DTP vaccination after 6 years. After vaccination akds. Why a vaccine is better than a disease

If you've been vaccinated against polio, measles, or diphtheria, you don't have to worry about your child accidentally picking up these infections and getting sick. But with whooping cough, the situation is different. Pertussis vaccine does not create lifelong immunity, in order to definitely avoid this disease, immunity must be constantly “whipped” by repeated vaccinations. In our country, babies are vaccinated against whooping cough three times up to six months: at 3 months, at 4.5 and at 6, and one more time at 18 months. The vaccine is called DTP, it immediately against three diseases: whooping cough, diphtheria, tetanus. From 6 months - after the 3rd dose - and for 5-8 years, the child is protected from this disease.

AT school age susceptibility to whooping cough is gradually returning, but those old vaccinations protect against it at least partially. So if a vaccinated child becomes ill, whooping cough occurs in him in an erased, mild form, sometimes it is even difficult to make a diagnosis. Therefore, although about 30 thousand cases of pertussis are registered in Russia every year, in fact there are many more.

But even a patient with atypical whooping cough infects everyone around: peers, adults, infants up to six months who have not received three more vaccinations and have not acquired immunity against the disease. This is how the infection circulates.

Probably, you have a question: why not continue vaccination and do not vaccinate children further, as they do, for example, before school, vaccinations against diphtheria and tetanus?

The fact is that pertussis vaccine often causes unpleasant reactions: fever, worsening general condition, in rare cases- Complications on the nervous system. And than older child the more often these reactions occur. So for mass vaccinations For older children and adolescents, the current vaccine is unsuitable.

The search for the ideal

Scientists have long been trying to create a vaccine more "soft", without adverse reactions. And their efforts were crowned with success. Since adverse reactions to vaccination are mainly associated with the action of lipopolysaccharides - the membranes of the microbial cell, the creation of new pertussis vaccines was based on their purification from these substances. As a result, cell-free (acellular) vaccines have appeared that actually give fewer adverse reactions. But whether they give fewer serious complications, it is not yet possible to say: experience has not yet been accumulated to compare these two types of vaccinations. The disadvantage of acellular vaccines is also that they are expensive. Therefore, WHO now recommends that children 1-2 years old be vaccinated with “whole-cell” vaccines (DTP), and the acellular vaccine should be administered to schoolchildren and adolescents. In the USA, Japan and a number of other countries, revaccination has already been included in the vaccination schedule. new vaccine primary school students and are considering another vaccination at age 16 in order to suppress the circulation of whooping cough among students as well.

Well, in Russia? We vaccinate 90% of babies with the DTP vaccine and it hasn't increased the number of complications. But the incidence due to vaccination has decreased by 25 times. And if earlier severe forms of the disease prevailed, then after mass vaccination the pathogen became “softer”.

Illness lasting 8 weeks

A typical whooping cough is manifested by a paroxysmal obsessive cough, which brings the child to exhaustion. Cough does not occur immediately, the first 2 weeks the disease differs little from the usual SARS, so it is difficult to suspect a true disease at this time. But when the whooping cough starts, it will not be relieved for 4-6-8 weeks, or even longer. Cough follows attacks, more often at night, cough tremors go one after another, the child sticks out his tongue in such a way that it injures the frenulum of the tongue on his teeth, his face turns red, at the end of the attack, during inhalation, the patient emits loud noise- a reprise by which whooping cough can be unmistakably recognized. After a few weeks of torment, the coughing fits become less frequent.

Infants are especially susceptible to whooping cough - coughing can lead to respiratory arrest. The older the child, the less the disease is dangerous to his life.

This excruciating debilitating disease is also unpleasant for its severe complications. If during whooping cough the child receives an additional infection: for example, he falls ill with ARVI, the cough increases sharply and becomes more frequent, before that normal temperature increases, pneumonia occurs. Whooping cough and encephalitis are fraught with inflammation of the brain, which leads to disability.

Even after recovery, the child’s body “remembers” the illness for several months: with each “cold”, whooping cough can return, and it’s difficult to do anything about it.

What will we treat?

Until recently, there was no salvation against whooping cough - they tried to raise sick children to a height on airplanes and balloons, lower them into mines, more than 200 drugs were offered for treatment - and all in vain. Cough is not relieved by expectorants, mucus thinners, rubbing, or heating.

Antibiotics do not help much either: although many of them act on whooping cough. Treatment only makes sense early stage, before the onset of a cough (and without it it is impossible to know that it is whooping cough!) Or at its very beginning.

The best of the means was and remains one thing - to walk as much as possible in the fresh air.

By the way

AT recent times there have been observations that whooping cough is relieved by inhaled corticosteroid drugs - they are usually used for the "basic" treatment of bronchial asthma.

Important

Why are we afraid of DTP vaccinations?

>> We believe that complications from the pertussis component of this vaccine are very common.

In fact. The wave of parental refusals of pertussis vaccination, which took place in Europe in the 70s, proved the opposite: an outbreak of whooping cough "backed up" with hundreds of cases of encephalitis. Such a number of complications from vaccination would not have accumulated even in 3 thousand years!

>> We believe that the whooping cough vaccine can cause allergies and asthma.

In fact. An extensive study in England found that children vaccinated against whooping cough had even less asthma than unvaccinated children.

>> We are afraid of the possibility of a rise in temperature after vaccination.

In fact. It happens. To avoid such a reaction, paracetamol should be given to the child within two days after vaccination. A dose of 10 mg per 1 kg of the child's weight should be divided into three to four doses per day.

DTP is a series of vaccinations that are so important in a person's life. The abbreviation hides such formidable diseases as Pertussis, Diphtheria and Tetanus. What does the letter A mean in DTP? Absorbed vaccine - i.e. a vaccine that contains aluminum hydroxide. It is this substance that is preserved muscle tissue long time after injection, the substance is not absorbed into the blood. Diphtheria and tetanus toxoids are absorbed on it - this is how immunity against them is developed.

Is DTP so terrible

Many parents are afraid to vaccinate their child with DTP and opt for DTP due to serious reactions that occur quite often. The culprit of parental fears is the whooping cough component, it is because of him that the vaccine most difficult to bear. But why deny your child his right to be immune to whooping cough, a highly contagious disease that is deadly to children in early age. In addition, it should be remembered that in modern vaccines, which are called AAKDS, the pertussis component is purified and side reactions are minimized. These vaccination vaccines are not produced on the territory of Ukraine, usually they are European manufacturers, which affects the price.

About reactions and complications

Let's bring common list mild reactions after DTP vaccination:

• temperature rise
• swelling, some swelling, redness and soreness at the injection site
• vomit
• irritability, moodiness, lethargy and decreased or no appetite.

One in a million

More rare reactions include convulsions, fever above 40 degrees, extremely rare serious allergic reactions, coma, prolonged convulsions, loss of consciousness, permanent brain damage.

About cramps

It is worth remembering that at an early age elevated body temperature a child can cause seizures, that is, seizures are not a consequence of vaccination, but a consequence of high temperature.

Oh, they got sick ... Is the vaccine to blame?

Parents often note with annoyance that a few days after vaccination their child gets sick - acute respiratory infections, acute respiratory viral infections, flu ... They blame the nasty vaccination for everything. And you should blame the trip to the clinic - alas, healthy children are seen there less and less, and those who come for vaccination have time to catch the infection of those who came to be treated.

Approach the issue of vaccination responsibly - if you cross the threshold of the clinic, then make sure that it will be in "healthy baby day", avoid contact with other children, especially those who go to kindergarten. During the season of exacerbations of respiratory diseases, do not use public transport with the baby and at the slightest sign of flu at home, transfer them to “quarantine”.

The disease against the background of the vaccination period is not fatal, but highly undesirable, because the immune system the child is already busy accumulating antibodies against other diseases.

injection site

There is a risk of injection into the buttock:

• getting into blood vessels
• entry into the sciatic nerve
• keeping the drug in subcutaneous tissue.

It is also worth noting that the level of antibody formation when DTP is injected into the thigh is much higher. Pay attention to the manipulations of the nurse who is going to vaccinate - DPT should be done only in the thigh.

About preparing for vaccination

It's simple - do not introduce new foods into complementary foods 2 weeks before vaccination, do not overfeed the child, walk more often.

When to do?

DTP vaccination is not done once. According to the vaccination calendar of Ukraine, DPT is done in 3, 4, 5 months first year of life, from revaccination in 1.5 years and 5 years. In developed countries, vaccination starts at two months.

The DTP vaccine is given to prevent diphtheria, whooping cough, and tetanus in a child.

All three infections can be prevented with preventive vaccinations. Children under 4 years of age are given DTP - a vaccine, and as an alternative on a commercial basis can be used foreign drugs, registered in our country - TETRAKOK, BUBO KOK and INFANRIX (more about vaccines will be discussed later). DPT and TETRAKOK vaccines are whole-cell, as they contain killed cells of the pertussis pathogen, diphtheria and tetanus toxoids. TETRAKOK also includes a polio vaccine containing cells of a killed pathogen. INFANRIX is a cell-free vaccine because it contains only single particles of the pertussis microorganism. It also contains diphtheria and tetanus toxoids.

