A post-vaccination reaction is understood to mean a complication, which is an unfavorable outcome of preventive vaccinations. Most often, disorders resulting from immunization are found in children. In some cases, a post-vaccination reaction of the body can be envisaged and vaccination can be abandoned in advance.
The consequences of vaccination as a diagnosis
In the International Classification of Diseases of the 10th revision (ICD-10), post-vaccination reactions do not have a separate section. To indicate the complication that developed against the background of the action of the preventive drug, doctors resort to the encoding T78 or T88.
In the first section, adverse effects are noted that are not classified in other sections. According to the ICD, a post-vaccination reaction refers to complications caused by an uncertain or inaccurately indicated cause. Section T78 “Adverse Effects” completely excludes complications arising from surgical and therapeutic intervention. They have a different code in ICD-10. A post-vaccination reaction is indicated by the code T88.8 when the health problems that have occurred after vaccinations are persistent and severe. The indicated reactions of the body after vaccination include anaphylactic shock, giant urticaria, Quincke's edema, sepsis and rash.
Is vaccination mandatory
Preventive vaccination measures in modern therapy and pediatrics have the following goal: to help the patient's body to form immunity, which will protect it from a specific infectious agent if repeated contact occurs with it. Mass vaccination allows you to develop not only individual resistance to pathogens, but also create collective protection against pathogens, designed to stop the circulation of infection and the development of epidemics in society.
In our country, the National calendar of vaccinations is in force. This document is approved by the Ministry of Health of the Russian Federation. He sets a schedule for mandatory and additional vaccination of children of various ages from birth to adulthood.
In isolated cases, complications occur. If the body responds to the vaccine unexpectedly, this is regarded as an adverse post-vaccination reaction. The likelihood of developing complications after vaccination can be different, depending on its type and the drug used. The most difficult children suffer from DTP - vaccination against pertussis, diphtheria and tetanus (A33-A35 - ICD code). A post-vaccination reaction that ends fatally occurs in approximately one in one hundred thousand cases.
Causes of Complications after Immunization
A negative reaction of the body to the drug can be caused by its reactogenicity. In none of the cases, the individual characteristics of the patient’s body and the manifestations of the so-called “human factor” (for example, errors and errors of the medical staff during vaccination) are also excluded.
The ability of the drug to cause complications depends on its composition. The reactogenic qualities of most vaccines used in medicine are explained by the high content of bacterial toxins, preservatives, stabilizers, antibiotics and other substances. Of great importance is the immunological activity of the vaccine. By the degree of reactogenicity, which determines the risk of severe side effects, the most dangerous are DTP and BCG. Post-vaccination reactions are rare after vaccination against polio, hepatitis B, mumps, rubella.
Speaking about the individual characteristics of the body, first of all, the presence of background disease is implied. The pathological process determines the frequency and severity of post-vaccination reactions. ICD-10 also includes allergic reactions, sensitization of the skin, idiosyncrasy.
Based on cases that have occurred in medical practice, a common cause of post-vaccination complications are personnel errors. Patients may experience local and general reactions of the body, which subsequently require therapeutic or surgical intervention, as a result of:
- violations of the drug administration technique;
- incorrect dosage calculation;
- improper dilution of the vaccine;
- neglect of aseptic and antiseptic norms.
Types of complications after vaccination
The consequences of vaccination are of two types - local or general. The first group of violations is considered less dangerous to the health of the child. Local post-vaccination reactions include:
- local hyperemia of the skin;
- swelling at the injection site;
- formation of infiltrate;
- abscess;
- purulent lymphadenitis;
- keloid scar.
In some children, after vaccination, the body temperature rises, muscle pains, core-like rashes appear throughout the body. In this case, general post-vaccination reactions are implied. The most serious complications after immunization are:
- anaphylactic shock;
- encephalitis;
- meningitis;
- sepsis;
- vaccine-associated polio.
The body's reactions are not only local and general. Doctors apply another classification. Complications are divided into specific, that is, those that are directly associated with the vaccine, and non-specific, caused by the individual characteristics of the body.
The mechanism of development of complications
The most common factor that triggers the process of post-vaccination manifestations is an infectious disease. If the day of vaccination and the disease that provokes the development of transient immunodeficiency coincides, the likelihood of complications increases several times. In the first days after vaccination in children, ARVI, obstructive bronchitis, pneumonia, infectious diseases of the kidneys and other serious ailments can occur.
More often post-vaccination reactions and complications are unstable disorders that persist for a short period and do not affect the life of the body. Clinical manifestations in them are of the same type and, as a rule, do not affect the general condition of the child, pass through two to three days without additional therapy.
Pathologies that may occur
Toxic reactions of the body that develop during the first three days after vaccination occur with pronounced signs of deterioration in the general condition of the child. In most cases, children’s body temperature rises above 39.0 ° C, chills, lethargy, insomnia, loss of appetite, vomiting, nosebleeds. Most often, vaccine-related complications occur after immunization against pertussis, the use of influenza drugs and live measles vaccine. Sometimes hyperthermia is accompanied by convulsive syndrome and hallucinations.
Post-vaccination reactions, which are allergic in origin, are divided into general and local by doctors. The first category includes post-vaccination complications of a systemic nature, affecting the general condition and functioning of the body as a whole:
- anaphylactic shock;
- hives;
- Stevens-Johnson syndrome;
- exudative erythema;
- Quincke's edema;
- Lyell's syndrome;
- an attack of bronchial asthma;
- atopic dermatitis.
The introduction of a vaccine can also cause severe immunocomplex reactions, which include serum sickness, hemorrhagic vasculitis, periarteritis nodosa, glomerulonephritis. Local complications after vaccination are redness, soreness and swelling of the tissues that go beyond the injection site. Local reactions after vaccination normally go away after three days. The main allergic component in immunization preparations is an aluminum hydroxide sorbent. This sorbent is present in DTP vaccines, Tetracock.
