Influenza vaccines are protection against a dangerous infection. Pros and cons. What are the benefits of flu vaccination? How and where do you get the flu shot?

Flu is a highly contagious viral respiratory disease that is acute with symptoms of intoxication, catarrhal phenomena and frequent complications.

The disease is equally common in men and women of all age categories. Influenza often causes epidemics and pandemics that affect a large number of the population of our planet.

The disease has life-threatening complications, often leading to the death of patients. This is why flu vaccination is so important.

The flu vaccine builds immunity against influenza viruses in the human body. In response to the introduction of influenza virus antigens contained in the vaccine.

Every year, the pharmaceutical market of our country is replenished with new and effective influenza vaccines.

Interesting! Influenza vaccination has been around for over half a century. According to WHO, the annual influenza vaccination in adults is effective in 90-95% of cases.

Why get a flu shot:

1. Reducing the incidence of influenza;
2. Reducing the number of deaths from influenza and its complications;
3. Prevention of exacerbations of cardiovascular, pulmonary and other pathologies.

Although flu vaccines have proved to be safe and effective for people of all ages during their existence, there are still some side effects:

• headache;
• body aches;
• general weakness;
• an increase in body temperature to subfebrile figures;
• hyperemia skin, swelling at the injection site, which will pass on their own in 1-2 days;
• Sometimes there are allergic reactions- itching of the skin, rash, urticaria, Quincke's edema.

To prevent the occurrence adverse reactions, you need to tell the doctor before vaccination about all the diseases that you had before and the presence of severe allergic history. Categorical contraindications for influenza vaccination:

• a history of allergic reaction to the vaccine component - chicken protein;
• an allergic reaction to an influenza vaccine earlier;
• allergy to aminoglycoside antibiotics;
• persons with exacerbated chronic pathology or acute infection, which is manifested by fever.

What are the types of flu vaccines?

Killed or inactivated influenza viruses were used to prepare the first influenza vaccines.

Live vaccines from attenuated viruses have also been produced. The substrate for growing influenza viruses is chicken eggs.

Almost all vaccines today are inactivated whole-virion vaccines. Viruses are grown on chicken eggs, then they are neutralized ultraviolet radiation or formalin.

Inactivated influenza vaccines are:

• whole-virion - which consist of whole viral cells;
• split vaccines - consist of particles (antigens) of destroyed influenza viruses;
• subunit, which contain only hemagglutinins and neuromidase.

AT Russian Federation The following trivalent vaccines are used to vaccinate children and adults:

• Grippovak;
• Begrivak;
• Grippol-plus;
• Inflexal V.

Classification of trivalent influenza vaccines:

1. Live whole virion vaccines (Ultravac);

2. Inactivated vaccines:

• whole virion (Ultrix, Microflu, Fluvaxin);
• split vaccines (Begrivak, Vaksigripp, Fluarix);
• subunit vaccines (Agrippal, Influvac);
• subunit adjuvant vaccines (Grippol, Grippol-plus, Sovigripp, Inflexal V).

Who needs to get the flu vaccine every year?

• people over 65;

• children under three years old;
• persons with chronic broncho-pulmonary and other pathologies;
• pregnant women;
• nursing mothers;
• healthcare workers, drivers public transport, conductors, teachers, teachers, educators, service workers, the military.

The American Centers for Disease Control recommended adding to these groups people over 50, pregnant women in the 2nd and 3rd trimesters, children who take Aspirin, and everyone who has contact with patients with influenza.

Given that swine flu affects young people, there is a need for mass prevention of schoolchildren, students, and cadets.

Important! Vaccination is especially important for pregnant women during the second and third trimesters, as the flu can cause congenital pathology child, lead to premature birth, miscarriage.

At what age can you get a flu shot?

Children can be vaccinated as early as six months. Until the age of three, children who have not been vaccinated before are given a double flu shot 30 days apart.

WHO at the beginning of the year predicts which type and serotype will cause an influenza epidemic. Based on these predictions, the right vaccine is being developed.

Unfortunately, errors often occur. Why is that? The influenza virus is often susceptible to mutations, as a result of which its genetic material and structure are highly variable. Therefore, in order not to miscalculate recent years five, the influenza vaccine necessarily includes antigens of the swine flu virus. Today, many countries have united and created an international monitoring system for the variability of the influenza virus.

There is a rule - what more faces are vaccinated, the lower the risk of influenza virus mutations. A vaccinated person for the flu will not get sick, and if he gets sick, he will suffer lung infection forms without complications.

WHO informs that due to influenza vaccination, it was possible to reduce hospitalization by 70%, mortality by 41%, and the number of influenza pneumonia in children decreased by 2.5 times.

Influenza vaccination is given before the start of the predicted outbreak, approximately September-October, because it takes at least 2-3 weeks to develop antibodies to influenza viruses. Acquired specific immunity valid for 12 months.

• influenza A (H1N1) - California flu 2009;
• influenza A (H3N2) - Hong Kong 2014;
• influenza B /60/2008.

How to behave after the flu vaccination?

• On the day that the flu shot was given, the injection site should not be wetted with hot water and steamed. You can take a short warm shower;
• In the next month, you need to limit the use of alcoholic beverages. Alcohol lowers the activity of produced antibodies;
• Individuals who suffer from allergies need to adhere to some dietary restrictions. Products must be hypoallergenic, dishes prepared with little salt, using gentle methods heat treatment. If necessary, antihistamines may be prescribed;
• Children with fever after vaccination should not walk on the street;
• With post-vaccination fever, if the temperature has risen to 38C, and the state of health is satisfactory, then it is not necessary to knock it down. The temperature returns to normal on its own. If the fever lasts 2-3 days, see a doctor;

Note! The injection site may ache for two days.

Popular influenza vaccines

I propose to consider in more detail the most popular influenza vaccines that are used in Russia.