Depending on the components of the pertussis component, vaccines differ in their reactogenicity (the ability to cause a reaction to the vaccine). Cell-free vaccines (INFANRIX) are less reactogenic, since they contain only the main elements of the microbe (proteins) sufficient to form immunity, without other, less essential substances and impurities. Whole-cell vaccines (DPT, TETRAKOK) contain the whole cell of the microbe, and this is a whole set of substances alien to the human body, provoking a pronounced response, including in the form of post-vaccination complications. After the introduction of acellular vaccines in children, post-vaccination reactions (fever, malaise, soreness and swelling at the injection site) are many times less likely to develop, these drugs practically do not cause post-vaccination complications, which, although very rare, occur when whole cell vaccines are used.

DPT vaccines.

Tetanus adsorbed liquid - DTP

manufacturer Federal State Unitary Enterprise NPO Microgen, Ministry of Health of the Russian Federation, Russia

Release form: 1 ampoule / 2 doses No. 10

Vaccination schedule:

prevention of diphtheria, whooping cough, tetanus according to the National Immunization Schedule for children three times with an interval of 1.5 months (3 months - 4.5 months - 6 months).

Instructions for use. Vaccine pertussis-diphtheria-tetanus adsorbed liquid (DPT-vaccine) suspension for injection

Compound. The DTP vaccine consists of a suspension of killed pertussis microbes and purified toxoids, tetanus and diphtheria, adsorbed on aluminum hydroxide.

Preservative - merthiolate at a concentration of 0.01%. Contains in 1 ml of the preparation 20 billion pertussis microbial cells, 30 flocculating units (LF) of diphtheria antitoxin-binding units (EC) of tetanus toxoid. One primary dose (0.5 ml) contains at least 30 international immunizing units (IMU) of diphtheria toxoid, at least 60 IU of tetanus toxoid and at least 4 international protective units of pertussis vaccine. It is a suspension of white or slightly yellowish color, separating when standing on clear liquid and loose sediment, easily broken when shaken.

Properties. The introduction of DTP vaccine into the human body causes the formation specific immunity against whooping cough, diphtheria and tetanus.

Appointment. The drug is intended for routine prophylaxis of whooping cough, diphtheria and tetanus in children aged 3 months and older according to a special scheme.

Application. Vaccinations with DTP vaccine are carried out at the age of 3 months. Before reaching the age of 3 years 11 months 29 days. (Vaccinations for children who have had whooping cough are carried out with ADS-toxoid). The DTP vaccine is administered intramuscularly, into the upper outer quadrant of the buttock at a dose of 0.5 ml (grafting single dose). The vaccination course consists of 3 vaccinations with an interval of 1.5 months (3 months, 4.5 months, 6 months.) The DTP vaccine can be administered simultaneously with the polio vaccine and other preparations of the national vaccination schedule. Revaccination is carried out once at the age of 18 months. (in case of violation of the timing of vaccinations - 12-13 months after the last vaccination with DTP vaccine).

Note: If the child is under 3 years 11 months 29 days. did not receive revaccination with DTP vaccine, then it is carried out with ADS-anatoxin (for ages 4 years - 5 years 11 months 29 days) or ADS - M-anatoxin (6 years and older)

Contraindications Progressive diseases of the nervous system. BUT febrile convulsions in history. The development of a strong general reaction to the previous administration of the DTP vaccine (an increase in temperature in the first two days to 40 and above) or complications.

Note.

1. Children with contraindications to the use of DPT-vaccine can be vaccinated with ADS - toxoid.

2. If the child is vaccinated twice, the course of vaccination against diphtheria and tetanus is considered complete, if the child has received one vaccination, vaccination can be continued with ADS-M-toxoid, which is administered once no earlier than 3 months later. In both cases, the first revaccination is carried out with ADS-M-anatoxin after 9-12 months. After the last vaccination. If a complication developed after the third vaccination with DTP vaccine, the first revaccination is carried out with ADS-M-anatoxin after 12-18 months. Subsequent revaccinations are carried out at 7, 14 and every subsequent 10 years with ADS-M-anatoxin.

Release form. DTP is produced in ampoules of 1.0 ml (2 vaccination doses). The package contains 10 ampoules.

Storage. Store in a dry, dark place at (6 ± 2)°C. Protect from freezing!

Best before date. 1 year 6 months

Infanrix™ / INFANRIX™ (diphtheria, whooping cough, tetanus)

INFANRIX™ vaccine for the prevention of diphtheria, tetanus, whooping cough acellular purified inactivated liquid (INFANRIX™ combined diphteria, tetanus, acellular pertussis vaccine) GlaxoSmithKline J07A X

COMPOSITION AND FORM OF RELEASE: susp. d / in. syringe 0.5 ml, 1 dose, No. 1

One dose (0.5 ml) contains at least 30 International Immunizing Units (MIU) of diphtheria toxoid, at least 40 IU of tetanus toxoid and 25 micrograms of detoxified pertussis toxin, and 25 micrograms of filamentous haemagglutinin and 8 micrograms of pertactin. Diphtheria and tetanus toxoids obtained from cultures of Corynebacterium diphteriae and Clostridium tetani are inactivated and purified. The acellular pertussis vaccine components are prepared by growing a phase I culture of Bordetella pertussis from which PT, FHA and pertactin are extracted and purified.

INDICATIONS: active primary immunization against diphtheria, tetanus and whooping cough in children from 3 to one month old.

APPLICATION: The primary vaccination regimen consists of three doses in the first year of life and may begin at 3 months of age followed by a booster dose in the 2nd and 6th year of life.

The Infanrix vaccine is intended for deep intramuscular administration. Infanrix vaccine should be given with caution to individuals with thrombocytopenia or a bleeding disorder, as these individuals may experience local bleeding. The injection site must be firmly pressed (without rubbing) for at least 2 minutes.

CONTRAINDICATIONS: Do not administer Infanrix to persons with a known hypersensitivity to any component of the vaccine or to persons who have shown signs of hypersensitivity after a previous administration of the diphtheria, tetanus and whooping cough vaccine.

The administration of Infanrix is ​​contraindicated in children if the child has previously had encephalopathy of unknown etiology within 7 days of a previous administration of a pertussis-containing vaccine. In this case, the vaccination course should be continued with a vaccine with diphtheria and tetanus components.

SIDE EFFECTS: pain, flushing, swelling, fever, atypical crying or screaming, vomiting, diarrhea, loss of appetite.

INTERACTIONS: Infanrix vaccine may be used simultaneously with other vaccines intended for immunization in children. The vaccine can be used in the same syringe with vaccines for the prevention of diseases caused by Haemophilus influenzae (type B). Places of introduction of vaccines must be necessarily different. In patients receiving immunosuppressive therapy, as well as in patients with immunodeficiency, a sufficient immune response may not develop.

STORAGE CONDITIONS: in a dry dark place at a temperature of 2–8 °C, do not freeze. The vaccine should be administered immediately after opening the vial (no more than 8 hours after opening the vial).

INFANRIX™ IPV

diphtheria, tetanus, whooping cough (acellular component) and polio vaccine (INFANRIX™ IPV)

GlaxoSmithKline J07C A02

COMPOSITION AND FORM OF RELEASE: susp. d / in. 0.5 ml syringe single dose, 1 dose, No. 1

A 0.5 ml dose of the vaccine contains at least 30 IU of diphtheria toxoid, at least 40 IU of tetanus toxoid, 25 µg of pertussis toxoid, 25 µg of filamentous hemagglutinin, 8 µg of pertactin; 40 D-antigenic units type 1, 8 D-antigenic units type 2 and 32 D-antigenic units type 3 of inactivated poliomyelitis virus.

PHARMACOLOGICAL PROPERTIES: Infanrix IPV is a combined vaccine for the prevention of diphtheria, tetanus, whooping cough/acellular component/DTPa and poliomyelitis (IPV).

INDICATIONS: Prevention of diphtheria, tetanus, whooping cough and poliomyelitis in children aged 2 months. Infanrix IPV vaccine is also indicated as a booster dose for children who have previously been immunized with diphtheria, tetanus, whooping cough and polio antigens.

APPLICATION: Primary vaccination regimen consists of 3 doses in the first year of life and may begin at 3 months of age. Between the introduction of subsequent doses, an interval of at least 1.5 months should be observed. Typically, the vaccine is given to a child at age 3; 4-5 and 6 months with revaccination at 18 months. After completion of the primary vaccination regimen, an interval of at least 6 months should be maintained for the introduction of a booster dose. Clinical data regarding the use of this vaccine as a booster dose have been obtained in children under 13 years of age.

