Transcript Contraindicated to vaccines

Immunization
Department of Childhood
Illness
Professor: Karimdjanov I.A
Immunization - number of infectious diseases has
allowed for the last two centuries,save millions of
lives.
Immunization of the population, carried out on all
the continents, led to globaleradication of
smallpox, polio, and limit a significant decrease
in the prevalence ofother
diseases preventable vaccine.
Immunization
"The vaccine - a drug that provides the
development of immunity, the development
ofimmunity to the pathogen" (RV Petrov, RM
Khaitov, 1988)
Immunization
To protect against any infection is necessary to
establish immunity mainly to several
major epitopes of the pathogen.
 However, modern technologies
of natural vaccine can not come close to a highest
degree of purification.
 Therefore, a vaccine in a given amount
of ballast substances contain - the components of
microbial cells destroyed

Immunization
The quality of vaccines in many cases depend
on purity of antigens of microbes
 As a growing number of people on Earth is
experiencing immunization, respectively,then increased a
nd the number of adverse reactions, including both the
true response to the vaccine, and coinciding with
the vaccination, but not caused by it.
 Should be aware of the risks of vaccination, and yet vaccination is better than the risk of the disease

The maximum number of cases of vaccinecontrolled diseases before the introduction of vaccination,
compared with 1995 in the U.S.

maximum number of
years
1995
to obtain a pre-vaccination
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Врожд. rubella
diphtheria
Gemofil
infection
measles
parotitis
whooping cough
polio
rubella
tetanus
The number of adverse
reactions and complications
20000
206 939
1964-65
1921
7
0
20 000
894 134
152 209
265 269
21 269
57 686
601
1984
1941
1968
1934
1952
1969
1948
1164
309
840
4315
0
146
34
0
10594
The main barriers to immunization in
most countries - is
A. Parents should be aware of the importance of
vaccination to prevent the risk of disease
B. Physicians should have a clear
understanding of the mechanisms of vaccine
C. Publicly funded programs vaccination should
aim at lowering the prices of vaccines
and their availability to the general population.
D. The system of vaccine should be well
established.
Immunization
The human immune system consists of a central (thymus,
bone marrow) and peripheral(spleen, l / y) of
These are the mechanisms of innate immunity that
act immediately and are the earliestresponse to infection.
If pathogens are these early lines of defense, then run the
adaptive immune responsemechanisms with the
development of antigen-specific effector cells
Within a few days formed a specific immunologic
memory, which provides long lasting protection for reinfection by the same agent.

