Japanese Encephalitis Vaccine For Babies

Viral Encephalitis occurs from the Japanese Encephalitis Virus, in Asia, where more than 68,000 cases are recorded annually. Out of these cases, approximately 30% (13,600 – 20,400) deaths happen annually.

Unfortunately, there is no cure for JE yet. This is why the doctors require the infected patient to be admitted and stay under continuous observation until they get alright enough to go. However, this disease is vaccine preventive.

How is Japanese Encephalitis Transmitted in Babies?

Mosquitoes (Culex species) transfer this virus from pigs and birds to human beings including babies. This is very common in Southeast Asia, the Far East as well as the Pacific islands. It is rare among travellers and cannot be spread from one human to another unless a mosquito is involved.

JE occurs more frequently in farming and rural areas of Asia and parts of the Western Pacific. The transmission is seasonal. It is seen to peak during the summer and fall in temperate areas of Asia. Whereas, in tropical and subtropical areas, the transmission can happen all year round and peak during the rains.

When the mosquito carrying the virus bites a human, it can transfer the virus to them. It takes about 5 to 15 days to develop symptoms of JE.

What Are The Signs And Symptoms of Japanese Encephalitis?

Many people do not show symptoms at all. Some experience mild symptoms and only 1 in 250 infected cases show serious symptoms, where the infection spreads to the brain, causing inflammation.

Getting bitten by a mosquito, especially in a place with farms, where avoiding a mosquito is difficult, is very common. Here are some JE symptoms you need to watch out for.

• High fever
• Fits resulting from the fever (seizures)
• Headaches
• Stiffness in neck
• Coma
• Disorientation
• Spastic Paralysis
• Inability to speak
• Tremors throughout the body

Among children the most common symptoms initially are

• Vomiting
• Gastrointestinal issues

Coma, paralysis, and seizures generally occur when the infection reaches the brain, after which it can turn fatal in some cases. For those who are cured of the disease, almost 30% of them suffer from permanent neurological, intellectual or behavioral impact, as the brain is affected.

Who Is at Risk of Getting JE?

People staying around or near rice farming regions where fields have stagnant water for irrigation are at risk of JE. So, rural areas and some urban areas near the fields are at risk of this infection. It predominantly affects children. Once a child gets JE, they attain immunity for life. So, adults who have been infected by this virus as a child are immune to it.
24 countries under WHO Southeast and Pacific regions have been identified as high-risk regions for transmission of JE.

How Common is JE in India?

JE is quite common in South-East Asia due to vast farming and rice irrigation facilities. India is very well known for its farming lands and farming animals.

As per statistics, more than 597,542,000 live in the JE endemic regions in India. Out of these, 1,500 to 4,000 cases of confirmed JE are reported annually. This is a record of just the reported cases, since many people show no or very mild symptoms, many cases go unreported.

What Are The Recommendations of IAP For Japanese Encephalitis Vaccine For Babies?

According to IAP recommendations, the JE vaccine is not compulsory for all like the Hepatitis B or BCG vaccination, it is recommended only for those living in and around endemic regions.

Though there have been reports of JE cases from urban areas, it is rare, so the urban population need not get vaccinated. Children living in the rural parts of the endemic regions need to get vaccinated against JEV. So far, the Indian government has identified 180 such regions and people in these regions need to get vaccinated for their own safety.

In the case of travellers, the risk of infection depends on where they visit and the duration of their stay. So IAP recommends travellers visiting rural endemic regions for more than 4 weeks, get vaccinated for JE before they go to their destination.

What Different Types of JE Vaccines Are Available In India?

When it comes to vaccinations, there are four main types to choose from. Two types of inactivated vaccines and two types of activated vaccines.

• Inactivated vaccines derived from mouse brain
• Inactivated vaccines derived from Vero Cell
• Live Attenuated Vaccines
• Live Recombinant (Chimeric) Vaccines

In India, you have the following vaccines to protect yourself against Japanese Encephalitis

• Live Attenuated, Cell culture-derived SA 14-14-2
• Inactivated SA-14-14-2 vaccine (IC51) (IXIARO® by Intercel& JEEV® by Biological Evans India Ltd.)
• Inactivated Vero cell culture-derived Kolar strain, 821564XY, JE vaccine (JENVAC® by Bharat Biotech)

WHO has prequalified the Chinese Live attenuated SA 14-14-2 vaccine in 2013. It is the most predominantly used vaccine in endemic regions. WHO has also approved the Inactivated cell structure vaccines based on the yellow fever vaccine strain.

