All FOR and AGAINST...

Talk about the need and harm of vaccinations flares up and then fades among parents. There are voices calling for the complete abandonment of extensive immunoprophylaxis in order to “preserve the health of children.” But everyone had the opportunity to make sure: as soon as, for some reason, the prevention of infectious diseases was weakened, diseases set in! On the contrary, mass vaccinations were able to significantly reduce the incidence of many dangerous infections and eliminate some (smallpox in a number of countries - poliomyelitis). In the light of modern knowledge, from the standpoint of world science and practice, the question of the significance of preventive vaccinations for a child's health can only be answered positively.

The effectiveness of vaccination throughout the world is generally recognized - there is no other program in the field of health that would bring such impressive results. Indeed, with the help of vaccination, it is possible to prevent a significant number of deaths every year, namely, to save up to 4.5 million human lives!

While appreciating the importance of vaccination, is it correct to say that vaccination cannot lead to adverse reactions? Of course not. But complications from the introduction of vaccines are very rare: no more than one case in hundreds of thousands and even millions of vaccinations. The need and benefit of vaccinations is immeasurably higher than their possible danger.

The question of the choice of vaccination concerns each of us and literally immediately with the advent of a new family member. It is the responsibility of every parent to protect their children from deadly infections by understanding the importance of vaccinations.

When and how to vaccinate...

Different countries have their own national vaccination schedules. In Russia, such a calendar was recently updated and provides for the mandatory protection of children against 12 infectious diseases:
Hepatitis B
Tuberculosis
Polio
whooping cough
Diphtheria
tetanus
Corey
Mumps
Rubella
flu
pneumococcal infection
Haemophilus influenzae (for children at risk)

Special examinations of the child, including blood and urine tests, and even more complex immunological studies before vaccination are not required. Only a thorough examination by a pediatrician is needed to exclude an acute disease.

It is important to understand that vaccination is not a whim of doctors, but a real opportunity to protect children from serious, often fatal diseases.

DEAR PARENTS, KNOW: BY VACTING YOUR CHILD, YOU PROTECT HIM FROM INFECTIOUS DISEASES.

IF YOU REJECT VACCINES, YOU RISK THE HEALTH AND LIFE OF YOUR CHILD!

Vaccination - this is the creation of artificial immunity to certain diseases; it is currently one of the leading methods of preventing infectious diseases.

In the human body, the vaccine causes a response of the immune system - the formation of its own protective factors - antibodies to a specific infectious agent. This is how specific immunity is formed, and the body becomes immune to this disease. Our immune system has a “good memory”, remembering the previous meeting, quickly develops protective factors and destroys pathogens that enter the body, preventing the disease from developing.

Updated 25.04.2016 25.04.2016

The effectiveness of vaccination throughout the world is generally recognized, there is no other health program that would give such impressive results. In almost a single generation, more than a dozen severe infections that previously caused severe damage were eliminated or minimized. Over the past 10 years, significant progress has been made in the development and introduction of new vaccines and the expansion of population coverage with immunization programs. Thanks to immunization, the number of deaths of children 0-5 years old from preventable infections (diphtheria, measles, neonatal tetanus, whooping cough, poliomyelitis) is decreasing every year.
Paradoxically, the fact that immunization has made many infectious diseases quite rare, and some of them even forgotten, has led parents and part of the population to form the opinion that vaccinations are no longer needed. In fact, refusal to vaccinate leads to a decrease in the immune layer and outbreaks of infectious diseases. Support is needed for immunization programs to prevent the return of high-risk infectious diseases that cause disability and death to the region. Immunization saves millions of lives every year. This success should be consolidated and maintained.
National Immunization Schedule- This is a list of vaccines used. National calendar of preventive vaccinations in Russia, determined by Federal Law No. 157-FZ "On Immunoprophylaxis of Infectious Diseases", includes vaccinations against 12 infections and list of vaccinations according to epidemic indications. The number of vaccines designed to prevent infectious diseases is increasing. This makes it possible to expand national vaccination schedules and improve the protection of human health. Combination vaccines are one of the obvious and effective solutions to the problem of reducing the number of injections given to a child during vaccination.
The biological foundation of the possibility of creating combined vaccines is the fact that the immune system is able to form a specific immune response to many antigens at once. In this case, the production of antibodies in response to all these antigens occurs in the same way as with their separate administration. Moreover, some vaccines, when administered simultaneously, can enhance the immune response. If we talk about reactions to the introduction of combined vaccines, then numerous studies show that there was no increase in the severity of general and local reactions to the introduction of these drugs.
Preventive vaccinations are carried out in the vaccination room of the children's clinic, medical offices of preschool institutions, schools.
Federal Law No. 157-FZ “On the Immunoprophylaxis of Infectious Diseases” provides: free vaccinations, complete and objective information about vaccinations, the use of vaccines registered in Russia, social protection of citizens in the event of post-vaccination complications, refusal of preventive vaccinations.
Parents' refusal to vaccinate their child violates his right to life and health. Unreasonable medical withdrawal of a child from vaccination can be equated to the failure to provide the necessary medical care. In the event that citizens refuse preventive vaccinations, the Federal Law provides for certain rights of the state: a ban on travel to countries where specific vaccinations are required; temporary denial of admission to educational and health institutions in the event of infectious diseases or the threat of epidemics.
Since 2014 The Ministry of Health of the Russian Federation has approved a new National Calendar of preventive vaccinations and a calendar of preventive vaccinations according to epidemic indications. Introduced into the Immunoprophylaxis Calendar vaccinations against Haemophilus influenzae and pneumococcal infections for all children .

Hemophilus infection- a group of acute infectious diseases with a primary lesion of the respiratory system, the central nervous system and the development of purulent foci in various organs. Hemophilus infection in newborns, infants and young children is the main cause of purulent meningitis, otitis media, various respiratory diseases (pneumonia, bronchitis, epiglotitis), conjunctivitis, osteomyelitis, endocarditis, peritonitis, etc. The disease is severe, with high mortality in children of early age. In this regard, in many countries and here in Russia, vaccination against Haemophilus influenzae is provided for in the vaccination calendar. Vaccination reactions are rare. Usually they are manifested by redness or induration at the injection site, rarely there is a rise in temperature to 37.5 degrees. Allergic reactions are unlikely due to the absence of protein impurities in the vaccine. Serious complications are not described. There are several vaccination schedules depending on the age of the child.
pneumococcal infection- the most common bacterial infection, according to WHO, it causes 1.6 million deaths per year, of which 50% occur in children 0-5 years old. Pneumococcal infections are many different clinical forms: pneumonia (inflammation of the lungs), purulent meningitis (inflammation of the meninges), bronchitis, otitis media (purulent inflammation of the middle ear), sinusitis (inflammation of the sinuses), arthritis (inflammation of the joints), sepsis (blood poisoning ) and etc.
The highest level of pneumococcal infection is recorded after the rise in the incidence of acute respiratory viral infections (ARVI) and influenza. These viral infections lead to the disruption of the "barrier" function of the epithelium of the upper and lower respiratory tract. Therefore, it is most advisable to vaccinate against pneumococcal infection simultaneously or after the introduction of the influenza vaccine (September-December).
The most effective way to prevent a child from developing pneumococcal disease is to administer a vaccine. Registered in our country vaccines "Pneumo-23", Prevenar, Synflorix. The introduction of the vaccine is well tolerated by all vaccinated. Local grafting reactions (compaction, redness at the injection site) are recorded in no more than 5 people per 100 vaccinated. General vaccination reactions (fever, malaise, etc.) are not typical for this vaccine. All reactions after the introduction of the vaccine go away on their own within a day from the moment they appear.
Prophylactic vaccinations protect the child from severe forms of infection, from serious complications that occur after infectious diseases (infertility, paralysis, and others). Vaccination is the most effective way to protect against infectious diseases.

Olga Anatolyevna Shekhovtsova,
doctor of the vaccination room KDP (for children) MC No. 3

Infectious diseases - This is a group of diseases caused by the penetration of pathogenic (pathogenic) microorganisms into the body. This group includes such serious diseases as malaria, rubella, measles, whooping cough, viral hepatitis, influenza and other acute respiratory diseases, mumps, dysentery, salmonellosis, diphtheria, plague, cholera, brucellosis, botulism and many others.

These diseases have been known to mankind since ancient times. Epidemics of "plague diseases" covered vast territories, including entire states and peoples, and their prevention and control has always been the most serious social problem.

Prevention of infectious diseases and their spread includes the following measures:

increasing the body's resistance to hygiene and physical education;
carrying out preventive vaccinations;
quarantine measures;
cure of the source of infection.

The most efficient method prevention of infectious diseases - graft .

GRAFT- this is the introduction into the body of weakened or destroyed pathogens in the form of a vaccine. The task of vaccines is to “acquaint” the human body with the infection before the body encounters the “wild” virus. For vaccines, either the constituent parts of microbes and viruses, or highly weakened and devoid of all dangerous properties of microorganisms, are used.

How does the vaccine work?

From the point of view of the immune system, any substance that enters the body is foreign. And almost any foreign substance is the so-called "antigen", that is, it can cause an immune response of the body. After vaccination, in response to vaccine antigens, the body begins to produce antibodies- special substances that can fight the virus of a particular disease. Having protective antibodies in sufficient quantities, a person becomes immune to the disease against which the vaccine was made. Some vaccinations need to be done once in a lifetime - full immunization, while others need to be repeated regularly.

