According to WHO, pneumococci most often become causative agents of bacterial infections in humans. Today, statistics are such that this microorganism causes death for 1.2 million people during the year. Of this number, more than 40% are children under 5 years of age. Of the so-called community-acquired pneumonia, the number of which in Russia reaches one and a half million a year, up to 75% of cases of adult diseases are initiated by these microorganisms - pneumococci. As for children in the age group up to 5 years, here the percentage of participation in this process of pneumococci reaches 90.
All children suffer from otitis media with varying degrees of severity. About 30-35% of all cases of the development of acute otitis media in young patients are initiated by pneumococci. These diseases are characterized by a special degree of severity, occur with a high probability of perforation of the eardrum. Often you can hear from experts about the development of orthogenic intracranial complications, to get rid of which it is often necessary to carry out tympanostomy. The process is a surgical intervention to sanitize the middle ear cavity and restore the position of the bones of the middle ear.
Vaccination against pneumococcal infection in adults and children can significantly improve the incidence of this initiator.
Pneumococcal infection: who is who?
Pneumococcus is one of the components of the normal microflora of the upper respiratory organs in a healthy person. Up to 70% of the total population are carriers of one or more species of this microorganism. Among children, the level of this “neighborhood” is higher than among adults. The maximum level of carriage among those who live, work and grow in collectives (preschool and educational institutions, work collectives, etc.).
This microorganism has a polysaccharide capsule in its composition, which is able to suppress the development of immunity in children under the age of 2 years. Today, science is aware of the existence of 84 subtypes of pneumococcus. With the development of the era of antibiotics, from a fairly harmless microbe, pneumococcus has turned into a fairly aggressive microorganism that is resistant to the bulk of traditional antibacterial medicines. The level of resistance to penicillin today is about 50%, to levomycetin and tetracycline - 30%. Since the penicillin group of antibiotics is wide enough, all of them will not be effective when infected with an organism such as pneumococcus. Vaccination in such cases is the only opportunity to win with the least loss in the fight against this microorganism. It is worth mentioning that the disease, as a rule, develops quickly enough (usually no more than 3 days), and there is no time to conduct studies on determining the degree of sensitivity to certain types of antibiotics.
Currently, the issue of pneumococcus resistance to antibiotics is becoming increasingly important, becoming an increasingly important problem.
What vaccines are used?
Currently, Russia uses two types of vaccines for the implementation of such a procedure as vaccination against pneumococcal infection: polysaccharide and protein-conjugated formulations.
Of the first group (polysaccharide), the most known vaccine is Pneumo-23 (sanofipaster). The solution is a mixture of 23 purified polysaccharides from a similar number of pneumococcal serotypes. This group of serotypes can be reliably attributed to 90% of blood strains and the vast majority of strains identified in Russia. Now at the registration stage is another similar vaccine - Pnevmovaks-23.
Of the type of conjugated vaccines in Russia, it has been officially registered and is currently being used Prevenar-7. The seven serotypes that make up it comprise 87% of pneumococcal isolates from children from the United States and some other countries. Due to the fact that the serotypic pattern in the USA and Russia is almost the same, it can be assumed that Prevenar-7 will also be effective in the Russian Federation, as well as in the USA.
Age framework for pneumococcal vaccination
"Pneumo-23" for vaccination is administered once, subcutaneously or intramuscularly. You can be vaccinated starting at the age of 2, the dosage is 0.5 ml. You can re-vaccinate no earlier than 3 years after the previous injection.
Vaccination against pneumococcal infection in children using Prevenar-7 is possible from 2 months of age. Vaccination is carried out in parallel with DTP (in 3 stages). Revaccination can be carried out for a child aged 1.5 years. However, this type of vaccine has several more vaccination scenarios. There is information about the effectiveness of vaccination in 2 stages (during the 2nd half of the year) followed by revaccination. Schemes with vaccination in 2 stages during the second year of life, and once during a period of 2 to 5 years are also possible.
Polysaccharide Vaccine Protection Level
High efficiency in the prevention of pneumonia was shown by vaccination against pneumococcal infection. Testimonials from statistical agencies suggest 80 percent protection. Epidemiologists recommend vaccination using “Pneumo-23” for people aged 18 to 21 years in large organizations and groups (for example, in army units). After a certain time period (from 2 months to 5) after vaccination, one can expect a decrease in the incidence of acute respiratory infections by more than 2 times, bronchitis - up to 13 times, pneumonia - not less than 6 times. With complicated pneumonia, meningitis, and other forms of pneumococcal infection of a bacterial nature, the percentage of effectiveness ranges from 56 to 81.
The age of the vaccinees affects the level of effectiveness of a procedure such as vaccination against pneumococcus. In the age group up to 55 years, this indicator amounted to 93%, from 55 to 64 years, the effectiveness decreased to 88%. The level of protection against pneumococcus from the age of 65 to 74 is 80%, and over 75 years of age is 67%.
For patients suffering from cardiovascular and bronchopulmonary diseases, the level of protection using polysaccharide vaccines (in particular, “Pneumo-23”) is approximately 69% (as in healthy people). Such vaccines are shown to be highly effective when used in children's groups. Good performance shows "Pneumo-23" in combination with influenza vaccines.
