Children's vaccination schedule. DTP vaccination for children: facts and myths, timing and risks. Child's reaction to DTP - side effects

Vaccinations for children

Currently, the World Health Organization (WHO) recommends the use of the DTP vaccine to prevent serious diseases such as whooping cough, tetanus and diphtheria.

What is the DPT vaccine?

Preventive vaccination DTP (adsorbed pertussis-diphtheria-tetanus) was first used abroad in the late 40s of the last century. Foreign analogue of the DPT vaccine - Infanrix. Both combined vaccines are classified as whole-cell, i.e. containing killed (inactivated) cells of whooping cough (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.

*) IU - international unit

What is the DTP vaccine for?

Whooping cough, diphtheria and tetanus are very dangerous, and in young children they are severe. Whooping cough is insidious with severe complications: pneumonia (inflammation of the lungs) and encephalopathy (brain damage). A convulsive cough can generally lead to respiratory arrest. After the vaccine is administered, the immune system produces antibodies from which memory cells are formed. If in the future the body again encounters the causative agent of the disease (whooping cough), the immune system, as it were, "remembers" that it is already familiar with the virus, and begins to actively include protective reactions.

The peculiarity of tetanus and diphtheria is that the development of the disease, the course and complications are not associated with microbes, but with its toxins. In other words, in order to avoid a severe form of the disease, it is necessary to create immunity in the body against the toxin, and not against the virus as a whole. Thus, the vaccine is designed to form the body's antitoxic immunity.

When and how often to do the DTP vaccine?

There is a vaccination schedule, which in Russia is determined by the national. The DTP vaccine - Infanrix according to the standard scheme consists of 4 vaccinations: the first is given at the age of 2-3 months, the next two at an interval of 1-2 months and the fourth is carried out 12 months after the third vaccination (DTP revaccination).

If the child was vaccinated after 3 months, then the pertussis vaccine is administered 3 times with an interval of 1.5 months, and the fourth time - 1 year from the date of the last vaccine administration. Subsequent revaccinations in Russia are provided only against tetanus and diphtheria. They are carried out at 7, 14 and then every 10 years throughout life.

The use of the domestic DTP vaccine has some peculiarities. According to the current instructions, children up to 4 years of age can be vaccinated with this vaccine only. When the child reaches 4 years of age, the unfinished course of DPT vaccination is completed with the use of the ADS vaccine (up to 6 years) or ADS-M (after 6 years). This restriction does not apply to foreign DPTs (Infanrix).

The reaction of the child's body after vaccination and possible complications

Any vaccination puts a great burden on the body, a complex restructuring of the immune system takes place. No one in the world has yet managed to create drugs that are indifferent to the body, not to mention vaccines.

If we consider the reaction of the child's body to vaccination as a whole, then the presence of mild side effects can be considered a normal phenomenon, indirectly indicating the correct formation of immunity. But even in the case of a complete absence of a reaction, it should not be taken as an alarm signal - this is how the result of efforts to minimize adverse reactions can be expressed.

The DTP vaccine for the child's body is quite heavy. The reaction of DTP can manifest itself in the first three days in the form of pain at the injection site, irritability, and an increase in temperature from low to moderate (rectal 37.8-40 ° C). These are the most common manifestations. A local DTP reaction is redness and swelling at the injection site. Sometimes the swelling reaches 8 cm in diameter (but no more!). This is noticeable immediately after vaccination and can persist for 2-3 days. The general reaction of DPT is expressed by malaise: the child may lose his appetite, drowsiness may appear, and much less often, slight vomiting and diarrhea may open.

There is a weak reaction to vaccination (temperature up to 37.5 ° C and minor violations of the general condition), medium (temperature not higher than 38.5 ° C) and a strong reaction to DPT (temperature above 38.6 ° C and pronounced violations of the general condition) .

The development of common adverse vaccine reactions does not depend on which portion of the vaccine is administered to the child. But with the frequency of administration of the DTP vaccine in some children, an increase in the manifestations of allergic reactions (most often local) is possible. This is due to heredity, the predisposition of the child to allergies.

Of course, there are no absolutely safe vaccines. Rarely, some complications are possible after DTP vaccination. This must be remembered, as, indeed, remember that the consequences of diseases such as whooping cough, diphtheria and tetanus are hundreds of times more dangerous.

Possible complications are local and general. A local complication is expressed by increased compaction and a significant increase in swelling at the injection site with a diameter of more than 8 cm. This can persist for 1-2 days.

Common complications after DTP vaccination are expressed in a piercing cry of a baby, reaching a squeal, which can appear within a few hours after vaccination and last about 3 hours or more. Also, the DPT reaction is accompanied by restless behavior of the child and fever. These symptoms should go away on their own in a few hours.

Sometimes there is a convulsive syndrome. A high temperature after DPT (above 38.0 ° C) can provoke febrile convulsions in the first three days after vaccination. Less common are afebrile convulsions (at normal temperature and subfebrile up to 38.0 ° C), which may indicate a previous organic lesion of the child's nervous system.

Complications can also be expressed by an allergic reaction: Quincke's edema, urticaria and anaphylactic shock are the rarest and most serious complication that manifests itself immediately or 20-30 minutes after the vaccination.

