Children's diseases are usually called measles, diphtheria, chickenpox and most diseases for which vaccinations are given. In fact, they are not children's at all - nothing changes with age.

It's just that all these diseases are easy to catch. Before mass vaccination, people became infected as soon as they encountered pathogens. This happened at an early age, and then those who became ill either died or acquired active immunity who protected them. So it seemed that only children were sick.

Now there is no need to risk your life for the sake of immunity - there is. But if you haven’t had them done or have had them done for too long, you are at risk.

Currently, no one will warn a person about the timing of immunization: you need to find out for yourself right time and age of revaccination.

Olga Vladimirovna Shirai, epidemiologist, head of the epidemiological department of St. Petersburg State Budgetary Institution "Elizabeth Hospital"

Many adults do not get revaccinated, but still do not get sick thanks to their immunity. Some people have it after an illness, some after a vaccination (even if everyone has forgotten about it), others are protected by collective immunity - epidemics simply have nowhere to roam if the majority are vaccinated. Revaccination is needed to avoid getting sick and not to provoke epidemics.

How can I find out what vaccinations I have had?

In theory, all vaccinations are recorded on a card or vaccination certificate, and cards with data travel with the person from clinic to clinic.

In practice there is none of this. Even if you have been attached to the same clinic all your life, your registration has not changed, all this data can easily be lost. For everyone else, this is a “I remember - I don’t remember” quest. Most likely you don't remember.

If this is so, then there is a guideline for those born in Russia - the national vaccination calendar. If there is a vaccine in it, you may have received it. Then you most likely need a revaccination, because not all vaccinations last a lifetime. If there is no vaccination national calendar, then you need to do it anyway.

What tests will show that there were vaccinations?

If a person has ever been vaccinated, he has antibodies to this disease. These are proteins that attack bacteria or viruses that have entered the body. They are designated as IgG. - immunoglobulins type G.

Conduct a blood test for the presence of antibodies to viral hepatitis B, diphtheria, tetanus, polio (in relation to three types virus), measles, rubella, mumps, whooping cough. To do this, a RPGA reaction is carried out with the appropriate diagnosticum (diphtheria, tetanus, measles, mumps) or ELISA (whooping cough, hepatitis, rubella).

Olga Shirai

For immunity to work, a certain titer is needed - the amount of these same immunoglobulins. If the titer is low, you need to get vaccinated. The indicators for all vaccinations are different; this is discussed with the doctor separately.

But even if you get vaccinated against a disease to which you already have immunity, nothing special will happen - the agents introduced with the vaccine will be destroyed.

What vaccines can you get vaccinated with?

When it comes to vaccines, the rule of thumb is “the newer the better,” because researchers are constantly working on improvements. New vaccines are well tolerated and often protect against several diseases at once.

Even if you were vaccinated with old vaccines as a child, you can safely revaccinate with new ones - there will be no conflict.

We have listed the vaccines that are approved for use in Russia Vaccines of the national vaccination calendar.. To learn more about them, you need to read the instructions and study the contraindications. Some vaccines are not available in clinics, while others are simply difficult to find.

How to get vaccinated against hepatitis B?

Women who have not had chickenpox and are planning a pregnancy should also be vaccinated against this disease, since infection during pregnancy (especially during pregnancy) early stages) can lead to the development of defects in the fetus and even miscarriage.

Olga Shirai

The chickenpox vaccination can also be done to prevent the disease if there has been contact with a sick person. WHO considers this measure effective if vaccination is carried out no later than 72 hours after contact of a healthy person with a sick person.

Vaccine: Varilrix.

How to get vaccinated against polio?

Polio viruses have terrible complications: one out of 200 people who recover from the disease suffers complications in the form of paralysis. You need to get vaccinated if you have no immunity and you are going to a country where the disease is common.

The vaccination is done in three stages. It is better to use an inactivated vaccine - the one that comes in injections, it is much safer than drops in the mouth.

Vaccines: Pentaxim, Imovax Polio, Poliorix, Tetraxim, Infanrix Hexa.

How to get vaccinated against hemophilus influenzae infection?

Haemophilus influenzae infection causes severe forms of meningitis, pneumonia, and sometimes leads to sepsis. The infection does not respond well to antibiotics.

Among children, only those who are at risk due to health conditions are vaccinated. This also applies to adults: the elderly, people in contact with sick people, and people with chronic diseases are vaccinated.

Vaccines: Act-HIB, Hiberix Pentaxim, Infanrix Hexa.

How to get vaccinated against papillomavirus?

Some types of papillomavirus (HPV) pose a risk to women's health causing cervical cancer, genital warts and some other diseases.

Vaccination is recommended for girls and women aged 9 to 26 years, preferably before the onset of sexual activity (because with its onset the risk of becoming infected from a partner increases sharply). The vaccination can also be done at a later age, up to 45 years.

Olga Shirai

Men can also get this vaccination so as not to be teased by the virus that causes cancer (not only of the cervix, but also of other organs) and not to suffer from condylomas. The vaccination is done in three stages according to the instructions.

Vaccines: Gardasil, Cervarix.

How to get vaccinated against pneumococcus?

Adults are vaccinated upon request. Pneumococcal infection, as a rule, joins other diseases and is a complication. It causes meningitis otitis media, sinusitis, .

• adults over 65 years old;
• people who frequently come into contact with possible carriers of infection;
• employees of preschools, schools, boarding homes;
• to those who have chronic diseases respiratory organs, liver, diabetes;
• people suffering from immunodeficiencies;
• patients who have an increased risk of meningitis (after traumatic brain injury, neurosurgical interventions on the spine).

Vaccines: Pneumo-23, Prevenar 13.

How to get vaccinated against meningococcus?

Meningococcus causes meningitis, but in a special way. This is always a rapid infection, potentially fatal. Every case of illness is an emergency.

In Russia, vaccination is carried out if there is an outbreak of the disease, as well as among those who are subject to conscription. military service, and those who travel to Africa and Asia.

Modern vaccines protect against several subtypes of the disease at once. One vaccination in adulthood is sufficient.

Vaccines: “Menactra”, “Mencevax ACWY”.

What other vaccinations should I get?

