Stabbing Or Not Stabbing: Why Vaccinations Are Needed And When To Get Them

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Stabbing Or Not Stabbing: Why Vaccinations Are Needed And When To Get Them
Stabbing Or Not Stabbing: Why Vaccinations Are Needed And When To Get Them

Video: Stabbing Or Not Stabbing: Why Vaccinations Are Needed And When To Get Them

Video: Adelaide mother wanted by police over alleged stabbing breaks silence while on the run | 7NEWS 2022, December
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Text: Dasha Sargsyan, co-author of the blog "Wet the Mantoux"

New drugs and technologies appear in the world every year, but general medical illiteracy and the lack of available information lead to the fact that many still trust "folk remedies" or advice "from the Internet" much more than scientific research. Vaccinations are one of these stumbling blocks: surely everyone has friends or parents who carefully protect themselves and their children from vaccination. A dense cloud of prejudices, often not based on anything, led to the active development of the anti-vaccination movement in Russia and the world, advocating a complete refusal of vaccination.

Medical journalist Dasha Sargsyan, with the help of infectious disease specialist Dmitry Troshchansky and pediatrician, allergist-immunologist, chief physician of the Fantasy Children's Clinic Nikolai Smirnov, explains what you need to know about vaccinations and the arguments of their opponents. You can read more about vaccination in Russian here and here, in English here.

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What are the vaccinations and why are they needed?

The principle of the vaccine is very simple: a weakened virus / bacterium or their components is introduced into the human body, the immune system naturally reacts, remembers the aggressor and gets rid of it faster and better at the next meeting. Not all vaccines provide one hundred percent protection against infections, but this does not mean that such vaccinations are not needed: even if a disease arises, a person will tolerate it more easily. This, for example, concerns BCG, which is often called the tuberculosis vaccine: the vaccine does not protect against infection, but makes it easier to transfer it if a person is already sick.

Vaccination helps not only before contact with a virus or bacterium, but also after. For example, if you are not a veterinarian or caver, then you do not need to get vaccinated against rabies, because the chances of being infected are extremely low. However, if you are bitten by a mad dog, you will need to be vaccinated if you do not want to die in agony. Also, after contact, you can protect yourself from hepatitis A (within two weeks, but the earlier, the better, ideally, in the first two days), hepatitis B (very desirable within 24 hours, but

allowed up to 7 days), chickenpox (within 72 hours), measles (within 72 hours) and tetanus. These recommendations may differ slightly depending on the age of the patient, their vaccination history, and whether it is known for certain that they have been in contact with the relevant viruses or bacteria.

Over time, there are more and more vaccines. And since there are many vaccinations, some of them are given together. For example, there is a combination vaccine DPT (whooping cough, diphtheria, tetanus), MMR (measles / mumps / rubella) and others. You should not be afraid of the "triple blow": such vaccines cause side effects no more often than monocomponent vaccines.

The main diseases for which there are no vaccines yet (but they are being worked on) are HIV infection, hepatitis C, cytomegalovirus infection and malaria. But are there vaccinations that, on the contrary, are being discarded? The only vaccine that has disappeared from all calendars is smallpox. Since 1979, this disease has not officially disappeared in the world due to the fact that volunteers have vaccinated people even in the most distant villages of the third world countries. Also recently, the World Health Organization changed the trivalent oral live polio vaccine to bivalent (polio type 2 virus was removed from it). In countries where tuberculosis is rare, the universal use of BCG is abandoned.

When you shouldn't get vaccinated

There are very few reasons for withdrawal from vaccination, absolute contraindications. This is, for example, a severe allergic reaction to a previous vaccination.Nikolai Smirnov, pediatrician, allergist-immunologist, chief physician of the Fantasy Children's Clinic, explains that even those patients who are weakened or suffer from chronic diseases are being vaccinated so that the child has protection. Of course, this should be done when there is no exacerbation or when the disease is under control.

