Component (subunit) vaccines. Immunobiological preparations

The Pentaxim vaccine is gaining more and more popularity. Many parents and their children have already appreciated the convenience of this invention, because now the baby does not have to endure several injections, each for a specific disease, and wait for a reaction to them. This five-component vaccination allows you to pass this unpleasant procedure shortcut way. What this vaccine is and how safe it is for children, we have to figure it out.

Pentaxim is a vaccine that protects the body against five infections at once, such as tetanus, diphtheria, polio, whooping cough, as well as Haemophilus influenzae type b, which causes pneumonia, meningitis and other serious diseases. Moreover, this drug belongs to the class of highly immunogenic vaccines, that is, giving high immunity from the above diseases.

Pentaxim belongs to a new generation of acellular (acellular) vaccines that have replaced cellular, that is, cellular vaccines. The new, acellular vaccine is less reactogenic and does not contain bacterial membrane lipopolysaccharides, which can cause complications after vaccination. But still, its main advantage is its multicomponent nature, because separate vaccination requires 12 injections, while with Pentaxim vaccination, only 4 are enough. The course consists of 3 injections and 1 revaccination.

Many parents are very apprehensive about vaccination for fear of adverse reactions of the child's body. In this case, you should find out which kids are suitable for Pentax? The instructions for use of the drug say that this vaccine is suitable for healthy children from the age of three months. Recommend the vaccine for children who have negative reactions to the introduction of whole-cell vaccines, such as DTP, babies with HIV infections, immunodeficiency, chronic diseases nervous system, stable neurological symptoms, allergic diseases and febrile convulsions.

In addition, many parents do not vaccinate due to frequent illnesses child with anemia, atopic dermatitis, dysbacteriosis, perinatal encephalopathy, dysbacteriosis. Pentaxim, in this case, is also recommended for use. The safety of the drug is confirmed by studies conducted by Russian scientists.

It is worth paying attention to the consequences that this vaccine can cause. It must be said that Pentaxim is absolutely well tolerated by children. In rare cases, vaccinated children may experience adverse reactions that require immediate medical attention. It is thanks to the cell-free pertussis component that the drug is well tolerated. In addition, the introduction of intramuscular polio vaccine, which is part of Pentaxim, reduces the risk of vaccine-associated poliomyelitis.

The described vaccine has no age limit for vaccination, due to the presence of a cell-free pertussis component, and therefore even adults can be vaccinated. Doctors' recommendations regarding DTP boil down to the fact that revaccination at 6-7 years of age involves its vaccines containing a low number of antigens (ADS or ADSM). That is why Pentaxim is ideal for vaccinating children under 6 years of age. In addition, the vaccine can be done without the HIB component, which comes in a separate vial.

In rare cases, the introduction of the Pentaxim vaccine causes an increase in temperature. During this period, doctors do not recommend the use of antipyretic drugs, because such actions can significantly reduce the body's immune response to the vaccine. Sometimes the injection site may hurt a little. The drug can be administered simultaneously with other vaccinations, for example, a vaccine against measles, mumps, rubella or hepatitis B.

But even despite the excellent performance of Pentaxim in clinical trials, you should consult a pediatrician before using it, because this vaccine has a number of contraindications. In addition, in the presence of a negative reaction of the body to this vaccination, it is impossible to establish which component of the drug it was. All this should also be taken into account when agreeing to vaccinate a child. Take care of your kids!

The "French" (actually Americans hiding behind a manufacturing plant in France) are testing their five-component a vaccine that is not even going to be used in such a test version. They just paid Moscow for it (information taken from the news).

This is a vaccine that consists of five different components in one syringe: , and Haemophilus influenzae type b.

Each component of any vaccination is in itself a shock and stressful effect on the child's body. And then there are five! It is possible to breed fruitless controversy on this issue for a long time. Or a simple metaphor: What is more harmful: five glasses of vodka in five days or a liter at a time?»

Their site (privivka.ru) (later gradually developed into a site about vaccinations in general) was (at the time of writing, September 10, 2009) completely strewn with various articles about vaccines that had nothing to do with the drug in general. Not a word about the real composition of the vaccine! Some Natalya P. wrote on their forum “ Anti-vaccine hysteria, flooding and advice from non-specialists on this site will be deleted”, She also claims that science has absolutely proven that vaccinations are completely harmless, although many mothers can rebuff her. And nowhere is it reported what kind of Natalya P. is, what her last name, position, place of work, and whether she herself has a medical education. Since 2009, there has already been a lot of news about child deaths. Mentions can be found in the press of other countries: Ukraine, India, Turkey, Poland, the countries of South Africa, the Czech Republic ... in general, they gathered all the countries of the third world + many NATO countries (the same France) and launched mass "tests" on the population, and even for their own money.

Quote about Pentax:

Combined pediatric vaccine for protection against 5 dangerous infections- hemophilic infection type b (Hib) - starting from 3 months of age.

Immunogenicity corresponds to that with separate administration of vaccines, while ( from the editor: the consequences of introducing such a large number of infections are silent.)

The inactivated polio component eliminates the risk of complications from the live vaccine virus ( editor's note: this is a five-component composition, and here it is talking about only one component)

Hib-component provides a high level of protection against meningitis, pneumonia, otitis caused by this infection at a very early age ( editor's note: This Hib component is supplied separately as a powder and can be used without it as a quadruple vaccine. Here's what the manager says Clinical center of immunoprophylaxis of childhood infections Professor Mikhail Petrovich Kostinov: “Hemophilus influenzae (HIB) infection is a group of diseases caused by Haemophilus influenzae type b. It is spread through saliva when sneezing and coughing, as well as through toys and household items that children drag into their mouths. Haemophilus influenzae can cause pneumonia, acute respiratory infections, bronchitis, sepsis, otitis media, meningitis and other diseases. Unfortunately, on a national scale in Russia, they are just beginning to detect and register this infection and, accordingly, to train doctors. It is for this reason that she is relatively little known." Before instilling the fifth component, ask if there is real threat in your area to get this infection.)

Many are against vaccines in general, but we want to warn against foreign vaccines that are being tested on experimental children in Russia, I advertise “miracle vaccines” with might and main and attract doctors to recommend them.

And now we honor vaccine reviews:

We put Pentaxin on our daughter and no problems. Not the slightest hint.

Europe has been sitting on Pentaxima for a long time, I don’t understand why they got it that they are testing it on Russian children. They've been doing it for over 10 years. Two friends have children in Germany vaccinated with this vaccine, and in fact they were not even offered alternatives!

This alone swayed me in favor of Pentaxim, since they make it the weakest, it means that it loads the body the least.

Good afternoon!!! we were vaccinated this Tuesday 11/16/10. They only did it, without Haemophilus influenzae + hepatitis vaccine. At the injection site, a blob was formed about 3 cm in diameter, the temperature was 36.9-37.5 the next day. I won’t tell the child that he was somehow not like that. And on the third day, a runny nose, sneezing began. In short, we are being treated now. I am not satisfied with this vaccination, for some reason I was very worried before I got it, I read a lot about it. The reviews were different, a lot of positive. No temperature, no swelling at the injection site. We wanted to do it, but not naked = we went to pharmacies. They say it disappeared for some reason

We did 2 times with Pentaxim, the first time with hemophilia, the second time without, and the third time we did Infanrix.

Transferred easier - in the evening slight temperature, the next day a slight temperature and that's it. Infanrix + Imovax (from) suffered much worse - three days of temperature and swelling of the injection site of Infanrix - the lump lasted a month !!! And this is with preparation: viburkol and zirtek. And only after donating blood and with the permission of a hematologist.

If I did, as they do in state clinics, immediately after examining the child, then, I think, they would definitely lie in the hospital after that.

Having done it to my son at 3 months old, I will regret it for the rest of my life! Exactly two hours after the vaccination, we began to have convulsions. I thought I'd go crazy until I wait for the ambulance (they arrived in 30 minutes). I've been in the hospital twice already. I understand that this is one case out of a hundred, but we got it! And how many children died from Pentaksim. And that's just what we know from the news! Think mommies! Health to you and your children!

I put it on my child. We had a fever all day. The maximum rose to 38.5.

Before that, like you put 3 times, there was no reaction.

They put the first temperature rose to 37.5, the second time there was nothing

we were given the first time yesterday, everything was fine, only the injection site hurt and swelled ..

