At what age is Akds performed? Composition of the DPT vaccine. Should I get vaccinated?

Good news: There are improved modern DTP vaccines, preparations in which the pertussis component is purified and is no longer afraid of complications. "Infanrix", "Pentaxim" (used from three months) and others, well tolerated by children. Read the instructions, consult your doctor, draw your own conclusions.

Doctors plan to ban the classic DPT vaccine with an unrefined pertussis component.

Contraindications

During the acute course of an infectious disease, with progressive diseases of the nervous system, a history of afebrile convulsions, or the development of a strong general reaction to the previous administration of DTP vaccine (increase in temperature in the first two days to 40 degrees and above), the child is contraindicated. In this case, the baby can only be vaccinated with the “lite” ADS vaccine - against diphtheria and tetanus.

By the way, the same applies to pregnant women. If future mom I have not been vaccinated against tetanus and diphtheria (whooping cough does not count, pregnant women are not vaccinated against it!) for more than ten years, this vaccination is very important at the stage of preparation for childbirth.

If your child is allergic to egg white, then vaccination against measles and rubella is also contraindicated for him. Strains of these viruses are cultivated in chicken embryo cells

Children who have had acute diseases, are vaccinated no earlier than four weeks after recovery, and mild respiratory diseases (rhinitis, mild hyperemia of the pharynx) - after 2-3 weeks. Stable manifestations allergic disease, for example, localized skin manifestations, are not considered a contraindication to vaccination. DTP for diathesis should be done without fear.

If there is no medical exemption from vaccinations, the child is prescribed it from the age of 3 months to the age of 3 years 11 months.

Side effects after DTP vaccination

Even a purified vaccine often causes illness.

Doctors warn parents that the child may have a similar reaction to the DPT vaccine: in the first two days, short-term general reactions may develop ( elevated temperature after DTP, malaise) and local (a child after DTP vaccination may complain of soreness, hyperemia, swelling). Complications may develop: convulsions, allergic reactions (urticaria, polymorphic rash, Quincke's edema). But according to statistics, there are thousands of times more cases of convulsions due to whooping cough than as a complication after vaccination against it. But it is up to parents to decide whether or not to vaccinate, wisely weighing the risks in both cases. A child’s reaction to DPT can be (and most often this is what happens) completely mild, without noticeable deterioration in well-being. The reaction to DPT revaccination is usually either the same as to the first vaccination, or even easier.

What to do? An elevated temperature should be brought down with antipyretic drugs (paracetamol, ibuprofen), without waiting for it to jump to the upper levels. The situation here is different than with a cold: a high temperature as a reaction to a vaccination does not mean that the baby’s immunity is fighting the infection. It means that the body is having a hard time and needs help.

Adsorbed (purified) pertussis-diphtheria-tetanus vaccine (in the Russian Federation called DPT) is an effective means of immunization. Helps prevent complications of diseases such as death or disability. However, despite her obvious benefit, can cause a number of unwanted and unpleasant manifestations, which are minimized by a competent approach to vaccination, taking into account possible severe reactions of the body and the availability of ways to relieve pain.

DTP vaccination protects against dangerous diseases, at the same time, a low-quality vaccine can provoke the development severe consequences

Russian vaccine DTP

DTP "NPK Microgen" of the Russian Federation is approved by WHO and is effective means for vaccination. The DPT vaccine contains toxoids of infectious agents. Persons with reduced immunity or immunodeficiency are at risk of experiencing negative post-vaccination reactions or getting sick. An undeniable advantage domestic vaccine is its low cost.

The preservative in the domestic DTP vaccine is merthiolate (thiomersal), which is prohibited in other countries. It is added to protect the vaccine from contamination pathogenic microorganisms, widely used in perfumery. It has been proven that the exclusion of mercury-containing substances in no way affects the likelihood of neuropsychiatric disorders.

Imported analogues

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The following names of the following DTP vaccines of various compositions are widely known:

• Infanrix, Infanrix Hexa (poliomyelitis, hepatitis B and Hib included): manufacturer - GlaxoSmithKline.
• Pentaxim: manufacturer - Sanofi Aventis Pasteur, France. Protects against 5 diseases - whooping cough, tetanus, diphtheria, polio and Hib infection.

The produced foreign analogues of DTP are basically identical. They do not contain the prohibited formalin and merthiolate. They are distinguished by cell-free technology for creating an anti-pertussis component, so post-vaccination reactions are much less common. Imported vaccines contain additional components. They give a less pronounced immune response of the body than Russian drug, but as vaccination continues, such differences virtually disappear.

Of no small importance is the release of foreign vaccines in convenient single-dose kits. They are stored in a dry, dark place at a temperature of 2 to 8 degrees and used immediately. They cannot be frozen.

Infanrix and Infanrix Hexa

The Infanrix vaccine from the English company GlaxoSmithKline has been registered in the Russian Federation since 2004. It has the lowest reactogenicity of all imported drugs. It is considered the safest, cleanest and hypoallergenic product. Sold exclusively in pharmacies and vaccination centers (in combination with the service).

