Vaccine options
The live attenuated rubella vaccine has been used for more than 40 years. A single dose provides over 95% of long-term immunity, similar to immunity developed as a result of natural infection. Rubella vaccines are either monovalent (a vaccine that targets only one pathogen) or, most often, combined with other vaccines, such as measles (MR), measles and mumps (MMR) or measles, mumps and varicella vaccines. (KSKV). In Russia the following are used: live rubella vaccine, live attenuated rubella vaccine, Priorix, MMR-II.
Vaccination dates
Rubella vaccination, when is vaccination done and how long does immunity last? Vaccination of the population is carried out only with drugs that have passed clinical trials.
Monitoring vaccinated people and determining the level of their antibodies to rubella made it possible to establish that
:
- in a small proportion of people immunity remains for life;
- in approximately 95% of unvaccinated people, immunity against rubella works during the first 15-20 years after vaccination;
- For some, antibodies are not activated after the first vaccination.
In this regard, a unified vaccination plan for the population has been developed and is being used in Russia:
- The first vaccination against rubella is carried out at 6 years of age;
- revaccination at 6 and 15-17 years of age.
Giving children the first and second vaccinations allows them to be reliably protected from rubella before puberty. Then immunity gradually decreases, so after 15 years another vaccination is necessary. Vaccination dates may be postponed for medical reasons.
After reaching 18 years of age and up to 35-40 years of age, all women are given the vaccine if 5 or more years have passed since the last vaccination against rubella.
How many times should the rubella vaccine be given during a lifetime? The official vaccination calendar provides for three-time vaccination against the rubella virus, but vaccination can be carried out more often if indicated. The World Health Organization recommends that adults be vaccinated every 10 years.
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Principles and purposes of vaccination
If a woman is infected with the rubella virus early in her pregnancy, she has a 90% chance of transmitting the virus to her fetus. This can lead to miscarriage, stillbirth, or severe birth defects known as CRS. Therefore, prevention of this disease is extremely important. By the end of 2013, rubella vaccine had been introduced nationally in 137 countries.
There are three main approaches to eradicating rubella and CRS: vaccinating children, vaccinating adolescent girls, and vaccinating women of childbearing age who plan to have children. The first strategy is effective against rubella itself, but does not completely solve the problem of CRS (this will require 20-30 years), since, according to available data, vaccination protects for about 20 years, which means that, theoretically, it can shift the incidence of rubella to childbearing years age. The second strategy, vaccinating teenage girls, is effective in eradicating CRS (although it will take 10-20 years to achieve this goal), but does not solve the problem of rubella incidence in general (in Russia, the peak occurs at the age of 7-14 years). Vaccination of women is extremely effective in combating CRS (although achieving 100% coverage of the adult population is almost impossible), but also does not solve the problem of rubella itself.
In view of these considerations, WHO recommends a combination of all three strategies whenever possible. An example of such a combination is the United States, where, in addition to vaccinating children, vaccination is carried out in colleges and the Armed Forces. In accordance with the National Vaccination Calendar, children from 1 to 18 years of age, women from 18 to 25 years of age (inclusive), who have not been sick, not vaccinated, vaccinated once against rubella, and who do not have information about vaccinations against rubella, must be vaccinated. An interesting solution to the problem of vaccinating women of childbearing age was found in France - a refusal to register a marriage in the absence of a stamp of vaccination against rubella or a record of previous infection.
Treatment of rubella in adults
To date, no special medications have been developed to treat the rubella virus. Treatment methods for rubella in adults are aimed at alleviating unpleasant symptoms.
If an adult detects signs of rubella, it is necessary to seek medical help and undergo an examination to confirm the diagnosis.
If rubella in an adult occurs without serious complications, treatment can be carried out at home.
The patient must be isolated in a separate room so that other family members are not exposed to infection. The room needs to be wet cleaned and ventilated every few hours.
At high temperatures (over 38°), an adult is prescribed antipyretic medications.
It is important to drink large amounts of fluid to detoxify the body after poisoning with waste products of pathogenic microbes.
ATTENTION!
- It is quite difficult to independently treat rubella in adults and is fraught with serious complications!!!
- Therapy must be prescribed by a qualified specialist!!!