Immunization
Classification of types of immunity:
I. Innate immunity.
II. Acquired (adaptive) immunity, which, in
turn, is divided into:
1) natural acquired arising after perebolevaniya b
y keeping the memory
cells. 2)Artificial acquired, which is divided into:
a) passive - at the expense of administration of
antibodies prepared
b) active - is achieved through safe and effective
vaccines.
Types of infectious agents and their localization in
the body
All known infectious agents that cause human disease are
divided into five groups: viruses, bacteria,
fungi, protozoa,helminths. From a pathogenetic point of
view of separation of the place of their preferential
growth and reproduction. Distinguish two main
groups of microorganisms:
1. Intracellular (intracellular).
2. Extracellular (extracellular).
It should be noted that virtually all
pathogens are ekstratsellyularnuyu phase where they
become vulnerable to the action of antibodies.
localization of the pathogen
intracellular
extracellular
cytoplasmic
vesicular
Virus
chlamydia
rickettsiae
Lister protozoal
mycobacteria
Salmonella
leishmania
Lister
trypanosomes
legionella
cryptococcus
Histoplasma
Yersinia
pestis
Interstitial spac
e, blood, lymph
epithelial surfac
e
Virus
bacteria
protozoal
mushrooms
helminths
gonococci
helminths
mycoplasma
pneumococcus
cholera vibro
E.coli
Candida alb.
Helicobacter
pylori
Key Features
Phase of the immune response
Immediate (0-4 hours)
Nonspecific congenital
- not immunological
memory
- not specific T-cells
Early (4-96 hours)
Nonspecific & specific
(induced)
- not immunological
memory
- not specific T-cells
Late (after 96 hours)
Specific (induced)
- induced
- there is immunological
memory
- specific T-cells
barrier function
- Skin
- Epitelium
- local inflammation
- TNF-a
-IgA-antibodies
- IgE-antibodies
on mast cells
response to
extracellular
pathogens
response to
intracellular
pathogens
-Fagocytosis
-alternative pathway
activation of
complement
- macrophages
- activation of
complement
- IgG-antibodies
- IgM-antibodies
- classic pathway
activation of
complement
-Activation
- Т-cellular Activation
of macrophages
- IL-1, IL-6, TNF-a, IL12
of macrophages with
help IFN-g
The
protective immunity - a response
to reinfection by antigen recognition, pre-existing
antibodies (preformed) and effector T cells
Immunological memory - is shown that in
response to reinfection is antigen recognitionby Band T-cell memory.
During acute infection
1.
infecting .
formation of infection . There is an increase of
antigen levels as a result of replication of the pathogen.
3. Induction of adaptive response . After 4-5
days, effector cells and molecules of the adaptive
response will start to realize the immune response
to antigen and purifying the body from infection.
4. Adaptive immune response . Antibody
production and activation of T cell-mediated immunity .
5. Immunological memory . When the infection
is wiped out and the dose of antigen falls below a threshold
level, the response is terminated.
2.
Mechanisms of tissue destruction of pathogens
a) Product exotoxins. Exotoxins, allocations micro
organisms, act on the surface of the host
cell and penetrating into the cell and destroy it
b) the allocation
of endotoxin. Endotoxins, released during the
destruction of somepathogens, are triggers for the
synthesis of cytokines by macrophages, which in
turncause local or general symptoms
c) a direct cytopathic effect. Some
microorganisms are able to exert a direct
destructive effect on cells
Innate immunity (non-adaptive protection)
1. Mechanical barrier in the form of the
epithelial surface, which protects a person
from entry of microorganisms.
2.Complement. Bacteria activate
the complement alternative route, which is located in
the plasma
3. Neutrophils . Macrophages. The bacteria are
absorbed by macrophages, which
havesurface receptors that are common to all
bacteria
4.NK-cells. Virus infected cells are destroyed NKlymphocytes (natural killer).
The main cells of the innate immune
Macrophages are derived from circulating
blood monocytes. In a lot of them are located in
the connective tissue, spleen, and liver.
Neutrophils, these cells predominate in
the early cellular infiltrate at the site
ofinflammation. They are in the blood and are
virtually absent in normal tissues.
Natural Killer (NK-cells) serve as an early defense
against intracellularmicroorganisms. NK-cells were
identified by their ability to kill certain tumor
cells in vitro without prior activation.
Vaccines can be divided into two main
groups:
to live and killed (inactivated) vaccine
1. Live vaccines attenuated strains (strains with attenuated path
ogenicity)
2. Killed vaccine derived molecular way that will
a) The biological synthesis
b) chemical synthesis
- Corpuscular:
a) Heal microbes
b) of subcellular molecular structures
Traditional vaccines
a) Inactivated
Inactivated vaccines are produced
by exposure to organisms by chemical or heat.
b) live attenuated
c) toxoids
Toxoids are used as vaccines to induce a specific
immune response. (eg, diphtheria, tetanus).
A new generation of vaccines
a) conjugated
In conjugate vaccines using the principle of
binding to proteins such antigens or toxoids
b) the subunit vaccine
Subunit vaccines composed of fragments
of antigens that can ensure an adequate immune
response.
Безопасность инъекций: компоненты
Закуп вакцин
Холодовая цепь и
обеспеченность
оборудованием
Безопасность
инъекций при
вакцинации
[
[
[
РАСЧЕТ потребности
ЗАКАЗ
Оплата
Производство
ОТГРУЗКА
Надзор за
ПВО
Хранение
Распределение
Запас
правильное проведение
вакцинации
Утилизация отходов
Currently, there are certain requirements
for vaccines:
1. The vaccine should be safe.
2. The vaccine must induce protective immunity with
minimal side effects
3. The vaccine must be immunogenic
4. The vaccine must induce the
"right" (required) type of immune response. Vaccines
should stimulate a specific immune response
5. Vaccines must be stable during storage period
The need for immunization, as the basis
for good health
Based on many years experience
in vaccine conducted in many countries, WHO has
developed an expanded program on immunization
(EPI).
Formula EPI in the last 20 years remains
unchanged, namely: the use of mass
immunization to reduce infectious morbidity .