Post-vaccination manifestations are standard, but occur more easily. The most dangerous of them - anaphylaxis or Quincke's edema - occur within half an hour after the injection and require prompt assistance. To avoid negative manifestations, need to:

• regularly ventilate the room, ensure high air humidity (at least 70%);
• observe drinking regime;
• consult a doctor if your body temperature is above 38.5 °C or if it increases for a long time;
• call urgently emergency assistance if hyperthermia has reached 40 °C or higher.

Contraindications for use: encephalopathy of unknown etiology, thrombocytopenia, bleeding disorders, sensitivity to active substances after the previous vaccination. Patients with immunodeficiency may not develop the necessary immune response.

Infanrix Hexa differs in that the drug contains an anti-hepatitis component. Its use is advisable if the dates of vaccination against hepatitis B and DTP coincide or if there is an individual scheme.

The Hexa package also contains a suspension against hepatitis B. The possibility of joint simultaneous vaccination allows you to reduce the number of vaccinations and not worry about the compatibility of individual components.

Tetraxim and Pentaxim

Let's look at what improved vaccines exist. Tetraxim manufactured by Sanofi Pasteur contains an additional anti-polio component. The quality of the drug is quite high, which eliminates the occurrence of unwanted reactions. In the Russian Federation, vaccination of children against polio coincides with DPT, so it is convenient to use Tetraxim: three injections of Tetraxim can replace 6 traditional DTP.

Pentaxim, as the name suggests, protects against 5 diseases (more details in the article:). It contains additional components against hemophilus influenzae and polio.

Pentaxim is not used for:

• hypersensitivity to its components;
• encephalopathy;
• severe reaction (hyperthermia, prolonged crying, convulsions) for 2 days after the previous management of the pertussis component;
• chronic diseases in the acute stage;
• during ARI even with slight hyperthermia.

Which vaccine should I choose?

The Russian vaccine can be replaced by paid analogues of foreign-made DTP. Their main advantage is the special production technology described above, which minimizes the load on the body, but at the same time provides the expected reaction immune system.

Another advantage of imported vaccinations is their convenience:

• comprehensively form immunity to several infections at once;
• the drug is poured into disposable syringes, ready for use.

According to the results of studies of DTP types, all of these vaccines are equally effective. However, imported vaccines are preferable for two reasons:

1. Combination. This significantly reduces the number of visits to a medical facility and the number of injections.
2. Convenient release form in ready-made kits. Syringes, needle, dosage - everything is selected so that the injection itself causes as little discomfort as possible.

The most important criterion is safety. If the doctor is convinced that the child’s body is weakened, ADS is prescribed instead of DPT.

Which vaccine is better is a difficult question to resolve. If you have the funds, you can choose a more expensive one. However, a high price is not a guarantee of quality. Not every family can afford to pay as much as 1 injection costs, so in most cases preference is given to the domestic vaccine.

Possible reactions to vaccinations and the care required for the child

There are adverse reactions to DPT: swelling at the injection site and hyperthermia. DTP is not dangerous drug for the child’s health, but on the contrary, a means of forming one’s own reliable, sustainable and quality protection from a number of severe infections.

Immediately after the injection, it is recommended not to leave the area for 20-30 minutes. medical institution so that the doctor has the opportunity to provide the child with full emergency care in the event of a severe allergic reaction. It is also better to reschedule activities such as walks, water treatments and massages. Over the next 3 days, it is necessary to pay close attention to the child’s behavior and condition and monitor his temperature. Any symptoms that appear later than 3 days, as a rule, are not consequences of vaccination.

The expected predicted reactions after DTP vaccination include the following:

• Increased body temperature from 1 to 3 days, so you need to prepare antipyretic drugs in advance. If the temperature before bedtime does not exceed 38°C, then it is better to give the child a suppository (candle). If the temperature exceeds this threshold, it is recommended to use anti-inflammatory drugs in the form of syrup (Ibuprofen, Nurofen, Nimesulide).

• Soreness, redness and swelling at the injection site. To eliminate this symptom, it is usually recommended to use an alcohol compress.
• Impaired functioning of the limb in which the injection was given, its pain or lameness. In this case, it is recommended to massage the leg and wipe it with a warm towel.
• Headache, malaise, general weakness.
• Indigestion, diarrhea. To prevent such unpleasant reactions, it is not recommended to feed the child for 1.5 hours before and after vaccination. When diarrhea occurs, use Smecta, Enterosgel, activated carbon;
• Prolonged crying, moodiness, irritability, sleep disturbance.
• A cough can manifest itself as a reaction of the body to the whooping cough component. Usually this symptom goes away on its own within 3-4 days and does not require treatment. medicines. If a child coughs for a week, this may be a sign of an infectious disease not related to vaccination.
• Decreased appetite or complete failure from food.
• The rash goes away on its own after a few days. For severe itching, it is recommended to use antihistamines.

To form lasting immunity, vaccinations must be repeated periodically. After each subsequent injection general reaction the body becomes less pronounced, however local symptoms appear more strongly.

Is it necessary to get this vaccination?

The population immunization program provides for a vaccination schedule, which is designed so that with age the child develops sufficient strong immunity against various pathogens. If you deviate from this schedule, no one can guarantee protection child's body from these infections by 100%.

