Havrix vaccine against hepatitis A for children syringes 0.5 ml

Vaccine options

There are several hepatitis A vaccines available on the international market. They are all similar in terms of how well they protect people from the virus and the side effects.
There are no licensed vaccines for children under one year of age. The following vaccines are used in Russia: Avaxim, Avaxim 80, Vakta, GEP-A-in-VAK, Havrix 720, Havrix 1440. Mortality from hepatitis A ranges from 1% to 30%, with a clear increase in mortality with age, which is associated with an increased likelihood of infection layering on chronic liver disease.

Tips and tricks

Despite the frightening list of possible adverse reactions and complications from vaccines, the main thing to remember is that severe consequences are extremely rare and they know how to deal with them, and local and general reactions are not so frequent, mild and not dangerous to health.

However, for several days or weeks after vaccination (how long depends on the specific vaccine), you should carefully monitor your child's well-being:

• High fever for 3 or more days, shortness of breath, convulsions, frequent vomiting, severe headache and other noticeable and persistent deviations from normal health are a reason to call a doctor.
• The administration of a vaccine is always an additional burden on the body, sometimes quite significant, so in the first days after vaccination you should rest more and avoid noticeable physical and emotional stress.
• When the temperature rises above 38°, antipyretic drugs are used in combination with physical methods - cold compresses, wiping with a damp sponge. It is especially important to reduce the temperature in children prone to seizures and with hypertensive-hydrocephalic syndrome.
• Carefully monitor the condition of the body if a vaccinated child, especially a child, has a high risk of allergic reactions.
• During the first 2 weeks before and after vaccination, it is better to avoid foods that are obligate allergens: seafood, honey and chocolate, eggs, strawberries, raspberries, citrus fruits.
• In the first 7-10 days, try to avoid contact with other people to reduce the risk of colds. This is especially true for people with reduced immunity and chronic diseases.
• It is recommended to do a general urine test 3 to 4 weeks after vaccination to identify possible kidney complications: this is especially important for children with diseases of the urinary organs. The analysis will also allow timely detection of deviations and take the necessary measures.

Principles and purposes of vaccination

Hepatitis A infection does not cause chronic liver disease and is rarely fatal, but it can cause debilitating symptoms and fulminant hepatitis (acute liver failure), which is associated with high mortality and long recovery. Individual cases and epidemics of hepatitis A occur throughout the world and tend to be cyclical. There are an estimated 1.4 million cases of hepatitis A worldwide each year. In areas where the virus is widespread (high endemicity), the majority of hepatitis A infections occur among young children. The use of the vaccine provides long-term protection for children and people who did not have hepatitis A in childhood.

Whether or not a vaccine is included in routine childhood immunization depends on the local context, including the proportion of susceptible people in the population and the level of exposure to the virus. Some countries, including Argentina, Israel, China, Turkey and the United States, include this vaccine in routine childhood immunizations. Many countries use a two-dose schedule using inactivated hepatitis A vaccine, but other countries may include a single dose of inactivated hepatitis A vaccine in their immunization schedules. A.

In Russia, vaccination against this disease is carried out according to epidemic indications. For example, for persons living in regions disadvantaged by the incidence of hepatitis A, as well as persons at occupational risk of infection (medical workers, public service workers employed at food industry enterprises, as well as those servicing water supply and sewerage facilities, equipment and networks ). In addition, people traveling to disadvantaged countries (regions) where outbreaks of hepatitis A are registered are vaccinated.

Post-vaccination reactions

Post-vaccination reactions are a normal reaction of the body to the introduction of a vaccine. All of them are characterized by a short duration (usually 1-2 days, up to a maximum of 5), go away on their own without external intervention and, most importantly, do not cause any negative consequences for the body of the vaccinated person.

Specific reactions largely depend on the type of vaccine (for live vaccines they can be similar to symptoms of the disease), and they are usually divided into local and general.

Local reactions

These are reactions localized at the site of vaccine administration. The most typical:

• Redness and induration, swelling, hardening of lymph nodes
• Painful sensations
• Allergic rash

These are typical reactions to damage to the skin during an injection and the appearance of “strangers” in the body. But you need to be careful: if, for example, redness is more than 8 cm and swelling is more than 5 cm, you should consult a doctor. Painful sensations should go away within 1-3 days; if the pain is severe or interferes with sleep, you can give an anesthetic.