And in general, we have a complete mess in the vaccination schedule. The baby is often sick. We caught herpes last summer when we were 9 months old, now it appears on her lips almost every month. That just did not try to raise immunity! I don't know what to do anymore. As soon as a couple of months of our health passes, the doctors again begin to persuade us to be vaccinated. We are 2 years and 5 months old, we also have not completed it yet. And the thing is that after the 2nd (fatherlands) at 5 months we had a temperature of under 40, and the leg was very sore, did not even let me touch it (I could not even pick it up for 2 days, just so as not to move the leg ), wept with her. At the same time, hepatitis was also done, but the leg in which it was made hurt. After that, for almost a year I didn’t dare to get a single vaccination, after that I got hepatitis separately, everything was fine, a month later in drops, everything was OK, then I decided to do it - even the temperature didn’t rise by a degree. After that, this fall they did also, hepatitis, measles, rubella, all separately, and everything is fine.But we vaccinate between diseases, keeping a "distance", but it happened on the 2nd or 3rd day after the vaccination the baby fell ill with acute respiratory infections.And now we need to do revaccination next week and. I wanted to do it, but in 2 hours I read so much (and not only from you) that now I obviously don’t agree to it.Most likely I will do it, but I don’t really want to do it right away with poliomyelitis.

Violet Violet 3 Mar 2011

We did it yesterday, everything was fine, and today the temperature is under 38. The instructions say that this is possible within 2-3 days, and you need to give an antipyretic. Gave me nurofen. Previously, there was no reaction to vaccinations - this was done. I worry.

Emma_tyan Mar 17, 2011

Not much is easier. And it's a terrible thing. It is terrible because out of 100 vaccinated, 99 children tolerate it normally, and 1 may become disabled and this may be your child. I was with a child in the 18th neuropsychiatric hospital. I can say that somewhere around 30% of children with cerebral palsy got cerebral palsy just after. I don’t need to read scientific articles - I saw it with my own eyes - poor children who developed normally before vaccination, and then stopped developing, their legs turned out, they stopped talking, frequent convulsions, etc.

To be honest, I'm not at all against vaccinations, I just think that a vaccine against 5 diseases at once is too much.

Why not give the child ADSM? This vaccine is much safer! There is no that same whooping cough component. Itself is not as terrible as the consequences after being vaccinated against it.

I will not do.

Hello!!! I'm scared to get vaccinated! Before the year I vaccinated my boy! I could not even imagine what the consequences would be! At 3 months we were given + poleomelit! My baby was born a completely healthy baby! after vaccination, we did not have a temperature, as I put imported vaccine! 1 day later we had a rash all over our body! I called the doctor, she said that it was not from the vaccine! then I thought that all the problems are from me, since I have a tendency to allergies! And I continued to vaccinate the Internet, I didn’t have it then, my child was covered worse and worse, covered with sores, and the doctors kept saying that we had atopic dermatitis! And when my child needed to be vaccinated at 1 year and 5 months already, I realized that all the problems are from vaccinations! and stop doing it! Soon all the sores were gone! But immunity is planted! Tell me, please, they found a cytomegalovirus infection in us, and we also had an Einstein-bar infection! can we make a medical withdrawal from all vaccinations!

We have a very strong local reaction - up to a month there was an infiltrate and a week of redness. The first time they thought that the needle had just hit unsuccessfully, but the second time the same parsley :(. We will wait for infanrix (search)

On the Internet I met information that if you are allergic to egg white and brewer's yeast, there can be a strong allergy to vaccination ...

We had a withdrawal from vaccinations, at 5 months they put it, they transferred it normally without temperature (ttt), there was a local reaction - redness, it disappeared after three days. True, we set up with preparation on the recommendation of a doctor for 5 days we took fenistil drops (2 days before, on the day of vaccination and 2 days after). 😉

My daughter is 6 months old, we have allergies, in connection with this we had a medical withdrawal. At 4.5 months, our pediatrician said that we should do better in paid clinic ostensibly he as times for kids with allergies. But there they told us that this vaccine might no longer be available, and they offered and said that it was even better than infanrix in terms of allergies. In general, we endured the 1st vaccination remarkably, the other day we did the 2nd one, and now the horror literally after 2 hours, my daughter started such a tantrum with crying excitedly and lasted 1, 5-2 hours, nothing could calm her down, the leg was swollen, and not "slight redness around the injection site "and all top part legs to knees. At night, the temperature rose to 39. At the expense of the 3rd inoculation of thoughts in a run (((((I don’t know how to be (((((

A year ago, they did it to my son at the age of 2 years, he endured it excellently, no changes were noticed.

Now my son is 3 years old. Yesterday afternoon there was a revaccination. By evening he became lethargic, began to complain that his leg hurt, began to limp, then he began to cry in general and refused to walk. They wore it on their hands. He could not step on his left leg, he roared from pain. The temperature rose 37, 3. At night she gave Nurofen. I woke up this morning: no fever, more cheerful mood, steps on my foot, walks, but limps. So this time we tolerate this vaccine much worse. I hope all the consequences are behind.............

grafted with Pentaxim the day before yesterday. well, we reacted something - temperature and terrible whims 🙁

At 3 months, the baby was given a domestic DTP - the temperature is 38 days, yesterday (5 months) they did Pentaxim - today 37.4, it's scary

And we delivered yesterday. We slept badly at night, we were whirling and moaning, in the morning the temperature was 37.5 and now it is already 38. Gave suprastin and nurofen. Has anyone had such a reaction the day after the vaccination?

The first time - (without consequences), then with hemophilic (the leg dragged 2 days + temperature 38 - 1 day), the third without hemophilic (the leg swelled up badly - it turned red, whims of tearfulness for a week - and it doesn’t go away ...)

the first vaccination was domestic, it was poorly tolerated, the rate was 39 for 3 days, unbreakable, then 2 times (the rate rose to 37.1 one evening), revaccination with Pentaxim, a bump formed at the injection site, resolved after 5 days. temperature was 2 days 37.5

everything went perfectly for us too 🙂 As if nothing had happened. But we put it without the Haemophilus influenzae component, until we decided not to overload the baby

Well, I finally found it! They did it to my baby (a relative works in a hospital - she got it out of court), the child fell ill after 11 days acute otitis media. Now I understand - this is a reaction to this Hib component. I treated a small crumb with antibiotics, we still cannot recover. And how is this to be understood? If this hib-component was supposed to just protect my little mouse from otitis media, and he got sick with it? How to understand this, in the end !!!

Prepared with fenistil, because they are allergic. Installed yesterday morning. Vomited at lunchtime. By the evening the temperature rose 38. Dali Nurofen. The child had diarrhea, about 6 times. Gave smecta. Vomited several times during the night. Didn't sleep all night. Temperature 37. They no longer knew what to do, in the morning an ambulance was called. The ambulance prescribed a sea of ​​drugs (enterosgel, rehydron, smecta, linex, enterofuril) and a diet. Weird gut reaction. They said that the immune system can react like that. If there is still vomiting, then you need to go to the infectious disease. It didn’t seem like he should have been poisoned, he didn’t eat anything like that. I will try to manage myself. Tomorrow they said to call the pediatrician for a consultation.

We are 1 year and 9 months old. This was not the case before. There was also a local reaction to, well, temperature. Once the leg was very swollen, which was taken to Matrekha. But there was no such intestinal reaction. In the morning before vaccination, the child was absolutely healthy and cheerful. Before vaccination, a pediatrician carefully examined. We looked around in the molecule and vaccinated. I trust this institution.

As a result, they spent a week in the hospital under drips. Got a rotovirus. And they put it. We did not know yet that the child was ill. The doctor explained to us that if it were not for the vaccination, the child would have shaved once and would not have been noticed. And since such a heavy vaccine was delivered, all the forces of the body were directed to fight against the vaccine. Still, there are 4 or 5 components. And that's why the virus was so hard to endure. My advice to mothers: before vaccination, do not take them to the playground, even if they have no contact with the children for two days. Then the vaccination will go well. And then you see how we did it. Before vaccination, we did not take them to the site. But in the evening, on the eve of the vaccination, they went out for a ride in a stroller. One girl came up to us and gave us a toy to touch. This is what seems to have been hooked. And the incubation period is 24 hours. This is where we started the next day.

We also delivered this vaccine for the first time, everything went well, she was only indignant when we arrived and our doctor said: “Didn’t you know that there are no free vaccines, now it’s only for a fee, if you don’t want it for a fee, come back in a month, suddenly it will, maybe it won’t", kick-ass. It is very expensive 1400 (we are not rich, we have never bought a vaccine with 1 child), we bought it, we will put it again in a month and what, now we constantly have to buy ????????

we put it on Thursday, we are 10 months old .. we put it on the third time, the last two times everything was perfect, and now the temperature has been holding for 3 days and the leg is swollen, the place near the injection is hard and red, the doctor sends to the surgeon on Monday. What are these side effects?

We put it on Tuesday for the 3rd time, the first times everything is fine, this time the injection site was swollen, reddened and hard, there was no temperature, but I give Nurofen immediately after the vaccination. Tied to the leg for 3 days cabbage leaf, then the nurse from the clinic advised me to do compresses with dimexide (dilute 1 to 5, on gauze, polyethylene on top and fix, hold for 1 hour, said to do it 5 times), but it started to go away with us, so I didn’t do it.

Apparently this is some kind of Pentaxima party, because the nurse said that we are not the only ones like that.

