What is the National Vaccinations Schedule ?

Likewise all parents out there, we believe that health care experts wish to provide the finest care and protection to their child in the best way possible. Thankfully in Malaysia, our government provides a variety of baby vaccinations that are free of charge for all infants,  young children, and adolescents, in turn, to ensure that everyone receives the protection they need to lower any potential risk of infections. 

At the same time, the National Vaccinations Schedule was originated by the World Health Organization (WHO), based on the Expanded Program on Immunization (EPI). The schedule was introduced, in turn to provide a better reference and convenience to fellow health care professionals and parents out there. Additionally, it is also to ensure that parents do not miss out on any mandatory baby vaccinations that their children are supposed to receive at the recommended age. Below (Figure 1) is the vaccinations schedule E-booklet designed by our clinic, based on the National Vaccinations Schedule. 

👉🏻Click to DOWNLOAD Your Vaccinations Schedule Booklet Here👈🏻

Figure 1: FirstStep Child Specialist Clinic National Vaccinations Schedule

Types of Vaccinations for Infants and Young Children Based on Age

Recommended Vaccinations for Newborns (0 months)

Bacillus Calmette-Guerin

The Bacillus Calmette-Guerin vaccine, is known as the BCG vaccine in short. Typically, a single jab is recommended in healthy infants as soon after birth. The vaccine is injected under the skin (intradermally), usually in the left upper arm (refer to Figure 2).  Figure 2: Intradermal injection

Why Should My Child Get the BCG Vaccine ? 

This vaccine is provided mainly to prevent the risk of infecting tuberculosis (TB) – a type of bacterial infection spread from the inhalation of expelled droplets from sneezes / coughs of an individual with active TB disease. 

What Are The Possible Side Effects ?

The BCG vaccine may cause side effects, but it is usually uncommon and mild in general.

Most common side effects:

1. A raised blister (bubble) will be developed at the injection site, which will disappear naturally as time passes. 
2. A tiny red spot may be seen at the injection site after 2 to 6 weeks.
3. It is completely normal when an ulcer is developed on the red spot, which it sometimes seeps before turning into a scab (dry, crusty layer). Hence, it is important to ensure that the injection site is uncovered and breathable as exposing it to air aids in the healing process. A small scar would usually be left after the side effects have subsided.

Figure 3: Sample picture of BCG side effects

Important Note:

At times, some infants developed a bad skin reaction, and this symptom should be subsided within a few weeks time. However, if your child’s skin reaction is concerning to you, do consult a general pediatrician for further assessment. Other side effects may be: 

• Raised temperature (fever)
• Headache 
• Soreness at the injection site
• Swollen glands under armpit at the injected arm

Complications of Side Effects:

• Bone inflammation 
• Abscesses at the injected site 

 

Hepatitis B

Infants should be receiving their first Hepatitis B vaccine as soon (usually within 24 hours) after birth. Hepatitis B jab is usually injected in the upper arm or in the thigh (refer to figure 4). Here’s a little interesting fact: Do you know that most individuals who received full doses of this vaccine are immune to the Hepatitis B virus (HBV) for life?

Figure 4: Injection in the thigh

Why Should My Child Get the Hepatitis B Vaccine ? 

The birth dose of Hepatitis B vaccine is significant in protecting your infant against the risk of infecting Hepatitis B disease – a contagious liver disease that is spread through semen, blood or other body fluids of an infected individual. This is because infants or younger children who are infected with this virus are usually asymptomatic (no symptoms), hence they may spread the disease to others without acknowledging.  Furthermore, the vaccine also serves to prevent your child from having the risk of developing a liver infection or cancer caused by the hepatitis B disease. 

What are the possible side effects ? 

The hepatitis B vaccine is usually very safe and effective in protecting individuals from the hepatitis B disease. Just as any other typical vaccine, the Hep B jab does contribute to some side effects. The side effects are usually mild and would subside by their own after a few days.  Common Side Effects: 

• Low grade fever 
• Soreness / swelling on the injected site 

Complications of Side Effects: Serious allergic reactions (rare), but they can be life threatening. This includes:

• Swelling of the throat and face
• Increase heartbeat 
• Hives
• Lightheadedness

Important Note:

Please note that, if any of the reactions occur, do reach out to the nearest hospital or call 999. 

