Vaccinating children can be a bittersweet experience for parents. While one wants to shield their little one from illnesses, the protection usually comes at the cost of side effects like fever, swelling and pain for a brief period. Painless vaccination is touted to go easy on the post-vaccination side effects, unlike the traditional painful vaccinations. Experts say that the pain during the prick is something a child has to endure, though the side effects post-jab are minimized in painless vaccines.
What are painless vaccinations?
Contrary to popular belief, there are no painless vaccines against all infections. “The only vaccine that comes with a painless alternative is the pertussis (whooping cough) vaccine which is a combination vaccine that also protects against Diphtheria and Tetanus,” says Dr Jagdish Kathwate, consultant neonatologist and pediatrician, Motherhood Hospital, Pune.
Elaborating further he says that the two types of pertussis vaccines are DwPT (Diphtheria, whole-cell pertussis, tetanus) and DaPT (Diphtheria, acellular pertussis, tetanus). Traditionally DwPT, the whole cell variant was used, which accompanies post-vaccination side effects like fever, pain and swelling at the site of injection. As per the Indian Academy of Pediatrics vaccination schedule, the five doses of the pertussis vaccine are given at 6 weeks, 10 weeks, 14 weeks, 18 months, and 4 – 5 years.
“To address the side effects observed in whole-cell vaccine, acellular pertussis vaccines were developed. The acellular variant (DaPT) usually produces minimal side-effects, compared to its counterpart,” adds Dr Kathwate.
“DaPT contains purified components of B. pertussis (Bordetella pertussis, the bacteria that causes pertussis). The cellular components that elicit the immune reactions are removed, retaining the bacterial fragments, lowering the side effects” says Dr Rajath Athreya, senior consultant and HOD, Pediatrics and Neonatology, Sakra World Hospital, Bengaluru.
Himani Joshi, a Bengaluru based sales and marketing professional and first-time mother of a 4-month-old boy, has tried both painful vaccination and the painless alternatives of pertussis vaccination for her baby. The painful vaccination doses were given the 6th and 10th week, followed by painless vaccine dose during the 14th week.
“Initially we weren’t aware of the painless alternative. When we knew of the option, we decided to go for it. We were traveling and wanted to reduce any discomfort that the baby would have to endure mid travel,” says Himani.
Himani observes that the baby’s post- vaccination symptoms like fever were less severe in comparison to the effects after administering the pain vaccine.
“On hearing the term painless vaccination, I assumed that there would be no pain during the prick. But later I learnt that it was the post-vaccination effects that would be reduced, and not the pain during administration,” says Himani.
Himani says that her baby cried during administration of both pain as well as painless vaccines.
Dr Athreya confirms that the pain involved at the time of prick is the same for both vaccines.
How effective are painless vaccines?
According to WHO, the whole-cell (painful) vaccine is about 78% effective while the acellular vaccine (painless) is 71–85% effective.
Dr Athreya says that studies show that the protection offered by acellular pertussis vaccine wore off earlier than that offered by whole cell vaccines, resulting in an increase in the cases of pertussis in the US and several developed countries that made a switch to acellular vaccine. The disease burden was seen to have shifted from infants to adolescents (11 -18 years old) in the US.
According to an article by American Society for Microbiology, during the mid-1990s, DTaP (painless) replaced DTP (painful) vaccines in the US, but by the early 2000s, the number of US cases of pertussis began to increase substantially again, reaching as high as 47,000 in 2012.
Dr Athreya opines that the vaccine wearing off isn’t usually a cause of concern as one doesn’t require the degree of protection against the bacteria in adulthood.
The CDC recommends that pertussis boosters be given at 11-12 years of age, for all pregnant women and at 10-year intervals for all other adults.
Takeaways
- Not all vaccines are available in painless alternatives. Only the vaccine against pertussis can be painless.
- The pertussis vaccine comes as a combination vaccine offering protection for Diphtheria and Tetanus.
- The pertussis vaccine comes in two forms: DwPT which is the whole cell, painful jab and DaPT acellular vaccine which is a painless alternative.
- DaPT vaccine is associated with less side effects compared to Dwpt.
- The effects of acellular pertussis vaccine are found to wane off earlier than the whole cell variant.
