Contents
- Pediatrician Fedor Katasonov about vaccinations, Fediatrics, read
- Principles of drawing up an individual vaccination calendar
- Number of shots and infections at one time
- Compatibility of different vaccines
- Continuing an interrupted vaccination
- Vaccination in the presence of specific immunity
- Interchangeability of vaccines
Pediatrician Fedor Katasonov about vaccinations, Fediatrics, read
The topic of childhood vaccination is a concern for many parents. The publishing house Individuum has published a book by pediatrician Fyodor Katasonov “Fediatriya”, it helps to understand this issue. Here is one of the chapters.
Principles of drawing up an individual vaccination calendar
Obviously, you are unlikely to create your own vaccination calendar. Unfortunately, even many doctors cannot cope with this task, although the matter is, in general, simple. Here are some principles you can use to create a rough calendar or check if your doctor has drawn it up correctly.
Number of shots and infections at one time
Multiple studies have shown that an increase in the number of vaccines administered simultaneously does not increase the likelihood and severity of post-vaccination reactions and complications. This likelihood seems to be more dependent on the condition of the body and the characteristics of the immune response than on vaccines. Previously, the number of vaccines administered at one time was limited, but the latest WHO recommendations encourage the introduction of any number of vaccines, if the deadline for them has come. American guidelines also say: if you can vaccinate, vaccinate. That is, if a child can already be given some kind of vaccine, but you are not doing it, this can be regarded as a mistake. Once a patient from the United States came to me and received seven injections at one appointment (needless to say, he endured them perfectly). And here we come to a limitation that is not related to the effect on immunity: this is the number of injections. Even if we decided to vaccinate all at once, there is a big problem to persuade the child to take several injections in a row. I myself rarely do more than three injections at a time, and more often two, and at the same time (in four hands with a nurse). But from the point of view of physiology, there are no restrictions for this.
Compatibility of different vaccines
Many vaccines can be given to a healthy child at the same time. That is why we prefer combination vaccines: with the same safety, they allow faster and less traumatic completion of the vaccination course. Notable exceptions are BCG and cholera and paratyphoid vaccines. It is better not to combine these vaccines with others. Children with impaired immunity have other compatibility restrictions, but this is best left to the discretion of the doctor. Let me remind you that immunity disorders are serious conditions that require constant monitoring and treatment, and frequent ARVIs do not apply to them.
Continuing an interrupted vaccination
An important principle unfamiliar to many doctors: vaccination always continues where it left off. Even after a few years, we do not resume vaccination, but continue it. This even applies to the hepatitis B vaccine given on the first day of life.
Vaccination in the presence of specific immunity
Often they ask what to do if you want to vaccinate a child with an imported combination vaccine, and he has already had one of the infections that the vaccine protects against. If we are talking about whooping cough, then there are no questions – an extra vaccination will never hurt, because the immunity is not very stable. But if we are talking, for example, about rubella, from which persistent lifelong immunity is formed? The same question arises when the child was not sick, but for some reason they looked at the antibodies in the blood, and they seem to be positive.
The answer is simple, and it lies in the way the vaccine works. If the child is ill, and the specific immunity has already weakened, then vaccination will whip him up, that is, there will be benefits from the vaccine. This booster vaccination is called a booster. The same thing happens when a child encounters an infection that he has been vaccinated against. The infection acts as a booster, and the immune system is updated.
If the child is ill and the specific immunity is still strong, then he will simply devour the vaccine dose of the antigen, as he would have done with the causative agent of the disease itself. After all, for this we also vaccinate! In this case, a person who has had rubella after a triple vaccination will receive immunity from measles and mumps, and anti-rubella immunity will instantly destroy the rubella vaccine virus, as if it did not exist.
In general, an extra dose of the vaccine is not harmful. There are rare exceptions, but even those, in my opinion, are controversial.
Interchangeability of vaccines
Almost all vaccines for the same disease are interchangeable, provided that they are of the same type (inactivated or live, conjugated or polysaccharide). “Pentaxim” is replaced by “Infanrix”, “Havrix” – “Avaxim”, “Encepur” – “Tick-Evac”. Russian vaccines are replaced by imported ones and vice versa.
Each vaccine has a schedule according to which it must be administered. This schedule is age dependent: some vaccines are given at a lower rate at an older age, while others (HPV) are given at a higher rate. The minimum intervals between the same vaccines must be strictly observed (most often they are 28 days), and there are no maximum intervals (see above).
The interval between different vaccines depends on which vaccine it is. There can be any interval between two inactivated vaccines, or between an inactivated vaccine and a live vaccine. That is, you can vaccinate even the next day. In practice, I do not recommend this, but I advise you to leave at least four days for the post-vaccination reaction, after which you can safely continue vaccinating. Unfortunately, in our country, these intervals are poorly regulated by law, so most clinics will tell you to wait a month between vaccines. But from the point of view of physiology, this is not justified. The only situation that requires a monthly interval between different vaccines is when both vaccines are live and injectable. Let me remind you that we have vaccines for measles, rubella, mumps and chickenpox, as well as BCG. Live oral vaccines (poliomyelitis, rotavirus) also do not require a monthly interval.
The recommended intervals for each catch-up vaccine can be viewed .