Vaccination from pneumococcal infection in children: reaction and feedback

According to WHO, pneumococci often become the causative agents of bacterial infection in humans. Today, statistics are such that this microorganism causes death for 1.2 million people during the year. Of this number of people, more than 40% are children under the age of 5. Of the so-called community - acquired pneumonias, whose number in Russia reaches one and a half million a year, up to 75% of cases of adult diseases are initiated by these microorganisms - pneumococci. As for children in the age group up to 5 years, here the percentage of participation in this pneumococcal process reaches 90.

All children have otitis with varying degrees of severity. About 30-35% of all cases of development of acute otitis media of the middle ear in small patients are initiated by pneumococci. These diseases are characterized by a special degree of severity, proceed with a high probability of perforation of the tympanic membrane. It is often possible to hear from specialists about the development of orthogenic intracranial complications, to get rid of which it is often necessary to carry out tympanostomy. The process is a surgical procedure for the purpose of sanitizing the middle ear cavity and restoring the position of the ossicles of the middle ear.

Vaccination from pneumococcal infection in adults and children can significantly improve the situation with the incidence of this initiator.

Pneumococcal infection: who is who?

Pneumococcus is one of the components of the normal microflora of the upper respiratory organs in a healthy person. Up to 70% of the total population are carriers of one or several species of this microorganism. Among children, the level of this "neighborhood" is higher than that of adults. The maximum level of support for those who live, work and grow in groups (preschool and educational institutions, work collectives, etc.).

This microorganism has in its composition a polysaccharide capsule, which is able to suppress the development of immunity in children under the age of 2 years. Today, science is aware of the existence of 84 subtypes of pneumococcus. With the development of the era of antibiotics from a rather innocuous microbe, pneumococcus has become a fairly aggressive microorganism, resistant to the bulk of traditional antibacterial medicines. The level of resistance to penicillin today is about 50%, to levomycetin and tetracycline - 30%. Since the penicillin group of antibiotics is sufficiently wide, all of them will not be effective when infected with such an organism as pneumococcus. Vaccination in such cases is the only opportunity to win with the least losses in the fight against this microorganism. It should be said that the disease usually develops quickly enough (usually no more than 3 days), and there is no time for research into determining the degree of sensitivity to certain types of antibiotics.

At present, the issue of pneumococcal resistance to antibiotics is becoming increasingly important, it is becoming an increasingly urgent problem.

What vaccines are used?

Currently in Russia, two types of vaccines are used to carry out such a procedure as vaccination against pneumococcal infection: polysaccharide and protein conjugated formulations.

Of the first group (polysaccharide), the most known vaccine is Pneumo-23 (sanofipaster). The solution is a mixture of 23 purified polysaccharides from a similar number of serotypes of pneumococcus. To this group of serotypes, 90% of strains from blood and the overwhelming majority of strains detected in Russia can be reliably attributed. Now at the registration stage there is another similar vaccine - Pnevmovax-23.

Of the type of conjugated vaccines in Russia, an official registration has been made and Prevenar-7 is currently in use. Seven serotypes, included in its composition, unite 87% of pneumococcal isolates of children who have recovered from the USA and some other countries. Due to the fact that the serotype pattern in the US and Russia is almost the same, it can be assumed that Prevenar-7 will also be effective in Russia, as in the US.

Age limits for pneumococcal vaccination

"Pnevmo-23" for vaccination is administered once, subcutaneously or intramuscularly. You can vaccinate from the age of 2 years, dosage - 0,5 ml. You can not re-vaccinate before 3 years after the previous injection.

Vaccination against pneumococcal infection for children using "Prevenar-7" is possible from 2 months of age. Vaccination is performed in parallel with DTP (in 3 stages). Revaccination can be given to a child aged 1.5 years. However, this vaccine has several other vaccination scenarios. There is information on the effectiveness of vaccination in 2 stages (during the 2nd half of the year) with subsequent revaccination. Also schemes with vaccination in 2 stages during the second year of life are possible, and once for a period of 2 to 5 years.

Level of protection of polysaccharide vaccines

High efficiency in the prevention of pneumonia showed vaccination against pneumococcal infection. Reviews of statistical agencies speak about 80% protection. Specialists-epidemiologists recommend that vaccination with the use of "Pnevmo-23" people aged 18 to 21 years in large organizations and teams (for example, in army units) is recommended. After a certain time period (from 2 months to 5) after vaccination, one can expect a decrease in the incidence of acute respiratory infections more than 2 times, bronchitis - up to 13 times, pneumonia - no less than 6 times. With complicated pneumonia, meningitis and other forms of pneumococcal bacterial infection, the percentage of efficacy ranges from 56 to 81.

The level of effectiveness of such a procedure as vaccination against pneumococcus is influenced by the age of the vaccinated. In the age group under 55, this indicator was 93%, from 55 to 64 years, the efficiency dropped to 88%. The level of protection against pneumococcal age 65 to 74 - 80%, over 75 years of age - 67%.

For patients suffering from cardiovascular and broncho-pulmonary diseases, the level of protection with polysaccharide vaccines (in particular, Pneumo-23) is approximately 69% (as in healthy people). A high degree of effectiveness is shown by such vaccines when used in children's groups. Good indicators are shown by Pneumo-23 in combination with influenza vaccines.

