Vaccinations have been resumed. “COVID-19 has not made other infectious diseases no longer dangerous.”

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Due to the spreading SARS-CoV-2 coronavirus pandemic, on March 13, the government decided to suspend the implementation of the mandatory immunization schedule for 30 days. From April 20, vaccinations resumed. What is the preparation for vaccination in the era of coronavirus? “COVID-19 did not magically stop other infectious diseases from being dangerous” – explains Dr. Ilona Małecka, pediatrician and academic teacher.

Suspension of the vaccination calendar due to the COVID-19 pandemic

In mid-March, due to the progressing SARS-CoV-2 coronavirus pandemic, Minister of Health Łukasz Szumowski decided to temporarily suspend the immunization schedule. This decision was not due to medical contraindications for vaccination, but was intended to limit visits to primary care clinics. Medical facilities have been given guidelines to limit the number of hospital admissions and to opt for television visits where possible.

Now, more than a month later, the vaccination schedule has been “hung up”. As we read on the website of the Ministry of Health: it is recommended to resume the current implementation of all compulsory vaccinations under the Childhood Immunization Program, while maintaining anti-epidemic safety during vaccination, with particular emphasis on:

1. vaccinations in neonatal wards,
2. compulsory vaccinations, which, according to PSO, should be performed until 24 months of age,
3. vaccinations, taking into account the individual situation of children with chronic diseases for whom there are specific health indications for vaccination,
4. post-exposure vaccinations against rabies, tetanus, measles, chicken pox, hepatitis B, according to medical indications in all age groups,
5. implementation of other preventive vaccinations, the necessity of administration or completion of which results from the Summary of Product Characteristics.

The Ministry of Health also recommends the dissemination of vaccination against pneumococci and influenza in the risk groups of adults, including people over 60 years of age and chronically ill, because chronic lung diseases, cardiovascular diseases, cancer, diabetes, kidney failure and immunity disorders contribute to pneumonia. It is also recommended to popularize vaccination against whooping cough in pregnant women.

Many parents have doubts about going to the clinic with their child during a pandemic. How is vaccination safely organized and what is the course of vaccination at this specific time?

Is it safe to go with my baby to the clinic for immunization?

Medical facilities had to significantly reorganize their work, also in the field of preventive measures, including performing preventive vaccinations.

– At this particular time, the work of health care centers mainly consists in teleporadach and this teleportation is also used before the vaccination visit. It is important that teleportation takes place on the same day or the day before the physical visit to the clinic. There must be a close temporal relationship between the teleportation and the actual visit for the data collected during the teleportation to be up-to-date, explains Dr. Ilona Małecka, pediatrician and employee of the Department and Institute of Health Prevention at the Medical University of Poznań.

– Teleporada is based on the so-called epidemiological interview. It is about identifying any situations that may be associated with exposure to coronavirus infection or suspected infection in a child or someone from his / her close environment. The second part of telepainting in the case of a child qualified for vaccinations is based on an interview on the child’s general health – says the expert and adds: – Teleporting allows you to significantly shorten the time the child and parent stay in the clinic, which minimizes the risk of infection. During the actual visit, the doctor verifies whether the data collected over the phone is up-to-date, but it takes less time than during a normal visit.

The visit to the clinic also looks different than before. Children are admitted less frequently, the visit is scheduled for a specific time. The goal is that patients do not have contact with each other. The best solution is to separate a zone that separates sick children from healthy children, but if for some reason this is not possible, it is recommended to separate the time between visits.

– Institutions solve it in various ways. The time for a vaccination visit is longer. Typically, patients are enrolled every half hour or every hour. The only contact a patient has in the clinic is contact with the doctor and nurse. It is also a period when we ask that only one guardian come to the clinic with the child – adds Dr. Małecka.

Of course, the child’s guardian, if there are no health contraindications, should come in a protective mask or other nose and mouth protection. The teleporter that precedes the visit to the clinic is also used to collect an interview about the health of the child’s guardian – the parent who comes to the clinic with the child must be healthy.

Editors recommend:

1. When not to vaccinate a child? Contraindications to vaccinations
2. Splitting vaccinations: “one visit – one vaccine”
3. Vaccination myths

What does a vaccination visit look like and why is it so important?

