Immunization is the process of making a person immune or immune to a disease. This process is done by giving a vaccine that stimulates the immune system to be immune to the disease.
Newborn babies already have natural antibodies called passive immunity. These antibodies were obtained from the mother when the baby was still in the womb. However, this immunity can only last a few weeks or months. After that, the baby will become susceptible to various types of diseases.
Immunization aims to build a person's immunity against a disease, by forming antibodies in certain levels. In order for these antibodies to form, a person must be given the vaccine according to a predetermined schedule. The immunization schedule depends on the type of disease to be prevented. Some vaccines are enough to be given once, but some must be given several times, and repeated at a certain age. Vaccines can be given by injection or by mouth.
Complete Routine Immunization in Indonesia
Now, the concept of immunization in Indonesia is changed from complete basic immunization to complete routine immunization. Complete routine immunization or mandatory immunization consists of basic immunization and follow-up immunization, with details as follows:
Basic immunization
- 0 months: 1 dose of hepatitis B
- 1 month old: 1 dose of BCG and polio
- 2 months of age: 1 dose of DPT, hepatitis B, HiB, and polio
- 3 months old: 1 dose of DPT, hepatitis B, HiB, and polio
- 4 months old: 1 dose of DPT, hepatitis B, HiB, and polio
- 9 months old: 1 dose of measles/MR
Advanced immunization
- Age 18-24 months: 1 dose of DPT, hepatitis B, HiB, and measles/MR
- Grade 1 SD/equivalent: 1 dose of measles and DT
- Grades 2 and 5 SD/equivalent: 1 dose of Td
Regarding immunization coverage, data from the Ministry of Health stated that around 91% of infants in Indonesia in 2017 had received complete basic immunization. This figure is still slightly below the 2017 strategic plan target, which is 92 percent. Nineteen of the 34 provinces in Indonesia have not yet reached the strategic plan target. Papua and North Kalimantan occupy the lowest place with less than 70% achievement.
Based on these data, it is also known that almost 9% or more than 400,000 infants in Indonesia do not receive complete basic immunization.
Meanwhile, for advanced immunization coverage, the percentage of children aged 12-24 months who had received DPT-HB-HiB immunization in 2017 reached around 63 percent. This figure has exceeded the 2017 strategic plan target by 45 percent. Meanwhile, the percentage of children who received measles/MR immunization in 2017 was 62 percent. This number is still far from the 2017 strategic plan target of 92 percent.
In addition to the several types of vaccines above, a COVID-19 vaccine is currently being developed and researched. It should be noted that immunization does not provide 100% protection for children.
Children who have been immunized are still likely to get a disease, but the chances are much less, which is only about 5-15 percent. This does not mean that the immunization has failed, but because the immunization protection is around 80-95 percent.
Immunization Side Effects
Vaccination may be accompanied by side effects or post-immunization follow-up events (AEFI), including mild to high fever, pain and swelling at the injection site, and a little fussiness. However, the reaction will disappear in 3-4 days.
If your child has AEFI as above, you can give warm compresses and fever reducers every 4 hours. Just wear thin clothes, without being covered. In addition, give breast milk more often, along with additional nutrients from fruit and milk. If the condition does not improve, immediately consult a doctor.
In addition to the above reactions, some vaccines can also cause severe allergic reactions to seizures. However, these side effects are relatively rare. It is important to remember that the benefits of immunization in children outweigh the possible side effects.
It is important to tell the doctor if your child has ever had an allergic reaction after giving the vaccine. This is to prevent the occurrence of dangerous reactions, which can be caused by repeated administration of the vaccine.
TypeImmunization in Indonesiaa
The following are the vaccines recommended by the Indonesian Pediatric Association (IDAI) in the immunization program:
- Hepatitis B
- Polio
- BCG
- DPT
- Hib
- Measles
- MMR
- PCV
- Rotavirus
- Influenza
- typhus
- Hepatitis A
- Varicella
- HPV
- Japanese encephalitis
- Dengue
Hepatitis B
This vaccine is given to prevent serious liver infections, caused by the hepatitis B virus. Hepatitis B vaccine is given within 12 hours after the baby is born, preceded by a vitamin K injection, at least 30 minutes earlier. Then, the vaccine is given again at the age of 2, 3, and 4 months.
Hepatitis B vaccine can cause side effects, such as fever and weakness. In rare cases, side effects can include itching, skin redness, and swelling of the face.
Polio
Polio is an infectious disease caused by a virus. In severe cases, polio can cause shortness of breath, paralysis, and even death.
Polio immunization is first given when a new child is born until the age of 1 month. Then, the vaccine is given again every month, namely when the child is 2, 3, and 4 months old. For reinforcement, the vaccine can be given again when the child reaches the age of 18 months. The polio vaccine can also be given to adults with certain conditions.
The polio vaccine can cause a fever of more than 39 degrees Celsius. Other side effects that can occur include allergic reactions such as itching, redness of the skin, difficulty breathing or swallowing, and swelling of the face.
BCG
The BCG vaccine is given to prevent the development of tuberculosis (TB), a serious infectious disease that generally attacks the lungs. Please note that the BCG vaccine cannot protect people from TB infection. However, BCG can prevent TB infection from progressing to serious TB disease conditions such as TB meningitis.
The BCG vaccine is only given once, namely when a new baby is born, until the age of 2 months. If until the age of 3 months or more the vaccine has not been given, the doctor will first perform a tuberculin test or Mantoux test, to see whether the baby has been infected with TB or not.
The BCG vaccine will cause ulcers at the injection site and appear 2-6 weeks after the BCG injection. The pus boil will burst, and leave scar tissue. While other side effects, such as anaphylaxis, is very rare.
