We vaccinate a 0-2 year old child: vaccination according to the calendar and more

Table of contents:

• What is a vaccination calendar?
• What should a child be vaccinated and when?
• In what cases are test results required for admission to vaccination?
• Why do children need to be vaccinated so early? Is it possible to postpone vaccination?
• In what cases should vaccination not be carried out?
• How does a reaction to a vaccine differ from complications?
• Is it possible to get sick from a vaccine against the disease against which it is given?
• Why should I vaccinate my child if everyone around me is vaccinated?
• “I heard a story: a healthy child was vaccinated, and after that he became seriously ill and became disabled”
• Why get vaccinated against chickenpox? After all, this is a mild childhood illness.
• The meningococcal vaccine is very expensive. Is it really necessary?
• Why is it better to choose a vaccine with a component that protects against Haemophilus influenzae infection?
• Why is it necessary to vaccinate a child against pneumococcus?
• We have never heard of the rotavirus vaccine. Why is it needed?
• How many vaccines can be given at one time?
• What should be the intervals between vaccinations?

What is a vaccination calendar?

The national vaccination calendar is a list of all vaccinations that the state provides to people free of charge to the entire population. As a rule, this calendar includes vaccines from domestic manufacturers, although there are exceptions. It is important that the national calendar is not a “list of all necessary vaccinations.” This list itself is broader, and it may include completely different vaccines. If parents have the opportunity to get vaccinated for a fee, they can supplement the calendar with those vaccines that are not included in it and replace the free vaccine options with paid ones.

All about the vaccination calendar

What should a child be vaccinated and when?

We have compiled for you our own extended list of infections against which your baby must be vaccinated.
In some places we also indicate specific vaccines, but at the time of writing this article there are significant difficulties with their supply in St. Petersburg. Most vaccines for a specific disease are interchangeable. When choosing a vaccine, remember that combination vaccines (those that include vaccines against several infections at once) are better than single vaccines. So, vaccinate your baby against the following diseases:

• tuberculosis - in the maternity hospital;
• hepatitis B - first vaccination in the maternity hospital, then at 1 and 6 months;
• rotavirus - from 6 weeks;
• whooping cough, diphtheria, tetanus, polio, hemophilus influenzae. There is a Pentaxim vaccine that protects against all these diseases at once, as well as Infanrix Hexa, which in addition to them also contains a vaccine against hepatitis B. The timing of administration varies depending on the vaccines available to you, but in any case, vaccination against these diseases must be completed by 6 months;
• pneumococcus - (Prevenar, from 2 months);
• influenza - (annually in the fall, from 6 months);
• meningitis - (Menactra, from 9 months);
• measles, rubella, mumps - (Priorix or analogues, from 12 months);
• hepatitis A - from 12 months;
• chickenpox - from 12 months.

Consult with your pediatrician to schedule vaccines and when to give them.

National vaccination calendar

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Additional materials

Vaccination calendar: the Russian path against the backdrop of global experience

The national vaccination calendar is a document approved by order of the Ministry of Health of the Russian Federation, which determines the timing and types of vaccinations (preventive vaccinations) carried out free of charge and on a large scale in accordance with the compulsory health insurance program (CHI).

The vaccination calendar is developed taking into account all age-related characteristics, including the most dangerous infectious diseases in children in the first year of life. Vaccinations, which are given as part of the National Calendar, can significantly reduce the risk of disease in children. And if the child does get sick, then the vaccination given will contribute to the progression of the disease in a milder form and will relieve serious complications, many of which are extremely life-threatening.

The national vaccination calendar is a system for the most rational use of vaccines, ensuring the development of intense immunity at the earliest (vulnerable) age in the shortest possible time. The vaccination calendar can be divided into two parts.

The first part is the National Calendar of Preventive Vaccinations, which provides vaccination against widespread infections that affect almost the entire human population (airborne infections - measles, rubella, mumps, whooping cough, chickenpox, diphtheria, influenza), as well as infections that are characterized by severe course with high mortality (tuberculosis, hepatitis B, diphtheria, tetanus, polio, hemophilus influenzae type b).

