Title: To Find the Order of BCG and Hepatitis B Vaccination Given At Birth

Authors: Dr Pratima Thakur, Dr Rakesh Sharma, Dr Pancham Kumar

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i7.66

Abstract

Background and Aims: Pain due to immunisation is unavoidable as all the children have to undergo repeated vaccine injections according to universal immunisation programme against the vaccine preventable diseases.BCG and Hepatitis-B vaccines are given at birth under immunization program. BCG is given intradermally whereas Hepatitis-B is given intramuscularly the present study was planned To find the less painful order of administration of BCG and Hepatitis B vaccine at birth i.e. BCG first followed by Hepatitis B vaccine or vice versa.

Methods: we observed 400 neonates receiving routine dose of Bcg and Hepatitis B vaccine given at birth, 200 in each group with first group receiving Bcg vaccine first and vice versa.Pain was assessed on NIPS scale in both the groups immediately after first injection, at 30 second after first injection, immediately before and after second injection, at 30seconds and 60 seconds after second injections.

Results: NIPS scores at all the intervals of time after start of vaccination as well as combined NIPS score  were  significantly lower when the BCG vaccine was given first (Group 1) with combined NIPS score  10.54+_3.92 as compared to when the Hepatitis B vaccine was given first ( Group 2) combined NIPS score 14.54+_4.97 ( P value of<0.0001) .

Conclusion: when BCG and Hepatitis-B vaccines are given in same vaccination session, the BCG should be injected before the Hepatitis-B vaccine to reduce the overall pain perceived.

Keywords: vaccination, neonatal infant pain scale score, neonate, pain, Bcg vaccine, Hepatitis B vaccine, Intra dermal, intramuscular.

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