 

Recommended Vaccinations for Infants (2-6 months)

6-in-1 Vaccine (HEXAXIM/ Infanrix)

The 6-in-1 vaccine is a combination vaccine, also known as the DTaP/IPV/Hib/Hep B vaccine or the hexavalent vaccine, which is given as a single dose.  

Why Should My Child Get the 6-in-1 Vaccine ?

The 6-in1 vaccine was given to protect your child against six severe childhood diseases:

1. Diphtheria
2. Hepatitis B
3. Pertussis (whooping cough)
4. Haemophilus Influenzae Type B (Hib Disease)
5. Polio
6. Tetanus

    According to the CDC, 3 doses are recommended to ensure that infants develop a strong immunity to be protected against the childhood diseases. A booster dose can be given too. The doses are usually injected into your infant’s thigh.

1. First dose: 2 months old 
2. Second dose: 3 months old 
3. Third dose: 5 months old
4. Booster dose: 18 months old

Additionally, the 6-in-1 vaccine is very safe as it is inactivated – does not contain any living organisms, hence there is no risk of your infant getting any of the diseases from the vaccine.  Every time another shot is injected, your infant’s immune response strengthens.  

What Are The Possible Side Effects ? 

• Swelling, pain / redness at the injection site 
• Fever (more common after the second and third dose)
• Increased irritability 
• Low appetite 
• Increased weakness

Complications of Side Effects 

• High-pitched crying and outburst of anger  
• Seizures 
• Severe allergic reactions – anaphylaxis 

 

Pneumococcal Vaccine

According to the CDC, the pneumococcal vaccinations is recommended for all children below the age of 2 years, as well as elderly who are 65 years or older. In Malaysia, usually there are two types of pneumococcal vaccines for use:

1. PCV-10 (Synflorix): It protects infants and younger children against 10 serotypes of pneumococcus bacteria. 
2. PCV-13 (Prevenar 13): It has a wider coverage than pneumococcal strains as PCV-10, which protects children against 13 serotypes of pneumococcus bacteria. 

In terms of the type of Pneumococcal Vaccine that will be provided to your child, that would usually be depending on the pediatrician’s assessment / suggestion.

Why Should My Child Get the Pneumococcal Vaccine ?

The Pneumococcal vaccine prevents your child from the risk of exposure to possibly severe or even deadly infections (if not treated properly) caused by the pneumococcal disease. The disease is caused by a type of bacteria called Streptococcus pneumoniae. (refer to figure 7) These infections include:

1. Pneumococcal meningitis – a life-threatening disease that inflames the layers surrounding the brain and spinal cord
2. Pneumonia – lung infection. The bacteria is usually spread through the expelled droplets from sneezes / coughs of an infected individual /  having close contact with them.
3. Bacteremia – Infection in the bloodstream. (Blood Poisoning)
4. Otitis Media – Middle ear infection

Figure 7: Streptococcus Pneumoniae

There are 3 recommended doses, in addition to a booster dose for this vaccine, which are usually injected into the thigh.

1. First dose: 2 months old
2. Second dose: 4 months old 
3. Third dose: 6 months old 
4. Booster dose: 15 months old

What Are The Possible Side Effects ? 

The pneumococcal vaccine is very safe and efficacious in protecting children against the pneumococcal disease. Just like any other vaccines, it contributes to certain side effects. Common Side Effects:

• Increased irritability
• Fatigue 
• Low appetite 
• Headache 
• Fever / chills 
• Swelling / soreness / redness at the injection site

Complications of Side Effects 

• Abnormally high body temperature, potentially leading to convulsions (seizures)
• Allergic Reactions – skin rash 

Important Note: 

If your child is experiencing especially an abnormal / overly high body temperature, please do reach out to the nearest hospital as soon as possible. 