The second part is vaccinations for epidemic indications - against natural focal infections (tick-borne encephalitis, leptospirosis, etc.) and zoonotic infections (brucellosis, tularemia, anthrax). This category may also include vaccinations carried out in risk groups - persons with both a high possibility of infection and a high danger to others in the event of their illness (such diseases include hepatitis A, typhoid fever, cholera).

The national calendar is an authoritative source of information that will help parents figure out what diseases they can protect their child from, and when it is best to do this.

Today, more than 1.5 thousand infectious diseases are known in the world, but people have learned to prevent only the 30 most dangerous infections with the help of preventive vaccinations. Of these, 12 infections, which are the most dangerous (including due to their complications) and which easily affect children all over the world, are included in the National Calendar of Preventive Vaccinations of Russia. Another 16 from the list of dangerous diseases are included in the National Vaccination Calendar for epidemic indications.

Number of preventable diseases around the world and diseases included in the mandatory National Vaccination Schedules of different countries

Basic Vaccination Calendars and Calendars for Epidemiological Indications

Each WHO member country has its own vaccination schedule. The Russian national vaccination calendar is not fundamentally different from the national vaccination calendars of developed countries. True, some of them provide for vaccinations against hepatitis A, meningococcal infection, human papillomavirus, rotavirus infection (for example, in the USA). Thus, for example, the US national vaccination calendar is more saturated than the Russian calendar. The vaccination calendar in our country is expanding - for example, since 2015, it has included vaccination against pneumococcal infection.

On the other hand, in some countries, the National Calendar does not provide for vaccination against tuberculosis, which in our country is forced by the high incidence of this infection. And to this day, vaccination against tuberculosis is included in the vaccination schedule of more than 100 countries, while many provide for its implementation in the first days after birth, as recommended by the WHO Vaccination Schedule.

National vaccination calendars of different countries

In Russia , the National Calendar is less saturated than the vaccination calendars of countries such as the USA and a number of European countries:

• there are no vaccinations against rotavirus infection, HPV, chickenpox;
• vaccinations against Hib are carried out only in risk groups, hepatitis A - according to epidemiological indications;
• there is no 2nd revaccination against whooping cough;
• Combination vaccines are underused.

Order of the Ministry of Health of the Russian Federation dated March 21, 2014 No. 125n “On approval of the national calendar of preventive vaccinations and the calendar of preventive vaccinations for epidemic indications

Registered with the Ministry of Justice of the Russian Federation on April 25, 2014. Registration No. 32115 Published: May 16, 2014 in “RG” - Federal issue No. 6381.

National calendar of preventive vaccinations

The child receives the first vaccinations according to the National Calendar in the maternity hospital - this is the very first vaccination against hepatitis B, which is given in the first hours of life. Often the first vaccination against tuberculosis is also carried out within the walls of the maternity hospital. Before one year of age, children are vaccinated against hemophilus influenzae, whooping cough, polio, diphtheria, tetanus, and pneumococcal infection. From the age of six months, you can vaccinate your child against influenza. Older children, at the age of 12 months, receive protection against measles, rubella, and mumps through vaccinations.

Vaccinations with polysaccharide vaccines (Pneumo23, meningococcal vaccine, etc.) should begin after 2 years of age, since the child’s body does not respond by producing antibodies to these antigens. For younger children, conjugate vaccines (polysaccharide with protein) are recommended.

Why do children need to be vaccinated so early? Is it possible to postpone vaccination?

Many people do this, but we don’t recommend it.

• Firstly, most vaccinated infections are deadly for young children. Deaths from whooping cough, pneumococcal pneumonia, and diseases caused by Haemophilus influenzae are most often recorded precisely at the age of 2-3 years. At 9-24 months there is a peak incidence of meningococcal meningitis, especially its invasive (most dangerous) form.
• Secondly, parental concerns about “immature immunity” are completely unfounded. The child’s immune system is constantly experiencing some antigenic load, and vaccination does not interfere, but helps it mature. Vaccinations are designed specifically for children. Of course, infant immunity is imperfect, so some vaccines are repeated. But following the correct schedule guarantees reliable protection against infection.
• Thirdly, the older the child, the more pronounced the reactions to vaccinations are, precisely because of the “ripe” immunity. This in itself is not scary, but redness and pain at the injection site, high fever and other “joys” are much more common in children with delayed vaccinations, and are not typical for infants.