Autoimmune disorders can lead to post-vaccination complications, which are characterized by damage to the central and peripheral nervous system, heart, joints. Vaccination can trigger the development of autoimmune hemolytic anemia, systemic lupus erythematosus, dermatomyositis, scleroderma, and other pathologies.
Dangerous vaccines
Vaccinations scheduled in the National calendar for the first year of life provoke the greatest number of complications. The most painful for babies younger than six months are drugs with a pertussis component. After the vaccine is administered, the child can scream shrillly and monotonously for several hours. The concern of children in their first year of life is explained by the fact that such vaccinations cause short-term changes in the microcirculation of the brain and sudden increases in intracranial pressure.
Vaccine-associated diseases are severe in nature of their course and post-vaccination consequences, which can be paralysis, polio, and inflammation of the brain. Such complications are extremely rare. The risk of their development increases after vaccination against measles, DTP, rubella, and mumps (mumps).
Separately, it is worth noting the post-vaccination reactions (the code from the ICD-10, the doctor has the right to apply at his discretion) after BCG. Among the complications, the most common local lesions caused by BCG infection. After vaccination, newborns in isolated cases encountered lymphadenitis, ulceration of the skin, abscesses, diseases of soft and hard tissues (keratitis, osteomyelitis, osteitis). Post-vaccination complications can even lead to death, especially with immunodeficiency.
What tests will have to pass
The suggestion of a post-vaccination reaction occurs in the pediatrician when certain clinical symptoms appear during the period of immunization. To confirm the fact of complications after vaccination, the child is sent for laboratory tests. Differential studies can exclude intrauterine infections, among which the greatest threat to the health of the fetus is cytomegalovirus, herpes, toxoplasmosis, rubella, chlamydia. Mandatory for a comprehensive examination are:
- general analysis of urine and blood;
- virological studies;
- bacteriological tests of blood, urine, feces.
All laboratory procedures are carried out by PCR, RNGA, ELISA, RSK. In addition, a biochemical study of blood and urine may be required, especially if the child is followed by seizures after vaccination. The results of biochemistry can exclude rickets and hypoglycemia in diabetes mellitus.
If the post-vaccination reaction has led to CNS disorders, the child is prescribed a lumbar puncture and a sample of cerebrospinal fluid is taken for laboratory study, electroencephalography, electromyography, neurosonography and MRI of the brain are prescribed. Complications after vaccination are similar in their manifestations to the clinical picture of epilepsy, hydrocephalus, benign and malignant brain tumors. Diagnosing post-vaccination complications is possible only when all possible causes of the violation of the child’s condition are refuted.
What to do in case of complications after vaccination
Any changes in the well-being of the child after immunization require a consultation with a doctor. It is impossible to give medicines or take other actions without the consent of the doctors. Depending on the type of reaction, the patient may be prescribed etiotropic therapy. Post-vaccination complications require a sparing regimen, careful care of the injection site and a rational diet.
Treatment of local suppuration, scars, abscess involves the application of an ointment dressing and the appointment of a course of physiotherapeutic procedures (ultrasound and shock wave therapy). If the result of vaccination is high fever, drinking plenty of fluids, taking antipyretics, rubbing and applying ice to physically cool the body is recommended.
In the event of a sudden allergic post-vaccination reaction (in the 10th edition of the ICD is indicated by code T88.7), a shock dose of an antihistamine is administered. With severe inflammation, hormones, adrenomimetics, cardiac glycosides are prescribed. If post-vaccination complications are observed on the part of the nervous system, the child is prescribed symptomatic treatment (e.g., anticonvulsants, antiemetics, dehydration medications, and adsorbents). In case of complications after BCG vaccine, the treatment is prescribed by a pediatric TB specialist.
How to prevent a painful reaction after vaccination
The main condition for the successful prevention of post-vaccination complications is the inadmissibility of immunization in the presence of contraindications for vaccination. Doctors should pay great attention to the selection of children to be vaccinated. For this purpose, pediatricians conduct a preliminary examination of patients and, if necessary, refer them for consultation with other specialists (allergist, immunologist, neurologist, cardiologist, nephrologist, pulmonologist, TB specialist). During the post-vaccination period, it is necessary to monitor the condition of the child.
Equally important is the professionalism of the medical staff authorized for vaccination. Vaccinations for children should be done by an experienced and qualified specialist. In case of post-vaccination complications, repeated administration of the vaccine is not allowed even after several months. However, other types of immunization are not contraindicated for the child.
Protection against post-vaccination reactions is more dependent on how responsibly parents approach children's immunization. If the child has complaints about feeling unwell, one should not be silent about this, it is necessary to inform the doctor. You can not be vaccinated if there are symptoms of a cold or other infectious disease. Before vaccination, each child should be examined.
In the predominant number of cases, complications are observed due to violation of the storage conditions of the vaccine. In this case, the likelihood of developing post-vaccination complications due to the individual characteristics of the body is minimal. In addition, we must not forget that the risk of infecting children with dangerous viral diseases is much higher than the risk of post-vaccination reactions.
Complications from vaccination - an occasion to be observed by a doctor. For mild to moderate reactions, it is sufficient to provide proper care for the infiltrate and monitor body temperature, and if 38 ° C is exceeded, give the child an antipyretic. After vaccination and for the next three days, in order to prevent allergic reactions, the child is prescribed an antihistamine.
In case of an adverse post-vaccination reaction to the vaccine, one cannot use alternative methods of treatment or give the child pharmacy medicines at his discretion. The consequence of such a careless attitude to the immunization process can be a serious weakening of health.