Childhood immunization schedule to 9
months of age in the EPI
Term
Vaccine
At birth
BCG, OPV
6 weeks
DTP, OPV
10 weeks
DTP, OPV
14 weeks
DTP, OPV
9 weeks
measles
The objectives of individual phases of the EWI
EPI-1 was carried out between May 1974 and 1990. During
this period, it was recommended to vaccinate at least 80% of
children against 6 infections: poliomyelitis,
measles, diphtheria, tetanus, whooping cough, tuberculosis.
EWI-2 covers the period from 1990 to 2000. It is
recommended to be vaccinated in 2000 to 95% of
children. The purpose of this step is the elimination
of paralytic polio in the world by 2000
EPI-3 - is a strategic program for the first 10 years of the
21st century. Its aim is to stop the circulation
of poliovirus and measles, which will repeal
these vaccinations.
Results of РПИ-1 & РПИ-2
1.
2.
3.
The use of mass immunization against
poliomyelitis eradication demonstrated the
possibility of paralytic polio endemic in the large region
Installed vaccine addiction humanity when it was
found that under conditions of mass immunizationpreventable diseases can return
The possibility of regaining control over the
situation with vaccine-preventable
diseases through immunization full coverage (as an
example of polio and diphtheria
SanPIN №0239-07, MH RUz
Calendar of vaccinations in
February, 2009
Calendar vaccination Uz
bekistan
Infection
1
2
3
4
5
6
12
16
1-3 mon mon mon mon mon mon mon mon 7
16
day
t
t
t
t
t
t
t
t year year
Pertussis,
Diphteria,
Tetanus
Polio
ОПВ
0
АКДС АКДС АКДС
1
1
2
АКДС АДС
4
5
ОПВ ОПВ ОПВ
1
2
3
ОПВ OПВ
4
5
К
2
К
1
П
1
Measles
Parotitis
Viral
ВГ-В
1
hepatitis B
Tuberculosi BCG
1
s
Hemofilus
inf
ВГ-В ВГ-В
2
3
АДС
6
П2
ВГВ4
BCG BCG
2
3
HIP
HIP
HIP
Age
name of vaccine
1 day
ВГВ-1
2-5 day
BCG against tuberculosis
Polio - OPV-0
2 months
Against diphtheria, tetanus, pertussis - DTP-1
OPW-1
HBV-2 HIB 1
3 months
АКДС-2 ВГВ 3 HI 2
ОПВ-2
4 months
АКДС-3 ВГВ 4
ОПВ-3
12 months
MPR- 1
16 months
АКДС-4
ОПВ-4,
6 years
КПК 2
1 class (7 years)
DT-5
ОПВ-5
БЦЖ R-1
8 class (14-15 years)
БЦЖ R-2
16 years
АДС-М-6
ХИБ 3
Характеристика вакцин, применяемых для иммунопрофилактики
Types of vaccines
Name of vaccine, dose and
route of administration
storage conditions
live vaccines
OPV (1 dose 2 drops in
the mouth), Measles (1
dose 0.5 ml n / a)
Epidparotitnaya (0.5 ml n /
a)
BCG (0.05 mg or 0.1 ml / h)
All vaccines can be
frozen but not freeze after
dilution
Pertussis (DTP is
a component)
Frosting can not be stored
at 4 C to 8 C
DTP, DT, Td,
AD M (0.5 ml / m)
Tetanus (0.5 and 1.0 ml)
Frosting can not be stored
at 4 C to 8 C
Hepatitis B (1 dose 0.5 ml /
m)
Frosting can not be stored
at 4 C to 8 C
killed
In
a
c toxoids
t
i
v
a
recombinant
t
e
d,
e
Contraindications to vaccine types
Types of vaccines
Противопоказания
all vaccines
-severe allergic reaction or complication to a previous dose;
-acute phase of infectious and somatic diseases (vaccination is
carried out 3-14 daysafter recovery)
All live vaccines
BCG
ВГВ1
ВГВ2(3)
ОПВ
АКДС
- immunodifitsitnoe-state (initial, immunosuppression);
-malignancy;
-pregnancy.
-premature baby (less than 1800);
-keloid scar, after previous one dose;
-severe cranial trauma, in childbirth;
- violation hemo-liquor dinamic third degree.
-the weight of a child less than 1800;
-severe nova procces.
cranial trauma, in childbirth;
-allergic reaction to baker's yeast.
-drug immunosuppression;
-malignant
-progressive disease of the nervous system;
afebrile seizures, a history (instead of DTP administered Td)
Are not contraindications:
state
-
perinatal encephalopathy
Stable neurological condition:
Cerebral palsy, Down syndrome,etc.
Allergies, asthma, eczema
Chronic diseases of the heart,
lungs,kidneys, liver
Anemia
Dysbiosis
The increase in the shadow of
theThymus
Congenital
Maintenance
therapy withsteroids, harmony
The incubation period of the
disease
Directions history
-
newborn jaundice
Prematurity
Hemolytic disease of newborn
Sepsis
Post-vaccination complications in
the family
Allergies, seizures in the family
Epilepsy in the family
Sudden death in the family
Transferred whooping cough,
measles, mumps, not documented
Terms of post vaccination complications
complications
Anaphylactic shock, anaphylactoid reaction, collapse
Encephalitis, encephalopathy
Encephalitic reactions:
febrile convulsions
afebrile seizures
continuous high-pitched cry
hydromeningitis
Сроки развития после
вакцинации
DTP, DT
ЖКВ, БЦЖ,
ОПВ
24 hour
24 hour
7 days
15 days
3 days
15 days
4 days
--
15 days
15 days
-30 days
Vaccine-associated polio:
the vaccinated
in contacts of vaccinated
in immunodeficient
30 days
any time
6 months
Lymphadenitis, keloid scar after BCG vaccination
Within 1 year
Generalized rash, angioedema, forms of severe allergic reactions.
10 days
10 days
Sudden death related to the time of immunization.
30 days
30 days
Background levels of
adverse reactions to vaccines