Contraindications

Common contraindications include exacerbation of a chronic disease, fever, allergy to vaccine components, and severe immunodeficiency. DTP vaccination is temporarily or absolutely contraindicated if the baby has had convulsions that are not associated with fever, or there is a progressive pathology of the nervous system. Then children are vaccinated with a vaccine that does not contain a pertussis component.

Questions for the article

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Through the umbilical cord, the child receives maternal antibodies, which are capable only during the first 60 days from the date of birth of the baby. Therefore, a DPT vaccination is necessary, which will protect the baby from serious infectious diseases.

If the child is sick and it is not possible to vaccinate at 3 months, do it when you can. The main thing to remember is that the first vaccination must be completed before 4 years of age. After four years, children not vaccinated with DTP are only vaccinated against tetanus and diphtheria. The vaccination schedule must be followed. That is, between vaccinations should not be less than four weeks. It is possible to postpone vaccination due to poor health, but it cannot be done ahead of time.

So, the first DTP vaccination was delivered to a healthy child at the age of three months.

The second vaccination is given after 45 days. Ideally, the drug should be the same as the first vaccination. But if there is no exactly the same, then you can put another vaccine - according to the requirements of the World Health Organization, absolutely all types of DTP must be interchangeable.

What you need to know about the second vaccination?

The response to the first vaccination is usually much weaker than to the second. During the first vaccination, the body simply encounters microbes, after forty-five days it will react much stronger to the second vaccination, and you need to be prepared for this. If after the first vaccination for some reason the second vaccination was not given on time, then it should be done as soon as possible. You can't do it at all.

If there was a strong reaction to the first vaccination, then the second should be given with another vaccine, the reactogenicity of which is much less. As a last resort, administer vaccines only against diphtheria and tetanus, without whooping cough.
The third vaccine is also given forty-five days after the second and the reaction of the body is observed. Try to do all vaccinations with one vaccine if there is no severe reaction.

Rules for the introduction of the vaccine

The peculiarity of the DTP vaccine is that it must be administered intramuscularly. In young children, the muscles in the legs are best developed, so doctors recommend that they be vaccinated in the thigh. In the muscles, the drug is released at the required rate for the formation of immunity. If you vaccinate just under the skin, the vaccine will not work. There is a large fat layer on the buttocks, which can also prevent penetration into the muscle.

What to do before DTP vaccination

• the doctor must examine the child and confirm that he is absolutely healthy
• it is advisable not to feed the child tightly before vaccination
• if there is a tendency to allergic reactions - give an antihistamine

After vaccination, do not run home immediately, stay outside near the clinic. If you develop a severe allergic reaction, you will quickly receive medical attention. At home, give your child an antipyretic before the temperature rises. Do not forget to constantly monitor the temperature, hyperthermia causes inconvenience to the baby and interferes with the development of immunity. Before going to bed, it is advisable to put candles with paracetamol so that the baby sleeps peacefully. Temperature rises should stop on the third day after vaccination. Antihistamines, if necessary, are also applied for three days. Discuss the dose of medications with your doctor in advance. Try to give your child as much water as possible, but not with juices, but with plain warm water and weak tea. Feeding tightly is also undesirable. New unfamiliar dishes cannot be introduced during this period. The mode of walking can not be changed. If the child feels well, walk in the fresh air as much as possible, just limit the amount of contact.

Side effects of DTP

Post-vaccination reaction occurs in 30% of children. A side effect is most often given by the third DTP vaccination. It is important to understand the difference between complications and side effects.

Side effects:

• temperature
• mood changes, tearfulness
• drowsiness
• diarrhea
• vomit
• lack of appetite
• redness and swelling at the injection site
• lameness
• cough

All of them appear on the first day after vaccination and eventually pass without a trace. Redness at the injection site may be an allergic or mild inflammatory reaction, while induration occurs when the vaccine is not administered correctly. A vaccine that does not get into the muscle, but into the adipose tissue is absorbed for a very long time, since there are few vessels in the subcutaneous fat layer. Ask your doctor which ointment you can use to speed up the resorption of the seal. Cough may occur in a child with a chronic respiratory disease.

This is the body's reaction to the pertussis component of the vaccine. The cough will go away in a few days. However, if a runny nose, fever, cough or diarrhea appeared 2 days after the introduction of the vaccine, then the reason for this is not the vaccination, but the infection that the baby caught on the street or in the clinic. Side effects can be severe - fever above 39 degrees, swelling more than 7 cm, prolonged crying for three or more hours. In this situation, it is necessary to bring down the temperature, take antihistamines and painkillers, call a doctor.

Complications of DTP

A complication is a severe reaction of the body to a vaccine, leading to a violation of health. According to statistics, such complications occur in 3 out of 100,000 vaccinated children. Complications include a severe allergic reaction leading to laryngeal edema, urticaria, anaphylactic shock and convulsions at normal temperature. Complications and side effects can be avoided if you approach vaccination correctly. And the right thing is to put aside unnecessary rumors, doubts and follow the advice of doctors.

