Vaccination measles - mumps - rubella : schedule , preparation , complications and contraindications
Vaccinations And Immunizations / / April 26, 2016
three common childhood diseases - measles, mumps and rubella - are viral and therefore very contagious.These viruses are not capable of infecting other species besides humans.Infection usually occurs through airborne droplets or by personal contact with already sick or infected person.And measles and rubella, and mumps affect young children, mostly under 10 years.A particularly large number of cases accounted for 5 - 7 year old children.
- Measles. Measles, one of the most contagious of all human infections, used to be a very common childhood disease.In most cases, it was impossible to recover from it without serious complications.In severe cases, however, the armature can cause pneumonia in approximately 1 in 1,000 cases, it can result in encephalitis (inflammation of the brain), or death.The risk of these severe complications is highest for the very young and very old people.In pregnant women, measles increases the percentage of miscarriage, low birth weight and congenital malformations of the fe
- Gilt. Approximately 15% of mumps (mumps) affects the brain and spinal cord membranes, although this is usually ultimately not harmful.The swelling of the testicles occurs in 20-30% of men who have reached puberty, but sterility is rare.Deafness in one ear occurs in a patient with mumps of 20000.
- Rubella (German measles). German measles infects children or adults, and it causes a mild form of the disease, which include a rash, swollen lymph nodes, and sometimes fever.However, if a pregnant woman is infected during the first trimester of pregnancy, her baby has a 80% chance of developing serious birth defects, including - heart abnormalities, cataracts, mental retardation and deafness.
Immunization Schedule measles-mumps-rubella
Immunization Schedule measles-mumps-rubella according to the national calendar Russia vaccinations, vaccination is carried out according to the following schedule:
1. In 1 year.
2. In 6 years.The double injection of the drug due to the fact that not all children develop immunity after the first injection, so you need the second.
3. In 15 - 17 years.
4. In the 22 - 29 years.
5. In the 32 - 39 years old and then every 10 years.
If a child is not vaccinated before the age of 13, then put the vaccine in this age, and all subsequent re-vaccination is carried out according to the schedule of the national calendar, ie 22 - 29 years, etc.
vaccine against measles, rubella and mumps is administered subcutaneously or intramuscularly.Children under three years are optimally inject the drug into the outer surface of the thigh, and more than a senior guys - and deltoid shoulder, between the upper and middle third.
Note.Much controversy has arisen according to unconfirmed reports of neurological side effects associated with the vaccination measles-mumps-rubella.This is of great concern, as these reports have led to a decrease immunization in some areas, particularly in areas rich in England, where vaccination levels decreased from 92% in 1996, to 84% at present.Where measles outbreaks are now sharply increased, and doctors fear that if the vaccination rate quickly rises, the number of cases will increase significantly.In these and other areas, some parents mistakenly believe that the risk of immunization outweigh the risk of childhood diseases.It should be noted that measles is still a cause of death of about 745,000 unvaccinated children who live in underdeveloped countries - mainly in Africa.
Vaccination measles-mumps-rubella for adolescents and adults
General recommendations for vaccination of adults MMP are as follows:
most people born before 1957, faced with such once-common childhood diseases, and in thistime, do not require vaccination;
all unvaccinated people born after 1956, who have no measles and mumps (mumps), should be given two doses of live vaccine measles, rubella, mumps, are introduced, at least at intervals of 1 month (teenagers) orone dose (for adults).
Immunizing teens can achieve more positive results:
- protection against rubella for girls who are in the majority in the next 5 - 10 years will bear and give birth to children, for whom and dangerous rubella virus.
- Development of immunity to measles, which will meet with the vaccine virus, and receive stimulation.
- Protection against mumps to young men who are in the most dangerous age, in terms of the negative effects of mumps disease, and in particular the transfer of these infections could have a negative impact on reproductive health and the subsequent offspring
Types vaccine measles-rubella-mumps
Safe and effective live virus vaccine against measles, mumps and rubella have been developed in recent decades.They are usually combined with vaccines against varicella (chickenpox).Live virus vaccine or combination its analog may be administered to children and adults, depending on the risk factors.
