Luga interdistrict hospital. Several recommendations for parents when vaccinating children Trivalent inactivated influenza vaccines

It is easier to prevent a disease than to treat it. Vaccination is a simple, but very effective method protect our pets from some serious diseases. Although most pet owners are now able to obtain the information they need, questions still arise.

The most important thing is that absolutely all dogs and cats, even exclusively “domestic” ones, must be vaccinated. The main risks of infection for them are:

• Infectious agents may be on your clothes or shoes
• you may have guests coming to you who have an animal walking outside
• your pet may accidentally jump into the stairwell or onto the street
• Without a vaccination mark, you will not be able to take your animal anywhere if necessary.
• no animal is immune from the need for a visit veterinary clinic and/or hospital

In addition, vaccination against rabies is mandatory under the legislation of the Russian Federation and some other countries.

For quite a long time, there was a standard vaccination schedule, which is still used by many veterinarians and breeders. But in 2007, the World Small Animal Veterinary Association (WSAVA) adopted and published Guidelines for Small Animal Vaccination, and periodically revises and supplements them. Here is the 2015 edition for owners.

Key Points of the WSAVA Vaccination Guidelines

1. All dogs and cats must be vaccinated. This not only protects the animal, but also creates what is called herd immunity, which reduces the risk of disease outbreaks.

2. You cannot vaccinate unless necessary.

3. Core vaccines should be given to all dogs and cats regardless of circumstances. They protect animals from serious illnesses, distributed throughout the world.

Basic vaccines for dogs against viruses:

• plague
• adenovirus
• parvovirus

Basic vaccines for cats against viruses:

• panleukopenia
• rhinotracheitis
• calicivirus

Vaccination recommendations have been developed based on the latest research findings. Firstly, vaccination is not an absolutely safe procedure - sometimes serious side effects develop after it. Secondly, new data have been obtained on the duration of immunity.

For childhood vaccination great importance has the level of colostral (obtained from mother's milk) antibodies in puppies and kittens. If vaccination is carried out in too early age, these antibodies reduce the effectiveness of vaccines, preventing the formation of an immune response. If antibody levels have already decreased, but vaccination has not yet been carried out, the puppy or kitten is vulnerable to infection - this is called the window of susceptibility. Since the level of maternal antibodies is different in each animal and without special analyzes We don't know, it is recommended that puppies and kittens receive a series of vaccinations starting at 6-8 weeks and ending no earlier than 16 weeks of age.

The ability of puppies and kittens to receive maternal antibodies through colostrum persists only for 24 hours after birth. Then the intestines become impermeable to antibodies. Accordingly, the level of maternal antibodies is not affected by the duration of breastfeeding of puppies and kittens; the amount of colostrum in the first day is important. If a newborn does not receive colostrum within 24 hours of birth, he will not have maternal antibodies.

• The start of vaccination for puppies and kittens depends on their lifestyle. From 6 weeks of age, animals that have been on artificial feeding who did not receive colostrum (do not have colostral antibodies), or whose fate is unknown. From 8 weeks of age, animals that grow up with their mother and have received mother's milk from birth are vaccinated.
• The last vaccination in a series of children should be given no earlier than 16 weeks of age (when maternal antibodies no longer block the effect of vaccines). Until then, vaccination should be carried out every 3-4 weeks. Thus, approximate The primary (children's) vaccination schedule may look like this: 8-12-16 weeks or 7-10-12-16 weeks
• For dogs over 16 weeks of age that have not been vaccinated previously (or in the absence of reliable data on vaccination), a single vaccination with core vaccines is sufficient. For cats older than 16 weeks of age who have not been previously vaccinated or have an unknown vaccination history, a single vaccination against panleukopenia is sufficient, but a double vaccination against calicivirus and rhinotracheitis is required.
• at the age of 26-52 weeks (six months to a year), revaccination is recommended. It will protect those animals that, for some reason, have not developed an immune response to previous vaccinations. This large interval can be used to optimally plan further annual vaccinations depending on the season.
• after revaccination at the age of 26-52 weeks, core vaccines should be administered no more often than once every 3 years (except for calicivirus and feline rhinotracheitis) throughout the life of the animal

These recommendations apply to core vaccines only. There are also additional ones, but it is wrong to consider them optional. These vaccines are recommended for those animals whose living conditions predispose them to infection with certain diseases - leptospirosis in dogs, leukemia (leukemia) in cats, rabies. In addition, this issue can be regulated at the legislative level (for example, rabies vaccination).

