Vaccine options
Diphtheria vaccines are based on diphtheria toxoid, which is a modified bacterial toxin that induces a protective antitoxin. The diphtheria vaccine is a toxoid adsorbed on aluminum hydroxide.
Diphtheria toxoid is also produced in combination with tetanus toxoid (ADS, ADS-m vaccinations) and pertussis vaccine (whole cell - DPT, Bubo-M, Bubo-Kok; and acellular or acellular - Infanrix, Pentaxim, Tetraxim, Infanrix Penta, InfanrixHexa) . Preventive vaccinations allow you to create long-term and intense antitoxic immunity against diphtheria. The DTP vaccination consists of a mixture of corpuscular pertussis vaccine, diphtheria and tetanus toxoids. ADS toxoid is purified and adsorbed diphtheria and tetanus toxoids. ADS-M-toxoid differs from ADS in its reduced antigen content - one vaccination dose (0.5 ml) contains 5 LF (a unit of measurement of the activity of components) of diphtheria toxoid and 5 EC (a unit of measurement of the activity of components) of tetanus toxoid (for comparison, 0 .5 ml of ADS vaccination contains 30 LF of diphtheria toxoid and 20 EC of tetanus toxoid).
All vaccines for the prevention of diphtheria, tetanus and whooping cough are inactivated (killed), that is, they do not contain anything living. It is known that individual antigens in their pure form and inactivated vaccines are inferior in effectiveness to live vaccines. In this regard, aluminum hydroxide is used as an amplifier (so-called adjuvant) for vaccination against diphtheria, tetanus, whooping cough (and a number of other infections). The point of using this substance is to enhance the inflammatory reaction at the site of vaccine administration and, as a result, intensify immune reactions and increase the effectiveness of vaccination in general.
Revaccination: vaccination of a child at 7 years old
ADS-M is used for revaccination at 7 and 14 years of age. Further renewal of the body’s protective properties occurs every 4 years. Children over 6 years of age who have not previously been vaccinated with similar serums can receive an injection of this type - they do not have stable immunity against the diphtheria bacillus.
DTP, ADS, ADS-M are given to children over seven years of age. They are used for revaccination of patients who do not have antibodies capable of resisting the diphtheria bacillus. According to the national calendar, 14-year-old children are not vaccinated, only revaccination. A person exposed to proper immunization will grow up protected.
Principles and purposes of vaccination
Diphtheria is an extremely dangerous disease due to its complications; vaccination is necessary to prevent it. Vaccine production is a complex multi-step process. Diphtheria toxoid is obtained from the toxin produced by the diphtheria microbe. Microorganisms are cultured in a liquid nutrient medium into which they secrete a toxin. The resulting medium is carefully freed from microbial cells and then processed to completely neutralize the toxin, retaining only its immunizing activity. Diphtheria toxoid is controlled according to several indicators (adopted by WHO in 1965): first of all, for safety, that is, the completeness of neutralization of the toxin. This indicator is tested on sensitive animals by injecting them with a dose 50-100 times higher than the dose for humans, which makes it possible to detect trace amounts of incompletely neutralized toxin. After the safety test, it is checked for the possibility of returning toxic properties. For this purpose, the purified toxoid is incubated for six weeks at different temperatures, and then a control test is performed on animals again.
Dosage - in children from 3 months to 4 years - three diphtheria vaccinations of 0.5 ml at an interval of 6 weeks, followed by revaccination 12 months after the third vaccination; for children over 4 years of age and adults - two diphtheria vaccinations of 0.5 ml at an interval of 4-6 weeks, followed by revaccination after 9-12 months.
After a series of primary immunizations, the average duration of protection against diphtheria is about 10 years. Not everyone knows that in adulthood revaccination with associated diphtheria-tetanus toxoid with reduced antigen content (ADS-m) every 10 years is indicated.
What can and cannot be done after vaccination?
Once the vaccine is given, the body will begin to produce antibodies. They will protect a person from the disease. Revaccination stimulates the process of antibody production. A single dose does not provide reliable protection,
Therefore, repeated administration of the vaccine is required at certain time intervals. The production of immunoglobulins in the body can lead to certain reactions on its part, so you need to follow the recommendations given by the doctor.
Forbidden:
- One day before the vaccine and 3 days after its administration, you should not drink alcohol.
- It is not recommended to eat foods that can cause an allergic reaction: all citrus fruits, honey, fish and seafood, confectionery and baked goods, chocolate, coffee and cocoa, sweet soda.
- For 3 days, a person should not exercise or put too much stress on the body.
- It is forbidden to visit the sauna and bathhouse, and you cannot go to the pool.