Vaccination against measles, mumps and rubella can be of several types.Kind of weakened vaccine viruses depends on the types that are included in the vaccine preparation.All current vaccine formulations contain viruses typed, which allows to produce a high percentage of activation of the immune system and the formation of a persistent immunity.Due to this, it is possible to use any kind of vaccination, without fear for their effectiveness and safety.
vaccination measles, mumps, rubella can be a ternary, two-component or mono-component.This means that all vaccines are interchangeable, ie a vaccination can put one drug, and the second - a completely different
According to the World Health Organization requirements of this type of vaccine are divided into the following types:
- The three- vaccine.Such a vaccine is a finished product, which contains all three types of attenuated viruses (measles, rubella and mumps).Such vaccines most predpochtiteltny as vaccine is administered in one injection and one visit to the doctor.
- Two-drug .This combination vaccine measles-rubella or measles-mumps.This vaccine should be combined with monocomponent missing - for example, measles vaccine, mumps and rubella still requires separately.In this case, inoculation is administered in two injections in different parts of the body.
- mono-component drug. This vaccine is the same infection - for example, only against measles, mumps, or rubella only.Monocomponent vaccine has to be administered in three injections in different parts of the body, becauseyou can not mix different vaccines in the same syringe.
differ vaccines and manufacturers.The Russian pharmaceutical market represented sledujushie types of vaccine measles-mumps-rubella:
- Domestic vaccine measles-mumps .This live attenuated vaccine is produced with Japanese quail eggs and eeeffektivnost not lower than imported analogues.Frequency for domestic vaccine reactions and complications are not different from the import.Less of this vaccine is that Russia does not produce three-component vaccine in which parts and against measles and rubella would be included, and mumps.In our country the manufacture dikomponentnuyu vaccine - measles-mumps.Therefore it is necessary to do two injections - one dvuhkomponetny and second odnokomponetny - measles in another part of the body.In this regard, the domestic vaccine is somewhat inconvenient.
- Imported vaccine measles-mumps-rubella. Three-component vaccines contain ingredients imported measles, rubella and mumps at the same time.Such a composition of imported drugs is very easy to introduce, because it requires only one injection in one place.The effectiveness of the import of vaccines is different from the domestic, and the frequency of adverse reactions and complications absolutely the same as that of the vaccines produced in Russia.Alas, imported vaccines are not always available in a regular clinic, so it is grafted in them, often have to buy the drug if desired, at his own expense.To date, use the following import vaccines:
- MMR-II (Measles Mumps-Rubella), USA.In our country, there is a greater experience of using MMR-II, compared to the "Priorix", so doctors often recommend it.In the case of use of antibodies to the measles virus have been discovered - 98% vaccinated to mumps virus - at 96.1%, and rubella virus in 99.3%.One year after vaccination all remained seropositive protective titers of antibodies to measles and rubella, and 88.4% - to the mumps virus.
vaccine may be administered simultaneously (in one day) with DPT and DT vaccines, live and inactivated poliomyelitis vaccine, vaccine N. ifluenzae type B, a live varicella vaccine, provided the introduction of individual needles in different parts of the body.Other live viral vaccines are administered at intervals of at least 1 month.
MMR-II should not be used in cases of hypersensitivity to neomycin and protein of chicken eggs, primary and secondary immunodefitsiet, during the period of acute illnesses or during exacerbation of chronic diseases.Pregnancy is a contraindication for this vaccination.
- "Priorix" Prospect in Belgium."Priorix" vaccine is the most popular to date.The reasons for this are quite simple - high efficiency, excellent cleaning and minimum adverse reactions.In relation to this vaccine have no medical complaints, so you can safely use this medication for vaccinations for children and adults.
Proivopokazaniyami to use "Priorix" are:
- increased sensitivity to neomycin and chicken eggs;
- contact dermatitis due to neomycin;
- any allergic reaction to chicken eggs neanafelakticheskogo character is not a contraindication to vaccination.
- primary and secondary immunodeficiency (but also suitable for asymptomatic HIV iSPIDe);
- ARI, diarrheal diseases (vaccination should be delayed until the temperature normalization);
- acute and chronic diseases in exacerbation (vaccination should be delayed until recovery)
- not allowed Priorix vaccine immunization during pregnancy.
- "Ervevax" Prospect in Belgium.Erevaks is odnokomponetnoy rubella vaccine - a live attenuated vaccine virus from a culture of a strain of rubella Wistar RA 27 / 3M, grown on human diploid cells.Generates specific immunity to rubella virus, which develops within 15 days after vaccination and lasts for at least 16 years.This drug also performed well in use in children older than 1 year, the girls prepubertal (11-13 years) in women of reproductive age.