In addition to those listed, there are also vaccinations for epidemic indications. They are done if an epidemic has started somewhere or if a person at work often encounters rare diseases. This is a matter for specialists, but there are several vaccinations that are worth getting without waiting for epidemics.

• Tick-borne encephalitis. We have already written about who, how and when to get vaccinated against ticks (start dealing with the issue in February in order to have time to do full course and develop immunity before the ticks wake up).
• Flu. We also already talk in detail about the flu shot. Read everything you want to know. Vaccination - best protection from the flu. It is worth getting vaccinated before mid-October to meet the epidemic head-on.
• Vaccinations for travelers. If you are going to a country where there are frequent outbreaks of infections, you should get vaccinated before traveling. Usually this is hepatitis A (you can get vaccinated against it just for prevention), yellow fever. It all depends on the country you decide to go to.

What to do right now?

To ensure you don't get sick:

1. Go to your local clinic and ask your therapist what vaccines are on your card.
2. Get tested for antibodies to those diseases for which this is required.
3. Find out if the clinic has vaccines and their names.
4. Find a private medical Center, who has a license to conduct vaccinations.
5. Find out which pharmacies sell vaccines.
6. Set up a vaccination schedule with your doctor. Several vaccines can be administered at the same time; it is not necessary to take breaks between different drugs. It all depends on the instructions for each specific vaccine.
7. Get your vaccinations on this schedule.
8. Do not be ill.

Yulia Viktorovna Andronnikova, head of the pediatric department of the Center for Traditional Obstetrics (Moscow), pediatrician of the highest category, shares her knowledge and experience on the issue of vaccination.

Yulia Viktorovna, the topic of vaccination, one might say, has split our society into two camps - supporters of vaccination exclusively according to the national calendar and ardent opponents of vaccination as such. Which camp do you belong to?

I definitely don’t consider myself an anti-vaxxer. Rather, I am opposed to the vaccination system that we have today. Dissatisfaction with this system is not unfounded. Our leading immunologists and vaccinologists, for example, N.V. Medunitsyn, say that vaccination will become safe when it becomes personalized and individual.

I personally really want it to become individual. While not being anti-vaccination, I share some of the positions of anti-vaxxers. First of all, it is not to vaccinate newborns. This is one of the main points. Babies must be treated with extreme care.

The second point is the use of live vaccines. Unfortunately, in my practice, back in the days when I worked as a local doctor (it was 1997), there was a case when one year old child died after vaccination with live polio. It was very difficult to prove any connection with the vaccine at that time, although that morning the child and mother were undergoing a medical examination, went through all the specialists, took tests, that is, there were all the documents confirming that the child was healthy. They made a live polio vaccine - and by the evening the child was gone. According to the conclusion of forensic experts, it was some kind of fleeting flu, although the child did not have any signs of the flu, the tests were in order.

I always treat this issue very carefully - although I vaccinate a lot.

What is the mechanism of action of the vaccine? What types of vaccines are there?

Vaccines are antibacterial, antiviral and antitoxic - depending on what component is contained in the composition. For example, vaccines containing processed toxins are used against diseases in which the main damaging effect is caused by toxins, such as diphtheria and tetanus.

Why are vaccines introduced into the body? In order to get an immune response. To develop specific antibodies to a given bacterium, virus, or toxin. When we say that with the help of vaccination you can defeat a disease forever, we must understand that this happens very rarely - only when the vaccine is used against a bacteria or virus, and when everyone is vaccinated against a specific infection. Theoretically, this is possible, as it was with smallpox.

We will never defeat diphtheria and tetanus, because in this case we vaccinate not against the disease, but against complications - against the toxin. The mechanism here is this: vaccine - body - immune response, and the most important thing in this chain is the body of a particular person. The body must give this immune response, so it must be healthy, mature enough to do so.

As you know, in our country there is a national vaccination calendar, according to which the first vaccinations (against hepatitis B and tuberculosis) must be given to a newborn already in the maternity hospital. What is your position on this issue?

My position is very strict: I do not recommend vaccinating newborns, because, firstly, when a child is just born, we still don’t know anything about him: neither the state of his immunity, nor any possible deviations. And, secondly, as I already said, I am a supporter individual approach to vaccination.

An absolute contraindication for live vaccines is an immunodeficiency state. What if the child has it? In the maternity hospital we don’t know this yet.

At what age can a child be accurately diagnosed with an immunodeficiency condition?

After the first month of a child’s life, it is already clear whether there are any purulent manifestations or not. Partially this process can veil the process of breastfeeding. But by about 3 months we can already guess about it.

There are situations when a child is born, and in the morning he is good condition, and in the evening it worsened - this often happens. And now, he is already being treated for pneumonia, for something else, and during this time we manage to get vaccinated. This is a factor that can worsen the course of the underlying disease or partially become a trigger for the disease.

Output IgG immunoglobulins, which have immunological memory, reaches an optimal level at 6-8 months of age. And this is the case for most children. good time to start vaccination. We already know the child, we can bring some aspects of the baby’s health back to normal and we will receive the immune response that we expect during vaccination.

The content of immunoglobulins in the child’s blood serum Vaccination is always a matter of weighing the risk from the vaccine and the risk from the disease. We are now living in a situation epidemiological well-being for major diseases (diphtheria, tetanus, polio) and therefore we can afford to postpone vaccination a little, choose a good vaccine, and monitor our child. If the epidemiological threshold is different - for example, there will be an outbreak of diphtheria - then we will count on other immunoglobulins (IgM, which do not have immunological memory, but are produced earlier and can protect the child early age) and get vaccinated at an earlier date.

Is there a good situation with hepatitis B in our country now?

Not bad.

In this case, at what age is it better to vaccinate against it?

A teenager must be vaccinated against hepatitis B - this is not discussed at all. It’s possible earlier. There are different situations: there is a risk, although very small, that the child will go out onto the street and encounter a syringe thrown by a drug addict. This is also a risk.

There are accidents, operations, blood transfusions. When the body is mature and gives a good immune response, we can get vaccinated. After 8 months, you can safely get vaccinated against hepatitis B, especially since there is now a good recombinant vaccine against this virus and a combined vaccine - Hexa.

