DTP vaccination : schedule , preparation , complications and contraindications
Vaccinations And Immunizations / / April 24, 2016
DTP - a prophylactic vaccine, which stands for the adsorbed pertussis-diphtheria-tetanus.This drug is combined and used to control, respectively, diphtheria, whooping cough and tetanus.It izgotovlyaeetsya toxoids of these bacteria and other antigens.Diphtheria and tetanus feature is that the development of the disease course and complications not associated with the microbe and its toxins.In other words, to avoid severe disease, it is necessary to create the body immunity against the toxin, but not against the whole virus.Thus, the vaccine is designed to generate protivotoksicheskoe immunity.
DTP vaccine takes place in the international nomenclature as the DTP.
Foreign analogue DTP vaccine - Infanrix.Both whole cell vaccines are combined, iecontaining killed (inactivated), pertussis cells (4 IU), tetanus (40 IU or 60 IU) and diphtheria (30 IU).This dose of tetanus and diphtheria toxoids, due to the need to achieve the desired intensity of the reaction of the immune system of the child, which is still
Diphtheria, tetanus and whooping cough
- Diphtheria. This is an acute infectious disease caused by Corinebacterium diphtheriae (Korinebakterium bacteria), transmitted by droplets;characterized croupous or diphtheritic inflammation of the mucous membranes of the throat, nose, larynx, trachea, rarely other organs to form a fibrinous films and general intoxication.When only the skin is involved, it is known as cutaneous diphtheria, and is probably caused by a non-toxic strain.If toxic strain affects the mucous membranes in the body structure - such as the throat, diphtheria becomes life-threatening.
- Tetanus. Tetanus is a disease that causes severe muscle contractions and spasms.This is due to powerful toxins produced by the bacterium Clostridium.This anaerobic bacteria, and therefore they survive without oxygen.People can become infected with these dangerous bacteria through skin wounds.Tetanus leads to death in 15-40% of cases.
- Whooping cough. Pertussis was a very common childhood illness throughout the first half of the 1900s.The disease is easily transmitted from one person to another, and it is the most severe in infants.The incidence has increased in recent years, up to 25,827 cases reported in 2004, but dropped to 10,454 in 2007.The advantage of the vaccine wears off by adolescence.Thus, more cases observed in adults.Such cases may be significantly underestimated.The younger the patient, the higher the risk of developing serious complications from it, including pneumonia, seizures, severe cough, and even death.Children younger than 6 months are at particular risk, because even with the vaccination of their protection is incomplete due to an immature immune system.
Vaccinations against diphtheria, tetanus and pertussis
Primary vaccination.Vaccination against diphtheria, tetanus and pertussis vaccine routinely given to children since 1940.Standard vaccines now - DTP.DTP uses a form of "pertussis", which consists of a weakened pertussis toxoid.DTP is equally effective but has fewer side effects than the previous vaccine (DTP).
protection against diphtheria and tetanus lasts about 10 years.During this period, the vaccine (Td) can be given against tetanus and diphtheria.Td vaccine contains a unit dose of tetanus and diphtheria less powerful.It does not contain components pertussis.
pertussis vaccine for children may start to lose effect after about 5 years, and some previously immunized adolescents and adults may get a mild form of the disease.Now two pertussis-containing booster approved for adolescents and adults.
In general, within the framework of vaccination on the territory of the Russian Federation applied tetanus adsorbed liquid - DTP production of FSUE "NPO" Microgen "MH RF, Russia.
As mentioned above, foreign domestic analogue DTP vaccine is Infanrix (Infanrix ™), the production of GlaxoSmithKline Biologicals S. A., Belgium.It is presented in the following types
- IPV Infanrix (DTaP + analogue inactivated polio vaccine).Whooping cough, diphtheria, tetanus, polio.
- Infanrix Penta (analogue DTaP + hepatitis B + inactivated polio vaccine).Whooping cough, diphtheria, tetanus, hepatitis B, polio.
- Infanrix Hexa (analogue DTaP + hepatitis B + + Hiberiks inactivated polio vaccine), instructions.Whooping cough, diphtheria, tetanus, hepatitis B, poliomyelitis, infection caused by Haemophilus influenzae type b.
Further DTP analogs are drugs manufactured by Sanofi Pasteur S. A., France:
- D.T.KOK (analogue DTP).Whooping cough, diphtheria, tetanus.
- tetrakis (analogue DTaP).Whooping cough, diphtheria, tetanus.