Whatever vaccine is preferred, domestic or imported, you need to check the authenticity of the drug and its storage conditions. The high cost of imported products significantly affects the frequency of their choice by parents.

There is an extreme approach to vaccination: parents completely refuse to vaccinate their children; they find many arguments why their child should not be vaccinated, citing the fact that pure form These diseases no longer occur. This position of adults is unacceptable. The choice of vaccines in Russia is quite large; you can choose another effective drug to replace the one offered with minimal side reactions.

DTP is one of the most serious injections with frequent negative post-vaccination reactions, regardless of the composition of the vaccine. Only children examined the day before receive DTP and must be closely monitored over the next 3 days. When negative reactions You should immediately contact a medical facility. The final decision whether to vaccinate a child with DPT with the proposed drug or not is made by the parents. However, you should not be guided only by personal prejudices - it is important to study the issue together with your doctor.

DTP is a preventive vaccination, which stands for adsorbed pertussis-diphtheria-tetanus. This drug is a combination drug and is used to combat, respectively, diphtheria, whooping cough and tetanus. It is made from toxoids of these bacteria and from other antigens. The peculiarity of tetanus and diphtheria is that the development of the disease, its course and complications are associated not with microbes, but with its toxins. In other words, to avoid a severe form of the disease, it is necessary to create immunity in the body against the toxin, and not against the virus as a whole. Thus, the vaccination is designed to form antitoxic immunity of the body.

The DTP vaccine is classified internationally as DTP.
A foreign analogue of the DTP vaccine is Infanrix. Both combination vaccines are whole cell, i.e. contain killed (inactivated) cells of the pathogens of whooping cough (4 IU), tetanus (40 IU or 60 IU) and diphtheria (30 IU). This dosage of tetanus and diphtheria toxoids is due to the need to achieve the required intensity of the reaction of the child’s immune system, which is still imperfect and is just being formed.

Diphtheria, tetanus and whooping cough

- Diphtheria. It's spicy infectious disease, caused by Corinebacterium diphtheriae (Corinebacterium bacteria), transmitted by airborne droplets; characterized by lobar or diphtheritic inflammation of the mucous membranes of the pharynx, nose, larynx, trachea, and less commonly other organs with the formation of fibrinous films and general intoxication. When only the skin is involved, it is known as cutaneous diphtheria, and is probably caused by a non-toxic strain. If the toxic strain affects mucous structures in the body, such as the throat, diphtheria becomes life-threatening.

- Tetanus. Tetanus is a disease that causes severe muscle contractions and seizures. It is caused by a powerful toxin released by the Clostridium bacterium. These are anaerobic bacteria, which means they survive without oxygen. People can become infected with these dangerous bacteria through skin wounds. Tetanus leads to fatal outcome in 15-40% of cases.

- Whooping cough. Whooping cough was a very common childhood illness throughout the first half of the 1900s. The disease is very easily transmitted from one person to another, and it is most severe in infants. The incidence has increased recently, to 25,827 cases reported in 2004, but decreased to 10,454 in 2007. Vaccine benefit softens towards adolescence. Thus, more cases are seen in adults. Such cases may be significantly underestimated. The younger the patient, the higher the risk of developing severe complications, including pneumonia, seizures, severe cough and even death. Children younger than 6 months are at particular risk because even with vaccination, their protection is incomplete due to their immature immune systems.

Vaccinations against diphtheria, tetanus and whooping cough

Primary vaccination. Vaccination against diphtheria, tetanus and whooping cough has been routinely given to children since 1940. The standard vaccines now are DPT. DTP uses the “pertussis component” form, which consists of one weakened pertussis toxoid. DTP is just as effective, but has less side effects than previous vaccines (road accident).

Protection against diphtheria and tetanus lasts about 10 years. During this period, the vaccine (Td) may be given against tetanus and diphtheria. The Td vaccine contains a standard dose against tetanus and a less potent dose against diphtheria. It does not contain whooping cough components.

The childhood whooping cough vaccine may begin to lose its effectiveness after about 5 years, and some previously immunized adolescents and adults may develop a mild form of the disease. Now two pertussis-containing accelerators are approved for adolescents and adults.

Types of DTP vaccine

Basically, as part of vaccination on the territory of the Russian Federation, tetanus adsorbed liquid is used - DTP produced by the Federal State Unitary Enterprise NPO Microgen of the Ministry of Health of the Russian Federation, Russia.

As mentioned earlier, foreign analogue The domestic DTP vaccine is Infanrix™, produced by GlaxoSmithKline Biologicals S.A., Belgium. It is presented in the following forms

Infanrix IPV (analogue of DTaP + inactivated polio vaccine). Whooping cough, diphtheria, tetanus, polio.
- Infanrix Penta (analogue of DTaP + hepatitis B + inactivated polio vaccine). Whooping cough, diphtheria, tetanus, hepatitis B, polio.
- Infanrix Hexa (analogue of DTaP + hepatitis B + inactivated polio vaccine + Hiberix), instructions. Whooping cough, diphtheria, tetanus, hepatitis B, polio, Haemophilus influenzae type b infection.

