Category Prevention  

All about vaccine-


2017-12-28 00:00:00


vaktsinoprofilaktika.jpg All of vaccine-


I`m not afraid of vaccinations:

If necessary -the shot!

Well, think of it, the shot!

Pricked and -went ...

Sergei Mikhalkov


HISTORY AND PROSPECTS Vaccinal


Protection capabilities of various infectious diseases are studied for a long time.

In ancient China, for example, people at great risk to life, drawn into the nose dried and ground crust smallpox patients.

Starting scientific approach to active immunization was initiated in the XVIII century by Edward Jenner, he became vaccinate people with cowpox to protect them against smallpox. In 1777 he founded in London the world`s first-JMPR privivalny point.

100 years later, Louis Pasteur was the first successful human vaccination against rabies.

Later followers of Pasteur developed methods of specific immunization for the prevention of infectious diseases. All this was made possible thanks to the proposed methodology attenuation Pasteur pathogens -reduce their virulence to cause pathological changes in special environments.

In 1887 in Paris, opened Institute of Vaccines and Sera, which bears the name of a prominent scientist Louis Pasteur.

In 1888, the Russian government has a financial institution and intellectual support in the face of such eminent scientists as Mechnikov, N. Gamaleia, DK Zabolotnyi, GN Gabrichevsky, LA Tarasevich A . Bezredka M., M. Weinberg, E. Wollman.

In 1880-1888 years. Russia had created the world`s first rabies station where carried rabies prophylaxis.

In 1880, the scientist LS Tsenkovsky created the first domestic vaccine against anthrax, which was used until 1942

In 1920, under the leadership Gamaleya in Russia has been improved rabies vaccine.

In 1930, in our country operates a network of institutions under the leadership of anti-epidemic profile Gamaleya, L.A.Tarasevicha, Zabolotny, GN Gabrichevskogo.

Vaccination era of development continues outstanding discoveries polio vaccine MP Chumakov and AA Smorodintsev, tularemia NA Gai, B. J. Elbert, pertussis, diphtheria, tetanus MS Zakharova, anthrax N. H . Ginsburg, typhus M. Majewski, MK Krontovskaya brucellosis PA Vershilova.

The Institute of Epidemiology and Microbiology. Louis Pasteur St. Petersburg created their own schools -researchers led by Academician AA Smorodintsev receive live virus vaccines. Begins mass vaccination infections in the USSR.

By the end of XX century there was the possibility of preventing the development of more than 40 infectious diseases.

Currently, the world produces more than 100 different vaccines. Every year, their range is expanding rapidly developed a combination of drugs, allowing one injection administered over 5-6 and vaccines. Being developed to change modes of administration of vaccines.

Vaccination -guarantee of he althy future


Every year the world of infectious diseases kill about 12 million children. The third part of which 4 million die from diseases that could be prevented through vaccination.

In the XIX century the diagnosis of "measles", "diphtheria", "disease", "lockjaw", considered a death sentence.

Beginning with the XX century, thanks to advances in the field of microbiology, virology and pharmacology incidence of these infections is reduced to almost zero.

The purpose of immunization is to develop specific immunity to infectious disease through artificial creation of an infectious process, which in most cases are asymptomatic or mild in an unvaccinated person for these diseases carry a heavy character, sometimes with fatal consequences.


mechanism of action of the vaccine


In response to vaccination in the body a chain of immunological reactions, which can be divided into three periods.

The first period of latency or "lag phase" continues with the introduction of the vaccine before the first antibody in the blood. During this period, special cells -macrophages -capture the pathogen, its parts or toxins ie antigens digested them and to "represent" on its surface. Submitted thus antigens recognized by circulating blood cells -T-lymphocytes. T-lymphocytes, in turn activates B-cells, which are transformed into plasma cells. Last develop specific protective factors -antibodies which neutralize antigens. Some B cells are long-lived and retain the so-called immunological memory.

The duration of the first latency, the period ranging from several days to 2 weeks, depending on the kind of vaccine, its method of administration and characteristics of the immune system.

The second period is characterized by an increased concentration of specific antibodies in the blood. After introducing some vaccine-specific antibodies appear very quickly, their content in the blood is rapidly increased, which allows the use of these vaccine preparations for emergency prevention in contact with measles, polio, mumps and other infections.

The second period lasts from 4 days to 4 weeks.

The third period begins after reaching the maximum level of specific antibodies when their numbers are starting to decline -first rapidly and then slowly. This decrease occurs for several years.