Grafting Idea appeared in China in the ΙΙΙ century AD, when humanity was trying to escape from smallpox. The meaning of the idea was that the transfer of an infectious disease could prevent this disease in the future. Therefore, a method was invented inoculation- transfer, or prophylactic infection smallpox by transferring smallpox pus through an incision.

In Europe, this method appeared in the 15th century. A French chemist made a great contribution to the development of vaccination Louis Pasteur who studied bacteriology. He proposed a new method to weaken the infectious disease. This method paved the way for new vaccines. The method proposed by Pasteur consisted in successive dilutions of the product of the disease, which contained the pathogen, in order to weaken it. In 1885, Pasteur inoculated against rabies a boy named Josef Meister, who had been bitten by a rabid dog. The boy survived. This has become a new round of development of vaccination.

Every year, 130 million children are born on the globe and approximately 12 million children die between the ages of 1 week and 14 years. About 9 million die from infectious diseases, 3 million from infections for which effective vaccines are available.

To date, vaccination is the only reliable way to avoid infectious diseases and the complications they cause. Currently, 80% of the world's child population is vaccinated, which helps to save 3 million lives annually and prevent the development of severe complications from these infections.

In the 20th century, prominent scientists developed and successfully used vaccinations against poliomyelitis, hepatitis, diphtheria, measles, mumps, rubella, tuberculosis, and influenza. New vaccines are now available, such as the cervical cancer vaccine.

Safety of modern vaccines , meeting international standards of cleaning and efficiency, is not questioned. The effectiveness of vaccination is clearly demonstrated by the example of individuals included in high-risk groups.

In modern medical practice, various types of drugs are used to form protection against infections:

* Live vaccines - consist of specially grown live microorganisms (bacteria, viruses). When ingested, they do not cause the development of an infectious disease, because they are devoid of aggressive properties. But at the same time, they form a strong and long-lasting (sometimes lifelong) immunity. Live vaccines are used to create immunity against measles, mumps, rubella, chicken pox and other infections.

*Killed (inactivated ) vaccines - consist of specially grown killed microorganisms (bacteria, viruses). Inactivated vaccines are used to create immunity against whooping cough, influenza and other infections.

*Vaccines that do not contain the whole microorganism , but only its individual components (antigens). These include vaccines for the prevention of viral hepatitis B, acellular (cell-free) pertussis vaccine, etc.

The causative agents of some infectious diseases (diphtheria, tetanus, etc.), when they enter the human body, release toxins that determine the symptoms and severity of the disease. In order to prevent the development of severe forms of such diseases and deaths, toxoids are used. They are produced by special processing of toxins to deprive them of their toxic properties and preserve their immunity-building properties.

We are on the verge of a new generation of vaccines.

If the purpose of classical vaccines is to teach the immune system to recognize a weakened or dead enemy for prevention purposes, then therapeutic vaccines are designed to help already initiated patients when the body has already entered the battle with the virus.

REMEMBER!

ANY VACCINATION IS HUNDREDS OF TIMES SAFE THAN THE DISEASE IT PROTECTS FROM.

Deputy chief physician

on the medical side

Kisel I.V.

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COURSE WORK

Specialty: 060501 Nursing

Topic: "The role of preventive vaccinations in reducing infectious diseases"

Student: Anna Demidova

group 113 mk

Supervisor:

Pavlova Elizaveta Karpovna

Ulyanovsk - 2016

VMANAGEMENT

In modern medicine, the main method of creating active acquired immunity is vaccination (immunoprophylaxis). With the help of vaccination, such a dangerous disease as smallpox was eradicated, and the number of polio ailments was minimized. Coordination of actions regarding the immunoprophylaxis of various ailments is carried out by the World Health Organization (WHO). The beginning of vaccination was laid by the brilliant experiment of E. Jenner, who in 1798 published a work entitled "A Study on the Causes and Effects of Variola Vaccine, a Disease Known as Cowpox". He called the grafting method vaccination, and the material taken from cow pox - vaccine. However, before a method of combating infectious diseases was scientifically substantiated and developed, an entirely new science had to arise - immunology. This science dates back to 1891, when Louis Pasteur discovered the ingenious principle: "If the toxicity of a microbe is reduced, it turns into a means of protection against the disease caused by it."

CHAPTER 1. THEORETICAL PART

Purpose of the study: Describe the features of immunoprophylaxis.

To achieve this goal, the following tasks must be completed:

1. To study the theoretical aspects of immunoprophylaxis as the basis for the prevention of infectious diseases.

2. To study the characteristic features of the Measures to prevent the spread of infectious diseases.

3. Consider the features of immunoprophylaxis of infectious diseases.

1.1 Immunoprophylaxis as the basis for the prevention of infectious diseasesdiseases

Immunoprophylaxis- a method of individual or mass protection of the population from infectious diseases, by creating or strengthening artificial immunity.

Immunoprophylaxis is:

Specific - against a specific pathogen.

1) Active - creating immunity through the introduction of vaccines

2) Passive - the creation of immunity by the introduction of serum preparations.

Non-specific - activation of the entire immune

infectious diseases- widespread diseases caused by a variety of microorganisms, the distinguishing features of which are: contagiousness, the presence of an incubation period, the cyclic development of clinical symptoms and the formation of specific immunity .

Preventive vaccinations have led to a decrease in the incidence of polio, measles, whooping cough, mumps, tuberculosis, malaria, typhoid fever and some other diseases. .

According to incomplete data, in the structure of infant mortality indicators, the total share of infectious diseases (taking into account mortality from pneumonia, acute respiratory diseases, congenital infections) is at least 70%.

The overall improvement of our primary health care system requires significant effort and time. However, we need to ensure effective immunization of our children, without waiting for changes in this system. Current health practices and policies across the board mean that many preschool children do not receive vaccines according to the established schedule. This situation is primarily due to existing barriers to effective immunization and the many missed opportunities for vaccination during children's visits to health facilities. The shortcomings of today's immunization practices are illustrated by outbreaks of infectious diseases, resulting in rising infant mortality rates that could portend outbreaks of vaccine-preventable diseases.

1.2 Mainprinciplesimmunopprophylaxis

Vaccinations should be carried out in medical institutions. Before vaccination, the doctor must conduct a thorough analysis of the condition of the child being vaccinated, determine the presence of possible contraindications to vaccination. Simultaneously with the study of the anamnesis, it is necessary to take into account the epidemiological situation, that is, the presence of infectious diseases in the environment of the child. This is very important, since the addition of infections in the post-vaccination period aggravates its course and can cause various complications. In addition, the development of specific immunity is reduced. If necessary, laboratory examinations and consultations with specialists are carried out. Before the prophylactic vaccination, a medical examination is carried out to exclude an acute disease, mandatory thermometry. In the medical documentation, a corresponding record of the doctor (paramedic) about the vaccination is made. It is recommended to carry out vaccinations, especially live vaccines, in the morning. The vaccination should be carried out in a sitting or lying position to avoid falling during fainting. Within 1--1.5 hours after vaccination, medical supervision of the child is necessary, due to the possible development of allergic reactions of the immediate type. Then within 3 days the child should be observed by a nurse at home or in an organized team. After vaccination with live vaccines, the child is examined by a nurse on the 5-6th and 10-11th days, since reactions to the introduction of live vaccines occur in the second week after vaccination. It is necessary to warn the parents of the vaccinated about possible reactions after the introduction of the vaccine, to recommend an anti-allergic diet and a protective regimen.

1.4 Counterindications for vaccination

The effectiveness of immunization, along with the quality of the drug, is influenced by the state of the body before vaccination, compliance with the vaccination technique and schedule, vaccination coverage of the population, and other factors. This raises the question of contraindications to immunization. It is known that vaccinations in a number of cases not only have no effect, but negatively affect the health of the vaccinated. At the same time, an exorbitant expansion of contraindications is unacceptable, since a person left without vaccination is at risk of contracting the corresponding infection. Contraindications to vaccination in most cases are temporary, so usually the immunization of such persons is postponed for some time. The issue of contraindications in each specific case should be decided by a specialist doctor, which is recorded in the history of the child's development with a clear justification for the medical challenge.

Absolute contraindications;

* Severe reactions that have occurred previously with the same vaccine.

* complications that arose earlier with the introduction of the same vaccine.

* immunodeficiency.

Relative or temporary;

* acute respiratory viral disease (especially if it occurs with high t).

* the presence of some chronic diseases (vaccination is carried out only after consultation with a specialist).

* premature infants (they begin to be vaccinated subject to a stable weight gain).

1.4 Vaccinesnation. The role of vaccination

Preventive vaccinations(vaccination) - the introduction of medical immunobiological preparations (vaccines and antitoxins) into the human body to create specific immunity to infectious diseases.

Types of vaccination:

Single (measles, mumps, tuberculosis)

Multiple (polio, DPT)

The multiplicity indicates how many times it is necessary to receive a vaccine for the formation of immunity.

Revaccination is an event aimed at maintaining immunity. Usually done a few years after vaccination.