The following analogues of DPT are drugs produced by Sanofi Pasteur S.A., France:

D.T.KOK (analogue of DPT). Whooping cough, diphtheria, tetanus.
- Tetraxim (analogue of AAKDS). Whooping cough, diphtheria, tetanus.
- Pentaxim (analogue of DTaP + inactivated polio vaccine + Act-HIB), instructions. Whooping cough, diphtheria, tetanus, polio, Haemophilus influenzae type b infection.
- Hexavak (analog of DTaP + hepatitis B + inactivated polio vaccine + Act-HIB). Whooping cough, diphtheria, tetanus, hepatitis B, polio, Haemophilus influenzae type b infection.

Monovalent (single-component) vaccines against whooping cough have been developed abroad and in Russia, but until now they have not been included in the daily practice vaccinations, due to availability combination vaccine and a number of conditions limiting their use.

In Russian pharmaceutical market The Bubo-Kok vaccine is presented - a vaccine against whooping cough, diphtheria, tetanus, and hepatitis B. Its manufacturer is the Scientific and Production Company Combiotech CJSC.

DTP schedule for children

There is a vaccination schedule, which in Russia is determined national calendar preventive vaccinations

All children under 7 years of age should receive the DTP vaccine. Vaccinations are done as follows:

Infants receive a series of three vaccinations at 2, 4, and 6 months of age. The only reason to postpone vaccination for now in children with suspected neurological problems is to clarify the situation. Children with resolved neurological problems can be vaccinated (this vaccine should not be provided?? later than first the child’s birthday – i.e., when he is no more than 1 year old);
- the fourth dose is administered from 15 to 18 months, 12 months after the third vaccination ( DPT revaccination). Infants with high risk- For those exposed to whooping cough outbreaks, this vaccine may be given earlier;
- If the child was vaccinated later than 3 months, then vaccines with a pertussis component are administered to him 3 times with an interval of 1.5 months, and the fourth time - 1 year from the date of the last vaccine administration.
- Subsequent revaccinations in Russia are provided only against tetanus and diphtheria. They are carried out at 7, 14 and then every 10 years throughout life.

The use of the domestic DTP vaccine has some peculiarities. According to current instructions, this vaccine can only be vaccinated in children up to 4 years of age. When the child reaches 4 years of age, an unfinished course DPT vaccinations is completed with the use of the ADS vaccine (up to 6 years) or ADS-M (after 6 years). This restriction does not apply to foreign DTP (Infanrix).

If a child has moderate or severe health problems or has recently had a fever associated with an illness, vaccination should be delayed until he or she has recovered. Colds and other lungs respiratory infections should not be a reason for delay. Parents should not be overly concerned if the interval between doses is longer than recommended. Immunity from any previous vaccination is maintained, and the doctor does not have to start a new series from scratch.

All adults who have been fully vaccinated, either as children or as adults, should have Td boosters at least every 10 years. If they have not received a DTP vaccination after age 19, they will need to receive it before the next one, but not after. Adults who have regular contact with infants under 12 months of age should receive a disposable Td booster.

Adults who have not previously been vaccinated against diphtheria, tetanus, and whooping cough at any age:

Must receive a three-dose series of tetanus, diphtheria, and pertussis (DTP) vaccines;
- a woman, if pregnant, should receive the DTP vaccine after 20 weeks of pregnancy;
- Any patient who requires medical attention for any wound may be a candidate for the tetanus vaccine. Wounds that place patients at high risk for tetanus are puncture wounds or contaminated wounds. Some considerations regarding tetanus vaccination for the wounded:
- vaccination is necessary if the last dose was given 5 or more years before the injury;
- children under 7 years of age are usually given DTP if they are not fully vaccinated;
- Patients who have not completed the primary tetanus vaccination and people who have experienced an allergic reaction to previous tetanus boosters may be given immune globulin.

Preparing for DPT vaccination

DPT vaccines can provoke numerous adverse drug reactions. This is explained as high content antigens, and the reactogenic properties of the vaccine components. For this reason, before vaccination with the DTP vaccine, medicinal preparation of the child is recommended.

Without exception, all DPT vaccines should be administered while taking antipyretics. This allows, on the one hand, to prevent a possible uncontrolled increase in temperature, on the other hand, to eliminate the risk of temperature cramps in young children that occur against a background of high temperature, regardless of what caused it. In addition, all antipyretic drugs have anti-inflammatory and analgesic properties, which is especially important in preventing pain at the injection site, which can be quite severe. In addition, this will help protect the child from pronounced edema at the site of vaccine administration.

If your child has allergic disorders such as atopic dermatitis or diathesis, the use of antiallergic drugs is also recommended.

Neither antipyretics nor antihistamines affect the development of immunity, i.e. effectiveness of vaccination.