Girls, they set it up for the first time - in general, everything was perfect, as if they didn’t set anything. And the other day the second vaccination was transferred just terribly !!! Maybe against the background of teething (the pediatrician saw that the gums were swollen, but sent for vaccination). They vaccinated in the morning - everything was absolutely fine all day, only there was liquid stool once, and at night T rose to 39, the poor daughter was shaking all over, her arms and legs turned blue, she screamed incessantly for about 40 minutes. It was kind of a nightmare!!! Candles (2) Nurofen came out after 10 minutes with diarrhea. The ambulance was so surprised that they called her, they say, everything is fine, as it should be (I'll kill myself against the wall) The whole next day I had diarrhea (8 times). What I experienced, even now it is terrible to remember. Now I'm contemplating whether to keep going. Someone wrote here that two vaccinations already seem to form immunity. Where does such infa come from?

An hour ago I had to go with my child to get vaccinated advised by an immunologist, it’s good that I looked at the reviews about it on the Internet, I’m in a little shock that I almost did something stupid an hour ago. In me, too, like in many others, two opinions are fighting, either for or against. Until two and a half years old, she did not vaccinate the child, she constantly eluded them, referring to the fact that the child was born eight months old, up to a year they underwent treatment at the St. with all this, they didn’t give me a medical exemption from vaccinations, they said that they didn’t see any reason for a medical exemption, only a neighbor who had nothing to do with medicine did not advise vaccinations for up to three years, since her daughter, after vaccinations at the age of eight months, fell into a coma, woke up on the eleventh day and now she is already five years old, but the girl is disabled (cerebral palsy) and in a very serious stage, their bitter experience scared me very much, and to the point of panic, I myself began to protect my child from all these vaccinations, not understanding exactly whether I was right I do, whether I will harm my child with my fear, because the doctors unanimously insist on vaccinations, and since then two opinions for and against have arisen in me. but how it touched to go to the garden, slowly gave up and a year ago we started doing it. The pediatrician advised to get vaccinated with the drug, we did it once, then a month and a half later we did it a second time, and when it was time to do it a third time, we got sick, then again and again, when we came to the discharge, the doctor immediately sent us for vaccination (and I had previously read that after an illness, at least two weeks should pass before vaccination) I left the office and went home without any vaccination there, my heart suggested that it was not time yet. In general, a year has already passed since the last vaccination, and the doctor sends us to do revaccination, saying that those two will be counted. So I want to know if this is true. I just decided that since I started doing this vaccination, I should finish it so that those first two injections would not be wasted. If we now do the third one a year later, will our vaccination be considered completed or will it give us nothing but a tick in the certificate. does it make sense to do now a third time?

I will describe our sad experience. The eldest child was given all vaccinations according to the schedule. The younger one was vaccinated with a delay (mother's heart felt it). 1 went fine. 2 vaccination gave a temperature of 38 for two days. After 3, 14 hours later, the temperature rose to 40, 5, the ambulance brought down the temperature, referring to the reaction to the vaccination. The pediatrician who came the next day also stated that the reaction was within the normal range. In general, 6 days of ad-not bringing down the temperature of 39-40 (the child was then 10 months old). The doctors kept saying it was normal. The lymph node in the neck was inflamed, but this did not bother the doctors either. On the 7th day, I just took the baby and went with him to the hospital myself, since there was a doctor I knew. The baby was examined. Outcome: emergency operation - purulent lymphadenitis. They said a couple more hours, the abscess would break through and the consequences are unpredictable. I thank God, all the doctors - the operation performed on time was successful. But here is the result - the card in the clinic is clean - not a doctor's call to the house, nor an ambulance who came three times, not my visits to the clinic - nothing. Now they require vaccinations in the garden. Tell me how to get official honey now. withdrawal and is it possible at all? Thank you.

1. By the nature of the antigen.

Bacterial vaccines

Viral vaccines

2. According to the methods of preparation.

Live vaccines

Inactivated vaccines (killed, non-live)

Molecular (anatoxins)

genetic engineering

Chemical

3. By the presence of a complete or incomplete set of antigens.

Corpuscular

Component

4. According to the ability to develop immunity to one or more pathogens.

Monovaccines

associated vaccines.

Live vaccines- preparations in which the following are used as the active principle:

Attenuated, i.e. weakened (lost their pathogenicity) strains of microorganisms;

The so-called divergent strains of non-pathogenic microorganisms having related antigens with antigens of pathogenic microorganisms;

Recombinant strains of microorganisms obtained by genetic engineering (vector vaccines).

Immunization with a live vaccine leads to the development of the vaccinal process, which occurs in the majority of those vaccinated without visible clinical manifestations. The main advantage of this type of vaccine- a completely preserved set of pathogen antigens, which ensures the development of long-term immunity even after a single immunization. However, there are also a number of disadvantages. The main one is the risk of developing an overt infection as a result of a decrease in the attenuation of the vaccine strain (for example, live polio vaccine can rarely cause poliomyelitis up to the development of a lesion spinal cord and paralysis).

Attenuated vaccines are made from microorganisms with reduced pathogenicity, but pronounced immunogenicity. Their introduction into the body mimics the infectious process.

Divergent vaccines- Microorganisms that are closely related to pathogens of infectious diseases are used as vaccine strains. The antigens of such microorganisms induce an immune response that is cross-directed against the antigens of the pathogen.

Recombinant (vector) vaccines- are created on the basis of the use of non-pathogenic microorganisms with the genes of specific antigens of pathogenic microorganisms built into them. As a result, a living non-pathogenic recombinant strain introduced into the body produces an antigen of a pathogenic microorganism that ensures the formation of specific immunity. That. the recombinant strain acts as a vector (conductor) of a specific antigen. As vectors, for example, DNA-containing vaccinia virus, non-pathogenic Salmonella, into the genome of which the genes of HBs, the antigen of the hepatitis B virus, the antigens of the virus tick-borne encephalitis and etc.

Note: Att. – attenuated, Div. - divergent.

Inactivated vaccines- prepared from killed microbial bodies or metabolites, as well as individual antigens obtained by biosynthetic or chemical means. These vaccines show less immunogenicity (compared to live ones), which leads to the need for multiple immunizations, but they are devoid of dietary fiber, which reduces the incidence of side effects.

Corpuscular (whole cell, whole virion) vaccines- contain full set antigens prepared from killed virulent microorganisms (bacteria or viruses) by heat treatment, or exposure to chemical agents (formalin, acetone). For example, anti-plague (bacterial), anti-rabies (viral).

Component (subunit) vaccines- consist of individual antigenic components that can ensure the development of an immune response. To isolate such immunogenic components, various physicochemical methods are used, therefore they are also called chemical vaccines. For example, pneumococcal subunit vaccines (based on capsule polysaccharides), typhoid fever(based on O-, H-, Vi - antigens), anthrax(polysaccharides and polypeptides of capsules), influenza (viral neuraminidase and hemagglutinin). To give these vaccines a higher immunogenicity, they are combined with adjuvants (sorbed on aluminum hydroxide).

Genetically engineered vaccines contain antigens of pathogens obtained using methods genetic engineering, and include only highly immunogenic components that contribute to the formation of an immune response.

Ways to create genetically engineered vaccines:

1. Introduction of virulence genes into avirulent or weakly virulent microorganisms (see vector vaccines).

2. Introduction of virulence genes into unrelated microorganisms, followed by isolation of antigens and their use as an immunogen. For example, for the immunoprophylaxis of hepatitis B, a vaccine has been proposed, which is the HBsAg of the virus. It is obtained from yeast cells into which a viral gene (in the form of a plasmid) encoding the synthesis of HBsAg has been introduced. The drug is purified from yeast proteins and used for immunization.

3. Artificial removal of virulence genes and the use of modified organisms in the form of corpuscular vaccines. Selective removal of virulence genes opens up broad prospects for obtaining stubbornly attenuated strains of Shigella, toxigenic Escherichia coli, causative agents of typhoid fever, cholera, and other bacteria. There is an opportunity to create polyvalent vaccines for the prevention of intestinal infections.

Molecular vaccines- these are preparations in which the antigen is represented by metabolites of pathogenic microorganisms, most often molecular bacterial exotoxins - toxoids.

Anatoxins- toxins neutralized with formaldehyde (0.4%) at 37-40 ºС for 4 weeks, completely lost their toxicity, but retained the antigenicity and immunogenicity of toxins and are used to prevent toxin infections (diphtheria, tetanus, botulism, gas gangrene, staphylococcal infections and etc.). The usual source of toxins is industrially cultivated natural strains-producers. I release toxoids in the form of mono- (diphtheria, tetanus, staphylococcal) and associated (diphtheria-tetanus, botulinum trianatoxin) preparations.

