Vaccination against pneumococcal infection: vaccination scheme for adults, children and conscripts

Vaccination against pneumococcal infection has become mandatory in Russia since 2014. The purpose of the vaccine is to prevent diseases caused by the pneumococcal bacterium. Protection against disease is guaranteed when completed on time.

Pneumococcus is a type of bacteria from the genus Streptococcus. The bacterium can most often cause the following diseases:

pneumonia;
meningitis;
endocarditis;
bacterial rhinosinusitis;
a number of other dangerous infections: conjunctivitis, phlegmon, peritonitis, sepsis.

Some diseases caused by the pneumococcus bacterium can lead to death (eg, meningitis, sepsis).

Pneumococcus lives in the respiratory organs of adults and children. The infection most often occurs between the ages of 6 months and two years. Children under this age have maternal antibodies that prevent the development of the disease.

Indications

More than ninety types of infections that cause disease are known. The peculiarity of this bacterium is its shell, which acts as a pathogenicity factor. It prevents you from developing immunity to the disease. Therefore, children get sick many times. Even if the baby does not attend kindergarten, the first and subsequent vaccinations should be done as early as possible. Bacterial infection occurs quickly. In childhood, this vaccine is considered mandatory. Also, in old age, vaccination is mandatory. After 60 years, diseases become chronic. The penetration of a dangerous infection can lead to complications in vital organs in case of illness. Therefore, old people in nursing homes and children in orphanages also need to be vaccinated.

According to the Internal Service Charter, army personnel are required to be vaccinated. Before entering the army, conscripts are given a vaccine against pneumococcal infection (during the autumn conscription period). During conscription, soldiers are also vaccinated against rubella, tick-borne encephalitis, and hepatitis.

Vaccination against pneumococcal infection

One of the most severe bacterial infections of humans on the globe is pneumococcal infection (especially for children from birth to 5 years and the elderly), which has a variety of clinical forms. According to the World Health Organization, every year in the world, diseases caused by pneumococcus claim 1.6 million lives, of which 800 thousand are children under 2 years old and 200 thousand are children from 2 to 5 years old.

Pneumococci - microbes that normally inhabit the upper respiratory tract of humans, can lead to a variety of diseases if the body's defenses are weakened.

The most common manifestation of pneumococcal infection is pneumonia (pneumonia); 7 out of 10 pneumonias are caused by pneumococcus. Pneumococcal infection can also occur in the form of various inflammatory diseases of the upper respiratory tract: sinusitis (inflammation of the sinuses), pharyngitis, tracheobronchitis, less often sepsis (blood poisoning), endocarditis (inflammation of the inner lining of the heart), arthritis (inflammation of the joints). In children, pneumococcus is the main cause of otitis, bronchitis, pneumonia, and meningitis. This bacterium is usually activated after illnesses such as influenza, measles, otitis media and even the common cold. Disability is also possible after illness.

Pneumococcal infection can affect any age group. The source of pneumococcal infection is only a person: a patient or a carrier of the bacteria. The infection is transmitted by airborne droplets. Infection occurs when coughing, sneezing, talking with a sick person (the entrance gates of pneumococcal infection are the mucous membranes of the oropharynx and respiratory tract). Unfavorable factors for the development of the disease are hypothermia, decreased immunity as a result of frequent acute respiratory viral infections, stressful situations, overwork and hypovitaminosis. Infection can occur already in the maternity hospital, as well as at home from family members.

The incubation period (from the moment of infection to the development of the disease) ranges from 1 to 3 days. Human susceptibility to pneumococcal infection is very high. The most effective method of protection against pneumococcal infection is vaccination. Specific immunity during vaccination is developed after 10-15 days and lasts for 5 years. This prevention is aimed at reducing the incidence of pneumococcal infection, preventing generalized forms of the disease, reducing disability and mortality rates.

Risk groups and effectiveness

Most often, pneumococcal infection occurs in children under two years of age and in the elderly. Vaccination against pneumococcal infection is recommended for all people at risk:

· Preschool children and elderly people;

· People in contact with carriers of infections;

· Adults susceptible to chronic cardiovascular diseases and syndromes, as well as lung and liver diseases and diabetics;

· People in whose body manifestations of sepsis are possible (for example, with cellular anemia and a removed spleen);

· Anyone with a weakened immune system, especially HIV infection, leukemia and similar diseases;

· Patients with traumatic brain injuries and spinal column injuries.

Vaccination against pneumococcal infections shows its effectiveness in people at risk in 85% of cases. Timely vaccinations have a positive effect on life expectancy and the quality of immunity in such people, allowing them to reduce the risks of severe complications and forms of infections, as well as fight against their consequences.

