Signs of a local normal vaccination reaction to vaccination. Post-vaccination reactions and complications. Vaccine reactions and complications

– various persistent or severe health disorders that have developed as a result of preventive vaccination. Post-vaccination complications can be local (abscess at the injection site, purulent lymphadenitis, keloid scar, etc.) or general (anaphylactic shock, BCG infection, encephalitis, meningitis, sepsis, vaccine-associated polio, etc.). Diagnosis of post-vaccination complications is based on the analysis of clinical data and their connection with the recent vaccination. Treatment of post-vaccination complications should include etiotropic, pathogenetic and symptomatic general and local therapy.

General information

Post-vaccination complications – pathological conditions, having a causal relationship with preventive vaccination, disrupting the health and development of the child. Carrying out preventive vaccination in pediatrics is aimed at the formation of protective immunity, which does not allow the development of an infectious process when the child comes into repeated contact with the pathogen. In addition to individual type-specific immunity, mass vaccination of children pursues the goal of creating collective (population) immunity, designed to stop the circulation of the pathogen and the development of epidemics in society. For this purpose, Russia has adopted a National Calendar preventive vaccinations regulating the list, timing and procedure for mandatory and additional vaccination of children from birth to adulthood.

In some cases, a child experiences an unexpected, pathological response of the body to vaccination, which is regarded as a post-vaccination complication. The incidence of post-vaccination complications varies greatly depending on the type of vaccination, the vaccines used and their reactogenicity. According to the data available in the literature, the “leader” in the development of post-vaccination complications is vaccination against whooping cough, diphtheria and tetanus - the frequency of complications is 0.2-0.6 cases per 100 thousand vaccinated people. When vaccinated against polio, against measles, against mumps undesirable consequences occur in 1 or less cases per 1 million vaccinated people.

Causes of post-vaccination complications

The occurrence of post-vaccination complications may be associated with the reactogenicity of the drug, the individual characteristics of the child’s body, and iatrogenic factors (technical errors and errors during immunization).

The reactogenic properties of a particular vaccine, that is, the ability, when introduced into the body, to cause post-vaccination reactions and complications, depend on its components (bacterial toxins, preservatives, stabilizers, solvents, adjuvants, antibiotics, etc.); immunological activity of the drug; tropism of vaccine strains to body tissues; possible change (reversion) of the properties of the vaccine strain; contamination (contamination) of the vaccine with foreign substances. Different vaccines vary significantly in amount and severity adverse reactions; The most rectogenic of them are considered to be BCG and DTP vaccines, the least “heavy” are preparations for vaccinations against polio, against hepatitis B, against mumps, against rubella, etc.

Individual characteristics the child’s body, which determine the frequency and severity of post-vaccination complications, may include background pathology that worsens in the post-vaccination period; sensitization and changes in immune reactivity; genetic predisposition to allergic reactions, autoimmune pathology, convulsive syndrome, etc.

As practice shows, mistakes are a common cause of post-vaccination complications. medical personnel, violating the grafting technique. These may include subcutaneous (instead of intradermal) administration of the vaccine and vice versa, incorrect dilution and dosage of the drug, violation of asepsis and antisepsis during injection, erroneous use of other medicinal substances as solvents, etc.

Classification of post-vaccination complications

Pathological conditions accompanying the vaccination process include:

• intercurrent infections or chronic diseases, added or worsened in the post-vaccination period;
• vaccine reactions;
• post-vaccination complications.

Increased infectious morbidity in the post-vaccination period may be due to the coincidence of the disease and vaccination in time or to transient immunodeficiency developing after vaccination. During this period, the child may experience ARVI, obstructive bronchitis, pneumonia, urinary tract infections, etc.

Vaccine reactions include various unstable disorders that occur after vaccination, persist for a short time and do not interfere with the vital functions of the body. Post-vaccination reactions are of the same type clinical manifestations, usually do not disturb the general condition of the child and go away on their own.

Local vaccine reactions may include hyperemia, edema, infiltration at the injection site, etc. General vaccine reactions may be accompanied by fever, myalgia, catarrhal symptoms, measles-like rash (after vaccination against measles), increased salivary glands(after vaccination against mumps), lymphadenitis (after vaccination against rubella).

Post-vaccination complications are divided into specific (vaccine-associated diseases) and non-specific (excessively toxic, allergic, autoimmune, immune complex). Depending on the severity of the pathological process, post-vaccination complications are local and general.

Characteristics of post-vaccination complications

Excessive in strength toxic reactions are regarded as post-vaccination complications if they develop in the first three days after vaccination, are characterized by a pronounced disturbance in the child’s condition (temperature rise above 39.5°C, chills, lethargy, sleep disturbance, anorexia, possibly vomiting, nosebleeds, etc.) and persist within 1-3 days. Typically, such post-vaccination complications develop after the administration of DTP, Tetracoc, live measles vaccine, influenza split vaccines, etc. In some cases, hyperthermia may be accompanied by short-term febrile convulsions and hallucinatory syndrome.

