1. Rotavirus vaccination for below 6 months old
2. Haemophilus influenzae  b (Hib) vaccine
3. Influenza vaccine
4. Varicella (Chickenpox) vaccine at 15-18 months
5. Hepatitis A vaccination
6. Human Papilloma Virus vaccine
7. Meningococcal Vaccine 

1. ROTAVIRUS
What is it ?
Rotavirus causes acute severe diarrhoea and vomiting in young children which lasts 4-8 days but occasionally persists up to 3 weeks.  In general, the younger the child, the higher is the risk of hospitalization for severe diarrhoea, fever and vomiting.  In Singapore, rotavirus infection is one of the most common causes of hospitalization for diarrhoea.

There is no specific treatment for rotaviral infection. Hospitalisation becomes necessary when child is dehydrated or unable to retain fluids. 

Dosage and Administration: Two oral vaccines are available. 2 doses of  Rotarix vaccine  are given during first 6 months of life with 1st dose given between 6 to 14 weeks and the second dose given between 14 and 24 weeks.  Rotateq is a pentavalent vaccine that consists of 3 doses. 

Side Effects: Both vaccines are well tolerated with no serious side effects. 

Estimated Cost: 2 doses of Rotarix at $180-$200; 3 doses of Rotateq at $190-$220
 

2. Haemophilus Influenzae b (HIb) Vaccine
What is it?  
Haemophilus influenzae b infections can lead to serious complications such as meningitis (brain infection), pneumonia(lung infection), acute epiglottitis (life threatening throat infection), septic arthritis (joint infection) and pericarditis(heart infection). It used to be the leading cause of meningitis in the States until the introduction of the vaccine.

Dosage and administration: Usually given as part of combined vaccine preparations 5- in- 1 or 6- in-1. 

Side Effects and Cost: As for 5-in-1 and 6-in-1 


3. INFLUENZA ( “FLU”) VACCINATION
What is it?
Influenza, commonly known as the flu, is an extremely contagious viral infection that  causes high fever, chills, muscle aches, sore throat and cough.  Elderly patients age 50 and above and children aged 6 months to 5 years are at higher risk for influenza related complications such as otitis media (ear infection) and death(rare). Anyone with chronic lung diseases such as asthma should also be vaccinated against influenza. Children who are receiving long term aspirin therapy are advised to be vaccinated against influenza as well.  Anyone with chronic metabolic diseases such as diabetes should also be vaccinated against influenza. 

Dosage and administration:   The flu vaccine should  be given for children above 6 months old  and have no egg allergy.  For children less than 9 years old who were previously not vaccinated against influenza, a booster dose one month later is recommended.  The flu vaccine is given as an injection once a year. 

Side effects:  Low grade fever, flu like symptoms and pain at injection site may occur. 

Estimated Cost: $25- $40


4. CHICKENPOX VACCINATION 
What is it ? 
The chickenpox virus is a highly infectious disease caused by the varicella-zoster virus.  Your child can be infected by breathing in the virus through respiratory droplets or by contact with fluid from the blister like skin rashes.  Infected person is able to spread the virus until all the skin blisters turn to crusts.  Outbreaks in child care centres are common.  Symptoms maybe mild in children and include fever, fatigue, muscle pain, loss of appetite, pain in joints and irritability.  Prevention is recommended still as possible complication though rare maybe serious and life threatening eg pneumonia and encephalitis (brain lining infection). As children with chickenpox will usually not be allowed to attend school for about 2 weeks, it maybe more practical to vaccinate them especially if both parents are working and taking leave to look after the child for 2 weeks is difficult. There is a break through rate of 2-20% even after the vaccination. However a child who has received the vaccination usually has milder symptoms and they last for a shorter time. 

Dosage and Administration: One dose is generally recommended for children below 12 years old.  The dose must be given after 1 year old.  Currently, a second dose may be recommended by your doctor at 4 to 6 years old if first dose is given between one to two years old. 

Side effects: Low grade fever and rash may occur but is rare. 

Estimated Cost: $70- $90


5. HEPATITIS A VACCINATION
What is it ?  
Hepatitis A is often transmitted through consumption of contaminated raw seafood or water.  It causes fever, jaundice (yellowing of eyes/skin), lethargy,diarrhoea , vomiting and on rare occasions death.  Although hepatitis A disease is usually asymptomatic in children below 8 years of age, outbreaks may occur at child care centers.  Hence, Hepatitis A vaccination is recommended for children attending child care centers, children who travel to countries where hepatitis A is endemic and children who are hepatitis B carriers. 

Dosage and administration: Hepatitis A vaccine is given to children above 12 months of age.  For children 1-15 years old, 2 doses of injection are given with second dose  given 6 months later. 

Side effect: rare 

Estimated Cost: $60-90

6. Human Papilloma Virus (HPV) Vaccine 
What is it ? 
The human papilloma viruses are responsible for cervical cancer, precancerous stages known as cervical intraepithelial neoplasia and vulvar intraepithelial neoplasia and genital warts

Is it recommended for all ladies?
HPV vaccination will set the stage for prevention of cervical cancer.  It is hence recommended by the US Advisory Committee on Immunisation Practices to include HPV vaccine in adolescent /adult immunization program for those in the age group of 9-26 years old who lack immunity.  Cervical cancer is one of the top 6 cancers in female Singaporeans. 

What is the benefit then of having a HPV vaccination?
Early vaccination in developed countries has resulted in reduced cancer rate by as much as 75% and shifted the burden of managing cervical cancer to managing pre-malignant lesions. 

Protection against HPV will also help to reduce incidence of genital warts.   

Currently two HPV vaccines, Gardasil and Cervarix,  are available locally.  Please discuss with your doctor with regards to each vaccine and their  immunization schedule. 

Dosage and Administration: The vaccine is injected over the upper arm or thigh with three doses given over a 6 month period.  The second dose is administered 1 to 2 months after the first dose and the third dose is given 6 months after the first dose. 

Who should get this vaccine?
Girls between the ages of 9 and 26 should be vaccinated against the human papilloma virus.  Currently, ladies older than 26 years old may want to check with their doctors for this vaccination as approval from Health Science Authority is pending. 

Ideally the vaccine should be administered before potential exposure to HPV through sexual activity; however, women who are sexually active should still be vaccinated. 

Vaccination is not recommended during pregnancy.  If a woman is found to be pregnant after initiating the vaccination series, the remainder of the three-dose regimen should be delayed until after the completion of the pregnancy. 

Side Effects: Common side effects as with most other immunizations include fever, pain and swelling over injection sites.   

Do I still need to be screened for cervical cancer after the vaccination?
Yes, routine PAP smear is still advised even after vaccination.  This is because there are many strains of the HPV and vaccines available currently are directed against the few main HPV types that account for the majority of the cervical cancers, but not all.  Hence, cervical cancer screening is still recommended ie PAP smears is still important. 

Estimated Cost: $150-$200 per dose (Cost of this vaccine has been reduced to about $100 per injection in some clinics.) 


7. Meningococcal Vaccine 
What is it ?
Travellers going to countries with meningococcal epidemics and those pilgrims on Haj should be given this vaccine which protects against brain infection.  It is available locally as the quadrivalent ACWY polysaccharide vaccine

Dosage and Administration: Vaccine is for children above 2 years old.

Side Effect: Pain and redness over injection site. 

Estimated Cost:  $52-$75




The information on this website is  strictly  meant to be used as an educational guide.  Parents are advised to consult their family doctor or paediatrician for  specific medical advice.