To vaccinate or not?
The issue of childhood vaccinations causes perhaps the most heated debate among modern parents. “Vaccinators” appeal to the fact that vaccination is the only proven way to train the immune system to fight deadly infections, and it is obviously safer than a previous illness. “Anti-vaxxers” point out the unwanted side effects that are possible with vaccination. In fact, blindly following everything that is prescribed at the district clinic and categorically denying all the achievements of modern medicine are equally meaningless. Most parents would still like to make a balanced, informed decision. This means that each specific vaccine should be considered separately.
In this case, we are talking about vaccinating a child under one year old against whooping cough, diphtheria and tetanus. Is vaccination aimed at preventing these diseases justified?
WHEN NOT TO BE VACCINED?
The following contraindications for vaccination against Haemophilus influenzae are identified:
- A history of hypersensitivity to the components of the drug;
- Acute course of infectious diseases;
- History of convulsive condition;
- Relapse of chronic pathologies;
- Encephalopathy;
- Recorded unpredictable reactions of the child to previous immunization.
If there is even a slight suspicion that the patient has the described problems, vaccination should be abandoned until the condition normalizes.
Why vaccinate your child against tetanus?
Tetanus is extremely dangerous: the mortality rate from this disease reaches 80% of the number of cases, among newborns - 95%. The course of tetanus is very painful: there are known cases of such severe convulsions that the patient’s bones were broken. Even if the patient survives, immunity to tetanus does not develop after the illness, and it can be infected again, but the damage to the central nervous system is irreversible.
The causative agent of tetanus is found in the intestines of humans and animals, from where it enters the ground along with the feces or bodies of dead animals. Hence the widespread belief that it is impossible to become infected with tetanus if you do not play in places of mass burial of people or animals. This condition is unlikely to be met: the tetanus causative agent can persist in the soil for more than a hundred years, and the burial of domestic animals in Russia is often spontaneous.
RELEASE FORM
The vaccine for the prevention of diphtheria, tetanus, whooping cough (acellular), polio (inactivated), hepatitis B, combined, adsorbed (suspension for intramuscular administration) is packaged: 0.5 ml (I dose) in a syringe closed with a rubber cap.
The vaccine for the prevention of infection caused by Haemophilus influenzae b, conjugated, adsorbed (lyophilisate for preparing a suspension for intramuscular administration) is packaged: no 1 dose in a bottle, sealed with a rubber stopper, an aluminum cap and a plastic cap.
For pharmacies: 1 syringe with two needles in separate plastic containers or without needles, complete with 1 bottle in a blister covered with film. 1 blister along with instructions for use in a cardboard box
For medical institutions: 10 syringes with 20 needles or without needles, complete with 10 bottles and instructions for use in a cardboard box with a built-in cardboard divider with protective perforation against unauthorized opening
BEST BEFORE DATE.
Shelf life: 3 years.
Do not use after the expiration date stated on the packaging. The expiration date is the last day of the month indicated on the packaging.
Why vaccinate your child against diphtheria?
Diphtheria (true croup, also known as “choking disease”) is transmitted by airborne droplets and is highly contagious. This is one of the diseases for which herd immunity is very important. Thus, since 1974, the disease was considered completely defeated thanks to mass vaccination, but in 1997, due to refusals to vaccinate, an outbreak of this disease was again recorded. Children are especially susceptible to diphtheria; about 25% of cases are very severe. As complications, diphtheria can cause paralysis, polyneuritis and myocarditis - inflammation of the heart muscle.
At the same time, diphtheria toxoid is one of the safest vaccines. Severe reactions to it are quite rare.
CONTRAINDICATIONS FOR USE
Hypersensitivity to the active ingredients of the vaccine or to any of the components of the vaccine, as well as to neomycin and polymyxin.
Hypersensitivity following previous administration of diphtheria, tetanus, pertussis, hepatitis B, polio, or Haemophilus influenzae type b vaccines.