On the effectiveness of vaccination immunity affect sl. factors;

Dependent on the vaccine itself (purity of the preparation, antigen lifetime, dose, frequency of administration)

From the body (the state of individual immune reactivity, age, the presence of immunodeficiency, the state of the body as a whole, genetics)

Vaccination process - This is a change in homeostasis that occurs in the body after the introduction of a vaccine preparation. It has been established that vaccinating preparations introduced into the body have a multifaceted effect on its various functions, causing their cyclic changes.

In most children, these changes practically do not go beyond physiological fluctuations, last 3-4 weeks and are not clinically manifested. But still, in some cases, reactions may occur, accompanied by clinical signs. The latter are called in practice post-vaccination reactions. They, as a rule, are of the same type and are more or less characteristic for each type, and are specific when using live vaccines.

Vaccine reactions are:

-Local reaction- this is tissue compaction at the injection site, not exceeding 8 cm in diameter, redness and mild soreness. These signs develop after administration of the drug, and disappear within a few days (1 - 4 days). They occur in 5-20% of children.

-General reactions characterized by fever, malaise, headache, sleep disturbance, appetite.

1.5 Characterization of vaccine preparations

For active immunization, various types of biological preparations are used, the main of which are vaccines and toxoids.

Vaccine- a medical product designed to create immunity to infectious diseases.

Anatoxin(toxoid) - a drug prepared from a toxin that does not have pronounced toxic properties, but at the same time is capable of inducing the production of antibodies to the original toxin.

Currently, the following types of vaccines are used to prevent infectious diseases:

1. Vaccines that include whole killed microorganisms, for example, pertussis, typhoid, cholera or inactivated virus vaccines - influenza polio vaccine.

2. Toxoids containing an inactivated toxin produced by a microbial pathogen, for example, diphtheria, tetanus toxoids.

3. Vaccines consisting of live attenuated viruses: measles, mumps, influenza, polio, etc.

4. Vaccines containing live cross-reacting microorganisms that are immunologically related to the causative agent of the given disease, but when administered to humans, cause a weakened infection that protects against a more severe one. This type includes the smallpox vaccine and the BCG vaccine.

5. Chemical vaccines consisting of fractions of killed microorganisms (typhoid-paratyphoid, pneumococci, meningococci).

6. Genetically engineered recombinant, subunit, polypeptide, chemically synthesized and other vaccines created using the latest achievements in immunological science, molecular biology and biotechnology. Thanks to these methods, vaccines have already been obtained for the prevention of hepatitis B, influenza, HIV infection, etc.

7. Associated vaccines, which include several monovaccines. An example of such vaccines currently used for immunization of children is the DTP vaccine widely used throughout the world, as well as the mumps-measles and rubella-mumps-measles vaccines used in a number of foreign countries.

1.6 Vaccine composition and quality control

Vaccines must include:

1. Active or immunizing antigens;

2. Liquid base;

3. Preservatives, stabilizers, antibiotics;

4. Auxiliary means.

1.7 Prospects for vaccination

According to leading experts, the ideal vaccine should meet the following requirements:

1. Induce lifelong immunity in 100% of those vaccinated with a single injection.

2. Be polyvalent, that is, contain antigens against the maximum possible number of infectious diseases.

3. Be safe.

4. Administered orally.

Vaccines against measles, rubella, mumps, yellow fever and, to a lesser extent, poliomyelitis currently meet these requirements most closely. It is with the introduction of these vaccines that lifelong immunity is created, while reactions to the introduction are rare and do not threaten human health.

Thus, strict requirements, many years of production experience, well-established technologies are a guarantee of the safety of these drugs. Over the past decades, tens of millions of doses of vaccines have been administered annually. World and domestic experience in the fight against infectious diseases shows that it is vaccination that is the most accessible means of individual and mass prevention, especially for children.

1.8 Activities for warnings dissemination infections

In kindergartens, orphanages, groups where children are gathered for supervision, as well as large families, conditions often arise for the spread of infectious diseases. According to the Ministry of Health and the RF Ministry of Health, more than half of all infectious diseases among children registered in the country occur in preschool institutions. Therefore, the program for the prevention of infectious diseases should be aimed primarily at preventing infection in children in children's institutions.

Conceptually, it should include a system of measures aimed at:

1) prevention of the introduction of an infectious disease into the team,

2) interruption of the ways of spreading an infectious disease in the team,

3) increasing the resistance of children to infectious diseases.

Among the measures aimed at increasing the immunity of children to infectious diseases, vaccination is of decisive importance. According to WHO experts, universal immunization at the appropriate age is the best way to prevent many infectious diseases. Immunization is especially important for preschool children, as they are the most susceptible to measles, whooping cough, diphtheria, and hepatitis A. Service personnel should also receive all vaccines recommended by the vaccination calendar. All staff must be fully vaccinated against diphtheria, tetanus and revaccinated every 10 years. They should also be vaccinated against measles, polio, mumps, and rubella. For all employees of preschool institutions and newcomers to work, it is mandatory to test for infection with tuberculosis using the Mantoux test.

Thus, in order to reduce the risk of transmission of pathogens of infectious diseases in children's institutions, it is necessary to consistently implement the following measures:

1. Strictly observe the principle of maximum separation of groups, avoid crowding, carry out early diagnosis and timely isolation of the source of infection, maintain a high level of sanitary and anti-epidemic regime.

2. Achieve 100% vaccination coverage. Modern vaccine preparations have high immunogenicity and weak reactogenicity. All children can be vaccinated against diphtheria, tetanus, whooping cough, polio, measles, rubella, tuberculosis, mumps. There are practically no contraindications to the introduction of these vaccines. In some cases, when there is a threat of a reaction to the administration of the relatively reactogenic pertussis component of the DTP vaccine, a weakly reactogenic acellular pertussis vaccine can be used. In children with an immunodeficiency state, in order to avoid the occurrence of complications of a live polio vaccine in the form of vaccine-associated poliomyelitis.

3. Exercise strict and constant control over the work of the catering unit.

4. Staff and children must observe the rules of personal hygiene.

5. Children infected with parenterally transmitted pathogens (hepatitis B, hepatitis C, cytomegalovirus infection, HIV infection, etc.) can attend an organized children's group, but additional precautions are introduced for them.

Each child care institution must operate according to the rules regulated by state epidemiological supervision under the obligatory supervision of a pediatrician and an epidemiologist.

1.9 Features of vaccination and National vaccination calendar

Nationalthe calendarpreventivevaccination

Each country, based on its own interests, creates its own vaccination scheme, which can and should change, be updated and improved depending on the epidemiological situation in the country and scientific achievements in the field of immunoprophylaxis .

National calendar of preventive vaccinations- a normative legal act that establishes the terms and procedure for carrying out preventive vaccinations for citizens. The National Immunization Schedule includes vaccinations against hepatitis AV, diphtheria, whooping cough, measles, rubella, poliomyelitis, tetanus, tuberculosis, mumps, hemophilic infection, influenza.

The preventive vaccination schedule should be compiled taking into account a number of points. First - what must be taken into account is the ability of the organism to an appropriate immunological response. Second- minimizing the negative effects of the vaccine, that is, its maximum harmlessness.

Rational construction of the immunization schedule should take into account the following conditions:

1. The epidemiological state of the country, due to the socio-economic, climate - geographical and sanitary conditions in which the population lives.

2. The effectiveness of existing vaccines, the duration of post-vaccination immunity and the need for revaccinations at certain intervals.

3. Age-related immunological characteristics, that is, the ability of children of a certain age to actively produce antibodies, as well as the adverse effect of maternal antibodies on the active immunological response of children.

4. Features of allergic reactivity, the body's ability to respond with an increased reaction to the repeated introduction of an antigen.

5. Accounting for possible post-vaccination complications.

6. The possibility of simultaneous administration of several vaccines, depending on the established synergy, antagonism and the absence of mutual influence of antigens that make up various mono- or associated vaccines.

7. The level of organization of health care in the country and the possibility of implementing the necessary immunization .

The immunization schedule in our country begins with vaccination against hepatitis B, for the first time 24 hours of life, including children born to healthy mothers and children from risk groups. The next vaccination, carried out in accordance with the calendar against tuberculosis, is carried out in the first week of life. Then at the age of 2-3 months they are vaccinated against polio. The live oral polio vaccine is given in most countries at the same time as the associated diphtheria-pertussis-tetanus vaccine, which is usually given at three months of age. In the period from three to six months, a second vaccination against diphtheria, whooping cough, tetanus, poliomyelitis is carried out (according to the vaccination schedule). At 7 months they are vaccinated against hemophilic infection, at 12 months against measles, rubella. In the period up to 24 months, subsequent vaccinations and revaccinations with vaccines are carried out. At 3-6 years of age, vaccination against hepatitis A is carried out. At 7 years of age, revaccination against diphtheria, tetanus, the first revaccination against tuberculosis. Currently, vaccines against 9 diseases are included in the preventive vaccination calendar. This vaccination is federally funded.

In practice, it often happens that for a child, for various reasons, the generally accepted scheme of vaccination is violated. Scientific and practical studies have established that skipping the timing of immunization does not require repeating the entire series. Immunization should be carried out or continued at any time, as if the immunization schedule had not been violated. In these cases, an individual immunization scheme is developed for this child, taking into account the generally accepted vaccination schedule in the country and taking into account the individual characteristics of the child's body. .