Is it worth getting vaccinated against tuberculosis (BCG) in the maternity hospital? Many parents refuse vaccination against hepatitis B, but they do BCG, explaining this, among other things, by the fact that later this vaccination cannot be given anywhere...

There is such a moment. It is due to the fact that BCG should be done by specialists who have been trained and have extensive experience. BCG is the only vaccine that requires a very serious administration technique. It is done intradermally, and the child’s skin is very thin, it is very difficult to get into the desired intradermal layer, you need to hold the needle at a certain angle - that is, this is a technique that you really need to master. A regular intramuscular injection can be given by a person who does it infrequently, and he will not miss, but with BCG there is a certain difficulty. And, unfortunately, the possibility of complications may depend on the injection technique. However, it can be placed quite calmly in a regular clinic. There is no choice of vaccines against tuberculosis.

As for my position, I am not a supporter at all BCG vaccination. I always cite WHO documents as an example recent years(2011,2013, 2015), which are aimed at combating tuberculosis as a disease in general, and combating child mortality from tuberculosis. There are no recommendations for BCG vaccination. On the contrary, the 2011 document clearly states that the BCG vaccine, created in 1921, has shown to be ineffective.

And at the same time, I in no way want to relax my parents about the fact that there is no tuberculosis, and we will never meet with it. But there is a paradox here: tuberculosis affects people (including children) who have an individual predisposition, and they can also get complications from a live vaccine, especially if it is administered at an early age. This is a very difficult period when there is very little personal protection - and if there is a predisposition, the child may get sick. On this issue, I always recommend reading V.P. Sukhanovsky - I agree with every word he says regarding the BCG vaccine.

Do you think that in principle it is not worth getting vaccinated against tuberculosis during your life?

Theoretically (precisely theoretically), the BCG vaccine protects against severe forms tuberculosis, tuberculous encephalitis, tuberculous meningitis, etc., which, according to statistics, affects 1 person in 5 million cases. Therefore, I believe that vaccinating all children en masse with a live vaccine, which interferes with the formation of their immunity, which can lead to complications, is, in general, impractical. Tuberculosis is social disease, its socio-economic growth and improved quality of life will win. Unfortunately, we are not at that level of prosperity now.

On the other hand, early, high-quality and reliable diagnosis of tuberculosis can improve the situation, but in our country it also, in general, suffers. If tuberculosis had been detected early and treated on time, the situation would have been different. Now the main diagnostic method is still the Mantoux test, which has many false-positive reactions, and this entails a trip with the child to the TB dispensary, additional research, sometimes x-ray, and so on. Appearing 8–10 years ago, unfortunately, has a small percentage of false negative reactions, but is still more reliable.

Thus, the BCG vaccine stands apart from other vaccines. If with other vaccines, due to the favorable epidemiological situation, we can wait, because there is no risk of getting sick, then here the situation is different: there is a risk of getting sick, but effective vaccine no, the current vaccine does not protect, and sometimes it itself gives complications in the form of BCG.

What can parents do to prevent tuberculosis, besides vaccination?

Firstly, the minimum number of contacts a child has with potential carriers is important. We usually say this: healthy newborn- V healthy family. When doctors get a job, they do x-rays, take a smear for staphylococcus, not to mention HIV, syphilis and so on. Why not do such an examination for the parents and the child’s immediate circle (grandparents, nanny) who are in constant contact with him? Mom needs such examination to a lesser extent, since she is examined during pregnancy, but the rest... A simple smear from the throat can show us the presence of various unfavorable threats. In an adult, unlike a child, tuberculosis is always in the lungs. Why not give those who go into the house a fluorography?

Next point. Mycobacterium tuberculosis does not like ventilation, fresh air. If these basic conditions are met, then people do not get sick even in close contact. Although newborns are, in principle, more predisposed to this, since their immune system is still weakened. However, if there are no sick people in the immediate environment, then, in general, the child has no chance of getting sick either.

And why live vaccine- this is bad?

A live vaccine retains some of its properties: it can multiply and can remain in the body for a long time. A killed vaccine, even if it does not have an effect, will simply be eliminated from the body. And living ones - especially Mycobacterium tuberculosis - can enter cells and remain in them quite long time. Therefore, for example, complications from the BCG vaccine can occur after a year and a half. That is, bacteria lie dormant in the body for a year and a half, and then cause a serious process.

What could it be?

This may be tuberculous osteomyelitis, generalized BCG infection. But this is not tuberculosis pure form, these are BCGits. There is a slightly different type of bacteria, but, nevertheless, the process is very similar and very difficult to treat. This, again, affects children who have an individual predisposition, they have their own problems with immunity, and if they get sick, the treatment process is long and difficult. Fortunately, such complications are rare.

In general, live vaccines can multiply in the body. The polio vaccine is also live. One of the places where it multiplies is the intestines, accordingly, it is very easily excreted into environment. Released into the environment, it can either immediately infect someone (although this happens very rarely), or it can live in the sewer, change its properties and begin its “feral” path.

IN in this case Are the unvaccinated at risk?

Yes, of course, mostly unvaccinated. If a person is vaccinated, he does not care what kind of polio he encounters - wild or vaccine. He won't get sick from either one or the other. And if an unvaccinated animal meets a vaccinated or wild one, an unfavorable situation may arise.

Is it better to give vaccinations at 7–8 months or the later the better, for example, at 3 years? At what age is the immune response best?

At 3 years old he is also very good, another thing is that the usual reaction to the vaccine may be more pronounced. The immune response matures by 6–7 months, and from this age until 1.5–2 years, sometimes 3 years, the child responds well to vaccination. His body is configured to perceive and respond. And after 3 years it becomes strong and can already give more pronounced usual reactions. Is not pathological reactions, that is, they do not harm the body, but the body’s response may be more violent, more pronounced - the temperature will rise, the local reaction will be more pronounced. But this is a common reaction to vaccination.

If it were possible to test everyone individually, probably in such a situation a particular child would need not three vaccines, but two, and he would already have a good immune response. But for this there must be some kind of guideline: how many antibodies should there be in order not to give the child a third vaccination? Unfortunately, there is no such data yet, so there is nothing to focus on.