Vaxigrip belongs to the inactivated split vaccines.

The drug is available as a suspension for intramuscular or subcutaneous injections.

The drug consists of inactivated split influenza viruses cultured on a chicken embryo and excipients. Vaccine strains A/Brisbane/59/2007/H1, A/Uruguay/716/2007/H3N2/NYMC, B/Florida/4/2006.

This vaccine was developed on the advice of WHO for northern hemisphere and corresponds to the composition of influenza vaccines of the 2008/2009 season.

Mechanism of action. After the introduction of the drug for 2-3 weeks, specific immunity to the influenza A and B virus is developed, which persists for 6-12 months

Vaxigrip is used to prevent influenza in adults and children from six months of age.

During pregnancy, vaccination can only be carried out from the second trimester, because there is evidence of a negative effect of the vaccine on the fetus. If indicated, a flu shot is given at any stage of pregnancy. Breastfeeding is not a contraindication to influenza vaccination.

Adverse reactions

Common side effects include the following:

• hyperthermia;
• chills;
• general weakness;
• headache;
• myalgia;
• arthralgia;
• soreness, redness and swelling at the injection site.

Rare side effects include:

• transient decrease in the number of platelets;
• swollen lymph nodes;
• vasculitis;
• paresthesia;
• Guillain-Barré syndrome;
• neuritis, neuralgia;
• convulsive syndrome;
• allergies in the form of urticaria, itching, skin rashes; shortness of breath, angioedema, shock.

Important! Vaccination with Vaxigrip is not effective if the patient is already in the incubation period of influenza, as well as with influenza caused by other strains of the virus.

Immunity is not developed to diseases similar in symptoms to the flu (parainfluenza, adenovirus infection and others).

Vaxigrip does not affect the speed of physical and mental reactions.

The drug is produced in France.

Average price in Russia:

• syringe 0.25 ml (1 dose) - 170 rubles;
• syringe 0.5 ml (1 dose) - 200 rubles.

Influvac is a killed influenza vaccine that is available as a suspension for intramuscular and subcutaneous injections.

The drug is a trivalent inactivated influenza vaccine, which consists of hemagglutinins and neuraminidase of influenza A and B viruses. Each year, the composition of viral strains is updated according to WHO.

Mechanism of action: antibodies to the surface antigens of influenza A and B viruses are produced within two weeks and are valid for one year.

• people over 65;
• persons with diseases of the respiratory and cardiovascular systems;
• people suffering from chronic renal failure;
• sick on diabetes;
• persons with congenital and acquired immunodeficiencies;
• children and adolescents who take long-term drugs based on acetylsalicylic acid;
• women carrying a child in the second and third trimesters.

The drug does not affect the fetus during pregnancy. Therefore, it can be used for vaccination of pregnant women, as well as during breastfeeding.

Contraindications and side effects are similar to Vasigrippa.

Influvac is made in the Netherlands.

The average price in Russia is 0.5 ml (1 dose) of suspension in a syringe with a needle - 200 rubles.

Grippol is a trivalent subunit influenza vaccine, which is administered intramuscularly and subcutaneously, consists of hemagglutinins and neuraminidase of influenza viruses A and B (H1N1 and H3N2), as well as the immunomodulator - Polyoxidonium.

The manufacturer changes the composition of the antigens of the drug annually according to WHO recommendations.

Mechanism of action. On the introduction of the vaccine in the body, highly specific anti-influenza immunity is produced on the 8-12th day and protects against influenza over the next year. Polyoxidonium reduces the vaccination dose, by increasing immunological memory and immunogenicity, makes the body resistant to other infections.

Indications, contraindications and side effects are the same as for the above vaccines.

The drug does not have pernicious influence on the fetus and children's body Therefore, it is widely used for vaccination of pregnant and lactating mothers.

Produced in St. Petersburg, Russia.

The average cost in Russia is 700 rubles per 10 amp. 0.5 ml suspension (1 dose).

Fluarix is ​​available as a suspension for intramuscular and subcutaneous injection. The drug consists of antigens of influenza A H1N1 / H3N2 and influenza B viruses and excipients. The drug activates the production of antibodies to the surface proteins of the influenza virus in an amount that will protect throughout the year. Immunity is formed within 2-3 weeks.

Indications and side effects to vaccination with Fluarix, such as the previous representatives.

The drug is contraindicated in case of hypersensitivity to the components of the drug, as well as to gentamicin, formaldehyde, merthiolate, sodium deoxycholate, egg protein, which are used in the manufacture of the vaccine. Do not vaccinate during an acute infectious disease or exacerbation of a chronic pathology.

The use of Fluarix during pregnancy has not been sufficiently studied, therefore, vaccination is carried out only if indicated, when the effect exceeds the risk of complications.

When breastfeeding, the drug is not contraindicated

This vaccine does not prevent infections of the upper respiratory tract caused by other pathogens.

Country of origin - Belgium.

The average cost in Russia is a suspension of amp. 0.5 ml (1 dose) 650 rubles.

Agrippal S1 is another representative of trivalent subunit vaccines for the prevention of influenza, which consists of surface antigens of the virus (hemagglutinin and neuromidase) grown on chicken egg proteins. Each year, the set of surface proteins in the vaccine is adjusted to the WHO-recommended serotypes.

Indications, contraindications and side effects are the same as for all trivalent influenza vaccines.

The vaccine is made in Switzerland.

The average cost of amp. 0.5 ml (1 dose) 560 rubles.

All vaccines are administered only after examination by a doctor and thermometry to healthy adults and children. After moderate and severe infections, specific prophylaxis can be carried out 30 days after recovery. After light flow infectious diseases, vaccination is carried out after the normalization of temperature and the disappearance of all symptoms.

After vaccination, the doctor monitors the patient's condition so that when the slightest sign allergies provide qualified medical care

What are the benefits of specific influenza prophylaxis?