Currently, the percentage of vaccinated children is approximately 95 - 98%. In order to increase this percentage, conditions are being created for the transportation, storage and use of vaccine preparations. Explanatory work is being carried out with the population about the need for preventive vaccinations. However, unresolved issues remain in vaccine prevention. For example, insufficient funds were allocated from the budget for hepatitis B vaccination in 1998, which led to a large number of cases: 10 per 100 thousand people. Money for the purchase of the vaccine was allocated in 2005. After that, the incidence of hepatitis decreased in 2007 by 1.3 compared to 2006, the figure was 5.28 per 100,000 people.

CHAPTER 2. PRACTICAL PART

immunoprophylaxis infectious disease vaccine

The research work was carried out on the basis State Healthcare Institution "City Children's Polyclinic No. 1

Conclusion: Comparing these two graphs, you can see that the majority support immunization, we see that in 2015, the percentage of vaccination increases compared to 2014, we see this in the percentage of vaccination against tuberculosis, the same situation for diphtheria and poliomyelitis, which means that people with each year, more and more people understand the significance of this procedure, but the majority treat this method with distrust and wariness, many believe that vaccination is more dangerous than the disease itself, I believe that this is an erroneous opinion, since with the advent of vaccination, the incidence rate has decreased significantly, my research work at this facility, I want to clearly show that a large number of people undergo this procedure, and of course there are adverse reactions to the vaccine, but this is much better than getting sick with one of the listed infectious diseases. It must be remembered that not doing preventive vaccinations you endanger not only yourself, but also your loved ones.

Implementation of a planpreventive vaccinations.

For 2014


Address, telephone, fax, e-mail	Ulyanovsk, Aviastroiteley Ave. 5, tel/fax 20-35-73, [email protected]
Name of vaccinations		For twelve months
Tuberculosis vaccinations:
Vaccination
Including newborns
Revaccination (total)
Including revaccination at 7 years
Against whooping cough:
Vaccination
Revaccination
Against diphtheria:
Vaccination
Revaccination (total)

2 revaccinations at 7 years
3 revaccinations at 14 years old
Tetanus shots
Vaccination
Revaccination (total)
Measles vaccinations (total)
Vaccination at 12 months
Revaccination 6 years

Vaccination at 12 months
Revaccination at 6 years

Including vaccination
Including revaccination
Including vaccination at 12 months
Vaccination Art. age
Revaccination 6 years

HBV vaccination total
newborns
Children from 1 to 17 years old

Vaccination of children born in 2013 (OPV)

Revaccination (total)
In t h 1 revacc. At 18 months
In t h 2 revacc. At 20 months
In t h 3 revacc. At 14


Including Students in grades 1-11
Of these, students in grades 1-4.
Of these, students in grades 5-11.
From 6 months up to 3 years
Including health workers
Meningococcal
Including children born in 2015
Including children born in 2014



IPV (total)

Implementation of a planvaccination of the national calendarpreventive vaccinations.For 2015

Sender's address: Ulyanovsk, Prospekt Aviastroiteley 5

NAME of the health management body, health care institution	State Healthcare Institution "City Children's Polyclinic No. 1"
Address, telephone, fax, e-mail	Ulyanovsk, Aviastroiteley Ave. 5, tel/fax 20-35-73, [email protected]
Name of vaccinations	Number of people to be vaccinated	For twelve months
Tuberculosis vaccinations:
Vaccination
Including newborns
Revaccination (total)
Including revaccination at 7 years
Against whooping cough:
Vaccination
Revaccination
Against diphtheria:
Vaccination
Revaccination (total)
Including 1 revaccination at 18 months
2 revaccinations at 7 years
3 revaccinations at 14 years old
Tetanus shots
Vaccination
Revaccination (total)
Measles vaccinations (total)
Vaccination at 12 months
Revaccination 6 years
Vaccination against epid. mumps (total)
Vaccination at 12 months
Revaccination at 6 years
Rubella vaccine (total)
Including vaccination
Including revaccination
Including vaccination at 12 months
Vaccination Art. age
Revaccination 6 years
Revaccination of children from 1 to 17 years old previously vaccinated once
HBV vaccination total
newborns
Children from 1 to 17 years old
Polio vaccination (total)
Vaccination of children born in 2014 (OPV)
Vaccination of children born in 2015 (OPV)
Revaccination (total)
In t h 1 revacc. At 18 months
In t h 2 revacc. At 20 months
In t h 3 revacc. At 14
Flu shots (total)
Including children attending doshk. institutions
Including Students in grades 1-11
Of these, students in grades 1-4.
Of these, students in grades 5-11.
From 6 months up to 3 years
Including health workers
Vaccination PNEUMOCOCCAL (total)
Including children born in 2015
Including children born in 2014
Revaccination at 15 months
IPV (total)

ZCONCLUSION

Immunoprophylaxis is the most important function in the fight against infectious diseases in children from 0 to 7 years old, and hence for the health of the nation. According to WHO experts, universal immunization at the appropriate age is the best way to prevent many infectious diseases. Immunization is especially important for preschool children, as they are the most susceptible to the incidence of measles, whooping cough, diphtheria, hepatitis A. Thanks to targeted work on immunoprophylaxis in Russia, it was possible to achieve the absence of morbidity for a number of preventable infections. In some regions of our country, the coverage of children with preventive vaccinations has improved up to 98-99%. Vaccination is one of the very best means to protect children against infectious diseases that caused serious illness before vaccinations were available. It is important to make sure that children are immunized at the right time, in full compliance with legal documents, the national vaccination schedule, using high-quality drugs and necessarily qualified medical staff, in specially equipped rooms, be it a clinic, kindergarten or maternity hospital. All the prerequisites for further improvement of immunoprophylaxis are available, new vaccines and new technologies are being developed. Modern vaccine preparations have high immunogenicity and weak reactogenicity. It is necessary to achieve 100% vaccination coverage of all children from birth. Carry out explanatory work with the population about the need for preventive vaccinations, both at the local and state levels, through the global promotion of vaccination. Ideally, immunoprophylaxis should be an integral part of a set of measures to protect the health of the child, supported by the state from the financial, logistical, scientific and legislative side. This is the ultimate goal, the steady pursuit of which should lead to the creation of the best model of primary disease prevention that can exist within the health system.

LIST OF USED LITERATURE

1. Federal Law “On Immunoprophylaxis of Infectious Diseases” of September 17, 2011, No. 157//http://www.privivki.ru/law/fed/main htm

2. Order "On the National calendar of preventive vaccinations according to epidemic indications." //http://www.lawmix.ru/med.php?id=224

3. Decree of the Chief State Sanitary Doctor of the Russian Federation “On additional immunization of the population of the Russian Federation”. //http://www.rg.ru/2005/11/29/privivki.html

APPS

Order No. 51n dated January 31, 2011

On approval of the national calendar of preventive vaccinations and the calendar of preventive vaccinations according to epidemic indications

Order of the Ministry of Health and Social Development of Russia No. 51n dated January 31, 2011