DPT
The DPT vaccine is a type of combined vaccine to prevent diphtheria, pertussis, and tetanus. Diphtheria is a serious condition that can cause shortness of breath, pneumonia, heart problems, and even death.
Not much different from diphtheria, pertussis or whooping cough is a severe cough that can trigger respiratory problems, pneumonia, bronchitis, brain damage, and even death. While tetanus is a dangerous disease that can cause seizures, muscle stiffness, and even death.
The DPT vaccine should be given four times, namely when the child is 2, 3, and 4 months old. The vaccine can be given again at the age of 18 months and 5 years as reinforcement. Then, follow-up vaccines can be given at the age of 10-12 years, and 18 years.
The side effects that appear after DPT immunization are quite diverse, including inflammation, pain, body stiffness, and infection.
Hib
Hib vaccine is given to prevent bacterial infection Haemophilus influenza type B. These bacterial infections can trigger dangerous conditions, such as meningitis (inflammation of the lining of the brain), pneumonia (wet lungs), septic arthritis (arthritis), and pericarditis (inflammation of the protective lining of the heart).
Hib immunization is given 4 times, namely when the child is 2 months old, 3 months old, 4 months old, and in the 15-18 month age range.
Like other vaccines, the Hib vaccine can also cause side effects, including fever above 39 degrees Celsius, diarrhea, and decreased appetite.
Measles
Measles is a viral infection in children characterized by several symptoms, such as fever, runny nose, dry cough, rash, and inflammation of the eyes. Measles immunization is given when the child is 9 months old. As reinforcement, the vaccine can be given again at the age of 18 months. But if the child has received the MMR vaccine, the second measles vaccine does not need to be given.
MMR
The MMR vaccine is a combination vaccine to prevent measles, mumps, and rubella (German measles). These three conditions are serious infections that can cause dangerous complications, such as meningitis, brain swelling, and hearing loss (deafness).
The MMR vaccine is given when the child is 15 months old, then given again at the age of 5 years as reinforcement. MMR immunization is carried out at a minimum distance of 6 months with measles immunization. However, if at the age of 12 months the child has not yet received the measles vaccine, then the MMR vaccine can be given.
The MMR vaccine can cause a fever over 39 degrees Celsius. Other side effects that can appear are allergic reactions such as itching, difficulty in breathing or swallowing, and swelling of the face.
There are many negative issues circulating around immunization, one of which is the issue of the MMR vaccine which can cause autism. This issue is not true at all. Until now, there is no strong association between MMR or other types of immunization with autism.
PCV
The PCV (pneumococcal) vaccine is given to prevent pneumonia, meningitis, and septicemia, which are caused by bacteria Streptococcus pneumoniae. Vaccination should be done sequentially, namely when the child is 2, 4, and 6 months old. Furthermore, the vaccination is done again when the child is 12-15 months old.
Side effects that may arise from PCV immunization include swelling and redness at the injection site, accompanied by a low-grade fever.
Rotavirus
This immunization is given to prevent diarrhea due to rotavirus infection. The rotavirus vaccine is given 3 times, namely when the baby is 2, 4, and 6 months old. Just like other vaccines, rotavirus vaccine also causes side effects. In general, the side effects that appear are mild, such as mild diarrhea, and the child becomes fussy.
Influenza
Influenza vaccine is given to prevent flu. This vaccination can be given to children aged 6 months with a frequency of 1 repetition per year, until the age of 18 years.
Side effects of influenza immunization include fever, cough, sore throat, muscle aches, and headaches. In rare cases, side effects may include shortness of breath, ear pain, chest tightness, or wheezing.
typhus
This vaccine is given to prevent typhoid, which is caused by bacteria SAlmonella typhi. Typhoid vaccine can be given when children are 2 years old, with a frequency of repetition every 3 years, until the age of 18 years.
Although rare, typhoid vaccine can cause a number of side effects, such as diarrhea, fever, nausea and vomiting, and stomach cramps.
Hepatitis A
As the name implies, this immunization aims to prevent hepatitis A, which is an inflammatory liver disease caused by a viral infection. Hepatitis A vaccine should be given 2 times, in the age range of 2-18 years. The first and second injections should be 6 months or 1 year apart.
Hepatitis A vaccine can cause side effects such as fever and weakness. Other rare side effects include itching, coughing, headache, and nasal congestion.
Varicella
This vaccine is given to prevent chickenpox, which is caused by the V . virusaricella zoster. Varicella immunization is carried out in children aged 1-18 years. If the vaccine is given to children aged 13 years and over, the vaccine is given in 2 doses, with an interval of at least 4 weeks.
1 in 5 children given the varicella vaccine experience pain and redness at the injection site. The varicella vaccine can also cause skin rashes, but this side effect only occurs in 1 in 10 children.
HPV
The HPV vaccine is given to adolescent girls to prevent cervical cancer, which is generally caused by a virus Hpapillomavirus. The HPV vaccine is given 2 or 3 times, starting at the age of 10 to 18 years.
Generally, the HPV vaccine causes side effects in the form of headaches, as well as pain and redness at the injection site. However, these side effects will disappear within a few days. In rare cases, recipients of the HPV vaccine may experience fever, nausea, and itching or bruising at the injection site.
Japanese encephalitis
Japanese encephalitis (JE) is a viral infection of the brain, which is spread through mosquito bites. In general, JE causes only mild flu-like symptoms. But in some people, JE can cause high fever, seizures, and paralysis.
The JE vaccine is given from 1 year of age, especially if you live or travel to an JE endemic area. The vaccine can be re-administered 1-2 years later for long-term protection.
Dengue
Dengue immunization is carried out to reduce the risk of dengue fever, which is spread by mosquitoes Aedes aegypti. The dengue vaccine is given 3 times with an interval of 6 months, at the age of 9 to 16 years.