• method safety;
• reduced risk of disease, hospitalization and death in groups increased risk;
• reducing the risk of complications;
• vaccination is much cheaper than flu treatment.

Vaccine options

The first influenza vaccines were made from killed or neutralized viruses, they are called whole-virion, as well as from attenuated strains, the so-called live vaccines. Almost all modern vaccinations for the prevention of influenza are inactivated (killed) vaccines with a replaceable strain composition. Influenza viruses for all vaccinations without exception are grown on chicken embryos, which is reflected in the lists of contraindications for vaccination.

Most inactivated whole-virion influenza vaccines consist of purified and concentrated viruses cultured in chick embryos, inactivated with formalin or UV irradiation. Inactivated vaccinations, in turn, are divided into whole-virion vaccines, which are based on undestroyed whole influenza viruses; previously killed and purified, split, or split vaccines, which include particles of destroyed virions, that is, a complete antigenic composition (external and internal proteins). Subunit influenza vaccines are also used, which consist of a mixture of two viral proteins: hemagglutinin and neuraminidase. Therefore, these vaccines are minimal amount side reactions.

Virosome vaccines - new technology in the manufacture of grafting material. These vaccines contain an inactivated virosomal complex with surface antigens of the influenza virus. Virosomes enhance the immune response to vaccination. The virosomal vaccine does not contain preservatives (thiomersal) and is well tolerated.

In Russia, the following inactivated trivalent influenza vaccinations are mainly used: Grippovak, Vaxigrip, Begrivak, Agrippal S1, Grippol, Grippol Plus, Influvak, Fluarix, Inflexal V ( virsomal vaccine). A total of 18 vaccinations have been registered in Russia.

Classification of trivalent influenza vaccines

Principles and goals of vaccination

Vaccination is especially important for people at higher risk of developing serious complications influenza, as well as for people living with people from groups high risk or caring for them. WHO recommends annual influenza vaccination for the following populations: pregnant women at any stage of pregnancy; children from 6 months to 5 years; elderly people 65 years and older; people with chronic diseases; healthcare workers.

Since 2006, influenza vaccination has been included in the National Calendar preventive vaccinations RF. Subject to annual vaccination: children from 6 months old, children attending preschool institutions, students of grades 1-11, students of higher professional and secondary professional educational institutions, adults working in certain professions and positions (employees of medical and educational institutions, transport, utilities, etc.), adults over 60 years of age.

It is important to note that the composition of vaccines changes every year. This is done to ensure maximum protection from the "wild" influenza virus. This process carried out under the supervision of the World Health Organization. It is she who is engaged in predicting the strains of the influenza virus that will circulate in the expected season, and sends these strains to vaccine manufacturers. In most countries, influenza vaccination is given annually.

Vaccine effectiveness

The use of influenza vaccination reduces the incidence rate by 1.4-1.7 times, helps to reduce the severity of the disease, prevents the development severe complications and deaths. Vaccination is effective in all age groups approximately in the range of 70-90% of cases.

Immunization results in a 40% reduction in hospital admissions for pneumonia in healthy adults and a 45-85% reduction in older adults. In addition, the frequency of otitis media decreases by 36-69%, exacerbations by 20%. chronic bronchitis, the number of exacerbations of bronchial asthma is reduced by 60-70%. In organized groups of older people (nursing homes, boarding schools), influenza mortality is reduced by 80%.

Immunity after the introduction of the vaccine is formed after 14 days and persists throughout the season. Unfortunately, the immunity produced after vaccination is short-lived. This is largely due to the high variability of the circulating influenza virus, the emergence of a new or even the return of an old subtype of the virus. In this regard, the anti-influenza immunity developed in the previous year does not save from the disease in the current year. Therefore, an annual immunization is necessary, using only the current year of production. Vaccination with last year's vaccines is effective only in 20-40%.

Post-vaccination reactions

Whole virion influenza vaccinations have a relatively high reactogenicity. Therefore, when applied, they can develop general reactions in the form of fever, headache, weakness, and local reactions in the form of swelling, redness and soreness at the injection site. Usually these reactions are mild and go away on their own.

The subunit, split, and virosomal vaccines are the least reactogenic of all influenza vaccines. Only in 3% of cases, vaccinated people are allowed to develop adverse reactions.

Risk of post-vaccination complications

At hypersensitivity to individual components of the influenza vaccine may appear pruritus, hives or other rash. Extremely rarely, severe (systemic) allergic reactions can occur, such as anaphylactic shock. From the side nervous system: often - headache, rarely - paresthesia, convulsions. However, there is no convincing evidence that these reactions are related to vaccination.

Contraindications

For all influenza vaccines:

• hypersensitivity to chicken protein or any other component of the vaccine
• severe temperature or allergic reactions after a previous vaccination with influenza vaccines.

Influenza vaccination is delayed until the end of acute manifestations of the disease and exacerbation chronic diseases. For non-severe acute respiratory viral infections, acute intestinal and other diseases, vaccination is carried out immediately after the establishment normal temperature at the patient.

The live vaccine is not suitable for children under 3 years of age, pregnant women and people with impaired immunity.

When to vaccinate?

Children can start flu shots at 6 months of age. Influenza vaccination is carried out annually.

Children from 6 months to 3 years of age who have not previously been vaccinated against influenza are vaccinated 2 times at 0.25 ml with an interval of 1 month.

Ask a question to a specialist

A question for vaccine experts

Questions and answers

I heard that if you get a flu shot, then you have to do it all the time, because. your immune system no longer works. Is it so?

No, it's not. Annual influenza vaccination is carried out due to the variability of the virus and therefore the renewal of the vaccine. In addition, post-vaccination immunity is not long-lasting and gradually fades away. Given the above, annual vaccination is required.

