Vaccinations against hepatitis and pneumonia - are they necessary?

Hepatitis A, or Botkin's disease, is an acute viral disease that affects liver cells and causes their death. According to WHO, it is the most common infectious disease in the world. With the help of medications, the course of the pathology can be alleviated. At the same time, the disease often causes severe complications, especially in children. The only effective method of preventing hepatitis A is vaccination.

Why is the hepatitis A pathogen dangerous?

The hepatitis A virus enters the body through water, food, household items, toys, and also through contact with a sick person. The pathogen is highly resistant to negative environmental factors and most disinfectants.

After entering the body, the hepatitis A virus multiplies on the mucous membranes of the digestive organs and enters the lymph and liver through the bloodstream. The latent period of the disease is 2–4 weeks. After it, symptoms characteristic of a cold appear.

A few days after the onset of clinical manifestations of the disease, the patient’s condition deteriorates sharply. During this period, jaundice appears - the skin, sclera and mucous membranes of the eyes acquire a yellow tint. With correct treatment, symptoms disappear after about 20 days, and the patient develops lifelong immunity to hepatitis A.

At the same time, in patients at risk, the hepatitis A virus causes inflammation and severe pathological changes in the liver, gallbladder and ducts. They may develop concomitant cholecystitis, cholangitis, liver failure and resulting disorders of brain function. In severe cases, the patient may fall into a coma.

Hepatitis vaccination schedule

Hepatitis B vaccines are recombinant - they contain artificial antigens (unlike the hepatitis A vaccine based on a live virus). The artificial origin of the vaccine is a guarantee of complete safety and long-term immunity to hepatitis B. But at the same time, recombinant vaccines are not as effective as vaccines based on the live virus. Therefore, if a single vaccination is sufficient to develop stable immunity against jaundice, three-time administration of the vaccine is necessary to form high-quality immunity against hepatitis B.

When is vaccination necessary?

Immunization against hepatitis A is not included in the National Compulsory Vaccination Calendar of the Russian Federation. It is recommended for cases of high risk of infection due to the absence of antibodies to the virus in the human blood. Representatives of risk groups are children under 5 years of age and adults over 55 years of age.

Children are vaccinated:

• 2 weeks before admission to a child care institution or a trip to epidemiologically unfavorable regions - countries of Asia, Africa, seaside resorts of the Russian Federation;
• patients with chronic liver pathologies, as well as hemophilia;
• as part of emergency prevention - within 10 days after contact with a carrier of the virus.

The vaccine is given to adults:

• for military personnel - if the military unit is located in an area with poor water supply;
• before traveling to Asia, Africa, the south of the Russian Federation;
• employees of child care institutions;
• medical workers;
• catering and food industry workers;
• employees of water treatment facilities and technical sewerage services;
• patients with liver and/or blood pathologies;
• people living in epidemically unfavorable areas;
• after contact with a patient with hepatitis A;
• drug addicts, homosexuals, people who are promiscuous.

Vaccines

In the Russian Federation, the following vaccines are used for immunization against hepatitis A:

• Harvix, UK, can be used in children from 1 year of age. 2 weeks after vaccination, antibodies are developed in 88% of patients, after 1 month - in 99%. Effective in focal epidemics of hepatitis A. Available in disposable syringes and vials.
• Avaxim, France, can be used in children from 1 year of age. 2 weeks after vaccination, antibodies are developed in 98.3% of patients, after 1 month - in approximately 100%.
• "Vakta", USA, can be used in children over 3 years of age. It is highly effective - out of 1 million vaccinated people, 1 person can get sick.
• "GEP-A-in-VAK", Russia, can be used in children over 3 years of age. Forms stable immunity for 20 years in 95% of adult patients and 90% of children. Available in ampoules.

All of these vaccines contain inactivated viral particles and therefore cannot cause infection.

Cost of vaccination

Standard vaccination schedule

Children from 1.5 years of age are injected with 0.5 ml of the drug intramuscularly into the anterior surface of the thigh. After 3 years, the vaccine is given in the deltoid muscle of the shoulder. For some blood pathologies, the vaccine is administered intradermally. One dose of the drug forms immunity within 1–2 weeks and provides protection for 1.5 years.

Imported vaccines are administered twice with an interval between injections of 6–18 months, depending on the drug. After a full course, immunity is formed for 20–25 years. The domestic vaccine “GEP-A-in-VAK” is administered according to the following scheme:

• 1st dose - at 3 years;
• 2nd dose - after 1 month;
• 3rd dose - after 1.5 years.

The drug can be administered on the same day with other vaccines except BCG or with an interval of 1 month after other vaccinations. In patients with immunodeficiencies, after a full course, the level of antibodies may be insufficient - in this case, the doctor prescribes additional vaccination.

Three hepatitis B vaccination schedules

• Basic (standard): 0-1-6 months
  Hepatitis vaccination for a newborn child (in the absence of contraindications), then when the baby reaches 1 month of age, and the third vaccination at 6 months.
• Alternative (fast): 0-1-6-12 months
  Prescribed for vaccination of children with an increased risk of contracting the virus.
• Emergency: 0-7-21 days – 12 months
  In case of probable contact with the hepatitis B virus.

