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Prophylactic vaccinations


In the Russian Federation, in recent years, there has been a worsening of the epidemic situation with regard to infectious diseases, against which there are effective means of prevention - vaccines. So the incidence of diphtheria over the period from 1980 to 1992 increased by 13 times. In 1993, about 400 deaths from this infection were reported in Russia and other CIS countries. Annually 25-30 thousand measles patients are registered, the number of patients with mumps, pertussis, and rubella is not decreasing. The epidemic situation that has developed in Russia is a consequence of serious shortcomings in the vaccine preventive system, in overcoming which one of the main ways to reduce the infectious morbidity, especially in children, is.
To create a collective (in school, in closed military teams) immunity from 85% (whooping cough) to 97% (measles) from the total number of the observed contingent is needed. In our country in 1993 during the diphtheria epidemic, the coverage of children with DTP vaccinations was only 45%.
This was largely facilitated by poorly delivered educational work with the population, an unreasonably expanded number of contraindications for vaccination. It was noted that the formation of specific anti-infective immunity to one infection is accompanied by an increase in the resistance (resistance) of children and other infectious diseases. The incidence of acute respiratory viral infections is also significantly reduced.
The timing, sequence and type of routine vaccination of children against various infections are determined by the age-related features of the child's immune system, the level of infectious morbidity, and the availability of preventive drugs. Taking into account these factors, a calendar of preventive vaccinations is being developed. A special feature of the Russian calendar is the vaccination against tuberculosis for all newborn children (due to the high incidence of tuberculosis) and the absence of vaccinations against hemophilia and rubella (domestic vaccines are under development).
The calendar of preventive vaccinations (from the order # 375 of the Ministry of Health of the Russian Federation on 18.12.97)
The timing of the vaccination
4-7 days BCG or BCG-M
3 months DTP, oral poliomyelitis vaccine (OPV)
4 months DTP, oral poliomyelitis vaccine (OPV)
5 months DTP, oral poliomyelitis vaccine (OPV)
12-15 months Vaccine against measles, mumps and rubella *
18 months DTP, oral poliomyelitis vaccine (OPV) - once
24 months Oral poliomyelitis vaccine (OPV) + once
6 years ADSM, oral poliomyelitis vaccine (OPV), vaccine against measles, mumps, rubella *
7 years BCG **
11 years old AD-M
14 years BCG ***
16-17 years old ADS-M
Adults once every 10 years ADS-M (AD-M)
Notes:
* - Vaccination against measles, mumps and rubella is carried out by monovaccines or trivaccine (measles, rubella and mumps) provided that domestic preparations are produced or foreign vaccines registered in accordance with the established procedure are imported;
** - revaccination is carried out for children not infected with tuberculosis;
*** - revaccination is performed for children not infected with tuberculosis and not vaccinated at 7 years of age
The vaccination schedule against viral hepatitis B (from the order # 375 of the Ministry of Health of the Russian Federation on 18.12.97)
Vaccination deadlines
1st scheme 2nd scheme
First vaccination Newborns in the first 24 hours of life (before BCG vaccination) +4 + 5th month of life of the child
Second vaccination 1st month of life of a child +5 + 6th month of a child's life
Third vaccination 5 - 6th month of life of the child +12 + 13th month of the child's life
Given the epidemiological features of hepatitis B, early childhood vaccinations and adults belonging to high-risk groups
Reactions and complications after vaccinations
There are general and local post-vaccination reactions. Common reactions are expressed by a moderate increase in body temperature, slight malaise. When the vaccine is injected subcutaneously, soreness appears, less often a swelling in the injection site (local reaction). Both general and local reactions after vaccinations are transferred easily and last no more than 3 days.
Severe general intoxication, swelling, suppuration at the site of administration of the vaccine is regarded as a post-vaccination complication. It is necessary to take into account the timing and nature of possible complications after vaccinations:
General severe reactions with fever, sometimes convulsive muscle twitching occurs no later than 48 hours after doses of DTP, ADS and ADS-m and not earlier than 4-5 days for measles and mumps vaccines (mumps);
The appearance of signs of meningitis is possible at 3-4 weeks after the introduction of the vaccine against mumps;
Allergic reactions to the skin may appear no later than 24 hours after the administration of any vaccine;
Qatar respiratory tract after the introduction of the measles vaccine is possible in the second week after vaccination.
Wastes from vaccinations
Often decisions are made about the impossibility of vaccinating children with weakened health. However, on the recommendation of the World Health Organization, weakened children should be vaccinated primarily because they are most seriously ill with infections. Recently, the list of diseases considered contraindications for vaccination is significantly narrowed.
Absolute contraindications for vaccination are: a severe reaction to the previous administration of this drug, malignant disease, AIDS.