Professor Medunitsyn also speaks about this: “ Immunological personalization of vaccination can be carried out through the selection of a vaccine among vaccines of the same name, the choice of doses, vaccine administration regimens, the use of adjuvants and other means of immunomodulation. Naturally, each vaccine has its own characteristics and each vaccine preparation requires its own immunological correction tactics”; “Immunity assessment can be done before and after primary immunization or at any stage of the vaccination cycle. This allows you to determine the need for further immunization, cancellation of vaccination, or, conversely, taking measures to strengthen the immune response in the vaccinated person. Correction of immunity level based on antibody titers in individuals increased risk accessible and real».

There are also people whose body, in principle, does not give an immune response, no matter what vaccinations they are given. It is believed that there are 5–7% of them. This does not mean that if they encounter an infection, they will definitely get sick - their immunity works a little differently, and perhaps they are the most protected in this regard. There are people who give a hyperimmune response, and perhaps a smaller dose of the vaccine is enough for them. There are even situations when the third vaccination inhibits the effect of the previous ones. This is precisely the question of the future individual approach. Unfortunately, we don’t have this yet.

Are there absolute contraindications for vaccination?

Now the only contraindication for which vaccination is not carried out, and then only with live vaccines, is congenital immunodeficiency syndrome. Acquired too: HIV-infected people are not vaccinated with live vaccines. And they can be vaccinated with killed vaccines, but under certain conditions.

In general, there are now practically no contraindications to vaccination. Previously, pediatricians had the opportunity to give medical advice: for example, a child atopic dermatitis- we gave him medical leave for a week, for two, for a month. Now, when parents come and ask to write a medical report, complaining that the child is sick all the time, we cannot do this. We must treat the child and vaccinate him within two weeks.

Who should not delay vaccinations until 7–8 months and should receive them earlier?

There are such situations. We make sure to vaccinate those children in their newborn age whose father or mother is a carrier of the hepatitis B virus. Since this disease is still very dangerous, we vaccinate such children.

Next, take, for example, pneumococcus. This disease exists in nature, but most children get sick absolutely calmly; rarely, anyone develops pneumonia or any complications. But children with serious illnesses, such as heart disease, may develop pneumonia or another complication that can greatly worsen their heart condition or even be incompatible with life.

Same with bronchial asthma. When I started working, asthmatics were almost never vaccinated; it was believed that this allergic disease, and they cannot be vaccinated. Then we actively got acquainted with foreign experience and saw that in the West, asthmatics are being vaccinated very actively and have good results. In my practice, when I was still working in a clinic (approximately 2002–2004), there was an experience when children with bronchial asthma were actively vaccinated against pneumococcus. Children were sick significantly less asthmatic attacks they became more rare.

Therefore, the approach here may vary. But there are children who definitely need to be vaccinated, because any disease - even chickenpox - can be dangerous for them. Although I don’t like being vaccinated against chickenpox.

Why?

The chickenpox vaccine is a live vaccine. It has not been used for very long. If we weigh the danger from the disease and the danger from the vaccine, in this case I prefer that the children get sick. Firstly, children receive lasting lifelong immunity, and there is a guarantee that they will not get sick in adulthood and old age. Secondly, chickenpox is not very serious disease. Yes, they are now writing that there are unfavorable outcomes of chickenpox, but this is not chickenpox itself, but again, background conditions that suggest the presence of a virus herpes simplex or cytomegalovirus. When they are combined with chickenpox, they can cause complications, but this is a very small percentage.

Therefore, my position is that the child should have chickenpox. Still, there are things that a child should be sick with. The child must develop this immunity, have the opportunity to develop it. If he has not had the disease before adolescence, it makes sense to vaccinate him, because chickenpox becomes more severe with age.

What other diseases are those that are best dealt with in childhood?

Chickenpox, rubella and even measles and mumps (mumps), if the child is generally healthy. These are childhood infections that are childhood are sick quite well.

There has always been a lot of rubella in our country, they began to vaccinate against it not so long ago, and in children this disease has always been quite mild, sometimes even unnoticed. But the girls received stable lifelong immunity and were no longer afraid of rubella by the time they became pregnant.

Now in our country, since 2010, there has been an increase in the incidence of measles. Pediatricians don’t really like to do it, because it requires double testing of blood from a vein for antibodies. However, it is very difficult to force a mother to donate blood from a vein 2 weeks after the child’s illness, when he is already absolutely healthy. And the diagnosis must be confirmed by an increase in antibody titer. If mothers are still taking the first test, then the second one, which should confirm the growth of antibodies, is no longer there. Therefore, most local doctors do not like to diagnose measles and, in order to avoid hassle, diagnose instead, for example, urticaria. But we see this disease, and children suffer from it quite well. My patients tolerated measles very easily, without any adverse consequences.

From all of us listed diseases it makes sense to get vaccinated adolescence, starting from 12 years old. We look at the level of antibodies in adolescence, and if they are not there, then we get vaccinated.

Should children be vaccinated against pneumococcus and Haemophilus influenzae?

If the child is healthy, then I also do not recommend giving the vaccine against pneumococcus and hemophilus influenzae. But I recommend that frequently ill children, adults, the elderly and children with complicated underlying conditions be vaccinated against pneumococcus. As for hemophilus influenzae infection, in adulthood it does not have such negative influence on the body, like pneumococcus, from which, unfortunately, people die, for example, those receiving chemotherapy, limited in movement after a stroke or heart attack, injuries, etc. In many countries, this vaccine is mandatory for older people.

Yes, definitely. I cannot afford to leave my children without vaccinations against these infections, because they are serious diseases that lead to complications in a fairly large percentage, quite high mortality and disability. I would especially focus on meningococcus, which is not even included in our national calendar, but it is from this that we most often lose children.

As you know, the situation with vaccines in our country has not been the easiest since last year, although now it appears to be improving. I recommend vaccines, either or. I have been working with them for a long time, about 10 years, and I see good effect, minimum negative reactions from the body.

I repeat: the state of the body at the time of vaccination is the most important component this process. You can take the best vaccine and put it in the most unfavorable period - and we will get complications. At the same time, if everything is fine in the body, then not even the most best vaccine will not cause serious complications.

For example, DTP?

