eligibility for some government benefits

• Acknowledgments 

What is immunisation?

Immunisation protects children (and adults) against harmful infections before they come into contact with them in the community. Immunisation uses the body's natural defence mechanism - the immune response - to build resistance to specific infections. Immunisation helps children stay healthy by preventing serious infections.

The routine childhood immunisations given under the National Immunisation Program currently provide protection against 12 diseases - diphtheria, tetanus, pertussis (whooping cough), poliomyelitis (polio), measles, mumps, rubella (German measles), Haemophilus influenzae type b (Hib), hepatitis B, meningococcal C, pneumococcal and varicella (chickenpox). All of these diseases can cause serious complications and sometimes death. All of the vaccines used in the National Immunisation Program are now given by injection.

Immunisation and vaccination

Technically, 'vaccination' is the term used for giving a vaccine - that is, actually getting the injection. 'Immunisation' is the term used for the process of both getting the vaccine and becoming immune to the disease as a result of the vaccine. Most people use the terms 'vaccination' and 'immunisation' interchangeably but their meanings are not exactly the same because immunity follows vaccination in most, but not all, cases. For the purposes of this book, we have always used the term 'immunisation' because this is the expression most commonly used in the community.

How does immunisation work?

All forms of immunisation work in the same way. When someone is injected with a vaccine, their body produces an immune response in the same way it would following exposure to a disease but without the person getting the disease. If the person comes in contact with the disease in the future, the body is able to make an immune response fast enough to prevent the person developing the disease or developing a severe case of the disease.

What is in vaccines?

Some vaccines contain a very small dose of a live, but weakened form of a virus. Some vaccines contain a very small dose of killed bacteria or small parts of bacteria, and other vaccines contain a small dose of a modified toxin produced by bacteria. Vaccines may also contain either a small amount of preservative or a small amount of an antibiotic to preserve the vaccine. Some vaccines may also contain a small amount of an aluminium salt which helps produce a better immune response.

How long do immunisations take to work?

In general, the normal immune response takes approximately two weeks to work. This means protection from an infection will not occur immediately after immunisation. Most immunisations need to be given several times to build long lasting protection. A child who has been given only one or two doses of diphtheriatetanus-acellular pertussis vaccine (DTPa) is only partially protected against diphtheria, tetanus and pertussis (whooping cough), and may become sick if exposed to these diseases. However, some of the new vaccines, such as the meningococcal C vaccine, provide long lasting immunity after only one dose.

How long do immunisations last?

The protective effect of immunisations is not always life-long. Some, like tetanus vaccine, can last up to 30 years, after which time a booster dose may be given. Some immunisations, such as whooping cough vaccine, give protection for about five years after a full course.

Is everyone protected from disease by immunisation?

Even when all the doses of a vaccine have been given, not everyone is protected against the disease. Measles, mumps, rubella, tetanus, polio, hepatitis B and Hib vaccines protect more than 95% of children who have completed the course. One dose of meningococcal C vaccine at 12 months protects over 90% of children. Three doses of whooping cough vaccine protects about 85% of children who have been immunised, and will reduce the severity of the disease in the other 15%, if they do catch whooping cough. Booster doses are needed because immunity decreases over time.

Why do children get so many immunisations?

A number of immunisations are required in the first few years of a child's life to protect the child against the most serious childhood infectious diseases. The immune system in young children does not work as well as the immune system in older children and adults, because it is still immature. Therefore more doses of the vaccine are needed. In the first months of life, a baby is protected from most infectious diseases by antibodies from her or his mother which are transferred to the baby during pregnancy. When these antibodies wear off, the baby is at risk of serious infections and so the first immunisations are given before these antibodies have gone. Another reason why children get many immunisations is that new vaccines against serious infections continue to be developed. The number of injections is reduced by the use of combination vaccines, where several vaccines are combined into one shot.

What are the side effects of immunisation?

Common side effects of immunisation are redness and soreness at the site of injections and mild fever. While these symptoms may concern you and upset your child at the time, the benefit of immunisation is protection from the disease. More serious reactions to immunisation are very rare. You may consider using paracetamol to help ease the fever and soreness. Other side effects are very rare but if they do occur, a doctor should be consulted immediately.

