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Immunizations or vaccinations for children

When we moved to China, one of the biggest sacrifices our kids have had to make are to take additional vaccinations.

Personally, I would only give my children the minimum required number of vaccinations.

Because China is still a developing country where you find hospitals / clinics specializing in tuberculosis (TB), my children have had to take the following vaccines:

1. Hepatitis A – both kids

Hepatitis A is a viral liver disease that can cause mild to severe illness.Globally, there are an estimated 1.4 million cases of hepatitis A every year. The hepatitis A virus is transmitted through ingestion of contaminated food and water, or through direct contact with an infectious person. Hepatitis A is associated with a lack of safe water and poor sanitation.

Hepatitis A is a liver disease caused by the hepatitis A virus. The virus is primarily spread when an uninfected (and unvaccinated) person ingests food or water that is contaminated with the faeces of an infected person. The disease is closely associated with a lack of safe water, inadequate sanitation and poor personal hygiene.

Unlike hepatitis B and C, hepatitis A infection does not cause chronic liver disease and is rarely fatal, but it can cause debilitating symptoms and fulminant hepatitis (acute liver failure), which is associated with high mortality.

Hepatitis A occurs sporadically and in epidemics worldwide, with a tendency for cyclic recurrences. Every year there are an estimated 1.4 million cases of hepatitis A worldwide.

The hepatitis A virus is one of the most frequent causes of foodborne infection. Epidemics related to contaminated food or water can erupt explosively, such as the epidemic in Shanghai in 1988 that affected about 300 000 people. Hepatitis A viruses persist in the environment and can resist food-production processes routinely used to inactivate and/or control bacterial pathogens.

2. Japanese encephalitis (JE) – my daughter

Japanese encephalitis is a viral disease that infects animals and humans. It is transmitted by mosquitoes and in humans causes inflammation of the membranes around the brain. Intensification and expansion of irrigated rice production systems in South and South-East Asia over the past 20 years have had an important impact on the disease burden caused by Japanese encephalitis. Where irrigation expands into semi-arid areas, the flooding of the fields at the start of each cropping cycle leads to an explosive build-up of the mosquito population. This may cause the circulation of the virus to spill over from their usual hosts (birds and pigs) into the human population.

The virus causing Japanese encephalitis is transmitted by mosquitoes belonging to the Culex tritaeniorhynchus and Culex vishnui groups, which breed particularly in flooded rice fields. The virus circulates in ardeid birds (herons and egrets). Pigs are amplifying hosts, in that the virus reproduces in pigs and infects mosquitoes that take blood meals, but does not cause disease. The virus tends to spill over into human populations when infected mosquito populations build up explosively and the human biting rate increases (these culicines are normally zoophilic, i.e. they prefer to take blood meals from animals).

Chemical vector control is not a solution, as the breeding sites (irrigated rice fields) are extensive. In some rice production systems faced with water shortages, however, certain water management measures (alternate wetting and drying) may be applied that reduce vector populations. Personal protection (using repellents and/or mosquito nets) will be effective under certain conditions. Eliminating the pig population is often a measure taken in the wake of outbreaks. Certainly, the introduction of pig rearing as a secondary source of income for rice-growing farmers in receptive areas must never be encouraged.

3. Rubella – my daughter

Rubella is an acute, contagious viral infection. While the illness is generally mild in children, it has serious consequences in pregnant women causing fetal death or congenital defects known as congenital rubella syndrome (CRS).

The rubella virus is transmitted by airborne droplets when infected people sneeze or cough. Humans are the only known host.


In children, the disease is usually mild, with symptoms including a rash, low fever.

The rubella vaccine is a live attenuated strain that has been in use for more than 40 years. A single dose gives more than 95% long-lasting immunity, which is similar to that induced by natural infection.

Rubella vaccines are available either in monovalent formulation (vaccine directed at only one pathogen) or more commonly in combinations with other vaccines such as with vaccines against measles (MR), measles and mumps (MMR), or measles, mumps and varicella (MMRV).

Adverse reactions following vaccination are generally mild. They may include pain and redness at the injection site, low-grade fever, rash and muscle aches.

4. Meningococcal – my daughter

Meningococcal meningitis is a bacterial form of meningitis, a serious infection of the meninges that affects the brain membrane. It can cause severe brain damage and is fatal in 50% of cases if untreated.

The meningitis belt of sub-Saharan Africa, stretching from Senegal in the west to Ethiopia in the east, has the highest rates of the disease.

Comment: Hmm…if this disease generally affects the African continent, maybe my daughter doesn’t need it?

(Source: World Health Organization)

I feel sorry for my son the most because the last time he visited the pediatrician, he had to take a blood test to check if he’s still got the Hepatitis A immunity. She said that he could skip it if the antibody levels were high but, unfortunately for him, he needs it.

My daughter? I wonder if she’s able to take 3 doses at one go!

I definitely dread having to take the both of them to the hospital, especially when my husband’s not around.