The prospect of vaccine prevention of pneumococcal infection: a modern view of the problem

Vaccination against pneumococcal infection

Eight out of ten people with pneumonia and one in three who have had meningitis are victims of this infection. Streptococcus pneumonia is the name in Latin for the culprit of the most serious illnesses that have already ended tragically for one and a half million inhabitants of the Earth.

Rapidly spreading through the bloodstream throughout the body, pneumococcal infection affects not only the lung tissue, but also other vital organs:

• Brain – with further development of purulent meningitis.
• ENT organs - with the development of otitis, sinusitis, pharyngitis, tonsillitis.
• The intestines, where peritonitis occurs under its influence.
• Heart – with endocardial damage.
• Hematopoietic system – with the occurrence of sepsis

How does infection occur?

Pneumococcus can be contracted from people who are already sick and from bacteria carriers who themselves are healthy, but shed the infection through their breath or when they sneeze. In them, the infection nests in the nasopharynx, but the barrier organs do not allow it to go down to the lungs. Nasal mucus, saliva, ciliated cells of the respiratory organs and the secretion they produce, which helps cleanse the mucous membranes of pathogenic organisms, also prevent its reproduction and spread.

This system is sometimes disrupted by the influence of external and internal factors:

• Hypothermia
• Overwork
• Mental stress
• Lack of vitamins

Together or separately, they weaken the immune system and the next attack of pneumococcal infection ends in illness.

Who especially needs vaccination

Pneumonia caused by Streptococcus pneumonia knows where to aim for sure: preschool children and elderly people who have crossed the sixty-year mark most often become its prey.

Children with the following diseases must be vaccinated:

• Chronic pathologies of the heart and kidneys
• Sickle cell anemia
• Immunodeficiency conditions

Adults (elderly) are highly recommended to get vaccinated for any chronic diseases that can suppress the immune system:

• Diabetes mellitus
• Blood diseases
• Liver diseases
• HIV-infected

In Russia, every year up to 70 thousand children fall ill with pneumococcal pneumonia.

Approximately another 2.5 million go to the doctor with symptoms of otitis media, an extremely unpleasant infectious disease that is fraught with dangerous complications, including the development of complete deafness. Even for such a large country as Russia, these are very serious numbers.

The best and easiest way to protect a child or elderly family member is to get vaccinated against pneumococcal infection, which is available at any clinic.

It is also necessary for those who have undergone surgery to remove the spleen, an important hematopoietic organ that also performs a protective function in the body.

Vaccination against pneumococcal infection is mandatory for children raised in orphanages and for elderly people living in nursing homes. This is due to the crowded living conditions and the high likelihood of outbreaks of lobar pneumonia if one person suddenly falls ill.

Benefits of vaccination

• Studies show that, subject to mass vaccination campaigns, the incidence of lobar pneumonia, purulent meningitis and other variants of pneumococcal infection decreases by six times.
• Vaccinated children and adults are less likely to get sick with other forms of respiratory diseases - influenza, ARVI, bronchitis. The number of otitis media, sinusitis and sore throats is significantly reduced.
• Even if pneumococcal infection does occur, the disease is much milder and never ends in death, and the treatment time is significantly shortened. In addition, there is no need to use strong and expensive drugs in therapeutic regimens.
• A dose of the vaccine is very expensive and buying it yourself is ruinous for the family budget. The state covers all costs and provides the opportunity to get vaccinated for free - so why miss it and put yourself at risk of getting seriously ill?

When to vaccinate

The first pneumococcal vaccination is recommended in infancy - it is prescribed when the baby is two to three months old, after which he receives two more injections at an interval of 1.5 months. Then revaccination at one and a half years of age is highly desirable.

It is also recommended that older people be vaccinated when they reach 60 years of age. Vaccination for adults is carried out once.

What about younger people? They also have a risk of contracting pneumonia - especially if they work in hospitals, educational institutions, retail establishments and transport. Vaccination against pneumococcal infection will provide reliable protection against a serious and dangerous disease, so if your profession involves people, it is better to find time to get vaccinated.

How to prepare for vaccination

If an adult or child is to be vaccinated against pneumococcus, then a number of important conditions must be met that will help avoid complications in the future.

1. At the time of vaccination, a healthy child or adult should not have any signs of a cold - cough, runny nose or fever. To know this for sure, it is better to take basic clinical blood and urine tests.
2. Chronic diseases must be treated before vaccination in order to achieve stable remission.