- You should refrain from going to crowded places, for example, a clinic, a store, a theater, etc.
After receiving the vaccine, the following actions are permissible:
- You can take a shower.
- You can apply a sterile bandage to the injection site.
- You can take allergy medications.
- You need to stick to a light diet: drink as much water as possible, eat fresh vegetables and fruits, cereals, and dairy products.
Vaccine effectiveness
Introduction in 1994 of mass immunization of the country's population against diphtheria with repeated revaccination of adults in 2003-2004. made it possible to provide sufficient specific protection of the population from this infection. Together with many years of surveillance, this led to a decrease in the incidence of diphtheria in Russia from 26.8 in 1994 to 0.01 per 100 thousand population in 2009-2011. During the period 1980-2000. The total number of reported cases of diphtheria has been reduced by more than 90%.
All components of DTP vaccines are capable of forming immunity in almost 100% of vaccinated people.
Answers to popular questions
- Why does tetanus cause death?
There are several reasons for the death of patients - a fracture of the spinal column, cessation of cardiac activity, suffocation.
- What are the complications of tetanus?
Complications include: convulsions with bone fractures, bronchitis, pneumonia, pulmonary atelectasis, sepsis, compression and deformation of the spine.
- What types of vaccines are there?
During routine vaccination, the vaccine used is DPT (whooping cough, diphtheria, tetanus), ADS (diphtheria and tetanus), ADS-M (small dose of a drug for tetanus and diphtheria), Infanrix (tetanus, diphtheria and whooping cough, the vaccine is manufactured in Belgium), Tetrakok (the vaccine is supplemented with a drug against polio, it is produced in France). If an emergency vaccine is required, then the drug AC, that is, tetanus toxoid, is used.
- How long does it take to fully recover from tetanus?
? From 45 to 60 days.
- If parents refuse to give their child a tetanus vaccine, can they be forced to do so?
No, if parents refuse in writing, then the child will not be given the vaccine.
- Do adults have to pay for tetanus vaccinations? Where can I put it?
The vaccination is free and can be done at any medical institution, for example, at a primary care facility or a community clinic.
- What is the prognosis for tetanus?
The prognosis is largely determined by the form of the disease; if it is generalized, then the prognosis is unfavorable. The length of the incubation period is also important; the shorter it is, the worse. If the infection is mild, then the person recovers completely from the disease. With the fulminant course of tetanus, patients most often die.
Author of the article:
Mochalov Pavel Alexandrovich |
Doctor of Medical Sciences therapist Education: Moscow Medical Institute named after. I. M. Sechenov, specialty - “General Medicine” in 1991, in 1993 “Occupational diseases”, in 1996 “Therapy”. Our authors
Adverse reactions
After the administration of adsorbed drugs (intramuscular or subcutaneous), a slight compaction may remain at the injection site for some time, which is not dangerous to the body.
DTP vaccinations are the most reactogenic, “heavy” childhood vaccines. On average, adverse reactions occur in a third of vaccinated people, and not with every vaccine. The peak frequency of reactions is observed, as a rule, on the third and fourth injections of the vaccine, which coincides with the peak rates of immunity development. They are manifested by a moderate increase in body temperature and mild malaise within 24 hours after vaccination. Redness, swelling, and pain at the injection site are also possible, and rarely transient ephemeral rashes occur. Reactions at the injection site for diphtheria vaccination are generally observed in 15-25% of vaccinated people: redness (1-2%) and swelling (1-2%) caused by immune inflammation at the injection site and the action of the adjuvant. Pain at the injection site (probability about 15%, manifested by the fact that when moving the child “protects” the leg and cries) is also a consequence of the inflammatory reaction.
General reactions to diphtheria vaccination are observed on average in 20% of vaccinated people: increased body temperature (up to 30%), others (restlessness or, conversely, lethargy, vomiting, diarrhea, appetite disturbances). As a rule, all adverse reactions to DTP vaccines develop no later than 24 (72) hours after vaccination, last no more than 24 (48) hours and do not require treatment.
At what age do adults get the measles vaccine?
Adults can get vaccinated against measles at any age if there is no medical record of vaccination in childhood, there was contact with a sick person and the analysis did not show the presence of antibodies to the virus in the blood. If vaccination was carried out in childhood (at 1 year and 6 years), revaccination is not necessary, since immunity is developed for life.
For adults who did not receive a measles vaccine as a child, the vaccine requires two doses of the vaccine, 1 month apart, to develop an immune response. Usually, people who have had measles or were vaccinated in a timely manner have good immunity against the disease, however, if a blood test does not show the presence of antibodies to the virus, the vaccination should be repeated.
