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Controversy and raises many myths and fears. Opponents of vaccination are trying to find a new “confirmation” of their conjectures, and followers talking about the dangers of vaccine refusal. Who is right? Is it true that we are soon to be vaccinated against every sneeze? What diseases need to be vaccinated first and why? Are there any contraindications to vaccination? Understand in detail in this issue.
Anna Levadne, neonatologist, pediatrician, candidate of medical Sciences:
– Let’s start with the pressing question: we will soon be vaccinated against every sneeze or not? Actually, no. We do not need to protect themselves from commonplace viruses. We are only vaccinated from those diseases that do not occur very difficult, have epidemiological significance, spread rapidly, have high rates of mortality (mortality) and have not been developed to date for the appropriate successful treatment.
The sooner we will graft branches of the child. And is really important to protect small children, because of the nature of the immunity they suffer all infectious diseases. On this basis, developed by the national immunization calendar. When we talk about in the first five or six years of life, we must understand the greatest incidence of complications and highest mortality in children. the population is the most important thing to protect.
Many people ask: “do we need to be vaccinated in the national calendar?” The fact is that it is only the vaccines that our government is obliged to make to children free of charge, within a medical institution, to which is bound a child. There are a number of vaccines that are not included in the national calendar. However, this is not the case, they are not important, but only because it is expensive for the state, and the Ministry of Health does not allocate the required amount in order to provide the population with these vaccines. A simple example: vaccination against meningococcus is an expensive vaccine that will not be included in the national calendar. Does this mean that the vaccine is not important? Of course not! Protection against meningitis is extremely important. It has a high epidemiological significance. Special role it plays in children of early age. It is very important to protect children from meningococcus, because the meningitis of children is fast, hard and has huge numbers on the mortality rate.
Clinic, of course, buys the Russian vaccine, as the most cheap and affordable. Parents can privately, in a private medical facility to buy an imported vaccine and introduce it to the child. This is most often a multi-component (multi-component) vaccine and this is the most obvious difference from the Russian DTP, which has to do three injections (pertussis, diphtheria, tetanus). The second shot is polio. And the third shot is a hemophilic Bacillus. They are included in the Western multicomponent vaccine. Of course, the standard is universal in the introduction of multicomponent vaccines. This is the number of injections, and pains, and the number of doctor visits. It has been proved that it does not increase the complication rate, and even lowers it in the syringe. And it even has the best immunological parameters.
In addition, the Russian vaccine (e.g., DTP) whole cell. It contains all-cell pertussis, which is released in the cell, which gives better pertussis immunity, but increases the reactogenicity of the vaccine. That is, the amount of any reactions to the vaccine is higher in the whole-cell than acellular vaccine. From the acellular vaccine, however, there is a minus: dies more vaccine-induced immunity. So there is always the choice for the parent: he can financially afford it or not? If, for any other reasons, choose a Russian or Western vaccine? The decision rests with the parent.
In addition, the national calendar is not included today, several other important vaccines. For example, the rotavirus vaccine – although there is an active discussion in order to include them in the national calendar. This is important because almost 98% of children under five years suffer rotavirus gastroenteritis. Certainly, vaccination helps to reduce these indicators and mortality rates, and rates of hospitalization, and risks of dehydration in rotavirus infection. A feature of this vaccine is up to 32 weeks (8 months). Under the law we can not hold the child. This is a drop in the mouth. They are threefold, starting with six weeks of life. In addition, there are several vaccines (e.g., Haemophilus influenzae, Bacillus), which the national calendar is spelled out for “risk groups”. Does this mean that they do not need? No, sorry, this is a very important infection, and of course we should protect against Haemophilus influenzae our kids. This infection is responsible for a large number of diseases caused by pathogen (Haemophilus influenzae).
In addition, there are vaccines that are applicable at epiparasites. For example, vaccination against tick-borne encephalitis. There are certain regions. The CPS is the endemic for tick-borne encephalitis. They make sense to protect the child from a similar disease. There are also important vaccine included in the national calendar is the vaccine against pneumococcus. It allows to reduce the risks from pneumococcal meningitis, otitis, sinusitis and pneumonia. A very frequent incidence! The problem with the pneumococcus is complicated by the fact that a lot of forms of resistant to antibiotics in recent years is developing.