Conjugate vaccines are complexes of bacterial polysaccharides and toxins (eg, a combination of Haemophilus influenzae antigens and diphtheria toxoid). Attempts are being made to create mixed cell-free vaccines, including toxoids and some other pathogenicity factors, eg, adhesins (eg, acellular pertussis-diphtheria-tetanus vaccine).

Monovaccines - vaccines used to create immunity to one pathogen (monovalent drugs).

Associated drugs - for simultaneous creation of multiple immunity, antigens of several microorganisms (usually killed) are combined in these preparations. The most commonly used are: adsorbed pertussis-diphtheria-tetanus vaccine (DTP vaccine), tetravaccine (vaccination against typhoid, paratyphoid A and B, tetanus toxoid), ADS-vaccine (diphtheria-tetanus toxoid).

Vaccine administration methods.

Vaccine preparations are administered orally, subcutaneously, intradermally, parenterally, intranasally and by inhalation. The route of administration determines the properties of the drug. Live vaccines can be administered skin-to-skin (scarification), intranasal, or oral; toxoids are administered subcutaneously, and non-live corpuscular vaccines - parenterally.

Intramuscular injected (after thorough mixing) sorbed vaccines (DPT, ADS, ADS-M, HBV, IPV). The upper outer quadrant of the gluteal muscle should not be used, since in 5% of children the nerve trunk passes there, and the buttocks of the baby are poor in muscles, so that the vaccine can get into fatty tissue (risk of slowly dissolving granuloma). The injection site is the anterolateral thigh (lateral part of the quadriceps muscle) or, in children older than 5-7 years, the deltoid muscle. The needle is inserted vertically (at an angle of 90°). After the injection, the plunger of the syringe should be pulled back and the vaccine should be administered only if there is no blood, otherwise the injection should be repeated. Before injection, the muscle is folded with two fingers, increasing the distance to the periosteum. On the thigh, the thickness of the subcutaneous layer in a child up to the age of 18 months is 8 mm (max. 12 mm), and the thickness of the muscle is 9 mm (max. 12 mm), so a needle 22-25 mm long is sufficient. Another method- in children with a thick fatty layer - stretch the skin over the injection site, reducing the thickness of the subcutaneous layer; while the depth of needle insertion is less (up to 16 mm). On the arm, the thickness of the fat layer is only 5-7 mm, and the thickness of the muscle is 6-7 mm. In patients hemophilia intramuscular injection is carried out in the muscles of the forearm, subcutaneous - in the rear of the hand or foot, where it is easy to press the injection channel. subcutaneously unsorbed - live and polysaccharide - vaccines are administered: into the subscapular region, into the outer surface of the shoulder (on the border of the upper and middle thirds) or into the anterolateral region of the thigh. Intradermal the introduction (BCG) is carried out into the outer surface of the shoulder, the Mantoux reaction - into the flexor surface of the forearm. OPV is injected into the mouth, if a child spit up a dose of the vaccine, he is given a second dose, if he spit it up, the vaccination is postponed.

Surveillance of the vaccinated lasts 30 minutes, when an anaphylactic reaction is theoretically possible. Parents should be informed of possible reactions requiring medical attention. The child is observed by a patronage nurse first 3 days after the introduction inactivated vaccine, on the 5-6th and 10-11th day - after the introduction of live vaccines. Information about the vaccination carried out is recorded in the registration forms, vaccination journals and in the Certificate of preventive vaccinations.

According to the degree of need, allocate: scheduled (mandatory) vaccination, which is carried out in accordance with the vaccination schedule, and vaccination according to epidemiological indications, which is carried out to urgently create immunity in persons at risk of developing an infection.

IMMUNICATION CALENDAR IN UKRAINE

(Order of the Ministry of Health of Ukraine No. 48 dated 03.02.2006)

Vaccinations by age

Vaccinations for the prevention of tuberculosis are not carried out on the same day as other vaccinations. It is unacceptable to combine vaccinations for the prevention of tuberculosis with other parenteral manipulations on the same day. Revaccination against tuberculosis is subject to children aged 7 and 14 years with a negative result of the Mantoux test. Revaccination is carried out with the BCG vaccine.

All newborns are subject to vaccination for the prevention of hepatitis B, vaccination is carried out with a monovalent vaccine (Engerix B). If the mother of the newborn is HBsAg "-" (negative), which is documented, the child can be vaccinated during the first months of life or combined with pertussis, diphtheria, tetanus, polio (Infanrix IPV, Infanrix penta). In the case of a combination of immunization with vaccinations against whooping cough, diphtheria, tetanus and poliomyelitis, schemes are recommended: 3-4-5-18 months of life or 3-4-9 months. life. If the mother of the newborn is HBsAg "+" (positive), the child is vaccinated according to the scheme (first day of life) - 1-6 months. The first dose is administered in the first 12 hours of a child's life, regardless of body weight. Together with vaccination, but no later than the 1st week of life, it is necessary to introduce specific immunoglobulin against hepatitis B into another part of the body at the rate of 40 IU/kg of body weight, but not less than 100 IU. If the mother of a newborn with HBsAg has an undetermined HBsAg status, the child must be vaccinated in the first 12 hours of life with a simultaneous study of the mother's HBsAg status. In the case of a positive result in the mother, hepatitis B prophylaxis is carried out in the same way as in the case of vaccinating a newborn child against HBsAg "+" of the mother.

The interval between the first and second, second and third vaccination with DTP vaccine is 30 days. The interval between the third and fourth vaccination should be at least 12 months. The first revaccination at 18 months is carried out with a vaccine with an acellular pertussis component (hereinafter referred to as AaDTP) (Infanrix). AaDPT is used for further vaccination of children who had post-vaccination complications from previous DTP vaccinations, as well as for all vaccinations for children with a high risk of post-vaccination complications based on the results of a vaccine commission or a pediatric immunologist. Combined vaccines (with different options combinations of antigens) that are registered in Ukraine (Infanrix hexa).

Inactivated polio vaccine (hereinafter IPV) is used for the first two vaccinations, and in case of contraindications to oral polio vaccine (hereinafter - OPV) - for all subsequent vaccinations according to the vaccination calendar (Poliorix, Infanrix IPV, Infanrix penta, Infanrix hexa). After OPV vaccination, it is proposed to limit injections, parenteral interventions, elective surgeries within 40 days, and exclude contact with patients and HIV-infected people.

Vaccination for the prevention of Hib infection can be carried out with monovaccines and combined vaccines that contain a Hib component (Hiberix). When using Hib vaccine and DPT from different manufacturers, the vaccines are given in different parts of the body. It is advisable to use combination vaccines with a Hib component for primary vaccination (Infanrix hexa).

Vaccination for the prevention of measles, mumps and rubella is carried out with a combined vaccine (hereinafter - MMR) at the age of 12 months (Priorix). Re-vaccination for the prevention of measles, mumps and rubella is carried out for children at the age of 6 years. Children who have not been vaccinated against measles, mumps and rubella at 12 months of age and at 6 years of age can be vaccinated at any age up to 18 years of age. In this case, the child should receive 2 doses with a minimum interval. Children aged 15 years who have received 1 or 2 measles vaccinations but have not been vaccinated against mumps and rubella and have not had these infections are given routine vaccination against mumps (boys) or against rubella (girls). Persons over 18 years of age who have not previously been vaccinated against these infections can be vaccinated with a single dose according to epidemic indications at any age up to 30 years. A history of measles, mumps or rubella is not a contraindication to trivaccination.

Which is better: Pentaxim vaccine, Infanrix Hexa vaccine or DTP?

Which is better: imported vaccine Infanrix, Infanrix Hexa or DTP?

At the same time, in new imported drugs from the group Infanrix the pertussis component consists of purified antigens, as a result of which it causes significantly fewer unpleasant side effects and serious complications.

Thus, when choosing between DPT and Infanrix, one should definitely focus on the Infanrix vaccine.

The conventional three-component vaccine Infanrix, in fact, is modern analogue good old DTP, because it protects only from three diseases - whooping cough, diphtheria and tetanus. This means that the prescribed vaccinations for polio, hepatitis B, and Haemophilus influenzae infections, you will have to administer separately.

Many parents unreasonably believe that they should not "torment the child" with too much antigenic load of complex multicomponent vaccines, and prefer the combination of Infanrix with monovaccines (that is, with vaccines that protect against only one disease), which are administered on different days.

For example, instead of Infanrix Hexa, you can use a combination of Infanrix + Imovax Polio ("killed" monovaccine against polio, manufacturer France) + Engerix B (vaccine against hepatitis B, manufacturer UK) + Hiberix (vaccine against hemophilic infection, manufacturer UK).

Of course, this is expensive, inconvenient and, in the end, painful for the child (after all, you will have to make 4 injections instead of one), but many parents think that in this way they can save the child from a one-time overload.

Meanwhile, it has been clinically proven that the use of multicomponent vaccines generally reduces the number of unpleasant side effects and complications. So if vaccinations against these six diseases have not yet been carried out or have not been carried out in full, then it is better to give preference to Infanrix Hexa before triple vaccine Infanrix.