Ervevax The vaccine can be administered on the same day with DTP, DT, live and inactivated poliomyelitis, measles, mumps vaccines, provided different injection drug needles in different parts of the body.Other live viral vaccines are administered at intervals of at least 1 month.
Contraindications to the use of "Ervevax" are:
- hypersensitivity (including neomycin);
- vaccination of women of childbearing age is carried out in the absence of pregnancy, and only if the woman agrees to be protected from conception for 3 months after vaccination;
- congenital or acquired immunodeficiencies (possibility of immunizing children with HIV decides consultation pediatricians);
- the introduction of Ig preparations endogenous immunostimulants (prior to vaccination);
- acute illness and exacerbation of chronic diseases.
- "Rudivaks" avenue in France.This drug is a live attenuated vaccine for the prevention of rubella - attenuated vaccine virus (strain Wistar RA 27 / 3M) is cultivated on human diploid cells.Specific immunity develops within 15 days after vaccination, and in accordance with available data for at least 20 years.
contraindications to this vaccine are the same as that of the "Ervevax".
Vaccination against rubella during pregnancy
especially important to get vaccinated against rubella for all non-vaccinated pregnant women who have not previously suffered from rubella.Rubella virus is particularly dangerous for pregnant women, asit is able to affect all tissues ploda.Krasnuha carried over into the first half of pregnancy, especially during the first 3 months, can cause miscarriage or stillbirth.It is also possible the appearance of a baby born with congenital rubella syndrome (SHS), which is characterized by three malformations - congenital heart disease, blindness (cataract) and deafness.In addition, for brain damage characteristic SHS until mental retardation, as well as liver, spleen, and other congenital platelet disorders.
woman may have been ill with rubella unnoticed: in the normal state of health for 1-2 days there is a small rash, which sometimes do not pay attention.A virus circulating in the blood of a pregnant woman, gets through the placenta to the fetus.Therefore, when suspected of being infected with rubella pregnant women need to conduct a special study (blood twice examined for content protivokrasnushnyh antibodies, and if their number increases significantly, indicating that the transferred rubella in early pregnancy raises the question of abortion, as great a threat to the child's birthwith deformities).
If a girl or a young woman is not sick rubella and not vaccinated, then, before planning a pregnancy herself to think about the appropriate vaccination.Vaccination protects almost 100% after a single vaccination immunity persists in 15-20 years old, then one can repeat immunization.
is recommended to wait at least 28 days after vaccination before you start trying to conceive.Except in special circumstances, a live vaccine, especially MMP is not already given to a pregnant woman, as for the fetus, there is a theoretical risk of birth defects from these vaccines.Fortunately, this risk is small.In fact, studies have not reported an increase in birth defects in children of women who were inadvertently vaccinated against rubella early in her pregnancy.
contraindications to vaccination measles-mumps-rubella
Contraindications to immunization against measles, rubella and mumps include Seba following:
- acute period of the disease, to stabilize the state;
- Pregnancy can be administered immediately after birth;
- the introduction of various blood products, such as gamma globulin, it is necessary to refrain from vaccination 1 month;
- interaction with the TB vaccine.Live measles vaccine can prevent TB test, so that the two processes should be carried out, at least at intervals of 4-6 weeks.There is no evidence that the vaccine has a negative effect on the development of tuberculosis.
Permanent contraindications for which vaccines are generally impossible:
- an allergic reaction to neomycin, kanamycin, gentamicin;
- allergy to egg protein;
- severe allergic reactions, such as angioedema;
- the presence of tumors;
- a severe reaction or complication to a previous dose of the vaccine;
- low platelet count;
- some HIV-infected;
- people affected by the immune system (for example, after organ transplants).
How to prepare for grafting kor- rubella - mumps
In general, for healthy patients, preliminary preparation for immunization proitv measles, mumps and rubella is required.
To prevent unwanted reactions to the introduction of vaccines after the use of these drugs can be used common approaches:
- Children who are prone to allergic reactions, allergy medications are appointed, the reception of which begin 2-4 days before vaccination.
- Kids with nervous system lesions, with chronic diseases from the day of vaccination for the duration of the possible reactions of vaccinations (up to 14 days) prescribed therapy aimed at the prevention of exacerbations of the underlying disease.