Application No. 1

National calendar of preventive vaccinations

	Name of vaccination	The procedure for conducting preventive vaccinations
Newborns in the first 24 hours of life	First vaccination against viral hepatitis B	It is carried out in accordance with the instructions for the use of vaccines for newborns, including those from risk groups: * born from mothers carrying HBsAg; * patients with viral hepatitis B or who have had viral hepatitis B in the third trimester of pregnancy; * who do not have the results of the examination for markers of hepatitis B; * drug addicts whose families have an HBsAg carrier or a patient with acute viral hepatitis B and chronic viral hepatitis (hereinafter referred to as risk groups)
Newborns on 3-7 days of life	Tuberculosis vaccination	It is administered to newborns with vaccines for the prevention of tuberculosis (for gentle primary immunization) in accordance with the instructions for their use. In the subjects of the Russian Federation with incidence rates exceeding 80 per 100 thousand of the population, as well as in the presence of tuberculosis patients in the environment of a newborn - a vaccine for the prevention of tuberculosis
Children at 1 month	Second vaccination against viral hepatitis B	Including those at risk
Children at 2 months	Third vaccination against viral hepatitis B
Children 3 months	1) First vaccination against diphtheria, whooping cough, tetanus	Carried out in accordance with the instructions for the use of vaccines for children of this age group
	2) First vaccination against Haemophilus influenzae	It is carried out in accordance with the instructions for the use of vaccines for children at risk: * with immunodeficiency conditions or anatomical defects leading to a sharply increased risk of Hib infection * with oncohematological diseases and / or receiving long-term immunosuppressive therapy; * HIV-infected or born from HIV-infected mothers; * located in closed preschool institutions (children's homes, orphanages, specialized boarding schools for children with psycho-neurological diseases, etc., anti-tuberculosis sanatorium and health-improving institutions). Note. The course of vaccination against hemophilic infection for children aged 3 to 6 months consists of 3 injections of 0.5 ml with an interval of 1 - 1.5 months. For children who have not received the first vaccination at 3 months, immunization is carried out according to the following scheme: for children aged 6 to 12 months from 2 injections of 0.5 ml with an interval of 1 - 1.5 months for children from 1 year to 5 years single injection 0.5 ml
	3) First vaccination against polio
Children at 4.5 months	1) Second vaccination against diphtheria, whooping cough, tetanus	Carried out in accordance with the instructions for the use of vaccines for children of this age group who received the first vaccination at 3 months
	2) Second vaccination against Haemophilus influenzae
	3) Second vaccination against polio	Administered with polio vaccines (inactivated) according to instructions for use
Children at 6 months	1) Third vaccination against diphtheria, whooping cough, tetanus
	2) Third vaccination against viral hepatitis B	Carried out in accordance with the instructions for the use of vaccines for children of this age group, who do not belong to risk groups, who received the first and second vaccinations at 0 and 1 months, respectively
	3) Third vaccination against Haemophilus influenzae	Carried out in accordance with the instructions for the use of vaccines for children of this age group who received the first and second vaccinations at 3 and 4.5 months, respectively
	4) Third vaccination against polio	Note. Children who are in closed preschool institutions (orphanages, orphanages, specialized boarding schools for children with psychoneurological diseases, etc., anti-tuberculosis sanatorium and health institutions) are vaccinated three times with vaccines for the prevention of poliomyelitis (inactivated) according to indications
Children at 12 months	1) Vaccination against measles, rubella, mumps	Carried out in accordance with the instructions for the use of vaccines for children of this age group
	2) Fourth vaccination against viral hepatitis B	Carried out in accordance with the instructions for the use of vaccines for children at risk
Children at 18 months	1) The first revaccination against diphtheria, whooping cough, tetanus	Carried out in accordance with the instructions for the use of vaccines for children of this age group
	2) First revaccination against polio	Administered to children in this age group with vaccines for the prevention of poliomyelitis (live) in accordance with the instructions for their use
	3) Revaccination against Haemophilus influenzae	Revaccination is carried out once for children vaccinated in the first year of life in accordance with the instructions for the use of vaccines.
Children at 20 months	Second revaccination against polio	Administered to children in this age group with vaccines for the prevention of poliomyelitis (live) in accordance with the instructions for their use
Children at 6 years old	Revaccination against measles, rubella, mumps	Carried out in accordance with the instructions for the use of vaccines for children of this age group who have received vaccination against measles, rubella, mumps
Children at 6-7 years old	Second revaccination against diphtheria, tetanus
Children at 7 years old	Revaccination against tuberculosis	It is administered to tuberculin-negative children of this age group who are not infected with mycobacterium tuberculosis with vaccines for the prevention of tuberculosis in accordance with the instructions for their use.
Children under 14	1) Third revaccination against diphtheria, tetanus	Carried out in accordance with the instructions for the use of toxoids with a reduced content of antigens for children of this age group
	2) Third revaccination against polio	Administered to children in this age group with vaccines for the prevention of poliomyelitis (live) in accordance with the instructions for their use
	3) Revaccination against tuberculosis	It is administered to tuberculin-negative children of this age group not infected with mycobacterium tuberculosis with vaccines for the prevention of tuberculosis in accordance with the instructions for their use. In the constituent entities of the Russian Federation with tuberculosis incidence rates not exceeding 40 per 100 thousand of the population, revaccination is carried out for tuberculin-negative children who have not received vaccination at the age of 7
Adults over 18 years old	Revaccination against diphtheria, tetanus	Carried out in accordance with the instructions for the use of antigen-reduced toxoids in adults over 18 years of age every 10 years from the last revaccination
Children from 1 to 18 years old, adults from 18 to 55 years old, not previously vaccinated	Vaccination against viral hepatitis B	It is carried out in accordance with the instructions for the use of vaccines for children and adults of these age groups according to the scheme 0-1-6 (1 dose - at the time of the start of vaccination, 2 dose - one month after the first vaccination, 3 dose - 6 months after the start of immunization)
Children from 1 to 18 years old, not sick, not vaccinated, vaccinated once against rubella; girls from 18 to 25 years old, not ill, not previously vaccinated	Rubella Immunization	Carried out in accordance with the instructions for the use of vaccines for children and adults
Children from 6 months; students in grades 1-11; students of higher professional and secondary professional educational institutions; adults working in certain professions and positions (employees of medical and educational institutions, transport, utilities, etc.); adults over 60	Influenza vaccination	Conducted annually in accordance with the instructions for the use of vaccines for these categories of citizens
Children aged 15-17 years inclusive and adults under the age of 35 who have not previously had measles, who have not previously been vaccinated and who do not have information about preventive measles vaccinations	Immunization against measles	Immunization against measles is carried out in accordance with the instructions for the use of vaccines twice with an interval of at least 3 months between vaccinations. Persons previously vaccinated once are subject to a single immunization (the interval between vaccinations must also be at least 3 months)

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- it is a system of state, social, hygienic and medical measures aimed at ensuring a high level of public health and disease prevention. Prevention is divided into primary, aimed at maintaining health, preventing the negative impact of natural and social factors that can cause pathological changes, and secondary, the essence of which is the early detection of diseases, preventing their progression, relapses and complications.

Allocate nonspecific and specific prevention of infectious diseases in children. Non-specific prevention includes a sanitary and hygienic regimen, a balanced diet, massage, gymnastics, stimulation of immunocompetent cells and restoration or stimulation of the immune response (use of adjuvants, interferogens, thymosin, thymalin, lymphocyte mediators). Specific prophylaxis is divided into active (by stimulating immunocompetent T- and B-lymphocytes, i.e. prophylactic immunization with vaccines) and passive (transferring a "ready" protective factor to the recipient by introducing immune sera of immunoglobulins).

Preventive vaccinations are one of the most important means of preventing infectious diseases.

1) mandatory (vaccination by age according to the National immunization schedule against tuberculosis, hepatitis, diphtheria, whooping cough, tetanus, polio, hemophilic infection, measles, mumps, rubella)

2) for health reasons - for patients with a high risk of occurrence and severe course of infections, vaccination against which is not provided for in the mandatory vaccination plan (chicken pox, meningococcal, pneumococcal infections, influenza, hepatitis A, etc.)

3) vaccination according to epidemic indications, in endemic and epizootic areas (against tularemia, brucellosis, yellow fever, rabies, influenza, diphtheria, tetanus, rubella, etc.);

4) recommended (at the request of the patient) - against any infectious disease for the immunoprophylaxis of which there is a vaccine or other medical immunobiological preparations (MIBP) registered in Ukraine (against influenza, hepatitis A, chicken pox, etc.).

For immunoprophylaxis, MIBT, created thanks to modern biotechnologies, is used. According to the method of manufacture and the type of immune response of the body to the introduction of such drugs, they are divided into vaccines and toxoids.

1) live, created from weakened or attenuated strains of viruses (measles, mumps, rubella, yellow fever, poliomyelitis, chickenpox) and bacteria (mycobacterium tuberculosis). The disadvantages of live vaccines are the possibility of developing a disease in a vaccinated person if he has an immunodeficiency, as well as difficulties in growing and storing cultures of microorganisms, and the introduction of unwanted pathogenicity as a result of mutations. However, live vaccines are most effective for immunoprophylaxis of infections;

2) killed (inactivated) - contain non-viable microorganisms or their fragments that have retained the ability to cause an immune response. Examples include inactivated polio vaccine (IPV), whole cell pertussis and influenza vaccines, rabies vaccine, hepatitis A vaccine. The disadvantages of such vaccines are a sharp decrease in immunogenic activity when the pathogen dies and, as a result, a relatively weak immune response of the body, which requires vaccine administration;

3) synthetic (recombinant, genetically engineered, vector) created using modern biotechnologies. Such vaccines are qualitatively different from simple copying of natural pathogens, are better purified, contain less ballast substances, and are thermostable (recombinant hepatitis B vaccine, subunit influenza vaccine, etc.).

Anatoxins are MIBPs that are based on inactivated bacterial toxins and do not contain cells or cell fragments of microorganisms. The most effective are diphtheria and tetanus toxoids and their combinations (ADS, ADS-m, AD, AP, etc.).

1) monovaccines (against tuberculosis, hepatitis, measles, mumps, rubella, poliomyelitis, etc.);

2) combined (MMR vaccine - against measles, mumps, rubella, KPKV vaccine - against measles, mumps, rubella, chicken pox);

3) associated - contain microorganism cells, cell fragments, toxoids (DTP - associated whole-cell pertussis vaccine and diphtheria and tetanus toxoids; ADP - associated diphtheria-tetanus toxoid; AaDTP - a variant of the DTP vaccine with a cell-free pertussis component; combinations of AaDTP with inactivated polio virus , surface antigen of the hepatitis B virus, a fragment of the cell wall of Haemophilus influenzae).

List of documentation for sites and clinics for planning, accounting and analysis of the state of immunization of the child population:

1) a register of the census of the child population of the site with marks on the arrival and departure of children;

2) the history of the development of the child (form No. 112/0);

3) preventive vaccination card (form No. 063/0);

4) preventive vaccination planning log (per year / quarter / month) at the site;

5) register of refusals from preventive vaccinations at the site;

6) a register of medical contraindications to preventive vaccinations at the site;

7) journal of registration and use of MIBP in the clinic;

8) register of ongoing preventive vaccinations in the clinic (form

9) a register of PVR (post-vaccination reactions) and PVR (post-vaccination complications) in the vaccination room (at the site, PVR and PVR are recorded in the primary medical documentation - forms No. 112/0 and 063/0).

