What immunizations for infants are available in Jos?

 Expatriate parents bringing young children, or planning to have children born while in Nigeria, are usually concerned about the availability of childhood immunizations here. Thus I've put together a list of what is available and what is not.

Some vaccines are routinely available at Evangel Hospital, government immunization centers, other hospitals and so on, while others must be specially ordered. Some are not available here at all (or not yet, as far as I know). For those bringing infants to Nigeria, note that some schedules can be accelerated to allow the primary series to be completed by about 4 months of age. Depending on the circumstances, you may also be able to bring vaccine from home to be used at the right time in Nigeria.

This information is intended only as a general guideline to availabilty and should not be used as a reference for immunization recommendations. For recommendations, see the links at the bottom of this page. The guidelines and comments on this page are from the US Centers for Disease Control (CDC). Recommendations and available vaccines in other countries will be different. Before traveling, you must consult with your own family doctor or pediatrician about the required immunizations and malaria prophylaxis. You may also want to contact a family doctor or pediatrician at Evangel Hospital or other medical center in Nigeria.

In our experience in Jos, the greatest vaccine-preventable infectious risks to young children are measles, hepatitis A and B, typhoid, and meningococcus. Pertussis and HiB are probably common though not easily diagnosed. Polio is fairly rare but Nigeria is one of the few countries in the world where it is still a risk.

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Immunizations for children 0-2 years of age

1. DTP is the older vaccine and has a higher rate of mild-moderate side effects (mainly fever, irritability) and a very small risk of severe side effects, probably in the range of 1 in 100,000 doses. The current CDC recommendation states, " if an accelerated schedule is required to complete the series before travel, the schedule may be started as soon as the infant is 6 weeks of age, with the second and third doses given 4 weeks after each preceding dose. The fourth dose should not be given before the infant is 12 months of age and should be separated from the third dose by at least 6 months. The fifth (booster) dose should not be given before the child is 4 years of age."

2. As with DTaP, HiB can be given as early as 6 weeks of age with second and third doses at four week intervals, to complete the three-dose series as young as 14 weeks. PedvaxHIB and ComVax brands require only the first two doses, rather than three, in the first year.

3. Live polio vaccine is associated with a small (about 1 in a million) risk of paralytic polio, which is why the US has moved to the inactivated vaccine. The risk is mainly for those not immunized already, so one option is to give the first dose as IPV and then continue with the standard Nigerian regimen of OPV. " If accelerated protection is needed, the minimum interval between doses is 4 weeks, although the preferred interval between the second and third doses is 2 months."

4. "Infants 6-11 months of age should receive a dose of MMR before departure. However, MMR given before age 12 months should not be counted as part of the series. Children who receive MMR before age 12 months will need two more doses of MMR, the first of which should be administered at age 12 months."

5. There is no stated age limit for giving rabies vaccine. However, it is mainly important at an age when the child could be exposed to unimmunized animals, typically after 1 year of age. Note that cats as well as dogs can transmit rabies.

6. "The serogroup A polysaccharide in this vaccine induces an antibody response in some children as young as 3 months. Thus, vaccinating infants traveling to high-risk areas can provide some degree of protection. For children vaccinated at <4 years of age, revaccination in 2-3 years should be considered if they remain at high risk for infection. For children vaccinated at 4 years of age, revaccination should be considered in 3-5 years if they remain at high risk." Nigeria is a high risk area.

7. CDC recommends the injectable (Vi) vaccine for ages above 2 years, and either injectable or live (oral) vaccine above age 6 years.

8. Approved by FDA in Oct 2005 for use above age 1 year. Previously approved for age above 2 years.

Current recommendations are available at http://www.cdc.gov/nip/recs/child-schedule.htm. Information on vaccines for international travelers with infants and small children is at http://www.cdc.gov/travel/vaccinat.htm#infants. General information from the CDC on health for travelers is at http://www.cdc.gov/travel/. Recommendations and quotes on this page are from these sources.

Keywords : immunization, vaccine, Jos, Nigeria, infant, child, travel, immunisation, prevention

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