An international study was conducted summarizing the meta-analysis of 52 studies comparing the immune response in the first and re-vaccinated, in which a total of more than 12 thousand people took part, the study showed that influenza vaccination does not reduce immunity.

The whole world (including our country) lives according to the WHO recommendations, which state that "the recommended vaccination schedule is one dose of inactivated vaccine annually, with the exception of previously unvaccinated preschoolers, who are indicated for the introduction of two doses of influenza vaccine with an interval of 1 month

We would like to adopt our 2 year old daughter. 11 months Vaxigrippom and combine with Act-Hib vaccine. But the daughter after bronchitis. Available residual cough in the morning and throughout the day. Do you need to get vaccinated twice a month apart? The second vaccination will be new year holidays. Is it better to put it later or earlier?

Harit Susanna Mikhailovna answers

For vaccination, the child must be healthy for at least 2 weeks. Vaccination against influenza (if the child has not had the flu and has not been vaccinated against influenza before) at your age is carried out twice, can be combined with vaccination against Haemophilus influenzae. Be careful, the flu is already registered in our country and now there is a risk of contracting this infection, since immunity is not developed earlier than 2 weeks after vaccination.

Can I opt out of the flu shot? Does an employer have the right to fire an employee who refuses to be vaccinated?

Harit Susanna Mikhailovna answers

According to the National Immunization Schedule, adults who work in certain professions and positions are subject to influenza vaccination. The list can be viewed at the link http://docs.cntd.ru/document/901738896 On approval of the list of works, the performance of which is associated with a high risk of contracting infectious diseases and requires mandatory preventive vaccinations (as amended as of December 24, 2014).

In accordance with the law, those citizens who ignore the law, really, TEMPORARY, and in a certain epidemic situation, may not be allowed to work if a certain set of vaccinations has not been made, incl. seasonal from influenza - on the basis of part 2 of Art. 76 of the Labor Code of the Russian Federation, the employer suspends (does not allow to work) the employee for the entire period of time until the circumstances that are the basis for suspension from work or exclusion from work are eliminated.

Yes, it is not always possible to get vaccinated for health reasons on the day of vaccination or for medical reasons. It is worth considering that a medical examination is mandatory on the day of vaccination, the results of which are recorded in writing. If a person has a runny nose, body temperature or pressure is elevated, the vaccine is not given, but postponed until recovery. The employer pays for the vaccination.

Who, when and for what reason included employees of higher educational institutions in Russia in the group of people who are required to be vaccinated against influenza? Under current law, university professors can be fired if they have medical contraindications and cannot be vaccinated. Who came up with this? People worked for 20 years without any vaccinations, and now they have to be fired? In the WHO recommendations on groups that need to be vaccinated against influenza, I do not even see workers school education not to mention universities.

Answered by Polibin Roman Vladimirovich

Teachers - the so-called decreed contingent. There is a law on immunoprophylaxis of the Russian Federation dated July 15, 1999 N 825. It contains a "List of works, the implementation of which is associated with a high risk of contracting infectious diseases and requires mandatory preventive vaccinations." Paragraph No. 12 defines that risky infections include "work in all types and types of educational institutions." And in accordance with the Federal Law of June 30, 2006 N 91-FZ “On Amendments to Art. 9 of the Federal Law "On Immunoprophylaxis of Infectious Diseases" in national calendar preventive vaccinations are included and flu shots. So in the epidemiological sense, teachers are at risk. And in accordance with the law, those citizens who ignore the law, really, TEMPORARY, and in a certain epidemic situation, may not be allowed to work if a certain set of vaccinations has not been made, incl. seasonal from influenza (on the basis of part 2 of article 76 of the Labor Code of the Russian Federation, the employer suspends (does not allow to work) the employee for the entire period of time until the circumstances that were the basis for suspension from work or exclusion from work are eliminated). Yes, it is not always possible to get vaccinated for health reasons on the day of vaccination or for medical reasons. On the day of vaccination, a medical examination is mandatory, the results of which are recorded in writing. If a person has a runny nose, body temperature or pressure is elevated, the vaccine is not given, but postponed until recovery. The employer pays for the vaccination.

The eldest child of 13 years old with a diagnosis of bronchial asthma, allergic rhinitis, polynoses, hr. pancreatitis. Do I need to get a flu shot, and if so, which one is better?

Harit Susanna Mikhailovna answers

It is a must - you can use Grippol plus, it has been studied for use in children with asthma and food allergies at the Scientific Center for Children's Health.

The child is 5 years old. First time vaccinated against the flu. Vaccine Vaxigrip. 0.5 ml was injected once. If necessary reintroduction vaccines at a dosage of 0.5 ml after 4 weeks?

Harit Susanna Mikhailovna answers

Yes, this is how children up to 9 years old who have not been previously vaccinated and have not had the flu are vaccinated with this vaccine.

Can breastfeeding mothers get the flu shot?

Harit Susanna Mikhailovna answers

It can be a non-live vaccine, one that is vaccinated in children from 6 months of age.

The flu vaccine protects a person from severe consequences flu and reduces the risk of morbidity by almost 2 times. Thanks to the vaccine, the disease is much easier to tolerate even if a person does get the flu, and the severity of symptoms is also significantly reduced. Not to mention deaths, which becomes almost 2 times less after mass vaccinations. Which flu vaccine works best and when should it be given?

Scientific experiments that have been conducted over the past few years have shown that thanks to vaccines, the course of influenza is much easier or does not manifest itself at all. In addition, studies have shown that vaccines are quite easily tolerated by humans, they stimulate well immune system humans and reduce the risk of epidemics.

• Influvac
• Grippol
• Waxigrip
• Begrivak
• Fluarix
• Agrippal

These drugs meet all the requirements of pharmacological international organizations controlling the production of vaccines. The level of protection of these vaccines is very high - more than 70%. This is very effective level flu protection. It avoids influenza complications, deaths and epidemics.