The Infanrix IPV vaccine is intended for deep intramuscular administration. For infants, the predominant injection site is the anterolateral thigh; in older children, the vaccine should be injected into the deltoid muscle. Each subsequent dose is desirably administered at alternate sites.

CONTRAINDICATIONS: Infanrix IPV vaccine should not be given to persons with hypersensitivity to any component of the vaccine or to persons who show signs of hypersensitivity after previous administration of diphtheria, tetanus, whooping cough or inactivated polio vaccines.

Infanrix IPV is contraindicated if the child has had encephalopathy of unknown etiology within 7 days of a previous vaccination with a pertussis-containing vaccine.

SPECIAL INSTRUCTIONS: Infanrix-IPV vaccine should not be administered to persons with a known hypersensitivity to any component of the vaccine or to persons who have shown signs of hypersensitivity after previous administration of diphtheria, tetanus, whooping cough or inactivated polio vaccines. Infanrix IPV is contraindicated if the child has had encephalopathy of unknown etiology within 7 days of a previous pertussis-containing vaccine. Under no circumstances should Infanrix IPV be given intravenously.

STORAGE CONDITIONS: Infanrix IPV vaccine should be stored at 2-8°C in a dark place. Cannot be frozen; do not use if Infanrix IPV vaccine has been frozen.

Infanrix™ HEXA / Infanrix™ HEXA

diphtheria, whooping cough, tetanus, hepatitis B, poliomyelitis, Haemophilus influenzae type b

INFANRIX™ HEXA combined diphtheria, tetanus, acellular pertussis, hepatitis B, enhanced inactivated polio vaccine and Haemophilus influenzae type b vaccine (DTPa-HBV-IPV/Hib))

GlaxoSmithKline J07C A09

COMPOSITION AND FORM OF RELEASE: susp. d / in. disposable syringe, + lyophil. since. d / in. in fl., No. 1

Contains diphtheria toxoid, tetanus toxoid, 3 purified pertussis antigens (pertussis toxoid (PT), filamentous haemagglutinin (FHA) and pertactin (PRN; 69 kDa outer membrane protein), purified hepatitis B virus (HBV) major surface antigen (HBsAg) and Purified polyribosyl-ribitol-phosphate capsular polysaccharide (PRP) Haemophilus influenzae type b (Hib) covalently linked to tetanus toxoid adsorbed on aluminum salts The vaccine also contains inactivated polioviruses type 3 (IPV) (type 1: Mahoney strain; type 2 : strain MEF-1, type 3: strain Saukett).

The drug is a suspension (DTPa-HBV-IPV) for injection in a disposable syringe and a lyophilized powder (Hib) for injection in a vial, which are mixed before use.

Tetanus and diphtheria toxoids are obtained by treating with formaldehyde purified toxins from Corynebacterium diphtheriae and Clostridium tetani. Acellular pertussis vaccine components are obtained by extraction and purification from phase I cultures of Bordetella pertussis, followed by irreversible detoxification of the pertussis toxin by treatment with glutaraldehyde and formaldehyde, and by treatment with formaldehyde FHA and PRN. Diphtheria toxoid, tetanus toxoid and components of the acellular pertussis vaccine are adsorbed on aluminum salts. The components of DTPa-HBV-IPV are prepared in isotonic solution of sodium chloride and contain 2-phenoxyethanol.

The HBV surface antigen is produced by a culture of yeast cells (Saccharomyces cerevisiae) obtained by the method genetic engineering that carry the gene encoding HBsAg. This surface antigen is thoroughly purified by physicochemical methods. It spontaneously transforms into spherical particles with a diameter of 20 nm, which contain non-glycosylated antigen polypeptides and a lipid matrix consisting mainly of phospholipids that have the characteristic properties of natural HBsAg. Type 3 polioviruses are cultured on the VERO cell line, purified and inactivated with formaldehyde. Hib polysaccharide is prepared from Hib strain 20752 and combined with tetanus toxoid. After purification, the conjugate is adsorbed onto aluminum salts and lyophilized in the presence of lactose as a stabilizer. Infanrix Hexa meets WHO requirements for the production of biologicals, diphtheria, tetanus, pertussis and combination vaccines, vaccines for the prevention of hepatitis B obtained using recombinant DNA technology, inactivated vaccines for the prevention of polio and Hib conjugate vaccines.

INDICATIONS: Infanrix Hexa vaccine is indicated for primary immunization to prevent diphtheria, tetanus, whooping cough, hepatitis B, poliomyelitis and Haemophilus influenzae type b infection in infants 6 weeks of age and older and may be given infants who received their first dose of hepatitis B vaccine at birth.

APPLICATION: Infanrix Hexa vaccine is injected deep intramuscularly into the vastus lateralis muscle in the anterolateral region of the middle or upper thigh.

CONTRAINDICATIONS: Do not use in persons with a known hypersensitivity to any component of the vaccine or in persons who have experienced hypersensitivity reactions after previous administration of diphtheria, tetanus, whooping cough, hepatitis B, polio, or Hib vaccines.

The introduction of Infanrix Hexa is contraindicated if the child has previously had encephalopathy of unknown etiology within 7 days after a previous vaccination with a vaccine containing a pertussis component. In this case, pertussis vaccination should be discontinued and the course of vaccination with diphtheria-tetanus, hepatitis B, inactivated polio and Hib vaccines should be continued.

SIDE EFFECTS: in clinical research The most common reactions (frequency 10%) reported after primary vaccination were:

Local - pain, hyperemia, swelling;

Systemic - anorexia, fever, drowsiness, irritability.

In studies involving 4083 individuals (vaccine doses documented), reactions at the injection site and irritability were reported from reactions that were regarded as due or likely due to vaccination.

Very rarely, allergic reactions, including anaphylactoid reactions, have been reported following immunization with vaccines containing DTPa.

For vaccines with a pertussis component, extremely rare cases of collapse or shock-like state (hypotonic hyporeactive episode) and convulsions have been reported within 2-3 days after vaccination. All vaccinated with similar reactions recovered without complications.

STORAGE CONDITIONS: in a dark place at a temperature of 2–8 °C. During transport, the recommended storage conditions must be observed. The DTPa-HB-IP suspension and the vaccine prepared for administration must not be frozen.

Vaccine "Pentaxim"

against diphtheria, tetanus, whooping cough, poliomyelitis and haemophilus influenzae "SanofiAventis Pasteur", France

Presentation: 1 syringe containing 1 dose of vaccine against diphtheria, tetanus and whooping cough, poliomyelitis, Haemophilus influenzae type B

Instructions for use of the Pentaxim \ Pentaxim vaccine.

Vaccine for the prevention of diphtheria and tetanus adsorbed, pertussis acellular, inactivated poliomyelitis, infection caused by Haemophilus influenzae type b conjugated.

PHARMACEUTICAL FORM

Lyophilizate for the preparation of a suspension for intramuscular injection 1 dose, complete with a suspension for intramuscular injection 0.5 ml.

COMPOUND. 1. Vaccine for the prevention of diphtheria and tetanus adsorbed; pertussis acellular; poliomyelitis inactivated (suspension for intramuscular injection).

One dose of the vaccine (0.5 ml) contains:

Active substances:

Diphtheria anatoxin...? 30 IU;

Tetanus toxoid...? 40 IU;

Pertussis toxoid ... 25 mcg;

Hemagglutinin filamentous ... 25 mcg;

Poliomyelitis virus type 1 inactivated……….40 units of D antigen;

Polio virus type 2 inactivated… 8 units of D antigen;

Polio virus type 3 inactivated ... 32 units of D antigen;

Excipients:

aluminum hydroxide 0.3 mg; Hank's medium 199* 0.05 ml; formaldehyde 12.5 mcg; phenoxyethanol 2.5 µl; water for injection up to 0.5 ml; acetic acid or sodium hydroxide - up to pH 6.8 - 7.3.

2. Vaccine for the prevention of infection caused by Haemophilus influenzae type b, conjugated (lyophilisate for suspension for intramuscular injection)

One dose of lyophilisate contains:

Active ingredient: Haemophilus influenzae type b polysaccharide,

conjugated with tetanus toxoid ... 10 mcg.

Excipients: sucrose 42.5 mg; trometamol 0.6 mg;

DESCRIPTION. Vaccine for the prevention of diphtheria and tetanus adsorbed; pertussis acellular; poliomyelitis inactivated (suspension for intramuscular injection): Whitish cloudy suspension.

Vaccine for the prevention of infection caused by Haemophilus influenzae type b, conjugated (lyophilisate for suspension for intramuscular injection):

White homogeneous lyophilisate.

PURPOSE. Prevention of diphtheria, tetanus, whooping cough, poliomyelitis and invasive infection caused by Haemophilus influenzae type b (meningitis, septicemia, etc.) in children from 3 months of age.