With repeated vaccination, local reactions occur more often: for example, for DTP - up to 50%, pneumococcal - up to 20%, for other vaccinations - from 5 to 15%. Of the live vaccines, local reactions are most often observed for BCG (for tuberculosis).

Sometimes vaccines are specially formulated to cause local reactions, which increases the body's immune response. For such vaccines (DTP, ADS, hepatitis A, B), local reactions are natural and should not cause concern.

Local reactions and their intensity are also influenced by the method of vaccine administration: it is better to do it intramuscularly, since the muscles are well supplied with blood - as a result, the vaccine is absorbed faster and the effectiveness of the vaccine increases.

You can find out more about local reactions in a separate article.

General reactions

Reactions that affect the body as a whole, but pass quickly and do not cause subsequent complications. The most typical of them:

• The most well-known is an increase in temperature: if it does not exceed 38-38.5 degrees and goes away within 2-3 days, there is nothing to worry about.
• General lethargy, discomfort, feeling of malaise, headache, dizziness, anxiety can last 2-3 days and are mild and do not interfere with usual activity.
• Sometimes there are short-term problems with sleep and even loss of appetite.
• Some components of vaccines can rarely cause allergic reactions, which manifest themselves as a rash.
• When using live vaccines, you may experience mild symptoms of the disease being vaccinated against: this is a normal reaction for this type of vaccine.

Normal reactions

Here are normal reactions to some vaccines, including those included in the national vaccination calendar:

• DTP - the injection site may hurt and there may be slight swelling, a short-term increase in temperature to subfebrile and even febrile levels for up to 3 days.
• BCG is a papule at the injection site that erodes and a scar remains in its place.
• Hepatitis B – possible pain at the injection site for no more than 3 days.
• OPV – without general reactions.
• Measles is a low-grade fever that may appear on days 7-12; it lasts no more than 3 days and does not require antipyretic medications. Measles rash is extremely rare.
• Rubella - after 6-14 days, cold symptoms may appear: low fever, sore throat, runny nose, but all this quickly passes without outside intervention.
• Mumps - pain at the injection site, a slight increase in temperature and mild malaise for 5-15 days.
• Chicken pox – within 3 weeks a small number of elements of chickenpox rash may appear, and a slight increase in temperature.
• Rotavirus infection - fever, vomiting and diarrhea, which quickly disappear.
• COVID-19 in most cases is mild or moderate in nature and is short-lived: fever, weakness, headache. muscle pain, chills, diarrhea, pain at the injection site. The likelihood of experiencing any of these side effects varies depending on the vaccine.

More severe and prolonged reactions are possible but are extremely rare. In addition, vaccines are constantly undergoing new tests. This is done to identify rare side effects.

The given list of possible side effects in no way claims to be complete or absolute truth: we just want to reassure parents whose children have been vaccinated.

Frequency of adverse reactions

The consequences of using known vaccines have been well studied, including the frequency of adverse reactions: they occur in no more than 10% of vaccinated people, and in 95% of cases the symptoms are so minor that they do not require visiting a doctor. The vaccine against rubella causes general reactions on average in 5% of cases, and against hepatitis B – 7% of local reactions.

As for possible complications, they occur much less frequently than adverse reactions: for most vaccines - 1 case per million or more vaccinations, and severe ones - even less often.

Timing of reactions

Adverse reactions to inactive vaccines usually appear early (within a few hours), but they are mild and pass quickly.

As a rule, side effects of vaccines appear within 4 weeks, and only after BCG side effects can be observed even after 14 weeks.

Reactions to a live measles vaccine cannot appear earlier than 4 days and later than 12-14 days, for polio and mumps vaccines - 30 days.

Vaccine effectiveness

After vaccination, immunity against the hepatitis A virus is formed in 95% of individuals within 2 weeks after the first injection and in 100% after the second dose of the vaccine. Even if exposed to the virus, one dose of the vaccine has a protective effect for two weeks after exposure to the virus. However, manufacturers recommend two doses of the vaccine to provide longer-lasting protection—for approximately 5 to 8 years after vaccination.

