Fever in Children: When to Worry and When to Wait
Fever is not the illness — it is the body fighting one. How the child looks and behaves tells you far more than the number on the thermometer.
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The national immunisation schedule protects against twelve serious diseases at no cost. Here is what is given when, what to expect afterwards, and what to do about missed doses.
The schedule at a glance
- At birth: BCG, Hepatitis B birth dose, OPV-0
- 6 weeks: Pentavalent-1, OPV-1, Rotavirus-1, PCV-1, fIPV-1
- 10 weeks: Pentavalent-2, OPV-2, Rotavirus-2
- 14 weeks: Pentavalent-3, OPV-3, Rotavirus-3, PCV-2, fIPV-2
- 9–12 months: Measles-Rubella-1, PCV booster, JE-1 (in endemic districts), Vitamin A-1
- 16–24 months: Measles-Rubella-2, DPT booster-1, OPV booster, JE-2, Vitamin A-2
- 5–6 years: DPT booster-2
- 10 years and 16 years: Tetanus and adult diphtheria (Td)
Worth knowing
Optional vaccines available privately include influenza (annually from six months), typhoid conjugate, hepatitis A, varicella and HPV. Discuss these with your paediatrician.
What each one prevents
BCG protects against severe forms of childhood tuberculosis, particularly TB meningitis. Pentavalent covers diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenzae type b — the last being a major cause of meningitis and pneumonia in small children. Rotavirus vaccine prevents the severe diarrhoea that still causes many infant hospital admissions, and PCV protects against pneumococcal pneumonia and meningitis.
Measles remains one of the most dangerous vaccine-preventable diseases in Indian children, and rubella in pregnancy causes serious birth defects — which is why the MR vaccine is given in two doses.
After the vaccine
- Mild fever, irritability and local swelling for one to two days are normal and expected
- Give paracetamol at the weight-appropriate dose if the child is uncomfortable
- Apply a cold compress to the injection site; do not massage it
- A small nodule at the BCG site that ulcerates and heals over several weeks is the normal response
- Continue normal feeding and bathing
When to return to the doctor
- Fever above 39°C, or any fever lasting more than 48 hours
- Persistent inconsolable crying beyond three hours
- A seizure
- Swelling of the face or lips, or difficulty breathing
- A large, spreading, hot area at the injection site
Missed doses and common concerns
A missed dose does not mean starting again. The schedule is caught up from where it stopped, and the protection at the end is the same. Bring the immunisation card and the paediatrician will plan the catch-up.
Mild cough, cold or low-grade fever is not a reason to postpone vaccination. Only significant acute illness warrants a short delay. Vaccines do not cause autism — the study that claimed this was found to be fraudulent and has been withdrawn, and very large subsequent studies have found no association whatsoever.
Key takeaways
- The national schedule covers twelve diseases free of charge at government and many private centres.
- Mild fever and local swelling for a day or two are expected reactions.
- Missed doses are caught up, never restarted from the beginning.
- Mild cough or cold is not a reason to delay vaccination.
A note on medical advice
This article is general health education written and reviewed by the Department of Paediatrics & Neonatology at SIMS. It is not a substitute for an examination, a diagnosis or the advice of your own treating doctor, and it cannot account for your history, medicines or reports. If a symptom is sudden or severe — chest pain, stroke symptoms, breathing difficulty, serious injury, seizures or heavy bleeding — call 9281862028 or come straight to the emergency department instead of reading further.
VaccinationChildrenImmunisationPrevention