Regarding another vaccine registered in Russia - Pnevmovaks-23 - we can say that its effectiveness for people with diabetes is 84%, with ischemia - 73%. For patients with heart failure, this percentage is 69, with problem lungs and asthma - 65. For people in the age group over 65, the effectiveness of the drug tends to 75%.
Conjugate Vaccine Protection Level
Using a conjugate vaccine, pneumococcal vaccination in children has shown a high degree of effectiveness. Not only the number of hospitalizations of children with pneumonia of any origin significantly decreased, but also the frequency of outpatient visits to the doctor. The incidence of pneumococcal meningitis is noticeably improving.
Pneumococci are quite resistant to penicillin. "Prevenar-23" is able to protect people from strains with intermediate and high resistance by 80-100%. In addition, this vaccine is highly effective combined with influenza.
According to the World Health Organization, the use of this conjugate vaccine for a procedure such as vaccination against pneumococcal infection in children (everyone living in 72 developing countries of the world) can prevent up to 407 thousand deaths annually.
Possible vaccination reactions
Specialists allow vaccination against pneumococcal infection at any time of the year and combine with any other vaccines (an exception is made only for BCG). On the introduction of both types of pneumococcal vaccines, certain reactions from the human body are possible. On "Pneumo-23" in individual patients, a local reaction may appear in the form of redness, soreness. The intensity of the reaction is usually weak and can last up to 48 hours. Inoculation from pneumococcus to a child (reviews of health care providers and parents agree on this issue) in some cases (not often) can cause a rash and pain in the joints.
There are cases when patients with thrombocytopenic purpura (in the calm phase) after a period of 2 to 14 days have developed relapses that last up to 2 weeks. Very rarely can one hear about anaphylactic conditions.
The Prevenar vaccine is characterized by good child tolerance. Such a vaccination against pneumococcal infection complications (we are talking about any serious problems), as a rule, does not cause. However, local reactions quite often appear in the form of irritability, sleep disturbances, localized redness and swelling, an increase in body temperature up to 38 ° C. In a small number of children (about 5%), the temperature can rise above 39 ° C.
Are there any contraindications for pneumococcal vaccination?
There are no general or special contraindications for vaccination for any of the vaccines, except perhaps the reaction to the pneumococcal infection in the previous time. There are separate recommendations of immunologists on the use of "Pneumo-23" at least 10 days before the course of immunosuppressive therapy begins . Failure to follow these instructions may induce a decrease in antibody levels.
Vaccination of pregnant women is allowed by medical workers only in the last trimester. However, it is recommended that you abstain from this procedure without emergency.
The incidence of pneumococcal infection: a risk group
Refusal of such a procedure as vaccination against pneumococcal infection? complications for certain groups of people can provoke greater than its implementation. Experts recommend that people over 65 years old are required to be vaccinated. In a number of developed countries, vaccination of this age group is elevated to the rank of mandatory procedure.
Weakened, often sick and hospitalized people with diabetes mellitus, chronic forms of bronchitis, insufficiency in the field of cardiac and respiratory activity, and liver function should be vaccinated against pneumococcus.
Vaccination against pneumococcus is necessary (reviews of health workers are evidence of this) to people with a weakened immune system. Here, at risk are patients who underwent surgery for removal of the spleen, suffering from nephrotic syndrome, sickle cell anemia. Also in this group include people who have leakage of cerebrospinal fluid.
Well, of course, do not forget about the growing generation. It is recommended to vaccinate often ill children (including those infected with tuberculosis) who enter large groups (nurseries, kindergartens, schools). From the age of 2, pediatricians are advised to vaccinate small patients suffering from cerebrospinal fluid, asplenia, insufficiency of complement components who underwent cochlear implantation.
Vaccination against pneumococcal infection in children can significantly reduce the incidence of morbidity and reduce mortality from this formidable microorganism.
Opinion of medical workers, patients, parents
The opinion of pediatric doctors, medical workers in many other areas of medicine on this issue is unambiguous - vaccination against pneumococcal infection (reviews about which by ordinary people are quite ambiguous) is mandatory. Doctors consider this method of protection the most effective in combating the mass of diseases of various etymologies. After all, it is always easier and less costly to prevent the development of the disease than to take medicines later (not one, but, as a rule, several and not the most harmless ones) to cope with the infection itself and its consequences and complications.
Among parents, persistent pediatrician recommendations for pneumococcal vaccination do not always resonate. A simple person, not a doctor, thanks to the media “knows for sure” that there are too many strains of pneumococcus, and whether the vaccine recommended by the doctor will protect the child is a big question. Although the vast majority of parents are still inclined to listen to the opinion of a specialist and get vaccinated.
From time to time you can hear that the vaccine against pneumococcal infection, the complications of which was the increase in temperature, was not effective - the child still got sick. In such cases, it is worth paying attention to the intensity of the disease. If the child was coughing, he had a temperature of up to 38 degrees, and he was sick for 7 days - this is understandable. And without vaccination, the consequences could be much worse: bronchitis, pneumonia, hospitalization, many not the easiest drugs and at least 21 days of treatment.
Summarizing
Pneumococcal infection leads the world in the development of acute respiratory infections, bronchopulmonary diseases, etc. And today, in the modern high-tech age, mortality from this microorganism is quite high. Therefore, from the side of the parents, a vaccine against pneumococcus for a child (reviews are not the information that should be followed in such cases) is an opportunity to protect your child, to prevent the development of serious diseases under far-fetched pretexts that do not have any evidence base.