Encephalopathy of unknown etiology that developed within 7 days after previous administration of a vaccine containing pertussis component. In this case, the administration of the whooping cough vaccine should be discontinued, and vaccination should be continued only with the diphtheria-hatoxa vaccine, as well as vaccines against hepatitis B, polio and infection caused by Haemophilus influenzae type b
Acute infectious and non-infectious diseases, exacerbation of chronic diseases are temporary contraindications for vaccinations. Routine vaccinations are carried out 2-4 weeks after recovery or during the period of convalescence or remission for non-severe ARVI. acute intestinal diseases and other vaccinations are carried out immediately after the temperature normalizes.
Why vaccinate your child against whooping cough?
Whooping cough is especially dangerous for children under two years of age because it can cause respiratory failure. At the same time, whooping cough is one of those diseases for which antibodies against which are not transmitted through mother's milk, even if the mother was vaccinated or had whooping cough. Even having whooping cough does not provide lifelong immunity after recovery.
The mortality rate from whooping cough among those ill in the first year of life is 50-60%. In addition, whooping cough can cause complications such as pneumonia, cerebral hemorrhage, and rupture of the eardrum.
FEATURES OF INFECTIOUS DISEASE
Haemophilus influenzae infection refers to a complex of infectious diseases that develop after the penetration of Haemophilus influenzae into the body. Infection can occur during personal contact with a sick person and carrier, through household items (shared toys, dishes).
Important! According to statistics, up to 40% of children in kindergarten are carriers of Hemophilus influenzae. Therefore, a child who attends children's groups gets sick more often.
The following forms of the infectious process are characteristic of hemophilus influenzae infection:
- ORZ. The most common form of pathology;
- Inflammation of the middle ear. Haemophilus influenzae is characterized by high resistance to traditional drugs, so it is quite difficult to cure the infection;
- Epiglottitis. The pathology develops mainly in children under 4 years of age and is characterized by a sharp increase in body temperature, sore throat, pain during speaking and swallowing. The disease can cause blockage of the airways and respiratory arrest. Therefore, if epiglottitis is suspected, the child needs urgent hospitalization;
- Haemophilus influenzae respiratory tract infection: pneumonia, bronchitis;
- Meningitis. This infectious lesion of the membranes of the brain is particularly dangerous for children under 1 year of age. The disease is difficult to treat. According to statistics, in 20-30% of cases, hemophilic meningitis leads to death;
- Purulent cellulite. The disease leads to purulent-inflammatory processes in the subcutaneous fat;
- Sepsis. The most dangerous form of hemophilus influenzae infection, in which pathogenic agents penetrate the blood and spread throughout the body.
The resistance of the pathogen to antibiotic therapy significantly complicates treatment. Therefore, the optimal way out of this situation is vaccination against Haemophilus influenzae infection. Only this will minimize the risk of developing serious diseases.
How does Infanrix differ from DTP?
“Anti-vaxxers” have perhaps the most complaints about the DTP vaccine among the entire range of vaccines that are administered to children in the first years of life. The reason for this is that DTP is quite difficult for children to tolerate. Many vaccinated people report high fever and poor health for several days after vaccination. Strong side effects are associated with the pertussis component of DTP - this is why neurologists and pediatricians recommend ADS-M instead of DTP for weakened children, that is, only diphtheria-tetanus toxoid, without whooping cough. Infanrix, unlike its domestic analogue, does not contain cells of the whooping cough pathogen.
To form an immune response, only three antigens (out of approximately three thousand) are extracted from these cells, which are used in the vaccine. This does not affect the effectiveness of Infanrix, but it is much less allergenic, much less often accompanied by fever and is easier to tolerate.
It also follows from this difference that during repeated vaccination or revaccination it is possible to switch to Infanrix after DTP, but vice versa is undesirable. If the first vaccinations contained only three antigens, you should not switch your child to a vaccine containing whole cells of the whooping cough pathogen.
DESCRIPTION OF THE MEDICINE
Infanrix meets WHO requirements for the production of biological substances and vaccines against diphtheria, tetanus and pertussis.
Appearance: A cloudy, whitish suspension that separates when standing into a colorless transparent liquid and a white precipitate that completely disintegrates when shaken.
Immunological properties:
1 month after a three-dose course of primary vaccination carried out in the first 6 months of life, in more than 99% of those immunized with the Infanrix® vaccine, antibody titers to diphtheria and tetanus toxoids are more than 0.1 IU/ml. Antibodies to pertussis antigens (KA, PHA and pertactin) are produced in more than 95% of vaccinated people.