Colic, umbilical hernia, runny nose, mild rash and other similar conditions are false rejection of vaccinations without any scientific basis. According to Smirnov, most of the rejections are raised because of old stereotypes or because doctors follow the lead of their parents. Perhaps the fact is that doctors cannot or are too lazy to explain their position. Studies before vaccination (blood tests, urine tests) to determine contraindications in civilized countries are not done. All conditions due to which vaccination is not allowed give symptoms that are easily detected by talking and examining. When creating vaccinations, the fact that they will be vaccinated, including in places remote from medical care, and not necessarily with the participation of a doctor, is taken into account. Therefore, contraindications to vaccination should be obvious.

Interestingly, some diseases are included in the contraindications not because vaccination in such a state can lead to serious consequences or not work. The fact is that an increase in temperature after vaccination will complicate the choice of treatment tactics: it will not be clear whether the fever appeared due to illness or due to vaccination. Pregnancy is not a disease, but also a contraindication for some vaccinations: against chickenpox, measles / rubella / mumps, live flu vaccine.

There are no diseases for which an extended vaccination schedule is shown. When the intervals between vaccinations increase, Nikolai Smirnov explains, the development of effective immunity in a child decreases from an early age, not to mention the fact that children are at risk of getting sick. In addition, they begin to remember the injections, they have a negative experience. Therefore, doctors advise to vaccinate children on time so as not to provoke bad emotions.

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Where did the anti-vaccination movement come from?

and where does it lead

The anti-vaccine movement was born with the spread of vaccination - in the early 19th century - as a manifestation of fear of new incomprehensible interventions in the body. In the future, the movement was not particularly popular. To understand why, ask older relatives about their childhood. Their peers fell ill with polio, measles, diphtheria, they were scared to go to school, vaccines seemed like a salvation. Now, thanks to vaccination, they are much less likely to get sick, and it is no longer obvious for young people why vaccinations are needed. For example, in the 1990s, there was an outbreak of diphtheria in Russia: people began to vaccinate less often - as a result, herd immunity was undermined, when, due to the vaccinated majority, the disease does not spread. When the vaccinated people are less than a certain level (each disease has its own border), then an outbreak occurs. This is especially dangerous for people with weakened immune systems, children who have not yet had time to be vaccinated, and the elderly.

The anti-vaccination movement in Russia has become the most active since the late 1980s. Then a publication appeared in Komsomolskaya Pravda, where the author gave the floor to Galina Chervonskaya (a popular opponent of vaccination) and did not check the information she insisted on. Anti-vaccine leaders often do not have a medical background, but they have great success. There are many reasons for this, and none of them is related to science - mainly to emotions. If you start checking the facts, it turns out that in the speeches, articles and books of opponents of vaccination there are a lot of falsifications and unscientific statements - for example, that BCG is done only in Russia (this is not so).

The main argument of supporters of the anti-vaccine movement: vaccination "destroys immunity."But, firstly, science does not know the possible mechanism of "undermining immunity" with the help of vaccinations, and secondly, such a process should be accompanied by severe, difficult to treat diseases and constant hospitalizations. However, there is no increase in the number of real immunodeficiencies in society. Most of these claims by opponents of vaccination break down on scientific data and have been repeatedly refuted by supporters of evidence-based medicine - here, for example, you can read a summary of such analyzes.

However, any parent who is told that "vaccinations are the death of the immune system" will inevitably wonder whether it is worth putting their child at risk. At the same time, the same fear for the health of the child will take its toll if he steps on a nail or ends up in a hospital with a complication of measles or mumps. Then usually the child begins to vaccinate against everything that is possible. People often do not spread about such stories, especially if anti-vaccination articles were widely shared in social media before, but there are still exceptions.