Yes, including. For 10 years, until 2004, I worked in a state clinic and vaccinated with domestic DPT vaccine because there was no other choice. And I think that if you approach the child carefully and carefully, then, in general, it does not cause a huge number of complications. But if you miss something somewhere: don’t take tests, don’t check the state of the body, miss the child’s contact with sick family members, then there is a risk that the child will tolerate the vaccine much worse. The main thing is the state of the body, but the vaccine is secondary.

I also say this because we have lived for many years with a sufficient number of vaccines good quality. There were many of them, but now they are difficult. But this does not mean that if diphtheria comes tomorrow, we will wait for the French vaccine: no, if diphtheria comes, we will be vaccinated with what we have. It will probably be easier for me to vaccinate with the ADS vaccine, without the pertussis component. But whatever happens, we will vaccinate.

There is a Russian vaccine, Meningo A, which is used only during the period when the disease is on the rise. There is a French vaccine, Meningo, A+C, which is well absorbed from the age of one and a half years. There is no point in doing it before one and a half years, since we will not get the good immune response that we want. There is a vaccine called Menactra, it can be given from 8 months of age, it is quite effective.

This year in Moscow and the Moscow region there is an unfavorable situation with meningitis. The media is silent about this, although there are cases of the disease, including deaths.

Meningococcal infection is different in that a person (child or adult) can be a carrier, and at the same time he will not have any pain, or will have a normal cough and runny nose (nasopharyngitis), caused precisely by meningococcus. Young children may develop meningococcemia - this is a severe form of the disease that develops very quickly and can end completely unfavorably. So it's enough serious illness. Of all the severe childhood infections, I have encountered it most often in my medical life, so I fear it the most.

And if a child was vaccinated with Pentaxim, and then it disappeared, is it possible to be vaccinated with another vaccine?

Yes, they are all interchangeable.

What vaccination schedule should be after the break due to the lack of foreign vaccines?

It depends what the break was. If two vaccinations were done on time with a difference of 1.5–2 months, then we calmly do the third, and then we do revaccination a year later. Thus, we received two vaccinations, received a certain level of immunity, the third will strengthen us, and revaccination in a year will help us. If between the first and second vaccination there was a very big gap, then the second and third vaccinations are done and a revaccination a year later. That is, the effect of the vaccinations is preserved.

Today, only the hepatitis B vaccine is lost: if the second vaccination was not given on time, after 4 months, then you need to start all over again.

What examinations should be carried out on the eve of vaccination?

I would like to note that in our country there is very good standard observations of children in the first year of life. It is much more complete than in other countries, where there is no such thorough examination of children under one year old. Sometimes they even laugh at this, saying, why is this necessary? So, if this standard is observed, then we, in principle, have an idea of ​​the child’s health status at the time of vaccination.

The most unfavorable combination is vaccination and inflammatory processes in organism. It basically gives the most frequent complications- as well as immaturity nervous system. Therefore, before vaccination, you must have fresh blood and urine tests (they must be ideal), and on the day of vaccination, a careful examination by a pediatrician. And the mother’s attention to the child for 3-4 days before vaccination (the parents know the child best, they need to pay attention to everything that deviates from the norm and report it to the pediatrician), as well as the absence of any dangerous contacts in the immediate environment.

What if tests before vaccination showed low hemoglobin?

If hemoglobin is below 100, then this is anemia, which requires treatment, and then there is no talk of any vaccination.

If a child has allergies, do we not vaccinate them either?

There must be a different approach to allergies. In general, the child must be healthy before vaccination. This does not mean that if he has an allergy today and tomorrow it goes away, then we will calmly vaccinate him. No. We must understand what this process is. It is very rare for young children to be truly allergic to anything. We must understand where the problem is: in digestive system(intestines, liver)? Or is it a nutrition problem? First you need to deal with the condition and remove it, and then go for vaccination.

Does it make sense to do tests like the "Eli-Vaccine Test" before vaccination, or is this unnecessary reinsurance?

The Eli-Vaccine Test shows the readiness of the immune system to respond so that vaccination is not wasted, and also shows possible risks.

I will express my personal opinion. I see a lot of children. I don’t give everyone the Eli-Vaccine test because I know these kids well. At one time I did it to everyone, but then I realized that basically it confirms my clinical observations. If your child is being observed in some way or not at all, and you yourself cannot assess the child’s condition, then it is better to do a test. It makes sense.

There are different situations. For example, I don’t like vaccinating three-month-olds, but, for example, the family is leaving for India. In this case, I cannot let them go without vaccination, so we do the Eli-Vaccine Test. It happens that parents are very worried about vaccination, and then we do it just to be on the safe side, so that they can feel calmer. Or it seems to me that the child is not ready yet: he still has immature intestines, lactase deficiency, and some other manifestations of immaturity. Then we do this test, and I understand that at least there are no risks. The immune system may not be ready yet, but at least there are no risks. The risks are very serious, especially from the nervous system, especially in the current situation of increasing incidence of autism.

By the way, about autism. Anti-vaccinators cite the connection between vaccinations and autism as one of the main arguments against vaccinations. Is such a relationship really possible?

We now live in the era of evidence-based medicine. Evidence-based studies in the US and Denmark have shown no link between vaccines and autism. But, nevertheless, autism is an autoimmune inflammation that is associated with endogenous (internal) intoxication of the body. And we live in a world where we can get intoxicated anywhere - and vaccination is not the primary (but possible) source here.

It doesn’t matter where the heavy metals in the body come from - from the vaccine or somewhere else. I now have a child with unknown anemia. We tested him for microelements, and it turned out that he had a lot of galium in his body. Where did he get this gallium from? There are no objective reasons for anemia in a child: he eats well, comes from a good family, his hemoglobin level is very good until he is one year old - and suddenly his hemoglobin drops. After conducting additional research, we understand that he is intoxicated with a certain element, a fairly heavy metal, which is unknown where it came from. Of water? From thin air? We can only guess. This is some kind of feature of the body: at a given moment in time, it accumulates this heavy metal, which gives such a complication. Therefore this is a very difficult question.