Divided into two groups:
- common
- rare
(coincidence ..........)
Common reactions
Vaccine
BCG
Hepatitis В
Local
T-ra
1-6%
General
-
ММR
OPV
DS: АU
To 10%
no
to 10%
To 5%
Less 1%
to 10%
to 5%
Less 1%
to 25%
DTP
to 50%
to 50%
to 60%
often
Adults 30;
children to5%
Rare serious reactions
vaccine
Reaction
inception Freaquaency
to 1 mln.
DTP
-Continuing cry<3 hours
-Convulsing
-Hypotonic and
hypertonic effects
-Anaphilaxis
-Encephalophaty
0-24 hours
0-3 days
0-24 hours
1000-60000
570
570
0-1 hour
0-3days
1-2
1
Rare serious reactions
vaccine
reaction
inception Freaquency
to 1 mln.
Measles,
ММР
High т-ра
Thrombocytopenia
Anaphylaxia
5-12 days
15-35 days
0-1 hour
333
33
1-50
OPV
Vaccine-associated
poliomyelitis
4-30 days
1,4-3,4
PROGRAMME ERRORS
 Occur
the fault of medical staff.
Such errors can be prevented with
proper organization of work!
Programm errors and their
implications
Errors
Non-sterile injections:
-reuse syringes;
-contamination of vaccine or
diluent
-reconstituted vaccine misuse
Expected effects
Abscesses at the injection
site, sepsis, toxic shock and
death.
Blood-borne infections:
hepatitis, HIV.
Software errors and their
consequences
Errors
Expected conditions
Injection in inappropriate places:
-the introduction
of BCG subcutaneously;
-local reaction or abscess;
-local reaction or abscess;
-introduction of other vaccines s/c
-damage to the sciatic nerve
; i/m
-injection in the buttock
Software errors and their
consequences
Errors
Expected conditions
Incorrect transportation or
storage of vaccines:
-Local or general reactions to the
use of frozen vaccines;
-ineffective vaccination;
Failure to comply
with contraindications:
Reaction, which can be avoided
VACCINATION OF PATIENTS WITH
BURDENED ANAMNESIS
 Allergic disease should not be a contraindication for
vaccination
Allergic to eggs can not be a permanent medical
challenge. It is recommended to carry out vaccination
skin testing with measles vaccine
1 - Division of Immunization (observation notes. The
conditions of the vaccination:
allergist-immunologist)
2 - Cabinet immunologist-allergist
3 - Under the supervision of district pediatricians

