We ask the professionals how to take the stress out of vaccinations, and ensure you have the right shots to stay healthy abroad.
It’s ironic that, when parents are at their most sleep-deprived and therefore memory-deficient, we are given the task of making sure our children are vaccinated on time and to schedule. Throw into that mix a move to a different country or two and it’s no wonder that some of us struggle to keep up with which child has had which vaccination and when they are due the next one. Relying on the support and advice of a leading healthcare practitioner can be a blessing when faced with the daunting prospect of vaccinations.
Preparing your child
Babies under a year old tend to be blissfully unaware of what they face when visiting the doctor’s surgery for their immunisations. But for children aged around 15 months and older, there are some ways to sooth their potential distress. Dr Natalie Epton from the International Paediatric Clinic (IPC) says talking to a child under two years old prior to vaccination is unlikely to help; rather, be prepared with their favourite comforter and perhaps a treat or snack for afterwards.
“After around two years old, and depending on your child’s temperament, it may help to briefly discuss why we vaccinate, and what he or she should expect,” says Dr Epton. “We always told our boys that they needed their jabs to stay healthy, and that Captain America got his super strength with an injection!”
How to make your children’s injections as stress-free as possible
Stay calm: Your child will feed off your behaviour, so if you’re a bag of nerves then your child will be too.
Distract: Squeeze their hand, sing a song, talk about what you’re going to do after your visit to the surgery.
Reward: The level of reward is, of course, up to you, but the promise of a fun visit to the park or favourite play area, a lollipop or sticker may be all that’s needed.
Don’t punish: Never use having a jab as a punishment, for example, “Sit still in the doctor’s surgery or they’ll give you an injection”. This will colour their future view of any vaccinations and make everything a lot harder!
Control: Let an older child decide which arm to have the shot in and whether they want it on the count of three or five.
It’s easy to lose track of which jabs our children may need, so a clinic’s own record, and your child’s personal health record, are there to help you keep organised. “Singapore also maintains a database of all vaccinations given to citizens and residents, which it uses to ensure that children have completed their compulsory vaccinations prior to school entrance. Parents can request that a copy be downloaded on their behalf,” points out Dr Epton.
And there’s no need to panic if your child misses a vaccination (not right away at least). “You are encouraged to try to keep to the schedule as much as possible, but often childhood illnesses, travel, and parental amnesia intervene. If you realise your child has missed one or more vaccinations, arrange to see your doctor to work out a suitable catch-up schedule. For routine childhood vaccinations, you will not have to repeat previous doses; some travel vaccinations are more time-sensitive, though.”
Travel to exotic and far-flung places can be part and parcel of expat life. Whether for work or pleasure, the fact remains that you should research the recommended vaccinations for your destination and allow plenty of time before your departure to actually get them done.
“Travel medicine deals with the prevention and management of health problems of international travellers, and the use of vaccines to prevent some of these health problems is an important aspect,” says Dr Tan, Medical Director (A&E department, 24-hour walk-in clinic) at Parkway Shenton. “Most people get vaccinated against flu, hepatitis A and typhoid, and vaccination is recommended one to two weeks prior to departure to allow for any side effects to resolve before the travel date.”
And for those diseases we can’t vaccinate against, such as malaria and dengue, there are other precautions we should take. “Anti-malaria tablets are available for prevention but will only protect for the duration that the medication is taken. Other preventive measures, which also apply to dengue, include the use of insect repellent, wearing long sleeves and long pants, and using mosquito nets while sleeping in non air-conditioned places.”
The hot topic of whether to vaccinate or not rolls on, but within the medical profession there is little argument. Dr Tan cites a classic example of the fallout when parents choose not to vaccinate their children: “If a vaccine is mandatory, there should not be any objections. As an example, the current outbreak of measles in the UK is likely due to the refusal of some parents to let their child or children have the Measles, Mumps and Rubella (MMR) vaccine because of unsubstantiated claims that it causes autism.” Dr Tan also emphasises that, although one should respect the individual’s wish when a vaccine is not mandatory, the doctor should take every opportunity to change the individual’s mind.
There is also currently a worldwide whooping cough (pertussis) epidemic, the worst in the last 70 years. IPC’s Dr Epton emphasises that small babies, and in particular those who have not yet received their vaccinations, are most vulnerable. “Parents and caregivers (including visiting grandparents) can increase their baby’s protection, especially if travelling to regions with recent outbreaks, such as certain parts of the US and Australia, by the practice of ‘cocooning’: adults and children in close proximity to the newborn ensure their pertussis vaccinations are up to date, and receive a booster if necessary.”