Science has proven that vaccination in groups of only 20% of employees significantly reduces the risk of epidemics and the number of diseases. This applies to both influenza and acute respiratory infections.

Vaccines that fight the flu are called medical term trivaccines. This name was given to vaccines because they contain antigens against the three most popular and dangerous influenza viruses: A, B, C.

Who needs to be vaccinated?

First of all, vaccination is given to those people who are at risk of catching the flu (but only on the condition that they agree, and this consent must be in writing).

1. Elderly people - over 60 years old
2. People with chronic diseases, hospital patients
3. Children and adults with bronchopulmonary diseases, especially with bronchial asthma
4. Children and adults with heart and vascular diseases
5. Children and adults with respiratory diseases
6. Children and adults who were treated in a hospital for kidney and liver disorders a year ago
7. Children and adults who have had chemotherapy, including one year ago
8. Nurses, doctors - medical and school institutions
9. People who work in numerous teams (and children attending kindergartens, schools)
10. Residents of hostels, communal apartments, nursing homes, as well as those who are in prison.
11. Pregnant women in the second or third trimester (as recommended by a doctor)

How is the flu vaccination given?

The vaccine is usually injected into the shoulder, in the area of ​​the deltoid muscle (this is the upper third of the shoulder muscle). After the vaccine, you can not wet the injection site during the day, as it may occur inflammatory response skin. Also, if you are told not to drink alcohol after the vaccine, be aware that this information is incorrect.

The vaccine can also be administered through the nose by instillation (children are told that these are “droplets”). In this case, the body's response to viruses and bacteria is weaker than when injected, which explains the unpopularity of this method of vaccination in our time.

The average time for the formation of stable immunity to influenza in humans is from 10 days to two weeks from the moment the vaccine enters the human body. Before October, doctors believe, there is no point in making a vaccine, because the effect of the drug gradually subsides, and by the beginning of the peak of the flu, the body may again be weakened.

What are the types of flu vaccines?

There are two types of vaccines: live (with live viruses that are already attenuated and adapted to human body) and inactivated (which do not contain live viruses).

What is the most effective flu vaccine?

Doctors recommend choosing inactivated vaccines in most cases (for example, influvac). These vaccines do not contain live viruses and are therefore easier to tolerate than those with live viruses. Non-live vaccines contain either particles of already destroyed viruses or surface antigens of the influenza virus.

The safety of these vaccines is combined with a very good immune support of the body. After the introduction of these vaccines, a person will no longer get the flu, unless some new unrecognized virus appears.

If a person hesitates about which vaccine to choose - domestic or imported, qualified doctors usually recommend imported ones. They have more degrees of purification and the degree of purification is step-by-step, multi-stage. In addition, laboratory specialists carefully control all processes at any stage of vaccine production. Therefore, adverse reactions to these vaccines are minimal - allergies do not occur even in children who are not yet a year old, as well as in pregnant and breastfeeding mothers.

The flu vaccine can save you a lot of trouble and save you a lot of work hours. Therefore, do not give up on it if you care about your health.

Influenza vaccine contraindications

Since the flu vaccine may use chicken protein (most commonly) or preservatives, it should not be administered to people who are allergic to these substances.

• Do not administer influenza vaccine before six months of age

• The vaccine is contraindicated in chronic diseases in the acute stage - then you need to wait another month after the person recovers and receives permission for vaccination from a doctor.
• The vaccine should not be given to those who previously received the vaccine, but it was very difficult to tolerate it.
• People who have had a cold or flu less than two weeks ago should not be vaccinated.

What are the complications after the flu vaccination?

They are divided into two groups - systemic complications and local.

Systemic complications after vaccination are an allergic reaction of the whole body, for example, headaches, breath holding, heart rhythm disturbances, fever, racing blood pressure, muscle and joint pain, meningitis and so on.

Local complications after a vaccine are the response of one system of the body, and not the whole body. This could be a sore throat or headache, or redness of the skin where the vaccine was given, or a runny nose.

In case of complications after the vaccine, you should definitely tell your doctor about it so that he can advise on what measures to take.

Do I have to pay for the flu vaccine?

For those people who are listed in the list of clients required for vaccination, the vaccine is administered free of charge - at the expense of state program fight the flu. If there is not enough vaccine or a person is not sure of its quality, he can purchase it in those places that he trusts (mainly state clinics or centers attached to them). The patient has the right to pay for the vaccine and services for its administration on the spot.

But if the flu vaccine was purchased in one place and administered in another, keep in mind that the doctor has the right to refuse to administer it. Reason - the doctor cannot guarantee the result of the introduction of a drug of unknown origin, as well as with unknown conditions of storage and transportation. Also, the doctor cannot predict the allergic reactions of the body to this drug.

You do not need to pay for vaccination if the company where the person works paid for it. This often happens when the management of the company is worried about the health of the entire team and orders mass vaccination. In this case, a commercial contract is concluded with the clinic where the vaccination is carried out, and the employee of the company is obliged to comply with its conditions. He can not come to the vaccination. Is that only he has contraindications to the introduction of the vaccine.

Every year, in anticipation of the influenza season, vaccination against this infection is gaining momentum. It is worth understanding the need for this procedure in general and the variety of vaccines on the market today, which I will try to do in this article. We will also analyze the characteristics of influenza vaccines from various manufacturers - vaxigripp, influvac, grippol and others. trade names and need in adults, children and pregnant women.

Vaccination in itself is a great boon, as it helped save humanity from destruction or a significant reduction in the population of the Earth's population. Let the opponents of universal vaccination sing their mantras about the dangers of vaccines, but it helps to build immunity against bacterial or viral agents with a stable structure cell membranes such as smallpox, measles, polio and many others, this procedure is very effective. What can not be said about the changeable infectious agents, which is, including the influenza virus.