Post-vaccination complications that occur in the form of allergic reactions are divided into local and general. The criteria for a local post-vaccination complication are hyperemia and swelling of tissues that extend beyond the area of ​​the nearest joint or to an area of ​​more than 1/2 of the anatomical zone at the site of vaccine administration, as well as hyperemia, swelling and pain that persist for more than 3 days, regardless of size. Most often, local allergic reactions develop after the administration of vaccines containing aluminum hydroxide sorbent (DTP, Tetrakok, anatoksins).

Among post-vaccination complications, there are also common allergic reactions: anaphylactic shock, urticaria, Quincke's edema, Lyell's syndrome, Stevens-Johnson syndrome, erythema multiforme exudative, manifestation and exacerbation of bronchial asthma and atopic dermatitis in children. Immunization can cause the initiation of immune complex post-vaccination complications - serum sickness, hemorrhagic vasculitis, periarteritis nodosa, glomerulonephritis, thrombocytopenic purpura, etc.

Post-vaccination complications with an autoimmune mechanism of development include lesions of the central and peripheral nervous system(post-vaccination encephalitis, encephalomyelitis, polyneuritis, Guillain-Barré syndrome), myocarditis, juvenile rheumatoid arthritis, autoimmune hemolytic anemia, systemic lupus erythematosus, dermatomyositis, scleroderma, etc.

A peculiar post-vaccination complication in children in the first six months of life is a shrill cry, which is persistent (from 3 to 5 hours) and monotonous. Typically, a high-pitched cry develops after the administration of pertussis vaccine and is caused by associated changes in microcirculation in the brain and acute attack intracranial hypertension.

The most severe post-vaccination complications in terms of their course and consequences are the so-called vaccine-associated diseases - paralytic poliomyelitis, meningitis, encephalitis, the clinical symptoms of which do not differ from those of diseases with a different mechanism of occurrence. Vaccine-associated encephalitis can develop after vaccination against measles, rubella, and DPT. The likelihood of developing vaccine-associated meningitis after receiving vaccination against mumps.

Post-vaccination complications after administration of the BCG vaccine include local lesions, persistent and disseminated BCG infection. Among the local complications, the most common are axillary and cervical lymphadenitis, superficial or deep ulcers, cold abscesses, and keloid scars. Among the disseminated forms of BCG infection, osteitis (ostitis, osteomyelitis), phlyctenular conjunctivitis, iridocyclitis, and keratitis have been described. Severe generalized post-vaccination complications usually occur in children with immunodeficiency and are often fatal.

Diagnosis of post-vaccination complications

A post-vaccination complication can be suspected by a pediatrician based on the appearance of certain typical clinical signs at the height of the vaccination process.

Mandatory for differential diagnosis post-vaccination complications and complicated course of the vaccine period is laboratory examination child: general analysis urine and blood, virological and bacteriological studies of blood, urine, feces. To exclude intrauterine infections (. Differential diagnosis of post-vaccination complications in these cases is carried out with epilepsy, hydrocephalus, etc.

The diagnosis of a post-vaccination complication is established only after all other complications have been excluded. possible reasons violations of the child's condition.

Treatment of post-vaccination complications

Within complex therapy post-vaccination complications are treated etiotropically and pathogenetically; a gentle regime, careful care and a rational diet are organized. In order to treat local infiltrates, local ointment dressings and physiotherapy (UHF, ultrasound therapy) are prescribed.

In case of severe hyperthermia it is indicated drinking plenty of fluids, physical cooling (rubbing, ice on the head), antipyretic drugs (ibuprofen, paracematol), parenteral administration glucose-salt solutions. For allergic post-vaccination complications, the amount of assistance is dictated by the severity of the allergic reaction (administration of antihistamines, corticosteroids, adrenergic agonists, cardiac glycosides, etc.).

In case of post-vaccination complications from the nervous system, syndromic therapy (anticonvulsant, dehydration, anti-inflammatory, etc.) is prescribed. Treatment of post-BCG vaccination complications is carried out with the participation of a pediatric TB specialist.

Prevention of post-vaccination complications

Prevention of post-vaccination complications involves a set of measures, among which the first place is occupied by the correct selection of children to be vaccinated and the identification of contraindications. For this purpose, a pre-vaccination examination of the child is carried out by a pediatrician, and, if necessary, consultations with pediatric specialists who monitor the child for the underlying disease (pediatric allergist-immunologist, pediatric neurologist, pediatric cardiologist, pediatric nephrologist, pediatric pulmonologist, etc.). In the post-vaccination period, vaccinated children should be monitored. Compliance with immunization techniques is important: only experienced, specially trained medical personnel should be allowed to vaccinate children.

