Vaccination against poliomyelitis

Vaccination against polio is a reliable way to prevent severe neurologic infection. Poliomyelitis is a viral infection that leads to the development of paralysis, which causes disability for life. There are no drugs that effectively affect the poliovirus. Therefore, to reduce the risk of disease can only be through vaccination.

The world has been using polio vaccine since 1955, which has allowed many countries to get rid of this disease completely. In the American and West-Pacific regions, the virus no longer circulates. Today, only some countries in Asia and Africa remain a source of infection (especially India, Pakistan, Nigeria, Afghanistan).

Schedule of vaccinations against poliomyelitis

Each country on the Earth has its own schedule of vaccinations against poliomyelitis. This is due to the varying degrees of risk of encountering the virus, since birth. In countries where poliomyelitis cases are regularly registered, vaccination is already done on the first day of life.

In Russia, the schedule for the introduction of the vaccine is as follows: at 3, 4.5 and 6 months (these three are called vaccinations), then at 1.5 years, 20 months and 14 years (these three are called revaccinations). This scheme is used when administering an oral vaccine or when combined use of oral and inactivated vaccines.

If only inactivated vaccine is used as an inoculation, the schedule is as follows: 3, 4.5 and 6 months (vaccination), then at 1.5 years and after 5 years (revaccination).

If, for whatever reason, the schedule for the introduction of the vaccine has been disrupted (for example, due to a child's illness), the timing of the vaccine is somewhat shifted. The child receives the necessary dose for recovery and further - scheduled according to the calendar.

Types of vaccines

There are two types of vaccines: live oral vaccine Sebina (OPV) and inactivated polio vaccine Salka (IPV). Both contain all three naturally occurring species of the poliomyelitis virus (1, 2, 3). OPV is manufactured in Russia, IPV - in other countries, but is allowed to be used in Russia (Imovax-polio). In addition, IPV is a part of the registered in Russia combination vaccine Tetrakok (simultaneous prevention of diphtheria, pertussis, tetanus, poliomyelitis).

Live oral polio vaccine

It was created by Dr. Sebin in 1955. It contains a significantly weakened, but living virus of poliomyelitis. It is a liquid of red color with a bitter taste. Introduced by instillation through the mouth for 2 (4) drops (depending on the concentration of the drug) through a special pipette dropper: in children under one year - try to get to the root of the tongue (there is less risk of regurgitation, since the root of the tongue does not contain any taste ends), at a later age - on the palatine tonsil. If the child still regurgitates, then the same dose should be re-injected. An hour after digging can not be neither eat nor drink. The vaccine strain of the virus, getting on the lymphoid tissue (in the region of the root of the tongue and palatine tonsil) and then into the intestine, begins to multiply there. The immune system in response synthesizes antibodies, which form the defense of the body. Immunity is formed similar to the one that is formed when the disease is "real" poliomyelitis. When an organism meets a real polio virus, the antibodies are activated, and the disease does not develop (and if it develops, it is in mild form, without paralysis).

In addition, children vaccinated with OPV secret the vaccine strain of the virus into the environment (for sneezing, coughing, and feces) for almost two months. The weakened virus spreads among other children, as if to "vaccinate" them additionally. Circulation of such a strain of the virus displaces the wild (the original from nature). It is thanks to this property of the live vaccine that the virus has been eradicated on several continents.

Reaction to live oral vaccine

In response to the introduction of OPV, the following reactions can occur:

• increase in temperature to 37.5 ° C from 5 to 14 days after vaccination;
• acceleration and relaxation of the stool for 1-2 days after vaccination.

These reactions are quite rare and are the norm (!). T. e. this is not a complication that has developed in response to an inoculation, but simply a reaction of the body that passes by itself and does not require therapeutic measures.

The complication of OPV is the development of vaccine-associated poliomyelitis. This is possible if the child was vaccinated incorrectly, for example, was not completely healthy at the time of the Inoculations or he has serious impairment of immunity, diseases of the stomach and intestines, malformations. In this case, the entry into the body of a living (albeit weakened) virus causes the development of a typical polio, including a paralytic form. The risk is higher in response to the introduction of the first dose, with subsequent doses the risk is reduced. It should be noted that this is a very rare complication (1 case per 1 million vaccinations).

Another complication may be the development of an allergic reaction.

Inactivated polio vaccine

This vaccine was created by Solcom in 1950. by neutralizing the virus with formalin. T. e. this vaccine contains the killed virus. It is available as a disposable syringe with a content of 0.5 ml. It is injected intramuscularly into the thigh or shoulder. There are no special instructions in the behavior after the injection, you can immediately eat and drink. Its introduction ensures the formation of antibodies in the blood, but in no way affects the natural strain of the virus (after inoculation in the body no one reproduces, since the virus is introduced dead, the competitor of "real" poliomyelitis is not allocated to the environment).

It should be noted that both types of vaccine create effective and lasting immunity against poliomyelitis. There are simply some peculiarities that cause a particular type of vaccine to be used.

Reaction to inactivated vaccine

A normal response to the introduction of IPV is:

• redness and a slight swelling at the injection site (not more than 8 cm in diameter);
• a rise in temperature in the first two days after vaccination, a general anxiety, a violation of appetite.

If an allergic reaction develops in response to the introduction of IPV, this is considered a complication.

In general, IPV is safer than OPV, since it can not cause the development of vaccine-associated poliomyelitis, has an accurate dosage (it is impossible to regurgitate as a drop in OPV).

Contraindications to vaccination against poliomyelitis

Contraindications to vaccination against polio are:

• acute infectious and non-infectious diseases at the time of vaccination (in such cases, the vaccination is performed 2-4 weeks after recovery. After a mild ARVI in consultation with a doctor, it is possible to vaccinate immediately after normalizing the temperature);
• exacerbation of chronic diseases (done during the remission period);
• strong reactions (an increase in temperature of more than 40 ° C, swelling and redness of more than 8 cm in diameter at the injection site) or post-vaccination complications (allergic reactions, vaccine-associated poliomyelitis) to the introduction of a previous dose of the same vaccine;
• pregnancy;
• contraindication for OPV - primary immunodeficiency states (eg, HIV), tumors, immunosuppressive therapy (taking corticosteroids or cytotoxic drugs), the presence of patients with immunodeficiency in the family. Such children are shown with IPV vaccination. Also IPV is made for children whose mothers are pregnant again;
• contraindication for IPV - allergic reactions in the anamnesis for such drugs as Neomycin, Streptomycin, Polymyxin B.

In Russia, this vaccination scheme is often used: the first two injections at 3 and 4.5 months are performed with IPV, and subsequent with OPV. Thus, the risk of developing vaccine-associated poliomyelitis is reduced, because a live vaccine enters the body with the immunity already available.

The problem of vaccine prevention of poliomyelitis has not lost its significance for today. Cases of this disease continue to be recorded. Many parents in recent years have refused vaccinations at all, which can have serious consequences. To vaccinate or not to vaccinate? You should compare the possible risks: get a complication from vaccination or get a serious infection? Everyone chooses himself, weighing all the pros and cons. The main thing is, before making a choice, make sure that you are sufficiently aware of this issue.

What you need to know about vaccination against poliomyelitis. Tells the family doctor Baktyshev A. AND.

What you need to know about vaccination against poliomyelitis

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