 

Recommended Vaccinations for Babies (9-12 months)

MMR Vaccine

The MMR vaccine is a 3-in-1 vaccine in which the antigens of 3 distinct viruses, namely Mumps, Measles and Rubella are combined together into a single jab. 

Why Should My Child Get the MMR Vaccine ?

Modifications have been made to the viruses present in the vaccine to become weaker. Thus, the vaccine functions by ‘fooling’ our immune system into perceiving that it’s being attacked by the viruses when the jab is given, hence triggering the production of antibodies. These antibodies serve to fight off the Mumps, Measles, and Rubella viruses if one is exposed to any of them. Two doses are recommended to be given to babies, which the preferred injection site will usually be in the thigh. 

• First dose: 9 months old
• Second dose: 12 months old

What Are The Possible Side Effects ? 

The MMR vaccine is very safe. Most experienced side effects are mild and would usually go away within a few days.  Common Side Effects:

• Swelling / soreness / redness at the injection site
• Loss of appetite 
• Weak body (7 to 11 days after vaccinations)
• Fever (7 to 11 days after vaccinations)
• Mild form of measles – rash (7 to 11 days after vaccinations)

These side effects are not infectious, hence parents shall not have to worry much about infecting these symptoms to another child who has not received the vaccine yet.  Complications of Side Effects 

• Bruise-like spots (2 weeks after vaccinations)
• Seizures (6-11 days after vaccinations)
• Severe allergic reaction (within minutes after vaccinations)

Important Note: 

If your child is experiencing abnormalities or complications of side effects, please do reach out to the nearest hospital as soon as possible. 

 

Additional Vaccines for Infants 

Rotavirus 

Infants should be receiving the first dose of rotavirus vaccine earliest at 42 days after birth. Unlike other typical vaccines, this vaccine is provided through oral (dripping liquid drops into the infant’s mouth).  There are two types of licensed rotavirus vaccines used for infants: 

1. RotaTeq (RV5): Given in 3 sets of doses,
   • Dose 1: 2 months of age
   • Dose 2: 4 months of age 
   • Dose 3: 6 months of age 
2. Rotarix (RV1): Given in 2 sets of doses, 
   • Dose 1: 2 months of age
   • Dose 2: 4 months of age 

Important note:

Do note that the first dose of rotavirus should be provided to infants before 15 weeks old. Your child should receive a full, complete dose of rotavirus vaccine before he or she reaches 8 months old despite the brand of rotavirus vaccine given.  In terms of which brand of rotavirus vaccine your child should be receiving, that would be depending on the pediatrician’s assessment and suggestion. 

Why Should My Child Get The Rotavirus Vaccine ?

The Rotavirus vaccine is given to protect infants from the risk of infecting rotavirus – a virus that can consequently lead to severe diarrhea and vomiting in infected infants and younger children. As the side effects are usually severe, it can cause serious dehydration, which can be deadly if not treated. 

What Are The Possible Side Effects ? 

Just as any other vaccines, there is a chance of side effects after receiving the dose. The side effects are usually mild, and would go away within a few days.  Common Side Effects: 

• Diarrhea 
• Vomiting 
• Increased irritability

Complications of Side Effects: Serious allergic reactions (rare). This includes,

• Swelling of the throat and face
• Increase heartbeat 
• Difficulty breathing 
• Lightheadedness 
• Bowel blockage (intussusception) – this usually involves symptoms such as persistent vomiting, swollen belly, high fever, stomach ache with severe crying / blood in stools. 

Important Note:

Parents are advised to observe and monitor their babies after receiving this vaccine, do reach out to the nearest hospital or consult a pediatrician if your child is experiencing one of the complications above. 

 

Influenza Vaccine (Flu Shot)

The Influenza Vaccine is known as the flu shot. According to the CDC, your child is recommended to get two doses of the flu shot once in the first year, and then a single dose every year later, starting as early as 6 months of age.