For children who have suffered a post-vaccination complication, the vaccine that caused the reaction is no longer administered, but in general routine and emergency immunization are not contraindicated.

We must not forget that vaccination is an immunobiological preparation that is introduced into the body in order to form stable immunity to certain, potentially dangerous infectious diseases. It is precisely because of their properties and purpose that vaccinations can cause certain reactions from the body. The entire set of such reactions is divided into two categories:

• Post-vaccination reactions (PVR).
• Post-vaccination complications (PVC).

Expert opinion

N. I. Briko

Academician of the Russian Academy of Sciences, Professor, Doctor of Medical Sciences, Head of the Department of Epidemiology and evidence-based medicine First Moscow State Medical University named after. THEM. Sechenova, President of NASKI

Post-vaccination reactions represent various changes in the child’s condition that develop after administration vaccines and go away on their own within a short period of time. They do not pose a threat and do not cause permanent health problems.

Post-vaccination complications– persistent changes in the human body that occurred after the introduction of the vaccine. In this case, the violations are long-term, significantly exceed the physiological norm and entail various problems with human health. Let's take a closer look possible complications vaccinations.

Unfortunately, none of the vaccines is completely safe. All of them have a certain degree of reactogenicity, which is limited by the regulatory documentation for the drugs.

Side effects that can occur when vaccines are administered are very varied. Factors contributing to the occurrence of adverse reactions and complications can be divided into 4 groups:

• ignoring contraindications for use;
• violation of the vaccination procedure;
• individual characteristics of the state of the vaccinated organism;
• violation of production conditions, rules of transportation and storage of vaccines, poor quality of the vaccine product.

But even despite possible complications when administering vaccines modern medicine recognizes the significant advantage of their beneficial properties to reduce the possible consequences of the disease compared to possible natural infection.

Relative risk of complications after vaccinations and related infections

The risk of complications after vaccination is hundreds and thousands of times less than the risk of complications after previous diseases. So, for example, if vaccinations against whooping cough-diphtheria-tetanus can cause encephalopathy (brain damage) in only one case per 300 thousand vaccinated children, then in the natural course of this disease one child per 1200 sick children is at risk of such a complication. At the same time, the risk of mortality in unvaccinated children with these diseases is high: diphtheria - 1 in 20 cases, tetanus - 2 in 10, whooping cough - 1 in 800. The polio vaccine causes flaccid paralysis in less than one case per 160 thousand vaccinated children, while time as risk fatal outcome in case of illness - 5 – 10%. Thus, protective functions Vaccinations greatly reduce the possibility of complications that can occur during the natural course of the disease. Any vaccine is hundreds of times safer than the disease it protects against.

Most often, after vaccination, local reactions occur that have nothing to do with complications. Local reactions (pain, swelling) at the vaccination site do not require special treatment. The highest rate of development of local reactions is for the BCG vaccine - 90-95%. In approximately 50% of cases, local reactions occur to the whole-cell DPT vaccine, while only about 10% occur to the acellular one. The hepatitis B vaccine, which is the first to be administered in the maternity hospital, causes local reactions in less than 5% of children. It can also cause an increase in temperature above 38 0 C (from 1 to 6% of cases). Fever, irritability, and malaise are nonspecific systemic reactions to vaccines. Only whole cell DPT vaccine causes systemic nonspecific vaccine reactions in 50% of cases. For other vaccines this figure is less than 20%, in many cases (for example, when vaccinated against Haemophilus influenzae) - less than 10%. And the possibility of nonspecific systemic reactions when taking the oral polio vaccine is less than 1%.

Currently, the number of severe adverse events (AEs) after vaccinations has been minimized. Thus, with BCG vaccination, 0.000019-0.000159% of the development of disseminated tuberculosis is registered. And even with such minimal values, the cause of this complication is not in the vaccine itself, but in negligence during vaccination and congenital immunodeficiencies. When vaccinated against measles, encephalitis develops no more often than in 1 case per 1 million doses. When vaccinated against pneumococcal infection with the PCV7 and PCV13 vaccines, no rare or very rare severe events were identified, although over 600 million doses of these vaccines have already been administered worldwide.

In Russia, official recording and control of the number of complications resulting from vaccination has been carried out only since 1998. And it should be noted that thanks to the improvement of vaccination procedures and the vaccines themselves, the number of complications is significantly reduced. According to Rospotrebnadzor, the number of registered post-vaccination complications decreased from 323 cases in January-December 2013 to 232 cases over the same period in 2014 (for all vaccinations combined).

Ask a question to a specialist

Question for vaccination experts

Questions and answers

The child is now 1 year old, we have to do 3 DPTs.