Additional vaccines

Vaccination schedules with additional vaccines differ from the basic ones, and the veterinarian’s task is to select an individual schedule for each animal, taking into account many factors. Below I will list common additional vaccines.

Rabies vaccination . According to the legislation of the Russian Federation, it is mandatory for all dogs and cats, regardless of lifestyle (including exclusively domestic ones), and therefore should be considered as basic. Her carried out starting at 12 weeks of age. The vaccine is administered once (sometimes it needs to be repeated), and then revaccination is carried out annually. There is a nuance - in accordance with the legislation of the Russian Federation, vaccination carried out no earlier than 3 months of age is legally significant.

For dogs

Vaccination against leptospirosis in dogs . Conducted no earlier than 8 weeks of age, twice with an interval of 3-4 weeks, then annual revaccination. For dogs at risk (kept in a private home where contact with rodents is possible, hunting), it is better to use vaccines with a large number of serogroups.

Vaccination against parainfluenza in dogs . Included in most comprehensive dog vaccines. But vaccination against parainfluenza should be carried out annually, and the remaining components of the vaccine - once every 3 years. In addition, it is preferable to use an intranasal vaccine, which is administered once from 8 weeks of age (possibly earlier) and then revaccinated annually. When using an injection vaccine (as part of a complex vaccine), puppies are vaccinated according to the same scheme as the basic vaccines.

Vaccination against bordetellosis in dogs. Included in the intranasal vaccine against bordetellosis and parainfluenza. It is carried out once from 8 weeks of age (if necessary, from 3 weeks), followed by annual revaccination.

Vaccination against coronavirus of dogs. Not recommended as there is no evidence of its effectiveness or necessity.

For cats

Vaccination against rhinotracheitis and calicivirus in cats . These are basic vaccines, but the frequency of revaccinations depends on the lifestyle of each individual cat - annually from high risk infections, once every 3 years – low. The peculiarity of this vaccination is that it does not prevent the disease, but reduces the severity of clinical symptoms.

Vaccination against chlamydia in cats. Start at 9 weeks, twice with an interval of 2-4 weeks, then annually. The vaccine is additional and is relevant for cats with a high risk of infection (multi-cat communities).

Vaccination against feline leukemia . Recommended for cats that have contact with the street (including indirect contact - for example, being kept with a cat walking on the street). Start at 8-9 weeks of age with mandatory repetition after 2-4 weeks. Revaccination is carried out at the age of 1 year, then no more often than once every 2-3 years. An important addition: if the cat is already a carrier of leukemia, vaccination will not harm, but will be pointless, so preliminary tests are necessary.

Vaccination against immunodeficiency . The vaccine is administered three times with an interval of 2-3 weeks, starting at 8 weeks. Revaccination at the age of 1 year, then annually. Please be aware that this vaccine does not protect against all subtypes of the virus. It makes no sense to vaccinate carriers, so preliminary tests are also necessary.

The recommendations in the WSAVA Vaccination Guidelines are currently inconsistent with the instructions for some vaccines. However, a veterinarian may administer a vaccine in accordance with the guidelines (and therefore current scientific knowledge) by obtaining the owner's informed and documented consent for off-label use.

Common Misconceptions

Treatment for worms 2 weeks before vaccination. Almost all owners know that before vaccination they need treatment for worms. Previously, it was believed that infected animals had reduced immunity and, accordingly, would have a poor response to vaccination. According to research, even if an animal has worms and there are so many of them that they affect the immune system, vaccination will still be effective (with the exception of clinically ill patients due to helminthic infestation kittens and puppies). And animals must be treated regularly for worms, regardless of vaccinations.

The vaccination site should not be wetted for several days.. There are no scientific justification this recommendation. It probably came from human medicine about the prohibition to wet the Mantoux reaction, which in fact can also be wetted :)

Side effects of vaccination

Slight lethargy and a short-term increase in temperature are normal and expected reactions associated with stimulation of the immune response.

Vaccination is rare, but possible allergic reactions – from mild redness and itching at the injection site to development anaphylactic shock(shortness of breath, drooling, severe weakness, pallor and then cyanosis of the mucous membranes). In the latter case, emergency assistance is required.