One of the most controversial vaccines that cause the most questions is the vaccine against chickenpox. People think that it is scary and mild illness, although, unfortunately, two or three out of a thousand occur in very severe form. Namely, in the form of veranorogum encephalitis. Many forms of chickenpox occur as heavy, with multiple purulent lesions, the addition of a secondary bacterial infection. Often scars are formed after suffering chicken pox, when the children can not help stesyvajut sores. This has a traumatic value – the scars remain for life. In addition, after suffering varicella increases the risk of developing herpes zoster. This is a very unpleasant condition in adulthood. These risks can be reduced by civilized development of postvaccinal immunity. Currently increased the number (multiplicity) of vaccination to two. Two-time vaccination against chickenpox is now considered the most effective way to reduce these risks.
Of course, the parents are concerned about the complications, side effects. It should be understood that very, very many false myths and statements can be found on the Internet and in the minds of many citizens. Unfortunately, not everyone should evaluate the data obtained. Of course, this is bullying. But the problem lies in us – doctors that are not willing to speak openly about the side effects, to openly discuss each effect. Many professionals shrug, saying, “This can not be! Go!” and people have the impression that they do not want to hear. However, this is what we need to say out loud.
Side effects of vaccination there are. Just as there are side effects from any drugs. If we open the user manual to jaroponijatuyu medicine, there just will be given a list of side effects. But for the sake of the obvious benefit of the antipyretic drug, because there is a problem here and now.
When we talk about vaccination, we are talking about the risks. He can not see them. This is a potential risk. Thus, the parent makes an informed decision. Making a choice in the favor of unconscious, uncontrollable risks. Here it turns out that the parent injects the vaccine, and this is the controlled risk (controlled damage), which it causes to a child. It inhibits parents. It scares them.
But we must understand that there are real, and there are fictional fantasies “antipresidential”. These positions will be split. Side effects from any vaccination. Manual is in the public domain. In any search engine you type the name of the vaccine and find the manual. You read and there is, including side effects. There is a local reaction, there is a common reaction, and there are severe reactions that develop very, very rarely. Well, for example, anaphylactic shock. If he can arise from the vaccine? Can! The frequency is extremely low-one in several million doses. It does not mean that it does not happen.
The problem we have, doctors, arises from the fears of parents that are associated with non-existent risks. The fact that vaccination occurs many times in the first year of a child’s life. Parents are very pleased to find guilty, and to associate a non-existent factors. The vaccine can be a genetically a child. For example, there is a certain syndrome that predisposes to the development of seizures. And often in the background of vaccination seizures happen, not because they are arose due to vaccination, but because of the child there is a certain genetic defect.
Perhaps we have a lot of interesting discoveries related to genetics, which we will explain. But today is not everything is explainable. That’s what caused many lawsuits that are won. But we always have to understand that vaccination is not always the result of vaccination.
There is a good example in the book by the American pediatrician Paul Offit’s “Deadly choice. Than the struggle with the vaccine threatens us all” (Paul Offit, “Deadly Choices: How the Anti-Vaccine Movement Threatens Us, “was published by Corpus in 2017.) The parent comes to the police for the long time at the same time, at the same time, at the same time. child develops the sudden infant death syndrome. “He writes:” Of course, if vaccination was done, I definitely would have been linked with the incident with vaccination “.
We must understand that for any event a physician should be treated carefully. Everything has to be analyzed. You must be ready for this. And only by having this relationship with parents, we will be able to calm down and find the truth. There should not be stories, such as “the hairdresser of my neighbor, her nephew developed this and this”. Such things should not be! Let us specifically each case to sort through.
In the calendar of inoculations also has a vaccination for the flu. It is permitted, from the age of six months. This is a very controversial vaccine, it raises many questions and disputes among parents. We need to know one very important thing: Yes, the virus mutates, it is well known, but the vaccine is updated every year and adapts to a new mutated strain of the virus!
The who (world health organization) for the last 28 years do several times wrong, and the virus had time to mutate. This year, including the vaccine was not very effective due to the fact that the virus had been taken (after taking samples), yet change – to make the vaccine! Samples taken, then make the vaccine. During this period, the virus could still mutate. Specifically in this season was the low effectiveness in some countries, for example in the United States. In Russia, the vaccine showed good results. This is due to the strains of flu.
