To instill, it is impossible to postpone: why vaccines are necessary for the child
Vaccinations have become safer, experts say. But the danger of preventing vaccine-prone infections still remains
The debate about whether to vaccinate children has long gone beyond social networks and private discussions of parents. Representatives of the medical community themselves are hotly discussing this issue, although there are indisputably more arguments for “yes”, and a recent example of measles outbreak in Europe is a striking example.
Leading experts, a guru in this field, were told about why vaccination is necessary for children and what consequences can result from the refusal of vaccinations at the conference “Actual issues of modern perinatology:” A complicated case “.
The four main questions
Given the speed of people’s movement around the globe, the extent and speed of the spread of infections is obvious, and its focus can break out anywhere, doctors say. And vaccines come to the rescue here.
Vaccination is the most effective preventive technology and the way to protect against infectious diseases, but with the right answer to four questions: what to vaccinate, how to vaccinate, who to vaccinate and when, says the president of the European Pediatric Association, deputy director of the Children’s Scientific Center for Children’s Health, corresponding member RAS Leila Namazova-Baranova.
According to the national vaccination calendar, now in Russia vaccines are made from 12 infections. In the Russian Federation, in fact, from 11.5, since only risk groups are vaccinated against hemophilic infection, about 150,000 children (about 10% of the total number). According to the world practice, an average of 15 diseases are vaccinated. If you compare the Russian national vaccination calendar and WHO vaccination calendar, the latter contains four more positions. For example, a second vaccination against whooping cough, which is not done in Russia. The vaccination ends in children by the age of 5-6, that is, the child ceases to be protected from pertussis and should be revaccinated. But this is not in the domestic calendar, hence a large number of coughing children at preschool and school age, the doctor points out.
Many parents often ask – than to vaccinate children. And this is the second important issue, says Leyla Namazova-Baranova. Indeed, now on the market a huge number of vaccine preparations, in her opinion, should be evaluated not from the point of view – domestic or foreign, but from the position of technology – how modern it is. “The main thing is that the technology is perfect. It is also important that the drug has a good dossier with numerous confirmed scientific studies. They should be proven that the drug is not only effective, but also safe, “she explains. For children, it is necessary to use large combinations: five-and hexavalent, to protect them immediately from several diseases.
On the question of who to vaccinate, the answer is obvious – all, but first of all children. In Russia, for some reason, vaccination is associated only with children, although in developed countries everyone is vaccinated. The elderly also stand apart, which in terms of security are comparable to children. “According to our calendar, diphtheria and tetanus should be vaccinated every 10 years. But who did this? Not all. Therefore, adults need to start with themselves, “- said the doctor.
If the child was born healthy and in due time, then the questions, whether it should be vaccinated and when, does not arise. You must follow the calendar. A large number of questions concern children of preterm, born with chronic diseases or from HIV-infected parents. Many doctors unreasonably postpone the timing of vaccination, thereby exposing children to risk. Although it is also necessary to vaccinate them, the academician says. For example, in preterm patients the risk of getting preventable infectious diseases is much higher – the probability of invasive pneumococcal infections is almost 10 times greater. Therefore, these children should be vaccinated, as soon as they gained weight in two kilograms.
It’s painful, but justified.
However, in order for the vaccine mechanism to work together, it is necessary to exclude the problems that exist in this area – from doctors ‘refusals and parents’ refusals, to the quality of vaccines themselves and the anti-vaccine position of some media, experts say. Head of the Department of Emergency Pediatrics of the National Medical Research Center for Children’s Health of the Russian Ministry of Health Tatyana Kulichenko believes that the main problem of vaccine prevention in Russia is related to the attitude of doctors to this issue and the patients themselves.
Themselves doctors often try to find different reasons for delaying the inoculation. And here there is a problem of unreasonable offenses. For example, among them – frequent ARI, allergic diseases without exacerbation, chronic illness, hypoxia at birth, pregnancy in the mother of the child, the specialist points out. Often they include anemia, allergies, prematurity, sepsis, allergies in the family, chronic diseases, infections (as soon as they go on recession – you can vaccinate the child), the senior research fellow of the department of vaccine preventive maintenance of children with deviations in the state of health of the Federal State Institution “NNPTSZD” of the Ministry of Health RF, PhD Marina Fedoseyenko.
