To inoculate or not to vaccinate – that is the question. And if you vaccinate, then from what? Before our mothers and grandmothers such a dilemma did not stand. In Soviet times, all children were given the same vaccinations.
The law of the Russian Federation on immunoprophylaxis of infectious diseases gives modern parents the choice: they can selectively make vaccines for the child or abandon them altogether. But in the case of illness and vaccinated, and unvaccinated child, first lead to the pediatrician. On how to prepare for vaccination, what vaccinations do not necessarily and what is important to check before the holidays, we asked Candidate of Medical Sciences, R Head of the Medical Department of the KDL Laboratory Network , pediatrician Irina Tereshchenko.
– The very first vaccine – for hepatitis B – is given to a newborn at the 12th hour of life. In the first week, children are also recommended to be vaccinated against tuberculosis (BCG vaccine). Until the year of the child is also waiting for the DPT vaccine, vaccinations against polio, measles, rubella and mumps. Some parents believe that this amount of vaccines is a bit too much for the first year of life. Is it possible to exclude something from this list?
– Behind the vaccination calendar is the daily long-term work of scientists around the world. It is as balanced and rational as possible, and includes all current vaccines recommended by WHO. No parent is able to calculate the risk of developing a child’s disease, since does not possess the necessary epidemiological information.
It must be remembered that for certain infections, rejection of vaccinations is extremely dangerous. For example, tetanus. His controversy is everywhere in the environment. And a child who has suffered skin damage (for example, a wound or bite) becomes an unwitting lottery participant that his parents offer him: will he get sick or not get tetanus?
Vaccines define protection against infections that are dire consequences. So, the complication after parotitis – orchitis – is fraught with sterility, and pancreatitis – the development of insulin-dependent diabetes mellitus. Measles is complicated by subacute sclerosing encephalitis. A woman without rubella protection is more likely to have a child with developmental disabilities.
A sufficient level of protective antibodies will provide a safe environment for the child. And this contributes to the vaccination.
There is no such case when you need to refuse vaccinations. Each child is an individual and it is necessary, together with the doctor, to build for him the optimal scheme for implementing the vaccination calendar: determine the sequence of administration, vaccine preparations, and competent preparation. In addition, vaccination efficacy can be monitored using laboratory tests.
– According to your observations, what mom vaccinations for their children miss most often and why?
– Most often, moms are afraid of DTP and BCG tuberculosis vaccine. There is a lot of information freely available that speculates on the complications of these vaccines. Often, such materials do not have sufficient evidence, and WHO annual data on true post-vaccination complications provide evidence of this (no more than 1 case per million vaccinated).
But in the press there is practically no information about the latest developments in the development of vaccine preparations. Individual reactions cannot be predicted, and standard reactions, such as an increase in temperature after vaccination, are more indicative of the good reactogenicity of the vaccine.
Taking into account the peculiarities of the development of modern tuberculosis, its resistance to known antibiotics and the presence of a large number of extrapulmonary forms (tuberculosis of bone, kidney, etc.), parents have a great responsibility for the life and health of the child, leaving him in such an environment unvaccinated.
– What about, on the contrary, to expand the list, for example, vaccinations against rotavirus infection or rabies?
– Regarding rotavirus infection: absolute recommendations for widespread administration have not yet been developed, only for epidemiological cases.
As for rabies, that is, a drug, and a scheme has been developed for emergency prophylaxis for situations of probable infection with this virus, as well as for prevention in decreed groups of the population (for example, hunters). The rabies vaccine is the only vaccine used for treatment, so there is no need to introduce it into the vaccination schedule.
For some groups of the population, for example, for HIV-infected patients or oncological patients, special vaccination prophylaxis schemes have been developed in which vaccinal preparations are introduced against infections dangerous for such patients (for example, chicken pox).
– How to prepare a child for vaccination?
– There is no preparation, uniform for all, providing reception of any preparations. But there are certain rules and sets of measures for each vaccine in each specific case – the presence of a chronic disease, allergic predisposition, etc. is taken into account.
In addition, special allergological examinations before vaccination have been developed to predict the development of an acute allergic reaction and vaccine selection.
– What are the complications after vaccinations from the national calendar and can they somehow be avoided?
– Post-vaccination reactions can be local and general. In extremely rare cases, they turn into true complications. Often, the development of reactions is the body’s natural response to drug administration.
Proper preparation will help to avoid the development of strong reactions (not to inculcate in the acute period of infectious diseases and in exacerbation of chronic diseases, observing storage and administration of vaccines, etc.), as well as observing the child after vaccination.
– Does the type of feeding the baby somehow affect the resistance to complications?
– Breastfed babies are considered healthier since they are provided with natural protective antibodies. However, the relationship of the type of food with the features of the reaction to vaccinations, the occurrence of complications and, especially, the need to introduce an individualized vaccination scheme in children at different feedings has not been proven. The national vaccination calendar is calculated taking into account the modern peculiarities of feeding children in the first year of life.
– The family is going to rest abroad, however, on the website of the embassy they recommend to be vaccinated against exotic diseases that we do not have. Should I follow their advice and will not the vacation be disrupted due to the fact that the children’s body reacts too much to several vaccinations?
– The introduction of multiple vaccinations is not prohibited, in addition, effective combination vaccines have been developed. Even for a two-week vacation period, it is necessary to protect your child, it is only necessary to do this taking into account the recommendations on the timing of vaccination for each particular drug (a certain period is necessary for the production of protective antibodies).
Many tourist countries are dangerous to meet with serious infectious diseases. For example, the very high incidence of polio in India and adjacent regions. In the world for a long time there is such a thing as the meningococcal belt (26 African countries). And against yellow fever, common in Africa and South America, the most effective vaccine in the world has been developed (95% of those vaccinated have lifelong immunity).