What to do if the scheme is broken?

If the newborn has not been vaccinated against hepatitis B, immunization can begin at any age (the main requirement is a healthy child). The time interval between the first and second vaccination should not exceed 4 months, and the third vaccination is carried out 4-18 months after the second.

It is not always possible to accurately follow the vaccine administration schedule due to the child’s illness or other reasons, so there is an acceptable interval during which the vaccine can be given.

For a standard schedule, the second vaccination should be done with a delay of up to 4 months, and the third - no earlier than 4 months and no more than 18 months after the second. If more than 4 months have passed and the second vaccination has not been done, the regimen is started again. If the third vaccination is missed, they resort to option 0-2 (vaccination is carried out, and after 2 months it is repeated). If immunization was started several times and the vaccine was eventually administered 3 times, the course is considered complete - long-term immunity to hepatitis B has been formed.

There is no vaccination schedule for hepatitis A, but doctors recommend it for all children starting at one year of age. And especially if:

• there is an infected person in your immediate environment;
• you will be traveling to a country with a socially low level;
• liver pathology was diagnosed.

In the latter case, vaccination is mandatory.

Emergency immunization

With the standard vaccination regimen, immunity to hepatitis A is formed within 2–4 weeks after vaccination. If there is a high risk of infection, emergency immunization is indicated. Patients are injected with immunoglobulin - the drug is effective even after the virus enters the body.

Emergency immunization is recommended:

• in case of a sewerage breakthrough into the city water supply system;
• sexual contact with a carrier of the virus;
• newborn children of mothers with hepatitis A;
• close household contacts with relatives with Botkin's disease.

Immunoglobulin is obtained from donor blood. The drug is administered once intramuscularly into the thigh or buttock. The dosage is calculated according to the patient’s age: children under 6 years old - 0.75 ml, 7–10 children - 1.5 ml, over 11 years old - 3 ml. The duration of the drug is 1–3 months. In case of repeated contract with the virus carrier, repeated administration is indicated. Immunoglobulin is contraindicated if you are allergic to the components of the drug.

Preparing for vaccination

To minimize the risk of adverse reactions, you should prepare for vaccination. During the week before vaccination, try to walk more in the fresh air, avoiding crowded places. People with chronic pathologies should undergo general blood and urine tests before vaccination.

3-4 days before vaccination, exclude allergenic foods from your diet - citrus fruits, tomatoes, grapes, chocolate, seafood, new dishes. Do not overeat to reduce the load on the digestive organs and ease the post-vaccination period. Take antihistamines 1–2 days before vaccination.

Immediately before vaccination, the doctor must make sure that the patient is healthy. If there is any doubt about this, vaccination is postponed for 2-3 days.

Post-vaccination period

After vaccination, you need to stay in a medical facility in case of an acute post-vaccination reaction for 20-30 minutes. For 2-3 days after vaccination, you should avoid crowded places, hypothermia and overheating. This will reduce the risk of developing ARVI, the symptoms of which can be confused with a post-vaccination reaction. To avoid injuring the injection site, wear clothes made from natural fabrics. Do not scratch or rub the papule. Do not wet it for 3 days after vaccination to prevent secondary infection.

If your temperature rises, take antipyretic drugs - paracetamol, aspirin or their analogues. To reduce the risk of post-vaccination reactions, take antihistamines for 2-3 days after vaccination.

Possible side effects from vaccination

Due to the high effectiveness of the vaccine, leading manufacturers are reducing dosages and completely eliminating preservatives from its composition. This further minimizes the occurrence of adverse reactions. However, each child’s body is individual and may respond to the hepatitis A and B vaccine in the following ways:

• slight malaise and weakness;
• increased sweating;
• redness and itching at the injection site;
• increased body temperature;
• diarrhea.

Parents should know that such manifestations are observed in only 5% of cases and are considered normal. After some time (1-2 days), the child’s condition stabilizes.

After vaccination, the injection site should be protected from contact with water. If water does get on the graft, there is no need to panic - carefully blot the injection site.

Possible adverse reactions

Post-vaccination reactions are evidence of an active immune response of the body to the introduction of pathogen proteins, therefore they are considered a normal variant and do not require treatment.

In children, post-vaccination reactions after vaccination against hepatitis A develop in 10–12% of cases. More often observed is an increase in temperature up to 38 ºС, weakness, soreness, redness, hardening and swelling of the tissue in the area of ​​the papule.

At the age of over 16 years after vaccination, the following are possible:

• general weakness, chills and fever;
• allergic reactions - from skin rash to Quincke's edema;
• decreased blood pressure;
• headache and joint pain;
• labored breathing;
• nausea, vomiting, dyspepsia;
• convulsions, paralysis.

Often, adults develop adverse reactions to vaccination due to alcohol consumption. In addition, alcohol impairs the production of antibodies to the hepatitis A virus.