Risk of post-vaccination complications
As with any other vaccine, in rare cases allergic reactions to the components of the DTP vaccine are possible. These complications are associated not with the properties of the vaccine, but with the amount of excipients in specific preparations, the child’s allergy to them and, in some cases, non-compliance with vaccination rules. It is significant that, according to statistics of post-vaccination complications in the United States, even severe allergic reactions to DTP vaccines have not led to serious consequences in any case since 1978, taking into account the fact that about 80 million vaccinations against diphtheria were given during this period . Possible specific complications of DPT vaccinations include neurological complications, which are extremely rare. It is assumed that they may be caused by the fact that the toxins of pertussis bacillus (even inactivated) in combination vaccines tend to irritate the meninges of an extremely small proportion of susceptible children.
Rare manifestations of neurological complications following diphtheria vaccination can be: convulsions without fever - 0.3-90 per 100 thousand vaccinations, complications in the form of encephalopathy - less than 1 case per 300 thousand vaccinated. Currently, in the world, convulsions without fever are not considered a complication of vaccination. Research conducted in Great Britain in 1960-1970. indicate the same incidence of seizures in vaccinated and unvaccinated children. Moreover, the first manifestations of diseases such as epilepsy and organic brain damage can appear in the form of seizures at the age of 3-4 months, when vaccination begins, and are associated with vaccination only by a temporary factor.
What parents need to know about the vaccination procedure
All vaccinations must be done according to certain rules under the supervision of a doctor. You should prepare for vaccination every time. To ensure that the baby is healthy before the start of the vaccination cycle at 3 months, blood and urine tests are ordered a few days before the first vaccination. If everything is normal, before the procedure the child’s temperature is measured and examined by a doctor. Particular attention is paid to the presence of allergic manifestations. If they are present, after vaccination, antihistamines are prescribed on the recommendation of a doctor. It is also advisable to give the child an antipyretic in the evening on the day of vaccination.
Before vaccination, the doctor must tell parents in detail about possible side effects and their elimination. At the same time, mom or dad should understand when symptoms after vaccination are not dangerous and can be dealt with using available means, and when it is worth seeking help. After consultation on all age-appropriate vaccinations has been received, parents sign consent to them. Unfortunately, in local clinics the matter is often limited to a signature.
The ampoule with the vaccine for children is removed from the package in the presence of parents. They may also ask you to inspect it for cracks. You must be in or near the clinic for 30 minutes after the procedure. This is a precautionary measure in case of an allergic reaction. It is better to be in the air, because crowds of people and various infections in the air can cause side effects.
Contraindications
In addition to general contraindications to vaccination against diphtheria, such as acute illness, allergies to vaccine components and severe immunodeficiency (in which the formation of immunity is impossible), DPT vaccines are temporarily or absolutely contraindicated if the child has a progressive pathology of the nervous system or has had seizures without fever (afebrile). In this case, children are vaccinated with a diphtheria vaccine without the pertussis component (ADS vaccination). Temporary and relative contraindications are exacerbation of chronic diseases (vaccinations can be carried out without exacerbations), recent acute respiratory infection (ARI) (vaccinations against diphtheria can be carried out immediately after recovery). It should be noted that in the United States, mild ARI is not a contraindication, and vaccinations can be carried out, including against the background of a slight increase in temperature, cough, or runny nose. Also a contraindication is the development of strong general and local reactions to the previous administration of DTP vaccination (fever above 40 C, swelling and hyperemia at the site of vaccine administration over 8 cm in diameter).
When is vaccination not recommended?
Before the procedure itself, in order to avoid dangerous relapses, the doctor makes sure that the patient has no contraindications; they can be temporary or permanent.
The doctor is obliged to warn that the medication should not be administered if an allergy or tendency to it is diagnosed. Vaccinations for adults may not be permitted due to illness; the health care worker must defer action until the patient recovers.
Vaccination should not be done in case of a temporary decrease in immunity; it should be postponed. After recovery, vaccination against diphtheria is carried out as planned. There is an absolute ban on vaccination of patients with severe immunodeficiency and people diagnosed with AIDS.
The procedure is suspended after the patient experiences neurological reactions. It can be done after recovery.
You cannot vaccinate while pregnant or breastfeeding your baby.
This is due to a possible negative effect on the newborn child or fetus. With the end of pregnancy or the cessation of feeding the child, contraindications are lifted for the woman without harm to her health. Vaccination against diphtheria manifests itself as the body’s reaction to serum, where the main provocateur is the tetanus component.
Compliance with all these restrictions will make the procedure effective and will avoid negative consequences.