Abroad, the beginning of the mass refusal of vaccination occurred in the late 1990s, when an article on the alleged link between autism and vaccinations was published in a scientific journal, and subsequently withdrawn and refuted. It turned out that the author had a commercial interest in publishing an article with such conclusions, in addition, ethical rules were not followed: the authors performed procedures that were not shown to sick children, for example, colonoscopy. Also, 12 children took part in the study, which by modern standards is not enough for any conclusions. It should also be noted that the symptoms of autism spectrum disorders appear at the age when the most vaccinations are given. Intuitively, these phenomena can be linked, but after large-scale research it turned out that the rule "after does not mean due to" is true here. Periodically, the spread of anti-vaccination sentiments leads to outbreaks of diseases that have already begun to be thought of as disappearing. As a result, not only children whose parents refused to be vaccinated die, but also those who were not vaccinated for medical reasons or due to age.

From what and at what age to vaccinate a child

In each country, the vaccination calendar is drawn up depending on the financial capabilities of the state and on the risk of meeting with causative agents of preventable diseases. In Russia, all vaccinations included in the National Calendar can be obtained free of charge. However, in comparison with other countries, our calendar is truncated. Fortunately, vaccines that cannot be vaccinated at the expense of the state are mostly registered, that is, they can be used at their own expense.

Unlike the obligatory calendars of many Western countries, our country does not have vaccinations against meningococcal infection, hepatitis A, chickenpox, human papillomavirus and rotavirus infection. The latter, according to Nikolai Smirnov, is extremely important for children in the first months of life. Frequent loose stools, vomiting lead to very rapid dehydration and high mortality in children in the first year of life. If you want to protect your child to the maximum, then you can focus on the American or European calendars (although there is usually no BCG) and get ready to spend.

Vaccine components make up only a small fraction of the viruses and bacteria that children have to deal with, even just being at home. That is, there is no question of any overload of the immune system during vaccination. But then why can't you get all the vaccinations in one go? Dr. Smirnov explains that the chickenpox vaccine is done from 12 months, because before that, children do not develop a strong immune response. From whooping cough, diphtheria and tetanus, they do it in the first year of life (the first three doses: at 2, 3, 4 months), so that by the age when the child starts walking, he would be protected.Moreover, whooping cough is most severe in the first year of life. However, if you vaccinate against these diseases immediately after birth, then sufficient immune protection will not be created. Hepatitis B is done in the first day of life, because hepatitis is more dangerous for young children and it is not known what kind of environment awaits the child at home.

But if a teenager comes to the pediatrician, who, having no contraindications, has not been vaccinated and is now going to, then you can do many vaccinations at once. Usually, Western calendars indicate separately which diseases it still makes sense to vaccinate against. Vaccinations can be done at once in several places available for intramuscular or subcutaneous injection, says Dr. Smirnov. For example, whooping cough / diphtheria / tetanus / poliomyelitis and hepatitis B - in two hands, and measles / rubella / mumps subcutaneously in any place accessible for subcutaneous injection. In the future, it is important to observe the intervals between subsequent vaccinations.

Many Western countries have abandoned live polio vaccines (they are buried in the mouth) and began to use inactivated (killed) vaccines, which are injected. With live polio vaccine, there is a minimal risk of developing so-called vaccine-associated poliomyelitis. But at the same time, says Nikolai Smirnov, it is believed that it creates a stronger, more reliable immunity. And the general approach now is this: in the civilized world, only an inactivated vaccine should be used. In countries where the risks of encountering polio are higher, a live vaccine is also used, and from the first months of life. A compromise option: one of the revaccinations is carried out with a live polio vaccine. Then there is already immunity, and there are no risks of contracting vaccine-associated poliomyelitis at all.

If you follow the calendar, then by the age of 14, the main vaccinations will end. Until the age of 18, only an annual flu shot will be needed. And, of course, vaccination, if you live in a territory (or are going to go there) where tick-borne encephalitis, tularemia and so on are common. When visiting some countries (especially Africa and Asia), additional vaccinations are also needed.