1. First dose: 6 months old (eg. January)
2. Second dose: Usually 28 days after first dose
3. Yearly dose: At any time of the year 

Important note:

For children from 6 months to 8 years of age who are getting the flu shot for the first time or have only gotten a single dose of the flu shot previously are recommended to get two doses after.  Once your child has received two doses of flu shot in the same year, he or she only requires a single dose for the following years.  However, for children above 8 years old who are not vaccinated with the flu shot, only a single dose is recommended for the first year.

Why Should My Child Get The Influenza Vaccine ?

• It lowers the risk of flu diseases and hospitalizations among babies and young children. 
• It makes diseases less serious among vaccinated individuals who are experiencing flu. 
• It lowers the risk of developing severe flu complications, particularly if your child is having certain chronic illnesses below the age of 5. 
• Lowers the rate of spreading flu to the bigger community. 

What Are the Possible Side Effects ? 

The flu shot has a good safety record. There have been extensive studies supporting the safety of flu shots. Just as any other vaccines, there is a chance of side effects after receiving the dose. The side effects are usually mild, and would generally go away within a few days.  Common Side Effects: 

• Swelling / soreness / redness at the injection site
• Fever
• Nausea 
• Muscle aches 
• Headache 

Complications of Side Effects:

• Difficulty breathing 
• Wheezing / Hoarseness (raspy voice)
• Increased heartbeat 
• Paleness
• Hives
• Lightheadedness

Important Note:

If any of these complications occur, it is usually within a few minutes to hours after the vaccine was injected. Pediatricians or health care professionals are usually trained to handle emergency situations like these.  

Meningococcal Vaccine 

According to the CDC, the Meningococcal vaccine is given in 2 doses, with the first dose given when your infant is as early as 6 weeks old (42 days). However, for non-vaccinated babies above 12 months old, only a single dose is recommended.  Recommended Doses:

1. First dose: 6 weeks old 
2. Second dose:   after 2 months from the first dose

Why Should My Child Get The Meningococcal Vaccine ?

The Meningococcal vaccine is given to protect young children against the meningococcal disease that is highly contagious, usually spread through having close contact with an infected person – it is caused by a type of bacteria known as Neisseria Meningitis / Meningococcus.  Furthermore, the vaccine also protects your child against two most common types of infections caused by the bacteria: 

1. Meningitis – Infection of the linings of the brain and spinal cord
2. Septicemia – Infection of the bloodstream (blood poisoning)

Moreover, the vaccine also prevents your child from developing permanent disabilities such as hearing loss, brain damage and learning disabilities – often a severe aftereffect of surviving meningococcal disease. 

What Are The Possible Side Effects ? 

The vaccine is safe and efficacious in protecting children against meningococcal disease. Just as any other vaccines, there is a chance of side effects after receiving the dose. The side effects are usually mild, and would go away within a few days.  Common Side Effects: 

• Swelling / soreness / redness at the injection site
• Fever 
• Headache 
• Fatigue 

Complication of Side Effects:

• Fainting 

Important Note:

If any of these complications occur, it is usually within a few minutes to hours after the vaccine was injected. Pediatricians or health care professionals are usually trained to handle emergency situations like these.   

Japanese Encephalitis Vaccine (J.E.)

The Japanese Encephalitis Vaccine, is known as the JE vaccine in short. Two doses of the JE vaccine are recommended to be given to your child earliest at 2 months old.

1. First dose: 12 months and above
2. Second dose: 12 months and above

Why Should My Child Get the JE Vaccine ?

The JE vaccine is given to protect infants and children against the JE virus – a virus found in pigs and birds, and is transmitted to humans through mosquitoes (from sucking blood of infected animals). This virus exists in many parts of Asia as well as the Western Pacific, including certain parts of Malaysia.  Hence, the JE vaccine is usually recommended for people who: 

• Lives / plans to live in a country or area where the JE virus is common. 
• Travels frequently to places / countries where the JE virus is commonly found. 

What Are the Possible Side Effects ? 