At 1 DTP the temperature was 38. The doctor said that before 2 DTP, take Suprastin for 3 days. And 3 days after. But the temperature was a little higher than 39. We had to knock it down every three hours. And so on for three days.

I read that suprastin should not be given before vaccination, but only after, because it reduces immunity.

Please tell me what to do in our case. Should I give suprastin in advance or not? I know that each subsequent DTP is more difficult to tolerate. I'm very afraid of the consequences.

In principle, suprastin has no effect on fever during vaccination. Your situation fits into the picture of the normal vaccination process. I can advise you to give an antipyretic 3-5 hours after vaccination before the fever appears. Another option is also possible - try to be vaccinated with Pentaxim, Infanrix or Infanrix Hexa.

The child is 18 months old, yesterday she was vaccinated with pneumococcus, the temperature rose in the evening, in the morning she is weak, her leg hurts, I am very worried.

Answered by Kharit Susanna Mikhailovna

If the fever lasts for several days without the appearance of catarrhal symptoms (runny nose, cough, etc.), then this is a normal vaccine reaction. Lethargy or, on the contrary, anxiety also fits into a normal vaccine reaction and should go away in a few days. Subsequently, on the day of vaccination, a few hours after vaccination, give an antipyretic in advance, even at normal temperature. If there is pain at the injection site and the child spares his leg when walking, then this may be myalgic syndrome; with the use of an antipyretic (for example, Nurofen), these symptoms should go away. If there is a local reaction, you can use 0.1% hydrocortisone ophthalmic ointment and Troxevasin gel (alternate them) several times a day, applying to the injection site.

My child is 4.5 months old. We have been diagnosed with atopic dermatitis since 2.5 months. Vaccinations up to 3 months were done according to plan. Now she is in remission, we are planning to do DTP. We categorically do not want to make a domestic one, because We are afraid of very poor tolerance + Prevenar caused swelling at the injection site. Now we are waiting for the decision of the immunological commission to approve free (imported) vaccinations. Please tell me, are there any positive solutions with such a diagnosis? Considering that dad is still allergic.

Answered by Kharit Susanna Mikhailovna

If local pathological reaction- swelling and hyperemia at the injection site greater than 8 cm, the issue of introducing another vaccine is being decided. If the local reaction is less, then this is considered normal and you can continue to be vaccinated while taking antihistamines.

The presence of a local reaction to Prevenar 13 does not mean that the child will have an allergic reaction to another vaccine. In such cases, it is recommended to take antihistamines on the day of vaccination and possibly for the first three days after vaccination. The most important thing is if you have food allergies do not introduce new food products before and after vaccination (for a week).

Regarding the solution to the issue of acellular vaccines, then general rules no, in each region the issue of free use of these vaccines is decided in its own way. You just need to understand that switching to acellular vaccines does not guarantee the absence of an allergic reaction after vaccination; it happens less frequently, but is also possible.

Is it worth getting the Prevenar vaccine at 6 months? And if you do, is it compatible with DPT?

Answered by Kharit Susanna Mikhailovna

Vaccination against pneumococcal infection is vital for young children, since children die from diseases caused by this infection (meningitis, pneumonia, sepsis). To protect against pneumococcal infection, at least 3 vaccinations are required - therefore, than earlier child starts to take root, so much the better.

Vaccination with DTP and Prevenar on the same day is recommended by the national vaccination calendar. Any vaccination can cause a fever in a child; we must remember this and give the child an antipyretic if the temperature rises.

We are faced with the same problem. My daughter is now 3 years old and 9 months old; she was given the 1st and 2nd vaccines against polio in the form of Pentaxim (at 5 and 8 months). We still haven’t gotten the third vaccination because we had a bad reaction to Pentaxim, after that we started doing it every 6 months. to donate blood from a vein for possible allergic reactions to vaccinations, and for 3 years we were not allowed to test either DTP, Ads-M, Pentaxim, Infanrix, or against measles-rubella based on the tests, and there was an official medical exemption from them. But no one ever offered to give us the 3rd and 4th polio during these 3 years (even the head of the children's clinic, when she signed the card for the kindergarten), also no one suggested that we be examined for it, and of course they did not explain that if someone in the kindergarten then they will install OPV, they will take us out of the garden (in our garden children eat in general cafe rather than in groups). Now they called from the garden and said that because... our vaccination is not completed, we are suspended from the kindergarten for 60 days, and so on every time someone is vaccinated, or we can give the 4th polio booster vaccination along with the rest of the children in the kindergarten. Because 3 can only be given up to a year, and we have already missed it, and 4 can be done up to 4 years (my daughter turns 4 in 3 months). On this moment We now have a complete medical exemption for 2 months from any vaccinations because... We are currently undergoing treatment due to the activity of the Epstein Bar virus. In the garden they answered because We have a medical outlet, so they won’t disembark us. The question for me is: to what extent do children vaccinated with OPV pose a danger to my child (in our kindergarten, children eat in a common cafe at the same time, and not in groups)? And before the age of 4, can you give the fourth one, skipping the third one, with a gap of 3 years between the 2nd and 4th vaccines? In our city there are no examinations for allergic reactions to vaccines, which means we can only undergo them on vacation, but the child will already be 4 years old at this time. What should we do in our situation?