Differences Infanrix Hexa and Pentaxim

It should be noted that the absence of a hepatitis component can be an advantage in the case when the vaccination against this disease has already been done.

The fact is that, in accordance with the vaccination calendar, primary immunization against hepatitis B begins to be carried out even in the maternity hospital, and the second dose is supposed to be administered in the second month of life. In total, you will need three doses of the hepatitis B vaccine, so in each case, you should carefully follow the vaccination schedule and consult with your doctor.

The second feature of the Pentaxim vaccine is that, unlike Infanrix Hex, the pertussis element is represented not by three, but by two antigens.

This approach has its positive and negative sides. The undoubted advantage of the Pentaxim vaccine will be less stress on the immune system and fewer adverse side effects associated with the pertussis component, since here it is significantly "lightened".

However this advantage is offset by the fact that in the case of infection with the whooping cough bacterium, the immune response will not be so strong.

Therefore, when choosing between the Pentaxim vaccine and Infanrix Hexa, one should consult with the attending physician, who will take into account such factors as the ratio between the risk of developing a reaction to a full-fledged pertussis component and the risk of pertussis infection in a particular child.

Which is better - Tetraxim or Infanrix IPV?

However, the analogy will not be complete because, as in the case of the Pentaxim vaccine, the pertussis element of the Tetraxim vaccine is represented by only two antigens - pertussis toxoid and filamentous hemagglutinin. So the immune response, in fact, will be developed only to toxins - "poisons" secreted by the bacterium.

While Infanrix also contains pertactin, the outer protein of the bacterium, which promotes its adhesion (sticking) to the walls of the trachea. Thus, the immune response generated by the Infanrix vaccine will not allow the whooping cough bacteria to gain a foothold and multiply in the body.

So, purely theoretically, Infanrix should cause stronger immunity, however, the number of adverse reactions to this vaccine will also be slightly higher. In controversial cases, it is better to consult with your doctor, who will weigh the pros and cons.

However, it should be noted that no particularly significant differences were found in clinical trials of both drugs. Children vaccinated with Tetraxim do not get whooping cough or suffer from a mild disease, and the number of complications and side effects after Infanrix is ​​not much different from Tetraxim.

So if only one of the vaccines is available, it makes no sense to wait for another, as a more suitable one.

Missing Infanrix. I looked through all the pharmacies - not available. Which is better: wait for the Infanrix vaccine to appear and skip the vaccination schedule, or administer Pentaxim or DPT after Infanrix (Infanrix IPV Hib, Belgium)? We have the third Infanrix vaccination

This is especially true for the whooping cough component, in without fail which is part of Infanrix, DTP and Pentaxim, as well as the vaccine against hemophilic infection, which is part of the drug Pentaxim.

Therefore, it is better to wait until the Infanrix vaccine appears.

Is it possible to revaccinate DTP with Infanrix?

The remaining two components (diphtheria and tetanus) in the Infanrix and DTP vaccines are completely identical.

Is DPT revaccination possible after Infanrix?

Moreover, Infanrix is ​​much better tolerated than DTP.

Can I start Infanrix vaccination after one year? I would like to wait until the baby gets stronger

Secondly, by postponing vaccinations for a year, you are doing a disservice to the child - just in the first year of life, vaccinations are much easier to tolerate.

When is caution necessary to avoid adverse side effects of the Infanrix vaccine?

Particular care is needed in the case of vaccination of children suffering from thrombocytopenia or pathology of the blood coagulation system, since such an unpleasant complication as bleeding is possible.

To prevent the formation of intramuscular hematoma, the injection site after the introduction of the vaccine should be pressed without rubbing for 2 minutes.

I read reviews for 2014 about complications after the Infanrix Hexa vaccine (manufacturer Belgium). Do I need any preparation for vaccination to avoid complications?

Will medication preparation for Infanrix Hexa vaccination help?

No special preparations for vaccination with Infanrix Hexa are required. However, it is known that a strong, healthy and hardened child tolerates any vaccination more easily than a frail and sick one.

It follows that the preparation for vaccination includes constant care for the health of the child, correct mode sleep and nutrition, hygiene procedures, hardening, etc.

In addition, there are several simple rules below.

"Family" temporary contraindications to vaccination with Infanrix Hexa

First and foremost rule: on the day of vaccination, the child must be absolutely healthy. Therefore, if parents notice some disturbing symptoms that are invisible to prying eyes, which may turn out to be signs of an incipient disease, it is better to postpone vaccination for one day to clarify the situation.

So, for example, it is undesirable to be vaccinated if the baby did not sleep well the day before, ate his favorite porridge poorly, was too capricious.

Also postpone the vaccination if the child less than three days before the vaccine was in contact with a large number of people and could "catch" any viral infection (this is the period necessary for the onset of symptoms of the disease).

Second rule: on the day of vaccination, as well as in the following week, the child should not be affected by adverse factors external environment: Postpone vaccination if it is extremely hot or brutally cold outside. Also, do not administer the drug if any of the household has contracted SARS, a family holiday with a large number of guests or a long trip is planned.

The introduction of new food is also stressful for the baby's body, so if you have introduced complementary foods or any new food, wait three days before the introduction of the vaccine (of course, if you know the day of vaccination in advance, then just do not experiment with the menu three days before the introduction of the vaccine and a week after).

Preparation for vaccination with Infanrix Hexa on the day of vaccination

In the clinic, try to contact as little as possible with strangers- it is best to stand somewhere on the sidelines, or take a queue and take a walk with the baby on the street. Alas, the polyclinic is a well-known source of infection; healthy people go there very rarely.

Gateway to the majority viral infections are the upper respiratory tract, therefore, in order to protect the child from infection in a corridor densely packed with people, bury the baby every 15-20 minutes saline(2-3 drops in each nostril).

How to behave after vaccination to prevent side effects of Infanrix Hexa?

Consequently, doctors will advise parents to sit with the child in the corridor, where, as we know, there is increased risk infection. The wisest way out of the situation would be to go for a walk with the child in the fresh air, without moving away from the clinic building for a long distance.

After vaccination, it is desirable to observe the maximum hunger interval, you can give the baby water to drink, entertain, distract, etc. It will be ideal if you manage to survive 3 hours without food.

On the day of vaccination, the child should not overeat, it is recommended plentiful drink and fresh air. In the next week, contact with strangers should be limited.

What is an Infanrix (Infanrix Hexa) vaccine reaction?

This is a fundamental difference between a reaction to a vaccine (an unpleasant side effect) and a complication, which is a more persistent violation and further serves as a contraindication for the repeated use of the vaccine.

All reactions to vaccination can be divided into general and local. Local reactions occur at the injection site and are manifested by the following symptoms:

• soreness;
• redness;
• compaction of soft tissues.

• increase in body temperature;
• general weakness, lethargy, drowsiness;
• arthralgia (pain in the joints);
• nausea, vomiting, abdominal pain;
• short-term fainting.

Temperature after Infanrix Hexa vaccination

What should I do if the Infanrix Hexa vaccine caused such a general reaction as a temperature?

In this case, parents must perform the following algorithm of actions:
1. In the room where the child is located, it is necessary to maintain relative coolness (about 20 degrees) and normal humidity (50-70%).
2. The standard rule for all childhood troubles is to reduce the amount of food and increase the amount of drink.
3. For drinking, it is very useful to use special solutions for oral dehydration, such as Gastrolit, Hydrovit, Regidron, Regidrare, Orasan, Humana Electrolyte, etc. (available in almost any pharmacy).
4. An increase in temperature in the case of a graft reaction is not associated with the actual immunogenicity of the graft, but with its reactogenicity. In other words, an increase in body temperature is not associated with the creation of an immune memory of the infection, but is a manifestation of an allergic reaction. Therefore, it is quite reasonable to prescribe antipyretic drugs when the temperature rises higher than 37.5 degrees Celsius.

Thus, it is advisable to stock up on solutions for oral dehydration and antipyretic drugs even before the introduction of the vaccine.

What antipyretic drugs "knock down" the temperature after Infanrix?

Paracetamol (Acetaminophen, Acetophen, Daleron, Panadol, Paracet, Efferalgan) is taken at a dose of 10-15 mg / kg of body weight. At the same time, the frequency of using the drug per day should not exceed 4-5 times at intervals of at least 4 hours, so that the total dose does not exceed 60 mg / kg of body weight.

Many parents use suppositories, this route of administration is more gentle on the baby's stomach. However, in this case, it should be remembered that the higher the body temperature, the slower the active substance into the blood. Therefore, when high temperature It is advisable to take paracetamol orally.

The optimal single dose of ibuprofen (Brufen, Nurofen) is much lower - 5-10 mg/kg of body weight. In this case, the intake of the antipyretic agent can be repeated only after 6 hours, so that the daily dose does not exceed 20 mg / kg.