Post-injection sarcoma of cats. A very rare complication (1 case in 10,000 injections), but its name is especially frightening to owners. It is based on a strong inflammatory reaction to subcutaneous or intramuscular injection any substance, not just a vaccine. There is evidence that adjuvanted vaccines are more likely than others to provoke the development of sarcoma, but there are still few good studies on this disease.

Autoimmune reactions. Like post-injection sarcoma, these reactions are delayed in time and therefore it is very difficult to establish their dependence on vaccination. However, there is evidence that less than 1% of animals autoimmune diseases possible.

Restrictions for vaccination

• elevated temperature
• recent injection of hyperimmune serum
• acute and some chronic diseases
• exhaustion of the animal
• conditions accompanied by significant immunodeficiency (including when taking certain medications)

There are vaccines on the market from different manufacturers and in different combinations of components. Selecting the optimal regimen, taking into account age, history of past vaccinations, lifestyle, and health characteristics of the animal, is not an easy task today, when data from scientific and clinical studies on diseases and immunity have been published. Therefore, I recommend vaccinating pets veterinarians who have up-to-date information.

M.P. Kostinov ( [email protected]), A.A. Tarasova

FSBI "Research Institute of Vaccines and Serums named after. I.I. Mechnikov RAS, Moscow

The features of vaccination of children with diabetes mellitus are covered. It is shown how the immunization schedule can be changed depending on the pathology and age of the child. Key words: immunization, children with diabetes mellitus

Vaccination of children with Diabet

M.p. Ustinov ( [email protected]), A.A. Tarasova

I.I. Mechnikov Research Institute of Vaccines and Sera of Russian Academy of Sciences, Moscow Abstract

Recommendations highlighted vaccination features of children with diabetes. It is shown how the immunization scheme may be changed according to the pathology and the age of the child. Key words: immunization, children with diabetes

Vaccination against hepatitis B

In children with diabetes mellitus (DM), the incidence viral hepatitis 2 - 7 times higher than in the population. Such patients are vaccinated in accordance with the National Preventive Vaccination Calendar. If there are more than three complications of diabetes, a violation of the Vaccination Schedule, or a questionable vaccination history, vaccination is carried out after a serological blood test.

In the case of concomitant chronic renal failure, vaccination is carried out according to the schedules and doses prescribed for patients with this pathology.

The accumulated experience in vaccinating children and adults with diabetes against hepatitis B allows us to conclude that vaccines are well tolerated, there is no increase in blood sugar and glycosylated hemoglobin, as well as the need to increase the dose of insulin.

A retrospective study of the developmental histories of 91 children with type 1 diabetes showed that vaccination against hepatitis B and simultaneous administration of vaccines against hepatitis B and ADS or ADS-M toxoid did not lead to a worsening of the underlying disease.

Vaccination against diphtheria, tetanus and whooping cough

Pertussis infection in children with diabetes is especially severe. Immunization can be carried out with both whole cell and acellular

vaccines. The issue of revaccination of 6-year-old children with diabetes against whooping cough using acellular vaccines requires additional consideration.

A study of the developmental histories of 98 children with type 1 diabetes showed that not a single child had the onset of the disease after the administration of the DTP drug.

It is likely that administering three doses of the drug and one revaccination is not enough to reduce the incidence of whooping cough in both healthy children and patients with type 1 diabetes. Despite the fact that whole-cell and acellular pertussis vaccines are not capable of long-term protection against mild forms of infection in children who have received four doses of the vaccine, with the advent of acellular pertussis vaccine in Russia, it became possible to create longer-term protection against whooping cough in children with diabetes by carrying out a second revaccination .

Evidence of negative or positive influence There is no immunization for the development or prevention of diabetes in children, but there is an assumption that pertussis infection in some cases can cause damage to the insular apparatus. Regression analysis shows the possibility of development diabetes mellitus after whooping cough suffered at any age.

Children with diabetes should be vaccinated against diphtheria and tetanus as scheduled. Three years after the first revaccination, a serological examination is indicated to resolve the issue of subsequent immunization of seronegative individuals with ADS-M toxoid. If there are two revaccinations against diphtheria, the third is carried out through

Vaccination practice |

seven years, but according to epidemiological observations, after 32 months a serological examination is carried out followed by the administration of AD-M toxoid.