Answered by Kharit Susanna Mikhailovna

What was the bad reaction to Pentaxim? On the basis of what tests could a medical outlet be placed? In our country, allergy tests to vaccine components are very rarely done. If you are not allergic to chicken or quail eggs, and your child receives them as food, then it is possible to be vaccinated against measles and mumps, but the rubella vaccine does not contain either chicken or quail egg. Cases of measles are being registered in the Russian Federation and your child is at risk because he is not vaccinated against it.

You can get vaccinated against polio - the vaccine is well tolerated and rarely causes any allergic reactions. When introduced into kindergarten oral polio vaccine to other children, you are at risk of developing vaccine-associated polio. You can be vaccinated against polio at any age, only vaccination against whooping cough in our country is done up to 4 years of age (in the summer of 2017, the vaccine against whooping cough is expected to appear - Adacel and it can be administered to children after 4 years).

Your child must already have 5 vaccinations against polio for complete protection against this infection; you can get an inactivated or oral polio vaccine and after 6 months the first revaccination, and after 2 months - the 2nd booster against polio.

Please explain the situation. In the morning we had a polio booster vaccination. Two hours later the sniffles and sneezing started. Is this ARVI due to vaccination? And is there a risk of further complications?

Answered by Kharit Susanna Mikhailovna

Most likely, you are suffering from a respiratory infection. The vaccination simply coincided with the onset of your illness. If you had not been vaccinated, you would have gotten acute respiratory infections in the same way. Now the incidence is high respiratory infections. Therefore, you can continue to get vaccinated, this is not a complication.

On November 11, a child aged 6 years and 10 months was vaccinated with ADSM in the hip in kindergarten, the nurse gave 1 tablet. suprastina. In the evening of that day the child was capricious, and from November 12 there were complaints about a feeling of pressure at the vaccination site, he began to limp right leg, the temperature rose to 37.2. Mom gave her son ibuprofen and suprastin. Swelling and hyperemia of 11 x 9 cm were found at the injection site. On November 13 (day 3), the same complaints, temperature 37.2, were also given 1 tablet. suprastin and applied fenistil at night. Fenistil reduced the feeling of pressure in the leg. In general, the boy’s condition is normal, his appetite is normal, he plays and is sociable. Today, November 14, the hyperemia around the injection is the same size, but the swelling is less (the child was not given any drugs), he does not notice a feeling of pressure. But they appeared slight runny nose, the child sneezes. Temperature at 21:00 36.6. Please tell me what we should do with this unusual reaction for vaccination. Will this reaction be a contraindication to subsequent administration of ADSM? How can you protect your child from diphtheria and tetanus in the future?

Answered by Kharit Susanna Mikhailovna

Perhaps low-grade fever and runny nose are a manifestation of a respiratory disease. The presence of hyperemia and swelling at the injection site, as well as myalgic syndrome (limping on the leg where the vaccination was given) is a manifestation of a local allergic reaction. Such reactions more often occur with 3 vaccinations or revaccination with DPT (Pentaxim, Infanrix, ADS, ADSm). The management tactics in this case were chosen correctly - non-steroidal anti-inflammatory drugs and antihistamines. Nurofen is prescribed routinely 2 times a day for 2-3 days (if myalgic syndrome persists), antihistamines (Zodak) - up to 7 days. Hydrocortisone ophthalmic ointment 0.1% and troxevasin gel are applied topically, ointments are alternated, applied 2-3 times a day. Under no circumstances should the injection site be smeared with iodine or warm compresses applied. If this was the 2nd revaccination against tetanus and diphtheria, then the next revaccination should be at 14 years of age. Before vaccination, it is necessary to be tested for diphtheria antibodies; if there is a protective level, vaccination is postponed.

Over many centuries of existence, man managed to invent many effective methods prevention of certain health problems. And one of the most effective ways prevention is worth recognizing vaccination. Vaccinations really help to avoid many serious diseases, including those that pose a serious threat to human life. But such a medical procedure, like all others, can cause unwanted reactions body. And the topic of our conversation today will be post-vaccination reactions and complications.

Local and general post-vaccination reactions

Such reactions represent various changes in the baby’s condition that occur after the vaccine is administered and go away on their own within a fairly limited period of time. Those changes in the body that qualify as post-vaccination reactions are considered unstable, purely functional and cannot threaten the health and life of the patient.