Why should I have my child immunised?

There are two reasons for immunising every child in Australia:

2. If enough people in the community are immunised, the infection can no longer be spread from person to person and the disease dies out altogether. This is how smallpox was eliminated from the world, and how polio has disappeared from many countries.

Are all immunisations free?

All vaccines that are routinely recommended for your child are funded by the Australian Government and are provided free of charge. The following vaccines are provided free for all children:

There are some differences in the way the Government funded immunisation programs are administered in each State and Territory. You should consult your usual immunisation provider for eligibility requirements under these programs. Alternatively, you can contact your State or Territory health department (see contact numbers at the rear of this booklet). There are other vaccines available that are not funded by the National Immunisation Program. These are usually recommended for special circumstances, such as international travel or for people engaged in certain occupations. If you choose to immunise your child with a vaccine that is not funded by the Program, you should speak to your local doctor or immunisation clinic for further information. If you are unsure which vaccines are free, please check with your doctor, immunisation clinic, or telephone the Immunise Australia Information Line on 1800 671 811.

What to tell the doctor or nurse when taking your child for an immunisation

Before you have your child immunised, tell the doctor or nurse if your child:

• is unwell today;

• has had a severe reaction following any vaccine;

• has any severe allergies;

• has had a live vaccine within the last month (including tuberculosis, MMR, chickenpox, oral poliomyelitis or yellow fever).

• has had injection of immunoglobulin, or a whole blood transfusion in the last three months;

• has a disease which lowers immunity (eg. leukaemia, cancer, HIV/AIDS) or is having treatment which lowers immunity (eg. steroid medicines such as cortisone and prednisone, radiotherapy and chemotherapy);

• lives with someone who has a disease which lowers immunity, or lives with someone who is having treatment which lowers immunity;

• is living with someone who is not immunised

• is an Aboriginal or Torres Straight Islander person.

Your doctor or health clinic staff should know about these conditions because your child may need to be immunised differently. You should also take your child's Personal Health Record with you when having your child immunised.

Common misconceptions for missing immunisation

Your child should still be immunised, even if he or she:

• has a family history of any reactions following immunisation;

• has a family history of convulsions;

• has had whooping cough, measles, rubella or mumps infection;

• is premature (immunisation should not be postponed);

• has a stable neurological condition such as cerebral palsy or Down's syndrome;

• has been in contact with an infectious disease;

• has asthma, eczema, hay fever or 'snuffles';

• is on treatment with antibiotics;

• is on treatment with locally-acting (inhaled or low-dose topical) steroids;

• has a pregnant mother;

• is being breast-fed;

• was jaundiced after birth;

• is over the age recommended in the standard vaccination schedule;

• has had recent or imminent surgery;

• is of low weight but otherwise healthy;

• has been treated with replacement corticosteroids.

If you want more information on this, please consult your local doctor or health clinic staff.

Tell me about the Immunisation Register and how it can benefit me?

The Immunisation Register is a useful service, helping you to keep track of the first six years of your child's immunisation. It provides you with:

• a history statement when your child turns one, two and five years

• documents to help with eligibility for some family payments, and

• the option of getting a copy of your child's immunisation details at any time.

How do I enrol my child on the Immunisation Register?

Children under seven years of age enrolled in Medicare are automatically included on the Immunisation Register. Children who are not eligible to enrol in Medicare can be added when a doctor or immunisation provider sends the details of a vaccination to the Immunisation Register.

How is information recorded on the Immunisation Register?

Information about your child's vaccinations should be sent as soon as possible by the doctor or immunisation provider to ensure the Immunisation Register is up-to-date.

Check with your doctor or immunisation provider to ensure the details are sent to the Immunisation Register when the vaccination is given.

How will the Immunisation Register help me keep track of my child's vaccinations?

A history statement will be sent to you when your child turns one, two and five years of age. Information about your child's immunisation details recorded on the Immunisation Register, and any immunisations that are missing for your child will be included in the statement. The child history statement will be sent to your address recorded with Medicare. To ensure you receive your child's statement, it is important to keep your address up-to-date with Medicare and your doctor or immunisation provider.

Your child's vaccinations will only be recorded on the Immunisation Register if your doctor or immunisation provider sends the details to the Immunisation Register.