Regarding another vaccine registered in Russia - Pnevmovax-23 - one can say that its effectiveness for people with diabetes is 84%, with ischemia 73%. For patients suffering from heart failure, this percentage is 69, with problem lungs and asthma - 65. For people in the age group over 65 years, the effectiveness of the drug tends to 75%.

The level of protection of conjugated vaccines

With the use of a conjugated vaccine, the inoculation against pneumococcal infection showed a high degree of effectiveness to children. Significantly decreased not only the number of hospitalizations of children with pneumonia of any origin, but also the frequency of outpatient visits to the doctor. The situation with the incidence of pneumococcal meningitis is significantly improving .

Pneumococci are quite resistant to penicillin. Prevenar-23 is able to protect a person from strains with intermediate and high resistance by 80-100%. In addition, this vaccine with a high degree of effectiveness is combined with influenza.

According to the World Health Organization, the use of this conjugate vaccine for a procedure such as vaccination against pneumococcal infection in children (all in 72 developing countries) can prevent up to 407,000 deaths annually.

Possible reactions to grafting

Vaccination against pneumococcal infection specialists are allowed to produce at any time of the year and combine with any other vaccines (an exception is made only for BCG). On the introduction of both types of vaccines against pneumococcus, certain reactions from the human body are possible. On "Pnevmo-23" in some patients, a local reaction may appear in the form of redness, soreness. The reaction intensity is usually weak and can last up to 48 hours. Vaccination from pneumococcus to the child (reviews of health workers and parents are solidary on this issue) in some cases (not often) can cause the appearance of rash, soreness in the joints.

There are cases when patients with thrombocytopenic purpura (in a calm phase) after a period of 2 to 14 days developed relapses lasting up to 2 weeks. It is very rare to hear about anaphylactic conditions.

The vaccine "Prevenar" is characterized by good child tolerance. Such a vaccination against pneumococcal infection complications (it is a question of any serious problems), as a rule, does not cause. However, local reactions often appear in the form of irritability, sleep disorders, localized redness and swelling, and increase in body temperature to 38˚C. In a small number of children (about 5%), the temperature can rise above 39˚C.

Are there any contraindications for pneumococcal vaccination?

There are no general or specific contraindications for vaccination for any of the vaccines, except that the response to vaccination of pneumococcal infection the previous time. There are separate recommendations of immunologists about the use of "Pnevmo-23" not less than 10 days before the course of immunosuppressive therapy begins. Non-observance of these indications can stimulate a decrease in the level of antibodies.

Vaccination of pregnant women medical workers are allowed only in the last trimester. However, without extreme necessity, it is recommended to abstain from this procedure.

Incidence of pneumococcal infection: risk group

Refusal of such procedure, as an inoculation from an pneumococcal infection? Complications for certain groups of people can provoke greater than its conduct. Specialists recommend to be vaccinated to people over 65 years of age. In a number of developed countries, the vaccination of this age group has been raised to the rank of mandatory procedure.

Should be vaccinated against pneumococcus weakened, often ill and come under hospitalization people suffering from diabetes, chronic forms of bronchitis, insufficiency in the sphere of cardiac and respiratory activity, liver functioning.

It is necessary to inoculate pneumococcus (reviews of health workers - to that testimony) to people with weakened immune system. Here, at risk, patients who underwent surgical intervention for the removal of the spleen, suffering from nephrotic syndrome, sickle cell anemia. Also, this group includes people who have leakage of cerebrospinal fluid.

And, of course, do not forget about the growing generation. It is recommended to vaccinate frequently ill children (including those infected with tuberculosis) entering large groups (nursery, kindergarten, school). Since the age of 2, pediatricians are advised to vaccinate small patients suffering from liquorrhea, asplenia, insufficiency of complement components that have undergone cochlear implantation.

Vaccination from pneumococcal infection for children is able to significantly reduce the incidence of morbidity and reduce mortality from this formidable microorganism.

Opinion of medical workers, patients, parents

Opinion of children's doctors, medical workers in many other areas of medicine on this issue is unequivocal - vaccination against pneumococcal infection (reviews about which from simple residents are quite ambiguous) - is mandatory. Physicians consider this method of protection to be the most effective in combating the mass of diseases of a variety of etymologies. It is always easier and less expensive to prevent the development of the disease than to take medications (not one, but, as a rule, several and not the most innocuous) to cope with both the infection itself and its consequences and complications.

Among parents, the pediatrician's persistent pediatric recommendations for vaccination against pneumococcus do not always find a response. A simple person, not a doctor, thanks to the media, "knows for sure" that there are too many strains of pneumococcus, and whether the vaccine the doctor recommends is a big question. Although the vast majority of parents still tend to listen to the opinion of a specialist and be vaccinated.

From time to time you can hear that the vaccination against pneumococcal infection, complications after which were to increase the temperature, was not effective - the child still fell ill. In such cases, it is worth paying attention to the intensity of the disease. If the child coughed, he had a temperature of up to 38 degrees, and he was ill for 7 days - this is understandable. And without vaccination, the consequences could be significantly worse: bronchitis, pneumonia, hospitalization, many not the lightest drugs and at least 21 days of treatment.

Summarizing

Pneumococcal infection is leading worldwide in the development of ARI, broncho-pulmonary diseases, etc. And today, in a modern high-tech century, the mortality from this microorganism is quite high. Therefore, from the parents' side, vaccination from pneumococcus to a child (feedback - not the information that should be guided in such cases) is an opportunity to protect your child, to prevent the development of serious diseases under false, unreasonable grounds and pretexts.