1. Vaccinations by age Vaccinations for prevention

Vaccinations against

Note

Hepatitis B

Tuberculosis1

Hepatitis B2

Poliomyelitis 1 OPV

Haemophilus influenzae 5

Diphtheria, whooping cough, tetanus 5

Poliomyelitis 1 OPV

Haemophilus influenzae 5

Children at high risk of developing post-vaccination complications from the AaDPT vaccine

Diphtheria, whooping cough, tetanus 3

Poliomyelitis 1 OPV

Haemophilus influenzae 5

Children at high risk of developing post-vaccination complications from the AaDPT vaccine

Hepatitis B2

Measles, rubella, mumps 6

18 months

Diphtheria, whooping cough, tetanus 33 with AaKDP vaccine

Poliomyelitis 1 OPV

Haemophilus influenzae 5

6 years

Diphtheria, whooping cough 1,

Poliomyelitis 1 OPV

Measles, rubella, mumps 6

7 years

Tuberculosis

Diphtheria, tetanus 3

Poliomyelitis 1 OPV

15 years

18 years

Diphtheria, tetanus 3

adults

Diphtheria, tetanus 3

1. Vaccination is subject to all newborns who do not have contraindications to this. Vaccinations are carried out with a vaccine for the prevention of tuberculosis (hereinafter referred to as BCG). To vaccinate premature infants weighing > 2000 g, it is necessary to use a vaccine for the prevention of tuberculosis with a reduced antigen content (hereinafter referred to as BCG-M).

Vaccinations for the prevention of tuberculosis are not carried out on the same day as other vaccinations. It is unacceptable to combine in one day of vaccination for the prevention of tuberculosis with other parenteral manipulations.

Children who were not vaccinated in the maternity hospital for any reason are subject to mandatory vaccination in children's clinics. For vaccination of children who are not vaccinated in the maternity hospital due to medical contraindications, it is necessary to use the BCG-M vaccine or a half dose of the vaccine. If the child is not vaccinated in the maternity hospital, not due to medical contraindications, vaccination is carried out with the BCG vaccine. Children who are under 2 months old are vaccinated against tuberculosis without first having a Mantoux test. After the child is two months old, before performing the BCG vaccination, it is necessary to conduct a Mantoux test. Vaccination is carried out with a negative test result.

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.

In the absence of a post-vaccination (BCG) scar, children with a negative reaction to the Mantoux test should be given an additional vaccination 2 years after BCG vaccination.

Matu test is performed annually from 2 years. Due to the fact that prophylactic vaccinations can affect the sensitivity to tuberculin, tuberculin diagnostics should be planned before prophylactic vaccinations. If, for one reason or another, the Mantoux test is carried out after preventive vaccinations, tuberculin diagnosis should be carried out no earlier than 1 month after vaccination.

2 Vaccination for the prevention of hepatitis B is subject to all newborns, vaccination is carried out with a monovalent vaccine.

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 vaccinations. In the case of combining immunization with vaccination against whooping cough, diphtheria, tetanus, poliomyelitis, schemes are recommended: 3-4-5-18 months. life or: 3-4-9 months. life.

Newborn with body weight<2000 г, родившихся от HBsAg негативных матерей, вакцинация проводится при достижении ребенком 2000 г или при достижении возраста 1 месяц.

If a newborn baby is in serious condition, the child's immunization should be carried out after his improvement before discharge from the hospital.

If the mother of the newborn has HBsAg, "+", 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, a specific immunoglobulin against hepatitis B must be injected into another part of the body at the rate of 40 IU / kg of body weight and at least 100 IU. If the mass of the new born child<2000 грамм, вакцинация проводится обязательно, но введенная доза вакцины не засчитывается как доза первичной иммунизации, при достижении ребенком возраста 1 месяца вакцинация должна быть проведена серией из трех доз вакцин 0-1-6 (0-дата первого введения вакцины, минимальный интервал между первой и второй прививками - 1 месяц вторым и третьим прививками - 5 месяцев).

If the mother of a newborn with HBsAg has an indeterminate 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 as in the case of vaccinating a newborn child against HBsAg "+" of the mother.

For vaccination of children and adults outside the hepatitis B vaccination schedule, it is recommended to use the 0, 1, 6 month schedule.

A vaccination series should not be started if a dose has been missed, no matter how much time has passed. It is necessary to introduce doses that are not enough according to the schedule, observing the minimum intervals (see section 1.2. "Vaccination of children with violation of the calendar" of this Calendar).

3 vaccinations for the prevention of diphtheria, tetanus and whooping cough at the age of 3.4 and 5 months are carried out with a pertussis-diphtheria-tetanus vaccine (hereinafter referred to as DPT). The interval between the first and second, second and third vaccinations with DTP vaccine is 30 days. The interval between the third and fourth vaccination must 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 AaDPT).

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 developing post-vaccination complications, as determined by the vaccine commission or a pediatric immunologist. Day of prevention of diphtheria, tetanus, whooping cough, poliomyelitis, hepatitis B and infections caused by the bacterium Haemophilus influenze type b (hereinafter referred to as Hib), you can use combined vaccines (with different combinations of antigens) that are registered in Ukraine.

Vaccination of children under 4 years of age outside the calendar terms is prescribed by a doctor in such a way that the child has time to receive a fourfold DTP immunization up to 3 years 11 months and 29 days.

The first revaccination against diphtheria and tetanus (at 6 years old) is carried out with diphtheria-tetanus toxoid (hereinafter - ADS), the second (at 14 years old) and the third (at 18 years old) - diphtheria-tetanus toxoid ¬ local with a reduced antigen content (hereinafter - ADS -M). Children vaccinated against tetanus due to trauma with tetanus toxoid (hereinafter - TA) over the past two years, the next revaccination is carried out only against diphtheria with diphtheria toxoid with a reduced antigen content (hereinafter - AD-M).

Children under the age of 5 years 11 months 29 days who have been ill with whooping cough are vaccinated with ADS. Vaccination is carried out three times with an interval between the first and second vaccination of 30 days, between the second and third - 9-12 months.

The first scheduled revaccination of adults by age and epidemiological indications who were previously vaccinated should be carried out with AD-M at an interval of 5 years after the last vaccination. Further planned revaccinations of adults are carried out with a minimum interval of 10 years VDP-M from the previous ADS-M vaccination.

Adolescents and adults who have not previously been vaccinated or do not have

data on immunization, ADS-M is vaccinated three times (the interval between the first and second vaccinations should be 30-45 days, between the second and third - 6-12 months). Revaccination of adolescents (who are vaccinated outside the schedule) is carried out at a minimum interval of 3 years after the last vaccination for the prevention of diphtheria and tetanus.

For active immunization against tetanus in persons over 60 years of age who have not been vaccinated for the last 10 years, an abbreviated vaccination regimen should be used (single AP vaccination at a double dose of 20 FU/ml, with mandatory revaccination after 12 months with a dose of 10 FU/ml) and then every 10 years without restriction of people.

Considering the likelihood of developing post-vaccination reactions to the introduction of DPT, such as an increase in body temperature, which can cause febrile convulsions, it is necessary to advise parents every time about taking paracetamol at a dose corresponding to the child's age, within a day after receiving the vaccine.

4. Inactivated vaccine for the prevention of polio (hereinafter - IPV) is used for the first two vaccinations, and in case of contraindications to the administration of oral polio vaccine (hereinafter - OPS) - for all subsequent vaccinations according to the calendar.

The OPV vaccine is used for the 3rd-6th vaccinations (the third vaccination and age-related revaccination) in the absence of contraindications to OPS.

After OPV vaccination, it is proposed to limit injections, parenteral interventions, elective surgeries within 40 days, to exclude contact with patients and HIV-infected people.

A vaccination series should not be started if a dose has been missed, no matter how much time has passed. Introduce doses that are not enough according to the schedule, observing the minimum intervals.

5 Vaccination for the prevention of Hb infection can be carried out with monovaccines and combined vaccines containing the Hb component. When using Hb vaccine and DTP from different manufacturers, the vaccines are administered in different parts of the body. It is advisable to use combined vaccines with the Hb component for primary vaccination.

Features of vaccination against Hb-infection of children outside the calendar - see subsection 1.2 "vaccinations ¬ for children with a violation of the "Calendar".

6 Vaccination for the prevention of measles, mumps and rubella is carried out with a combined vaccine (hereinafter referred to as CPV) at the age of 12 months. The second vaccine for the prevention of measles, mumps and rubella is given to children at the age of 6 years.

Children who have not been vaccinated against measles, mumps or rubella by age 12 months and 6 years can start vaccinations at any age up to 18 years. In this case, the child should receive 2 doses with a minimum interval between them.

Children aged 15 years who have received 1 or 2 measles vaccines, but are not vaccinated against mumps and rubella and have not had these infections, are routinely vaccinated against mumps (boys) or 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. If two of these diseases have been transferred in the anamnesis, vaccinations should be carried out with a monovaccine against the infection that the child did not have. Reliable conclusions about the child's immunity can only be made based on the results of serological studies: if there are IgG class antibodies to the corresponding virus, the person is considered immune.

Women of childbearing age who have not been ill with rubella and have not been vaccinated against it can receive individual vaccinations of their own free will according to the vaccine instructions.

1.2. Vaccination of children with violation of the calendar

When deciding on the vaccination of children with a violation of the vaccination schedule for children.

You must plan for the following minimum intervals.

