Q: We have not yet immunised our 8 year old daughter against chicken pox. My wife and are I in our mid thirties and have never had chicken pox. We have not taken the immunisation either. I have just seen the immunisation schedule given by the doctor for my 3 month old son and find that it is a huge list. I have the feeling that this list is growing longer and longer with every passing year, as more and more vaccines are being developed. Is it wise to take Varilrix, as I have heard conflicting versions from doctor friends regarding this vaccine? And also, meningitis, typhoid, hep-A, hep-B. How much more should we subject our infants to pricks? Could you please advise on the suitability of being administered so many vaccines?

A:Regarding chickenpox, this is usually a mild disease in children, below 8-10 years of age. It tends to be a severe disease in older children and adults. One thing is almost sure that disease gives practically life long immunity. The vaccine is in use for almost last two decades and we know that it is good, for these last twenty years, to prevent chickenpox. We don't know what happens after 30-40 years of the vaccine, whether repeat dose would be required if vaccinated in childhood. What I practice is that if the child has not developed chickenpox by 8-10 years of age, I give the vaccine for two reasons - one, child may develop severe chickenpox, and secondly, the child has to be away from the school for maybe two weeks, if infected, with parents taking leave from their work and doing baby sitting. So you can decide. For other vaccines like Hep B, it is a must, because hepatitis B is a preventible dreaded disease which can have lifelong implications with chances of chronic liver disease. Please also give Hepatitis A vaccine; it is water borne transmitted hepatitis i.e. liver infection leading on to jaundice. In large majority of children it is a mild self limiting disease without any significant complications. But a small percentage can get complications. It is a safe and effective vaccine and remember what ever protection we can give safely to our children should be given. Typhoid is not a very great vaccine with protection rates upto 60-70%. But typhoid is very common in India specially during summers and rainy season and since it is a safe vaccine, should be given. Meningitis vaccine if you are talking of meningococcal vaccine is not routinely recommended unless there is epidemic situation and that too the vaccine is not against strains which commonly cause epidemics.