Many parents ask the doctor to give them a waiver, and pediatricians follow their lead. In fact, neither colic, nor an umbilical hernia, nor small residual cysts in the baby’s brain, nor even a runny nose without a rise in temperature will in any way affect the child’s condition after vaccination. Such challenges have no medical basis. Unfortunately, most cases of severe childhood infections are detected in children whose parents decided to “just wait six months or a year.”

The importance of observing breaks between vaccinations

At the time of primary vaccination, special antigens are introduced into the body, which stimulate the production of antibodies . Depending on the type of vaccination, they may provide reliable protection for a certain period, such as several months or years.

The easiest way to consider the need to comply with vaccination intervals is to use DPT as an example. After the first injection, antibodies are produced, the maximum amount of which is observed after 2-3 weeks. Then their volume gradually decreases.

Repeated vaccination 45 days after the first one again stimulates the body’s protective functions, contributing to the formation of an adequate response. In the case of DTP, three injections and one revaccination are required to develop full immunity against whooping cough, diphtheria and tetanus.

What happens if you violate the recommended deadlines? If you do not maintain the interval and introduce immune drugs earlier, the already formed antibodies will be practically neutralized. This means that the effectiveness of vaccination will be reduced to zero, in addition, there is a high risk of harm to health (serious side effects may develop).

If, on the contrary, the period is increased, this will not in any way affect the strength of protection against infectious diseases - in such a situation, only the immune layer is reduced.

If we talk about the interval between different drugs, then the explanation is even simpler - vaccination seriously loads the body, so taking breaks gives it the opportunity to recover. This takes about a month.

The recommended intervals between vaccinations are scientifically based - before the introduction of any vaccine, it is tested for more than one year.

In what cases should vaccination not be carried out?

• Acute febrile condition, for example, with ARVI. As soon as the temperature drops, you can wait 3-4 days and get vaccinated. A runny nose and cough without fever are not a contraindication to vaccination!
• Seizures (children with epilepsy who do not show seizures on medications can be vaccinated).
• Exacerbation of chronic diseases. At the same time, atopic dermatitis, anemia, benign neutropenia of childhood and other asymptomatic or easily removable conditions are not contraindications.
• Severe reaction to a previous administration of the same vaccine. At the same time, a vaccine against a specific infection can and should be replaced with an analogue.
• There is one more contraindication for live vaccines: immunodeficiency - primary (congenital), HIV infection or resulting from treatment with hormones or chemotherapy. All these conditions cannot be “accidentally overlooked.”
• It is important that vaccination should not be delayed due to “incorrect” test results. Moreover, the requirement to take tests before vaccination is unlawful, and you can refuse to do so.

Who should be vaccinated against hepatitis B first?

First of all, it is recommended to vaccinate against hepatitis B for adults at risk:

• medical workers, specialists who work with biological fluids (blood, sperm);
• patients who regularly undergo blood transfusions and are on hemodialysis;
• members of families in which patients with hepatitis B virus live;
• persons who engage in promiscuous sexual relations or suffer from drug addiction;
• patients who are fond of tattoos;
• persons traveling to regions with unfavorable epidemiological conditions for hepatitis B;
• patients who plan to undergo extensive dental interventions, surgeries, and traumatic instrumental research methods.

How does a reaction to a vaccine differ from complications?

A reaction to a vaccine is a variant of the norm. After all, vaccination is an accelerated, stimulated development of immunity. The reaction may be local (swelling, pain, redness at the injection site) or general (fever, poor sleep and appetite, headache, rash).

The reaction to the vaccine is not dangerous and goes away within 1-2 days. If the fever lasts longer or occurs later, the vaccine is not the cause.