Temporary contraindications for vaccinations with all vaccines are acute febrile illness in the period of heightening or exacerbation of chronic diseases. The minimal terms of medical taps after acute and exacerbation of chronic diseases in children are tested in the Research Institute of Children's Infections and are presented in the table.
Duration of medical inspectors from vaccinations after exacerbation of diseases, months.
Diseases Medotvodov during the use of vaccines
DTP DTP Poliomyelitis Koryovaya Parotitnaya
Allergic dermatoses 1 1 1 1 1
Anaphylactic shock *** 3 1 3 6
Bronchial asthma *** 1 1 1 6
Febrile convulsions *** 1 1 1 1
Afebra Cramps *** 3 1 3 6
Hydrocephalus *** 1 1 1 1
Neuroinfections *** 6 1 6 12
Brain Injuries *** 1 1 1 1-3
Acute infections 1 1 1 1 1
Exacerbation of chronic diseases 1 1 1 1 1
Systemic diseases *** 1 1 12 12
Thrombocytopenia *** 1 1 6 6
Diabetes mellitus *** 1 1 1 6
Tuberculosis *** 1 1 1 6
Chronic hepatitis *** 1 1 1 6
*** - permanent medical officer.
It is known that the risk of unwanted reactions to modern vaccines is incommensurably lower than the risk of complications and deaths in infectious diseases.
The list of medical contra-indications for carrying out preventive vaccinations (from Order N375 of the Ministry of Health of the Russian Federation of December 18, 1997)
Vaccine Contraindications
All vaccines A strong reaction or complication to a previous dose
All living vaccines Immunodeficiency status (primary), immunosuppression, malignant neoplasms, pregnancy
BCG vaccine The child's weight is less than 2000 g, the colloidal scar after a previous dose
OPV (oral polio vaccine) There are no absolute contraindications
DTP Progressive diseases of the nervous system, afebrile convulsions in the anamnesis (instead of DTP injected ADP)
ADS, ADSM There are no absolute contraindications
HCV (live measles vaccine), Severe reactions to aminoglycosides
HPV (live mumps vaccine) Anaphylactic reactions to egg white
Notes: Routine vaccination is postponed until the end of acute manifestations of the disease and exacerbation of chronic diseases. For non-severe acute respiratory infections, acute intestinal diseases and other vaccinations are carried out immediately after the normalization of body temperature.
* - a strong reaction is the presence of temperature above 40 degrees, at the place of administration of the vaccine - edema, redness is greater than 8 cm in diameter, the presence of anaphylactic shock reaction.
False contraindications for carrying out preventive vaccinations
Conditions in the anamnesis
Perinatal encephalopathy Prematurity
Stable neurologic conditions Sepsis
Enlargement of the thymus gland Disease of hyaline membranes
Allergy, asthma, eczema Hemolytic disease of newborns
Congenital malformations Complications after vaccination in the family
Dysbacteriosis Allergy in the family
Supportive therapy Epilepsy
Steroids topically applied Sudden death in the family
Calendar of preventive vaccinations PREVENTIVE PRIVATIVES Schedule of prophylactic vaccinations (from order # 375 of the Ministry of Health of the Russian Federation on 18.12.97)
The timing of the vaccination
4-7 days BCG or BCG-M
3 months DTP, oral poliomyelitis vaccine (OPV)
4 months DTP, oral poliomyelitis vaccine (OPV)
5 months DTP, oral poliomyelitis vaccine (OPV)
12-15 months Vaccine against measles, mumps and rubella *
18 months DTP, oral poliomyelitis vaccine (OPV) - once
24 months Oral poliomyelitis vaccine (OPV) + once
6 years ADSM, oral poliomyelitis vaccine (OPV), vaccine against measles, mumps, rubella *
7 years BCG **
11 years old AD-M
14 years BCG ***
16-17 years old ADS-M
Adults once every 10 years ADS-M (AD-M)
Notes:
* - Vaccination against measles, mumps and rubella is carried out by monovaccines or trivaccine (measles, rubella and mumps) provided that domestic preparations are produced or foreign vaccines registered in the prescribed manner are imported;
** - revaccination is carried out for children not infected with tuberculosis;
*** - revaccination is performed for children not infected with tuberculosis and not vaccinated at 7 years of age
The vaccination schedule against viral hepatitis B (from the order # 375 of the Ministry of Health of the Russian Federation on 18.12.97)
Vaccination deadlines
1st scheme 2nd scheme
First vaccination Newborns in the first 24 hours of life (before BCG vaccination) +4 + 5th month of life of the child
Second vaccination 1st month of life of a child +5 + 6th month of a child's life
Third vaccination 5 - 6th month of life of the child +12 + 13th month of the child's life
Given the epidemiological features of hepatitis B, early childhood vaccinations and adults belonging to high-risk groups





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