In general, the topic of autism is a separate big topic; a lot can be said about it. In our country, children with autism are considered equal to children with mental illness, With mental retardation. They are not treated as they should, they do not undergo the necessary social adaptation, which also involves certain medical and biological components (cleanse the intestines, remove toxins from the body, select appropriate replacement therapy). Children with autism are treated by psychiatrists, just like patients with schizophrenia. Parents should be aware of the manifestations of autism, because cases of the disease have increased many times over.

What about mercury in vaccines?

There is very little mercury in vaccines. There is even less of it in newer and cleaner vaccines. But what younger age child, the less possibility of breeding heavy metals from the body, and this is also why I do not recommend vaccinating newborns.

Sometimes the child’s vaccination period coincides with new pregnancy moms. What to do in this case - to vaccinate or not to vaccinate?

If we vaccinate non-living ones, inactivated vaccines, then they pose absolutely no danger to a pregnant woman. The question is only about live vaccines - in this case it is better to postpone them.

If you were born to parents who love to travel healthy child, then what would you recommend to them - to go with a one-year-old baby, for example, to Thailand or is this a crazy idea and it’s better to stay at home?

Southeast Asia is an extreme. I would advise against going there. If you travel, it is better to go to Europe, which, according to at least, before the latest influx of migrants, was as epidemiologically safe in terms of diphtheria and polio as Russia. What will happen next is still unclear. But now - why not? Go. There is no diphtheria, no polio. And in India there is polio, diphtheria, and meningococcus, so it is better to refrain from traveling to this country. But staying at home is absolutely not necessary.

Very desirable for a child under one year old breast-feeding, since it forms a serious defense for the body. In addition, children under one year old who go to travel with their mother in their arms, face to face, tolerate this much easier than one and a half year olds or two year old children who have already separated from their mother and try to put everything in their mouths, who no longer have such protection.

Should you get a flu shot before cold season?

There are risk groups, for example, elderly people, they should be vaccinated. People who fly a lot on business trips and have little time to get sick are being vaccinated. Healthy man, who has the opportunity to get sick, tolerates the flu normally. I would categorically not recommend vaccinating pregnant women - it is better to vaccinate those around you. The same as in the case of a small child. As preventative measure You can use Nazaval Plus by carefully following the instructions. A fabric mask, alas, does not help; on the contrary, it promotes the accumulation and proliferation of microbes. And, of course, you must wash your hands after visiting public places.

Interviewed by Anastasia Khramuticheva

As a person who has worked for quite a long time in infectious diseases hospital, I declare with confidence: in relation to all diseases against which vaccinations are done, the likelihood of disease remains very real. Children get sick with these diseases, and the outcomes are, to put it mildly, different. Therefore, for normal, sensible and prudent parents there is and cannot be any discussion about whether vaccinations should be done or not.

Definitely do it!

A completely different question is that the response to vaccinations depends very significantly on the state of the child’s body. And if you are very afraid, then the logic is not not to vaccinate. The logic lies in the targeted preparation of the body: a normal lifestyle, natural feeding, hardening, eliminating contacts with sources of allergies, etc.
Vaccinations must be carried out at the time prescribed by the pediatrician, and the more accurate they are, the higher the preventive effectiveness. This should definitely be taken into account when planning, for example, a summer vacation; It would be nice to ask yourself when and what kind of vaccination should be done.
Each country in the world has its own calendar approved by the relevant government agency preventive vaccinations. This calendar takes into account the age of the child, the interval between vaccinations and the list of specific diseases for which vaccinations, in fact, are given.
What is the essence of preventive vaccinations?
Injected into the body medical drug - vaccine. In response to the introduction of a vaccine, the body produces special cells - specific antibodies, which protect a person from the corresponding disease.
Each of the vaccines has its own strictly defined indications, contraindications and timing of use, its own schedule and its own routes of administration (orally, intramuscularly, subcutaneously, intradermally).
The body reacts differently to each vaccine. In some cases, one vaccination is enough to develop long-term immunity. In others, multiple administrations are necessary. This is where two medical words came from - vaccination And revaccination . The essence of vaccination is to achieve the production of specific antibodies in quantities sufficient to prevent a specific disease. But this starting (protective) level of antibodies gradually decreases, and repeated administrations are necessary to maintain their (antibodies) required amount. These repeated injections of the vaccine are revaccination.
The expression we mentioned “reacts differently” refers not only to the quality and timing of the formation of immunity, but also directly to the responses of the child’s body. Reactions that both doctors and parents can directly observe (violation general condition increase in body temperature, etc.).

The severity and likelihood of these reactions are determined by three factors .
The first one - we have already talked about it - the health status of the specific child being vaccinated.
Second - quality and properties of a specific vaccine. All vaccines approved for use (certified) by the World Health Organization (and only such vaccines are used in our country) have high preventive effectiveness, and there is not a single one among them that is obviously bad or of poor quality. Nevertheless, vaccines from different manufacturers can contain different doses of antigens, differ in the degree of purification, and in the type of preservative substances used. In addition, vaccines, even those intended to prevent the same disease, may differ from one another in the most fundamental way - for example, they may be a drug created based on a living but weakened microbe, or a drug based on a killed microbe (or even part this killed microbe). It is clear that if a microbe, although weakened, is alive, there is always a possibility of developing a disease (the very disease for which the vaccine was given), but with a killed microbe there is no such probability.
Third factor - actions of medical workers. Vaccination - This is not an ordinary standard process, according to the principle “inject everyone at three months,” but individual, very specific and very responsible actions that a specific doctor carries out in relation to a specific child. And these actions are not at all as simple as they might seem at first glance. It is necessary to assess the child’s health status, select a vaccine preparation, and give the baby’s relatives clear and available recommendations regarding how to prepare a child for vaccination and how to treat him after it (food, drink, air, walking, bathing, medications). It is also very important to scrupulously observe many vaccination subtleties: how to store the vaccine correctly, how to heat it before use, where to inject it, etc.