When is fever after vaccination an indication for seeking medical attention?

Sealing after Infanrix: what to do?

It should be noted that the local reaction to inactivated vaccines, which includes Infanrix, is always higher than to live ones. This circumstance is due to the fact that special substances are added to the composition of such vaccines - adjuvants that enhance the local reaction and contribute to the formation of a more pronounced immune response.

A local reaction to the Infanrix vaccine appears within the first two days, and lasts from two to ten days. In doing so, there are three severity local reaction :

• light (up to 2.5 cm);
• moderate (2.5 - 5 cm);
• heavy (more than 5 cm).

In such cases, compaction after Infanrix may be complicated by the development of local purulent complications requiring surgical intervention and/or antibiotic therapy.

In addition, severe local reactions include the appearance of an allergic rash at the injection site and / or an increase in regional lymph nodes. In extremely severe cases, edema can capture a nearby joint or spread to the entire limb. Such reactions are extremely rare and require specialized medical attention.

As for a mild local reaction, it is normal indicating the activation of the immune sphere. Therefore, no additional measures no need to remove it.

There are tips on the net about how to use it to reduce unpleasant local symptoms such means as iodine mesh, compresses, cabbage leaves, etc. However, experienced experts say that the effectiveness of such drugs is close to zero.

The child is one and a half years old. We make vaccinations according to an individual calendar. Have already done BCG and hepatitis B. Which is better: a combination of Infanrix (DPT) + Imovax Polio or Pentaxim vaccine? I'm not interested in the price, but how the vaccine is tolerated. I read the reviews - I can’t decide, it seems that everything happens there, and there

It's not just the cost of drugs, in general, multicomponent vaccines are easier to tolerate, you will save time and will not expose your baby to the risk of infection during an additional visit to the clinic for vaccination against Haemophilus influenzae. So already in this respect you will definitely win.

In addition, in your case (the child began to be vaccinated a year later than the standard schedule), Pentaxim containing a lightweight pertussis element is more suitable.

If you opt for the Pentaxim vaccine, please note that you will need two more vaccinations with the same drug. Doctors recommend primary immunization with a vaccine from one manufacturer.

We had our first shot at 3 months with Infanrix IPV. Now the second injection. It is not clear where Infanrix IPV has gone, but the Infanrix vaccine (DTP) can be ordered. What is the best way to put Infanrix and poliomyelitis - separately (Infanrix + OPV), or wait for Infanrix IPV?

These two components are interchangeable. Moreover, schemes have been developed where vaccination of children begins with IPV-type vaccines, and then switches to OPV. So in this regard, you should not be afraid of anything.

The advantages of OPV are improved immunity, ease of use (taken orally), and low cost of the drug. This vaccine is generally well tolerated. However, there are also disadvantages.

The OPV vaccine is a live, albeit attenuated, vaccine, so there are additional contraindications. This drug is strictly not recommended for children with severe disorders. immune system.

In addition, a vaccinated child for some time turns into a spreader of attenuated polio infection, so the use of the OPV vaccine is undesirable in cases where the following categories of people are among the persons in contact with the baby:

• unvaccinated against polio;
• suffering from immunodeficiency;
• pregnant women.

We have 3 Infanrix shots. The first two vaccinations were given with the Infanrix IPV vaccine. Today I checked the availability in pharmacies: Infanrix IPV is not available, but you can buy Infanrix (DPT) and Poliorix. I looked for reviews on the net, but it turned out that few parents decided on such a combination. And Komarovsky does not write anything about this. Which is better: put Infanrix and Poliorix or wait for Infanrix IPV?

The Poliorix vaccine contains the same killed polio virus culture as the polio component of the Infanrix IPV vaccine. Moreover, the Poliorix vaccine is produced by the same company as Infanrix IPV. So with a combination of Infanrix (DPT) + Poliorix it is quite possible to replace Infanrix IPV.

However, the higher cost of drug combinations is not the only thing you lose out on. Your child will suffer from an increase in the number of injections as Infanrix and Poliorix will be given separately in different limbs.

Of course, this is not so tragic, but it’s better to check with the pharmacy when the drug arrives, it might make sense to wait.

How to replace Infanrix IPV HIB? Revaccination required. I don't know why, but Infanrix (all types) is gone. Can Pentax be used?

Pentaxim protects against the same diseases as Infanrix IPV Hib, so it can be successfully used as an analogue.

What is the difference between Infanrix with hepatitis (Infanrix Hexa) and Pentaxim? Which drug is better to choose for the first DPT vaccination? The doctor says that in the future it will be necessary to pay attention to production and choose drugs from one company.

In the future, you should switch to Infanrix IPV-HIB and continue to develop an immune response against whooping cough, diphtheria, tetanus, polio, and Haemophilus influenzae. Three more doses will need to be administered with this drug: two remaining from the primary immunization course and one booster (rebooster), at 4.5, 6 and 18 months, respectively.

Pentaxim is manufactured by Sanofi Pasteur and is traditionally used for all four doses required for primary immunization and booster vaccination against whooping cough, tetanus, diphtheria, polio and Haemophilus influenzae.

If you choose this drug, you will have to give the third dose of hepatitis B separately. Its administration can be combined with the administration of the Pentaxim vaccine (on the same day, but in different parts of the body). If you feel sorry for the baby and refuse to have two injections in one day, you will have to go to the clinic once again, exposing the child to the risk of contracting some kind of SARS.

Both drugs (Pentaxim and Infanrix) are well tolerated and have sufficient a large number of appreciative reviews online. To commit optimal choice consult with your doctor, who will take into account the availability of drugs from this manufacturer in your area.

With the same availability of both drugs, it should be borne in mind that choosing Infanrix, you will reduce the number of injections for your baby by at least one injection. You should especially think about it if you have not yet received a single vaccination against hepatitis B.

It should be noted that during revaccination, the use of drugs from another manufacturer is allowed, although not recommended.

One of the most important areas of applied immunology is the creation effective drugs for immunoprophylaxis and immunotherapy of infectious diseases.

Immunotherapy– introduction from medicinal purposes immunobiological preparations (for example, therapeutic vaccines, sera, immunoglobulins, interferons, cytokines).

Immunoprophylaxis - the introduction of immunobiological preparations in order to prevent the development of infectious diseases (for example, vaccines, sera).

All agents used to influence the immune system are known as immunobiological preparations. These include substances of various nature and origin.

^ Types of immunobiological preparations:

1. Prophylactic and therapeutic drugs of microbial origin (for example, vaccines, bacteriophages, eubiotics, toxoids).

2. Medications(e.g. immunoglobulins, cytokines)

3. Diagnostic immune preparations(eg, antisera), as well as diagnostic bacteriophages and allergens.

4. Immunomodulators (various synthetic drugs, biostimulants of natural origin).

Immunobiological agents may have different action on the human body:

1. Active action - drugs induce the development of immune reactions (eg, vaccine preparations).

2. Passive action - the effects of drugs that are effector products of immunocompetent cells (eg, immunoglobulins, cytokines, sera).

3. Drugs that provide protection against a specific pathogen (eg, measles vaccine, tetanus toxoid) show a specific effect.

4. A non-specific effect is exerted by drugs that non-selectively stimulate the functions of the immune system (eg, immunomodulators, many biostimulants).

Vaccines.

The name "vaccine" was given by L. Pasteur to all vaccination preparations obtained from microorganisms and their products. The first vaccine was received by E. Jenner. It contained a live vaccinia virus, identical in antigenic properties to the human variola virus, but of low virulence for humans. That. the first vaccine strain was borrowed from nature. The merit of L. Pasteur is the development of principles for the targeted production of vaccine strains and the creation of vaccines against rabies and anthrax. He discovered the phenomenon attenuation (attenuation) - selection of strains with reduced virulence and preserved immunogenic properties by cultivating them under certain conditions or passing animals resistant to this infection through the organism.

Currently, there is a section of immunoprophylaxis that deals with the development and use of vaccines - vaccinology. Thanks to vaccination, many epidemic diseases dangerous to all mankind have been defeated - smallpox (eliminated), poliomyelitis, diphtheria (practically eliminated), measles, whooping cough, tetanus, brucellosis, tularemia, anthrax, tick-borne encephalitis, rabies (epidemic danger has been reduced).

Antigens in vaccine preparations are:

1. whole microbial bodies (live or killed)

2. individual antigens of microorganisms

3. microorganism toxins

4. artificially created antigens of microorganisms

5. antigens obtained by genetic engineering.

classifications of vaccines.

1. By the nature of the antigen.

Bacterial vaccines

Viral vaccines

2. According to the methods of preparation.

Live vaccines

Inactivated vaccines (killed, non-live)

Molecular (anatoxins)

genetic engineering

Chemical

3. By the presence of a complete or incomplete set of antigens.

Corpuscular

Component

^ 4. According to the ability to develop immunity to one or more pathogens.