Local post-vaccination reactions

Local reactions include all kinds of manifestations that occur at the site of vaccine administration. Almost all nonspecific local reactions appear during the first day after administration of the drug. They may present as localized redness (hyperemia), the diameter of which does not exceed eight centimeters. Swelling and, in some cases, pain at the injection site are also possible. If adsorbed drugs were administered (especially subcutaneously), an infiltrate may form.

The described reactions last no longer than a couple of days and do not require any specific treatment.

However, if the local reaction is particularly severe (redness more than eight centimeters and swelling more than five centimeters in diameter), this drug cannot be used further.

The introduction of live bacterial vaccines can lead to the development of specific local reactions caused by the infectious vaccine process that develops at the site of application of the product. Such reactions are considered as an indispensable condition for the development of immunity. For example, when administering a vaccine BCG for a newborn one and a half to two months after vaccination, an infiltrate of 0.5-1 cm in size (in diameter) appears on the skin. It has a small nodule in the center, becomes crusty, and pustulation is also possible. Over time, a small scar forms at the site of the reaction.

Common post-vaccination reactions

Such reactions are represented by changes in the patient's condition and behavior. In most cases, these include increases in body temperature. When inserted inactivated vaccines Such reactions appear a couple of hours after vaccination and do not last more than two days. In parallel, the patient may experience sleep disturbances, anxiety, myalgia and anorexia.

When immunized with live vaccines, general reactions occur approximately eight to twelve days after vaccination. They are also manifested by an increase in temperature, but in parallel they can occur catarrhal symptoms(when using measles, mumps and rubella vaccines), measles-like skin rashes (when using measles vaccine), unilateral or bilateral inflammation of the salivary glands under the tongue (when using mumps vaccine), as well as lymphadenitis of the posterior cervical and/or occipital nodes (when using use of rubella vaccine). Such symptoms are not associated with post-vaccination complications and are explained by the replication of the vaccine virus. They usually go away within a few days with the use of symptomatic remedies.

Post-vaccination complications

Such pathological conditions are represented by persistent changes in the human body that have developed due to the introduction of vaccinations. Post-vaccination complications are long-lasting and greatly exceed physiological norms. Such changes significantly impair the patient's health.

They can be toxic (unusually strong), allergic (with manifestations of disturbances in the functioning of the nervous system) and rare forms of complications. Most often, such conditions are explained by the administration of the vaccine when the patient has some contraindications, insufficiently correct implementation of vaccination, poor quality of the vaccine preparation and individual properties and reactions human body.

Post-vaccination complications can be presented:

Anaphylactic shock that developed within 24 hours after vaccination;
- allergic reactions that affect the entire body;
- serum sickness;
- encephalitis;
- encephalopathy;
- meningitis;
- neuritis;
- polyneuritis, Guillain-Barré syndrome;
- convulsions that occur against the background of low body temperature (less than 38.5C) and are recorded within a year after vaccination;
- paralysis;
- sensitivity disorders;
- vaccine-associated polio;
- myocarditis;
- hypoplastic anemia;
- collagenoses;
- decrease in the number of leukocytes in the blood;
- an abscess or ulcer at the injection site;
- lymphadenitis – inflammation of the lymphatic ducts;
- osteitis – inflammation of the bones;
- keloid scar;
- screaming of a child for at least three hours in a row;
- sudden death.
- disease thrombotic thrombocytopenic purpura;

Similar conditions can occur after various vaccinations. Their therapy is carried out exclusively under the supervision of several qualified specialists and is comprehensive.

Folk remedies

The medicinal properties of lemon balm herb will help reduce the severity of unpleasant symptoms during post-vaccination reactions.

So, to improve the condition of anxiety, sleep disturbances and fever after vaccination, you can make tea. Brew a tablespoon of dried herb with half a liter of boiling water. Infuse the drink for an hour, then strain. Adults should drink a couple of glasses a day, sweetened with honey, and children can be given this medicine two or three tablespoons at a time (if there are no allergies).

Content

A vaccine is the introduction of inactivated (weakened) or non-living microbes into the human body. This promotes the production of antigens and forms type-specific immunity against a certain type of pathological bacteria. No one can predict the reaction of both children and adults to an unknown drug, so in some cases post-vaccination complications (PVO) occur.

Why do post-vaccination complications occur?

Vaccination is aimed at developing protective immunity, which will prevent the development of an infectious process when a person comes into contact with a pathogen. A vaccine is a biological serum that is injected into the patient’s body to awaken the immune system. It is prepared from killed or greatly weakened microbes and antigens. Different immunization preparations may contain different compositions:

• waste products of pathogens of viral infections;
• synthetic compounds (adjuvants);
• modified infectious agents;
• live viruses;
• inactivated microorganisms;
• combined substances.