At the second meeting with the antigen or infection with revaccination immunized child "lag phase" absent as activated memory B cells and a specific immune response occurs more rapidly and different intensity.

Remember vaccinations save your he alth and life!

Today every person has a unique opportunity to protect themselves from serious diseases simple and accessible manipulation -vaccination. Do not miss the chance to be he althy!

To protect the public from dangerous infectious diseases introduced by the National calendar of immunization. In this calendar are infectious diseases, timing and the age at which vaccination. To complete the effective protection of the organism is necessary to complete a full course of vaccination according to this calendar, see table. 1. Parents who have babies about upcoming vaccination report pediatrician. Adults not previously vaccinated -need to see a physician and a full course of vaccinations.

Sometimes identifying any individual characteristics of the specialist is an individual plan survey, preparation for immediate vaccination and vaccination patient.

National calendar of immunization t ab. 1
Age Name vaccinations
Newborns in the first 24 hours of life first vaccination hepatitis B1, 3,4
Newborn 3-7days BCG vaccination against tuberculosis or BCG-M 2
Children: 1 month second vaccination against hep B3 atita children at risk
2 months third vaccination against hepatitis B3 children at risk



3 months second vaccination against hepatitis B4, first vaccination against diphtheria, pertussis , tetanus, poliomielita5

4,5 months second vaccination for diphtheria, pertussis, tetanus, poliomielita5

6 months third vaccination hepatitis B4, diphtheria, pertussis, tetanus, poliomielita5
12 months fourth vaccination against hepatitis B3 children at risk, vaccination measles, rubella, mumps
18 months first revaccination against diphtheria, pertussis, tetanus, polio
20 months second revaccination against polio
6 years revaccination against measles, rubella, mumps
6-7 years second revaccination against diphtheria, tetanus
7 years revaccination against tuberculosis with BCG 2
14 years third revaccination against diphtheria, tetanus, tuberculosis BCG revaccination 2, third revaccination against polio
adults 18 years revaccination against diphtheria, tetanus -every 10 years from the last booster
Children 1 to 17 years, adults 18 to 55 years, not previously vaccinated Vaccination against hepatitis B
Children 1 to 17 years, without a history, not grafted, once grafted rubella;

girls from 18 to 25 years, without a history of not vaccinated previously
rubella immunization
Children attending preschool, students grades 1-11, students of higher and secondary vocational schools; adults working in specific occupations and positions of employees medical and educational institutions, transportation, public utilities and other adults over 60 years old Influenza vaccination
Adolescents and adults under the age of 35 years, without a history of not vaccinated and have no information about vaccinations against measles; contact persons of the hotbeds of the disease, not bolevshie not vaccinated and have no information about vaccinations against measles -No age limit Measles immunization


1 Vaccination against hepatitis B is carried out to all newborns in the first 24 hours of life, including children born to he althy mothers and children at risk, which include infants born to mothers -carriers HBsAg, patients with viral hepatitis B or hepatitis B undergoing in the third trimester of pregnancy without the survey results on markers of hepatitis B, as well as related to the risk groups: drug addicts, in families in which there is HbsAg carrier or patients with acute viral hepatitis B and chronic viral hepatitis further -risk group.

2 Vaccination of infants against tuberculosis conducted by BCG-M; vaccination of infants against tuberculosis with BCG is held in the Russian Federation with incidence greater than 80 per 100 thousand population, as well as the presence of a newborn surrounded by TB patients.

Revaccination is not held against tuberculosis infected with Mycobacterium tuberculosis tuberkulinootritsatelnym children 7 and 14 years.

In regions of the Russian Federation with the TB incidence rate not exceeding 40 per 100 thousand population, revaccination against tuberculosis in 14 years held tuberkulinootritsatelnym children who have not received vaccination at age 7.

3Vaktsinatsiya against hepatitis B by the scheme 0-1-2-12 first dose -in the first 24 hours of life, a second dose -aged 1 month, a third dose -2 months of age, the fourth dose -12 months of age newborns at risk.

4 Vaccination against hepatitis B by the scheme 0-3-6 1 dose -at the start of vaccination, 2 dose -three months after one vaccination dose of 3 -6 months after the beginning of immunization for all children, not related to risk.

5 Polio vaccination is carried out with inactivated polio vaccine IPV triply all children of the first year of life.

Notes:

1. Immunisation under the National calendar of preventive vaccinations vaccines conducted domestic and foreign production, registered and approved for use in the Russian Federation in the prescribed manner in accordance with the instructions for use.