Contraindications

Progressive encephalopathy with or without seizures. Encephalopathy occurring within 7 days of any vaccine containing Bordetella pertussis antigens. A strong reaction that developed within 48 hours after the previous vaccination with a vaccine containing a pertussis component: an increase in body temperature up to 40 ° C and above, a syndrome of prolonged unusual crying, febrile or afebrile convulsions, hypotonic-hyporeactive syndrome. Allergic reaction after previous exposure to diphtheria, tetanus, whooping cough, polio vaccine and Haemophilus influenzae type b vaccine. Confirmed systemic hypersensitivity reaction to any vaccine ingredient, as well as glutaraldehyde, neomycin, streptomycin and polymyxin B. Diseases accompanied by fever, acute manifestations infectious disease or exacerbation of a chronic disease. In these cases, vaccination should be delayed until recovery.

METHOD OF APPLICATION AND DOSES

The vaccine is administered intramuscularly at a dose of 0.5 ml, the recommended injection site is the middle third of the anterior-lateral surface of the thigh. Do not administer intradermally or intravenously. Before insertion, it is necessary to make sure that the needle has not penetrated into the blood vessel. For the packaging option with two separate needles, before preparing the vaccine, the needle should be firmly fixed by rotating it a quarter of a turn relative to the syringe.

The PENTAXIM vaccination course consists of 3 injections of one dose of the vaccine (0.5 ml) with an interval of 1-2 months, starting from the age of 3 months. Revaccination is carried out with the introduction of 1 dose of PENTAXIM at the age of 18 months. life. According to the National Immunization Schedule Russian Federation, the vaccination course for the prevention of diphtheria, tetanus, whooping cough and poliomyelitis consists of 3 injections of the drug with an interval of 1.5 months, at the age of 3, 4.5 and 6 months, respectively; revaccination is carried out once at the age of 18 months. If the vaccination schedule is violated, the subsequent intervals between the administration of the next dose of the vaccine do not change, including the interval before the 4th (revaccinating) dose - 12 months.

If the first dose of Pentaxim was administered at the age of 6-12 months, then the second dose is administered after 1.5 months. after the first, and as the 3rd dose, administered after 1.5 months. after the second, a vaccine should be used to prevent diphtheria, tetanus; pertussis and poliomyelitis, initially presented in a syringe (i.e. without dilution of the lyophilisate in a vial (HIb)). As a booster (4th dose) is used usual dose Pentaxima (with dilution of lyophilisate (HIb)).

If the first dose of Pentaxim is administered after the age of 1 year, then for the 2nd, 3rd and 4th (booster) doses, a vaccine should be used to prevent diphtheria, tetanus; whooping cough and poliomyelitis, initially presented in a syringe, without dilution of the lyophilisate in a vial (HIb).

STORAGE CONDITIONS. Store in the refrigerator (at a temperature of 2 to 8 ° C). Do not freeze.

Keep out of the reach of children.

Tetracoccus

It is a vaccine for the combined prevention of diphtheria, tetanus, whooping cough and polio. Tetrakok fully complies with international and Russian requirements for the concentration of antigens and is a classic DTP vaccine in combination with an inactivated polio vaccine. The Tetrakok vaccine application scheme is fully consistent with the Russian vaccination schedule - vaccination can be carried out at the age of 3, 4.5 and 6 months, followed by revaccination at 18 months.

A safer alternative to conventional vaccines

TETRAKOK does not contain mercury-based preservatives, which reduces the risk of allergic reactions and the risk of exacerbation of diathesis.

Thanks to the inactivated polio vaccine (IPV), which is part of the Tetracoc preparation, the likelihood of developing vaccine-associated paralytic poliomyelitis is completely excluded. Therefore, the Tetrakok vaccine is especially indicated for children with diseases of the immune system, as well as for children whose immediate environment has similar diseases.

Inactivated polio vaccine is a safer (and more effective) alternative to the live oral polio vaccine (OPV) traditionally used in clinics.

There are other benefits to using inactivated polio vaccine (IPV):

A vaccinated child does not infect others, as IPV does not contain live viruses. This means that this vaccine can be safely used in those children in whose family or immediate environment there are pregnant women and patients with diseases of the immune system.

Unlike a live vaccine, IPV is not administered by mouth, in the form of drops, but by injection, which means that the child will not be able to spit out or burp IPV. This in turn means that there will be no need for repeated vaccinations and visits to the clinic.

Unlike a live vaccine, IPV can be given to children with stomach and intestinal disorders, that is, the effectiveness of the vaccination will be guaranteed.

IPV is less sensitive to storage conditions and more effective than OPV.

Safety proven by experience

Due to the high degree of purification of the TETRAKOK vaccine, 85% of children have no post-vaccination reactions to its administration. Like any DPT vaccine, Tetracoccus causes temperature reactions in about 10-20% of vaccinated children, but the risk of reactions can be minimized by prophylactic administration of antipyretics. Other adverse reactions to the Tetracox vaccine may include redness, swelling, and soreness at the site of the vaccine. As with any other DPT vaccine, a fairly rare adverse reaction to the Tetracox vaccine is the baby's "prolonged unusual crying" - loud, atypical crying that lasts from one to several hours.

According to pharmacovigilance data in France, following the results of using the TETRAKOK vaccine for 6 years (during this time, about 15 million vaccinations were made), complications to this vaccine occurred at a frequency of 3.6 per 100 thousand vaccinations, and only 5% of them were heavy.

As with any other DTP vaccine containing a whole cell pertussis component, Tetracox vaccine is contraindicated in children with a history of afebrile (i.e., not associated with fever) seizures, as well as in children who have had severe adverse reactions to a previous administration of the vaccine. . In this case, it is recommended to use a vaccine without a pertussis component (D.T. Vax or ADS) or to carry out special prevention of adverse reactions.

Higher Efficiency

After a completed course of vaccination (4 shots), the level of protection (percentage of those with immunity) against polio, diphtheria, tetanus and whooping cough reaches virtually 100%.

The vaccine is especially effective in preventing whooping cough - immunity develops in 92-96% of children, which is 10-26% higher than other vaccines used in Russia and other CIS countries, including the so-called. acellular.

Time-tested reliability

Over 15 years of use in more than 50 countries around the world introduced more than 45 million doses of the vaccine. Tetrakok has a wide experience of use in Russia - the best commercial vaccination centers in Russia and other CIS countries choose it as having the best combination of safety, convenience, efficiency and economy.

Convenience

The vaccine is produced in disposable syringes, the needle of which is treated with a special compound that makes the vaccination procedure painless. Your child receives protection from 4 infections at the same time.

Tetracoccus vaccine can be combined with other vaccinations: In one syringe: with Akt-HIB vaccine(for the prevention of hemophilic infection - meningitis, pneumonia, sepsis). Thus, one vaccination protects the child from 5 infections at once. Such combined vaccination is carried out in France, the USA, Germany and other developed countries.

It is possible to combine the Tetracox vaccine with all other vaccines of the vaccination schedule, but in this case, vaccinations are given with separate syringes, in different places.

The allowable interval between Tetrakok vaccination and other vaccinations, if they are not carried out on the same day, in accordance with Russian recommendations, is 1 month.

VACCINE Bubo-Kok

It is a combination of recombinant yeast surface antigen of hepatitis B virus (HBsAg) and a mixture of pertussis microbes killed by formalin and diphtheria and tetanus toxoids (DPT) ballast proteins purified from ballast proteins adsorbed on aluminum hydroxide gel.

The drug contains in one vaccination dose (0.5 ml) 5 mg HBsAg, 10 optical units(OE) pertussis microbes, 15 flocculating units (Lf) diphtheria and 5 binding units (EC) tetanus toxoids. Preservative - merthiolate at a concentration of 0.01%.

The drug is a homogeneous suspension of a yellowish color, which separates on standing into a colorless transparent liquid and a loose yellowish-white precipitate, easily broken up by shaking.

IMMUNOBIOLOGICAL PROPERTIES

The introduction of the drug in accordance with the approved scheme causes the formation of specific immunity against whooping cough, diphtheria, tetanus and hepatitis B. Studies have shown that the Bubo-Kok vaccine is characterized by safety and high immunological activity.

PURPOSE

Prevention of whooping cough, diphtheria, tetanus and hepatitis B in children.

METHOD OF APPLICATION AND DOSAGE

Vaccinations with the Bubo-Kok vaccine are carried out from the age of 3 months to the age of 4 years. The drug is administered intramuscularly into the upper outer quadrant of the buttock or into the anterolateral thigh at a dose of 0.5 ml (single dose) three times according to the DTP vaccination schedule.

The vaccination course consists of 3 vaccinations (3 months, 4 months, 5 months).

Bubo-Kok revaccination is carried out once at 12-18 months. An exception should be made for children born to HBsAg-positive mothers. Such children should be vaccinated in the first days of life with a recombinant hepatitis B monovaccine.

REACTIONS TO INTRODUCTION

Some of those vaccinated in the first two days may develop short-term general (fever, malaise) and local (soreness, hyperemia, swelling) reactions. In rare cases, complications may develop due to the content of the DTP component in the preparation: convulsions (usually associated with fever), episodes of a piercing cry, allergic manifestations(Quincke's edema, urticaria, polymorphic rash), exacerbations of diseases.