- Pentaxim (analogue + DTaP + inactivated polio vaccine Act-HIB), instructions.Whooping cough, diphtheria, tetanus, poliomyelitis, infection caused by Haemophilus influenzae type b.
- Geksavak (analogue DTaP + hepatitis B + + inactivated polio vaccine Act-HIB).Whooping cough, diphtheria, tetanus, hepatitis B, poliomyelitis, infection caused by Haemophilus influenzae type b.
monovalent (one-component) pertussis vaccine developed abroad and in Russia, but so far they are not included in the daily practice of vaccination, because of the presence of the combined vaccine and a series of conditions limiting their use.
See. Detailed information about the composition, dosage, and order entry for each vaccine.
The Russian pharmaceutical market is represented by the vaccine Bubo Kok - a vaccine against whooping cough, diphtheria, tetanus, hepatitis B and its manufacturer is JSC Scientific Production Company "Combiotech".
Schedule DTP for children
There is a vaccination schedule, which in Russia is determined by the national calendar of preventive vaccinations
All children under 7 years of age should receive the vaccine DTP.Vaccinations are made as follows:
- babies get a series of three vaccinations at 2, 4 and 6 months of age.The only reason to postpone vaccination in children with suspected neurological problems - to clarify the situation.Children with neurological problems can be eliminated to be vaccinated (the vaccine should be given no later than ?? the first day of birth of the child - that is, when he was no more than 1 year);
- fourth dose is given between 15 and 18 months, 12 months from the third vaccination (DTP booster).Infants at high risk - those who are exposed to outbreaks of whooping cough, the vaccine can be given before;
- If your child vaccinated later spent 3 months, with a pertussis component vaccine is administered to him 3 times with an interval of 1.5 months, and for the fourth time -. 1 year from the last date of administration of the vaccine.
- Subsequent revaccination in Russia are only against tetanus and diphtheria.Carry them in 7, 14 and then every 10 years throughout life.
Application domestic DTP vaccine has some peculiarities.According to the current regulations of the vaccine can be vaccinated only children up to 4 years of age.Upon reaching the child 4 years of an unfinished course of DPT vaccination is completed with the use of Td vaccine (up to 6 years) or Td (after 6 years).On foreign DTP vaccine (Infanrix), this restriction does not apply.
If your child has moderate or severe health problems, or he had recently suffered a fever associated with the disease, vaccination should be delayed until recovery.Colds and other mild respiratory infections should not be a reason for the delay.Parents should not be overly concerned if the interval between doses longer than recommended.Immunity from any previous vaccination remains, and the doctor does not have to start a new series from scratch.
DTP recommendations for adults
All adults who have been fully vaccinated either as children or as adults, need to have Td-amplifiers, at least every 10 years.If they have not received DTP vaccine after 19 years, they will have to get it to the next, but not after.Adults who have regular contact with infants under 12 months of age should receive a one-time Td booster.
Adults who have not previously been vaccinated against diphtheria, tetanus and pertussis at any age:
- should receive a series of three vaccines doses - tetanus, diphtheria, and pertussis (DTP);
- a woman who is pregnant should get the vaccine DTP after 20 weeks of pregnancy;
- any patient who needs medical care from any wound, can be a candidate for a vaccine against tetanus.Wounds that put patients into the category of high-risk patients tetanus - this stab wounds or contaminated wounds.Some considerations regarding tetanus vaccinations for the wounded:
- vaccination is necessary, if the last dose was given 5 years or more before the injury;
- children under 7 years old are usually given DPT, if they are not fully vaccinated;
- patients who have not completed the primary vaccination against tetanus and people who have experienced an allergic reaction to previous amplifiers tetanus immunoglobulin can be given.
Preparing for DTP vaccination
DTP vaccine can provoke numerous adverse reactions to drugs.This is due to high content of antigens and properties reactogenic components included in the vaccine.For this reason, prior to vaccination is recommended for DTP vaccine dosage preparation of the child.
Without exception DTP vaccine should be administered to patients receiving antipyretic.This allows on the one hand, to prevent an uncontrolled increase in temperature, on the other hand - to exclude the risk of seizures temperature in infants arising against high temperature, regardless of whether that was the cause.In addition, all drugs have antipyretic analgesic and anti-inflammatory properties, which is especially important to prevent pain at the injection site, which can be quite strong.In addition, it will help to protect the child from pronounced swelling in the injection site.
If you have a child allergic disorders such as atopic dermatitis, or diathesis, also recommended the use of anti-allergic drugs.
