Who you are:
You are an FY2 in GP surgery.Who the patient is:
Wendy presented to the clinic with her 8 week old boy, Tom. She wants to know about the vaccines that can be given to her baby.What you should do:
Talk to her, explain to her about the vaccines that can be given at 8 weeks and address her concerns.
You don’t have to discuss everything. Only follow the patient and discuss what she needs. Be smart and always ask about ICE, this is a conversation station and you are simply explaining to the patient what she wants to know.
Doctor: Hello my name is doctor (name) I am one of the doctors here in the GP clinic. Am I talking to Wendy?
P: Yes.
D: I understand that you have booked this consultation because of some concerns related to your little one, may I get his full name and date of birth please?
P: (Confirms details)
D: May I ask you what brought you to the GP today? Or How can I help you
today?
P: Doctor I want some clarification about the 8th week vaccination? There are a lot of them and I am quite confused to be honest.
D: Not a problem at all and thank you for coming today, I appreciate you being very cautious and protective of your son. Rest assured I will explain everything you need to know. Can you tell me how much you know about these vaccinations and if there is anything specific that you would like to know about the 8th weeks vaccination?
P: I want to know about all of them.
D: Very well there are 3 vaccines that are given at 8 weeks. Let’s take them one by one.
1. The 6-in-1 vaccine
It’s given as a single injection into your baby’s thigh to protect your baby against 6 serious childhood conditions
− Diphtheria
– Polio
− Pertussis (whooping cough)
− Hepatitis B
− Haemophilus influenzae type b
− Tetanus
Mnemonic DiPHTheria
D: The 6-in-1 vaccine is given to babies when they’re 8, 12 and 16 weeks old. They need 3 doses to make sure they develop strong immunity to the conditions the vaccine protects against. The 6-in-1 vaccine works well and produces very good immunity to diphtheria, tetanus, whooping cough, Hib, polio and hepatitis B infections. Clear so far?
P: Is It safe to take all of that in one injection?
D: The 6-in-1 vaccine is very safe. It’s killed (inactivated), which means it does not contain any live organisms, so there’s no risk of your baby getting the conditions from the vaccine. But it may give some Side effects. Common reactions include:
− pain, redness and swelling where the injection was given
− high temperature (more common after the 2nd and 3rd doses)
− being sick
− irritability
− loss of appetite
− Unusual high-pitched crying and fits or seizures are rare side effects of the 6-in1 vaccine.
− Very rarely, a baby may have a severe allergic reaction (anaphylaxis) after the 6-in-1 vaccine.
P: Are there any situations where this vaccine can be contraindicated?
D: Yes, there might be some situations such as:
− a high temperature at the time of the vaccination appointment – wait until they’ve recovered
− a neurological problem that’s getting worse, including poorly controlled epilepsy – wait until they’ve been seen by a specialist
There’s no need to postpone vaccination if your baby has a minor illness, such
as a cough or a cold with no temperature.
2. Rotavirus vaccine
It is an oral vaccine against rotavirus infection given to babies as a part of their routine childhood vaccinations.
The vaccine is given as 2 doses, 4 weeks apart. Usually, the first dose is given
at 8 weeks, and the second dose at 12 weeks. The vaccine is given as a liquid straight into the baby’s mouth for them to swallow.
P: What makes this the rotavirus vaccine important doctor?
D: Rotavirus is a highly infectious stomach bug that typically affects babies and young children, causing diarrhoea and vomiting, tummy ache and a high temperature. Occasionally, treatment in hospital is needed for complications such as severe dehydration.
P: How the rotavirus vaccine work?
D: The vaccine contains a weakened version of rotavirus. This helps your baby build up immunity, so that the next time they come into contact with rotavirus they will not get the infection.
P: How effective is the rotavirus vaccine doctor?
D: The rotavirus vaccine is very effective and gives good protection against rotavirus infection. It’s possible for a baby to get a rotavirus infection after being vaccinated. But this is uncommon and it’s usually milder than it would have been if they had not been vaccinated.