Children and adults need vaccinations as an effective means of combating dangerous infectious diseases. One of the very first vaccinations given to a child is DPT, which represents vaccine against whooping cough, diphtheria and tetanus. All three infectious diseases are serious and potentially dangerous for humans, because, even with the use of the most modern and highly effective antibacterial drugs, the percentage of deaths is very high. In addition, severe forms of infections can lead to developmental disorders and disability of a person from childhood.

Deciphering the DTP vaccination and the types of vaccines used

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

• ADS (according to the international nomenclature DT) is a vaccine against tetanus and diphtheria. Today, domestic ADS and imported D.T.Vax are used in our country;
• ADT-m (dT) is a tetanus and diphtheria vaccine given to children over 6 years of age and adults. In Russia, domestic ADS-m and imported Imovax D.T.Adyult are used;
• AC (international nomenclature T) - tetanus vaccine;
• AD–m (d) – diphtheria vaccine.

Should I get vaccinated with DTP?

Of course, the question "should I get vaccinated with DTP?" can be set in different ways. Someone thinks that vaccinations are not needed in principle, someone believes that this particular vaccine is very dangerous and causes serious consequences in the form of neurological pathologies in a child, and someone wants to know if it is possible to put baby vaccination.

If a person has decided not to vaccinate at all, then naturally he does not need DTP. If you think that the DTP vaccine is harmful, and contains a lot of components that put too much stress on the child's body, then this is not so. The human body is able to safely transfer several components of the vaccine against various infections at once. What matters here is not their quantity, but compatibility. Therefore, the DTP vaccine, developed in the 40s of the XX century, became a kind of revolutionary achievement when it was possible to place the vaccine against three infections in one vial. And from this point of view, such a combined drug means a decrease in the number of trips to the clinic, and only one injection instead of three.

It is certainly necessary to be vaccinated with DTP, but you need to carefully examine the child and obtain admission to vaccination - then the risk of complications is minimal. According to a report from the World Health Organization, the most common causes of DTP vaccination complications are ignoring medical contraindications, improper administration, and spoiled drug. All these reasons are quite capable of being eliminated, and you can safely make an important vaccination.

Parents who doubt the advisability of immunization can be reminded of the statistics of Russia before the start of vaccination (until the 1950s). Approximately 20% of children suffered from diphtheria, of which half died. Tetanus is an even more dangerous infection, the infant mortality from which is almost 85% of cases. In the world today, approximately 250,000 people die from tetanus every year in countries where they are not vaccinated. And absolutely all children had whooping cough before the start of mass immunization. However, you should know that the DPT vaccine is the most difficult to tolerate of all those included in the national calendar. Therefore, vaccination, of course, is not a gift from God, but it is necessary.

DPT vaccination - preparation, procedure, side effects, complications - Video

DPT vaccination for adults

How many DTP vaccinations are there, and when are they given?

Then children are revaccinated at 6 - 7 years old, and at 14. Thus, each child receives 6 DTP vaccinations. After the last immunization at the age of 14, it is necessary to revaccinate every 10 years, that is, at 24, 34, 44, 54, 64, etc.

Vaccination Schedule

Interval between vaccinations

If the time has come for another DPT vaccination, and the child is sick, or there are any other reasons why vaccination cannot be done, then it is postponed. You can postpone vaccination for a fairly long period of time, if necessary. But the vaccine should be given as soon as it can be done (for example, the child will recover, etc.).

If one or two doses of DTP were delivered, and the next vaccination had to be postponed, then when returning to vaccination, it is not necessary to start it again - you just need to continue the interrupted chain. In other words, if there is one DTP vaccination, then two more doses must be delivered at an interval of 30 to 45 days, and one a year from the last. If there are two DPT vaccinations, then simply put the last, third, and a year later from it - the fourth. Then vaccinations are given according to the schedule, that is, at 6-7 years old, and at 14.

First DPT at 3 months

To minimize the risk of reactions, the child must be healthy at the time of the vaccine. A great danger is the presence of thymomegaly (enlargement of the thymus gland), in which DTP can cause severe reactions and complications.

The first DTP shot can be given with any vaccine. You can use domestic, or imported - Tetrakok and Infanrix. DTP and Tetracoccus cause post-vaccination reactions (not complications!) in about 1/3 of children, while Infanrix, on the contrary, is very easily tolerated. Therefore, if possible, it is better to put Infanrix.

Second DPT

The reaction to the second DPT can be much stronger than the first. This should not be afraid, but be mentally prepared. Such a reaction of the child's body is not a sign of pathology. The fact is that the body, already as a result of the first vaccination, met with the components of microbes, for which it developed a certain amount of antibodies, and the second "date" with the same microorganisms causes a stronger response. In most children, the strongest reaction is observed precisely on the second DPT.

If the child missed the second DPT for any reason, then it should be delivered as soon as possible, as soon as possible. In this case, it will be considered the second, and not the first, because, even with a delay and violation of the vaccination schedule, there is no need to cross out everything done and start over.

If the child had a strong reaction to the first DPT vaccination, then it is better to make the second one with another vaccine with less reactogenicity - Infanrix, or just administer DTP. The main component of the DTP vaccination that causes reactions is pertussis microbe cells, and diphtheria and tetanus toxins are easily tolerated. That is why, in the presence of a strong reaction to DTP, it is recommended to administer only ADS containing antitetanus and antidiphtheria components.