Vaccination against pneumococcal infection in children should be carried out only on the day of a healthy child - contacts with sick children waiting their turn in the clinic corridors can lead to infection with other infections, which will certainly make themselves known in a few days and will look like complications after receiving the vaccination.

Contraindications

You can get the pneumococcal vaccine without fear for your own health. The vaccines used for this are of high quality and have only standard contraindications:

• Intolerance to the components of the grafting material.
• A previously noted allergy to the same vaccination, if it is already time for revaccination.
• The first two trimesters of pregnancy, unless specifically recommended by a doctor.
• Respiratory diseases at the time of vaccination.
• Exacerbation of chronic pathologies.
• Feverish conditions of any origin.

Possible side effects

After vaccination against pneumococcal infection, most children and adults usually do not experience any significant side effects, but doctors warn about possible ailments that may appear in the first 12-24 hours after vaccination:

• Short-term rise in temperature.
• Reactions at the injection site - redness, soreness, mild itching.
• The general picture of the malaise is weakness, drowsiness or, conversely, insomnia

All these symptoms disappear within a day at most. If they appear two or three days after the pneumococcal vaccination, then we can say with confidence: the vaccine is definitely not to blame. Obviously, on the day of vaccination, the child or adult already had a slight cold, and a small dose of the drug only accelerated the disease - the same ARVI or flu.

This is why doctors especially insist on examination before any vaccinations: firstly, so as not to provoke the onset of another infectious disease, and secondly, so as not to discredit the very idea of ​​vaccination.

After vaccination

How to behave after vaccination? Here are some recommendations:

• Rest more on the first day.
• If the temperature rises above 38, take an antipyretic.
• Do not treat the injection site with anything.
• It is quite possible to wash a baby or an adult: water has no effect on the skin around the vaccination

You will definitely need to see a doctor if the temperature persists or, even worse, increases for more than a day, and swelling of more than five centimeters, thickening and discharge appear at the injection site.

Based on materials from the site pro-privivku.ru

Vaccination can be done in all departments of the Toksovskaya MB.

Vaccination against pneumococcal infection in 2021

Immunization schedule for pneumococcal infection

All developed countries have adopted a unified vaccination scheme for children under two years of age, which is also recommended to be followed in the Russian Federation:

• two-stage vaccination at 2 and 4.5 months;
• revaccination at 15 months.

According to the Moscow Vaccination Calendar, this vaccination only needs to be done once - at the age of two years. However, due to the strong susceptibility of younger children to the disease, specialists at the Gorbakov Clinic strongly recommend completing the full course according to the scheme accepted throughout the world.

Contraindications

For pneumococcal conjugate vaccines: increased sensitivity to previous vaccination (severe generalized allergic reactions); hypersensitivity to diphtheria toxoid and/or excipients; acute infectious or non-infectious diseases, exacerbations of chronic diseases. Vaccinations against pneumococcal infection are carried out after recovery or during remission. Pneumococcal polysaccharide vaccines: pronounced reaction to the previous vaccination, PPV23 vaccination less than 3 years before the intended PPV23 vaccination.

There are 4 vaccines registered in our country:

• Prevenar (Pfizer, USA/UK) – contains a mixture of purified capsular polysaccharides of 7 serotypes of Streptococcus pneumoniae, individually conjugated to a diphtheria carrier protein, used in children from 2 months to 5 years.
• Prevenar 13 (Pfizer, USA/UK) – the vaccine contains a mixture of purified capsular polysaccharides of pneumococcus 13 serotypes.
• Pneumo 23 (Sanofri Pasteur, France) – contains a mixture of purified capsular polysaccharides of 23 serotypes of pneumococcus, used in children over 2 years old, administered once in frequently ill children, as well as in children with severe oncological and hematological diseases.

The following vaccination schedule with Prevenar vaccines is recommended: if vaccination begins after 6 months, the vaccine is administered 3 times (two injections in the 1st year of life with an interval of 1 month, the 3rd injection in the 2nd year of life). If the vaccine is administered in the 2nd year of life in the period from 12 to 15 months, it is recommended to administer it twice with an interval of 2 months; when vaccinated after 2 years, it is administered once intramuscularly into the shoulder.

Currently, the vaccine Synflorix (Glaxo Smith Klein Biologicals) is being registered - a mixture of purified capsular polysaccharides of 10 serotypes of pneumococcus.