- In severe cases, the patient will need to be hospitalized!!!
Complications of rubella in adults
Having discovered signs of rubella, it is important to promptly seek medical help and strictly follow the doctor’s recommendations. Otherwise, when the disease is left to take its course, serious complications are possible, which usually occur in adult patients.
Most often, the virus can provoke the development of the following pathologies:
- Meningitis of viral etiology. This is a serious disease that affects the upper lining of the brain and spinal cord. The disease can cause paralysis of various nerves and respiratory muscles, coma, convulsions, and death of the patient.
- Pneumonia. An acute inflammatory process affects the structures of the lungs. It may occur in a patient who has had rubella against the background of an associated infection.
- Otitis. Ear pain caused by rubella poses a particular danger to the patient. Inflammation can lead to hearing loss.
- Arthritis, polyarthritis. The inflammatory process in the joints, accompanied by pain and stiffness, is most often a consequence of a viral disease. It can occur not only in an adult, but also in a child.
- Developmental defects in the fetus. The rubella virus poses the greatest danger to the unborn baby. When infected in the womb, pathologies of the auditory, visual or nervous system almost always occur. Therefore, gynecologists strongly recommend terminating pregnancy in case of rubella in the early stages. In the last months of pregnancy, the woman is given immunoglobulin.
Complications from rubella occur in adults in almost every case, but pregnant women experience the most severe consequences.
Contraindications
Immunodeficiency conditions; malignant blood diseases and neoplasms. severe reaction (temperature rise above 40 C, swelling, hyperemia more than 8 cm in diameter at the site of vaccine administration) or a complication to the previous dose; acute infectious and non-infectious diseases, exacerbation of chronic diseases - vaccination should be carried out no earlier than 1 month after recovery; pregnancy;
Notes:
- When prescribing immunosuppressants and radiation therapy, vaccination is carried out no earlier than 12 months after the end of treatment;
- HIV - infected children can be immunized with rubella vaccine;
- The vaccine should not be administered during pregnancy. Precautions must be taken to avoid conception for 2 months after vaccination.
Features of vaccination
Before vaccination, the child must be examined by a pediatrician. Fever, colds, and diarrhea are temporary contraindications for vaccinations. Combination vaccines are given into the muscle.
At the age of one year, children are usually given an injection in the thigh; at an older age, it can be given in the shoulder muscle or under the shoulder blade.
The rubella vaccine cannot be given in the buttock, since due to the well-developed layer of subcutaneous fat, the rate of absorption of viral particles is weakened.
Vaccination should be carried out observing the following rules:
- vaccine injections are administered only by a specially trained health worker;
- vaccinations are given strictly in the treatment room under aseptic conditions;
- It is necessary to use only disposable syringes with a thin needle;
- before and after the injection, the injection site is treated with a skin antiseptic;
- the ampoule with the vaccine is opened immediately before use;
- a change in the color of the solution in the ampoule is unacceptable; if this happens, the drug is immediately thrown away;
- After receiving the vaccine, the patient must remain under staff supervision for at least 30 minutes.
After vaccination, pediatricians usually recommend not going out for walks on the first day and try to avoid crowded places for a week or two.
Should you get vaccinated?
Rubella is a viral infectious disease that is transmitted from person to person. Its symptoms themselves do not pose a potential threat to life; they lead to the formation of a specific rash and general intoxication, while stable immunity to the pathogen is formed.
The danger of this disease lies in its teratogenic effect. It is extremely dangerous for pregnant women and the unborn child, as it causes deformities and developmental abnormalities.
The most effective way to protect against this infection is the rubella vaccine.
Whether vaccination against rubella is necessary, each person decides for himself. But if he wants to protect himself and his child from infection, he must be vaccinated. This is especially true for women of childbearing age who want to give birth and raise a healthy baby in the next 10 years. Considering that the body of a pregnant woman with a weakened immune system will not be able to fight the infection, preventive measures should be taken in advance. This also applies to the man living with her.
With vaccinations for children, the situation is more complicated, since many parents now refuse vaccinations altogether. Yes, a child tolerates rubella relatively easily, but he comes into contact with many people, including pregnant women and people with chronic diseases and allergies, so it is better to protect both him and those around him from possible complications.