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What vaccinations do you need

make an adult

Adults need to be vaccinated not only against exotic diseases when traveling to Angola, Brazil or another country with an unsafe epidemiological situation. Unfortunately, the effects of many childhood vaccinations have faded away. Therefore, you need to defend yourself anew. The Russian calendar for adults is even more meager than for children, so most likely, the bulk of the vaccinations will need to be done at their own expense. What should adults be vaccinated against? In an amicable way, these are diphtheria / tetanus (every 10 years), flu (every year), chickenpox (if not sick), human papillomavirus (up to 26 years for women and up to 21 years for men) and measles / rubella / mumps. Ideally, you still need to be vaccinated against whooping cough, but such a vaccine for adults is not registered in Russia.

Smokers and people with diseases of the bronchopulmonary system (for example, asthma) need to get vaccinated against pneumococcal infection. The list may differ if you were under-acclimated to something in childhood (it is better to show all your medical records to the doctor at the first visit), if you have some chronic diseases, if you are a homosexual man, if your profession is associated with certain risks, and so on.

Women who are planning a pregnancy should definitely be vaccinated against rubella (if a blood test shows that there is no protection) and chickenpox (if you have not been sick before). But after that you need to protect yourself for at least a month. Such diseases cause gross malformations of the fetus, so it is important to be protected. Influenza is more likely to be difficult for a pregnant woman, so you also need to be vaccinated against it (only with an inactivated vaccine).In the third trimester, in an amicable way, you need to be vaccinated against whooping cough in order to transfer antibodies to the child and thereby protect him from this disease for the first time.

People over 60 have additional risks and, accordingly, an additional set of vaccinations. Up to 64 years old, it is better to get vaccinated against shingles (unfortunately, such a vaccine is not registered in Russia), from 65 years old - from pneumococcus.

Does the flu shot work?

Vaccination is now the surest way to protect yourself from the flu. But, I must say, this vaccine does not work as well as we all would like. As you know, the flu virus mutates, and every year a new vaccine needs to be created. The definition of the strains that will form the basis of vaccination is carried out by the World Health Organization. Failures are quite rare, and the WHO chooses the wrong strains that are common. Accordingly, the protection of vaccinated people in such years falls. But on average, the vaccine prevents 3 out of 5 people from getting sick. It should also be said that those vaccinated people who do get sick are usually more likely to tolerate the flu.

Influenza vaccination is especially recommended for children over 6 months old, the elderly and pregnant women, because they are at a higher risk of complications. For the rest, the benefits are not so obvious: they usually get sick less often and more easily. But if you want to protect yourself, the US Centers for Disease Control and Prevention recommends doing so.

Are Russian vaccines inferior to imported

There is an opinion that foreign analogues are safer in terms of side effects - and Nikolai Smirnov agrees with this. According to him, they are more standardized, more refined - in other words, better quality. However, if there is no alternative, it is better to use domestic vaccines. For example, DPT, which protects against diphtheria, tetanus and whooping cough, has a plus: it forms a rather powerful and durable immune response.

With Russian influenza vaccines, the story is somewhat different: the most popular of them have three times less antigens than the WHO recommends. But they have immunostimulants (for example, polyoxidonium), which, according to the idea of ​​manufacturers, should spur the immune response, that is, the response to a lower dose of antigens should be sufficient for protection. According to infectious disease specialist Dmitry Troshchansky, data on clinical trials of these drugs are classified. That is, in fact, we do not know anything about the effectiveness of these vaccines.

If you do not want to be vaccinated with a domestic vaccine, but there are no foreign ones, you can go abroad - flu vaccines are available there already in August. It is better to get vaccinated directly abroad, because it is difficult to transport the vaccine to Russia: it requires strict adherence to the temperature regime and must be surrounded by ice packs. If stored improperly, Smirnov says, some vaccines lose their effectiveness, less often - the risk of side effects increases. So, if you are going on vacation abroad, you can already prepare there for the seasonal flu outbreak.

Photos: sveta- stock.adobe.com, Damian Gretka - stock.adobe.com, koosen - stock.adobe.com, osoznaniejizni - stock.adobe.com

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