2. For the hepatitis B immunization of infants is recommended to use a vaccine that does not contain the preservative thimerosal.

3. Vaccination against hepatitis B by the scheme 0-1-6 1 dose -at the start of vaccination, 2 dose -1 month after vaccination, 3 dose -6 months after the beginning of immunization for children who have not received vaccinations before the age of 1 year and not related to the risk groups, as well as adolescents and adults not previously vaccinated.

4. Enforced within the national calendar of preventive vaccinations vaccines except BCG, BCG-M can be administered at intervals of 1 month or simultaneously separate syringes at different sites,

5. Violation start date vaccinations carried out their schemes, provided by the National calendar of preventive vaccinations, and in accordance with instructions for use of drugs.

6. Immunization of children born to HIV-infected mothers, carried out within the national calendar of preventive vaccination on an individual schedule of vaccinations, and in accordance with instructions for use of vaccines and toxoids.

7. Immunization of children born to HIV-infected mothers, conducted taking into account the following factors: the type of vaccine live, inactivated, the presence of immunodeficiency considering the child`s age, comorbidities.

8. All inactivated vaccines, toxoids, recombinant vaccines are given to children born to HIV-infected mothers, including HIV-infected children, regardless of the stage of the disease and the number of CD4 + lymphocytes.

9. Live vaccines are given to children with a diagnosis of "HIV infection" after immunological screening to exclude immunodeficiency. In the absence of immunodeficiency live vaccines administered in accordance with the National calendar of preventive vaccinations. In the presence of immunodeficiency administration of live vaccines is contraindicated.

10. 6 months after the initial administration of live vaccines against measles, mumps, rubella, HIV -infected are assessing the level of specific antibodies and in their absence, a booster dose of vaccine administered with preliminary laboratory control of immune status.


Immunizations for adults


Adult National calendar of immunization, acting in our country, provides vaccination against dangerous infectious diseases not only in childhood. It is in order to protect people from adulthood terrible diseases in the Calendar provided vaccinations and the dates for persons of adult age, who need to conduct vaccinations, as against certain diseases must be instilled throughout life with a certain periodicity.

In immunization schedule shall be submitted and approved at the State level changes for additional supplementary immunization of vaccination of the population.

Within the framework of the national project "He alth" and the National calendar of preventive vaccinations you free to make the following vaccinations:

-Diphtheria, tetanus, remember that it is necessary to be vaccinated against them every 10 years,

-If you get the flu in the contingent risk groups, or if you are over 60 years old,

-Hepatitis B in age from 18 to 55 years,

-Rubella if you -woman aged 18-25 years, measles at the age of 35 years -not bolevshie not vaccinated and have no information about vaccinations against measles.

Unfortunately, today there are increasing illiterate publication in newspapers, idle talk ignorant people advocating harm vaccination sow unwarranted fear vaccinations and abandoning them.

The consequences of such movements -increase in the number of cases of tetanus, diphtheria, whooping cough, measles, mumps, rubella.

For opponents of vaccination would like to quote a very significant argument -1974, WHO developed "Expanded Programme on Immunization," aimed at combating 6 major infections: diphtheria, tetanus, tuberculosis, polio, whooping cough and measles. Thanks to the program each year prevented more than 4 million deaths and thousands of children are avoided blindness, mental retardation and other causes of disability.

Variety vaccines


Live vaccines -are produced from living organisms with low virulence. Most of these vaccines contribute to achieving long-term remains at a high level of immunity. Are live influenza vaccine, measles, mumps, yellow fever, etc.

inactivated killed vaccines -is produced by the complete neutralization of bacteria and viruses while preserving their immunogenic properties.

Distinguish between whole-cell, subunit recombinant vaccine and split vaccine.

Tselnovirionnye whole cell vaccine -is prepared by the lyophilized drying at low temperature under vacuum, heat or chemical treatment with formalin, formaldehyde. These include pertussis DTP vaccine, influenza, hepatitis A virus, tick-borne encephalitis, cholera, etc.

Subunit vaccines -contain only the surface antigens, which reduces the content of protein in the vaccine, and consequently reduce its allergenicity. For subunit vaccines include vaccines against influenza, pneumococcal, meningococcal, Haemophilus influenzae, etc.

Split vaccine -made from viruses destroyed. They contain fragmented and purified particles, including surface proteins of viruses and other components. This group includes a vaccine against influenza and other

Recombinant vaccines -are a new generation of immune products produced by inserting into the genome of the virus antigen of the yeast cells. Representative of this group is a vaccine against hepatitis B.

toxoids -made of exotoxins toxins produced by pathogens. They are easy to dose and combined with other vaccines. When administered toxoids produced antitoksigesky immunity. Use of diphtheria, tetanus, staphylococcal toxoids and toxoids against botulism and gas gangrene.

