In recent years, more and more parents decide not to vaccinate their child. They talk a lot about the dangers of vaccination, so the anti-vaccination movement is gaining momentum. By law, parents have the right to decide whether to instill their baby in them or not. But here another problem may arise: the danger of contact between a child vaccinated with a live vaccine against polio and an unvaccinated child. It is believed that this threatens the development of vaccine-associated polio, which can occur even in severe paralytic form. In recent years, about 10 such cases per year are registered in Russia. Therefore, a resolution of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare was issued, which obliges to isolate unvaccinated children from those vaccinated with a live vaccine. Many parents try to figure out if this is actually necessary.
What is poliomyelitis?
This is a serious, highly contagious disease that most often occurs in childhood and affects the nervous system. It is transmitted by the fecal-oral route: through dirty hands, toys, household items. But it can also be transmitted by airborne droplets. And infectious can be not only sick people, but also carriers that themselves do not get sick, as well as vaccinated with a live polio vaccine.
Poliomyelitis can occur in various forms. The lightest, almost asymptomatic, similar to ARVI or rotavirus. It occurs with symptoms of a cold and bowel disorder. In a severe case, poliomyelitis affects the front horns of the spinal cord and the motor nuclei of the cranial nerves. This is a paralytic form of the disease, which is characterized by paralysis of the limbs, their deformation, muscle atrophy. In the most severe cases, the disease ends in death due to paralysis of the respiratory muscles.
Polio vaccination
Although this disease has been studied for a long time, there is still no cure for it. The only protection is vaccination. Vaccinations against poliomyelitis began to be done only in the middle of the 20th century, before that there was a great mortality from this disease, epidemics often flared up. Thanks to vaccination, the number of cases of the disease gradually decreased by the end of the 20th century, and wild strains of the virus were virtually eradicated. It is believed that this requires 95% of children under one year old to be vaccinated.
In Russia, polio is almost never found, and all thanks to vaccination. But recently, more and more parents began to refuse vaccinations. Many children are vaccinated with a live polio vaccine, and an unvaccinated child may become infected. Not all countries use such a vaccine, but so far it is believed that its combination with IPV provides the strongest immunity against all strains of polio.
Vaccination schedule
To form a stable immunity against poliomyelitis, three vaccinations and three booster vaccinations are necessary. Since the child can be infected at any age, vaccination is recommended to start from 3 months. Only sometimes, if there are contraindications, a decrease in immunity or a decision by the parents to start vaccinating the child later, vaccination is not done at this time. This shifts the entire vaccination schedule and leads to a problem when a live polio vaccine is used in a school or kindergarten and the child is unvaccinated. After all, often the vaccination schedule for each baby is individual, and therefore such situations arise.
Begin vaccination with a safer inactivated vaccine. Do one vaccination, then after a month and a half - the second. This contributes to the formation of initial individual immunity. And although it is low, it still protects the child from infection in case of contact with the virus.
OPV is used during the third vaccination - after six months. It can not do any harm to the child himself, as it contains weakened viruses, which the immunity formed under the influence of IPV can cope with.
But for the formation of a stable immunity against the disease and its complete eradication in the country, revaccination is still necessary. It is also done 3 times and also with the oral polio vaccine. In accordance with the vaccination calendar, in Russia revaccinations are done at 18 and 20 months, and then at 13-14 years. Therefore, infection from children vaccinated with a live polio vaccine, an unvaccinated child in school is also possible. But at the same time, they do not try to isolate children from each other, it is believed that the disease at this age is not so dangerous, in addition, most children received at least two vaccinations by the age of 13.
Vaccine features
Now there are two types of polio vaccines. Inactivated contains dead viruses. It is absolutely safe, after its application, cases of the development of polio in the vaccinated child himself or in those around him have never been recorded. This vaccine is administered by injection. It contributes to the formation of local immunity in the child. For this, two vaccinations are needed with an interval of one and a half months. About a month after the second vaccination, immunity is formed.
Oral polio vaccine is a drop that drips into a baby's mouth. Such a vaccine is usually given after the child has been vaccinated with a twice inactivated polio vaccine. The droplets contain a live polio vaccine. And how can an unvaccinated child get infected? This question is asked by many parents. In fact, there really is a risk. Since this disease is transmitted by the oral-fecal route, this virus can enter the body of other children through common household items, unwashed hands, or toys.