CONTRAINDICATIONS

Contraindications to the use of the Bubo-Kok vaccine are the same as for the DTP vaccine.

RELEASE FORM

In ampoules of 0.5 ml (grafting dose). The package contains 10 ampoules.

STORAGE AND TRANSPORTATION

The drug is stored in a dry dark place at a temperature of 62C. A vaccine that has undergone freezing should not be used.

Transportation is carried out by all types of covered transport under the same temperature conditions.

EXPIRY DATE - 1 year 6 months.

Varieties of toxoids

For vaccination only against diphtheria, AD or AD-M toxoid is used, and separately against tetanus - AC toxoid.

For immunization against diphtheria and tetanus in children under 6 years of age, if they have had whooping cough and they no longer need to be vaccinated against this disease, or they have permanent contraindications to the use of the pertussis component of the vaccine (afebrile convulsions, a progressive disease of the nervous system), about which will be discussed later, use ADS toxoid. During primary immunization, this vaccine is administered twice with an interval of 1.5 months. 12 months after the second injection, a single revaccination is necessary. Starting from the age of 7, only ADS-M toxoid is administered to children and adults. This drug is used for planned revaccinations in accordance with the vaccination schedule (at 7, 14 and then every 10 years). If for some reason a child under 6 years of age was not vaccinated against diphtheria and tetanus, then after this age he is vaccinated with ADS-M toxoid twice with an interval of 1.5 months and revaccination after 6-9 months, and then revaccinated according to the vaccination schedule. DTP-M toxoid is also used to continue immunization against diphtheria and tetanus in children under 6 years of age who have had complications from DTP vaccination.

DTP in questions and answers.

DPT - it is this vaccination that raises the most questions, it is about its consequences that they often argue and are interested.

DPT is an adsorbed pertussis-diphtheria-tetanus vaccine. In Russia, vaccination against whooping cough, tetanus and diphtheria begins (more precisely, it is recommended to start) at three months. In parallel, it is recommended to vaccinate against hepatitis and polio.

Why is this vaccination given so early? Can't it be postponed? I answer. If there are no contraindications, you need to be vaccinated, these infections are considered especially dangerous, before vaccination they were fatal. Whooping cough is especially dangerous for babies. If the baby falls ill with it before the age of one, the risk of developing suffocation, severe brain damage and disability for life is very high.

Although diphtheria and tetanus are no less dangerous. And in order to create full-fledged immunity by the time the baby begins to walk and the risk of contact with pathogens increases, you need to start that early. The fact is that full course vaccination consists of several repeated injections of the vaccine - this is done at 3, then at 4.5 and at 6 months. A year later, a supporting (revaccinating) injection is made. That is, vaccination will be completely completed by the time when the little one will already actively begin to explore the world and contact the external environment and a large number of children and adults.

Subsequently, Russia does not vaccinate against whooping cough, and vaccination against diphtheria and tetanus is carried out further - usually this is done at 7 and 14 years. And then adults get the vaccine every 10 years. Now remember yourself - and when you yourself last time did you get vaccinated? Isn't it time for you to introduce another vaccine? Tetanus can be contracted by digging in the country or in the garden, at a picnic, in nature .... There are not so few carriers of diphtheria around us. And it is transmitted like a banal cold, there is only a limited time to administer antidiphtheria serum during infection - about a day. And the lethality from diphtheria is still high.

The DTP vaccine is used not only in our country. It is included in the vaccination calendars of almost all countries in Europe, Asia and the Americas. It’s just that the vaccine preparations themselves are used differently, the principle itself is preserved - everywhere vaccination starts at 2-3 months, and is carried out at intervals of 1-2 months. Now in Russia there are several vaccines officially registered and approved for use.

All routine vaccinations in Russia they are free, they are made with drugs that the state buys and distributes to hospitals, clinics, vaccination centers. Therefore, it is not known which vaccine will be purchased. Most often it is a domestic vaccine.

If the timing of vaccination is violated.

If the baby begins to be vaccinated after three months, then you need to know some rules.
If for some reason the baby was not vaccinated at 3 months, then DPT is also administered three times, the minimum interval between injections should be 1.5 months, revaccination is carried out 12 months after the last vaccination. If at the time of revaccination the baby is not yet 4 years old, he is given DTP, and if he is already four years old, then the vaccination is completed without the pertussis component of the ATP or ATP-m vaccines. However, if the baby was vaccinated with the Infanrix vaccine - the age limit of 4 years does not apply to it, then the baby is also revaccinated with the same vaccine.

If the vaccination schedule is violated - that is, the period between vaccinations is more than 1.5 months, then all previous injections are counted in the vaccination for the baby, and the vaccination and revaccination are completed in time (1.5 months between vaccines, revaccination a year later), and then everything is carried out according to the vaccination calendar .

All DTP vaccines or toxoids are freely combined with other vaccinations. You can not do them only with BCG.

The composition of the vaccine. Rules for the administration of the vaccine.

The vaccine is an ampoule with a cloudy liquid. It should be shaken before administration to obtain a homogeneous medium. Mom can control the actions of a medical worker. If there are flakes, sediment or various uncharacteristic inclusions in the ampoule, this may indicate a violation of the storage of the vaccine and directly indicates its unsuitability. This vaccine should not be used.

The vaccine contains killed (inactivated) cells of pertussis (4 IU), tetanus (40 IU or 60 IU) and diphtheria (30 IU) pathogens. Such a dosage of tetanus and diphtheria toxoids is due to the need to achieve the desired intensity of the reaction of the child's immune system, which is still imperfect and is only being formed. There is also an analogue of the Tetrakok vaccine - but both vaccines are whole-cell. That is, the pertussis component in them is unsplitted cells of the pertussis bacillus. There are other analogues (for example, Infanrix), where the pertussis component is represented by fragments of whooping cough sticks. It causes immunity in terms of tension the same, but it usually gives fewer reactions.

The composition of the vaccines also contains an adsorbent, aluminum hydroxide, which increases the immunogenicity of the introduced vaccine, that is, it contributes to the formation of a depot of the vaccine (that is, the bumps that our mothers love to treat so much). In fact, inflammation forms at the injection site due to this substance, and it should be there - thus, in the focus of this inflammation large quantity immune cells can get acquainted with the vaccine. Then the immune system will develop more actively. But if the lump is not groped, this does not mean that the body does not develop immunity - it's just that all children are different. And the degree of inflammation is also not the same. I will return to this in more detail later.
Thiomersal (mercury salt) acts as a vaccine stabilizer, for some reason many people are very afraid of it. But the vaccine contains such a negligible amount that, compared to what we breathe in every day from exhaust gases, this is just nonsense.

Any DPT vaccine, both our domestic and any imported one, is administered only intramuscularly. Moreover, if the vaccine was previously practiced in the buttock (in the ass, in other words), now they refuse this method (you have the right to demand too), because the structural features of the buttocks of the baby are such that there is a layer of adipose tissue (for cushioning during falls to the fifth point). And when the vaccine gets there, a long-absorbing infiltrate (seal) is formed, and the effectiveness of vaccination may decrease.

Therefore, now vaccination is carried out in the anterior outer part of the thigh for babies. And for children older than one and a half years - in the upper third of the shoulder, in the deltoid muscle. If ADS or ADS-m is found, then they are injected into the same places. And if the child is older than 7 years old, it is also permissible to inject under the shoulder blade, but then you need to use special needles for hypodermic injections.

What are normal reactions to a vaccine?

The introduction of any substance for the body is not indifferent. This is especially true of substances that can cause an immune response in the body. DTP is one of the most responsible and difficult vaccinations for a baby's body. But this does not mean that it should be abandoned. You just need to know what can happen when a baby is vaccinated, how to help him and how to minimize the risks. I wrote about preparing for vaccination in my forehead. This information can be viewed in the vaccination section. Let's talk about reactions to the introduction of DTP.

The reaction can be both to our, domestic, vaccine, and to any imported one. Whole-cell vaccines (DPT and Tetracoccus) give a reaction more often. Reactions can be local and general. And they must be clearly distinguished from post-vaccination complications. Unfortunately, they are often confused. And especially fellow “anti-beer drinkers” are inclined to dramatize and attribute quite normal reactions to complications.

Reactions to DTP may occur the first three days after vaccination. Everything that happens after this period has nothing to do with vaccination, and the vaccine is not at all to blame here.
A local reaction is a slight soreness at the injection site, as it is accompanied by a violation of the integrity of the tissues. Perhaps the development of redness and swelling (infiltration), which I mentioned earlier. and this is actually not bad, it allows you to create a focus of local inflammation. A large number of lymphocyte cells, which are responsible for the immune response, will rush there. There they will get acquainted with the components of the vaccine, multiply and create a special clone of cells - memory T-lymphocytes. The development of swelling and redness up to 8 cm is allowed and is considered a normal reaction, and infiltrates occur more often when injected into the buttock, and at the same time they resolve somewhat more slowly. In this case, no actions need to be taken - neither lotions, nor even Vishnevsky's ointments, should be applied in any case. By your actions, you can translate normal inflammation and the usual vaccine reaction into an abscess (in other words, an abscess). Just do not touch the injection site - do not press, do not crumple and do not rub!