The introduction of the vaccine leads to the appearance of protective antibodies to the hepatitis A virus 15-28 days after vaccination. The concentration of antibodies after vaccination is slightly lower than during infection, but is sufficient for reliable protection against the disease. The resulting protective immunity lasts for at least a year after vaccination. When a second dose of the vaccine is administered (6-12 months after primary immunization), it is possible to prolong immunity to hepatitis A for up to 10 years. The repeatedly proven effectiveness of vaccination of the population against hepatitis A makes the task of completely eliminating this infection quite realistic.

Hepatitis A vaccination

The program is hosted by Alla Volokhina and Alexander Khaburgaev .

What types of hepatitis exist? Which ones can you be vaccinated against? Under what conditions should this be done? What are the side effects?

In touch with the studio is a hepatologist, head of a specialized scientific hepatological center Bella Leonidovna Lurie .

What types of hepatitis exist? And what types of hepatitis can you be vaccinated against?

B. Lurie: There are three main types of hepatitis. Hepatitis A, hepatitis B and hepatitis C.

What is “jaundice”?

B. Lurie: “Jaundice” is the color of all viral acute hepatitis. Hepatitis A, hepatitis B and hepatitis C in acute periods may be accompanied by “jaundice”.

Hepatitis A. The only way the hepatitis A virus can enter is through the mouth. This means: dirty hands; water that is contaminated with a virus; food that may be contaminated with viruses if prepared with dirty hands.

Unfortunately, a very common opinion regarding viral hepatitis A is that it goes away like the flu, that it is not a dangerous disease, that it never turns into cirrhosis. But the acute process itself can be very difficult, accompanied by high fever and, as it were, an intestinal infection.

Is this also called “Botkin’s disease”?

B. Lurie: Yes. “Botkin's disease ” is an acute viral hepatitis A, which is transmitted with dirty hands. This is relevant not only for Moscow, but also for any area. And at the resort this is very important. When a person is away from home, it means that he cannot wash his hands constantly, he does not control the food he eats in terms of what hands it was prepared with. Therefore, this is always a problem when traveling.

There are disinfectant wipes and disinfectant liquids. How do you feel about them?

B. Lurie: This is very wonderful. Wipe your hands with wet wipes, etc. But there are circumstances that depend not on your compliance or non-compliance with personal hygiene rules, but on other people who prepare food for you, supply water, etc. If, for example, something in a restaurant was done with dirty hands, you could get hurt. Therefore, the easiest way is to get vaccinated, although there is a slight attitude towards hepatitis A. Well, I got sick a little, and everything went away. The jaundice was there and went away, no traces remained.

Can the vaccination have any side effects that will ruin your vacation?

B. Lurie: Side effects from vaccination are very rare. We have done a large number of vaccinations over the past 17 years.

At what age can you start getting vaccinated against hepatitis A? And is it necessary to re-vaccinate?

B. Lurie: Children can be vaccinated. There is a childhood vaccination, there is a different dose. I would like to draw your attention to the fact that hepatitis A is a really serious disease, because, yes, it goes away, but it can cause severe autoimmune diseases, which will then have to be treated for the rest of your life. The virus will provoke them.

In addition, if there are already some concomitant other chronic liver diseases: for example, viral hepatitis B - chronic, sluggish, viral hepatitis C - chronic, sluggish, fatty liver disease (hepatosis) - a very common and dangerous disease, viral hepatitis A may provoke an aggravation of the process.

Is it harmful to get vaccinated against hepatitis?

B. Lurie: No, it’s not harmful. Vaccination must be done in any case. It works immediately and lasts for about 10 years. That is, vaccination is a solution to the problem for 10 years.

How long before leaving the country should you get vaccinated?