Just on the composition of the vaccine are divided into:

monovaccines containing one antigen,

Associated, or combined with several vaccine antigens, polyvalent vaccines consisting of different strains of a single species of microorganisms.

Any vaccine contains adjuvants: adsorbents, preservatives, emulsifying agents, pH indicators, stabilizers.

Adsorbents adjuvants -insoluble phosphate s alts of aluminum hydroxide or enhance the effect of the vaccine and, thus, significantly increasing strength of the immune response. Sometimes used as adsorbents transport proteins they are part of the diphtheria, tetanus toxoids.

Preservatives suppress reproduction of "outsiders" microorganisms. For this purpose, using thimerosal thiomersal, formaldehyde, phenoxyethanol, phenol and antibiotics neomycin, gentamicin, polymyxin.

Contents of preservatives in vaccines is so low that do not represent any danger to humans.

Emulsifiers are added to improve the dissolution of dry vaccines.

As stabilizers use dextran, sucrose, sorbitol, gelatin, albumin.

As the pH indicator methyl red are often used. You can immediately detect "shift" pH indicator to change color and reject the vaccine preparation.

effective vaccine

Effectiveness of the vaccines included in the National calendar of immunization is confirmed by the following indicators:

Become impervious

By polio -95% of vaccinees;

To Diphtheria -95% of grafted;

To tetanus -95% of vaccinees;

To measles -98% of vaccinees;

To mumps -90% of vaccinees;

Rubella -100% of vaccinees;

For hepatitis B -84-98% of vaccinees, depending on age;

Pertussis -80-90% of vaccinees;

By TB -70-85% of vaccinated children, almost completely protecting them from generalized forms of infection disseminated tuberculosis, tuberculous meningitis.

Vaccine Safety

Guaranteed to talk about full safety of the vaccine does not make sense, because you can not talk about the complete safety of even the most harmless of any subject. But we can talk about guaranteed following:

1. All series of vaccines are tested directly in production and quality control department of the enterprise. In addition, they are monitored for operational protocols and laboratory control sample with the National Authority control -GISCO them. LA Tarasevich. This triple expertise ensures proper quality of the series of vaccines.

2. All vaccines have a degree of reactogenicity, which limited normative documents for drugs.

3. According to the Law of the Russian Federation "On Medicines", approved June 22, 1998 g, the production of medicines, which include immunobiological preparations, carried out by enterprises producing drugs that are licensed to produce them. "

4. In Russia 16 enterprises produced 50 types of vaccines against 28 infectious diseases. Almost all vaccines are held on the main indicators of safety and efficacy requirements of WHO.


Methods of administering vaccines


Vaccination can be carried out in the following ways:

- Orally -dose of the vaccine is instilled in the mouth. After vaccination for an hour not eat or liquid.

- Intranasally -drugs injected into the nasal passages, which contributes to the development of not only common, but also the local immunity.

- On skin skarifikatsionnye optimal vaccination by immunization with live vaccines against the most dangerous infections plague, tularemia, and others. Vaccines are applied to the outer surface of the shoulder, and then dry ospoprivivochnym make incisions through the pen drop.

- Intradermal -the vaccine is carried out in the area of the outer surface of the shoulder live BCG vaccine against tuberculosis.

- Sc -vaccination is used to introduce some live vaccines of measles, mumps and others. Injections are made in the sub-scapular region or area of the outer surface of the shoulder.

- Intramuscularly -vaccination is mainly used for administration of inactivated vaccines, as local reaction in this method of immunization is less pronounced. Children up to 3 years is recommended vaccines administered in the anterolateral aspect of the thigh, children older than 3 years, adolescents and adults -in the region of the deltoid muscle of the shoulder.


Simultaneous administration of several vaccines


According to the Order of Ministry of He alth of the Russian Federation № 229 of 27.06.2001 opportunities simultaneous vaccination using any combination of several vaccines have increased significantly.

There is a legitimate question, what is the reaction of the organism to such a method of vaccination? Our body is constantly faced with a huge number of infectious agents, and each of them produces antibodies specific form, so while the introduction of several vaccines, the number of antibodies begins to grow in geometric proportions, without immunosuppression. Thus, the number of vaccines that can be entered at the same time the child without compromising its immunity is not limited to the same in combined immunization reduced the frequency of reactions and side effects.