The general reaction is how the body as a whole reacted to the administration of the vaccine. Usually it develops a few hours after the injection and is expressed in malaise, refusal to eat, fever. There are three degrees: weak, moderate and severe reactions to vaccination.

Weak is expressed in a rise in temperature to 37-37.5? C and insignificant general malaise. The average is an increase in temperature of 37.5-38.5? C and a moderate violation of the general condition and expressed with a temperature of up to 39.5? C and enough severe violation general condition, lethargy, weakness, refusal to eat.

With an increase in temperature to 40 ° C in the first two days, it is an indication to refuse further vaccination with the DPT vaccine, and the baby is vaccinated in the future only with ADS or ADS-m. it is no longer considered a reaction to the vaccine. And it is regarded as a post-vaccination complication.
There is no relationship between the severity of the reaction and what kind of injection it is, it is usually believed that the reaction is more pronounced for the first injections of the vaccine, because the baby first encounters several foreign antigens and its immune system works more actively. But this applies to absolutely healthy babies.

Any vaccine can cause a reaction, but more often general reactions give whole-cell vaccines - our domestic DPT and Tetrakok. Different series of vaccines also differ. But cell-free vaccines and toxoids give reactions very rarely.

And if the baby is allergic or has some kind of disease?

Babies who are prone to allergies have some features of the course of the vaccination process that should not be forgotten. Still, the vaccine activates the entire immune system as a whole, including the synthesis of immunoglobulin E (allergic globulin). Therefore, these guys may have increased local reactions - that is, swelling, redness and swelling. When the baby receives the first dose of the vaccine, the body gets acquainted with the antigens, and from the second dose it already begins to secrete immunoglobulin E in increasing quantities for the introduction of the vaccine, and it is he who is responsible for enhancing the reactions. To prevent or reduce this phenomenon, it is necessary to vaccinate only outside the exacerbation of allergies and use antihistamines before and after vaccination.
But, I want to warn parents right away, these drugs do not prevent a temperature reaction. So there's no point in instilling undercover antihistamines all indiscriminately children is unjustified. Do not forget that allergies are provoked by a violation of complementary foods. Errors in the nutrition of a nursing mother, stress. Therefore, there is a rule - 7-10 days before vaccination and three to five days after it, you should not introduce any new food products into the diet, you should not change cosmetics, go out into nature and change your place of residence. Older babies do not need to be treated with sweets, citrus fruits and other allergenic foods as a token of encouragement for patience with vaccination.

If the baby has chronic diseases without exacerbation, vaccination is carried out with the permission of the specialist who is observing the child and passing all the tests necessary to confirm the health or state of remission.

When is help needed? What should parents do?

First you need to remember one thing - the temperature after vaccination is an acceptable and normal reaction of the body, this is a sign of an actively developed immune response and you should not be afraid of this. We have already figured out that it is permissible to increase it to 39? C. But that doesn't mean you have to sit idly by.
We will reduce the temperature if it has risen above 38.5 ° C, and if the baby has a tendency to convulsions or has a history of any neurological disorder, then it is above 37.5 ° C. for starters, you can simply wipe the baby with a damp sponge or towel, give more liquid or decoctions of herbs (chamomile, Linden blossom, Birch buds). If the temperature tends to rise, you can give the child antipyretic drug(paracetamol, cefecon, tylenol) in children's dosage.

Antipyretic drugs should not be abused. They should be given again no earlier than 6-8 hours after the previous dose. By the way, giving antipyretics in the absence of temperature or a slight increase in it - for prevention - is also unjustified.

If within 6-8 hours the temperature does not go astray, or there is an increase above 39-39.5? C, you should immediately call ambulance or a doctor. You should also call a doctor in case of any other alarming symptoms, which will be discussed below.

And if there are other signs besides temperature?

If the child has vomiting in addition to fever, liquid stool, runny nose and cough, or the temperature rises after three or more days - most likely this is an infection that simply coincided with the moment of vaccination, and the child should be shown to the doctor and treated accordingly.

Now let's talk about complications.

Yes, unfortunately none of the modern vaccines is absolutely safe. As well as any medicine in general. However, in fairness it should be noted that complications and negative impacts Vaccinations are nothing compared to the consequences of the infections themselves.
I won’t load you with statistics - I don’t see any point in operating with numbers, “anti-vaccinators” love these games with numbers very much, but, to put it mildly, they are far from the truth. My job is to convey information objectively, but it's up to you to decide.

There are differences between local and common complications. local complications consider the formation of a dense infiltrate (an area of ​​edematous tissue) larger than 80 mm, and pronounced redness and soreness of this place is also possible. Usually these phenomena last for several days (most often 2-3), and resolve on their own. But if you are very worried, you can use a resolving ointment, such as Troxevasin.

General complications usually affect the entire body of the child to one degree or another. These include the following:

1. As with any other drug, the introduction of the vaccine may develop allergic reaction- its manifestations are different - from acute urticaria (manifested by a rash like mosquito bites). Quincke's edema (manifested by severe swelling of the face and neck, to anaphylactic shock ( a sharp decline pressure, loss of consciousness, convulsions). All these manifestations develop acutely during the first 20-30 minutes after the administration of the drug. Therefore, dear parents, please note that according to the rules, you must not leave the territory of the office or clinic (well, last resort do not go far from her, take a walk nearby) within 30 minutes after the injection. This will allow, in case of allergy development, to help you as quickly as possible, since all vaccination rooms equipped with anti-shock and anti-allergic aids.

2. Complications of vaccination include convulsions. They are divided into two groups:
afebrile seizures - they occur due to an organic lesion of the nervous system. Which was not established prior to vaccination. And the vaccination is a provoking factor, so these children are suspended from subsequent vaccinations until a comprehensive examination by a neurologist is carried out. This complication is very rare - but you need to know about it.
- the second type - febrile convulsions - occur against the background of high temperature (above 38-38.5? C), and most often on the first day of vaccination. Not all doctors agree that this is a post-vaccination complication, since a certain part of children are generally inclined to convulsions for high fever, regardless of the cause that causes it.

3. Separately, such a complication as a persistent monotonous cry or a piercing screech is singled out - it manifests itself a few hours after vaccination and is expressed in incessant crying. lasting 3 or more hours. which can also be accompanied by an increase in temperature, the general anxiety of the baby. this does not affect the subsequent health of the baby in any way and usually goes away on its own.

4. Well, directly - the most serious complication - an increase in temperature to 40? C and above.
Usually, complications occur with whole-cell vaccines - DPT or Tetracoc, Infanrix and Pentaxim rarely give complications.

If a complication has developed in the management of DTP, vaccination is continued with toxoids. Without pertussis component. This is because the pertussis component is the most reactogenic. Immunity to whooping cough will be developed, and it is still better than nothing at all, but incomplete and vaccination is considered incomplete.

Are there any conditions in which it is impossible to do DTP?

Of course. Any vaccine has its own contraindications - and they need to be discussed separately and in detail. The fact is that recently the data on vaccination has been very distorted and many parents are unreasonably trying to expand their child's list of contraindications. And they try to force their doctor to follow their lead, asking: “Doctor, can we put it off for now? Write something like this. In order not to do it yet ... ”and in vain. There are clear criteria and instructions that should be followed in carrying out vaccination and determining contraindications to it. And most often they try to postpone vaccinations for precisely those children who need them more than other babies. for example, if a child is asthmatic or has non-progressive problems with the nervous system - gets sick with whooping cough, it is much more severe for them and often leads to death.

So, the real contraindications are:

Temporary contraindications.

1. Any acute infectious disease - from SARS to severe infections and sepsis. Upon recovery, the period of medical withdrawal is decided individually by the doctor, taking into account the duration and severity of the disease - that is, if it was small snot, you can vaccinate after 5-7 days from the moment of recovery. But after pneumonia, you should wait a month.

2. Aggravation chronic infections- then vaccination is carried out after subsiding of all manifestations. Plus a medical bill for a month.
In order to exclude the vaccination of an initially unhealthy baby. On the day of vaccination, the baby should be carefully examined by a doctor, take the temperature. And if there is any doubt, it is necessary to conduct a more in-depth examination - blood and urine is a matter of course, but if necessary, involve narrow specialists for consultation.

3. Do not vaccinate if there are sick people in the family acute infections or under stress (death of relatives, moving, divorces, scandals). Of course, these are not entirely medical contraindications, but stress can have a very negative effect on the results of vaccination.

Permanent contraindications.