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Vaccination of patients receiving SIT.
Vaccination of patients with atopic diseases in
treatment allergen - specific immunotherapy.
It may be in atopic asthma, hay fever, perennial
allergic rhinitis, etc..
In deciding whether to conduct routine
vaccination should be
discontinuedallergoterapii rate not less than
2 months.
After 1-2 months. after vaccination in the absence
of postvaccinate complications treatment with
allegovaccines can continue
Vaccination of adults


Because the problem of hepatitis B - this is not just a
problem of childhood, but in many respects the
problem of adolescents and adults, it should provide an
indication for vaccination of adults:
Persons at high risk of infection
Health care workers who have contact with
blood (surgeons, dentists, obstetricians, gynecologists,
laboratory technicians, nurses and treatment, etc.)
Vaccination of adults

Patients with hemophilia and on hemodialysis

Addicts (intravenous)

Members of the families and community media HbsAg

People traveling to Russia and worldwide

Police officers, emergency services, morgues, military, etc.

Teenagers, people often receive injections in relation
to diseases

Individuals with immune deficiencies

All residents of areas with high prevalence
TACTICS OF TREATMENT
OF CHILDREN WITH
DIFFERENT PATHOLOGY
BEFORE AND AFTER
VACCINATION



Basic Asthma therapy in accordance with the degree of the
disease. Membranestabilizers mast cells1015 days. Antihistamines I and II generation 5-6 (up to 12
daysafter vaccination with live vaccines) Theophylline
(teotard, teopek, etc.)
Pollinosis Membranestabilizers (zaditen, ketotifen) The entire
period pollinosis 2-3 months. Antihistamines. On the day
of vaccination 7-10 - nal-chrome in the eye, INTALinhalation. The whole period of vaccination. Topical hormones
(aldetsin, etc.) The whole period of vaccination
Antihistamines atopic dermatitis. Membranes of mast
cell stabilizers (nalkrom, zaditen,ketotifen) 3-4 weeks 2-3
months. Calcium (gluconate, lactate). Enzyme
preparations(abomin, Festal, panzinorm,
pancreatin, mezim forte.) Local therapy (naftalin ointment, zinc)
Clinical management of children with damage of brain before
and after vaccination
Therapy
Before vaccination
(days)
After vaccination
(days)
Perinatal encephalopathy
Active therapy
course before
stabilizing
Continue if
neccesary
Anticonvulsant therapy (temporary)
5-7
5-7 (
Against the background
of continuing anticonvulsant
therapy
5-7
5-7
Dehydration and anticonvulsants
Seizures (febrile, afebrile)
dose correction
Cerebrospinal fluid distension, hydrocephalus
Dehydration
(diakarb, glyceron and etc. )
5-7
5-7 до 14
Kalium preparats (in neccesary)
5-7
5-10
Neuroinfection in history (there was a convulsive disorder)
Dehydration and anticonvulsants
5-7
14
Vaccination reactions and complications