Third DPT

Some children react most strongly to the third rather than the second DTP vaccine. A strong reaction is not a pathology, as is the case with the second vaccination. If the previous two injections of DTP were delivered with one vaccine, and for the third one for some reason it is impossible to get it, but there is another drug, then it is better to get vaccinated rather than postpone.

Where are they vaccinated?

Do not administer the DTP vaccine in the buttock, as there is a high risk of getting into a blood vessel or sciatic nerve. In addition, there is a rather large layer of subcutaneous fat on the buttocks, and the needle may not reach the muscles, then the drug will be injected incorrectly, and the drug will not have the desired effect. In other words, DTP vaccination in the buttock should not be done. In addition, international studies have shown that the best production of antibodies by the body develops precisely when the vaccine is injected into the thigh. Based on all these data, the World Health Organization recommends administering the DTP vaccine in the thigh.

Contraindications

In this case, the child cannot be vaccinated in principle.

If there are neurological symptoms or seizures due to fever, children can be vaccinated with a vaccine that does not contain a pertussis component, that is, ATP. Until recovery, children with leukemia, as well as pregnant and lactating women, are not vaccinated. A temporary medical exemption from vaccination is given to children against the background of an exacerbation of diathesis, who are vaccinated after achieving remission of the disease and normalizing the condition.

False contraindications for DPT vaccination are as follows:

• perinatal encephalopathy;
• prematurity;
• allergies in relatives;
• convulsions in relatives;
• severe reactions to the introduction of DTP in relatives.

The introduction of the DTP vaccine is contraindicated only in people who have had an allergic or neurological reaction in the past to this drug.

Before DTP vaccination - preparation methods

• the child must be completely healthy at the time of vaccination;
• the child must be hungry;
• the child must poop;
• the child should not be dressed too hot.

A bump after DPT can form when the vaccine does not get into the muscle, but into the subcutaneous fatty tissue. There are much fewer vessels in the fatty layer, the rate of absorption of the vaccine is also sharply reduced, and as a result, a long-lasting lump is formed. You can try Troxevasin or Aescusan ointments to increase blood circulation and speed up the absorption of the drug, which will lead to the resorption of the bump. Can a bump also form if the vaccine was administered without observing the rules of asepsis? and dirt got into the injection site. In this case, the bump is an inflammatory process, pus forms inside it, which must be released and the wound treated.

Redness after DPT. This is also normal, since a mild inflammatory reaction develops at the injection site, which is always characterized by the formation of redness. If the child is no longer bothered, do nothing. As the drug dissolves, the inflammation will go away by itself, and the redness will also go away.
Pain after DPT. Soreness at the injection site is also due to an inflammatory reaction, which can be more or less pronounced, depending on the individual characteristics of the child. Do not force the baby to endure pain, give him analgin, apply ice to the injection site. If the pain does not go away for a long time, see a doctor.

Cough after DPT. Some children in response to the DPT vaccine may develop a cough during the day if they have chronic respiratory diseases. This is due to the body's reaction to the pertussis component. However, this condition does not require special treatment, and goes away on its own within a few days. If a cough develops a day or several days after vaccination, then there is a typical situation when a healthy child "caught" an infection in the clinic.

Complications

• severe allergies (anaphylactic shock, urticaria, angioedema, etc.);
• convulsions against the background of normal temperature;
• encephalopathy (neurological symptoms);

At present, the relationship between the development of encephalopathies and DPT vaccination is not considered scientifically proven, since no specific properties of vaccines that can cause such phenomena have been identified. Experiments on animals also did not reveal a connection between DPT vaccination and the formation of neurological disorders. Scientists and vaccinologists believe that DPT is a kind of provocation, during which an increase in temperature simply leads to a clear manifestation of hitherto hidden disorders.

The development of short-term encephalopathy in children after DTP vaccination causes a pertussis component, which has a strong irritating effect on the meninges. However, the presence of convulsions against the background of normal temperature, twitching, nodding, or impaired consciousness is a contraindication to further administration of the DTP vaccine.

DTP is a preventive vaccination, which stands for adsorbed pertussis-diphtheria-tetanus. This drug is combined, and is used to combat, respectively, diphtheria, whooping cough and tetanus. It is made from the toxoids of these bacteria and from other antigens. The peculiarity of tetanus and diphtheria is that the development of the disease, the course and complications are not associated with microbes, but with its toxins. In other words, in order to avoid a severe form of the disease, it is necessary to create immunity in the body against the toxin, and not against the virus as a whole. Thus, the vaccine is designed to form the body's antitoxic immunity.

The DTP vaccine passes in the international nomenclature as DTP.
Foreign analogue of the DPT vaccine - Infanrix. Both combination vaccines are whole cell, ie. contain killed (inactivated) cells of whooping cough (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.