1. In no case should you be vaccinated at all if the baby has an allergic reaction to one of the components of the vaccine - the baby may develop anaphylactic shock or Quincke's edema.

2. You can not drive this vaccine and in case. if at the previous dose there was an increase in temperature above 39.5-40? C, convulsions.

3. Whole cell DTP or Tetracoccus vaccines should not be administered to children with progressive diseases of the nervous system. Also, they should not be administered to children who have had episodes of afebrile seizures.

4. severe congenital or acquired immunodeficiency.

I also want to separately note that if a child has had whooping cough, then he is no longer vaccinated with DTP. And they continue the introduction of ADS or ADS-m, with diphtheria, they begin to vaccinate with the last dose, and with tetanus, they vaccinate after the disease on a new one.

And in conclusion, I want to say whether to do or not to do DPT is up to you, but weigh the pros and cons before making a decision.

Hearing the phrase "DTP vaccine" many young mothers fall into real horror, because this vaccine is considered the most dangerous and difficult to bear for the baby. Such opinions are also supported by gossip and rumors from the World Wide Web, due to which many women completely refuse DPT vaccination. So, what is the DTP vaccine really?

Whooping cough, diphtheria, tetanus

DTP (international name DTP) is a vaccine that develops immunity to three diseases at once - whooping cough, diphtheria and tetanus.

Whooping cough is a dangerous disease caused by a bacterium called Bordatella pertussis. Its main symptom is attacks of severe spasmodic cough. Whooping cough is especially dangerous for one-year-old children, as it is fraught with respiratory arrest and complications such as pneumonia. The disease is transmitted from an infected person or carrier of the infection airborne way.

Learn more about whooping cough.

Diphtheria is even more difficult in small patients, the causative agent of which is a special bacterium (diphtheria bacillus), which, among other things, is capable of releasing a toxin that destroys the cells of the heart muscle, nervous system and epithelium. Diphtheria in childhood is very difficult, with high fever, swollen lymph nodes and characteristic films in the nasopharynx. It should be noted that diphtheria poses a direct threat to the life of the child, and younger child the more dangerous the situation becomes. It is transmitted through the air (when coughing, sneezing, etc.), or through household contact with an infected person.

Learn more about the disease diphtheria.

Finally, tetanus is very dangerous disease for both children and adults; in addition, immunity in people who have recovered from tetanus is not formed, so there is a possibility of re-infection. The causative agent of the disease is tetanus bacillus, which can exist for a very long time in environment, and is very resistant to antiseptics and disinfectants. It enters the body through wounds, cuts and other damage to the skin, while producing toxins that are dangerous to the body.

Learn more about tetanus

A way to protect yourself from the above diseases is the DTP vaccination, after which a person develops a stable long-term immunity.

DTP vaccination

What is the DTP vaccine?

The DPT vaccine against whooping cough, diphtheria and tetanus (DPT infection) consists of toxoids (attenuated pathogenic bacteria diseases), sorbed on a special basis, which is aluminum hydroxide, as well as merthiolate (preservative). 1 ml of this vaccine contains approximately:

• 20 billion microbial cells of whooping cough;
• 30 LF (flocculating units) diphtheria toxoid;
• 10 EU ( antitoxin-binding units) of tetanus toxoid.

In addition, there are so-called cell-free DTP vaccines, which contain particles of microorganisms, which are sufficient to develop the necessary immunity.

The mechanism of action of the vaccine

Once in the body, the drug releases weakened microorganisms that stimulate infection and cause an appropriate protective reaction of the body. Thanks to this, antibodies are formed and, as a result, immunity to the disease.

What vaccine is given as part of the vaccination?

Most often for DPT vaccination as part of state program adsorbed tetanus vaccine of domestic production is used, as well as imported vaccines DPT.

Where is it entered?

Any DTP vaccines are administered intramuscularly, but if injections into the buttock were practiced before, now the drug is recommended to be injected into the thigh. DTP vaccination in the buttock has a high risk of suppuration, and there is also a risk that the vaccine will get into the fatty layer and its effectiveness will be reduced to zero. Older children are given an injection in the upper part of the shoulder, and some vaccines (for example, ATP-m and ATP) are injected under the shoulder blade with a special needle.

Vaccination schedules

All DTP vaccines have one feature - through certain time after routine vaccination, immunity is gradually weakened, so a person needs DPT revaccination, that is, a second injection. In the absence of contraindications, the DTP vaccination schedule is as follows:

• I vaccination - 3 months;
• II vaccination - 4-5 months;
• III vaccination - 6 months.

Mandatory condition: the first three doses of the drug should be administered at intervals of at least 30-45 days. With the introduction of subsequent doses, the minimum interval between them should be 4 weeks.

• IV vaccination - 18 months;
• V vaccination - 6-7 years;
• VI vaccination - 14 years.

Further, vaccination is carried out approximately once every ten years. If the dose schedule is violated, DPT vaccines are administered in compliance with the rule described above: that is, three vaccinations are administered after 45 days each, and the next is at least a year later.

DTP vaccines

On the territory of the CIS, there are several registered DPT vaccines, both domestic and imported. Some of them may contain weakened microorganism pathogens other diseases such as poliomyelitis.

• Adsorbed tetanus liquid vaccine(Producer - Russia). Whole-cell DTP vaccine, which consists of dead pertussis pathogens and diphtheria and tetanus toxoids. The drug can only be administered to children who have not yet reached the age of four. Adults and children from 4 years of age, as well as those who have been ill with whooping cough, are vaccinated with ADS or ADS-m preparations that do not contain pertussis microorganisms.
• Vaccine Infarix(Manufacturer - Belgium, England). Refers to cell-free vaccines that give minimal side effects. There are several types of Infarix vaccine: a vaccine whose components are similar to the DPT vaccine, Infarix IPV (DTP + polio infections), Infarix Hexa vaccine (DTP + polio infections, hepatitis B and Haemophilus influenzae). The drug should be used with caution in people who have problems with blood clotting.
• Vaccine Pentaxim(Manufacturer - France). Cell-free vaccine that protects the body against DTP infections, Haemophilus influenzae and poliomyelitis. Thanks to minimum quantity side effects, the Pentaxim vaccine is considered an excellent alternative to domestic whole-cell vaccines.
• Vaccine Tetracoccus(Manufacturer - France). whole cell inactivated vaccine for the prevention of DTP infections and poliomyelitis. It is considered one of the safest whole cell vaccines, which is highly purified and forms immunity in 95% of vaccinated patients.
• Vaccine Bubo-Kok . Combined drug, consisting of the antigen of the causative agent of hepatitis B, obtained by a recombinant method (using genetic engineering), as well as killed microbes of whooping cough, tetanus and diphtheria toxoids. The vaccine is not recommended for children born to mothers who are carriers of the hepatitis B virus.

In our country, DPT and polio are usually given together, except when the child is vaccinated according to an individual schedule. Read more about setting DTP + poliomyelitis read

Vaccine safety

Like all medicines and vaccines, DPT can cause side effects. It should be noted that cell-free vaccines containing microbial particles are considered safer and more easily tolerated than whole cell preparations containing whole microorganisms. That is why the main task of parents is to choose the type of vaccine that will be as safe as possible for the baby.

immune response

The immune response of the body to the DPT vaccine is strong enough that it is considered the most serious vaccination on the calendar. As a result of vaccination, approximately 92-96% of vaccinated patients develop antibodies to the relevant infectious diseases. In particular, one month after three vaccinations, the level of antibodies to diphtheria and tetanus toxins in 99% of vaccinated children is more than 0.1 IU / ml.

How long does post-vaccination immunity last?

Post-vaccination immunity to infectious diseases largely depends on the type and characteristics of the DTP vaccine. Usually, immunity after vaccinations carried out according to the schedule lasts up to about 5 years, after which the child needs DPT revaccination. Subsequently, it is sufficient to carry out immunization approximately once every 10 years. Generally speaking, almost every child after being vaccinated with DPT is considered to be well protected from pertussis, tetanus and diphtheria viruses.

Preparation for vaccination

Since the DTP vaccine is a serious burden on the body, it is very important to properly prepare the baby for immunization before administering DPT to a child in order to reduce the risk of complications in a child after DTP vaccination.

• Before routine immunization visit children's specialists, in particular, a neuropathologist, since most often complications after this vaccination occur in children with disorders of the nervous system.
• Necessary take tests blood and urine to make sure that there are no diseases that can complicate the child's condition after the injection.
• If the baby has had any infection (for example, SARS), then from the moment of absolute recovery to the moment of administration of the drug, at least two weeks should pass.
• Children who are prone to allergic reactions should start maintenance antihistamines about three days before the DTP vaccination.
• Immediately before vaccination, the child should be examined by a pediatrician and adequately assess its condition.

Read more about preparing for vaccination.

Body reactions and side effects

An adverse reaction to DTP vaccination is observed in about a third of patients, and the peak of such reactions occurs at the third dose of the vaccine - it is during this period that intensive immunity formation occurs.