No fever, no antihistamines do not affect the production of immune system, ie,effectiveness of vaccination.
Choosing antipyretic for your child pay attention to the following aspects:
- When buying products pay attention to the fact that this type of issue is appropriate for your child's age;
- Make a choice in favor of rectal suppositories as flavoring syrups can provoke more allergic reactions;
- Enter antipyretic in advance, without waiting for the temperature rise after vaccination.The temperature may rise too quickly, in order that it can be then controlled;
- In no case do not give your child aspirin (acetylsalicylic acid)!
- If the maximum allowable dosage of antipyretic exceeded, but the effect is not achieved, then move on to another drug with the active ingredient (such as paracetamol to ibuprofen);
- If a previous vaccination in the child had no reaction, it does not mean that the subsequent grafting reaction will not be.Adverse reactions are more common after repeated injections of vaccines, so do not neglect pdgotovkoy to vaccination;
- In all cases of doubt consult your doctor.Do not hesitate to call in the "ambulance";
- When the vaccine was given in the paid center of vaccination, do not hesitate to take the doctor's contact information, in case of adverse reactions.
approximate scheme of preparing the child for vaccination with DTP vaccines:
- 1-2 days before vaccination. If your child has diathesis, or other allergic disorders, begin receiving antihistamines maintenance dose;
- After vaccinations. Immediately after returning home, enter the child candle with antipyretic.This will prevent some reactions developing in the first hours after vaccination (long weeping, swelling at the injection site, etc.).If the temperature will rise during the day, enter another candle.Mandatory is a candle in the night.If your child wakes up at night for feeding, check the temperature and increase it enter another candle.Continue taking antihistamines.
- Day 1 after immunization. If in the morning the temperature is increased, enter the first candle.If the temperature will rise during the day, enter another candle.You may need to introduce one more candle on the night.Continue taking antihistamines.
- Day 2 after vaccination. antipyretic apply only if the child's temperature.If it increase slightly, can be dispensed with antipyretics.Continue taking antihistamines.
- Day 3 after vaccination. appearance on day 3 (and later), fever and reactions at the site of inoculation is not typical for inactivated vaccines.If the temperature still rose should look for another reason (cutting teeth, acute respiratory infections and so forth.).
Before using any drugs precise dosage regimen, and a list of names of specific drugs can and should only recommend attending pediatrician examines your baby directly.It is important.Do not self-medicate!
Side effects of DPT - diphtheria, tetanus and pertussis
- Allergic reactions. In rare cases, a person may be allergic to the diphtheria, tetanus and whooping cough.Parents should inform their doctor if their child has an allergy.New DPT vaccine may give a somewhat greater risk of allergic reactions than the older DTP vaccine.Children with severe reactions should not receive additional vaccinations.The rash, which occurs after a dose of DTP, does not matter.In fact, it usually does not indicate an allergic reaction, but only temporary immune responses and typically is not repeated thereafter.It should be noted that in response to the DTP have been no deaths from allergic reactions, even severe (anaphylactic).
- Pain and swelling at the injection site. Children may feel pain at the injection site.In some cases, a small lump or shishechka can remain in place for several weeks.It can help clean, cool washcloth over any swollen, hot or red zone.Children should not be covered or tightly wrapped in a cloth or blanket.The risk of swelling or sores entire hand or foot, followed by injection increases - in particular, when the fourth and fifth doses.Whenever possible, parents should request that their children receive a vaccine of the same brand every time, to reduce the risk of side effects.
- Fever and other symptoms.The child may develop after the shot: mild fever, irritability, drowsiness, loss of appetite.
states that should cause concern:
- very high temperature (over 39 ° C), which causes seizures in children.Such cases should be reported immediately to the doctor.New DTP significantly reduce the risk of this side effect in comparison with the old vaccine.Although such a fever and associated seizures are rare and have almost no long-term consequences.Relapses after vaccination followed very unlikely;
- fever, which develops within 24 hours after vaccination, or fever that persists for more than 24 hours, most likely caused by not vaccinations, and other factors;
- hypotonia and unresponsiveness (HHE).HHE is an unusual response to the pertussis component, and occurs within 48 hours after injection in children up to 2 years.The child usually begins fever, he becomes irritable, and then - pale, weak, listless, taciturn.Breathing is shallow, and the child's skin may be bluish.The reaction lasts for an average of 6 hours and, although it looks frightening, almost all children will soon return to normal.This is a rare side-effect after administration of DTP vaccine, but it can be;
- neurological effects in component pertussis.