Vaccination and revaccination of 50 children with type 1 diabetes aged 2 to 14 years with ADS or ADS-M toxoid in combination with live polio vaccine, carried out against the background of insulin therapy in a state of clinical and metabolic compensation for at least one month, did not lead to to the occurrence of post-vaccination reactions, complications from the underlying disease and an increase in the incidence of inter-current diseases compared to the group of healthy children.

A study of the vaccination history of 100 children with type 1 diabetes showed that vaccination with ADS-M or AD-M toxoid against the background of the disease was not accompanied by a worsening of the underlying disease.

The clinical effect of vaccination against diphtheria and tetanus was studied using the developmental histories of 299 children with type 1 diabetes with different vaccination histories during a period of relatively favorable epidemiological situation. Analysis of the data obtained showed that none of the children fell ill with diphtheria and tetanus.

Vaccination against polio

To exclude the possibility of eliminating polio viruses and taking into account the frequent hospitalizations of patients with type 1 and type 2 diabetes, it is advisable to vaccinate against polio with an inactivated vaccine. In case of an unfavorable epidemiological situation, patients aged 7 to 18 years with a history of five to eight doses of polio vaccine, with a three-year duration of the disease and the number of complications of more than three, should receive an additional dose of the vaccine without a preliminary serological examination.

An analysis of the vaccination history of patients with type 1 diabetes showed that the post-vaccination period in children who received the oral polio vaccine against the background of already developed diabetes mellitus was uneventful. No decompensation of the underlying disease was detected within a month after vaccination.

nation against influenza should be routine practice along with the determination of glycosylated hemoglobin. Vaccination against influenza is carried out annually in the autumn in accordance with the instructions for the drugs used. In this case, inactivated split vaccines or subunit vaccines are used.

Influenza vaccination is especially important for patients with diabetes who have concomitant pathologies of cardio-vascular system and kidney damage, including chronic renal failure. The effectiveness of immunization does not decrease with repeated administrations of the vaccine. It is recommended to vaccinate against influenza those in the home environment of children with diabetes. Vaccination against influenza should be supplemented with immunization against pneumococcal infection; both vaccinations can be given on the same day intramuscularly in different parts of the body.

Vaccination results demonstrate good vaccine tolerance. Immunization against influenza does not lead to an increase in blood sugar and glycosylated hemoglobin, or an increase in doses of insulin and oral hypoglycemic drugs.

Clinical effectiveness flu vaccination is confirmed by a reduction in the number of hospitalizations by 54%, hospitalizations due to diabetic ketoacidosis by 79%, and a reduction in deaths by 58% (including those due to pneumonia by 25.7%). In patients with type 2 diabetes there was a more pronounced clinical effect, which persists for two epidemic seasons.

bThe effectiveness of immunization against influenza increases with repeated vaccination. When children living with relatives suffering from diabetes were immunized, the frequency of its exacerbations during the epidemic season was reduced by 2.3 times.

There is no available information on the clinical and immunological effectiveness and safety of vaccination using virosomal vaccines in children with diabetes.

Anti-epidemic effectiveness of various antiviral drugs, interferon inducers, vitamins in patients with diabetes has not been proven.

Flu vaccination

Due to the severe course of influenza infection in patients with diabetes types 1 and 2, vaccination

The topic will be continued in future issues of the magazine. (Bibliography can be obtained from the editorial office)

What is a vaccine and how do vaccinations work?

1. The body's first encounter with infection
2. Recognition of microbes by the immune system and production of protective factors
3. Removing infection from the body due to the body's immune response
4. Preservation in the immune system of the “memory of the infection” and a violent reaction aimed at removing microbes in the event of subsequent contacts of the body with a similar infection.

A vaccine (inoculation) is a solution of weakened or dead microbes or their inactivated poisons, which, when introduced into the human body, triggers the development of immunity against a specific infection.

What are the risks and negative effects of vaccinations on the human body?

How can vaccinations harm the human body?

Misconceptions regarding the negative effects of vaccinations on the human body

Key issues related to vaccination in children and adults

Why is repeated vaccination necessary?

What should be the interval between repeated doses of the same vaccine and how does the child’s age affect the effectiveness and safety of the vaccine?

