The optimal interval between vaccinations - how long should it take?

In the Russian Federation there is a National Vaccination Calendar, according to which children and adults are vaccinated. Deviation from the deadlines recommended by the regulatory document is possible only in certain (justified) situations. The calendar contains information regarding the types of vaccines used, doses of immunotherapy drugs, the age at which they are given, as well as the interval between vaccinations that should be observed.

The importance of observing breaks between vaccinations

At the time of primary vaccination, special antigens are introduced into the body, which stimulate the production of antibodies . Depending on the type of vaccination, they may provide reliable protection for a certain period, such as several months or years.

The easiest way to consider the need to comply with vaccination intervals is to use DPT as an example. After the first injection, antibodies are produced, the maximum amount of which is observed after 2-3 weeks. Then their volume gradually decreases.

Repeated vaccination 45 days after the first one again stimulates the body’s protective functions, contributing to the formation of an adequate response. In the case of DTP, three injections and one revaccination are required to develop full immunity against whooping cough, diphtheria and tetanus.

What happens if you violate the recommended deadlines? If you do not maintain the interval and introduce immune drugs earlier, the already formed antibodies will be practically neutralized. This means that the effectiveness of vaccination will be reduced to zero, in addition, there is a high risk of harm to health (serious side effects may develop).

If, on the contrary, the period is increased, this will not in any way affect the strength of protection against infectious diseases - in such a situation, only the immune layer is reduced.

If we talk about the interval between different drugs, then the explanation is even simpler - vaccination seriously loads the body, so taking breaks gives it the opportunity to recover. This takes about a month.

The recommended intervals between vaccinations are scientifically based - before the introduction of any vaccine, it is tested for more than one year.

What reasons may cause a violation of the standard interval between vaccinations?

There are much fewer cases when the window between drug administration is shortened compared to those situations when the interval needs to be increased. There may be several reasons for adjusting the schedule:

• presence of contraindications at the time of routine vaccination. This could be an illness or allergy (most often in children);
• lack of vaccine;
• changing the immunization schedule.

Violation of the vaccination schedule without indications creates a health hazard and minimizes the effectiveness of the entire immunization process.

Is it possible to reduce the minimum interval

In Russia, unlike the United States, there is no regulatory document regulating the question of whether it is possible to reduce the minimum recommended interval between vaccinations. Abroad, it is allowed to introduce the vaccine three days earlier. In Russia, such decisions are made by the attending physician.

What to do if the vaccine administration is overdue

All vaccines must be administered within the time limits indicated on the calendar. Otherwise, their immunogenicity is reduced.

If the immunization schedule is not followed, a catch-up vaccination schedule is drawn up. Different drugs require separate approaches:

• resumption of use from the point where it was stopped;
• reducing the number of doses due to increasing age;
• dose reduction;
• decreasing intervals.

What are the dangers of too long a gap?

Too much time between vaccinations makes them ineffective. If, for example, the schedule for administering DTP is violated (the second injection is given not after 45 days, but later), then the immunization process stops. To resume it, you will need to start giving injections again, observing the required intervals.

Every person should be immunized. For it to be effective, it is necessary to be vaccinated according to the national vaccination calendar, except in situations where there are contraindications. Otherwise, a catch-up vaccination schedule is drawn up. This should be done by an immunologist.

Minimum interval between vaccinations in children

According to the official recommendations of the Ministry of Health of the Russian Federation, the minimum interval between two doses of the same vaccine should not be less than 1 month.

BCG vaccine

It is allowed to simultaneously administer different vaccines (except BCG) used within the framework of the National Preventive Vaccination Calendar on the same day using separate syringes in different parts of the body.

The optimal interval between the administration of vaccines against different infections

The standard regimen involves maintaining a one-month interval between the use of “live” and inactivated vaccines. The exception is the rabies vaccination, which is given regardless of the presence of contraindications and drugs introduced into the body.

Inactivated vaccinations can be given together, either in accordance with the National calendar or according to an individual schedule.

Official recommendations for vaccination:

1. Vaccination against tuberculosis should be carried out separately from others, with an interval of one month. An exception is made only for hepatitis B vaccination, which is given in maternity hospitals 1-2 days before BCG. Conducted studies prove that the production of antibodies is not impaired, cases of negative side reactions are rare;
2. DTP can be combined with other vaccinations; the practice of using six-component vaccines, including antigens for 6 infections at once, is widespread abroad: diphtheria, tetanus, whooping cough, hepatitis B, Haemophilus influenzae, polio;
3. “live” vaccines that require a monthly interval include: tuberculosis, measles, rubella, mumps, OPV, yellow fever, typhoid fever, chicken pox, influenza (practically not used now), as well as some others.