Why is this vaccine still used if it is so dangerous? In fact, only this type of vaccination helps to stop the spread of the wild virus in nature. Even if not all children are vaccinated, those vaccinated spread weakened, semi-living strains of the virus into the environment. They enter the body of other people and contribute to the eradication of the wild strain due to such passive vaccination. This vaccine is still used, since IPV forms only individual immunity, without helping to interrupt the spread of the virus.
Vaccine-associated polio
This vaccine is considered the safest. It very rarely causes any side effects. But sometimes OPV leads to the development of vaccine-associated polio. This is a disease that passes through the type of polio, but is easier. This form of the disease can develop in people who have not previously been vaccinated. If a child has been given at least two doses of IVP, he will not develop vaccine-associated polio. Such cases are extremely rare, about 1 person per 10-12 million people. Children with immunodeficiency are usually at risk for VAP.
In addition, a child who is given a live polio vaccine is sometimes infectious. Contact with unvaccinated children in this case puts them at risk of infection. Indeed, within 60 days after vaccination, the child releases into the environment a certain amount of a weakened, but still living polio virus. When infected with it, its vaccine-associated form develops. Moreover, there is a danger in all children's groups where a live polio vaccine was used. And an unvaccinated child at home can also become infected by his brothers or sisters.
The consequences of such an infection
Sometimes polio in any form proceeds easily, without leaving any consequences. A child can also easily tolerate vaccine-associated polio. In this case, symptoms resembling a respiratory disease or intestinal infection appear. But in about 30% of cases, a paralytic form develops. After it, persistent paralysis of the limbs remains, their deformation is possible. The child then remains disabled.
Live polio vaccine and unvaccinated child
Is it possible to get infected in this case? This issue has recently become the occasion for heated discussions. It is proved that after vaccination with the oral polio vaccine, the child releases the virus of this disease into the environment within 1-2 months, so contact with it can become dangerous for others. But only unvaccinated children have a risk of getting sick. The rest receive a small amount of attenuated vaccine strains. This is the so-called passive immunization. But contact with children vaccinated with a live polio vaccine is dangerous for an unvaccinated child, since there is a risk of developing vaccine-associated polio.
Is insulation necessary
Many parents are outraged that their unvaccinated child was suspended from visiting a kindergarten or transferred to another group, as one of the children was vaccinated with AFP. Since the reaction to a live polio vaccine in an unvaccinated child can be serious, the heads of childcare facilities are reinsured and try to isolate such children. It depends on the conditions of the institution. Typically, the problem occurs in kindergartens, camps, hospitals, where children are in close contact. Parents of an unvaccinated child are offered to visit another group or sit at home for 2 months.
There is ongoing debate about whether this is worth doing. Doctors believe it is definitely worth it. Even if the risk of getting infected is very small - about 1 child out of 14 million contacts gets sick - he still is. And if you stop isolating such children, the number of cases of vaccine-associated polio will increase, and it will begin to spread among other children.
In what cases is infection possible?
There is still debate whether contact between unvaccinated children and those who have been given OPV is dangerous. Some doctors believe that the risk is minimal, so it makes no sense to introduce some prohibitions and restrictions. Such children can become infected from the vaccinated child:
- not vaccinated against polio even once;
- vaccinated less than three times;
- vaccinated with violation of the terms of vaccination;
- with immunodeficiency;
- if personal hygiene is not observed.
Moreover, several of these conditions must be observed. Therefore, vaccine-associated polio is found mainly in orphanages, orphanages, hospitals, where children are weakened and are in close contact with each other.
Live polio vaccine and unvaccinated child: reviews
Many parents who choose not to vaccinate their children are outraged that their rights are being infringed. Lack of vaccinations can also be forced due to weak immunity in the child. And because of the order of Rospotrebnadzor to separate unvaccinated children and those who have received AFP vaccination, there have been cases when a child is forbidden to attend kindergarten. There are many reviews on forums where parents describe such situations. In most children's institutions there are no conditions for a separate stay of an unvaccinated child, there are no premises, educators. Therefore, he is simply forbidden to attend DOW. But if parents know their rights, they can protest, since it is illegal. There are still disputes about who needs to be isolated: an unvaccinated child, or someone who has been vaccinated, because it just becomes dangerous for others. There is no consensus on this matter, so in each case, you need to calmly try to find a solution acceptable to everyone.