Monovaccines

associated vaccines.
Live vaccines- preparations in which the following are used as the active principle:

Attenuated, i.e. weakened (lost their pathogenicity) strains of microorganisms;

The so-called divergent strains of non-pathogenic microorganisms having related antigens with antigens of pathogenic microorganisms;

Recombinant strains of microorganisms obtained by genetic engineering (vector vaccines).

Immunization with a live vaccine leads to the development of the vaccinal process, which occurs in the majority of those vaccinated without visible clinical manifestations. The main advantage of this type of vaccine- a completely preserved set of pathogen antigens, which ensures the development of long-term immunity even after a single immunization. However, there are also a number of disadvantages. The main one is the risk of developing a manifest infection as a result of a decrease in the attenuation of the vaccine strain (for example, live polio vaccine in rare cases, it can cause poliomyelitis up to the development of spinal cord injury and paralysis).

^ Attenuated vaccines are made from microorganisms with reduced pathogenicity, but pronounced immunogenicity. Their introduction into the body mimics the infectious process.

^ Divergent vaccines - Microorganisms that are closely related to pathogens of infectious diseases are used as vaccine strains. The antigens of such microorganisms induce an immune response that is cross-directed against the antigens of the pathogen.

^ Recombinant (vector) vaccines - are created on the basis of the use of non-pathogenic microorganisms with the genes of specific antigens of pathogenic microorganisms built into them. As a result, a living non-pathogenic recombinant strain introduced into the body produces an antigen pathogen providing the formation of specific immunity. That. the recombinant strain acts as a vector (conductor) of a specific antigen. As vectors, for example, a DNA-containing vaccinia virus, non-pathogenic salmonella, into the genome of which the genes of HBs, the antigen of the hepatitis B virus, antigens of the tick-borne encephalitis virus, etc., are introduced.

^ Corpuscular (whole cell, whole virion) vaccines - contain a complete set of antigens, prepared from killed virulent microorganisms (bacteria or viruses) by heat treatment, or exposure to chemical agents (formalin, acetone). For example, anti-plague (bacterial), anti-rabies (viral).

^ Component (subunit) vaccines - consist of individual antigenic components that can ensure the development of an immune response. To isolate such immunogenic components, various physicochemical methods are used, therefore they are also called chemical vaccines. For example, subunit vaccines against pneumococci (based on capsule polysaccharides), typhoid fever (based on O-, H-, Vi-antigens), anthrax (polysaccharides and polypeptides of capsules), influenza (viral neuraminidase and hemagglutinin). To give these vaccines a higher immunogenicity, they are combined with adjuvants (sorbed on aluminum hydroxide).

^ Genetically engineered vaccines contain antigens of pathogens obtained using genetic engineering methods, and include only highly immunogenic components that contribute to the formation of an immune response.

Ways to create genetically engineered vaccines:

1. Introduction of virulence genes into avirulent or weakly virulent microorganisms (see vector vaccines).

2. Introduction of virulence genes into unrelated microorganisms, followed by isolation of antigens and their use as an immunogen. For example, for the immunoprophylaxis of hepatitis B, a vaccine has been proposed, which is the HBsAg of the virus. It is obtained from yeast cells into which a viral gene (in the form of a plasmid) encoding the synthesis of HBsAg has been introduced. The drug is purified from yeast proteins and used for immunization.

Anatoxins- toxins neutralized with formaldehyde (0.4%) at 37-40 ºС for 4 weeks, completely lost their toxicity, but retained the antigenicity and immunogenicity of toxins and are used to prevent toxin infections (diphtheria, tetanus, botulism, gas gangrene, staphylococcal infections and etc.). The usual source of toxins is industrially cultivated natural strains-producers. I release toxoids in the form of mono- (diphtheria, tetanus, staphylococcal) and associated (diphtheria-tetanus, botulinum trianatoxin) preparations.

Conjugate vaccines are complexes of bacterial polysaccharides and toxins (eg, a combination of Haemophilus influenzae antigens and diphtheria toxoid). Attempts are being made to create mixed cell-free vaccines, including toxoids and some other pathogenicity factors, eg, adhesins (eg, acellular pertussis-diphtheria-tetanus vaccine).
Monovaccines - vaccines used to create immunity to one pathogen (monovalent drugs).

Associated drugs - for simultaneous creation of multiple immunity, antigens of several microorganisms (usually killed) are combined in these preparations. The most commonly used are: adsorbed pertussis-diphtheria-tetanus vaccine (DPT-vaccine), tetravaccine (vaccine against typhoid fever, paratyphoid A and B, tetanus toxoid), ADS-vaccine (diphtheria-tetanus toxoid).
^ Vaccine administration methods.

Vaccine preparations are administered orally, subcutaneously, intradermally, parenterally, intranasally and by inhalation. The route of administration determines the properties of the drug. Live vaccines can be administered skin-to-skin (scarification), intranasal, or oral; toxoids are administered subcutaneously, and non-live corpuscular vaccines - parenterally.

Intramuscular injected (after thorough mixing) sorbed vaccines (DPT, ADS, ADS-M, HBV, IPV). ^ The upper outer quadrant of the gluteal muscle should not be used, since in 5% of children the nerve trunk passes there, and the buttocks of the baby are poor in muscles, so that the vaccine can get into fatty tissue (risk of slowly dissolving granuloma). The injection site is the anterolateral thigh (lateral part of the quadriceps muscle) or, in children older than 5-7 years, the deltoid muscle. The needle is inserted vertically (at an angle of 90°). After the injection, the plunger of the syringe should be pulled back and the vaccine should be administered only if there is no blood, otherwise the injection should be repeated. Before injection, the muscle is folded with two fingers, increasing the distance to the periosteum. On the thigh, the thickness of the subcutaneous layer in a child up to the age of 18 months is 8 mm (max. 12 mm), and the thickness of the muscle is 9 mm (max. 12 mm), so a needle 22-25 mm long is sufficient. Another method- in children with a thick fatty layer - stretch the skin over the injection site, reducing the thickness of the subcutaneous layer; while the depth of needle insertion is less (up to 16 mm). On the arm, the thickness of the fat layer is only 5-7 mm, and the thickness of the muscle is 6-7 mm. In patients hemophilia intramuscular injection is carried out in the muscles of the forearm, subcutaneous - in the rear of the hand or foot, where it is easy to press the injection channel. subcutaneously unsorbed - live and polysaccharide - vaccines are administered: into the subscapular region, into the outer surface of the shoulder (on the border of the upper and middle thirds) or into the anterolateral region of the thigh. Intradermal the introduction (BCG) is carried out into the outer surface of the shoulder, the Mantoux reaction - into the flexor surface of the forearm. OPV is injected into the mouth, if a child spit up a dose of the vaccine, he is given a second dose, if he spit it up, the vaccination is postponed.

^ Surveillance of the vaccinated lasts 30 minutes, when an anaphylactic reaction is theoretically possible. Parents should be informed of possible reactions requiring medical attention. The child is observed by a patronage nurse first 3 days after the introduction of an inactivated vaccine, on the 5-6th and 10-11th day - after the introduction of live vaccines. Information about the vaccination carried out is recorded in the registration forms, vaccination journals and in the Certificate of preventive vaccinations.
According to the degree of need, allocate: scheduled (mandatory) vaccination, which is carried out in accordance with the vaccination schedule, and vaccination according to epidemiological indications, which is carried out to urgently create immunity in persons at risk of developing an infection.

^ CALENDAR OF PREVENTIVE CHIPS IN UKRAINE

Chip for a vіkom

1 The splintering is used by the new people, so they can’t think of any counter-indication. Vaccination is carried out on the 3-5th day of life of a child (not earlier than the 48th year after the birth). For vaccination of premature babies with body weight ≥ 2000 it is necessary to zastosovuvat vaccine for the prevention of tuberculosis with a change in the antigen (hereinafter - BCG-m).

Cleavage for the prevention of tuberculosis should not be carried out on the same day with other splits and other parenteral manipulations.

Children, if they were not split in the canopy hospital, are given obligatory vaccination in order to protect their health.

Even though the child is not split in the canopy hospital due to medical contraindications, splitting is carried out with the BCG vaccine, in other cases, splitting is carried out with the vaccine for the prevention of tuberculosis (hereinafter referred to as BCG).

For children who have not been cleared for two months, splitting against tuberculosis is carried out without anterior Mantoux test. After two months, before the end of BCG splitting, children should conduct a Mantoux test. Cleavage is carried out with a negative test result.

With the method of early detection of tuberculosis, the Mantoux test with 2 tuberculin units of tuberculin is detected for all children from the age of 12 months systematically once a day, regardless of the previous result.

Revaccination against tuberculosis is offered to children in 7 years of age with a negative result of the Mantoux test. Revaccination is carried out with BCG vaccine.