Evidence base for influenza vaccination

In the corresponding article, and taking into account the easily mutating structure of the virus itself, this allows you to get big number combinations of the same influenza virus. As a result, all of the above leads to the profanation of the very idea of ​​​​vaccination against influenza, when a weakened virus is injected into the body of a large number of people, but they cannot exactly predict whether this will help in a real fight against influenza or not. AT best case Such vaccination helps to strengthen the non-specific immunity of the human body, that is, not aimed at a specific virus or bacterium, but such immunity is not one hundred percent protection against the possibility of infection with a virus.

vaccine Influvac

Also striking in their absence are the results of studies on the MEDLINE database. There are indications of vaccine safety studies, but there are no indications of efficacy studies, and both for domestic vaccines, and foreign, presented on our market. This means that there is simply nothing to show in these studies, or the results will be discouraging and inconsistent with the information that is brought to the layman.

Anyone can find reviews of influenza vaccination in large numbers on the Internet, and the people who vaccinated themselves will tell you many reasons why they will not do this procedure in the future: starting from a flu-like state after vaccination (consider the flu in miniature, but the strength is sometimes like that of a normal flu), until the next influenza season in the season, despite the vaccination. So is the game worth the candle?

Now let's start from the motivational characteristics of the topic and consider the whole variety of influenza vaccines and their manufacturers on the market, and their effects in adults, children and pregnant women.

Vaccine production

The production of influenza vaccines is the cultivation of the virus in chick embryo cell cultures. Accordingly, this vaccine is already contraindicated in persons allergic to chicken protein. Novartis is now producing the Optaflu vaccine using an animal cell culture mattress, which increases throughput and avoids chicken protein in the production of vaccines, reducing the number side effects from its application. Russian manufacturers use chicken eggs in the production of flu vaccines.

Determination of the viral spectrum

The composition of the influenza vaccine changes every year, because, based on the forecasts of experts from the World Health Organization, manufacturing companies receive a viral spectrum, that is, an estimated set of those influenza viruses that will attack the population in the upcoming epidemic season and begin production and distribution of influenza vaccines. Naturally, this principle determination of the viral spectrum and the production of vaccines can absolutely rightly be called a guessing game, which was confirmed in 2009, when the epidemic of the new at that time that swept through the world showed the absolute inefficiency of the approach used and forced pharmaceutical companies and experts to reshape the spectrum of attacked influenza viruses on the go and start the production of new vaccines is already in the midst of an epidemic. All this led to the accumulation of a huge mass of new vaccines in warehouses, which were never used due to the imminent end of the epidemic and the calming of the population.

influenza vaccine

Indications for vaccination

Persons who are at risk and who are indicated for influenza vaccination with their consent:

• the elderly, persons over 60;
• department patients nursing care any age with chronic diseases;
• adults and children suffering from chronic bronchopulmonary (including bronchial asthma) and cardiovascular diseases, including malformations of the respiratory and cardiovascular systems;
• adults and children subject to permanent medical supervision and were hospitalized in the previous year for metabolic disorders (including diabetes mellitus), kidney disease, liver disease (including cirrhosis), hemoglobinopathies, immunosuppression (including drug, chemotherapy and HIV-induced);
• doctors, nurses and other hospital and outpatient staff;
• people living in organized communities where the flu can spread quickly, such as a prison, nursing home and hostel (this recommendation is typical for foreign healthcare structures, we only apply to nursing homes, and even then based on the first paragraph of the recommendations regarding the elderly );
• women in the 2nd and 3rd trimesters of pregnancy (the most debated issue at present is the vaccination of pregnant women, given potential danger and the presence of complications from the use of vaccines).

Persons from the risk groups indicated above are vaccinated against influenza free of charge at the expense of budgetary funds, the rest need to purchase this vaccine at a pharmacy and get vaccinated at a polyclinic or medical center (this service is free or paid), the option is also practiced when paid on the spot the cost of vaccinations and services.

The doctor has the right to refuse to administer the vaccine to a patient who independently purchased it, since in this case he cannot guarantee the safety and correct storage and transportation of the drug, which can cause adverse reactions and even death of the vaccinated, and this point should also be taken into account.

Some employers practice concluding commercial contracts with health care institutions and vaccinating their employees at the expense of the enterprise or company, in which case the employee will not be able to get away from vaccination.

Also, in view of the well-established lobby in the healthcare structures, any patient who comes to the clinic for an examination, consultation or for sick leave at vaccination time will be sent for vaccination. All this will be done according to the instructions above. There are oral recommendations from heads and chief doctors for district therapists not to close sick leave anyone who has not had a flu shot, even if it was not opened by colds, under pain of deprecation. So doctors are forcing flu shots more out of fear of losing their money than realizing the real benefits of this procedure.

Since the higher authorities require the implementation of the influenza vaccination plan from each healthcare institution. Say, vaccines are purchased, budget resources mastered and cut down, it is necessary to fulfill the plan. And how many unused vaccines are thrown away and then fake reports are drawn on the vaccination plan. The scale of the development of money in this monstrous and useless campaign is simply amazing.

Vaccination contraindications

• intolerance to chicken protein and / or preservatives used in the manufacture of vaccines;
• children under 6 months of age;
• acute illnesses or exacerbations of chronic illnesses until complete recovery, it is usually recommended to wait 3-4 weeks after subsiding acute process and then allow influenza vaccination;
• a history of other post-vaccination complications in response to previous vaccine administrations.