Now a few words about specific vaccinations from specific diseases.
The very first graft- this is a vaccine against tuberculosis (the famous anti-tuberculosis vaccine called BCG).
It is usually done directly in the maternity hospital on days 4-7 after birth, once. In the future, theoretically, revaccination is carried out at 7, 12 and 16-17 years. Why theoretically? Yes, because the question is whether to do or not to do revaccination against tuberculosis, largely depends on Mantoux reactions. This reaction is given to children every year, but the vast majority of parents have no idea what it is or what it is for.
The fact is that almost every person sooner or later becomes infected with the tuberculosis bacterium, that is, the microbe enters the human body. But the fact of infection does not at all indicate that a person has contracted tuberculosis. Let's say a microbe has entered, and the body, thanks to the same vaccination, has a protective amount antibodies- the disease does not develop, although the tuberculosis bacterium is present. Mantoux test - is not graft, this is a test for tuberculosis infection. Expression " not a vaccination, but a test"very important. After trials there is no general reactions- the temperature does not rise, the state of health does not change. Local reaction, i.e. directly in the place where they were injected, it may well be that this is actually why the test is done.
If there are no tuberculosis bacteria in the body, the test is negative, but after infection it becomes positive.
How is all this done in practice? The child undergoes the Mantoux test every year, it is, of course, negative, but then, at one not very wonderful moment, from negative test becomes positive. Doctors call this the turn of the tuberculin test, and this same turn sooner or later occurs in almost all people, but for one at 3 years old, and for another at 12 or 19. And here a very responsible situation arises. It is necessary to get an answer to a very fundamental question: a person became infected, but did not get sick, naturally because he had immunity, or infection led to the development of a disease - there were not enough protective antibodies.
Doctors and tuberculosis specialists (TB specialists) answer this question. To do this, the child is examined, certain tests are taken, and, if necessary, an x-ray of the organs is taken. chest. Depending on the results, the doctor makes an appropriate conclusion. Tuberculosis has been detected - we treat tuberculosis, questionable results - course preventive treatment special anti-tuberculosis antibiotics, everything is fine - everything is fine, but revaccination now there is no need to do it - anti-tuberculosis immunity will no longer be supported vaccine, but by a microbe directly entering the body. And the task of doctors is not to let such a child out of sight, to register and regularly examine it in order to promptly identify a situation when the body cannot cope and will still have to be treated.
At the age of about 3 months, vaccinations begin directly at the clinic. For three injections with an interval of 1-1.5 months, carry out vaccination against four diseases at once - polio (the vaccine is liquid, it is dripped into the mouth) and whooping cough, diphtheria, tetanus - this is an injection. Used vaccine, which is called DTP: one drug and against three diseases at once (K - whooping cough, D - diphtheria, C - tetanus). In the second year of life it is carried out revaccination from all these diseases.
IN one year old The child is vaccinated against measles, and at 15-18 months - against mumps.
Preventive vaccination calendar is constantly being revised. It depends on the epidemic situation, the emergence of new vaccines, availability of funds from the state. The modern calendar provides, for example, vaccinations against hepatitis B, but they are almost never done anywhere - there is no money for the vaccine. Specifically timing of specific vaccinations you can always check with your pediatrician.

After any vaccination (any!) the body may have a reaction - increased body temperature, refusal to eat, lethargy. This is normal: the body produces immunity(protection) to a specific disease. Alone vaccines are very easily tolerated and almost never cause serious reactions - typical example - vaccine against polio. The administration of other drugs, on the contrary, is often accompanied by a pronounced increase in temperature and a significant disturbance in the general condition of the child - again, a typical example is the pertussis component of the DTP vaccine.
It is very important for parents to understand the fundamental difference between reaction for vaccination and complication after vaccination.
Reactions to vaccination, to one degree or another, simply must be and this, as we have already noted, is absolutely normal.
What are complications? This is exactly what should not happen, which happens extremely rarely. There should be no convulsions, no loss of consciousness, no temperature above 40 °C. The child should not be covered from head to toe with a rash, and there should be no suppuration in the place where the injection was given.
Complications after vaccinations- it's always serious. Each such case is analyzed in detail, an entire medical commission decides why this happened and what to do next? Vaccinate or not, if yes, then with what drug and for what diseases.
When is it possible and when not to get vaccinated?
First of all, remember that any graft is done to a child who at this moment does not have any acute infectious disease - no runny nose, no diarrhea, no rash, no fever. Why is the absence of an infectious disease important? Yes, because any . In order to respond to vaccination correctly and produce a sufficient amount of antibodies, the body must be more or less free from other matters, in turn related to the production immunity. From here there are two conclusions: if a child has a leg in a cast, then this is not contraindication to vaccination. If any disease, even an infectious one, occurs with a normal temperature and an undisturbed general condition, it is clear that such a disease does not carry a significant burden on immunity and is not contraindication to vaccination.
There are exceptions to the above rule. Some infectious diseases specifically affect those cells human body who are responsible for development of immunity. This is, for example, chicken pox And Infectious mononucleosis. That is, if a child has chickenpox, then normal temperature and satisfactory general condition are still not a reason to do vaccinations. But exceptions only confirm the rules - moderate sniffing in a generally cheerful state allows vaccinations do.
Some infectious diseases suffered by a child cause a long-term weakening of the body’s defenses and this, in turn, is contraindication to vaccinations for a certain period (about 6 months after recovery). These diseases include meningitis, viral hepatitis, the infectious mononucleosis we have already mentioned.
At the same time, to do or not vaccinate- a question that falls solely within the competence of the doctor. For each disease - allergic, congenital, neurological, etc. - corresponding rules have been developed: how, when and with what vaccinate.

How to prepare for vaccination?

There is no need to do anything special. Well, maybe avoid experimenting with food in every possible way - don’t give any new products.
Remember: prepare healthy child It is impossible to vaccinate with any medicines . Any drugs that supposedly make vaccination easier to tolerate: “vitamins”, homeopathic remedies, herbs “for blood vessels”, beneficial bacteria, drops “for immunity”, etc., etc. - all these are popular methods of psychotherapy for mom and dad, an attempt to implement the widespread mental principle “well, we have to do something” and the business of the manufacturers (distributors) of these medicines.