P: Is it safe doctor?
D: There’s a lot of evidence showing that the rotavirus vaccine is safe. Most babies do not have any problems at all after having their rotavirus vaccination. The brand name of the vaccine used in the UK is Rotarix. This vaccine has been used in many countries for more than 10 years. But it may have some side effects:
− Some babies who have the vaccine may become restless and irritable, and some may develop mild diarrhoea in the days following vaccination.
− Very rarely, the vaccine could cause a severe allergic reaction (anaphylaxis) or a blockage in a baby’s intestine (intussusception). Allergic reaction can occur after any vaccinations, but rest assured that the personnel giving this vaccination are very well trained to deal with severe allergic reactions and can provide rapid treatment for any similar case.
Does it all make sense to you so far?
P: Yes doctor, are there any other vaccination given at this stage?
D: Yes the third and last one is Meningitis B vaccination.
3. MenB vaccine
The MenB vaccine will protect your baby against infection by meningococcal group B bacteria. These bacteria are responsible for about 9 in every 10 meningococcal infections in young children. Meningococcal infections can be very serious life-threatening, causing meningitis and sepsis. This can lead to severe brain damage, amputations and, sometimes, death.
P: Who can have the MenB vaccine and when?
D: It’s given to babies at: 8 weeks - 16 weeks - 1 year
P: How is the MenB vaccine given ? It’s given as a single injection into your baby’s thigh.
P: Is it safe doctor?
D: Like all vaccines, the MenB vaccine can cause side effects, but studies suggest they’re generally mild and do not last long.
Side effects of the MenB vaccine
− Babies given the MenB vaccine alongside their other routine vaccinations at 8 and 16 weeks are likely to develop a high temperature within 24 hours of vaccination.
− It’s important to give your baby liquid paracetamol following vaccination to reduce this risk and help with other symptoms. Other common side effects of the MenB vaccine include:
− pain, swelling or redness where the injection was given
− diarrhoea or being sick
− crying and irritability
− An allergic reaction is a rare side effect of the MenB vaccine. This may be a rash or itching that affects part or all of the body.
Very rarely, a baby may have a severe allergic reaction (anaphylaxis) after having the MenB vaccine. And we are always prepared for such sudden and unfortunate scenarios and can handle them with proper medication quickly.
P: How does MenB vaccine work doctor?
The MenB vaccine is made from 3 major proteins found on the surface of most meningococcal bacteria, combined with the outer membrane of 1 MenB strain. Together, they stimulate the immune system to protect against future exposures to meningococcal bacteria.
P: Is it safe for my baby to have all these vaccinations all at once.
D: It’s safe for your baby to have the 6-in-1 vaccine at the same time as other vaccines, such as the rotavirus vaccine, and MenB vaccine. And if there is a small risk of some complications as I elaborated before, they are usually routine and can be treated quickly, but the benefit of these vaccines far exceeds their risk as they protect against serious infections and illnesses.
D: Is it all clear now?
P: Yes doctor.
D: Do you have any other queries?
P: No.
D: Would you like me to book Tom in for his vaccine appointment?
P: Yes doctor that’s fine.
D: Great I will arrange with my senior and we can schedule that but for now may I ask about his health in general to make sure he is fit for the vaccine?
Head to toe quickly to make sure the baby is fit for the vaccine
− Does your son have any fever/cough?
− Any discharge from eyes/ ears or nose?
− Any vomiting?
− Any diarrhea or constipation?
− Any problem with his wee like change in colour or smell?
− Any rash anywhere on his body?
− Does he have any allergies?
− Any problems with the red book?
− Is he well in himself generally?
P: Yes doctor.
D: Glad to hear that, is there anything else I can help you with?
P: No, thank you doctor.
Safety net:
D: Thank you. If your child ever becomes too ill or drowsy or not their usual self, please come back and seek medical care. If he develops a fever/ sore throat/ or infection symptoms please inform the GP because it might affect what will happen on the vaccination day, it might have to be postponed until he recovers.