Immunisation and your eligibility for some government benefits

To help increase Australia's immunisation rates a number of Government family assistance payments are only available for children who meet the immunisation requirements, that is, they are up to date with immunisation or have an exemption.

Do vaccines have side effects?

Modern vaccines provide high levels of protection against many infectious diseases. All vaccines used in Australia have been extensively tested for safety. Like all medications and natural medications, vaccines may have side effects. For vaccines most side effects are short-lived and do not lead to any long-term problems. This table (hyperlink to table at end) lists the side effects of those vaccines that are commonly used in Australia.

So what is an adverse event following immunisation?

An adverse event following immunisation is any reaction that you may consider serious or unexpected, and possibly related to vaccination.

An adverse event following immunisation does not include any of those side effects listed in the Common minor side effects to vaccines that do not require reporting table (hyperlink to table at end).

What do I need to do if I think an adverse event following immunisation is taking place? 

Seek immediate medical attention from your general practitioner, immunisation provider, hospital or ambulance service. The reaction will be treated and recorded.

A medical consultation is recommended before the next vaccination.

Do adverse events following immunisation need to be reported? 

All adverse events following immunisation need to be reported to the South Australian Immunisation Coordination Unit (SAICU).

Please report an adverse event following immunisation promptly.

For 0-18 years:

Child and Youth Health Parent Helpline: 1300-364-100 – 24 hrs, 7 days a week (cost of a local call) or direct to SAICU Ph: 8226-7177

For adults:

SAICU ph: 8226-7177

Or you can ask your immunisation provider, general practitioner, hospital doctor or nurse to report it for you.

Why report an adverse event following immunisation? 

You will receive support and advice on whether or not further vaccines should be given to the person who had the adverse event following immunisation.

You will receive additional information about the risks and benefits of continuing vaccinations.

Reporting of adverse events following immunisation helps to ensure the safety of vaccines is well monitored. 

What happens when you report an adverse event following immunisation?

A report is taken of which vaccine was involved and the nature and severity of the reaction.

The SA Immunisation Coordination Unit will assess each report.

You will be given information about the risks of having the immunisation compared with the risks of getting the disease.

Your child or you may need to attend a special immunisation service to decide on further immunisations. You will be informed of services in your area.

If the reaction is serious, confidential information will be sent to the national health authorities.

What about future vaccinations?

In the majority of cases, immunisation can continue under medical supervision and reactions do not usually happen again.

Where can I get further information?

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Comparison of effects of vaccine-preventable diseases and vaccines