Complications of vaccination can be divided into two groups:

• local - which are found at the injection site (swelling, redness, soreness at the injection site; for nasal vaccines (introduced through the nose) - runny nose, cough, sore throat)
• systemic - represent the response of the whole organism to the introduction of the vaccine (headache, allergic reactions, fever, chills, feeling of weakness, otitis media, meningitis, myositis and other complications)

The standard timing for influenza vaccination is October-November. It is believed that in the time remaining before the start, a stable immunity will be formed that will protect the vaccinated from infection. It takes 10-15 days from the moment the vaccine enters the body to develop sufficient immunity against influenza. Vaccination before October is not advisable, as it leads to a drop in the level of antibodies against influenza by the end of the epidemic and an increased risk of infection.

Ways of administering vaccines

• nasal - by introducing a special vaccine into the nose, which leads to a greater development of local immunity, probably a weaker protective reaction develops and is currently this method rarely used
• injection - the standard and most common way of administering the influenza vaccine, the vaccine is administered subcutaneously or intramuscularly

Types of Vaccines

For specific prevention influenza vaccines are divided into two large groups:

• live vaccines (containing attenuated and non-infectious viruses) (influenza allantoic live dry vaccine ("Microgen", Russia))
• inactivated (do not contain live viruses)

1. whole-cell - contain whole cells of the influenza virus (inactivated liquid influenza vaccine (manufacturer "Microgen", Russia));
2. split or split vaccines - contain split influenza virus cells containing both surface and internal protein molecules and antigens, due to the high degree of purification they do not contain viral lipids and chick embryo proteins (Grippol vaccine (manufactured by Microgen, Russia), Fluarix vaccine (manufactured by GlaxoSmithKline, Belgium), Begrivak vaccine (manufactured by Kyron Behring, Germany), Vaxigrip vaccine (or, as some mistakenly write Vaxigripp) (manufactured by Sanofi Pasteur, France));
3. subunit vaccines - contain only surface viral proteins (hemagglutinin and neuraminidase) (Grippol plus vaccine (manufactured by Petrovax Pharm, Russia), Influvac vaccine (manufactured by Abbot Products LLC, former Solvay Pharma, the Netherlands), Agrippal vaccine (manufactured by Novartis, formerly Chiron Co, Italy)).

1. Influenza vaccine allantoic live dry ("Microgen", Russia)
2. Fluid inactivated liquid vaccine (manufacturer "Microgen", Russia)
3. Grippol (manufacturer "Microgen", Russia)
4. Fluarix (manufactured by GlaxoSmithKline, Belgium)
5. Grippol plus (manufacturer "Petrovax Pharm", Russia)
6. Influvac (manufacturer "Abbot Products LLC", the Netherlands)
7. Agrippal (manufacturer Novartis, Italy)

Split and subunit vaccines do not have such a frequency of complications on administration, and at the same time form immunity at a fairly decent level, therefore, in this moment are the benchmark in use for influenza prevention. Which of these vaccines is the best? Most likely, the golden mean, in the form of a split vaccine, which has a minimum of side effects, but has the ability to form immunity to the flu virus well.

Vaxigrip vaccine

Vaccine prices

I will quote prices for vaccines for reference, since depending on the region, season and special conditions supplies, it can vary, and within fairly large limits.

Grippol - from 150 to 200 rubles for 1 dose of 0.5 ml
Grippol plus - from 150 to 250 rubles for 1 dose of 0.5 ml
Influvac - from 250 to 350 rubles for 1 dose of 0.5 ml

Thus, in the article I tried to summarize the available information on influenza vaccines. I did this on the basis of reliable sources, and not repeatedly reprinted information about the benefits of vaccines, distributed clearly by whom and for what money, and here everyone decides for himself what to choose: to get a flu shot or not. In any case, do as you see fit, and if without vaccination you feel uncomfortable in the impending flu epidemic, then do it better than feel psychological discomfort, because it is known that stress affects the immune system worse than any vaccination. I personally made my choice and I don’t remember when last time got vaccinated against the flu.

Influenza is an acute infectious disease that affects mainly the upper respiratory tract and proceeds with a high temperature (lasting for 3-5 days), with a pronounced deterioration in well-being, which is manifested by high fever, severe weakness, severe headache and muscle pain, nausea, vomiting.

Influenza viruses

Children become especially susceptible to influenza after six months of age, because by this age they have a decrease in the number of mothers transmitted to them in utero, and their intake decreases with breast milk- Babies begin to be fed, which reduces the frequency of breastfeeding.

pathogens this disease- three types of influenza viruses: A, B, C. Influenza viruses have the ability to change rapidly, as they constantly circulate among people and exchange genetic material. Many contacts and development of transport in modern world contribute to the lightning spread of these viruses in the most remote parts of the world. Severe type A influenza epidemics occur every 10-40 years, less severe recur every 2-3 years. Large-scale outbreaks of influenza type B are repeated every 4-7 years. Influenza C-type diseases occur evenly throughout the year, rarely outgrowing and epidemics.

If the virus is "captured"

When entering the upper respiratory tract, the virus (regardless of type) invades the cells of the outer layer of the mucous membrane, causing their destruction. Cells containing the virus are rejected by the body and enter the environment with breathing, coughing, sneezing, infecting others. This route of transmission is called airborne.

Infection is also possible through toys, dishes and other objects of the patient.

Within a few days, and sometimes even hours, the virus, multiplying in the body, causes the first signs of the disease - malaise, chills, aching joints, muscle pain. Then the temperature rises rapidly to 39-40 ° C (in some children, against the background of high temperature convulsions may develop), dizziness, headache, coughing, sore throat, transparent, and then purulent discharge from the nose.

Having been ill with the flu (most often severe), the child acquires immunity to it. However, the problem is that the virus is changing all the time, so that antibodies that have been developed earlier (protective specific proteins directed against the pathogen) will not fully protect even those who have already had the flu from the new version of the virus.