Dr. Małecka draws attention to one more important aspect related to vaccination during a pandemic. When it is possible and safe, several vaccinations can be combined during one visit. Thanks to this, we will minimize visits to the clinic.

– In such special situations as this, one should follow the recommendations of the vaccine manufacturers and general recommendations that allow combining vaccinations during one visit. These are situations where, by combining these vaccinations, we do not increase the risk or frequency of side effects, such as local reactions or fever – explains Dr. Małecka.

Our expert also dispels the doubts of parents who are afraid that several different vaccinations given during one visit may significantly weaken the child’s immunity.

– If in the Summary of Product Characteristics or in the general recommendations the possibility of two preparations is allowed, this means that it is preceded by studies which have shown that these vaccines do not affect each other. This means that antibodies that arise after administration of, for example, two different preparations, are as valuable as when administered separately, and more importantly – the risk of side effects does not increase – he explains and adds: – If such actions have occurred, these are clear recommendations to keep these vaccinations separate.

In addition to compulsory vaccinations, vaccinations are also recommended in the calendar. In the case of the latter, caregivers of the child may have doubts as to whether the vaccination is worth going to the clinic and exposing themselves to potential infection.

– The fact that some vaccinations are recommended vaccinations in our calendar, i.e. they are in fact not reimbursed, does not mean that they are less important from the health point of view than compulsory vaccinations. An example is vaccination against rotavirus, which is very often chosen by parents – he says and adds: – It is not that we implement compulsory vaccinations because we have to, and the recommended ones do not. We can carry out both, and if possible, we should administer these vaccinations during one visit.

In connection with the suspension of vaccinations, another doubt has arisen regarding the rotavirus vaccinations, which must be administered up to a certain week of a child’s life. What to do if my child had been vaccinated before the pandemic and the next appointment has been ‘suspended’?

– For rotaviruses, the timing of vaccination is important. They should be given up to 24 weeks of age. In the case of a three-dose preparation, the SPC provides for the possibility of administering a third dose of the preparation before 32 weeks, but this should be considered an absolute exception. In the case of a two-dose preparation, the second dose cannot be administered later than in the 24th week of the child’s life – the expert explains.

Both preparations must not be administered after this date, even if it would mean not completing the basic vaccination schedule.

– You have to stay within the specified time frame, and if it fails, this is the only exception to vaccinations, where we cannot supplement the child later with this vaccination.

Infectious diseases are still dangerous. COVID-19 has not changed that

Some parents were relieved to hear about the “suspension” of vaccinations, others are looking for options such as postponing the visit to the clinic until the situation with the SARS-CoV-2 coronavirus calms down a bit.

– It should be remembered that despite the COVID-19 pandemic, which is currently spreading around the world, the infections against which we have vaccines have not disappeared. They are still a real danger to children. All health organizations, led by the World Health Organization, recommend that during a pandemic vaccination should be carried out as long as organizational conditions in health care allow it.

Our expert explains that the diseases against which we vaccinate are still dangerous and we cannot allow a situation where, due to non-vaccination and disorganization of health care, there will be an epidemic of further diseases.

– Vaccinating young children who are not immunized is a priority. In the case of booster doses, e.g. those performed at the age of six or fourteen, vaccination can be performed throughout the calendar year. The older child has immunity against these diseases which needs to be strengthened by a booster dose. Older children find themselves in a different situation than younger children.

Parents should be told how important it is to vaccinate and immunize the population at a sufficiently high level.

– If vaccination coverage is declining for various reasons, it may be that we will overcome the COVID-19 pandemic, but we will have an epidemic of measles or whooping cough. We would not want that, because these are also very serious infections, affecting young children in this case.

Fear of coronavirus infection cannot stop us from taking care of our health and that of our loved ones.

Have a question about the coronavirus? Send them to the following address: [email protected]. You will find a daily updated list of answers HERE: Coronavirus – frequently asked questions and answers

The most important information about the coronavirus:

1. Coronavirus in Poland and in the world. Actual information
2. Obligation to cover the mouth and nose in Poland. What are the types of face masks?
3. Why should everyone wear face masks? Scientists explain
4. “Coronavirus is not suitable for biological weapons” – interview with prof. Włodzimierz Gut

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