During the largest restrictions related to the spread of the coronavirus in Poland, it was decided to temporarily suspend vaccinations in children. And although it is possible to return for vaccinations normally, some parents are afraid of visiting clinics. How does it look now? Is it safe? Paweł Grzesiowski, MD, PhD, immunologist, lecturer at the School of Public Health at CMKP, president of the “Institute of Infection Prevention” Foundation, dispels parents’ doubts. The expert also says when the COVID-19 vaccine can be expected and what is the epidemiological situation in the country.
- Dr. Grzesiowski says that this is the best time to vaccinate children who have experienced delays in vaccination
- Parents should not be afraid of giving several vaccines at the same time: – Scientific research shows that the body of a young child is perfectly capable of responding to a larger number of antigens administered simultaneously. So there is no reason to fear that a young child’s body will not be able to cope with several vaccines given at the same time
- The specialist also chills hopes that the COVID-19 vaccine will be on the market later this year. “To think that a vaccine will be available this fall, as some predicted, is a sign of a lack of realism. The earliest we expect a vaccine is in spring 2021.
Journalists for Health Association: Although the Ministry of Health recommended the resumption of compulsory immunization under the Childhood Immunization Program in mid-April, it seems that many parents still do not know what to do. Some people decide not to vaccinate their child – and it is not about the anti-vaccine attitude, but rather doubts and fears. On the other hand, those who have always complied with the vaccination deadlines are concerned whether delays in the implementation of the vaccination program resulting from the temporary recommendation of the Ministry of Health will adversely affect the child’s health …
Paweł Grzesiowski, MD, PhDWhen it comes to delays in the implementation of the vaccination program, most of these vaccinations can be carried out even with a delay of several weeks without fear that any adverse effects may occur.
How vaccinations are continued after the vaccination suspension period depends on many factors, first of all at what stage of the vaccination schedule was interrupted and the age of the child. However, there cannot be a situation where no continuation will take place. It is vaccination that is, after all, a safe path to the health of the individual and the population.
Who, what social groups should be vaccinated as soon as possible after the temporary suspension of immunization?
These are mainly children up to 24 months of age, pregnant women and people with chronic diseases, regardless of age. In the case of children, this applies mainly to compulsory vaccinations, but it would be ideal if parents also remember about the recommended vaccinations.
Vaccinations against rotavirus or meningococcus should be included in the mandatory vaccination calendar, which we have been striving for for years. Almost every child under the age of three or four passes rotavirus infection. Annually in our country we have about half a million cases of rotavirus diarrhea in children under the age of five. Of these, about 10 percent require hospitalization. Today it is already known that after rotavirus infection, long-term complications may occur, e.g. a child may develop type 1 diabetes.
Meningococcal infection can be very dangerous. As a result of this infection, invasive meningococcal disease can occur, and this is life-threatening. T.like pouring an extremely toxic poison into the blood. Meningococcal sepsis can develop rapidly as a result of invasive meningococcal disease.
Meningococcal infection is especially dangerous for young children, but anyone who is in large groups is at risk. More than 12 serological groups of meningococci have been isolated, in Poland the most common types B and C are the most dangerous, which is why the use of meningococcal vaccines is so important.
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Therefore, we currently have a situation in which, on the one hand, parents are afraid to take their children to the clinic for vaccinations, and on the other hand, they would like to make up for overdue vaccinations as soon as possible or make new ones, resulting from the calendar, because they are afraid of the consequences of delay …
These consequences can be avoided if, as I have already mentioned, the vaccination schedule is individually adjusted. And when it comes to vaccination safety, everything has been described in detail in the recommendations of the Ministry of Health and the Chief Sanitary Inspector. These recommendations define how vaccinations should be performed to ensure the highest protection measures – both for the child and its caregiver, and for the medical staff.
Disinfection activities are carried out on an ongoing basis in the offices. It is best to contact the facility first by phone, not only to arrange the vaccination date, but also to conduct an initial interview about the child’s health. Such an interview should take place as close as possible to the planned date of the visit.
What should a vaccination visit look like in the new conditions?
Vaccinations are to take place in separate rooms, where sick people with symptoms of infection cannot be admitted. Children are arranged individually, for a specific hour and ideally come with one guardian, so that there are as few people in the waiting room as possible. Of course, the caregiver must be healthy, as previously stated in the telephone interview. Such an interview should also contain information about the health of other household members. If a person with a respiratory infection is at home, in quarantine or home isolation, vaccination should be postponed.