Diphtheria, tetanus and whooping cough

- Diphtheria. This is an acute infectious disease caused by Corinebacterium diphtheriae (bacteria Corinebacterium), transmitted by airborne droplets; characterized by croupous or diphtheritic inflammation of the mucous membranes of the pharynx, nose, larynx, trachea, less often other organs with the formation of fibrinous films and general intoxication. When only the skin is involved, it is known as cutaneous diphtheria, and is likely caused by a non-toxic strain. If the toxic strain affects mucous structures in the body, such as the throat, diphtheria becomes life-threatening.

- Tetanus. Tetanus is a disease that causes severe muscle contractions and spasms. This is caused by a powerful toxin produced by the bacterium Clostridium. They are anaerobic bacteria, which means they can survive without oxygen. People can become infected with these dangerous bacteria through skin wounds. Tetanus is fatal in 15-40% of cases.

- Whooping cough. Whooping cough was a very common childhood illness throughout the first half of the 1900s. The disease is very easily transmitted from one person to another, and it is most severe in infants. The incidence has increased recently, to 25827 cases reported in 2004, but decreased to 10454 in 2007. The benefit of the vaccine wears off by adolescence. Thus, more cases are seen in adults. Such cases can be significantly underestimated. The younger the patient, the higher the risk of developing severe complications, including pneumonia, seizures, severe coughing, and even death. Babies under 6 months of age are at particular risk because even with vaccination, their protection is incomplete due to immature immune systems.

Vaccinations against diphtheria, tetanus and whooping cough

primary vaccination. Vaccination against diphtheria, tetanus and whooping cough has been regularly administered to children since the 1940s. Standard vaccines now - DTP. DTP uses the "pertussis component" form, which consists of a single, attenuated pertussis toxoid. DTP is just as effective but has fewer side effects than previous vaccines (RTDs).

Protection against diphtheria and tetanus lasts about 10 years. During this period, the vaccine (Td) can be given against tetanus and diphtheria. The Td vaccine contains a standard dose against tetanus and a less powerful dose against diphtheria. It does not contain whooping cough components.

The childhood whooping cough vaccine may begin to lose its effect after about 5 years, and some previously immunized adolescents and adults may get a mild form of the disease. Two whooping cough boosters are now approved for teens and adults.

Types of DPT vaccine

Basically, within the framework of vaccination in the territory of the Russian Federation, adsorbed liquid tetanus is used - DTP produced by FSUE NPO Microgen of the Ministry of Health of the Russian Federation, Russia.

As mentioned earlier, the foreign analogue of the domestic DTP vaccine is Infanrix (Infanrix ™), manufactured by GlaxoSmithKline Biologicals S.A., Belgium. It is presented in the following forms

Infanrix IPV (analogue of AaDTP + inactivated polio vaccine). Whooping cough, diphtheria, tetanus, poliomyelitis.
- Infanrix Penta (analogue of AaDPT + hepatitis B + inactivated polio vaccine). Whooping cough, diphtheria, tetanus, hepatitis B, polio.
- Infanrix Hexa (analogue of AaDTP + hepatitis B + inactivated polio vaccine + Hiberix), instructions. Whooping cough, diphtheria, tetanus, hepatitis B, poliomyelitis, Haemophilus influenzae type b infection.

The following DTP analogues are drugs manufactured by Sanofi Pasteur S.A., France:

D.T.KOK (analogue of DTP). Whooping cough, diphtheria, tetanus.
- Tetraxim (analogous to AaDTP). Whooping cough, diphtheria, tetanus.
- Pentaxim (analogue of AaDTP + inactivated polio vaccine + Act-HIB), instructions. Whooping cough, diphtheria, tetanus, poliomyelitis, Haemophilus influenzae type b infection.
- Hexavak (analogue of AaDPT + hepatitis B + inactivated polio vaccine + Act-HIB). Whooping cough, diphtheria, tetanus, hepatitis B, poliomyelitis, Haemophilus influenzae type b infection.

Monovalent (one-component) pertussis vaccines have been developed abroad and in Russia, but so far they have not been included in the daily practice of vaccination due to the presence of a combined vaccine and a number of conditions limiting their use.

The Bubo-Kok vaccine is presented on the Russian pharmaceutical market - a vaccine against whooping cough, diphtheria, tetanus, and hepatitis B. Its manufacturer is CJSC Research and Production Company Combiotech.

DPT schedule for children

There is a vaccination schedule, which in Russia is determined by the national calendar of preventive vaccinations

All children under the age of 7 should receive the DTP vaccine. Vaccinations are given as follows:

Infants receive a series of three shots at 2, 4 and 6 months of age. The only reason to postpone vaccination in children with suspected neurological problems for the time being is to clarify the situation. Children with corrected neurological problems can be vaccinated (this vaccine must be provided?? no later than the child's first birthday - that is, when he is not more than 1 year old);
- the fourth dose is administered 15 to 18 months, 12 months after the third vaccination (DPT booster). High-risk infants - those exposed to whooping cough outbreaks - may be given this vaccine earlier;
- If the child was vaccinated after 3 months, then the pertussis vaccine is administered 3 times with an interval of 1.5 months, and the fourth time - 1 year from the date of the last vaccine administration.
- Subsequent revaccinations in Russia are provided only against tetanus and diphtheria. They are carried out at 7, 14 and then every 10 years throughout life.