Contraindications

Any vaccination is additional work for immunity. It may be contraindicated in the following cases:

If the child is under two months old, vaccination is contraindicated. 8 weeks is the optimal age for immunization;
during exacerbation of any disease;
intolerance to vaccine components;
in the first and second trimesters of pregnancy;
with fever.

The decision to shift the schedule is made by the doctor together with the patient. In some cases it is worth waiting for remission, in others - not at all.

The effectiveness of immunoprophylaxis

Research by the Department of Infectious Diseases of the Northern State Medical University has proven the effectiveness of the vaccine against severe forms of pneumococcal infection. Practice has shown that, compared with unvaccinated children, the incidence of severe forms of the disease among vaccinated children is:

meningitis, sepsis – 80% less;
otitis, pneumonia - 30% less.

According to WHO, mass immunoprophylaxis reduces the incidence of meningitis and otitis in children, and there are fewer carriers of pneumococci. In addition, the disease is becoming less and less common among unvaccinated adults and children.

The health organization predicts that worldwide use of the pneumococcal vaccine will help prevent the deaths of 5.4-7.7 million children by 2030.

The effect of pneumococcal vaccines was refuted in the media, and cases of death from vaccinations were cited. However, the media rarely provides statistics on the death of children who could not withstand the infectious pressure, although such data exist.

Types of vaccines

There are 3 types of vaccines in our country. The actual classification depends on the number of strains in the injection:

"Prevenar" (USA). There are 2 types: the number in the name 7 or 13 indicates the number of virus strains in the composition. Used in many countries around the world. Children from five months to 2 years can be vaccinated.
"Synflorix" (Belgium). Against 10 strains of the virus. Also contains an ingredient against hemophilus influenzae. The vaccine was recently registered in the country, the benefits have not yet been thoroughly studied (except for the low price).
"Pneumo 23" (France). The vaccine is the “oldest” in the world. Can be done from 2 years old. Protects against 23 strains. The effect of the drug is justified by long-term use. It is painful to tolerate and adverse reactions may occur.

Vaccination dates

A necessary rule for vaccination is to observe the interval between vaccinations.

Vaccination scheme against pneumococcal infection

Age for first injection	Dose	Scheme of implementation
2-6 months	3	3 doses every month each. Revaccination should be carried out at 1 year and 3 months
7-11 months	2 doses	The interval is a month. Re-inserted after first birthday
12-23 months	2 doses	Minimum interval 2 months. Repeatedly according to indications
2-5 years	1 dose	One time

This vaccination calendar is a system for the rational use of vaccines. It will be useful for parents to contact him to determine the right moment for vaccination.

Methodology

Injections for patients in the first years of life are performed in the muscles of the front surface of the thigh; for older children, the injection is given in the shoulder area. Before the manipulation, the nurse shakes the bottle well and takes a single dose of 0.5 ml. The injection site is disinfected with alcohol. The mother holds the baby in her arms or on the couch. The immunized patient is observed for about 30-40 minutes in order to identify immediate hyperergic reactions in time.

Pneumococcal immunization of premature infants born at 28 weeks of gestation or later is carried out according to a separate protocol. For such newborns, a primary vaccine complex of 3 standard dosages of the PCV10 conjugate drug is recommended. The interval between administrations is at least 1 month. Revaccination is performed at 12-15 months. For very premature infants (less than 28 weeks of gestation), PCV13 is used.

Features of childhood vaccination

Parents need to know how to prepare for vaccination:

the child is not introduced to new complementary foods 3 days before/after the injection. If the baby is breastfeeding, the mother can wait a while with new products, especially allergenic ones;
A healthy child should not have any complications, but it is better to play it safe and get tested to make sure he is in complete health;
Doctors recommend refraining from walking and swimming on the day of vaccination. This is necessary in order to exclude hypothermia or the possibility of contracting any other infection.

According to the instructions, the rules for administering the vaccine require an intramuscular injection. If the child is under two years old, they place it in the thigh, the anterolateral muscle, or perhaps in the shoulder.

It is prohibited to mix different vaccines in one syringe.

At the appointment before administering the vaccine, the doctor examines the child and measures body temperature. If there are skin rashes, vaccination is postponed until recovery.

Complications after pneumococcal vaccination

The pneumococcal vaccine rarely causes side effects and is well tolerated by children. The following reactions are considered normal:

slight lethargy, drowsiness;
tearfulness;
decreased appetite;
increased temperature (normalized with the use of antipyretics);
redness and slight swelling at the injection site;
formation of an infiltrate (compaction) in the injection area (can persist for a month).

The following conditions require immediate medical attention:

fever that does not go away after taking antipyretics;
convulsions;
Quincke's edema;
loss of consciousness;
skin rash;
severe enlargement of the lymph nodes in the groin (when the vaccine is administered in the thigh).