Simultaneous administration of different vaccinations

Some notes on some vaccinations

• The introduction of a combined MMR vaccine gave the same efficacy and safety results as the separate administration of measles, mumps and rubella vaccines, in different places bodies. Therefore, there is no practical basis for the separate introduction of these vaccinations as part of routine vaccination of the population
• Rotavirus vaccination can be administered at the same time as, or any time after, the administration of injectable or intranasal live vaccinations.
• The simultaneous administration of tuberculosis vaccination (BCG) with other live vaccinations is not recommended.
• The simultaneous administration of pneumococcal polysaccharide vaccine and inactivated influenza vaccine produces a satisfactory immune response and does not increase the risk of side effects, and is therefore recommended for all people who are prescribed both vaccinations by age.
• Depending on the vaccinations received during the first year of life, children aged 12-15 months can receive up to 9 vaccinations during one visit to the doctor (MMR, smallpox, Haemophilus influenzae, pneumococcus, DTP, polio, Hepatitis A, Hepatitis B and flu).
• The use of combined vaccinations helps reduce the number of injections during one visit to the doctor (this is important in the case of childhood vaccinations), and also increases the likelihood that the child will receive all the vaccinations recommended for him, according to his age and schedule. It is important to note that only approved (licensed) combination vaccinations should be used. It is forbidden to mix individual vaccinations in one syringe.

Separate administration of vaccinations

Interval between vaccinations and medications containing antibodies

Interruption of the vaccination schedule

What to do if a person does not know for sure whether he has been vaccinated against certain infections or not?

Vaccination of premature babies

Vaccination of nursing mothers

Before vaccination

• Before the first vaccination, the DTP vaccine must be given general analysis blood and urine, and also receive permission neurologist for vaccination.
• If your child has allergic disorders (diathesis, etc.), discuss the regimen with your doctor in advance prevention of exacerbation of allergies. Usually it is a technique antihistamines(suprastin, fenistil) for 2 days before vaccination and 2 days after.
• If you haven't already, buy it children's antipyretics with paracetamol. It is better to buy candles, since flavorings in syrups themselves can cause adverse reactions. Buy analgin.

On the day of vaccination

• Do not introduce new complementary foods or new types of food. If the child is on breastfeeding- do not introduce new foods into your diet.
• Don't forget to take antihistamines and other medications prescribed by your doctor.
• Make sure that you have analgin at home (especially in the case of DTP vaccines) and baby suppositories with paracetamol (Efferalgan, Panadol). Do not rely solely on homeopathic medicines - they can be used, but they will not help if you have severe reactions to vaccinations.
• If the child is old enough - never, even as a joke don't scare your child with vaccinations.
• If your child asks about the injection, be honest and say that it may be a little painful, but it’s only for a few seconds.

Before leaving home

• If you have a vaccination certificate showing your vaccinations, take it with you.
• Be sure to take it with you favorite toy or baby's diaper.

At the time of vaccination

Just before the vaccination

• Make sure with your doctor that your child does not have a fever at the time of vaccination. This is the only universal contraindication to vaccination.
• Ask your doctor from what and with what kind of vaccine The child will be vaccinated today.
• Don't hesitate to ask your doctor if you have any doubts about the vaccine.

At the moment of injection

• Don't worry. Your excitement and anxiety are transferred to the child. Be calm and confident - and the child will tolerate the vaccination much easier.
• Don't worry about the fact that you are still worried, just turn your anxiety into a constructive direction.
• To distract the child(and yourself) - communicate with him, play, sing songs, look at interior items, play with a toy taken from home.
• Smile and be affectionate to your child.
• During the injection, the child must be in your arms- this way it will be more comfortable for him and you.
• Let your child cry after the injection. Don’t force your child to “be brave” or tell him that crying is a shame.
• If a child says that he is in pain, “blow out” the pain. Take a deep breath and slowly “blow out” the pain. Repeat this exercise several times.

After vaccination

In the first 30 minutes after vaccination

• Don't forget and be shy ask your questions to the doctor. Be sure to ask about what and when reactions to the vaccine may occur and in what cases to seek medical help.
• Take your time leave the clinic or medical Center. Sit for 20-30 minutes near the office. Firstly, this will help you calm down, and secondly, it will allow you to quickly provide help in case of immediate allergic reactions to the vaccine.
• If the child is breastfed - give him a breast, this will help him calm down.
• If the child is old enough, please him with some pleasant surprise, reward him with something, praise. Tell him it's okay.