Grafting reaction - the reaction is occurring as a result of
vaccination, but not an obstacle for the subsequent introduction of
the same vaccine.
Complications (adverse reactions) - is a reaction arising from a
vaccine and prevent the reintroduction of the same vaccine.
Pharmacological effects of vaccines.
Vaccination infection.
Tumorigenicity effect.
Induction of antibodies to non-protective antigens contained in
vaccines
Allergy.
Immunomodulatory effects of vaccines
The induction of autoimmunity.
Induction of immune deficiency.
Psychogenic effect of vaccination
Contraindications to vaccination.
Contraindicated to vaccines
Not contraindicated to vaccines
Common to all vaccines (DTP, OPV, IPV, MMR, Hib, Hep B)
1. Anaphylactic reaction to previous dose the next dose of the vaccine is
notadministered.
2. Moderate or severe
illnesses with or without fever.
1. Mild local reactions.
2. Acute pulmonary
disease severity.
3. Conduct of antimicrobial
therapy.
4. Phase of recovery of the
disease.
5. Prematurity.
6. Allergy
to penicillin or other
nonspecific allergies
DTP (DT)
Contraindicated to vaccines
1. Encephalopathy within 7 days
after the last dose of DTP.
2. Fever above 40.5 ° C for 48 hours
after vaccination the previous dose of
DTP
3. Collapse within 48 hours after
receiving a previous dose of DTP.
4. Congestive heart failure within 3
days after receiving the first dose of
DPT.
5. Inconsolable crying, cry (scream)
for 3 hours within 2 days after
receiving the initial dose of DTP
Not contraindicated to vaccines
1 . 40.5 ° C fever than after the
previous dose.
2. The presence of convulsions in a
family with other children.
3. The presence of a family history
of sudden infant death.
4. Indications for the presence of a
history of other unusual
reactions after vaccination
OPV
Contraindicates to vaccine
Not contraindicated to vaccine
1. HIV infection in a patient
or contact with HIV-infected house.
2. immunodeficiencies:
- Congenital;
- Acquired: in tumors with longterm immunosuppressive therapy
(including corticosteroids).
3. Contact with patients
with immunodeficiencies.
4. Pregnancy.
1. Cerebral violations
2. Anti-microb therapy
3. Diarea
MMR (measles, mumps, rubella)
1. Anaphylactic reaction
to eggs (chicken, quail).
2. Drug
allergies to kanamycin, monomitsin,
neomycin.
3. Pregnancy.
4. immunodeficiencies:
- Congenital;
- Tumors;
- For long-term immunosuppressive
therapy.
5. If administered immunoglobulin in
the period up to 3 months before
vaccination.
1. A positive Mantoux test.
2. Brain disorders.
3. Pregnancy the mother of
the childvaccinated.
4. The presence
of immunodeficient pati
ents in the family.
5. HIV infection.
6. Contact allergy to
neomycin.
Immunprevention of hepatitis B
Since 1991, the Hepatitis B vaccination was included in the Expanded
Programme ofImmunization. To date, there are several different schemes of
immunization.
1. Recombinant hepatitis B vaccine (JSC SPC: Kombioteh Ltd:,
Russia).Form-ampoules of 1.0 ml (20mkg). Enter i \ m. Doses and
schedules: at the age of 0-10 years at a dose of 0.5ml (10mkg), over 10 years
and adult-1.0ml (20mkg.) Vaccine consists of a triple vaccination: a second
injection made 1 month after the first and the third-later 3-6 months after the
second
2. Endzheriks-B - Standard scheme :0-1-6 months, in case of emergency
(Fast Track) :0-1-2-12 Months
3. H-B-Wah 11-standard schemes :0-1-6-month or 0-1-12 months,
fast mode:0-1-2 month or 0-2-4 months.
4. Rec-HbsAg , children from 0 to 10 years imposed in 0.5 ml i\m, over
10 years and adult-1.0ml. Entering threefold: a second injection is
made after 1 month, the third-after 3-6 months after the second
.
Vaccination of HIV-infected children
In HIV-infected children without
severe immunodeficiency are held fully
immunized(BCG, DPT, OPV or IG)
Contraindications to vaccination are:
BCG children with symptomatic HIV or AIDS
DTP, if after its introduction in 3
days any shock or seizures, enter ADS
DTP with recurrent convulsions and central nervous
system diseases, introduce ADS
Immunprevention of hepatitis А

