Recommended Immunisations in Hong Kong

Posted on 03 November 2014 by Kristrun

blockforVaccinationsARrticleThere is not much difference between vaccinations in the public health system and the private health system in Hong Kong. A few things to consider are:

The Hong Kong government schedule recommends to give Hep B and BCG at birth. Some parents have a preference to delay those vaccines and then usually the Hep B is given at 1, 2, and 6 months as a part of a combined vaccine with DaPT and HIB (Haemophilus Influenza B).

The BCG (only one dose is needed), is then usually given in the buttock instead of the other option of the upper arm if given by the Government hospital staff.  There is not any obvious reason for this except that many parents feel that the scar will not be visible there as in the arm (the BCG is the only vaccine that always produces a scar, which is usually circular and can be 1 to 2 cms in diameter).  Some doctors claim that there is more risk of an infection by the BCG vaccine, or in the pimple that it gives before the scar is formed (the first three months or so there is a pimple that may burst, with some pus, but then eventually heals) – the infection being caused by rubbing of the diaper on the area, urine, stools etc.  

The HIB part of the 2, 4, and 6 months vaccine is not available in the public health system and therefore if you wish to give this to your child, you must see a private doctor.   For this you will pay a consultation fee and the fee for the vaccine.  Because the HiB can be given as a part of the 5 in 1 mentioned above, many parents then choose to give all of these together, instead of having the DTaP and Polio in the Government clinic, and then HiB in the private clinic, at the same time (2, 4 and 6 months).  It is more expensive to get the full 5 in 1 than it is to just get the HiB but it saves a trip and one injection (the actual needle).  In terms of giving many vaccines at the same time, this is a discussion of a different story, – in developed countries it is considered the safest to give these vaccines and they have been on the market for a long time, so they are not considered unsafe because of heavy metals, interactions, etc.

  • In the past, the Hepatitis B vaccine contained Mercury as a preservative, but nowadays, in Hong Kong, the vaccine used is a Mercury free Hepatitis B (ENGERIX).
  • Both private and government doctors recommend to give the MMR vaccine around 12 to 15 months.    This is the only vaccination given that contains live vaccines, and usually has side effects (the actual symptoms of all three diseases, or at least some fever and usually rashes, around 10 to 14 days after injecting it).
  • It is very important that the child is free of any diseases, colds etc. when being vaccinated, and as some get a little sick and feverish, and it may be a good idea to have some paracetamol on hand, doses depending on age and weight of baby.
  • All vaccines, can cause side effects, but they’re generally mild and short-lived and the benefits outway the risks of severe illness or fatality due to disease.

Below is information about the most common vaccinations in Hong Kong:
The 5-in-1 vaccine, the DTaP/IPV/Hib vaccine, is a single injection which protects against five serious childhood diseases. These five illnesses are diphtheria, tetanus, whooping cough, (pertussis) Polio and Haemophilus influenza type b.  In the government system, this vaccine is a 4 in 1 (without the HIB), as there are not many outbreaks of HIB in Hong Kong, although other countries see a reason to vaccinate against this.  Private clinics in Hong Kong offer this as a 5 in 1, vaccinating against the following diseases:

Diphtheria is a highly contagious bacterial infection that mainly affects the nose and throat. Less commonly, it can also affect the skin. The bacteria spread when an infected person coughs or sneezes and droplets of their saliva enter another person’s mouth or nose.  Diphtheria can lead to potentially life-threatening complications, such as breathing difficulties and problems with the heart and nervous system.

Tetanus is a serious but rare infection caused by bacteria. It usually occurs when a flesh wound becomes contaminated. The symptoms include: Stiffness in jaw muscles usually the first symptom, also known as lockjaw. Muscle spasms and stiffness then spread from jaw into neck and limbs. Other symptoms include high temperature (fever), sweating, rapid heartbeat (tachycardia), and high blood pressure (hypertension).  Muscle spasms in neck can make swallowing difficult (dysphagia). In the most serious cases, severe breathing difficulties could develop. This may lead to suffocation and death.

Whooping cough (pertussis), Whooping cough is a highly contagious bacterial infection of the lungs and airways. The condition usually begins with a persistent dry and irritating cough that progresses to intense bouts of coughing. These are followed by a distinctive ‘whooping’ noise, which is how the condition gets its name.  Other symptoms include a runny nose, raised temperature and vomiting after coughing. The coughing can last for around three months. Whooping cough is caused by a bacterium called Bordetella pertussis, which can be passed from person to person through droplets in the air from coughing and sneezing.

Polio, in the past was very common it caused paralysis and death. Since a polio vaccine was introduced in 1955, the number of polio cases has dramatically reduced. There are now only a few countries in which the condition remains a serious problem.