The simultaneous use of a large number of antigens seriously loads the immune system. However, this is justified in a number of cases: a child has missed many vaccinations at once, an unfavorable epidemiological situation has developed in the region, a woman is planning a pregnancy, a person is preparing to travel abroad, etc.

Standard vaccination schedule

Vaccination of a child against viruses begins from the first day of life. But it is performed at certain intervals. Below is a standard vaccination schedule:

• the first day after birth – HBV-1;
• on days 3-4 - BCG (BCG-M);
• 1 month – HBV-2;
• 3 month – DPT-1, IPV-1 (OPV-1);
• 4 month – DPT-2, OPV-2;
• 5 month – DTP-3, OPV-3, VGV-3;
• 1 year – trivaccine (or LCV, LPV, rubella vaccination);
• 1.5 years – DTP-4, OPV-4;
• 2 years – OPV-5;
• 6 years - ADS, trivaccine (or LIV, LPV, rubella vaccination);
• 7 years – OPV-6, BCG (BCG-M);
• 11 years old – AD-M;
• 13 years old - HBV;
• 16 years (and then every decade until the age of 60) - ADS-M (AD-M, AS).

Vaccine abbreviations and notes:

• HBV – hepatitis B;
• BCG - tuberculosis;
• BCG-M – tuberculosis with a lower content of antigens;
• DTP - whooping cough, diphtheria, tetanus;
• DDS – diphtheria, tetanus;
• ADS-M – diphtheria, tetanus with reduced antigen content;
• AD-M – diphtheria, virus dosage reduced;
• AS – tetanus toxoids;
• OPV – polio (live virus);
• IPV – polio (dead virus);
• LMV – live measles virus;
• LPV – live mumps virus;
• triple vaccine: measles, rubella, mumps.

It should be noted that preventive vaccination should be carried out according to the deadlines established in the schedule (approved by the Ministry of Health). If for some reason the deadlines are violated, it is allowed to administer several drugs into different areas of the body and only with separate syringes. If the deadlines are not violated, then the minimum interval between vaccinations is 30 days.

How much time should pass between the vaccination and the administration of immunoglobulin?

If it is necessary to simultaneously administer vaccinations and immunoglobulin, their greatest “interaction” is observed when using “live” vaccines - inactivated drugs and toxoids have little effect on each other, so their simultaneous use is permissible.

In the case of “live” vaccines, it is permissible to reduce the interval between vaccination and administration of immunoglobulin to two weeks, but this is only possible in the event of a situation threatening life and health.

Improper vaccination schedules: what are the consequences of too long a gap between injections?

In the overwhelming majority of cases, missed vaccination dates occur for good reasons, that is, due to the child’s illness.
Parents are worried about whether failure to adhere to the schedule threatens to reduce the effectiveness of immunization, whether they need to give a second injection if a lot of time has passed, etc.

Experts say that despite a slight decrease in the quality of the immune response, the body will still receive the necessary protection.

In addition, the child does not need to receive additional vaccinations, even if the deadlines are greatly exceeded. Typically, such children are vaccinated according to an individual schedule. But it should not be compiled by parents, but by a specialist.

It’s good if they have a competent immunologist who, if there is any doubt, will prescribe a special serological test to detect antibodies to a particular virus in the child’s blood.

In what cases should vaccination not be carried out?

• Acute febrile condition, for example, with ARVI. As soon as the temperature drops, you can wait 3-4 days and get vaccinated. A runny nose and cough without fever are not a contraindication to vaccination!
• Seizures (children with epilepsy who do not show seizures on medications can be vaccinated).
• Exacerbation of chronic diseases. At the same time, atopic dermatitis, anemia, benign neutropenia of childhood and other asymptomatic or easily removable conditions are not contraindications.
• Severe reaction to a previous administration of the same vaccine. At the same time, a vaccine against a specific infection can and should be replaced with an analogue.
• There is one more contraindication for live vaccines: immunodeficiency - primary (congenital), HIV infection or resulting from treatment with hormones or chemotherapy. All these conditions cannot be “accidentally overlooked.”
• It is important that vaccination should not be delayed due to “incorrect” test results. Moreover, the requirement to take tests before vaccination is unlawful, and you can refuse to do so.