The reaction to the DTP vaccination manifests itself within three days after the introduction of the vaccine. It should be noted that any symptoms that appear after this period are not related to vaccination. Normal reactions to the injection, which resolve within two to three days after taking antipyretics and antihistamines, include the following:

• Temperature rise. The temperature after DPT vaccination can rise to 38 °, so about two to three hours after the injection, doctors recommend giving the child a small dose of antipyretic. If the temperature rises again in the evening, it is necessary to repeat the antipyretic (the interval between taking the drugs should be at least 8 hours).
• Changes in behavior. A child after DTP may be restless, whimpering and even screaming for several hours: this reaction is usually associated with pain syndrome after injection. In other cases, the baby, on the contrary, may look lethargic and slightly inhibited.
• Redness and swelling at the injection site. Normal reaction swelling of less than 5 cm and redness of less than 8 cm are considered. In this case, the child may feel pain at the injection site, and as if protecting the leg from other people's touches.

Strong adverse reactions include a significant increase in temperature (up to 40 ° C) and above, short febrile convulsions, significant local swelling and redness (more than 8 cm), diarrhea, vomiting. In this case, the child should be shown to the doctor as soon as possible.

Finally, in rare cases, complex allergic reactions are noted: rash, urticaria, Quincke's edema, and sometimes anaphylactic shock. Usually they appear in the first 20-30 minutes. after the injection, so during this time it is recommended to be near the medical facility in order to be able to immediately provide the child with the necessary assistance.

Read about actions after vaccination.

Contraindications to DTP

There are general and temporary contraindications to DPT vaccination. To general contraindications, in the case of which a medical exemption for vaccination is given, include:

• Progressive disorders of the nervous system;
• Severe reactions to previous vaccinations;
• History of afebrile seizures (that is, those that were not caused by high fever), as well as febrile seizures associated with previous vaccine administrations;
• Immunodeficiency;
• Hypersensitivity or intolerance to any components of vaccines.

If you have one of the above violations, you should definitely consult with specialists because some of these children may receive a dose of DTP vaccine that does not contain pertussis toxoids, which are the main source of severe side effects.

In some cases, encephalopathy, prematurity, low weight or diathesis are considered contraindications to vaccination. In this case, vaccinations are recommended during periods of stabilization of the child's condition, using cell-free vaccines with a high degree of purification for this.

Temporary contraindications to DTP vaccination are any infectious diseases, fever and exacerbation of chronic diseases. In such a situation, vaccination should be done no less than two weeks after the absolute recovery of the child.

Video - “DPT vaccination. Dr. Komarovsky"

Have you and your child had a positive or negative experience with DTP vaccination? Share in the comments below.

DPT vaccine - prophylactic adsorbed pertussis-diphtheria-tetanus vaccination recommended by the World Health Organization use for prevention serious diseases such as whooping cough, tetanus and diphtheria.

Whooping cough , diphtheria and tetanus - dangerous infectious diseases that can lead to grave consequences for the body. Children are especially difficult to tolerate these diseases, they may have serious consequences and incurable disorders.

What are the DTP vaccines?

Now there are two types of combined vaccinations against diphtheria, tetanus and whooping cough:

• whole cell vaccination (DTP);
• cell-free (acellular) vaccination (AaDPT).

Cell-free DTP vaccination was created in order to reduce the number of serious neurological complications on the pertussis component of the vaccine.

Today, parents have the opportunity to choose a vaccine - domestic drug DTP or Infanrix (UK).

There are also combined vaccines that contain not only DTP, for example:

• Pentaxim - DPT + against polio + hemophilic infection;
• Bubo - M - diphtheria, tetanus, hepatitis B;
• Tetracoccus - DTP + against polio;
• Tritanrix-HB - DTP + against hepatitis B.

DPT and tetracoccus are similar in composition - they consist of killed cells of infectious agents and such vaccines are called whole-cell vaccines.

Infanrix differs from DTP in that it is a cell-free vaccine that contains small particles of pertussis microorganisms and diphtheria and tetanus toxoids. Infanrix causes a less violent reaction of the body than DPT and tetracoc, and causes fewer complications.

Grafting scheme

DTP inoculation occurs according to.

Optimal DTP vaccination schedule (as recommended by the World Health Organization) is:

• primary course of vaccination at the age of 2 to 6 months - 3 doses with a minimum interval of 1 month;
• additional dose (booster) at 15-18 months of age;
• vaccination of older children and adolescents - at 4-6 years old with a vaccine with a special pertussis component or ADS (without whooping cough).

If a vaccination was interrupted , and there was a long period between vaccinations, no need to start over , to vaccinate again - it is important to simply continue vaccination as soon as possible.

Adults and children over 14 years of age are vaccinated against diphtheria and tetanus (DT) every 10 years from the last revaccination.

How many times does a child need to be vaccinated with DPT

The essence of any vaccination is to a level of antibodies has arisen in the child’s blood, which will protect the body from diseases . In order for the required level of antibodies from whooping cough, diphtheria tetanus to occur after DPT, 4 injections are required .

The interval between injections should be at least 30 days . During the first year of life, the child is given 3 injections and then, a year after the first vaccination, another one.

After 4 injections the child receives sufficient protective level of antibodies to illness. Of course, there is a certain level of antibodies after one injection, but it is not enough in order to fully protect the child's body .

: “Contrary to popular belief, all WHO-certified vaccines are interchangeable in any order. Of course, if possible, in order to avoid complications, it is desirable to use vaccines from the same manufacturer. If a child has symptoms of a cold on the 2nd day after DTP, there is a 90% chance that you have become infected colds in the clinic building. AT this case it is necessary to understand that this is not the fault of the vaccine, it is necessary to improve the vaccination system itself.”

Reaction to DTP vaccination

Of all the vaccines that are included in the vaccination calendars, the DTP vaccine has serious percentage of side effects and complications , as well as as a result of its introduction, the child may experience allergic reactions .

Main DTP allergen is a component of whooping cough however, in modern vaccines, in which the pertussis component is modified and purified, the risks are minimized.

There are two types of vaccines: DTP and AaDPT. In the AaDPT vaccine, the pertussis vaccine is split, the main allergenic components are isolated from it, due to which such a purified vaccine is much better tolerated.

However, it should be noted that the AaDPT type vaccine is much more expensive than the regular DPT vaccine.

Possible reactions and complications associated with DTP vaccine with acellular pertussis component:

Lungs:

• boost ;
• redness, swelling, or soreness at the injection site;
• irritability;
• lethargy;
• poor appetite;
• vomit.

Medium :

• convulsions;
• continuous crying;
• heat(above 40.5).

Heavy :

• serious allergic reactions;
• prolonged convulsions, coma, loss of consciousness;
• permanent brain damage.

At rise in temperature , the child, without waiting for the number 38 on the thermometer, must give an antipyretic in candles or in syrup. If the antipyretic does not help - seek help from a doctor .

Our mother- Tanya 1 tells : « We started vaccinating at 1.8 g. We did Infanrix IPV. The first two went fine. But the third - the temperature was 39.3-39.6 for 4 days, almost did not go astray. There were no runny noses, red throat, cough (to the fact that it was not SARS). Before vaccination, as prescribed by the doctor, they took an antihistamine - it did not help. Now we will do the ADS.”

Our mother- elen 27 tells : « Our doctor says that the temperature (up to 3 days) may very well be on the second or third vaccination. This means that the body has begun to produce antibodies against diseases.”

Doctor Komarovsky Evgeny Olegovich tells: "DTP vaccine according to modern recommendation WHO is only done intramuscularly in the thigh and not in the buttock. When injected into the buttock, there is a risk of getting into the sciatic nerve, blood vessels, and remaining in the subcutaneous tissue. It has been reliably proven that the level of antibody formation with an injection in the thigh is higher than with an injection in the buttock.

Rules for preparing for DPT

Before administering the DTP vaccine, show baby , neurologist , take a blood and urine test .

Parents must be absolutely sure that their child was completely healthy before the vaccine was given.

If something bothers the baby, it must be cured, and thinking about vaccination only after two weeks.

Contraindications to DTP vaccination

DTP vaccination is not given to a child in such cases:

• if the child suffers from a moderate or severe form of an acute illness (bronchitis, pneumonia, pyelonephritis, temperature above 38 C), it is necessary to wait until the child's condition improves;
• if the child had a severe allergic reaction to a previous dose of DPT vaccine;
• if within 7 days after the introduction of the previous dose of DTP vaccination, the child developed a disease of the nervous system;
• if the child has serious illness heart, kidney or liver;
• if the child suffers from progressive neurological diseases, vaccination is postponed until the child's neurological condition stabilizes.

Vaccination - possibility protect your baby from many diseases. Of course, before deciding on an injection, parents need to understand all the available vaccines and the conditions for their transportation and storage, as well as be sure of the health of their child.

The opinion of a qualified doctor and your reasonable choice are the main weapon on guard of a child's health!