Is Japanese Encephalitis Vaccine For Babies Safe?

Yes, it is. It is in fact necessary for people living in the rural areas of Southeast Asia and the Western Pacific, especially in the regions identified by WHO as high risk for JE.

The vaccine is approved only for babies over 2 months old. It cannot be given to a newborn like many other vaccines, even if they live in a JE high-risk area.

When it comes to adults, those with severe allergies, pregnant and nursing women must avoid this vaccine. If you are suffering from a mild cold, it is still OK to get the vaccine. However, if you have a serious illness or even a high fever, you must wait until your health is better, to take this vaccination.

To sum it up, the following people should not take the vaccine:

• Babies below the age of 2 months
• Pregnant women
• Nursing mothers
• Suffering from high fever
• Have a history of allergic reactions to JE vaccine
• Have a history of allergic reactions to other vaccines
• Suffering from a serious injury or health issue

If you are currently unwell, it is advisable to wait till you are better, if not back to normal. The vaccine is safe until you follow the protocols. As with any medicine, there are small risks of infection, allergic reactions or serious health issues.
If you are still worried, fix an appointment with your doctor and get all your doubts clarified. It is always better to clear all doubts and inhibitions before you take a vaccine.

Dosage And Administering The Japanese Encephalitis Vaccine For Babies

The JE vaccine is generally given in 2 doses over a period of 28 days. The idea is to give a gap of 28 days between both shots. For those between the ages 3 and 18, the vaccine can be given with just a gap of 7 days.
Here are the details regarding the JE vaccines:

The vaccine can be given only to babies over 2 months old. While the above-mentioned site and dose are ok, for babies, only 0.25 ml can be given. The medical professional administering the vaccine must expel half of the medicine and then only inject it into the baby.

Are There Any Side Effects To The Vaccine?

The common side effects of any vaccine exist for the JE vaccine too. Some of the side effects include

• Swelling, tenderness, redness, or pain at the injection site
• Fever – mostly in children
• Headache or muscle aches – mostly in adults.

The above side effects are felt by most for almost all vaccines. This does not mean these side effects are a definite feature of vaccinations.

Many people – both children and adults do not have any reaction to the vaccine. So if you or your child does not develop a fever after the vaccination, do not worry. The medicine will still work effectively in protecting you against JE.

For some people who already have allergies or other underlying health conditions, the following side effects might be experienced (note –  these are side effects in rare cases)

• Hives
• Swelling of throat or face
• Breathing trouble
• Erratic or fast heartbeat
• Dizziness
• Weakness

In case you experience any of the above immediately or a few minutes after the vaccine, you need to get to the nearest hospital quickly. You need to get thoroughly checked by a professional. Ensure you inform them about the vaccine.

Japanese Encephalitis is a serious disease not many in urban areas know about. It is one of the perils of farming and agriculture in dense rural areas where water is left stagnant for irrigation purposes. If you are planning to visit such places for more than 3 or 4 weeks at a stretch, it is recommended to consult your doctor regarding the JE vaccination – for both kids and adults.

JE is vaccine-preventable, for which more awareness and access to the vaccines are required. Since it is not contagious from human to human, you need not worry about getting it from an infected person or transferring it to other people.

FAQ’s

1. Is Japanese Encephalitis Vaccine For Babies Compulsory?

No, it is not compulsory like the BCG vaccine. It is recommended only for those babies that are over 2 months old and live in one of the regions identified by WHO as high-risk areas for JE.

2. How Long Is JE Vaccine Good For?

The exact duration of the vaccine’s effect is still unknown. For those who live in high-risk areas, like farmers or young children who live around rice fields, a booster shot might be recommended, as they are constantly exposed to the disease-spreading mosquitoes.

3. Is Japanese Encephalitis Vaccine necessary in India?

Yes, it is necessary for the rural areas and some urban areas near the agricultural fields. It is not necessary for those who live in the cities.

4. How Common is Japanese Encephalitis in Indian babies?

It is quite common among children between the ages of 3 and 6, living in endemic areas. The overall estimation of the disease in India is close to 50,000 cases per year – both adults and babies together.