When choosing an antipyretic drug for your child, pay attention to the following aspects:

When purchasing medications, pay attention to this form release was suitable for your child’s age;
- Make a choice in favor of rectal suppositories, since flavorings in syrups can provoke additional allergic reactions;
- Administer antipyretics in advance, without waiting for the temperature to rise after vaccination. The temperature may rise too quickly to be controlled;
- Never give your child aspirin (acetylsalicylic acid)!
- If the maximum permissible dosage antipyretic is exceeded, but the effect is not achieved, then switch to a drug with another active substance(for example, from paracetamol to ibuprofen);
- If a child had no reactions to the previous vaccination, this does not mean that there will be no reaction to the subsequent vaccination either. Adverse reactions are more common after repeated vaccinations, so do not neglect preparation for vaccination;
- In any in doubtful cases consult your doctor. Feel free to call " ambulance";
- If the vaccination was given in paid center vaccinations, do not hesitate to take the doctor’s contact information in case of development adverse reactions.

An approximate scheme for preparing a child for vaccination with DTP vaccines:

1-2 days before vaccination. If the child has diathesis or other allergic disorders, start taking antihistamines in a maintenance dosage;

After vaccination. Immediately after returning home, give your child a suppository containing an antipyretic. This will prevent some reactions that develop in the first hours after vaccination (prolonged crying, swelling at the injection site, etc.). If the temperature rises during the day, introduce another suppository. A candle at night is a must. If the baby wakes up at night for feedings, check the temperature and if it rises, introduce another suppository. Continue taking your antihistamine.

Day 1 after vaccination. If the temperature is elevated in the morning, introduce the first suppository. If the temperature rises during the day, introduce another suppository. You may need to introduce another suppository at night. Continue taking your antihistamine.

Day 2 after vaccination. Use antipyretics only if the child has a fever. If its increase is insignificant, you can refuse antipyretics. Continue taking your antihistamine.

Day 3 after vaccination. The appearance on the 3rd day (and later) of an increase in body temperature and reactions at the vaccination site is not typical for inactivated vaccines. If the temperature does rise, you should look for another reason (teething, acute respiratory infections, etc.).

Before using any medications exact dosages, dosage regimens, list and names of specific medications can and should be recommended only by the attending pediatrician who directly examined your child. It is important. Don't self-medicate!

Side effects of DTP - vaccines against diphtheria, tetanus and whooping cough

Allergic reactions. In rare cases, a person may be allergic to diphtheria, tetanus and whooping cough. Parents should tell their doctor if their children have allergies. Newer DTP vaccines may carry a slightly greater risk of an allergic reaction than older DTP vaccines. Children with serious reactions should not receive additional vaccinations. A rash that occurs after a dose of DTP does not have special significance. In fact, this usually does not indicate an allergic reaction, but only a temporary immune reaction, and usually does not recur subsequently. It should be noted that in response to the DTP vaccine there was not a single case of death from allergic reactions, even severe ones (anaphylactic).

Pain and swelling at the injection site. Children may feel pain at the injection site. In some cases, the small lump or bump may remain in place for several weeks. Using a clean, cool washcloth over any swollen, hot, or red area may help. Children should not be covered or tightly wrapped in clothing or blankets. The risk of swelling of the sore or the entire arm or leg increases with subsequent injections - particularly with the fourth and fifth doses. Whenever possible, parents should require that their children receive the same brand of vaccine each time to reduce the risk of side effects.
- Fever and other symptoms. After the injection, the child may develop: mild fever, irritability, drowsiness, loss of appetite.

Conditions that should cause concern:

Very high temperature (over 39°C), which causes seizures in children. Such cases should be reported to your doctor immediately. New DPT vaccines significantly reduce the risk of this side effect compared to older vaccines. Although such fever and associated convulsions are rare and have almost no long term consequences. Relapses after subsequent vaccination are very unlikely;
- fever that develops 24 hours after vaccination, or fever that persists for more than 24 hours, most likely caused by causes other than vaccination;
- hypotension and unresponsiveness (HHE). HHE is an uncommon response to the pertussis component and occurs within 48 hours of injection in children under 2 years of age. The child usually develops a fever, becomes irritable, and then becomes pale, weak, lethargic, and taciturn. Breathing will be shallow and the baby's skin may appear bluish. The reaction lasts on average 6 hours and, although it looks scary, almost all children soon return to normal. normal condition. This is a rare side effect after receiving the DTP vaccine, but it can happen;
- neurological effects in the whooping cough component. Of concern are several reports of permanent neurological damage that have occurred after children have been vaccinated. Symptoms: attention deficit disorder, learning disorders, autism, brain damage (encephalopathy) and sometimes even death.

It is well known that diphtheria and tetanus components do not cause adverse neurological effects, so some people suspect a whooping cough component. However, many large studies have found no causal relationship between neurological problems and whooping cough vaccination. Studies of the new DTP indicate that it is not completely safe today.

Studies show that in cases where neurological problems were closely related to vaccination, high fever was observed when not immunized.
Children with neurological disorders may also be at risk for a flare-up of symptoms 2 or 3 days after vaccination. Such a temporary worsening of their illness rarely poses a particular danger to the child. Children who have new neurological reactions after vaccination may have a pre-existing but unknown condition, such as epilepsy, that reacts to the vaccine. To date, there is no evidence that the whooping cough vaccine causes these neurological reactions, which are rare in any case.