There is also a vaccination against human papillomavirus (HPV). It appeared relatively recently. In those countries where it is already long, this problem does not exist. All of the adult population, almost 90%, is a carrier of the human papilloma virus. It was called “the second vaccine against cancer.” The first vaccine is against hepatitis B … the first vaccination against cancer. And the human papillomavirus protects against cervical cancer.
There are also additional vaccination, which can be done by a parent when going somewhere to relax. Including, by the way, is still the recommended vaccination against hepatitis A, rabies, “yellow fever”. A lot of them. Need to see the region where he was going. As for the adult population, we should not forget that every 10 years should be vaccinated against diphtheria and tetanus. Those adults who were not vaccinated, for example against hepatitis B, influenza, pneumococcus, measles or rubella at the time, also from the human papillomavirus, can be revaccinate if I find enough time, money and arguments.
By the way, is another argument in favor of the recommended vaccinations at an early age. Children tolerate the procedure worse. First, it is more stress at an older age. They begin to fear they are harder to keep. They are pulled out. Due to the peculiarities of immunity of children, responding to vaccination is stronger. The number of side-reactions also increases with age.
Another issue of concern to many parents: whether to take a blood test before vaccination? Or urine test? And when I try to load some specialists or immunologists? To go to the immunologist? First I want to say: nowhere in the world, one did not give up, do not go to the experts. In some countries, vaccination makes the nurse without even examining a pediatrician.
In Russia, however, due to the peculiarities of national anxiety, they are much calmer if they come with a blood test. We need to understand that every unnecessary blood test is stressful for the child. After all, it is shot and hurt. Secondly, it is an extra trip to a medical facility. Thirdly, if it is a waste of money. Fourth, this will delay the time of vaccination. You pass, you wait, you look at the results. If these results are any abnormal, we postpone vaccination, retake the tests and wait again. Why is it not necessary? No change of blood will be a contraindication to vaccination. What can we see? For example, changing the platelets. This is not a contraindication! Anemia is not a contraindication to vaccination. Elevated levels of eosinophils will not be a contraindication to vaccination. Some other changes, such as increase in lymphocytes as markers. Low neutrophils? It used to be a contraindication. Neutropenia (agranulocytosis) were previously considered a contraindication. Now the opposite: children with low level of neutrophils to protect in the first place, because they are at risk of complications and secondary bacterial infections. These children we need to instill. And when the level of neutrophils is over 300 we should protect them. Less than 300 live vaccines is not desirable to do.
It’s enough to take a blood test. If we see changes that are typical for systemic inflammation, and the child we have will be healthy before the vaccination, we carry out the examination of the child, interview of parents. Feel someone at home, say? We see that the baby is healthy and today can get vaccinated. And then we say, we see blood that does not match the results of the inspection. The doctor will be forced to postpone the vaccination and send the parents to re-sit analysis. Most likely it will be due to a mistake, as a rule, the blood reacts later than the disease. And if the child is clinically unwell, seen the doctor naked eye. In the analysis of urine for us as there should be no contraindications to vaccination.
It is necessary to understand that in Russia very much about medical exemptions from vaccinations. The most striking example is anemia. It was not invented by me. In General, all what I say, I’m not making this up. Everything happens for a reason. In General, the physician should not be his opinion. The physician should be guided by international protocols, national orders, standards of treatment. There is an approved list of contraindications to vaccination. Yes, it is divided into false and true. It is also divided into temporary and permanent contraindications. Very few of them.
Among the true contraindications to vaccination, such as very pronounced reaction to the previous vaccine (temperature over 39 ° lasts a long time, not break, swelling around the site of injection more than 10 centimeters, anaphylactic reaction), and infectious and not infectious diseases. This means that as soon as an infectious disease becomes acute, the child can be vaccinated. No need to wait two to three weeks to restore immunity. Also, no need to go to the immunologist and be evaluated for some “hidden” infections.
You have to understand that common diseases such as atopic dermatitis, are not a contraindication to vaccination. That is no reason not to protect our children. All this is not reason to subject them to such a risk! And prematurity is not a contraindication. Many children who come to me have a medical exemption up to six months, although in all civilized countries. That is, is a group of people at high risk of infectious diseases.
Please refer to the sane sources of information you use. Analyze them. Please contact the official sources for research on certain efficacy and safety of certain methods.
Responsibility for the health of our children is not only doctors, but also the parents! Please, take care of kids!