The use of the domestic DTP vaccine has some peculiarities. According to the current instructions, children up to 4 years of age can be vaccinated with this vaccine only. When the child reaches 4 years of age, the unfinished course of DPT vaccination is completed with the use of the ADS vaccine (up to 6 years) or ADS-M (after 6 years). This restriction does not apply to foreign DPTs (Infanrix).

If the child has moderate or severe health problems, or has recently had a fever associated with the illness, vaccination should be delayed until recovery. Colds and other mild respiratory infections should not be a reason for delay. Parents should not be overly concerned if the interval between doses is longer than recommended. Immunity from any previous vaccination is maintained, and the doctor does not have to start a new series from scratch.

All adults who have been fully vaccinated either as children or as adults should have Td boosters at least every 10 years. If they have not received a DPT vaccination after age 19, they will need to receive it before the next one, but not after. Adults who have regular contact with infants under 12 months of age should receive a one-time Td booster.

Adults who have not previously been vaccinated against diphtheria, tetanus and whooping cough at any age:

Must receive a three dose series of tetanus, diphtheria, and pertussis (DPT) vaccines;
- a woman, if pregnant, should receive the DTP vaccine after 20 weeks of pregnancy;
Any patient requiring medical attention for any wound may be a candidate for a tetanus vaccine. Wounds that place patients at high risk for tetanus are puncture wounds or contaminated wounds. Some considerations regarding tetanus toxoid vaccination for casualties:
- vaccination is required if the last dose was given 5 years or more before the injury;
- children under 7 are usually given DTP if they are not fully vaccinated;
- Patients who have not completed their primary tetanus vaccination and people who have experienced an allergic reaction to previous tetanus boosters may be given immunoglobulin.

Preparing for DTP vaccination

DTP vaccines can provoke numerous adverse drug reactions. This is due to both the high content of antigens and the reactogenic properties of the components included in the vaccine. For this reason, drug preparation of the child is recommended before vaccination with the DTP vaccine.

Without exception, all DTP vaccines should be administered while taking antipyretics. This allows, on the one hand, to prevent a possible uncontrolled increase in temperature, on the other hand, to eliminate the risk of temperature cramps in young children that occur against a background of high temperature, regardless of what caused it. In addition, all antipyretic drugs have anti-inflammatory and analgesic properties, which is especially important in preventing pain at the injection site, which can be quite severe. In addition, this will help protect the child from severe swelling at the injection site.

If the child has allergic disorders, such as atopic dermatitis or diathesis, the use of antiallergic drugs is also recommended.

Neither antipyretics nor antihistamines affect the development of immunity, i.e. effectiveness of vaccination.

When choosing an antipyretic for your child, pay attention to the following aspects:

When buying drugs, pay attention to the fact that this form of release is suitable for your child's age;
- Make a choice in favor of rectal suppositories, since flavorings in syrups can provoke additional allergic reactions;
- Enter antipyretics in advance, without waiting for the rise in temperature after vaccination. The temperature may rise too quickly to be controlled later;
- Never give your child aspirin (acetylsalicylic acid)!
- If the maximum allowable dosage of the antipyretic is exceeded, and the effect is not achieved, then switch to a drug with another active ingredient (for example, from paracetamol to ibuprofen);
- If the child had no reactions to the previous vaccination, this does not mean at all that there will be no reaction to the next vaccination either. Adverse reactions are more common after repeated vaccinations, so do not neglect vaccination preparation;
- In any doubtful cases, consult your doctor. Feel free to call an ambulance;
- If the vaccination was done at a paid vaccination center, do not hesitate to take the contact information of the doctor in case of development of adverse reactions.

An approximate scheme for preparing a child for vaccination with DTP vaccines:

1-2 days before vaccination. If the child has diathesis or other allergic disorders, start taking maintenance antihistamines;

After vaccination. Immediately after returning home, give the child a suppository with antipyretic. This will prevent some reactions that develop in the first hours after vaccination (prolonged crying, swelling at the injection site, etc.). If the temperature rises during the day, enter another candle. A night candle is a must. If the baby wakes up at night for feedings, check the temperature and if it rises, insert another suppository. Continue taking your antihistamine.

Day 1 after vaccination. If the temperature is elevated in the morning, enter the first candle. If the temperature rises during the day, enter another candle. You may need to enter another candle at night. Continue taking your antihistamine.

Day 2 after vaccination. Antipyretic use only if the child has a temperature. If its increase is insignificant, you can refuse antipyretics. Continue taking your antihistamine.

Day 3 after vaccination. The appearance on the 3rd day (and later) of an increase in body temperature and reactions at the vaccination site is not typical for inactivated vaccines. If the temperature still rises, you should look for another reason (cutting teeth, acute respiratory infections, etc.).

Before using any drugs, the exact dosages, regimens, list and names of specific drugs can and should be recommended only by the attending pediatrician who directly examined your child. It is important. Do not self-medicate!