Important note. Unreasonable fears of side effects from vaccination can be dangerous. In England, such concerns have led to a significant decline in immunization rates since 1970. As a result, outbreaks of whooping cough occurred and increased brain damage and death in many children. Young children are especially at risk if they become infected from older, unvaccinated children (who usually have more mild course diseases).

Contraindications to DTP

Temporary contraindications to DTP vaccination are:.

Infectious disease. Any spicy infection- from ARVI to severe infections and sepsis. Upon recovery, the period of medical withdrawal is decided individually by the doctor, taking into account the duration and severity of the disease - that is, if it was minor snot, vaccination can be done 5-7 days after recovery. But after pneumonia you should wait a month.

Exacerbation of chronic diseases. In this case, vaccination is carried out after all manifestations have subsided. Plus another medical exemption for a month. In order to prevent vaccinations for an initially unhealthy baby. On the day of vaccination, the baby should be carefully examined by a doctor and the temperature taken. And if there are any doubts, it is necessary to conduct a more in-depth examination - blood and urine this goes without saying, but if necessary, involve specialists for consultation.

Stress. You should not vaccinate if there are people in the family with acute infections or stress (death of relatives, moving, divorce, scandals). This is of course not entirely medical contraindications, but stress can have a very negative impact on vaccination results.

Absolute contraindications to DTP are:

Allergy to the vaccine. Under no circumstances should you be vaccinated at all if your baby has been diagnosed with allergic reaction to one of the components of the vaccine - the baby may develop anaphylactic shock or Quincke's edema.

Strong reaction to previous vaccination. You cannot drive a DTP vehicle if it is previous dose there was an increase in temperature above 39.5-40C, or the child experienced convulsions.

Diseases of the nervous system. Whole-cell vaccines DPT or Tetracok should not be administered to children with progressive diseases of the nervous system. They should also not be administered to children who have had episodes of afebrile seizures.

Immunity disorders. Severe congenital or acquired immunodeficiency is a complete contraindication for DTP vaccination.

Whooping cough, diphtheria, tetanus. If a child has suffered whooping cough, then he is no longer given the DPT vaccination, but the administration of ADS or ADS-m is continued; if he has had diphtheria, he will begin to be vaccinated with the last dose, and if he has tetanus, he will be vaccinated after past illness on a new one.

If you've been vaccinated against polio, measles, or diphtheria, you don't have to worry about your child accidentally catching these infections and getting sick. But with whooping cough the situation is different. The pertussis vaccine does not create lifelong immunity; in order to certainly avoid this disease, immunity must be constantly “stimulated” with repeated vaccinations. In our country, infants are vaccinated against whooping cough three times before six months: at 3 months, at 4.5 and at 6, and once again at 18 months. The vaccine is called DTP, it is against three diseases at once: whooping cough, diphtheria, tetanus. From 6 months – after the 3rd dose – and for 5–8 years, the child is protected from this disease.

IN school age susceptibility to whooping cough gradually returns, but those old vaccinations protect against it at least partially. So if a vaccinated child gets sick, whooping cough occurs in an erased, mild form, and sometimes it’s even difficult to make a diagnosis. Therefore, although about 30 thousand cases of whooping cough are registered in Russia every year, in reality there are many more.

But a patient with atypical whooping cough infects everyone around him: peers, adults, infants under six months of age who have not received three more vaccinations and have not acquired immunity against the disease. This is how the infection circulates.

You probably have a question: why not continue vaccination and continue to vaccinate children, as they do, for example, before school, diphtheria and tetanus vaccinations?

The fact is that the pertussis vaccine often causes unpleasant reactions: fever, deterioration general condition, in rare cases – complications on nervous system. And the older the child, the more often these reactions occur. So for mass vaccinations of older children and adolescents existing vaccine unsuitable.

Search for the ideal

Scientists have long tried to create a “softer” vaccine, without adverse reactions. And their efforts were crowned with success. Because the unwanted reactions on vaccination are associated mainly with the effect of lipopolysaccharides - microbial cell membranes; the creation of new vaccines against whooping cough was based on purifying them from these substances. As a result, cell-free (acellular) vaccines have appeared, which actually produce fewer adverse reactions. But do they give less? serious complications, it is impossible to say yet: experience has not yet been accumulated to compare these two types of vaccinations. The disadvantage of acellular vaccines is also that they are expensive. Therefore, WHO now recommends that children 1–2 years of age be vaccinated with “whole cell” vaccines (DTP), and acellular vaccines be administered to schoolchildren and adolescents. In the USA, Japan and a number of other countries, revaccination of students with the new vaccine has already been included in the vaccination calendar. primary classes and are considering another vaccination at the age of 16, in order to suppress the circulation of whooping cough among students.

Well, what about in Russia? We vaccinate 90% of babies with the DTP vaccine, and this has not increased the number of complications. But the incidence rate thanks to vaccination has decreased by 25 times. And if earlier severe forms of the disease prevailed, then after mass vaccination the pathogen became “softer”.