Common Side Effects: 

• Swelling / soreness / redness at the injection site
• Fever 

Complications of Side Effects:  Research have shown that serious reactions to the JE vaccine are very rare

• Lightheadedness
• Severe allergic reactions – hives, swelling of the face and throat
• Difficulty breathing
• Increased heartbeat 

Important Note: 

Parents are advised to observe and monitor their babies after receiving this vaccine, do reach out to the nearest hospital or call 999 if your child is experiencing one of the complications above.   

Hepatitis A 

The Hepatitis A vaccine, is known as the Hep A vaccine in short. The vaccine is recommended in 2 doses, for babies as early as 12 months old. 

1. First dose: 12 through 23 months old
2. Second dose: 6 months after the first dose

Why Should My Child Get the Hepatitis A Vaccine ? 

It protects your child from the Hepatitis A virus – a very contagious virus that can cause a severe liver disease that can spread through having close contact or eating contaminated food / drink of an infected person. In addition, infected children who are below 6 years old are usually asymptomatic, hence they often spread the disease to others with no realization from both sides. This is why the vaccine is recommended, in turn to protect your loved ones and the bigger community from infecting the Hep A virus.

What Are the Possible Side Effects ? 

The Hep A vaccine is very safe and efficacious in protecting young children against the Hep A disease. Just as any other vaccines, there is a chance of side effects after receiving the dose. The side effects are usually mild, and would generally go away within a few days.  Common Side Effects: 

• Soreness at the injection site
• Fever 
• Fatigue
• Headache 
• Low appetite 

Complications of Side Effects:  Serious allergic reactions are rare, but can be life threatening. This includes:

• Hives
• Swelling of the face and throat
• Difficulty breathing
• Increased heartbeat 
• Lightheadedness 

Important Note: 

Parents are advised to observe and monitor their babies after receiving this vaccine, do reach out to the nearest hospital or call 999 if your child is experiencing one of the complications above.  

Chickenpox Vaccine 

According to the CDC, two doses of the chickenpox vaccine are recommended for younger children below 13 years old. 

1. First dose: 12 through 15 months old
2. Second dose: 4 through 6 years old 

However, the second dose can also be given at a younger age, if the gap between the first dose is at least 3 months apart.  For teens above 13 years old who have never developed chickenpox or received the chickenpox jab should get two doses as well, but with at least a month apart for both doses. 

Why Should My Child Get the Chickenpox Vaccine ? 

It protects your child from developing or infecting chickenpox (varicella) from others – a highly contagious disease caused by the varicella-zoster virus (VZV) that is spread through having close contact with an infected person (refer Figure 3). It can be possibly severe, and even life threatening if not treated. A vaccinated person may still develop or be infected with chickenpox, but with way less severe symptoms compared to the non-vaccinated individuals.  

Figure 3: Chickenpox

What Are the Possible Side Effects ? 

The Chickenpox vaccine is very safe and efficacious in protecting young children against chickenpox. Just as any other vaccines, there is a chance of side effects after receiving the dose. Fortunately, most children did not experience any side effects after vaccinations. However, if there are, the side effects are usually mild, and would generally go away within a few days. Common Side Effects: 

• Soreness / redness / swelling at the injection site
• Fever 
• Mild rash
• Temporary stiffness and pain in the joints 

Complications of Side Effects:  Serious allergic reactions are rare, but can be life threatening. This includes:

• Hives
• Swelling of the face and throat
• Difficulty breathing
• Increased heartbeat 
• Lightheadedness 

Important Note: 

Parents are advised to observe and monitor their babies after receiving this vaccine, do reach out to the nearest hospital or call 999 if your child is experiencing one of the complications above. 

What Should I Do If My Child Misses The Vaccinations Appointment ?

It’s best if your infant / child is able to receive all vaccines at his or her recommended age, so that they can be protected from unnecessary childhood diseases as early in life as possible.  However, if your child has missed any of the vaccinations appointments, please do reach out to a pediatrician as soon as possible for advice / suggestions.  Research vaccines and ready your child before the visit. 

If you need any consultation, you can also visit us at our clinic at Sri Hartamas, Kuala Lumpur.  Our team consists of qualified and experienced child specialists, nurses, and clinic assistants.

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