Side effects of DPT - diphtheria, tetanus and whooping cough vaccines

Allergic reactions. In rare cases, a person may be allergic to diphtheria, tetanus, and whooping cough. Parents should tell their doctor if their children have allergies. Newer DTP vaccines may carry a slightly higher risk of an allergic reaction than older DTP vaccines. Children with serious reactions should not receive additional vaccinations. A rash that occurs after a dose of DTP is not particularly significant. In fact, this usually does not indicate an allergic reaction, but only a temporary immune reaction, and usually does not recur later. It should be noted that in response to the DTP vaccine, there was not a single case of death from allergic reactions, even severe (anaphylactic).

Pain and swelling at the injection site. Children may feel pain at the injection site. In some cases, a small lump or bump may remain in place for several weeks. A clean, cool washcloth over any swollen, hot, or red area may help. Children should not be covered or tightly wrapped in clothing or blankets. The risk of swelling of the sore or of the entire arm or leg increases with subsequent injection - in particular at the fourth and fifth doses. Whenever possible, parents should require that their children receive the same brand of vaccine every time to reduce the risk of side effects.
- Fever and other symptoms. After the injection, the child may develop: mild fever, irritability, drowsiness, loss of appetite.

Conditions to be concerned about:

Very high temperature (over 39 ° C), which causes seizures in children. Such cases should be reported to the doctor immediately. The newer DTP vaccines significantly reduce the risk of this side effect compared to older vaccines. Although such a fever and the convulsions associated with it are rare and have almost no long-term consequences. Relapses after subsequent vaccination are very unlikely;
- fever that develops 24 hours after vaccination, or fever that persists for more than 24 hours, most likely due to other causes than vaccinations;
- hypotension and lack of response (HHE). HHE is an unusual response to the pertussis component and occurs within 48 hours of injection in children under 2 years of age. The child usually develops a fever, becomes irritable, and then - pale, weak, lethargic, taciturn. Breathing will be shallow and the baby's skin may appear bluish. The reaction lasts an average of 6 hours and, although it looks frightening, almost all children soon return to normal. This is a rare side effect after the DTP vaccine, but it can happen;
- neurological effects in the whooping cough component. Of concern are several reports of permanent neurological damage that has occurred after children have been vaccinated. Symptoms: attention deficit disorder, learning disorders, autism, brain damage (encephalopathy) and sometimes even death.

It is well known that the components of diphtheria and tetanus do not cause adverse neurological effects, which is why some people suspect a pertussis component. However, many large studies have not found a causal relationship between neurological problems and pertussis vaccination. Research on the new DPT suggests that it is not entirely safe today.

Studies show that in cases where neurological problems were closely related to vaccination, high fever was observed when not immunized.
Children with neurological impairment may also be at risk of symptom flares 2 or 3 days after vaccination. This temporary aggravation of their illness rarely poses any particular danger to the child. Children who have new neurological reactions after vaccination may have a pre-existing but unknown condition, such as epilepsy, that responds to the vaccine. To date, there is no evidence that the pertussis vaccine causes these neurological reactions, which are rare anyway.

Important note. Unwarranted fears of side effects from vaccinations can be dangerous. In England, such concerns have led to a significant decline in immunization rates since 1970. As a result, there were outbreaks of whooping cough, and in many children there was an increase in the number of brain injuries and deaths. Young children are especially at risk if they become infected from older unvaccinated children (who usually have a milder course of the disease).

Contraindications to DTP

Temporary contraindications for DPT vaccination are:

infectious disease. Any acute infectious disease - from SARS to severe infections and sepsis. Upon recovery, the term of the 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.

Exacerbation of chronic diseases. In this case, vaccination is carried out after the subsidence 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.

Stress. You should not vaccinate if there are acute infections in the family 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.

Absolute contraindications to DTP are:

Allergy to a vaccine. 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.

Strong reaction to a previous vaccination. DTP should not be administered if the previous dose had an increase in temperature above 39.5-40C, or the child had convulsions.

Diseases of the nervous system. Whole-cell DPT or Tetracoccus vaccines should not be given to children with advanced neurological disease. Also, they should not be administered to children who have had episodes of afebrile seizures.

Immune disorders. Severe congenital or acquired immunodeficiency is a complete contraindication to DTP vaccination.

Whooping cough, diphtheria, tetanus. If the child has had whooping cough, then DTP vaccination is no longer given to him, but the administration of ADS or ADS-m is continued, with diphtheria, they begin to vaccinate with the last dose, and with tetanus they are vaccinated after the disease on a new one.

Vaccinations are important for both older and younger as an effective way to prevent diseases. DPT vaccination for children is protection immediately from a list of diseases - diphtheria, tetanus and whooping cough. These four important letters stand for adsorbed pertussis-diphtheria-tetanus vaccine. It was invented in the middle of the last century - then it turned out to combine three different monovaccines in one bottle. This invention is used everywhere, and where it was abandoned, an outbreak of morbidity immediately occurred and the death rate of children from these diseases increased. 1. Types of vaccines

3. How many times is the vaccine given?
4. First vaccination
5. Second vaccination
6. Third vaccination
7. Where is the vaccine placed?
8. Preparing your child for DTP
9. A child after DTP vaccination - what to look for
10. Child's reaction to DTP - side effects

Types of vaccines

• Pentaxim - DTP + against polio + hemophilic infection
• Bubo M - diphtheria + tetanus + hepatitis B
• Tetrakok - DTP + against poliomyelitis
• Tritanrix - DTP + against hepatitis B.