Vaccination is considered to be “training” the body against dangerous pathologies. If immunization is successful, then re-infection is impossible, but sometimes serious complications occur after vaccination. A child or adult patient may develop an unexpected pathological response to vaccination, which medical personnel regards as a post-vaccination complication.

The frequency of these processes varies depending on the type of vaccines used and their reactogenicity. For example, the reaction to the DTP vaccine (tetanus, diphtheria and whooping cough) has Negative consequences child's body in 0.2-0.6 cases per 100 thousand vaccinated children. When vaccinated with MMR (against mumps, measles and rubella), complications occur in 1 case per 1 million vaccinated people.

Causes

The occurrence of complications after vaccination can occur due to the individual characteristics of the human body, due to the reactogenicity of the drug, the tropism of vaccine strains to tissues or the reversion of their properties. Also, the body’s pathological response to vaccination occurs due to personnel errors in violation of the serum administration technique. Iatrogenic factors include:

• incorrect dosage or microbial contamination of the drug;
• unsuccessful administration (subcutaneous instead of intradermal);
• violation of antiseptics during injection;
• erroneous use of medicinal substances as solvents.

Individual characteristics of the human body that determine the severity and frequency of post-vaccination complications include:

• genetic predisposition to allergic reactions;
• background pathology that worsens after vaccination;
• change and sensitization of immune reactivity;
• convulsive syndrome;
• autoimmune pathologies.

Classification

The vaccination process is accompanied by the following pathological conditions:

• Chronic diseases or intercurrent infections that worsened or occurred after vaccination. The development of the disease in the post-vaccination period is sometimes caused by the coincidence of the onset of the disease and the administration of serum, or by developing immunodeficiency. During this period you can get sick obstructive bronchitis, ARVI, infectious pathologies urinary tract, pneumonia and other ailments.
• Vaccine reactions. These include unstable disorders that arise after vaccination and persist for a short time. They do not affect the general condition of the vaccinated person and quickly go away on their own.
• Post-vaccination complications. They are divided into specific and nonspecific. The first are vaccine-associated diseases (poliomyelitis, meningitis, encephalitis and others), and the second are immunocomplex, autoimmune, allergic, and overly toxic. Based on the severity of symptoms, post-vaccination reactions are divided into local and general.

What are the post-vaccination reactions and complications?

After vaccination, the body may react with the following local or general symptoms:

• Local reactions: pain at the site of serum injection, swelling, hyperemia, regional lymphadenitis, conjunctivitis, nosebleeds, catarrhal manifestations from the outside respiratory tract(with intranasal and aerosol administration of drugs).
• General reactions: malaise, sleep disturbance, loss of appetite, increased body temperature, headache, nausea, pain in joints and muscles.

Local reactions manifest themselves as individual symptoms, and all of the above. High reactogenicity is characteristic of vaccines containing a sorbent when they are administered using a needle-free method. Local reactions appear immediately after the vaccine is administered, reach a maximum within a day and last from 2 to 40 days. General complications reach a maximum after 8-12 hours, and disappear after vaccination from 1 day to several months.

When using sorbed vaccines administered subcutaneously, local reactions occur slowly, reaching their maximum after 36-38 hours. Next, the process moves into the subacute phase, which lasts about 7 days, ending with the formation of a subcutaneous compaction, which resolves in 30 days or more. The most severe reactions occur during immunization with toxoids.

Main complications after vaccination:

Diagnostics

If complications arise after vaccination, the doctor refers the patient for laboratory tests. For differential diagnosis you need:

• general urine and blood tests;
• virological and bacteriological examination of feces, urine, blood to exclude convulsive conditions;
• PCR and ELISA methods to exclude intrauterine infections in children of the first year of life;
• lumbar puncture with examination of the battleship (for lesions of the central nervous system);
• electroencephalography (according to indications);
• MRI of the brain (if necessary);
• neurosonography, electromyography (for post-vaccination complications).

Treatment

Within complex treatment For complications after vaccination, pathogenetic and etiotropic therapy is carried out. For a patient of any age, a rational diet, careful care, and a gentle regime are organized. To exclude local infiltrates, local dressings with Vishnevsky ointment and physiotherapy (ultrasound, UHF) are used. Some complications after DTP are treated with the help of a neurologist.

The body will tolerate the post-vaccination period more easily if the gastrointestinal tract is not stressed, so on the day of vaccination and the day after it, it is better to observe a semi-starvation regime. Fried foods, sweets, fast food and other foods containing stabilizers and preservatives should be avoided. It is better to prepare vegetable soups, liquid porridges, and drink plenty of fluids. It is not recommended to introduce complementary foods to infants until stable remission is achieved. You should limit contact with other people if your health is impaired after vaccination until full recovery immunological activity.