B. Lurie: Literally the next day the vaccine starts working. It’s better, of course, to do it in advance. But in principle, it can also be done urgently if someone has had contact with a patient with viral hepatitis. Jaundice does not appear immediately, it has an incubation period, it can appear three weeks after possible infection. And the person doesn’t see or know anything, but you had contact with him. It is during the incubation period that a given person is contagious, although he does not have “jaundice.” When “jaundice” appears, the patient is not very contagious. But when hepatitis A develops asymptomatically, a person feels absolutely healthy and looks good, but at that moment he can already become a source of infection with the hepatitis A virus.

What if a person doesn’t remember whether he was vaccinated against hepatitis before?

B. Lurie: This is not necessary to remember. We have a test that will show whether a person already has protective antibodies or not. It's very easy to make. Why should it be passed? Because sometimes viral hepatitis A occurs without “jaundice”. And the person thinks that he has some kind of viral respiratory disease, for example, the flu, or some kind of intestinal infection, but in fact the person at that moment is suffering from acute viral hepatitis A, which does not appear yellow.

Hepatitis B virus is a completely different virus. Hepatitis C virus is the third virus. They enter a person not through the mouth, but through the blood. For example, when visiting the dentist, during surgery or blood transfusion, during sexual intercourse. These diseases are very dangerous, one might say, deadly, because they become chronic and, over time, in the vast majority of cases turn into cirrhosis.

What about hepatitis B?

B. Lurie: Yes. But here it must be said that viral hepatitis B is currently an incurable disease . Medical science does not yet have any drugs to kill the virus. Therefore, the task of curing is not even worthwhile in the case of viral hepatitis B, the task is to survive, live your life without cirrhosis, live to an old age, give birth to children and do everything that a person planned to do, despite this virus.

It turns out that a person comes to the clinic and says that he needs to get vaccinated against hepatitis?

B. Lurie: You can get vaccinated against hepatitis A. There's nothing scary about it. It is necessary to get vaccinated against hepatitis B only if the virus has not existed, does not exist at the moment and there are no protective antibodies to it. For this purpose, a special examination is carried out. According to the law, which has existed all over the world for more than 30 years, and in Russia for exactly 20 years, everyone who was just born on the territory of Russia receives this vaccine. This means that for the first eight years of life a person is protected by law from hepatitis B. And children do not get viral hepatitis B if they did not receive it from their mother during pregnancy. And then the responsibility of parents begins. And this is where the problems begin. Because without the protection of a vaccine, it is very easy to get the hepatitis B virus. Any visit to the dentist can be very dangerous.

It turns out that hepatitis B is worse than hepatitis C, which everyone is so afraid of?

B. Lurie: As for who is more terrible, I don’t know what to say. Both hepatitis are dangerous because they can cause cirrhosis. But there is a treatment for viral hepatitis C. There are very good modern drugs, the same pills, that can cure hepatitis C if treatment is started on time, while there is no cirrhosis yet. The probability of recovery in this case is up to 99 percent. The goal of treatment is to remove the hepatitis C virus from the body.

For viral hepatitis B, sexual transmission is relevant . But this issue can be solved by vaccination . But there is no vaccine against hepatitis C. Therefore, knowing the conditions in which we live, and this situation is relevant for the whole world, you need to undergo examination from time to time to make sure that you do not have viral hepatitis B and there are no traces of the virus. You need to undergo a special examination to be vaccinated. And only after such an examination get vaccinated. Then you need to make sure that the body has produced protective antibodies in a certain amount. To conduct the study, you need to donate blood for three markers of viral hepatitis B. If a person wishes, he can simultaneously get vaccinated against viral hepatitis A and viral hepatitis B.

Do people feel any symptoms after vaccination?

B. Lurie: No. Most often, vaccination is asymptomatic. But antibodies are not produced immediately. Therefore, the vaccine is given in three doses over six months in order to obtain protection against viral hepatitis A. To obtain protection against viral hepatitis B, at least six months are required. Therefore, everyone who is at risk, who are in married couples in which one of the spouses has viral hepatitis and the other does not, needs to be tested to make sure that there is no virus and get vaccinated.

For those who are in a special risk group, an urgent scheme can be applied, when the vaccination is done not six months in advance, but three months in advance. Antibodies are produced quickly. True, they leave faster. But this is a less pressing question. They need to be formed as quickly as possible.

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