Don't worry that too many ingredients will put a lot of stress on your child's body. What matters is not how many parts, but how they are compatible with each other. The invention of the DTP preparation was at one time a revolutionary breakthrough in the field of vaccination of children and now firmly stands on the positions of stability, innovation and reliability.
IMPORTANT!!! Such an injection is necessary, but only after a thorough examination of the child by a pediatrician and preliminary observation of his condition for several days - then the child will avoid the unpleasant consequences of the injection. After all, it is precisely the inattentive attitude to the health of the baby, the incorrect administration and the useless drug, according to a study by the World Health Organization, that are leaders in terms of complications for DTP vaccination.
Before the advent of vaccination against diphtheria, a fifth of the children died, from tetanus the mortality rate was terribly high - 85%. Yes, DTP has its own characteristics. She is not a gift from heaven, but she is definitely needed.

How many times is the vaccine given?

• First time in 3 months
• Then at 4.5
• Then when the baby is six months old
• The last of the 4 servings will be administered to the child at the age of one and a half years.

By receiving these doses, the baby develops immunity and all other injections only help to maintain it. Once again, children are vaccinated at 6-7 years old and at 14. Then - evenly, every 10 years.

First vaccination

Further, if this is not done, the child will be vaccinated only against ADS. The first injection can be made with any drug - foreign or domestic. Keep in mind that DPT and Tetrakok can provoke a post-vaccination reaction (not to be confused with a complication !!). Foreign Infanrix is ​​accepted by the child's body easier. When there is a financial resource, it is better to inject this particular vaccine.

Second vaccination

Feel that for some reason you are missing the second vaccination - give an injection as soon as the baby's health allows, then it will be counted as the second. As mentioned above, they react to DTP and if the first time the response was strong, then for the second injection you can use either less reactogenic vaccines such as Infanrix, or give an injection of ATP, excluding the pertussis component (pertussis microbe cells), which causes such violent body manifestations.

Third vaccination

Where is the vaccine placed?

Absolute refusal to DTP

• disease in the acute phase (including diathesis)
• allergy to components
• immunodeficiency

Distorted contraindications

• baby was born prematurely
• baby has perinatal encephalopathy
• the child's family has allergies
• the child's family has seizures
• relatives of the baby once reacted unpredictably to the introduction of DTP

Preparing a child for DPT

• your son or daughter must be healthy at the time of vaccination
• do not feed the baby for some time before the procedure (approximately 3 hours)
• it is highly desirable for the baby to go big before vaccination
• don't dress too warmly

The use of antipyretic and antiallergic drugs is allowed. Paracetamol and ibuprofen have some analgesic effect - pain in the injection area can be smoothed out in this way. If there is no effect from paracetamol, use the other active ingredient ibuprofen.

The readiness rules are

• In a couple of days, they begin to give anti-allergic - Fenistil drops, as an option - Erius
• After coming home, give the baby an antipyretic painkiller (Nurofen), let the child calm down and sleep. Continue to drink anti-allergic drops, carefully monitor the temperature on this day. In case of increase, it is allowed to shoot down. The first day - control of general well-being and temperature, we continue anti-allergic.
• The second day - control of general health and temperature, we continue anti-allergic.
• Third day. Body temperature has stabilized, allergy medication can not be drunk.

A child after DTP vaccination - what to look for

No need to wait - give your baby a drug like Nurofen right away. Scientists are not inclined to say here that high temperature helps the development of immunity in a child, rather it is the inconvenience and discomfort of the baby.

Watch your child's appetite and do not feed him if he does not express a clear desire to do so. Most often, he just wants to drink - now the liquid is very useful to him now, the more the better. It can be water, tea, a weak decoction of chamomile, but not juice from bags.

Provide a humid air environment in the child's room (cover the battery with a wet sheet and change it as it dries - as an option) and the temperature is not higher than 22 degrees.

You need to walk more, but not in a large children's team "near the sandbox", but simply take the baby for a ride outside crowded areas and admire nature.

Child's reaction to DTP - side effects

The vaccine causes the following side effects

• at the puncture site there is redness, painful swelling.
• The baby's gait changes (is disturbed) due to this anomaly.

• the temperature rises
• the child is anxious and naughty
• baby sleeps after DTP
• upset appetite
• possible vomiting and diarrhea

If, however, despite all the preparatory measures and careful monitoring, a severe reaction occurs, namely

• incessant crying for hours
• body temperature above 39 degrees
• edema and a spot more than 8 cm in diameter formed at the puncture site

Bump in a child after DTP

Redness after DTP at the injection site

Cough in a child after DPT

Summarizing and analyzing information about the vaccination in advance, it's up to you, the parents. Whether to do DTP to a child is only your choice. Our request is to approach decision-making without emotions, from the standpoint of reason. You can save your child from very serious diseases if you make a positive choice. Preparation, control and observation - these are the three pillars of DTP success. And in cooperation with a pediatrician and a neurologist, success is guaranteed.

Health and happiness to your children!

Video by Doctor Komarovsky