Haemophilus influenza type B. HiB is a bacterial infection that can cause a number of serious illnesses especially in young children. Many of children who get HiB infections become very ill and need hospital care.  HiB can cause any of the following infections: meningitis (lining of the brain and spinal cord), pneumonia (lungs), pericarditis (lining surrounding the heart), epiglottitis (epiglottis – flap that covers the entrance to your windpipe), septic arthritis (joints) and cellulitis (skin and underlying tissues). Some of these infections can lead to septicaemia (blood poisoning), which can be fatal.

Side-effects of the 5 in 1 vaccine:   
The 5-in-1 vaccine is very safe but some babies do have side effects. Your baby may have any of the following side effects after receiving the 5-in-1 DTaP/Td/IPV infant vaccine.

Very common reactions include:  pain, redness and swelling at the injection site, irritability and increased crying, being off-colour or having a fever.

Common reactions include: loss of appetite, diarrhoea, vomiting,

Rare reactions include:  febrile convulsions (fits) and floppiness.

Pneumococcal infections are caused by the bacterium Streptococcus pneumonia which can lead to pneumonia, septicaemia (blood poisoning) and meningitis.

Side effects of pneumococcal vaccine

Although the pneumococcal vaccination is safe, both the childhood and adult versions of the vaccines can cause mild side effects, including:

a mild fever, redness at the site of the injection, hardness or swelling at the site of the injection

Occasionally, the childhood version of the vaccine may lead to more serious side effects including:

high temperatures sometimes leading to convulsions (febrile seizures)
mild allergic reactions in the form of itching skin rashes
In very rare cases, children and adults can have a serious allergic, anaphylactic reaction and it can cause life-threatening breathing difficulties and collapse. It’s a serious side effect and is very alarming at the time, but it can be completely treated with adrenaline. The doctor or nurse giving the vaccine will have been trained to know how to treat anaphylactic reactions and, provided they receive treatment promptly, children and adults make a complete recovery.

Rotavirusis a highly infectious stomach bug that typically strikes babies and young children, causing an unpleasant bout of diarrhoea, sometimes with vomiting, tummy ache and fever. Most children recover at home within a few days, but nearly one in five will need to see their doctor, and one in 10 of these end up in hospital as a result of complications such as extreme dehydration. A very small number of children die from rotavirus infection each year. The rotavirus vaccine is expected to prevent four out of five cases of vomiting and diarrhoea caused by rotavirus and there could be 70% fewer hospital stays as a result.

Side effects of rotavirus vaccine

Common side effects: restless and irritability, mild diarrhoea
Rare side effects: As with all vaccines, there is a very rare (approximately one in a million) possibility of the rotavirus vaccine causing a severe allergic reaction called anaphylaxis. Anaphylaxis is very serious and a medical emergency, but with prompt treatment most people make a full recovery. All health professionals responsible for giving vaccines should be trained to recognize and treat anaphylaxis. In very rare cases (about two in every hundred thousand babies vaccinated), the rotavirus vaccine can affect the baby’s lower gut and they may develop a rare gut disorder called intussusception. The symptoms of intussusception are tummy ache, vomiting and sometimes passing what looks like redcurrant jelly in their nappy. If this happens, contact your doctor immediately.

The Meningitis group C bacteria, can cause two very serious illnesses: meningitis and septicaemia.  The Men C vaccine does not protect against meningitis caused by other bacteria or by viruses such as meningococcal group B, so it’s important for parents to be aware of the symptoms of meningitis.

Side effects of Meningitis C vaccine

The Men C vaccine has an excellent safety record. The most common reactions tend to be minor and very temporary.   Many children and adults have no side effects at all after having the meningitis C vaccine, and in those that do, any side effects tend to be mild and short-lived.

Common reactions are: swelling, redness and pain around the injection site, mild fever, vomiting and diarrhoea (more common in babies and toddlers), crying, irritability, drowsiness, disrupted sleep and going off food (more common in babies and toddlers), headaches and muscle aches (teenagers and adults).
Rare side effects:  A baby can have an allergic reaction soon after the injection. This may take the form of a rash or itching that affects part or all of their body.
In very rare cases, an anaphylactic reaction – a severe allergic reaction – within a few minutes of the vaccination. This can cause breathing difficulties and collapse. It’s very alarming at the time, but the doctor or nurse giving the vaccine will have been trained to know how to treat these reactions and, provided they receive treatment promptly, children and adults make a complete recovery.  Very rarely, vaccine may trigger dizziness, fever-related seizures, fainting, numbness and a type of muscle weakness called hypotonia.

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