Upon returning home after vaccination

• In case of vaccination with DTP vaccine: unless otherwise prescribed by the doctor, give the child a dose (suppository or syrup) of an antipyretic. This will avoid unpleasant reactions that occur in the first hours after vaccination.
• If the child does not have a temperature, you can swim as usual. The presence of reactions at the injection site is not a contraindication to swimming, and even vice versa.

First night after vaccination

• Most often, temperature reactions to inactivated vaccines (DPT and others) occur on the first day after vaccination.
• In the case of DTP vaccines: prophylactically, be sure to give the child at night antipyretic, even if the temperature is currently normal. Keep analgin on hand.
• If strong temperature reactions occur (38.5°C or higher), give once child one quarter of 0.5 g of analgin tablet. In children over 2 years of age, the dose can be increased to one third of the same tablet.
• In case of temperature reactions, do not neglect wiping your child warm water. Do not use vodka for rubbing - it irritates and dries baby's skin.
• Don't forget that the daily allowance paracetamol dosage is not unlimited. In case of overdose, serious complications are possible. Carefully read the instructions for the drug you are using (Panadol, Efferalgan, Tylenol).
• In no case don't use aspirin. Its use in children younger age is fraught with serious complications.

The first two days after vaccination
(DTP, ADS, hepatitis B, Hib vaccine, IPV)

• Take the medications prescribed by your doctor to prevent allergic disorders.
• Continue taking antipyretics according to the instructions for the medications if the temperature remains elevated.
• DTP vaccines. Monitor your child's body temperature. Try not to let it rise above 38.5°C (under the arm). In some children, against the background of an increase in temperature, the so-called so-called febrile seizures. Take antipyretics without waiting for the temperature to rise.
• You can and should walk with your child, you can and should bathe him. The exception is when the child has a fever due to or regardless of vaccination.
• If a Mantoux test was performed, when swimming, try not to let water get into the place where the test was taken. Don't forget that sweat is also a liquid, so make sure your baby's hand doesn't sweat.
• Don't introduce new products into the child’s diet (and your own if the child is breastfed). This can be done on the 3rd day after vaccination and later.
• In the case of DPT, ADS, hepatitis B and ADS-M vaccines. If strong reactions occur at the injection site (swelling, thickening, redness), apply a warm compress or simply periodically apply a cloth moistened with water. If you are not already taking anti-inflammatory medications, start taking them.

5-12 days after vaccination

• In case of vaccination with live vaccines (drops polio vaccine OPV, measles, mumps, rubella) adverse reactions usually occur 5-12 days after vaccination.
• If any reaction occurs, but the vaccination was not done with a live vaccine, then vaccination with 99% probability has nothing to do with it. Most common cause temperature and some other reactions in young children are teething, in older children - colds.

3-5 days before vaccination protect the child from numerous contacts: do not take him to crowded places (to the market, supermarket, etc.), or ride with him in crowded transport; it is necessary to avoid contact with infectious patients; avoid hypothermia.

The day before and for 2-3 days after vaccination, it is not recommended to introduce new complementary foods or new types of food. If the child is breastfed, you should not introduce new foods into the mother’s diet. There is no need to eat foods that often cause allergic reactions - chocolate, strawberries, citrus fruits, etc.

At the doctor’s appointment, parents should tell them whether the child’s temperature has risen or whether the child’s behavior has changed in the days preceding the vaccination. If the child has previously had seizures and severe allergic reactions to food and medications, you must inform your doctor about this. It is advisable to tell how the child tolerated previous vaccinations.

Recommendations for parents after preventive vaccination

The child should be examined 30 minutes after the vaccination medical worker who carried out preventive vaccination. After vaccination (usually in the first 3 days), an increase in body temperature is possible. If your child has been vaccinated with a live vaccine (for example, measles, mumps, rubella), then an increase in temperature is possible at a later date (on the 10th -11th day). If the temperature rises, swelling, thickening, or redness appears at the injection site, you should seek medical help.

It is not recommended to bathe the child within 24 hours after vaccination; walks should be limited.