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
Beginning in 1993, 27 countries were
vaccinated 50,677 people and introduced the120 000 doses of
vaccine Havrix (Smith Kline Beecham company). The results showed
that the vaccine is safe, clinically well tolerated and highly
immunogenic in all age groups.
Seroconversion was achieved by 100% at 1 month
after priming. Vaccine-inducedanti bodies persist after the primary
immunization over a year (1 dose = 1440 units.ELISEI) in adults
and after 2 doses (360 units) children.
Booster dose is given 6-12 months after priming. According to the
mathematical model, it is theoretically possible protection is 20 years or
more. Subject to the immunization schedule the opportunity to
combine the introduction of vaccines.
The estimated rate of complications after immunization with measles vaccine to
1000000 vaccinated compared with the frequency of diseases to 1000000 cases of the
disease (1984)
postThe frequency of
vaccination complications complications in
measles cases reported to
1000000
Postvaccination complications
of
measles immunization to
1000000
encephalitis
encephalopathy
0,1
50-400(0,05-0,4пр)
Sub acute lycosing
panencephalitis
Pneumonia
0,05-0,1
3800-7300(3,8-7,3пр)
---
Convulsions
500-1000(0,5-1,0пр)
0,021-190
Death
10-10000(0,01-10,0пр)
0,02-0,3
The estimated rate of complications after immunization
with DTP vaccine to 1000000vaccinated compared with the frequency of
diseases of pertussis cases reported to 1000000 (1984)
PostThe frequency of
DPT vaccination compl
vaccination complicat complications in
ications of
ions
whooping cough cases
immunization to
reported to 1000000
1000000
Brain damage
600-2000(0,6-2пр)
0,2-0,6
100-4000(0,1-4.пр)
0,2
Encephalitis
Encephalopathy
90-4000(0,09-4,0пр)
0,1-0,3
Convulsions
600-8000,(0,6-8,0пр)
0,3-9,0
Death
Shock
0,5-3,0
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WHO experts recommend changes in vaccination:
1. Vaccination of all children under 5 years of Haemophilus
influenzae type D hepatitis B.
2. Increased percentage of children immunized against
meningococcus, which reduses mortality, and increase the
level of graft against pneumococcus and influenzaleads not
only to reduce mortality, but also to reduce exacerbations of
chronic diseases.
3. Routine immunization of children should include
the prevention of the following infections: diphtheria, tetanus,
pertussis, measles, mumps, rubella.
4. All patients on hemodialysis is
shown staphylococcal vaccine.
5. In the future be included in
national vaccination calendar vaccination following
infections: hepatitis B, polio, rubella,
influenza, pneumococcal, meningococcal disease.
EMERGENCY MEDICAL ACTIVITIES IN THE DEVELOPMENT
POST-VACCINATION COMPLICATIONS
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1. Hyperthermia (t> 38,6 ° C) - antipyretics in the age dose
(example, paracetamol, Panadol, etc.) - 1-3 times a day to reduce
the temperature to 38.0 ° C, to continue for 1-2 days, or lytic mixture.
2. Convulsions - diazepam 0.05 mg / kg i/m /; magnesium
sulfate 25% - 0.2 ml / kg / m
A) febrile convulsions - in addition: antipyretics, seduksen 0.5%
solution / m 0.5 ml for children 4-6 months.,
B) afebrile convulsions - anticonvulsants, in the future consulting neurologist.
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3. Anaphylactic shock, collaptoid state adrenalin chloride 0.1% p / or / m at a dose of0.30.5 ml every 10-15 minutes until improvement.
4. Decrease in body temperature below 35.5 ° C,
drowsiness - antihistamines, biostimulants
5. Bronchial asthma - aminophylline, 4 mg / kg 3-4 times a
day to relieve the attack.
6. Local reactions (redness of more than 8 cm), edema antimediatornye meansperitol dose for the age 5-7 days,
calcium gluconate, locally - lotion with magnesiumsulfate,
iodine grid.
7. Complications of BCG vaccination, local - use
of local and inward-specific anti-TB drugs (isoniazid,
rifampicin)
Acquired (secondary) immunodeficiency states are 4
types:
1) The failure of T-cell immunity;
2) deficiency of B-cell immunity;
3) failure of phagocytic immunity;
4) combined.
Immunoactive drugs can be divided into four
groups:
1) immunomodulators
2) immunocorrectors
3) immunostimulants
4) immunosuppressors
1.
2.
3.
4.
5.
6.
Principles for the use of immunomodulators
Immunomodulators administered in the complex therapy
Appropriate early use of immunomodulators is
Immunomodulators that
act on phagocytic immunity link (Polioksidoniy,
Likopid,Estifan, Immunal, etc.) can be given to patients with
established as well as with undetected disorders of immune
status
In the presence of appropriate health facilities against the
backdrop of immunological monitoring
Immunomodulators can be used as monotherapy during
the immuno-rehabilitation activities, in particular with
incomplete recovery after acute infection
The presence of reducing any of the parameters of immunity, a
practically healthy person is not necessarily a basis for assigning
the therapies.
Indications for use of some immunomodulators
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Polioksidoniy: chronic nonspecific lung diseases,
acute and chronic suppurative-septic diseases,
acute and chronic bacterial and viral infections;
Likopid: chronic nonspecific diseases of bronchopulmonary apparatus, pulmonary tuberculosis,
acute and chronic herpes infections of all sites
Immunal and Estifan: acute and chronic infectious
and inflammatory diseases, prevention of bacterial
and viral infections.
Myelopid: chronic respiratory diseases (laryngitis,
tracheitis, bronchitis, pneumonia) in the acute stage
Imunofan: chronic bacterial and viral infections,
including brucellosis, hepatitis, opportunistic
infections in AIDS patients, long-term
healing injuries of extremities