For children from 4 months to 6 years 11 months. 29 days


DTP, AaDTP			12 months
		9 months
Polio vaccine			12 months
Hepatitis B vaccine

HIB vaccine	8 weeks (as last dose): if first dose given at 12-14 months of age Not administered: if the first dose is administered at 15 months. or older in age	4 weeks: if the first dose is administered before 12 months. 8 weeks(as the last dose): if the child is 12 months old. or more and the second dose was administered before the age of 15 months. Not administered: if the first dose is administered at 15 months. or older in age

	Minimum interval between doses
	1-2 ha dose	2-3 dose	3-4th dose
		6-9 months
	1 year
Hepatitis B vaccine
Polio vaccine			12 months

When planning vaccinations using individual vaccines or toxoids for the prevention of various infectious diseases, the following features must be observed:

If necessary, the doctor has the right to administer all vaccines, toxoids indicated according to the plan (except for BCG) in one visit to a medical institution, injecting into different parts of the body. Otherwise, the doctor plans such vaccinations, taking into account the minimum intervals between vaccines, toxoids and on the basis of a combination of vaccines against various infectious diseases.

Vaccinations for prevention	At-risk groups
chicken pox	Healthy children who have reached the age of 15 months and have not had chickenpox;
	Children at school entry who have not previously had chickenpox (according to documentation);
	Health and education workers who are at high risk of infection and who have not had chickenpox
Hepatitis A -	medical workers;
	personnel of preschool institutions;
	Personnel of public catering establishments and the food industry, which is involved in the preparation (production), transportation and sale of food products;
	Military personnel, employees of the Ministry of Internal Affairs of Ukraine, firefighters, personnel of special services (operational services);
	Personnel for maintenance of water treatment facilities, water supply networks, maintenance of sewer systems and sewer treatment facilities;


	Students of medical schools;
	Persons who take part in peacekeeping activities, providing humanitarian assistance, etc.;
	Persons who use drugs intravenously, HIV-infected persons, persons with sexually transmitted diseases
	Persons living in endemic regions for hepatitis A;
	Individuals who travel to regions with high endemic hepatitis A; Persons who communicated with patients with hepatitis A in the foci of infection
Hepatitis B	Military personnel, employees of the Ministry of Internal Affairs of Ukraine, firefighters, personnel of social services (operational services);
	Personnel and patients of closed institutions (psychiatric institutions, institutions for the maintenance of mentally retarded persons, etc.);
	Personnel and persons who are in institutions for the execution of sentences;
	Service sector personnel, according to the specifics of their professional activities, may have contact with human biological fluids (hairdressers, beauty salon personnel, massage therapists, etc.), as well as persons studying in these specialties;
	Athletes;
	Persons who use narcotic substances intravenously, are HIV-infected, persons with sexually transmitted diseases
	Persons who often change sexual partners, prostitutes, homosexuals;
	Young people aged 20-40 years, especially women;
	Patients with chronic and oncological diseases, with chronic renal failure.
	Persons who travel to regions with a high epidemic of hepatitis B
flu	Military personnel, builders, employees of the State Automobile Inspectorate of the Ministry of Internal Affairs, etc.; Individuals who care for influenza patients at home; Children of preschool institutions and schoolchildren; Labor collectives of enterprises, institutions, organizations; Women are expected to be in their 2nd or 3rd trimester of pregnancy during an influenza epidemic
pneumococcal infection	Children over 2 years old; Adults with impaired immune status and the elderly, especially those living in boarding schools
infectious disease	For the immunoprophylaxis of which there is a vaccine registered in Ukraine Persons wishing to be vaccinated in medical institutions in the direction of a doctor

Vaccination of children is carried out according to the vaccination schedule, taking into account the age-related characteristics of immunogenesis and the reactivity of the child's body, the epidemic situation, the effectiveness and reactogenicity of the vaccine, the possibility of developing complications and the association of individual vaccines.

Preventive vaccinations are carried out in accordance with the instructions for the use of vaccines. In cities, healthy children should be vaccinated in the vaccination rooms of children's clinics, in medical offices of preschool institutions and schools, for children at risk - in day hospitals of polyclinics, general hospitals and specialized departments. In rural areas, healthy children are vaccinated in FAPs or in rural outpatient clinics of family medicine. Children who have health problems and require special vaccination tactics are sent to the central district clinics, where a special medical commission decides on the possibility and method of immunizing such patients. Do not vaccinate at home. About the nature, time of vaccination, possible complications, parents must be warned in advance.

Immediately before preventive vaccinations, a doctor or paramedic conducts a medical examination of the child with mandatory thermometry, and parents or persons replacing them are informed about the possible manifestations of side effects of vaccines in the post-vaccination period. In the primary medical documentation (form No. 112/0), an appropriate entry is made about informing about the possible manifestations of side effects of vaccines, which is certified by the child's parents or persons replacing them, and a doctor's (paramedic's) entry about permission to vaccinate.

The fact of refusal of preventive vaccinations with a note that the medical worker has given explanations about the consequences of such a refusal is documented in the child's development history and signed by both the child's parents or persons replacing them, and the medical worker, which is reported to the territorial CEC.

In the history of the development of the child (form No. 112/0) indicate the date of vaccination, dose, series, control number of the vaccine, manufacturer, route of administration, describing reactions to the vaccine.

Children who are not vaccinated within the decreed terms due to temporary contraindications are vaccinated according to an individual schedule in accordance with the recommendations of specialists and instructions for the use of vaccines.

In the office where vaccinations are carried out, there should be sets of medicines for emergency medical care and anti-shock therapy.

Separately, one should dwell on absolute contraindications to revaccination of children and adolescents who are not listed in the general list. These include :

1) infection with the causative agent of tuberculosis or tuberculosis in the past;

2) positive or questionable Mantoux reaction at 72 hours;

3) complicated reactions to the previous administration of the BCG vaccine (keloid scars, increased local reaction - a papule of 10 mm in size, infiltrate necrotization, cold abscesses, mesenteric lymph node hyperplasia, regional lymphadenitis, fistula, osteomyelitis, skin lesions like lupus erythematosus, infection generalization) .

After the removal of a temporary contraindication to vaccination, the local pediatrician conducts a comprehensive examination of the child, studies the hemogram, proteinogram, C-reactive protein level, urine, feces. Children in a state of stable clinical and laboratory remission for chronic and recurrent diseases, dermatorespiratory allergies, who had a history of unusual allergic reactions to previous vaccinations or medications, undergo 2 stages of preparation for vaccination.

At the first stage for 1-1.5 months. before vaccination, an appropriate diet, regimen is prescribed, chronic foci of infection are sanitized, and physical and mental overload is eliminated.

Stage II consists in prescribing 2 days before vaccination, on the day of vaccination and 3-4 days after it, a course of premedication, which includes antihistamine basic, dehydrating, anticonvulsant, immunomodulatory therapy, depending on the prevalence of pathology in the anamnesis.

Vaccination is an increased antigenic load on the child's body, after which post-vaccination reactions and complications can be expected. The post-vaccination period is often asymptomatic. However, 5-30% of those vaccinated may experience health problems associated with the introduction of vaccines.

These are unstable pathological changes in the body, have a temporary connection with vaccination and practically do not require medical intervention. The timing of the occurrence of PVR is determined by the type of vaccine and the place of its administration. As a rule, local and general reactions to the introduction of DTP, DPT, DTP, ADS-m, ShV, hepatitis B vaccines can be observed in the first 48-72 hours in the form of an increase in body temperature, changes in the child's behavior, decreased appetite, pain, swelling and redness of soft tissues at the injection site. Post-vaccination reactions are divided into normal and strong depending on the condition of the child, fever (more than 39 ° C - a strong general reaction), the magnitude of hyperemia, edema or soft tissue infiltration (hyperemia more than 8 cm, edema more than 5 cm, infiltrate more than 2 cm - strong local reaction). On the introduction of live vaccines (against measles, mumps, rubella), the development of VS is caused in the first 48 hours by the action of the components of the vaccine - allergic reactions are possible, from the 6th to the 15th day - by the action of pathogens contained in the live vaccine. In such cases, general reactions are possible in the form of hyperthermia, a specific rash on the skin and mucous membranes, and transient lymphadenopathy.

Post-vaccination complications (PVS) are persistent health disorders that occur late after vaccination (mainly from 15 to 35 days), go beyond physiological fluctuations, have a temporal relationship with vaccination and require medical intervention.

During the first 24 hours after vaccination, anaphylactic shock, anaphylactoid reactions, and collapse may occur. In the first 10 days of the post-vaccination period, allergic skin reactions can be diagnosed: a generalized rash, polymorphic exudative erythema, Lyell's syndrome, encephalitis, encephalopathy, polyradiculoneuritis, mononeuritis, serous meningitis. Encephalitic reactions appear in the first 15-30 days after vaccination with inactivated and live vaccines. At the same time, acute myocarditis, acute nephritis, thrombocytopenic purpura, agranulocytes, hypoplastic anemia, up to sudden death can be diagnosed.

Vaccination against poliomyelitis can induce during the first 30 days vaccine-associated poliomyelitis in vaccinated and in contact with vaccinated, as well as encephalomyelitis. During the year, complications are possible after BCG vaccination in the form of an enhanced local reaction (papule more than 10 mm in diameter), necrotization of the infiltrate, cold abscess, hyperplasia of mesenteric lymph nodes, regional lymphadenitis, fistulas, keloid scars, skin lesions like lupus erythematosus, osteomyelitis, phlyctenulosic conjunctivitis, generalization of infection.