Illness lasting 8 weeks

Typical whooping cough manifests itself in paroxysmal obsessive cough which brings the child to exhaustion. The cough does not appear immediately, during the first 2 weeks the illness differs little from the usual ARVI, so suspect true disease It's difficult at this time. But once the whooping cough starts, it will not go away for 4-6-8 weeks, or even longer. The cough follows in attacks, more often at night, cough tremors come one after another, the child sticks out his tongue so that he injures the frenulum of the tongue on the teeth, his face turns red, at the end of the attack, while inhaling, the patient emits loud noise- a reprise by which whooping cough can be unmistakably recognized. After several weeks of suffering, coughing attacks become less frequent.

Infants are especially seriously ill with whooping cough - their cough can lead to respiratory arrest. The older the child, the less life-threatening the disease is.

This painful, debilitating disease is also unpleasant due to its severe complications. If during whooping cough a child gets additional infection: for example, someone gets sick with ARVI, the cough sharply intensifies and becomes more frequent, before normal temperature increases, pneumonia occurs. It is fraught with whooping cough and encephalitis - inflammation of the brain, which leads to disability.

Even after recovery, the child’s body “remembers” the illness for several months: with each “cold,” the whooping cough can return, and it is difficult to do anything about it.

How will we treat?

Until recently, there was no cure for whooping cough - they tried to lift sick children to heights on airplanes and balloons, lower them into mines, more than 200 drugs were proposed for treatment - and all in vain. The cough is not relieved by either expectorants or sputum thinners, or rubbing, or heating.

Antibiotics don’t help much either: although many of them have an effect on whooping cough bacillus. Treatment only makes sense early stage, before the cough appears (and without it it is impossible to know that it is whooping cough!) or at the very beginning.

The best remedy was and remains one thing - to walk as much as possible. fresh air.

By the way

Recently, there have been observations that whooping cough is alleviated by inhaled corticosteroid drugs - they are usually used for “basic” therapy of bronchial asthma.

Important

Why are we afraid of DPT vaccinations?

>> We believe that complications from the pertussis component of this vaccine are very common.

In fact. The wave of parents refusing the pertussis vaccine, which took place in Europe in the 70s, proved the opposite: the outbreak of whooping cough “came back” with hundreds of cases of encephalitis. Such a number of complications from vaccination would not have accumulated in 3 thousand years!

>> We believe that the whooping cough vaccine may cause allergies and asthma.

In fact. An extensive study in England found that children who received the whooping cough vaccine were even less likely to have asthma than those who were not vaccinated.

>> We are afraid of the possibility of an increase in temperature after vaccination.

In fact. It happens. To avoid such a reaction, the child should be given paracetamol for two days after vaccination. A dose of 10 mg per 1 kg of child weight should be divided into three to four doses per day.

Despite the fact that the widespread use of the DPT vaccine has practically rid humanity of epidemics of whooping cough, tetanus and diphtheria, this vaccine is still viewed with distrust. And for good reason: it can cause quite severe complications, and some side effects (which, however, occur quite rarely) plunge young parents into shock and force them to call an ambulance.

What does DTP mean?

The decoding of the medical term is as follows: adsorbed pertussis-diphtheria-tetanus vaccine. This means that a mixture of three vaccines is injected into the child's blood - antibodies to whooping cough, diphtheria and tetanus. All these diseases are deadly for humans.

Complications in children after vaccination with the DPT vaccine arise due to the rare presence of lipopolysaccharides and pertussis toxins in it. They can cause an unpredictable reaction of the immune system within three days after the injection.

What diseases does vaccination protect against?

The DPT vaccine is injected into the baby's body to protect against three dangerous infections: tetanus, whooping cough and diphtheria.

Tetanus

Doctors call tetanus an infectious disease, the causative agent of which is considered to be a special ubiquitous bacterium Clostridium tetani, capable of penetrating into open wounds on the surface of the human epidermis or mucous membranes. Tetanus is characterized by high fever, dehydration and severe cramps, which are often fatal.

Diphtheria

Diphtheria -acute infection, transmitted both by airborne droplets and by contact, caused by the so-called diphtheria bacillus - Corynebacterium diphtheriae. The disease most often affects the nasopharynx (a fibrinous film forms on the mucous membranes), causing Quincke's edema and asphyxia, another common fatal dangerous complication is myocarditis.

Whooping cough

Whooping cough is infectious, mainly childhood disease, caused by the bacillus Bordetella pertussis, transmitted by airborne droplets. The disease causes uncontrollable spasms of the tracheal muscle and its necrosis, frequent cough, similar to a bird's cry. Damage to the heart muscle and lungs, attacks of suffocation, and in children severe hypoxia, encephalopathy and convulsions are common.

DPT vaccination plan

Despite the fact that the DTP vaccine is the vaccination that most often causes any side effects in children, it is absolutely necessary to do it: this way, you will quite possibly save your child’s life or save him from disability and other consequences of severe infections.

DPT for kids

Young children are vaccinated four times:

• the first time - at the age of two to three months;
• the second time - a month and a half after the previous one;
• the third time - three months after the first;
• fourth time (re-vaccination) - at one and a half years.

Mandatory vaccination against diphtheria, tetanus and whooping cough is recommended (but not required) before the baby enters kindergarten.

DPT for adults

Unfortunately, only a quarter of the adult population of our country knows about these recommendations and adheres to them, and they often give a “tetanus injection” only when the body has already become infected - in case of severe soft tissue injuries or animal bites.