Immune response to revaccination with Infanrix vaccine
After revaccination with the Infanrix vaccine in the second year of life (13-24 months), in all children who were primarily immunized with the Infanrix® vaccine, antibody titers to diphtheria and tetanus toxoids are more than 0.1 IU/ml. A secondary immune response to pertussis antigens occurs in more than 96% of children.
Protective effectiveness of Infanrix
The protective effectiveness of the vaccine reaches an average of 88%.
Infanrix or Pentaxim?
Infanrix is not the only foreign-made vaccine that uses antigens isolated from the pertussis pathogen instead of whole cells. Pentaxim, also a very well-known foreign analogue of DPT, is produced using the same scheme. Which one should you choose?
They are very similar in composition and action, so it is logical to use the vaccine that is more accessible to you at the moment. However, there is one significant difference to consider. Infanrix contains only tetanus, whooping cough and diphtheria toxoids. Pentaxim, in addition, contains components for the prevention of hemophilus influenzae infection, as well as polio, that is, it is a five-component vaccine. This means that if you have already chosen Infanrix or Pentaxim, at the next vaccination or revaccination you will not be able to replace one with the other, since the vaccination protocol against polio and Haemophilus influenzae infection will not be completed to the end.
Should I combine all five components or get by with three, preferring Infanrix? The choice is up to the parents. Some believe that multicomponent vaccines create too high a one-time antigenic load on the body. Others rely on the National Vaccination Calendar, which provides for simultaneous vaccination against several diseases (without indicating how many vaccines are used). The Infanrix line has additional vaccines - Infanrix IPV (whooping cough, diphtheria, tetanus, polio) and even Infanrix Hexa (the same four diseases plus hepatitis B and hemophilus influenzae). The domestic DTP also has expanded options: Tetrakok (DTP + polio) and Bubo Kok (DTP + hepatitis B).
POSITIVE AND NEGATIVE ASPECTS OF VACCINATION
The number of parents refusing to immunize their children increases every year. Opponents of vaccinations argue that the introduction of vaccine preparations is dangerous for the child’s body and provokes the development of neurological complications and disability.
However, many years of immunization experience have proven the following advantages of vaccination against Haemophilus influenzae:
- High efficiency. The vaccine provides protection for a child for 5 years in 95% of cases;
- Vaccinations have reduced the incidence of haemophilus influenzae meningitis in children by 87% in the UK. There are completely no cases of this infection in the Netherlands;
- Vaccination can reduce the incidence of illness in a child upon entering kindergarten;
- In vaccinated children, if infected, the infection is mild.
The listed facts indicate the need for vaccination if the child has no contraindications.
How is Infanrix administered?
According to the National Vaccination Calendar, the first preventive immunization against tetanus, diphtheria and whooping cough is carried out at three months. As a rule, it is preceded by an examination of the child by a neurologist, who “gives the go-ahead” for vaccination or, on the contrary, a waiver from it according to indications, and then by a pediatrician.
Infanrix allows for shifts in the timing of vaccination in this case. This will not affect its effectiveness.
The second stage of immunization occurs at 4.5 months.
The third is for six months.
This first course of three procedures builds immunity a month after vaccination. Its effectiveness is 99% for diphtheria and tetanus, 95% for whooping cough.
Revaccination against whooping cough, diphtheria and tetanus is carried out at 18 months (one and a half years). During revaccination, a secondary response of the immune system is formed, which consolidates the effect of primary vaccination. Revaccination against diphtheria and tetanus is also given to children aged 7 and 14 years. In an adult, immunity against diphtheria and tetanus acquired as a result of vaccination lasts about 10 years.
Directions for use and doses
A single dose is 0.5 ml, contained in a specially designed syringe. This syringe dose of the Infanrix vaccine is aseptically packaged and adapted for convenient transportation and storage, equipped with a special needle that minimizes pain from the injection. The use of such a syringe eliminates overdose and reuse.
The Infanrix vaccine is administered intramuscularly into the thigh. Injection into the buttock is not currently practiced. Intravenous administration is strictly contraindicated.