Within 5-12 days after vaccination against measles, mitigated measles may develop.

If the child has a clinic of anaphylactic shock, you should stop the administration of the drug, which caused, put the patient on his side, his head thrown back.

Immediately intravenously inject 0.1% adrenaline solution (0.01-0.015 ml / kg) into 10-20 ml of 0.9% sodium chloride solution, prednisolone (2-5 mg / kg) or dexamethasone (0.3 - 1 mg / kg) or hydrocortisone (10-20 mg / kg), 0.1% solution of atropine sulfate (0.1 ml per year of life) subcutaneously. With prolonged arterial hypotension, 0.2% solution of norepinephrine (0.01-0.02 ml/kg) or 1% solution of mezaton (0.01-0.02 ml/kg) is injected intravenously by drip. After stabilization of blood pressure, a 2.4% solution of eufillin (0.15-0.2 ml / kg) is injected intravenously. In a state of clinical death, artificial ventilation of the lungs, indirect heart massage should be carried out.

In a state of hyperthermia after vaccination, the child is placed in a ventilated room. Intramuscularly injected 50% solution of analgin and 1% solution of diphenhydramine at the rate of 0.1 ml per 1 year of life. In case of hyperthermia with a sharp reddening of the skin, mechanical cooling of the sections of the carotid and femoral arteries is used with bubbles of cold water or compresses with a 4.5% solution of vinegar. When hyperthermia is accompanied by spasm of peripheral vessels (severe pallor of the skin), the skin is rubbed with alcohol diluted by half with water, a 2% solution of papaverine hydrochloride, a 24% solution of aminophylline at the rate of 0.1 ml per 1 year of life is injected. To stop intoxication, a glucose solution cooled to 15 ° C is injected at the rate of 5-10 ml / kg, neocompensated at the rate of 10-20 ml / kg. The child is given sweet tea, fruit and berry juices, 5% glucose.

In the case of encephalic syndrome, along with hypothermic, detoxification therapy, anticonvulsant and dehydration treatment is carried out. Intramuscularly injected 25% solution of magnesium sulfate at the rate of 0.2 ml / kg, 0.5% solution of seduxen at the rate of 0.1 ml per year of life, prescribe chloral hydrate in an enema from 5 - 15 ml of a 2% solution to infants, up to 20 ml - for children aged 1-6 years, phenobarbital at a dose of 0.01 ml per 1 year of life, starting from the acute period, for 3-12 months. In case of severe cases, sodium oxybutyrate (GHB) is used at the rate of 50-100 mg/kg in 30-50 ml of 5% glucose solution slowly intravenously. If convulsions develop against the background of hyperthermia, a lytic mixture is administered, consisting of a 2.5% solution of chlorpromazine, 2.5% solution of pipolfen, 0.25% solution of novocaine, at the rate of 2-4 mg / kg of chlorpromazine intramuscularly 4-6 times a day .

COMPLICATIONS

Possible complications during vaccination and the timing of their occurrence

- Anaphylactic shock, anaphylactoid reactions, collapse;
- Generalized rashes, polymorphic-exudative erythema, Lyell's syndrome and other severe forms of allergic reactions;
- Encephalitis, encephalopathy, polyradiculonkvrit, mononeuritis;
- Middle meningitis
- encephalitic reactions: febrile convulsions, afebrile convulsions
- Acute myocarditis, acute nephritis, thrombocytopenic purpura,
- Agranulocytosis, hypoplastic anemia, systemic connective tissue diseases;
- Sudden death;
- Vaccination-associated poliomyelitis: in vaccinated and persons in contact with vaccinated;
- Complications after vaccination with BCG vaccine: - lymphadenitis - regional abscess - keloid scar;
osteomyelitis in the first 24 hours

- Oncological diseases
- primary immunodeficiency states of the cellular link, combined immunological deficiency, agammaglobulinemia;
- Immunosuppression due to cytostatic therapy, the use of corticosteroids for more than 14 days;
- HIV-infected seropositive;
- Anaphylactic reactions to egg white;
- Anaphylactic reactions to antibiotics;
- Severe post-vaccination reactions in the past;
- Neurological disorders: - seizures more often than 1 time in 6 months;
- Early forms of progressive neuromuscular diseases;
- Diseases of metabolism, accumulation;
- Phakomatosis, demyelinating and degenerative diseases;
- hydrocephalus in the stage of decompensation;
- epilepsy and epileptic syndrome with seizures once every 6 months;
- Organic pre-and perinatal lesions of the nervous system in the stage of compensation;
- Acute diseases;
- Chronic diseases in the acute phase;
- Autoimmune diseases;
- Prematurity: third and fourth degree;
- Anemia with hemoglobin levels below 80 g /

The introduction of live vaccines against tuberculosis, poliomyelitis, measles, mumps, rubella can be started after 1 month. after stopping treatment.

The introduction of BCG vaccines is contraindicated if the vaccine is made on the basis of a chicken embryo, if the vaccine contains an antibiotic that has previously caused an anaphylactic reaction

So, the main principle of immunoprophylaxis of infectious diseases in children should be an individual approach that would guarantee a high level of vaccination and a low percentage of post-vaccination reactions and complications.

Literature:

1. Maydannik V.G. Pediatrics: Textbook for students of higher medical educational institutions III - IV levels of accreditation. 2nd ed., Spanish. and additional / Kharkov: Folio, 2002. - S. 85-108, 145 - 187.

2. Sedelnikov V.M., Bezrukov L.A., Migal V. Practical allergology of childhood. - K .: Health, 1985. - 160 s

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ACTIVE IMMUNIZATION OF CHILDREN. THE SIGNIFICANCE OF VACCINATION FOR THE PREVENTION OF INFECTIOUS DISEASES. POST-VACCINAL COMPLICATIONS AND THEIR PREVENTION. PREVENTION OF THE MOST COMMON DISEASES OF THE RESPIRATORY ORGANS AND TUBERCULOSIS. TUBERCULIN DIAGNOSIS

Prevention of infectious diseases- it is a system of state, social, hygienic and medical measures aimed at ensuring a high level of public health and disease prevention. Prevention is divided into primary, aimed at maintaining health, preventing the negative impact of natural and social factors that can cause pathological changes, and secondary, the essence of which is the early detection of diseases, preventing their progression, relapses and complications.

Preventive vaccinations are one of the most important means of preventing infectious diseases.

Preventive vaccinations are divided into:

3) vaccination according to epidemic indications, in endemic and epizootic areas (against tularemia, brucellosis, yellow fever, rabies, influenza, diphtheria, tetanus, rubella, etc.);

In turn, vaccines are:

According to the quantitative composition of the types of pathogens, vaccines are divided into:

1) monovaccines (against tuberculosis, hepatitis, measles, mumps, rubella, poliomyelitis, etc.);

2) combined (MMR vaccine - against measles, mumps, rubella, KPKV vaccine - against measles, mumps, rubella, chicken pox);

List of documentation for sites and clinics for planning, accounting and analysis of the state of immunization of the child population:

1) a register of the census of the child population of the site with marks on the arrival and departure of children;

2) the history of the development of the child (form No. 112/0);

3) preventive vaccination card (form No. 063/0);

4) preventive vaccination planning log (per year / quarter / month) at the site;

5) register of refusals from preventive vaccinations at the site;

6) a register of medical contraindications to preventive vaccinations at the site;

7) journal of registration and use of MIBP in the clinic;

8) register of ongoing preventive vaccinations in the clinic (form

№ 064/0);

1. Vaccinations by age Vaccinations for prevention

Age

Vaccinations against

Note

1 day

Hepatitis B

3-7 day

Tuberculosis1

1 month

Hepatitis B 2

3 months

Diphtheria, whooping cough, tetanus 3

Poliomyelitis 1 OPV

Haemophilus influenzae 5

4 months

Diphtheria, whooping cough, tetanus 5

Poliomyelitis 1 OPV

Haemophilus influenzae 5

Children at high risk of developing post-vaccination complications from the AaDPT vaccine

5 months

Diphtheria, whooping cough, tetanus 3

Poliomyelitis 1 OPV

Haemophilus influenzae 5

Children at high risk of developing post-vaccination complications from the AaDPT vaccine

6 months

Hepatitis B2

12 months

Measles, rubella, mumps 6

18 months

Diphtheria, whooping cough, tetanus 33 AaRT vaccine

Poliomyelitis 1 OPV

Haemophilus influenzae 5

6 years

Diphtheria, whooping cough 1 ,

Poliomyelitis 1 OPV

Measles, rubella, mumps 6

7 years

Tuberculosis

years

Tuberculosis

diphtheria, tetanus 3

Poliomyelitis 1 OPV

15 years

Rubella (girls), mumps (boys)"

18 years

diphtheria, tetanus 3

adults

diphtheria, tetanus 3

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.

In the absence of a post-vaccination (BCG) scar, children with a negative reaction to the Mantoux test should be given an additional vaccination 2 years after BCG vaccination.

2 Vaccination for the prevention of hepatitis B is subject to all newborns, vaccination is carried out with a monovalent vaccine.

Newborn with body weight