Perhaps in a pandemic, it would be safer to administer several vaccines at once, which would reduce the number of visits to the clinic. But wouldn’t it be harmful to my baby to accumulate more vaccines in one? Parents often ask about it …
So-called combination vaccines are nothing new. Research shows that a young child’s body is great at responding to more antigens given simultaneously. So there is no reason to fear that a young child’s body will not be able to cope with several vaccines given at the same time. The final decision is made by the doctor in consultation with the parents after assessing the child’s condition and analyzing the vaccination schedule.
You recently mentioned that the coming months are the best time for immunization. Why?
First of all, now the children are healthy, they have not attended nurseries and kindergartens, and they still have limited contacts in groups. In two months, another autumn-winter period awaits us, when respiratory infections and flu, as well as coronavirus infections usually appear. Children will probably go to nurseries, kindergartens, schools, where it is easy to get infected with many viruses and enveloped bacteria (pneumococci, meningococci). Therefore, you should think about protecting yourself against them now. Vaccines offer this chance.
When we talk about vaccinations, we mainly mean children. But adults need them too.
Absolutely, especially those from high-risk groups, i.e. people suffering from chronic diseases such as lung diseases, cardiovascular diseases, diabetes, cancer, kidney failure, immunity disorders, people over 65 years of age. First of all, they should get vaccinated against influenza, pneumococcus, whooping cough. Pertussis vaccination is also recommended for pregnant women.
It seems obvious that vaccinations protect against dangerous, often fatal diseases, that they are much cheaper than treating complications from infectious diseases. Yet the anti-vaccine movement is holding up well. What it comes from?
In recent years, the influence of anti-vaccines has significantly weakened in Poland, the social acceptance of vaccinations has increased, the vaccination schedule has been enriched with pneumococcal vaccinations, and the number of unvaccinated children has decreased.
But confidence in immunization builds up over decades, so you need to keep educating, though no one seems to need to be convinced that vaccination is the cheapest way to avoid dying from an infectious disease. Even so, there will always be a group of people who question this obvious truth.
But every year there are various campaigns, educational campaigns with very strong slogans, for example “Inoculate your desire to vaccinate”, “Inoculate yourself with knowledge” or, more specifically – “Stay ahead of meningococcus” …
Anti-vaccine views do not lend themselves to logical arguments, fortunately there are few declared anti-vaccines, a much larger group are people lost, uncertain, looking for answers to questions about the effects and safety of vaccinations. Therefore, competent, wide-ranging communication on the role of vaccination in public health is essential.
And one more question that is impossible not to ask when talking about vaccines. When can we expect an effective, safe COVID-19 vaccine?
I think it will be a long time before we can enjoy it. It is not enough to “develop” it and test it to be safe and effective, then a huge number of doses have to be produced.
The vaccine is kind of the Holy Grail. Every scientist dreams of it, every government, everyone would like to have it, but it is not easy. Yes, you can shorten some procedures, but only the official ones, while research and tests on a new vaccine must be carried out in accordance with the accepted rules, because no one will allow the use of an unfinished product.
At the moment, over a hundred research teams from various scientific institutions are working on the vaccine, some are more, others less advanced. To think that a vaccine will be available this fall, as some predicted, is a sign of a lack of realism. The earliest we expect a vaccine is in spring 2021.
The problem is also who will get this vaccine, what the price will be. You may find that this is a product that is available to a very limited extent.
And how do you now assess the epidemiological situation in the world and in Poland resulting from Sars-CoV-2 infections?
The pandemic has not ended, the world will certainly have many problems with the coronavirus, because it is still dangerous and can come back with double strength at any time.
We are only on the first lap of this race and we have to remember that all the time. You should closely follow reports from other countries, bearing in mind that what we hear in the media may only be a fraction of what is really happening.
Based on serological tests, we know that the number of cases is much higher than officially reported. We announced a lockdown very early, thanks to which the transmission of the virus practically stopped, so now we have a creeping epidemic, with local outbreaks, and it’s really hard to predict how things will turn out.
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Authorized press interview, prepared by the Association of Journalists for Health in connection with the on-line workshop Quo vadis medicina? XXIII edition, How to vaccinate in the era of the coronavirus pandemic?, July 2020.
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