And a few more tips:

• the less stress on the digestive system, the easier the vaccination is tolerable . Never force your child to eat. Don't offer food unless asked. The day before vaccination, limit the volume and concentration of food you eat if possible;
• don't feed (nothing) at least an hour before vaccination;
• going to the clinic for vaccination, very, very try not to overdo it with clothes . It would be extremely undesirable if the vaccine is given to a heavily sweating baby with a lack of fluid in the body. If sweaty people still arrive at the clinic, wait, change clothes, and give them a good drink;
• 3-4 days before vaccination Limit your child's interactions with people as much as possible. (children). Don’t look for infections: if possible, avoid crowded events, shops, public transport, etc.;
• while in the clinic, curb your sociability . Stand (sit) aside, reduce your contacts. Ideally, put dad in line and take your baby for a walk in the fresh air.

Actions after vaccination

1. Walk!!!

Try to underfeed a little (if you have an appetite) or feed only according to your appetite (if your appetite is reduced or absent).

Drink more - mineral water, dried fruit compote, green, fruit, berry tea.

Clean cool moist air.

Limit communication with people as much as possible - the child develops immunity, his body is busy. Other microbes are undesirable to us now. And the source of these other microbes is other people.

If the body temperature rises and there is a significant disturbance in the general condition, a doctor’s examination is required, but paracetamol in any form (suppositories, tablets, syrup) can be given. The higher the body temperature, the more relevant the rules set out in paragraphs 2,3 and 4.

If your child gets sick after vaccination

On Friday Petya was done vaccination, on Monday he started coughing, and on Wednesday the doctor diagnosed him with pneumonia. Eternal questions: why did this happen and, of course, who is to blame?
From the parents' point of view, the vaccination is to blame - this fact is obvious and lies on the surface - I don't really want to go deeper. There are actually three probable reasons:

Incorrect actions immediately after vaccinations.

Additional infection, most often acute respiratory viral infection against the background of “busy” immunity.

Decline immunity in general - “thanks” to appropriate upbringing.

So who is to blame and what to do to prevent this from happening? The question is rhetorical, because it is obvious that the child’s ability to respond normally to vaccinations largely depends on the system of care and education. And this is entirely within the competence of the parents.

Modern parents often have doubts about the vaccinations offered by doctors. Let's figure out whether vaccination is really necessary, what are the disadvantages of vaccinations and whether everyone should get them.

Calculate your vaccination schedule

Pros and some statistics

• All the diseases that vaccinations seek to prevent are very dangerous for young children. The hepatitis B virus, having entered the body of a baby in infancy, will remain there for life, causing damage to liver tissue. By giving your baby BCG in the maternity hospital, you will protect the child from severe forms of tuberculosis. Infections such as tetanus, whooping cough, measles, polio, hemophilus influenzae and others pose a great danger in childhood. For example, the mortality rate from tetanus is over 80%.
• By refusing to vaccinate their children, parents increase the risk of epidemics of dangerous diseases in the future.
• The effect of vaccination on the development of autism was studied in a 2005 study. which took into account data from about 100 thousand vaccinated children. It found no connection between vaccinations and the disease.
• The percentage of complications after vaccination is many times lower, than the percentage of complications in the disease if the child is not vaccinated.

These are not just nice words: vaccination literally saves the lives of many children

Cons

Parents who oppose vaccinations usually offer a variety of reasons, most of which are only partially true:

1. Vaccinations have a negative impact on immune system child. Immediately after vaccination, the baby becomes more vulnerable to diseases that an unvaccinated child might not have developed. This is true, but the weakening is only temporary.
2. The vaccine does not protect against the disease against which it is directed 100%. Although having partial protection is still better than no protection at all. When a vaccinated child does become infected, his illness is milder and has virtually no complications.
3. A child receiving breast milk is protected from infections, so you should not overload his immune system in the first year of life. Indeed, antibodies are transferred to the baby with mother’s milk and during the first months they provide the baby with good protection against infections, but already at 3 months of age their concentration decreases and the child becomes defenseless against bacteria and viruses.
4. Each vaccine contains toxic preservatives that have a negative effect on the baby’s body. It should be noted that vaccines are constantly improving and the concentration of such substances is decreasing. In addition, if the child gets sick, he will have to take medications, which can also be toxic to the baby’s kidneys and liver.
5. There are no completely safe vaccines; each of them can cause allergies, brain damage and even death. This is true, but the diseases for which vaccinations are given most often lead to disability and death; in the case of vaccination, these are only exceptions to the rule.

Due to cases of complications after vaccinations, parents are increasingly refusing to vaccinate their children. But remember that such cases are very rare

Opinion of E. Komarovsky

A well-known pediatrician says that vaccination is very important. He reminds that all diseases against which people are vaccinated modern child, continue to be detected by doctors and threaten both the health of children and their lives. That is why parents need to think carefully about whether it is worth depriving their children of protection from those dangerous diseases whose pathogens are targeted by vaccinations from the national calendar.

Do all children need to be vaccinated?

If the child is completely healthy, vaccinations will undoubtedly benefit him. However, there are situations where vaccination is either delayed or cancelled. Therefore, the vaccine is not given:

• A child with any acute illness and deteriorated general condition.
• A child whose chronic pathology has worsened.
• Children who have had severe reactions to a previous vaccine.
• Infants with immunodeficiencies, severe anemia or cancer.

In addition, the hepatitis B vaccine should not be given to children who are allergic to yeast, and the measles or flu vaccine should not be given to a child with a protein allergy. chicken egg, and vaccination against rubella and measles for children with allergies to aminoglycosides. Premature babies are not given BCG, and the DTP vaccine cannot be administered to babies with neurological diseases.

Before vaccination, read the contraindications and take your child to the pediatrician to assess his condition.

Admission to kindergarten

Only parents can decide whether to vaccinate their baby or not. All vaccinations provided for in the national calendar are carried out only on a voluntary basis, that is, after the consent of the parents.

Since 1998, the opportunity to refuse vaccination has been enshrined in law; to do this, you need to write refusal of vaccinations. However, in practice it is very difficult to get into the garden without vaccinations.

Parents trying to place an unvaccinated child in kindergarten may face a refusal to sign medical card at the clinic from the medical staff and accept the card in kindergarten on the part of the manager. This is a violation of their child's right to education, so it can be fought. Ask for written confirmation of the child’s refusal to enter the kindergarten. Usually after this the problem disappears.

However, if you are planning to send your baby to a child care facility without having vaccinated him, you should not forget that you are responsible for his health yourself.