At the same time, that prophylactic fissures can lead to sensitivity to tuberculin, when tuberculin diagnosis is carried out for a century, it is necessary to plan before prophylactic fissures are carried out. In case of quiet or other reasons, the Mantoux test is carried out after the prophylactic split, tuberculin diagnosis should be done no earlier than one month after the split.

2 Vaccinations for the prevention of hepatitis B are available for new people. For vaccination of children against hepatitis B, there is a scheme: 0 (first doba) -1-6 months of a child's life.

Newly born with a body mass less than 2000, born from HBsAg positive mothers, vaccination is carried out obov'yazkovo at birth according to the scheme 0-1-2-7 (0 - the first day of life, the date of the first introduction of the vaccine, the minimum interval between the first and other splits - 1 month, with other and third chips - 1 month, with third and fourth chips - 5 months).

3 Cleavage for the prevention of diphtheria, correcting and coughing is carried out for a century at 3 months (first splitting), 4 months (other splitting), 5 months (third splitting) and 18 months (fourth splitting).

The interval between the first and other, other and third vaccines against cough, diphtheria, is less than 1 month. The interval between the third and fourth splits is to be no less than 12 months.

For vaccination of children against cough in the first life cycle, vaccines can be given both with acellular (hereinafter - AaKDP), and with a whole-cell (hereinafter - AAKDP) cough component.

Transferring cough in history is not a contraindication before vaccination against this disease.

Vaccination against cough is carried out for children up to 6 years of age 11 months 29 days.

Revaccination against diphtheria and right in 6 years is carried out with diphtheria-right toxoid (hereinafter - ADP), in 14 years and in 18 years - diphtheria-right toxoid with a change in antigen (hereinafter - ADP-M).

The first scheduled revaccination of grown-ups for a century and epidemiological indications, if there were splits earlier, to carry out ADP-M with an interval of 5 years after the remaining splitting. Further planned revaccinations of mature adults are carried out by ADP-M with a minimum interval of 10 years from the forward splitting of ADP-M.

4 The inactivated vaccine for the prevention of poliomyelitis (hereinafter referred to as IPV) is reserved for the first two splits, and in case of contraindications before the introduction of oral poliomyelitis vaccine (hereinafter referred to as OPV) - for all advanced lesions according to the calendar.

The OPV vaccine is prescribed for the 3rd-6th split (splitting for a century - 5 months, 18 months, 6 years and 14 years) for the most recent contraindication to OPV.

The IPV vaccine can be stocked up for the 3rd-6th split as well as in the warehouse of combination vaccines.

For children who are being treated by a family member with HIV-infection, or with individuals who are contraindicated for the introduction of OPV, splitting should be carried out exclusively with IPV-vaccine.

After the splitting of OPV is recommended to the surroundings, planned operations for 40 days, turn off contact with persons who are contraindicated for the introduction of OPV.

5 Vaccination of children to prevent infection with Haemophilus influenzae type b (hereinafter referred to as the Hib vaccine), can be carried out as monovaccines and combination vaccines to avenge the Hib component. In case of Hib vicarious vaccine for primary vaccination, it is necessary to override combination vaccines with a Hib component.

Cleavage for the prevention of infection, Haemophilus influenzae type b, followed by a schedule of 3-4-18 months.

Vaccination against Hib-infection is carried out for children up to 4 years of age 11 months 29 days. In the senior veterinarian, vaccination against Hib-infection is carried out only in individuals from the risk group, only up to chapter 4 of the division.

6 Vaccination for the prevention of measles, mumps and rubella is carried out for 12 months. Other splitting - at Vіtsі 6 rokіv.

Children who have not been vaccinated against bark, mumps and rubella for a century at 12 months and at 6 years, splitting can be repaired at any age up to 18 years. In this case, children may take 2 doses with additional doses between doses at a minimum interval.

The transfer of illness to kіr, mumps and rubella are not contraindicated to splitting.

Vaccination against bark, mumps, rubella osib older than 18 years old, who did not take away chips for a century, was introduced at branches III and IV of the th Calendar.

I didn’t follow up with a series of vaccinations, as if a dose had been missed, regardless of how long the hour had passed. It is necessary to administer doses that are not on schedule, at minimum intervals between doses.

^ Contraindications for vaccinations

Healthy people are allowed to be vaccinated, however, in preventive work, the doctor is often faced with the need to determine contraindications to vaccination in children and adults with various pathological conditions. Pathological conditions that are the basis for a permanent withdrawal from vaccinations on the basis of current contraindications are rare, their total frequency does not reach 1%. Another group of conditions (e.g., acute illnesses) require only a delay in immunization - in these cases, the term "withdrawal" should not be used, since the child (or adult) to be vaccinated is actually included in the list of vaccinated and monitored to determine the moment, when vaccination becomes available.

Contraindications requiring a delay in immunization should be differentiated for each drug and approached individually for each vaccinated. At the same time, there are a number common approaches: the intervals between any vaccinations with live vaccines must be at least 2 months, and with killed vaccines and toxoids - at least one month. Vaccinations are not carried out for the maximum incubation period people who have been in contact with the source of infection, except for vaccinations against benthic infection. But, in the event of a threat to the life of a child, quarantine for any disease is not an absolute obstacle to immunization and in each case requires individual approach. In acute diseases, the introduction of drugs specific prevention delayed until recovery.

There are no contraindications for emergency prophylaxis of tetanus and rabies vaccinations, however, here it is also necessary to remember about the choice of drugs for each vaccinated person.

^ False contraindications

Unreasonable withdrawal from vaccinations using diagnoses such as stable or regressing neurological conditions, asthma, eczema, anemia, birth defects, an increase in the thymus, long-term treatment with antibiotics, steroids, etc. Also, withdrawals from vaccinations of children who have had sepsis are not justified, hemolytic jaundice, pneumonia or having a family history of epilepsy, SIDS, strong vaccination reactions. Such references do not speak of the doctor's concern for children, but only of his medical illiteracy.

^ Post-vaccination reactions and complications

post-vaccination reactions. Post-vaccination (vaccination) reaction is a state of the body characterized by a short-term, mostly subjectively assessed, change in the nature of its functioning. It is objectively manifested in a change in the functional state of homeostasis systems, which, as a rule, does not go beyond physiological norm and compensatory in nature. In some cases, post-vaccination reactions can be considered as borderline with a pathological condition. Changes in subjective and objective indicators in such cases go beyond the norm, but are short-term (no more than 7 days).

Post-vaccination reactions are divided into local and general. Local develop directly at the injection site. With parenteral administration, the intensity of the local reaction is estimated as follows: hyperemia without infiltration or infiltration with a diameter of up to 2.5 cm - a weak reaction; infiltrate with a diameter of 2.6 - 5.0 cm - medium strength; infiltrate with a diameter of more than 5 cm, or infiltrate in the presence of lymphangitis with lymphadenitis - a strong reaction.

The severity of the general reaction is usually assessed mainly by the degree of temperature increase, i.e. the reaction is weak - at a temperature of 37-37.5°C, medium - at 37.6-38.5°C, strong at a temperature above 38.5°C. In addition to the degree of temperature increase, other criteria can be used, for example, lowering blood pressure, vomiting, short-term fainting after the introduction of typhoid vaccines, dyspeptic disorders after the use of the cholera vaccine, the severity of conjunctivitis, catarrhal phenomena in the nasopharynx, the intensity of the rash after immunization with measles vaccine.

Post-vaccination complications. Post-vaccination complications are painful reactions that differ in time of onset, strength and quality from the usual reactions characteristic of this drug. Pathological processes that occur in the post-vaccination period are divided into:

1) actually post-vaccination complications, the development of which was a direct consequence of the vaccination (anaphylactic shock, post-vaccination encephalitis, etc.);

2) complications associated with violation of the rules of asepsis during the production of vaccination and inoculation with the vaccine of foreign microorganisms;

3) exacerbation of chronic diseases and activation of latent infection (tuberculosis, rheumatism, bronchial asthma, etc.);

4) pathological processes associated with intercurrent infection that joined in the post-vaccination period.

In these cases, the vaccination process can contribute to the aggravation and complicated course of an intercurrent infection (respiratory viral, staphylococcal, meningococcal, etc.). In turn, intercurrent infection can cause a more severe course of the vaccination process.

All cases of complications and unusual reactions that have developed after the use of bacterial, viral and serum preparations are subject to special accounting. The investigation is organized by the territorial CGE, which received an emergency notification from the medical facility. An epidemiologist, a clinician take part in the work of the commission general profile(therapist or pediatrician), a doctor with a narrow specialization in the profile of the complication. The act drawn up at the end of the investigation is sent through the authorities to the Ministry of Health.

In order to prevent post-vaccination complications, it is necessary:

Impeccable vaccination technique, especially strict observance of asepsis;

Compliance with the established deadlines for vaccinations;

Identification of contraindications;

Timely implementation of recreational activities;

Use of sparing immunization methods.