Experts recommend calling an ambulance:

• at temperatures above 39 °C;
• convulsions against a background of normal temperature;
• paralysis;
• Quincke's edema;
• bronchospasm.

Contraindications to vaccination

Hepatitis A vaccination is contraindicated:

• in case of exacerbation of chronic diseases - until the condition stabilizes;
• acute infectious and inflammatory diseases - until complete recovery;
• hypersensitivity to any of the components of the vaccine.

A medical examination before vaccination allows you to minimize post-vaccination complications. Pregnant women are vaccinated with non-live vaccines under strict medical supervision.

Viral hepatitis A, especially without effective treatment, can cause irreversible changes in the liver. The only way to protect yourself from this disease is vaccination. A full course of immunization of 2-3 vaccinations reliably protects children and adults for 20-25 years. To get more information or get vaccinated, contact us in any convenient way.

How children are vaccinated against hepatitis B

We asked all the questions about vaccinating children to the leading pediatrician at the Medsi children's clinic on Pirogovskaya, Madina Abdulaeva . According to her, the very first vaccination against hepatitis B is given to a child in the maternity hospital on the first day of life, the second at one month, and the third at six months. However, there are other cases.

“There is an alternative scheme for children at risk (if the parents are carriers of hepatitis B): in the first day after birth, then at one month, two months and 12 months of life. Emergency vaccination (before surgery, with massive blood transfusion, if the child has not been vaccinated previously) is carried out according to the scheme 0-7-21 days with the introduction of the fourth dose after 12 months,” comments the specialist.

pixabay.com/DarkoStojanovic

How does the vaccine work?

The vaccine contains an agent that is a microorganism, but in a safe form, causing the development of the disease during normal infection. By administering a vaccine, it is possible to obtain acquired immunity—resistance to the pathogen. As a result, the body begins to recognize it as a threat to health and immediately destroys it, preventing the disease from developing. The duration of the body's protection varies. It depends on the course of immunization, the type of drug, and the individual characteristics of the body.

Some features of vaccination against hepatitis in children

As mentioned, vaccination against hepatitis is not mandatory, but an extremely necessary procedure. The child’s parents have the right to refuse it, but in some cases there are irresistible indications for use:

• in cases where the baby lives in a family where there is a person with hepatitis;
• if the child is born to a mother infected with the disease;
• in the absence of testing of the mother for infection with the virus;
• when spouses or one of them suffers from drug addiction.

Given all these factors, you should not hesitate to vaccinate your child.

Pros and cons of vaccination

The controversy surrounding vaccination never goes away. Should I vaccinate or not? If there are no contraindications, and there is a risk of contracting hepatitis, it is better to vaccinate. Artificially created immunity protects against the development of the disease over an extended period of time. But often people are afraid to immunize and refuse it unreasonably.

The response to the vaccine depends largely on the individual characteristics of the body and the degree of risk of infection by pathogenic microorganisms. Modern drugs undergo thorough cleaning and do not contain live pathogens that can cause complications. Unexpected reactions can arise due to the hidden course of complex diseases of internal organs, autoimmune pathologies, which many people are not aware of until obvious clinical manifestations of the disease appear.

It is recommended to conduct a thorough diagnosis before vaccination if there is a possibility of complex diseases that can be complicated by the introduction of vaccination. It is also important to pay attention to the quality of the vaccine and the reputation of the manufacturer.

The effectiveness of vaccination depends on the rules for storing the drug and compliance with certain standards during transportation. There are diseases that are considered life-threatening for adults and children. Viral hepatitis, contrary to popular belief, can be quite severe, causing destructive changes in the liver. Therefore, the best option would be vaccination, which reliably protects against pathogenic viruses and allows you to feel more free in society and in a professional environment.

But the decision to immunize is made by the person himself. If a child needs to be vaccinated, the appropriateness of vaccination is determined by the parents or other legal representatives.

Everyone is in favor of baby vaccinations

First of all, it should be noted that vaccination against hepatitis A is necessary in countries with hot climates. The disease does not pose any particular danger to humans. And hepatitis B can seriously impair liver function.

According to international rules, any vaccination is voluntary. Therefore, the decision whether the baby needs vaccination and when to do it is made by the baby’s parents. Taking into account the danger of hepatitis, you should weigh all the arguments about the benefits of vaccination:

• despite the generally accepted opinion that a child lives in a prosperous family, the likelihood of illness does not decrease;
• if the hepatitis virus enters the body of a child under 5 years of age, the disease may become chronic;
• Vaccination greatly reduces the risk of illness, but does not eliminate the possibility altogether. We must not forget that in this case, the progression of hepatitis B will be easier. Recovery will occur much earlier than in an unvaccinated baby;
• WHO studies have shown that vaccination against hepatitis does not have a harmful effect on the human body. Does not enhance the development of other diseases, if they occur.

Virologists are making every effort to convince parents that vaccinations are safe. The effectiveness and benefits of the vaccine leave no doubt. If the baby is vaccinated on time, according to the schedule, he will acquire immunity from the disease for a period of 22 years.