Possible side effects of Infanrix
The instructions for the drug mention the following side effects of the vaccine as the most common: drowsiness, loss of appetite, irritability, anxiety, fever, itching and swelling at the injection site, vomiting, diarrhea. Infrequently, vaccination may be followed by headache, cough, rash, or lump at the injection site.
Adverse reactions occurring in more than 1% of vaccinated people are considered frequent. Any vaccination can cause an allergic reaction. Therefore, after the vaccination is administered, it is not recommended to leave the clinic for 30-40 minutes: in any office where vaccinations are given, there is a first aid kit for a quick response to possible anaphylactic shock. After this time has passed, an acute allergic reaction to the drug will no longer occur, and you can safely go home.
If a child's temperature rises after vaccination, it is recommended to ventilate the room in which he is located and maintain a humidity level above 70%. At temperatures above 38.5 °C, it is better to give an antipyretic, and if it rises above 40 °C, you should immediately call an ambulance. Be sure to give your child more fluids.
If any of the adverse reactions persist for more than two days, you should consult a doctor. This can happen when vaccinated with a low-quality vaccine (improperly stored or expired) or if the vaccination itself was done incorrectly, with a violation of sterility.
SIDE EFFECTS AND COMPLICATIONS
After vaccination against Haemophilus influenzae, adverse reactions rarely occur, so the drug is often combined with other vaccines. However, some patients note the development of such symptoms:
- Soreness, swelling of the place where the vaccine was administered. Symptoms develop in 10% of children vaccinated;
- Increased body temperature (up to subfebrile values) in 1% of vaccinated patients.
The listed adverse reactions do not require medication and go away on their own 2-3 days after the injection.
If vaccination against Haemophilus influenzae was carried out using a polyvalent drug (Infanrix penta, Pentaxim), then the following symptoms often develop:
- Convulsions;
- Increased body temperature;
- Swelling of the limb where the drug was injected;
- Local reactions: redness, soreness, hardening of the injection site;
- The occurrence of neuritis of the brachial nerve;
- The appearance of skin itching;
- Decreased appetite, nausea.
If immunization is carried out in the presence of an unidentified contraindication, complications develop:
- Development of angioedema, if there is individual intolerance to any ingredient of the vaccine;
- Existing chronic pathologies become aggravated;
- Development of fever if the child was vaccinated against a background of elevated temperature;
- The occurrence of neurological symptoms due to damage to the central nervous system if immunization was given to an infant with encephalopathy.
However, such cases occur quite rarely, so parents should not refuse vaccination. It is important to understand the importance of immunization for a child's body. After all, timely prevention is better than long and painful treatment.
How to prepare for Infanrix vaccination
The likelihood of adverse reactions occurring, as well as their severity, can be reduced by preparing for vaccination. First, you need to make sure that the child is healthy. Even a mild ARVI without fever is a temporary contraindication to vaccination. If the child is healthy, but one of the relatives who had contact with the child for several days before vaccination is sick, it is also better to reschedule the vaccination.
It is better to reschedule the vaccination if it is very hot outside or, conversely, very cold. In general, gentle conditions are indicated on the day of vaccination and for several days after. Stressful factors, including walking in the heat and cold, must be excluded.
It is recommended not to overload the stomach on the day of vaccination; vaccination should be done at least an hour after meals. On the day of vaccination, new complementary foods should not be introduced. It is recommended to pay attention to whether the child had bowel movements during the day before vaccination, and if not, give him an enema to help empty his bowels.
On the day the vaccination is scheduled, you can give your child an antihistamine.
INTERACTION WITH OTHER DRUGS
In accordance with the rules adopted in Russia, Infanrix can be administered simultaneously (on the same day) with other vaccines of the National Preventive Vaccination Calendar and inactivated vaccines of the Preventive Vaccination Calendar for epidemic indications. However, other vaccines must be administered to other areas of the body. It is allowed to mix Infanrix® with the Hiberix® vaccine (vaccine against Haemophilus influenzae type b). In this case, the solvent supplied with the Hiberix® vaccine must be replaced with the Infanrix vaccine.
