The group of diseases caused by pneumococcal infection includes pneumonia, meningitis, pathologies of the joints, middle ear, sinusitis. Since 2014, vaccination against pneumonia for children is mandatory. The inclusion of the vaccine in the National Calendar is due to an increase in morbidity and mortality. The vaccine has a proven effect in clinical studies, but in rare cases it causes side effects.
Indications
Children are vaccinated, according to the National Calendar, against pneumonia, meningitis and other pathologies caused by infection with pneumococcal bacteria.
In addition, the vaccine may be prescribed if the child is at increased risk for:
- HIV infection, especially in the formation of acquired immunodeficiency syndrome, since there is a high probability of infection with a pathogen as a result of a decrease in the activity and number of immunocompetent cells;
- the presence of oncological diseases that lead to a decrease in the immune status;
- treatment with immunosuppressive drugs – glucocorticosteroids , cytostatics ;
- congenital anomaly, characterized by the absence of the spleen or the lack of its function. This pathology is accompanied by suppression of immunity, since the organ takes an active part in the formation of lymphocytes and antibodies;
- the presence of a cochlear implant or in preparation for its installation;
- chronic heart, respiratory, or renal failure;
- diabetes mellitus of any type;
- frequent infections of the respiratory system;
- bronchial asthma;
- tuberculous infection.
Contraindications
Immunization with pneumococcal vaccine is contraindicated if the child has an allergic reaction to the components of the drug in the form of anaphylactic shock. Also, it cannot be vaccinated if an intolerance to diphtheria toxoid or other components of the vaccine has been previously identified.
Vaccination is postponed during the period of infectious or non-infectious diseases, since against the background of reduced immunity there is a risk of adverse reactions. The administration of the drug is carried out one to two weeks after recovery or in remission.
It is not recommended to administer the pneumococcal vaccine to children during the period of radiation or chemotherapy treatment.
A contraindication is less than 2 months of age, however, vaccination is carried out in premature infants to prevent nosocomial pneumonia and its possible complications.
Is it possible to vaccinate a child under one year old
The first time a child is vaccinated at the age of 2-6 months, if there are no medical contraindications. In clinical studies of pneumococcal vaccines, it has been proven that the drugs are safe even for premature babies. The incidence of side effects did not differ from babies born on time.
Types of vaccines for children
The first vaccine against pneumococcus appeared not so long ago – in the second half of the 19th century. It was called 14-valent, that is, it contained 14 pneumococcal genotypes. In the 80s, it was replaced by a 23-valent drug, which is also used in modern medicine.
There are two types of vaccines – polysaccharide 23-valent, called PPV23, and conjugated 10- and 13-valent – PCV10 and PCV13.
The polysaccharide vaccine consists of the capsular antigens of the pathogen. The main mechanism of action of the drug is the stimulation of B-lymphocytes and the production of antibodies, namely, class M immunoglobulins. This effect does not lead to long-term protection of the child’s body, but to the immune memory. In addition, the drug is ineffective in relation to babies under two years old, since in newborns B cells remain immature for many months, this makes it difficult to recognize the antigens in the drug. The vaccine is used to immunize a high-risk group.
The main component of a conjugate vaccine is an antigen-carrier protein complex. When the drug enters the body, a cascade of complex immune reactions mediated by T-lymphocytes is triggered. As a result, class G immunoglobulins are formed. This mechanism of action provides more reliable protection of the body against pneumococcal infection and prolonged immune memory of cells. This vaccine is effective in children 2 months of age and older and is used as the drug of choice for immunization according to the National Immunization Schedule.
Do you need preparation
Healthy children do not need special preparation for vaccination. If your child has allergies, you should discuss the vaccination tactics with your doctor in advance. The doctor may prescribe a course of antihistamines – 2-3 days before the procedure and 3 days after.
Vaccination is prohibited in the acute period of infectious and non-infectious diseases, therefore, often ill children before the scheduled date of immunization are advised to refuse to attend kindergarten, prolonged stay outside in cold weather. You can also drink a vitamin complex.
Vaccination schedule
The table reflects the scheme for the frequency of vaccination adopted by the Ministry of Health of the Russian Federation and included in the National Vaccination Schedule.
| Age of first vaccine administration | PKV10 | PKV13 |
| 2 to 6 months | Shown three times the introduction of the vaccine with an interval of 1 month, revaccination is carried out in 2 years.
The second option is a double injection of the drug with an interval of 2 months, revaccination is carried out in two years. |
Three or two vaccinations with an interval of 1 or 2 months, respectively. |
| 7 to 11 months | Two injections of the drug with an interval of 1 month, repeated vaccination in two years. | |
| 12 to 23 months | Double vaccination with an interval of 2 months. | |
| 2 to 5 years old | Two doses with an interval of 2 months. | One injection of the drug. |
| Over 5 years old | Not used. | One injection of the drug. |
Children from 2 to 18 years old, who are in the group of increased risk of developing pneumococcal infection and its complications, receive special prophylaxis according to a special scheme. At the initial stage, it is recommended to use PKV13. After 12 months, repeat immunization with PPV23 is carried out. The interval between the two vaccines can be reduced to 8 weeks in preparation for organ transplantation or immunosuppressive treatment.
Vaccination
Vaccination is carried out in a medical institution. For children under two years of age, the vaccine is administered intramuscularly to the front of the thigh. From 2 years of age and older, the vaccination is done in the shoulder.
The immunization nurse must open a fresh vaccine, check the expiration date and storage conditions of the drug. Further, the treatment of the skin with an antiseptic and the administration of the medicine are required.
It is recommended to stay in a medical facility for 30 minutes after the procedure, as allergies may develop. In the event of a hypersensitivity reaction to the vaccine administration, symptomatic therapy is performed.
Adverse Reactions
The most common side effect is a reaction at the injection site. There is redness, swelling up to 2-7 cm in diameter, painful sensations. There may be a change in the child’s mood, anxiety, insomnia, tearfulness. In some cases, the body temperature rises, a rash appears, dyspeptic disorders.
Edema at the injection site of more than 7 cm in diameter, convulsive syndrome, allergic reaction in the form of urticaria, dermatitis and eczema are rarely noted. Isolated cases of anaphylactic shock have been reported.
The incidence of adverse post-vaccination reactions increases in adults.
What to do if side effects appear
When the temperature rises against the background of the introduction of the vaccine above 38 degrees, it is recommended to give the child an antipyretic agent and provide him with plenty of drink. In case of edema and redness of the injection site, cold applications and non-steroidal anti-inflammatory drugs can be used.
With the development of an allergic reaction, therapy with antihistamines is carried out. Preference is given to second-generation drugs that do not have a sedative effect – Loratadin , Cetirizine , Ebastine .
Anaphylactic shock requires emergency treatment: a tourniquet is applied above the injection site of the drug, and then adrenaline is injected. In the event of acute respiratory failure is carried intubating the trachea.
Preventing the development of pneumococcal infection or its severe complications in a child is simple. It is enough to carry out immunization in a timely manner. To achieve the maximum effect, you must follow the deadlines indicated in the National Immunization Schedule.