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Before immunizing a child, many parents would like to know the answers to some extremely important questions. We asked Dr. Aneta Górska-Kot – head of the pediatric ward at the Children’s Hospital at Niekłańska in Warsaw, who – as she claims – is an advocate of vaccination, but not an Orthodox one.
Increasingly, the so-called anti-vaccination movements argue that people should not be forced to vaccinate. Who are the members of these movements and can they be right?
Refusals to vaccinate their children are most often made by educated mothers and fathers from big cities. They are often people with a lot of knowledge about vaccination, but their view is not entirely objective. They include parents of children who received 10 points on the Apgar scale after birth, and yet at a certain age, their development ceased to be normal, as well as those who experienced an undesirable post-vaccination reaction. It is commonly believed that the maximum number of points on the Apgar scale is a guarantee of the child’s health. Meanwhile, there are defects in the nervous system that do not appear immediately after childbirth, but at a later age. Parents looking for the cause often suspect that it is a vaccine. Unfortunately, wrongly. Occasionally, a vaccine may hasten some problems to emerge. On the other hand, those who have experienced a severe adverse vaccine reaction in their child are more suspicious, and this is understandable. However, it should be remembered that the vast majority of parents do not have such problems. On the other hand, there are those who have experienced severe pneumococcal disease, due to which their child is crippled or even died. They consider the vaccine to be the greatest boon they have failed to take advantage of.
What are the side effects of pneumococcal vaccines?
As with all drugs and vaccines, pneumococcal drugs can have side effects. The manufacturer lists them all in the vaccine information leaflet. You need to know that he does it extremely meticulously and even a little exaggerated, because when deciding to use the preparation, we have to take them into account. This is a certain safeguard for the manufacturer. Adverse reactions from pneumococcal vaccine clinical trials and post-marketing experience are classified into very common (≥ 1/10 subjects), common (≥ 1/100 to <1/10 subjects), uncommon (in ≥ 1 / 1 to <000/1 subjects), rarely (in ≥ 100 / 1 to <10 / 000) and very rarely (in ≤ 1 / 1). Very common symptoms include decreased appetite, fever, irritability, injection site erythema, induration, swelling or pain and tenderness, somnolence, restless sleep. Common symptoms include fever above 000 ° C, injection site tenderness impairing limb movement due to pain, and uncommon: vomiting, diarrhea, erythema or injection site swelling greater than 1 cm in diameter. Rare side effects include hypersensitivity reactions including facial swelling, dyspnoea, bronchospasm, seizures (including febrile seizures), gastrointestinal disorders, rash, urticaria, anaphylactic and pseudo-anaphylactic reactions including anaphylactic shock, angioedema, hypotonic-hyporesponsive. Lymphadenopathy around the injection site and erythema multiforme are very rare.
The most serious side effect is anaphylactic shock. Therefore, the child should be in the vicinity of the doctor’s office for half an hour after vaccination, so that in the event of shock, he or she should be given adrenaline immediately. It is best to vaccinate children who are allergic in a hospital setting.
Does it happen that a child dies as a result of a vaccine? Are the numbers of deaths investigated?
Death as a result of an ingested vaccine can of course occur, for example as a result of anaphylactic shock, fainting during vaccinations while standing, and the resulting head injury. Death numbers are investigated and recorded. However, complications from vaccination are on average 1000 times less frequent than complications from contracting the disease against which the vaccine is intended to protect. Mortality from invasive pneumococcal disease ranges from 10 to 20 percent. The risk of developing the disease among two- or three-year-olds in nurseries is high, because 8 out of 10 children are carriers of pneumococci. The incidence of invasive pneumococcal disease is 15-20 per 100. The disease can also result in deafness, limb paresis, epilepsy, and learning difficulties. These consequences may appear even several years after it has traveled. Meanwhile, serious vaccine adverse events are rare – one in a million vaccinations.
Is the doctor obliged to report adverse reactions after vaccination?
A doctor who suspects a serious post-vaccination reaction should report it to the Sanepid Department within 24 hours. The latter, in turn, is obliged to investigate whether the administered vaccine could be related to such an incident. If so, he reports it to the drug manufacturer.
Do pharmaceutical companies care about such reports?
Companies are interested in such information, because then they can withdraw the suspicious series from the market themselves and not expose themselves to a larger scale of the phenomenon.
Is it possible to vaccinate a child with a runny nose or other infection?
The most unfavorable vaccination is when an infection is just developing. Then the entire immune system is set to fight the pathogenic microorganism. The vaccine can be an additional burden. Unfortunately, it is often the case that we do not know yet that the child has been attacked by some virus or bacteria because there are no symptoms. However, children should not be vaccinated in the first days of infection.
Is it better to vaccinate the baby or wait until the child is 2 years old?
It is better to vaccinate a younger child, as the risk of severe pneumococcal infection is highest in the first year of life and then systematically decreases.
It’s best to start the vaccination course in the first 6 months of life and finish before your toddler goes to nursery, where exposure to pneumococcus is enormous.
Do vaccinations immunize against all pneumococcal strains?
There are over 90 types of pneumococci, of which 20 are dangerous. From these 20, on the basis of epidemiological studies, the most common ones were distinguished, and this is what the vaccine protects against. There are 7, 10, 13 and 23 types of pneumococcus on the market. 23- valent, due to its structure, does not work in children under 5 years of age. The efficacy of these vaccines is very good. Thanks to the pneumococcal vaccination, financed by the municipal government in Kielce, it fell by 60 percent after the first year of their introduction. the number of cases of pneumonia among the youngest inhabitants of this city. In the following years, it decreased by as much as 2/3 compared to the average before the introduction of the pneumococcal prophylactic vaccination program.
Can a child get sick despite vaccinations?
Your baby can be attacked by pneumococcus, which is rare and cannot be protected against by the vaccine. This happens extremely rarely. A small percentage of children do not develop immunity after being vaccinated. However, it appears in over 90 percent. vaccinated. Vaccine coverage for children under 2 years of age for the 13-valent vaccine is approximately 85%, which means that out of 10 children who develop invasive pneumococcal disease, 8 will be protected against it.
It is worth knowing, however, that although the vaccinated may develop pneumococcal disease, the infection is usually milder in them, and the possibilities of antibiotic therapy are much wider than in the unvaccinated.
Could mass vaccination cause bacteria to mutate and become immune to the vaccine?
You have to remember that in the eternal fight against bacteria, they are always a few steps ahead of us. The elimination of any of the bacteria that inhabit our body may cause the uncontrolled growth of another. Getting rid of certain types of pneumococci may make others more active. Pneumococcus is also known to control staphylococci, which may become more active after mass pneumococcal vaccination is introduced. However, there are studies showing that vaccination does not disturb the total number of strains, but changes them from pathogenic to saprophytic, ie protecting the body against the “bad” ones. Two groups of children up to 9 years of age were presented at the ISPPD-4 International Symposium in Hyderabad, India: one was vaccinated against pneumococci and the other was not. All of them were tested for carriage of pneumococci in the nasopharynx. In both groups, the number of pneumococcal carriers was identical – approx. 30% of children, while the quality of the bacteria was different. Only 5 percent of those who were vaccinated were the most aggressive strains, and in the unvaccinated – 57 percent.