All children from 1-2 years of age to 5 years are subject to vaccination against pneumococcal infection; it is especially important for frequently ill children and elderly people over 55 years of age.

Principles and purposes of vaccination

Pneumococcal disease is one of the leading causes of morbidity and mortality worldwide. Serious diseases often caused by pneumococci include pneumonia, meningitis, and bacteremia with fever. In 2005, WHO estimated that 1.6 million people die each year from pneumococcal disease. Therefore it must be prevented.

By the end of 2013, pneumococcal vaccination had been introduced in 103 countries, and immunization coverage had reached 25%. By order of the Ministry of Health of the Russian Federation No. 125 of March 21, 2014, vaccination against pneumococcal infection was introduced into the National Calendar of Preventive Vaccinations of the Russian Federation.

PREVENAR-13

Basic information about vaccination:

• Inactivated
• Country of origin: USA

Protects against infections caused by 13 serotypes of pneumococcus (Streptococcus pneumoniae 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F and 23F) - pneumonia, bronchitis, meningitis, sepsis, otitis, etc. .

Who is recommended for vaccination?

Adults and children from 2 months - for the purpose of prevention.

Particular attention should be paid to people with an increased risk of developing pneumococcal infections:

• with immunodeficiency - incl. HIV, oncology;
• those suffering from chronic diseases of the lungs, heart and blood vessels, liver, kidneys;
• patients with diabetes mellitus;
• patients with bronchial asthma;
• infected with tuberculosis;
• premature babies;
• those who are in a group - in an orphanage, boarding school, army, etc.;
• frequently ill children;
• smokers;
• people over 50 years old
• and in other more special cases..

Contraindications to vaccination Prevenar 13

1. History of hypersensitivity to Prevenar13/Prevenar vaccination.
2. Hypersensitivity to diphtheria toxoid and excipients.
3. Diseases in the acute stage, chronic diseases in exacerbation.

How many times do you need to be vaccinated to develop immunity?

Children 2 - 6 months

: 3 vaccinations with an interval of 4 weeks, revaccination - at 11-15 months
Children 7 - 11 months
: 2 vaccinations with an interval of 4 weeks, revaccination - at 11-15 months
Children 1 - 2 years
: 2 vaccinations with an interval of 8 weeks
Children over 2 years old and adults
- once.

Risk groups for the incidence of pneumococcal infection:

• persons 55 years of age and older;
• children and adults with chronic diseases;
• “organized” contingents (children attending kindergartens, schools, military personnel, residents of nursing homes).

Streptococcus pneumoniae is a representative of the normal microflora of the human upper respiratory tract. Normally, 5 to 70% of people are carriers of one or more types of pneumococci. “Organized” (living or being in groups) children and adults have the highest level of carriage. To date, more than 90 different serotypes (immunological variants) of pneumococci have been identified. All of them are potentially pathogenic, but about two dozen of them cause severe infections.

In response to the use of antibiotics, pneumococci have developed resistance to many of them. Thus, in countries with widespread use of antibiotics, the level of resistance of pneumococci to penicillin is up to 50% of all isolated pneumococci, and to tetracycline and chloramphenicol - about 30%. In addition, due to the rapid development of the disease (2-3 days), there is no time for special Determination of sensitivity to antibiotics is usually not available. Patients with severe infections often die despite the use of standard antibacterial drugs.

In Russia, vaccination against pneumococcal infection began in 2008, it was a 7-valent vaccine (Prevenar). It is included in the national vaccination calendars of most developed countries and is recommended by WHO for use in all countries of the world. In the USA, it was used in 2000; during the first 5 years, the frequency of severe forms of infection in children under 4 years of age was reduced by 40 times. At the same time, in unvaccinated children aged 5-15 years and adults, the frequency of infections caused by this pathogen significantly decreased. According to American scientists, due to a decrease in the number of pneumococcal carriers, mass vaccination with this vaccine has led to a 2-fold decrease in visits for otitis of any etiology.

Due to the fact that the effectiveness of the vaccine against complicated pneumonia was not so significant, scientists developed a new 13-valent vaccine containing additional strains of pneumococcus, “guilty” of the development of complications of pneumonia.

This vaccine most widely covers the spectrum of pathogens that cause life-threatening diseases such as bacteremia, sepsis, meningitis, pneumonia, acute otitis media and other diseases.