Today before the WHO task is to create a combination vaccine that could protect against infections 25-30, was introduced to once inside, in a very early age, and would not cause side effects.


Storage and transport conditions


One important condition for the effectiveness of immunization is the proper storage and transport of vaccines. To preserve all the vaccines used a special system of "cold chain" on 4 levels following vaccine manufacturer organization to the point of use.

Sanitary Rules 3.3.2.1028-95

"Transportation and storage of medical immunobiological preparations"

Most vaccines are stored at a temperature of domestic refrigerators 2odo 8oC. Temperatures below 0 ° C is not allowed to store vaccines, which include adsorbent DTP, DT, AD vaccine against tick-borne encephalitis, because then desorption of antigens and "hlopkovanie" sorbent.

Currently available in the VVM, which when placed in special containers for storing vaccines, changes its color when exposed to elevated temperature.

1. Transportation and storage of vaccines should be administered in cold boxes with VVM or avtorefrizheratornym transport at 0 ° to 8 ° C.

2. Avoid freezing adsorbed preparations.

3. Polio vaccine can be stored at a temperature of minus 20C. Transportation is carried out at t 0 to 8 ° C. Allowed subsequent re-freezing to -20.

4. Yellow fever vaccine should be stored at t ° -12 to -20 C. Transportation produce at t ° from 0 to 8 ° S.

5. Alive dry vaccine against measles, mumps, rubella during prolonged storage at -20 ° C contained.

6. Vaccines should not be stored on the shelves of the refrigerator door, as well as with food.

Before use it is necessary to make sure that it is desired drug, read the label, check the expiration date of the vaccine. The vial was then shaken and ready to eat.

Also closely watching the preservation of the integrity and tightness vaccine package her release form.

Violation of the cold chain can cause the development of allergic complications occurring on the immediate type.

Evidence of the violation temperature storage and transportation of adsorbed vaccines may be the formation of agglomerates deposited quickly.

Innovations in vaccination

DNA vaccines

Embedding gene microorganism causing the infection in the human genome. In this case human cells begin to synthesize them to a foreign protein, and the immune system in response to produce antibodies thereto. These antibodies will capture and pathogen infection if it enters the body of infection. To date, created about 60 such vaccines.


"Edible" vaccine

Such vaccines are produced by plants into whose genome was inserted into the genome of the microorganism causing the disease. In 1992 was created the hepatitis B vaccine using tobacco plants. In 1998, "based on" potato was received vaccine cholera toxin. Rabies vaccines are tested on animals, the production of which requires "participation" tomatoes.


"Vaccines-candy"


The creation of such vaccines was made possible by the unique properties of the disaccharide trehalose with cooling goes into the "candy." Use of this technology will produce "vaccine needle" dissolving a certain rate when administered.


Legislative base


Given the social importance of the fight against infectious diseases in the Russian Federation, September 17, 1998, the Federal Law № 157-FZ "On immunoprophylaxis of infectious diseases", which established the legal norms of the state policy in the field of infectious diseases immunization carried out in order to protect the he alth and sanitary and epidemiological welfare of the population.

Under this law, the State guarantees:

-The availability of preventive vaccinations;

-Free inoculations included in the National calendar of immunization and preventive vaccination on epidemic indications in organizations of state and municipal he alth systems;

-Use for the implementation of effective immunization drugs;

-Implementation of the state quality control effectiveness and safety of these drugs;

-Ensuring the current level of production;

-Social protection of citizens in the event of post-vaccination complications;

-Changes in the National calendar of preventive vaccinations

FEDERAL LAW

On Amendments to Article 9 of the Federal Law "On immunoprophylaxis of infectious diseases"


Adopted by the State Duma on June 14, 2006

Federation Council approved June 23, 2006

Amend paragraph 1 of Article 9 of the Federal Law of 17 September 1998 N 157-FZ "On immunoprophylaxis of infectious diseases" Laws of the Russian Federation, 1998, N 38, Art. 4736 modified to read as follows:

"1. National calendar of immunization includes preventive vaccination against hepatitis B, diphtheria, pertussis, measles, rubella, polio, tetanus, tuberculosis, mumps and influenza. The national calendar of preventive vaccinations are set dates for these vaccinations and categories of people subject to compulsory vaccination.

Dates of preventive vaccination against influenza and categories of people subject to compulsory vaccination, set annually based on the predicted incidence. "

President of the Russian Federation V. Putin Kremlin, Moscow, 30 June 2006



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