How dangerous is the flu

The influenza virus suppresses the immune response of the body, so the ability of the child to resist illness is significantly reduced. It is known that during influenza epidemics, the incidence bacterial infections respiratory tract increases sharply. In addition, the flu causes an exacerbation and exacerbates the course of chronic diseases (if any). It happens that a child's chronic illness increases the likelihood severe course influenza and the development of its complications, which are the main cause of high mortality.

Complications of influenza: pneumonia - inflammation of the lungs, otitis media - inflammation of the middle ear (sometimes turning into meningitis - inflammation of the meninges), damage to the cardiovascular and central nervous system.

Who is indicated against the flu

The World Health Organization (WHO) has recommended influenza vaccination as the only real way to be protected from this infection to the vaccinated and the possibility of creating herd immunity. WHO has identified groups of people who need vaccination (of course, with their consent). AT this group risk included children:

often ill; suffering from chronic respiratory diseases (for example, bronchial asthma) and / or having malformations of the respiratory system; suffering from diseases and / or malformations of the central nervous system; with congenital and / or acquired heart defects, disorders heart rate; with kidney disease (chronic glomerulonephritis, chronic kidney failure); with blood diseases; suffering endocrine diseases(diabetes); with immunodeficiency states; children who are treated with drugs that suppress the immune system; as well as children attending childcare facilities.

Influenza Vaccines

For the specific prevention of influenza, inactivated (not containing live viruses) and live vaccines (containing attenuated, non-infectious viruses) are used. The latter are practically not used at present - a new generation of live vaccines is being intensively developed. Inactivated vaccines have a significantly lower peaactogenicity (the ability to cause complications). To date, three types of such vaccines have been created: whole-cell, split-vaccines and subunit. They differ from each other in the degree of splitting the virus into its constituent parts: a whole cell vaccine contains whole cells of the virus, a split vaccine (split - split) contains all the proteins of the virus (surface, internal), and a subunit vaccine contains only surface proteins of the virus.

Whole cell and live vaccines can cause post-vaccination complications and therefore have wide range contraindications that severely limit their use. Their only advantage is a good ability to form immunity to influenza.

Split vaccines and subunit vaccines, due to the fact that they do not contain the entire virus, but only its main elements, figuratively speaking, do not contain impurities that can cause complications, are by far the safest and are especially well suited for protecting children in the first year of life, and also for children suffering from immune deficiency. Which of these vaccines would you prefer? While it is difficult to answer this question categorically, therefore, many different studies are being carried out. According to available data, split vaccines are the golden mean. They are able to maximally stimulate the immune system and effectively protect a person from influenza with a low level of adverse reactions.

To date, 11 influenza vaccines have been registered. Here are just a few of them.

Inactivated split vaccines Flu-arix (Belgium); Waxigrip (France); Begrivak (Germany). Inactivated subunit vaccines: Influvac (Netherlands), Agrippal S1 (Italy), Grippol (Russia; efficacy and safety of this vaccine for young children is still under investigation).

How the vaccine works

The introduction of an inactivated virus (or its parts) into the body causes the production of antibodies of various types, which allows you to create a multi-level system of protection against influenza, and since influenza viruses have similar structures to acute respiratory infections, the anti-influenza antibodies produced after vaccination also protect the body from acute respiratory infections - with an efficiency of 50-60%, the number of cases of pneumonia, exacerbations of chronic diseases is reduced. Already two weeks after vaccination, anti-influenza antibodies accumulate in the body and it becomes immune to the disease. Protective proteins recognize the virus and destroy it, preventing it from multiplying.

Sufficient immune reactivity of the body persists for about 6 months (according to other sources - up to a year), which ensures its high resistance to the influenza virus throughout the epidemic season. The effectiveness of immunization with modern influenza vaccines is 70-90% and depends both on the specific vaccine, the conditions of its storage and transportation, and on the epidemiological situation in the country. exact time, from the characteristics of the baby's body and other factors. That is, the likelihood that a vaccinated child will get the flu still remains, but at the same time he will get sick with it in a mild form and without the development of complications.

Vaccination schedule

All currently available influenza vaccines are used according to standard scheme. Optimal timing the beginning of vaccination are September-October, then by the beginning of the epidemic season, which usually occurs in December-January, sufficient immune defense. It is necessary to have time to be vaccinated before the start of the epidemic: if this is done later, then the risk of being vaccinated during the latent (incubation) period of the disease increases.

Children can be vaccinated against the flu from 6 months of age. Previously unvaccinated and flu-free children, depending on the vaccine used, are recommended to administer half the adult dose twice with an interval of 1 month. The injection is made intramuscularly or deep subcutaneously. When using vaccines in disposable syringes (syringe-dose), it is recommended to shake the syringe immediately before injection. Currently, intensive development of a new generation of vaccines that do not require intramuscular injection is underway.

When not to be vaccinated

The main contraindication for the use of influenza vaccine is intolerance to the components of the drug: proteins chicken egg and special preservatives contained in some preparations.

Do not administer vaccines when acute diseases or in exacerbation chronic ailments. After 3-4 weeks after recovery or subsidence of manifestations chronic disease vaccination can be done.

Where can you get vaccinated?

Vaccinations can be carried out in any licensed vaccination (In a clinic, commercial clinic, center). Vaccinations are carried out by certified medical personnel in vaccination room or at home, when the parents conclude an agreement with a private medical company about observing the child.

To date, science has proven the effectiveness and safety of modern influenza vaccines, which is especially important for children at risk.

You can discuss the expediency of vaccinating your child with someone who constantly observes the baby and knows the characteristics of his body: how he tolerates vaccinations in general, how he reacts to a rise in temperature during acute respiratory viral infections, whether there are convulsions, etc. For insurance before vaccination, you can go through at least minimum medical examination- pass general analyzes urine and blood, consult an immunologist.

Andrey Stepanov
immunologist,
older Researcher departments for premature babies Science Center children's health Russian Academy of Medical Sciences, Ph.D.
Article from the September issue of the magazine