Complications from vaccination, in contrast to post-vaccination reactions, occur extremely rarely and are severe. Thus, 1 out of 10,000,000 children vaccinated against measles develops post-vaccination measles encephalitis, and pneumococcal vaccines have not caused a single complication in the entire history of observation. Information on the frequency of complications can be easily found in open sources. WHO collects and analyzes all cases of complications and, based on this, adjusts its recommendations on vaccinations. Complications can be caused by improper administration or storage of the vaccine, or violation of vaccination rules (for example, if a child with an infectious disease was vaccinated).

In addition, (also very rarely) an allergic reaction to vaccine components occurs. This is why parents are often asked to wait in the hallway for half an hour after vaccination. An allergy to the vaccine, if any, manifests itself immediately, and doctors are prepared for such situations.

How much time should pass between the vaccination and the administration of immunoglobulin?

If it is necessary to simultaneously administer vaccinations and immunoglobulin, their greatest “interaction” is observed when using “live” vaccines - inactivated drugs and toxoids have little effect on each other, so their simultaneous use is permissible.

In the case of “live” vaccines, it is permissible to reduce the interval between vaccination and administration of immunoglobulin to two weeks, but this is only possible in the event of a situation threatening life and health.

Why get vaccinated against chickenpox? It's a mild childhood illness.

Indeed, most often chickenpox passes quickly and without traces in a child, although a high fever and an itchy rash are also not a gift. But sometimes chickenpox can cause serious complications: encephalitis, pneumonia, epiglottitis.

The older the child, the more severe chickenpox tends to be. In addition, chickenpox is an extremely contagious disease. That’s why it’s called that, because the virus is literally carried by the wind over a distance of up to twenty meters.

And if we decide that our child can get over the disease, then we are also responsible for that pregnant woman who sits opposite us on the transport and whose plans do not include the disease.

Therefore, it is better not to get chickenpox - but to get vaccinated against it in advance!

The meningococcal vaccine is very expensive. Is it really necessary?

Vaccination against meningococcus is of great importance for both young children and adolescents. It is children under 5 years of age who most often become victims of the invasive form of the disease - meningococcemia (more than 30% of all cases). In fulminant forms, only a few hours may pass from the first symptoms to death. Meningococcemia and meningococcal meningitis have a high mortality rate - about 15%, even with timely treatment. It is not difficult to understand that meningococcal infection at the moment, although rare, is the most terrible of childhood diseases.

In the North-West region, the incidence of meningococcal infection caused by serogroup B (not included in the vaccine) has decreased in recent years at the expense of serogroup W (which is included). Therefore, if you have the opportunity, it is definitely worth vaccinating your child.

We have never heard of the rotavirus vaccine. Why is it needed?

The RotaTek vaccine is used for vaccination against rotavirus. These are drops in the mouth, not an injection. Rotavirus enteritis can be a very dangerous disease for infants and children under 5 years of age. The mortality rate with it is not so low - 3%, and in children under one year old, even a moderate course threatens with rapid dehydration. RotaTek reduces the likelihood of disease (protection efficiency is 98% in the first season, then 70%) and makes the course of the disease easier, protecting against dangerous complications. Therefore, it is better to vaccinate your child, especially since complications from this vaccination occur infrequently.

What should be the intervals between vaccinations?

It has been established that longer than recommended intervals between vaccine doses do not significantly reduce the antibody response. In this regard, interruption of the immunization schedule does not require the restoration of the full vaccination series or the addition of additional doses of the vaccine. However, administering doses of vaccines or toxoids at shorter than recommended intervals may reduce the antibody response and should therefore be avoided. This is especially important for primary immunization.

The minimum interval is 1 month; after the administration of some live vaccines, the next vaccination can be administered only after 2 months; the correct sequence and duration of intervals is determined by the doctor in each specific situation.

Minimum interval between vaccinations in children

According to the official recommendations of the Ministry of Health of the Russian Federation, the minimum interval between two doses of the same vaccine should not be less than 1 month.

BCG vaccine

It is allowed to simultaneously administer different vaccines (except BCG) used within the framework of the National Preventive Vaccination Calendar on the same day using separate syringes in different parts of the body.