The cause for withdrawal is often the transferred or forthcoming surgical intervention, jaundice at birth, hypotrophy, mother’s pregnancy, stable neurological condition – Down’s syndrome, cerebral palsy. However, if we go back to the topic of real contraindications, then there are far fewer of them, experts say. For all vaccines – this is a strong reaction or complication of the previous introduction of the vaccine, notes Marina Fedoseenko. For example, a fever with a temperature of 40, Guillain-Barre syndrome for 6 weeks after vaccination, a collapoid reaction, says Fedoseyenko. Symptoms should be systemic. In this contra-indication extends to the vaccine of the same name, but it is possible to choose a similar vaccine, she notes.
For living vaccines, contraindication, for example, is the primary immunodeficiency state, immunosuppression, malignant neoplasms, pregnancy. And for a tuberculous dry vaccine (BCG-M) – the weight of a child at birth is less than two kilograms, a keloid scar. At the same time, parents and doctors often believe that because of the vaccinations the child experiences a lot of pain, hence the saying “let it get stronger by the year, then vaccinate”, “the child hurts” or “too many injections and so on.” However, according to Tatiana Kulechenko, if you look at the frequency of unreasonable pain that children receive in hospitals, it is much higher – up to 67%. And 70% of hospitalized children receive more than one injection per day. And as a rule, if the child has a fever, then antibiotics start to stab him. At the same time on which specific flora, on what microbe the therapy is directed, the doctors themselves often can not answer.
For example, a year and a half year old boy with eight days of hospitalization with complaints of fever and diarrhea received 52 intramuscular injections of antibiotics. Although there were no indications for the injection forms themselves, the doctor points out. He was not vaccinated. “We do not discuss this. But when we have three injections in one calendar of vaccinations, this fact we meet roughly – this is terribly painful. Yes, it’s painful, but justified, “- says the head of the emergency pediatrics department of the National Medical Research Center for Children’s Health of the Russian Ministry of Health.
Another problem is the coverage of vaccinations. For example, it is low among vaccines for pneumococcal disease, although they are the most common in children under five years old. And they often cause death (according to WHO). Acute otitis, for example, occurs at least once in 70% of children under one year and in 91% of children under two years old. All this can be avoided by making pneumococcal vaccines for children. For vaccination to be effective, coverage is 90%. This, in turn, will form in the future “collective immunity”.
In addition, the resistance of pneumococci to antibiotics is increasing. For example, in 2016 resistance to penicillin increased to 40%, and from 38% it is believed that the antibiotic ceases to function and leaves the arsenal of treatment. Now this resistance has decreased, but the sensitivity to amoxicillin is increasing. “Therefore, vaccination is still important to preserve the arsenal of medicines that can treat children,” said Tatiana Kulechenko.
Towards effective vaccine prevention
The ways of solving the problems, which concern vaccine prevention, are, experts are sure. And in many ways to look for them you need, starting with yourself. First, the education of doctors in this field. Today, many medical professionals simply do not have enough knowledge. Therefore, continuous medical education should also concern vaccination issues, and the findings should be justified. To establish their exact causes, you need a special form, while it is not.
In most cases, parents themselves are willing to cooperate. Therefore, doctors need to inform them about the diseases that a child can avoid through vaccination.
Not the least role in this matter is played by the regulatory framework, which must take into account all the nuances. “We are working to create a national guide to good immunization practices. This is an expanded program document, where all the nuances of vaccination will be prescribed for both children and adults in connection with different clinical situations that will allow access to new documents of Rospotrebnadzor, “says Leila Namazova-Baranova.
Unfortunately, until now many experts believe that the main danger for the patient is an inoculation. Marina Fedoseyenko continues many patients, especially hard ones, to protect against this, from a large number of injections.
Parents themselves talk about big side effects, often associating any negative manifestation with the vaccine. However, according to her, today the production of vaccines is at a sufficiently high level – the number of auxiliary substances has been reduced, security control and cleaning have been strengthened. “Vaccinations have become safer. But the danger of preventing vaccine-dangerous infections is still there, “she says.
Of course, the problem of vaccine prevention concerns not only Russia, many countries are trying to solve it. For example, in France (which was badly affected by the measles epidemic simply because not all were vaccinated) this year there is a law on mandatory vaccination – 11 mandatory vaccinations, without which the child will not be taken to school or kindergarten. And in Australia they went even further and canceled social payments for parents who refuse to vaccinate their children. In order not to pass the vaccination, the parents must provide a justified withdrawal of the doctor, otherwise they will not be able to receive the allowance. All this to avoid those diseases that can be prevented.
Even if one looks at vaccination purely from the economic point of view, then, according to the Global Alliance for Vaccines and Immunization (GAVI), it is beneficial – every dollar invested in vaccine prophylaxis brings 18 dollars of investment.
Perhaps this is a small reason to think about whether to get vaccinated or not. And carefully weigh the pros and cons, especially when you are making a choice for your child.