DISEASE	EFFECTS OF DISEASE	SIDE EFFECTS OF VACCINATION
Diphtheria - contagious bacteria spread by droplets; causes severe throat and breathing difficulties.	About 1 in 15 patients dies. The bacteria release a toxin, which can produce nerve paralysis and heart failure.	DTPa vaccine – about 1 in 10 have local inflammation or fever. Serious adverse events are very rare, and much less common than with DTPw.
Hepatitis B – virus spread mainly by blood, sexual contact or from mother to newborn baby; causes acute hepatitis or chronic carriage.	About 1 in 4 chronic carriers will develop cirrhosis or liver cancer.	About 1 in 15 to 1 in 100 have pain and fever. Anaphylaxis occurs in about 1 in 600,000.
Hib – contagious bacteria spread by droplets; causes meningitis, epiglottitis (respiratory obstruction), septicaemia, osteomyelitis.	About 1 in 20 meningitis patients dies and 1 in 4 survivors has permanent brain or nerve damage. About 1 in 100 epiglottitis patients dies.	About 1 in 20 have discomfort or local inflammation. About 1 in 50 have fever.
Influenza – contagious virus spread by droplets; causes fever, muscle and joint pains, pneumonia.	Causes increased hospitalisation in the elderly. High-risk groups include the elderly, diabetes, alcoholics.	About 1 in 10 have local reactions, Guillain-Barre syndrome occurs in about About 1 in 1 million.
Measles – highly infectious virus spread by droplets; causes fever, cough, rash.	1 in 25 children with measles develops pneumonia and 1 in 2,000 develops encephalitis (brain inflammation). For every 10 children who develop measles encephalitis, 1 dies and 4 have permanent brain damage. About 1 in 25,000 develops SSPE (brain degeneration), which is always fatal.	About 1 in 10 have discomfort, local inflammation or fever. About 1 in 100 develops a rash, which is non-infectious. 1 in 1 million recipients may develop encephalitis (inflammation of the brain).
Menigococcal infections – bacteria spread by respiratory droplets; cause sepsis(infection of the blood stream), meningitis (infection of the tissues surrounding the brain).	About 1 in 10 patients dies. Of those that survive 1 in 30 has severe skin scarring or loss of limbs, and 1 in 30 has severe brain damage.	Polysaccharide vaccine: Local reactions common. Mild fever, headache, malasie in 1 in 30. Conjugate vaccine: About 1 in 10 has local inflammation, fever, irritabilty, anorexia or headaches.
Mumps – contagious virus spread by saliva; causes swollen neck glands, fever.	1 in 200 children develops encephalitis. 1 in 5 males past puberty develops inflammation of the testes. Occasionally mumps causes infertility or deafness.	1 in 100 recipients may develop swelling of the salivary glands. 1 in 3 million recipients develop mild encephalitis.
Pertussis – contagious bacteria spread by droplets; causes whooping cough and vomiting, lasting up to 3 months.	About 1 in 200 whooping cough patients under the age of 6 months dies from pneumonia or brain damage.	As for DTPa vaccine (see diphtheria).
Pneumococcal infections – bacteria spread by froplets; cause fever, pneumonia, septicaemia, meningitis.	About 1 in 10 meningitis patients dies.	Polysaccharide vaccine: Less than 1 in 20 has pain or local reaction. Conjugate vaccine: About 1 in 10 has local reaction or fever.
Polio – contagious virus spread by faeces and saliva; causes fever, headache, vomiting and may progress to paralysis.	While many infections cause no symptoms, about 1 in 20 hospitalised patients dies and 1 in 2 patients who survive is permanently paralysed.	OPV: Less than 1 in 100 recipients develop diarrhoea, headache, and/or muscle pains. 1 in 2.5 million recipients develop paralysis. IPV: Local redness(1 in 3), pain(1 in 7) and swelling(1 in 10) common. Up to 1 in 10 has fever, crying, and decreased appitite.
Rubella – contagious virus spread by droplets; causes rash, fever, swollen glands, but causes severe malformations to babies of infected pregnant women.	About 5 in 10 patients develop a rash and painful swollen glands; 5 in 10  adolescents and adults have painful joints; 1 in 3000 develops thrombocytopenia (bruising or bleeding); 1 in 6,000 develops inflammation of the brain; 9 in 10 babies infected during the first 10 weeks after conception will have a major congenital abnormality (such as deafness, blindness, brain damage, or heart defects).	About 1 in 10 have discomfort, local inflammation, or fever. About 1 in 20 have swollen glands, stiff neck, or joint pains. About 1 in 100 have a rash, which is noninfectious. Thrombocytopenia (bruising or bleeding) occurs after a first dose of MMR at a rate of 1 in 30,500
Tetanus – caused by toxin of bacteria in soil; causes painful muscle spasms, convulsions, lockjaw.	About 1 in 10 patients dies. The risk is greatest for the very young or old.	As for DTPa vaccine (see diphtheria).
Varicella (chickenpox) – caused by highly contagious virus; causes low-grade fever and vesicular rash. Reactivation of the virus later in life causes herpes zoster (shingles).	About 1 in 5000 patients develop encephalitis (brain inflammation). About 3 in 100,000 patients die. Infection during pregnancy can result in congenital malformations in the baby. Onset of infection in the mother from 5 days before to 2 days after delivery results in severe infection in the newborn baby in up to one-third of cases.	About 1 in 5 has a local reaction or fever. A mild varicella-like rash may develop in 3-5 per hundred recipients.

Reference: NHMRC (2003) The Australian Immunisation Handbook (8^th Edition)                                            September 2003

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| For Parents | Vaccines and common side effects | Comparison of effects of vaccine-preventable diseases and vaccines | For Immunisation Providers |

Applications Management ICT Services South Australian Department of Health Last updated: 28th November 2007

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