Vaccines for children with spina bifida

Vaccines are made from parts of bacteria or viruses that cause infections and trigger people to develop immunity to the respective diseases.

Modern vaccines are very safe and will not cause the infections they are designed to prevent. Vaccination is considered to be safe for children with spina bifida and hydrocephalus, indeed far safer than the consequences of acquiring any of the serious diseases.

In many cases vaccination will not only protect those vaccinated but also help to prevent the disease in other contacts at home or school. In each case there are some people who should not receive a certain vaccine, or who should seek medical advice if in doubt.

People with stable, neurological conditions such as spina bifida or hydrocephalus, are not excluded from any vaccinations, see PHE Green Book for more information.

Premature babies

Premature babies should have their vaccinations at the appropriate chronological age. Very early babies (less than 28 weeks gestation) having their immunisations in hospital, should have their breathing carefully monitored in case of apnoea.

Here is a link to information for parents.

Latex allergy

People with severe latex allergy should check with their health professionals whether latex is contained in the packaging, such as stoppers. At the time of writing, PHE Green book lists

  • one of the Hepatitis B vaccines (HBVaxPro)
  • one of the MenC vaccines (Menjugate)
  • MenB vaccine (Bexsero)

as containing latex, so ask for an alternative if you have a latex allergy.

For information on other contraindications, click here

Acutely unwell babies and children

Babies and children who are acutely unwell, with a temperature over 38.5⁰ when their vaccination is due should delay, then have it as soon as possible after recovery.

The vaccinations we are most frequently asked about

Pertussis immunisation – whooping cough

Pertussis or whooping cough is a serious infection that can last for months and lead to significant complications. Modern pertussis vaccines have a very good safety record, and had succeeded in bringing down the number of cases of whooping cough from over 120,000 a year to around 800. However, an epidemic in 2012 saw over 9,000 confirmed cases, and there were around 5,000 confirmed cases in 2017. The vaccine is now available only as part of a combined vaccine against diphtheria and tetanus and pertussis (DTaP) or one containing polio and Haemophilus vaccine in addition.

MMR II vaccination – measles, mumps, rubella

Childhood diseases such as measles, mumps and rubella (German measles) are often thought of as trivial, but they can give rise to serious complications. Measles is a cause of ear infection and can cause pneumonia. Mumps causes painful swelling of the saliva glands in the mouth, but it is also a cause of meningitis and deafness. In older boys it can cause inflammation of the testicles. Rubella is a relatively mild disease with only rare complications, but if it is caught in pregnancy (usually from unvaccinated children) it can result in miscarriage or the birth of a baby with serious abnormalities of the heart, eye and other organs.

The introduction of the updated MMR II vaccine in September 1996 was intended to continue the process of elimination of measles, mumps and rubella from the population. Following this, rubella in pregnancy has been almost eliminated. Until 1999, when vaccination rates fell again, the number of mumps cases also fell dramatically. Similarly, cases of measles have also fallen, with virtual elimination of the most serious complications.

Reasons for NOT receiving the vaccine are:
  1. A confirmed anaphylactic reaction (that is an extreme emergency, not just a rash) following a previous dose of the same vaccine or to some vaccine components such as streptomycin or polymyxin (uncommon antibiotics).
  2. The presence of malignant disease or an immunosuppressive illness such as HIV, or treatment with immune suppressive drugs.
  3. MMR is contraindicated in pregnancy.
  4. The administration of MMR vaccine (or one of its three component vaccines) by injection within the past four weeks. MMR is the only one of the “childhood diseases” vaccines in this category.
  5. Illness with a high temperature. The vaccine should be given later, when the child has recovered.

There may be a raised temperature or a rash showing about a week to 10 days after receiving the vaccine, but this can be controlled with paracetamol. A history of convulsions is not a contraindication to this vaccine. Measles vaccination can cause febrile convulsion (not the same as epileptic convulsions). If your child has a history of febrile convulsions your doctor may recommend giving paracetamol for 72 hours following vaccination to prevent his/her temperature from rising.

Allergy to eggs is not a contraindication to MMR vaccine and children who have shown egg allergy in the past should receive the vaccine. If in doubt parents should consult their GP or paediatrician. Hydrocephalus is not a reason for withholding the vaccine.

MMR vaccine and autism

The issue of whether there is a link between MMR and autism or inflammatory bowel disease has been extensively investigated in several countries. No such link has been found and evidence now shows that the original report from a single source was not correct. For more information, parents are advised to consult their family doctor.

Vaccines against meningitis

There are now several vaccines for bacterial meningitis in the UK, including Haemophilus influenzae type b (Hib), Meningococcus C (Men C) and Pneumococcus. In addition to protection from meningitis they often prevent other complications of infection, such as sepsis. Bacterial meningitis is itself a potential cause of hydrocephas. Meningitis vaccines are given at various stages of infancy, childhood and in the teenage years (MenACWY).

Reasons for NOT receiving the vaccines are:

A confirmed anaphylactic reaction (that is an extreme emergency, not just a rash) following a previous dose of the same vaccine or to some vaccine components. This is an extremely rare event. A minor reaction to the first dose such as a rash or slight, passing fever should not deter further administration.

People with shunts are NOT at any more risk from pneumococcus than people without shunts, and adults who have (or are about to have) shunts should not be more concerned about risk of pneumococcal disease.

Vaccination schedules for children

Most of the major childhood disease can now be covered by the UK immunisation programme. The schedule can be found here.

Some of these are dealt with here, but others including polio, diphtheria and tetanus are also very important. These have all now been put together into combined vaccines, so it is possible to have all the protection with fewer injections. Vaccination should begin at two months of age, with repeat doses at intervals. Your GP or paediatrician will be able to tell you which combination vaccines are available and when to have your child vaccinated.

Seasonal flu vaccine

Annual flu vaccination is offered to all people who might experience complications. Many people with spina bifida have curvature of the spine or diaphragmatic hernias which affects lung expansion. This can mean that influenza could cause serious chest problems. It is advisable to arrange vaccination at the start of each Autumn, before ‘flu season’ begins. Flu jabs are needed every year, as the virus changes, meaning different vaccines are needed.

Vaccines for travellers

People with spina bifida and hydrocephalus travelling to countries where vaccines are recommended (e.g. yellow fever, typhoid etc) should receive exactly the same vaccinations as any other traveller.

For further information on travel health, click here.

Types of spina bifida

You may not know, but there are a number of different types of spina bifida.  We’ve listed them here along with an explanation of what each one means. 

Learn more about the condition

Need more help?

If you need to speak with one of Shine’s specialist advisers about spina bifida or hydrocephalus, call us on 01733 555988 or click here to email us.

Our office hours are Monday to Friday, 9am to 5pm. We aim to respond to all enquiries as quickly as possible!

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