Mandatory DTP vaccination of the entire population in Soviet period practically eliminated epidemics of diphtheria and tetanus, and far fewer children suffered from whooping cough (and the illness was milder than in unvaccinated children). However, in our time, many are again beginning to refuse vaccines, which gives rise to outbreaks of epidemics of dangerous infections.

Contraindications to vaccination

Doctors identify two groups of contraindications to vaccination with the DTP vaccine:

• Relative contraindications:
  1. Recent acute respiratory infection or ARVI, as well as exacerbation seasonal allergies- reasons to postpone vaccination until full recovery to avoid complications.
  2. Neurological illnesses are a reason to postpone vaccination until a period of calm (no progression of neurology).
• Absolute contraindications:
  1. Diseases of the central nervous system are in a state of progress.
  2. Previously present convulsive syndrome due to high body temperatures.

If there are absolute contraindications, children are vaccinated with the ADS vaccine - a pertussis-free variant that extremely rarely causes a reaction in children.

Who needs to be vaccinated?

• polycystic disease;
• bronchial asthma;
• chronic diseases liver;
• heart and vascular diseases;
• chronic kidney disease;
• neurology in remission.

The fact is that successful outcome at possible infection diphtheria, tetanus or whooping cough among such children is unlikely - the infection can kill them or make them deeply disabled.

When is it better to postpone vaccination?

• in case of severe acute respiratory infections, acute respiratory viral infections;
• during other serious illnesses;
• with progressive neurology;
• at strong reaction to the previous dose of vaccine.

IN the latter case Pediatricians advise purchasing an analogue of the domestic vaccine - Pentaxim. Foreign drug does not cause side effects due to the replacement of the whole-cell component of whooping cough with an acellular one and is well tolerated by children.

DPT vaccination: side effects

During a traditional examination by a pediatrician before vaccination, doctors often warn mothers that they need to monitor the baby for at least 24 hours after vaccination - it is during this period that 99% of severe complications develop.

The consequences of DPT vaccination can be:

• Increased temperature in a child. The complication is considered a completely normal reaction of the immune system to foreign antibodies; a pediatrician or nurse in the treatment room will most likely warn you about this. If the temperature rises above 38.5 °C, it is necessary to give the child antipyretic drug. Which one - ask your doctor, he will prescribe a dosage appropriate to the age and weight of the baby. If the reaction turns out to be unexpectedly strong and the temperature rises to 39 ° C or higher, convulsions occur - call an ambulance; such complications are best treated under the supervision of experienced doctors.
• Sleep disturbances in the baby associated with itching and discomfort in the injection area, as well as neurological characteristics. If a child’s leg hurts after DTP (he may limp slightly during the first day, “take care” of it), lubricate the injection site with ointment (the prescription can be obtained from the pediatrician in advance).
• Lethargy and lack of appetite are also a normal reaction of the body. Do not burden the baby, let him lie down in peace - soon acute period will pass.
• Tearfulness, restlessness of the baby.
• Induration and redness of the thigh at the injection site. If it does not bleed or itch, its diameter is less than 2-3 cm - this is normal. A constantly growing spot size of more than 3 cm is a reason to consult a doctor. Attention! The injection must not be heated, scratched or rubbed! If necessary, clean the injection site with alcohol.
• Cough, runny nose and other symptoms of ARVI that occur after vaccination are not consequences of vaccination, but indicate a child’s weak immunity. In addition, in the clinic, where sick children are often taken for examination, it is easy to catch an infection.

Severe complications after DTP

The following symptoms occur very rarely, but parents should be aware of them and be prepared to immediately take their baby to the hospital if they occur:

• High-pitched scream syndrome (occurs in infants under six months of age) is an extremely rare neurological complication after vaccination. It is characterized by a sharp and piercing cry of a child that lasts for hours. Take your baby to a specialist immediately!
• Convulsive syndrome occurs more often and is accompanied high temperature bodies, which is very dangerous. Sometimes children lose consciousness due to seizures.
• Exacerbation or first manifestations of chronic diseases (diathesis, bronchial asthma, etc.).

What to do after vaccination?

For possible prevention and to alleviate the consequences of vaccinating an infant, parents should behave as follows:

1. A couple of hours after the DTP vaccination, the baby can be given a dose of an antipyretic drug recommended by the pediatrician.
2. Give it to your baby at night antihistamine(the pediatrician will prescribe the name and dosage to the child in accordance with his age, weight and developmental characteristics).
3. IN night period If possible, go to the baby to check how he sleeps. It would be ideal to spend the night in the same bed.
4. Let's drink as much as possible: offer your child his favorite drinks (jelly, juices, compote, sweet tea).
5. Do not introduce new complementary foods to your child for 10-14 days after vaccination.
6. If the baby is breastfeeding, the mother is prohibited from eating new foods and drinks; if possible, it is recommended to exclude potential allergens for at least three to four days.
7. Avoid contact with strangers for two to three days after the DTP vaccination: the child’s immunity is weak, he can easily catch an infection.
8. Ventilate your child's room frequently.
9. Take a walk in the fresh air (if you don't have a fever).