IMMENSE VALUE of the twin ZERO DOSES
It is our regular practice to administer the TWIN DOSES of OPV – ZERO DOSE and the HBV – ZERO DOSE within max. 48 hours of birth of every Newborn Baby, usually along with the BCG VACCINE.
This new practice in our newborn care has the following Logical Benefits :
1 . OPV ZERO DOSE
The gut of a newborn baby is STERILE , in terms of other enteric pathogens being simultaneously present, which can possibly reduce the immunological benefit of the ZERO OPV dose. This clean status , in the first few days – positively helps the good build-up of MUCOSAL IMMUNITY by zOPV so as to counter the potential future WPV encounters by the child. The sero-protection achieved here by the zOPV dose additionally helps lower the chances of VAPP that can remotely occur with the bOPV doses administered later on. The final levels of POLIO SERO-PROTECTION are far higher if the Zero dose was correctly administered at birth. The logical explanation for this new practice is hopefully clear. The ZERO OPV DOSE is therefore the golden dose of Oral Polio vaccine in resource – poor countries, like India, just because IPV is less available to our kids, in view of the Vaccine Shortage globally However, things are improving on this front , off late. POLIOVAC IPV has emerged after a pretty long wait. Thanks to SERUM INSTITUTE OF INDIA launching IPV as a single dose vial.
2. HBV ZERO DOSE
In view of the high probability of perinatal transmission of HBV ( ( Hepatitis B Virus ) at birth, there is a need for a BIRTH DOSE of HBV vaccine within 24 hours after birth, as strongly recommended by ACVIP. We are aware that the very first infection with the HBV virus at birth is going to lead to higher chances of chronic HBV complications at a later age, far more than HBV infections contracted in later childhood. Therefore the HBV ZERO DOSE becomes the golden dose in terms of HBV disease prevention.
In case of any pregnant mother being detected as HBsAg POSITIVE , the newborn baby additionally needs a single shot of HBIg immuno-globulin 0.5 ml intramuscularly , within 48 hours after birth , but preferably as early as possible. HBIg dose given in this situation, gives temporary protection for next 3-6 months, during which Hep-B IMMUNITY is well established by the primary 3-dose schedule of HBV vaccine.
This BLOG finally concludes the clear relevance and high significance of the TWIN ZERO DOSES of OPV + HBV as the FIRST BABY STEP in protecting kids against these two dreaded Viral infections that are impossible to treat if contracted in later life.
First lessons in saving our children against these health enemies TRULY BEGIN on Day ONE of postnatal life and surely not later than that. Let’s now update our Immunisation practices, based on best available evidences.
Dr. Dhananjay Shah
Ped. Practice of 40 years
@ Rajkot. Gujarat.