Drugs

In case of complications after vaccination from the nervous system, doctors prescribe syndromic therapy (anti-inflammatory, dehydration, anticonvulsant). Combination treatment involves taking the following medications

• antipyretics: Paracetamol, Brufen when body temperature rises above 38 ° C;
• antihistamines: Diazolin, Fenkarol in case of an allergic rash;
• corticosteroids: Hydrocortisone, Prednisolone in the absence of effect from antihistamines;
• antispasmodics: Eufillin, Papaverine for spasm of peripheral vessels;
• tranquilizers: Seduxen, Diazepam for severe agitation, motor restlessness, continuous shrill scream of a child.

Physiotherapeutic procedures

Post-vaccination complications are successfully eliminated with the help of physiotherapeutic procedures. The most effective:

• UHF. Ultra-high frequency electromagnetic fields are used for treatment. The procedure helps reduce pain and inflammatory processes, eliminating swelling, removing toxins from the body. At muscle spasms UHF therapy quickly relieves painful symptoms.
• Ultrasound therapy. To eliminate complications caused by vaccination, ultrasonic vibrations with a frequency of 800-900 kHz are used. The procedure has a thermal, mechanical, physicochemical effect on the body's cells, activating metabolic processes, and helps improve immunity. Ultrasound therapy has antispasmodic, analgesic, and anti-inflammatory effects. Improves tissue trophism, promotes regenerative processes, stimulates lymph and blood circulation.

Prevention of post-vaccination complications

Contraindications to the introduction of live viruses are the presence of an immunodeficiency state, malignant neoplasm and pregnancy. BCG should not be administered to an infant whose birth weight is less than 2000 grams. A contraindication to DPT vaccination is a history of afebrile seizures and pathologies of the nervous system. Immunoglobulin vaccination is not given in the first week of pregnancy. The Mantoux test is not performed for people with schizophrenia and other neurological diseases. Mumps (mumps) vaccination cannot be given for tuberculosis, HIV, or oncology.

The vast majority of civilized society are vaccinated at some point in their lives. In most cases, the introduction of necessary vaccines occurs in infancy - children are most vulnerable to dangerous diseases. Often, the immature bodies of children experience negative reactions to the administration of vaccine preparations. So is it worth using vaccines if their use can lead to unpleasant consequences?

According to medical classification, the vaccine is an immunobiological preparation. This means that by introducing a weakened strain of the virus into the patient’s body, a strong immunity to the viral disease is developed. This is achieved by the formation of antibodies in the blood, which subsequently destroy the real virus that has entered the body. By itself, even a weakened strain of the virus cannot be beneficial to the body - which means that mild post-vaccination complications and reactions are inevitable.

Consequences of vaccinations

The consequences of vaccinations can be very diverse, especially in children. In medicine, they are not strictly divided into two types: reactions to vaccinations or complications. The former always represent a short-term change in the child’s condition, often only external; post-vaccination complications are long-term and serious side effects, the consequences of which are often irreversible. The good news is that even susceptible to disease In children, post-vaccination complications occur extremely rarely. The approximate chances of a particular complication occurring in a child can be compared in the table below.

The table uses average values ​​from the late 90s to the present. As can be seen from the data, the chance of developing any complications after vaccination is quite insignificant. Minor reactions common to this type were not taken into account. medical procedures. It is important to remember that children’s exposure to any viral disease is tens or hundreds of times higher than the likelihood of developing a complication from this vaccination.

Vaccination is reliable protection against viral disease!

The main principle of a parent is not to risk the health of their children and not to avoid vaccinations at the right time! But it is important to approach the procedure responsibly. All vaccines are given under the strict supervision of a supervising physician and mandatory consultation. Vaccination technology must be followed - in 80% of cases, complications are observed precisely because of the negligence or insufficient qualifications of the personnel administering the vaccinations. Most probable cause- violation of storage conditions of the drug. Incorrect injection site, failure to identify contraindications and allergic reactions, improper care for children after vaccination, illness of the child at the time of vaccination, etc. Individual characteristics of the body play almost the last role in the development of post-vaccination complications - the chance is so insignificant. It is in the interests of parents to provide for all this in order to minimize risks and not cause harm to the child.

When to expect reactions

Post-vaccination complications can be easily calculated by the time of onset of symptoms relative to the date of vaccination - if the ailment does not fit into the time interval for the reaction to the vaccine, it means that there is no connection with the vaccination and you need to consult a doctor! Vaccination is a great stress for the body of children, and against the background of a weakened immune system the child can easily catch another disease. The average time for reactions to vaccination to appear is from 8 to 48 hours, but symptoms can last up to several months (minor and harmless). Let's look at how and how long reactions should occur from certain types of vaccinations. How and when a reaction to a vaccine may occur:

• The body’s general reaction to the vaccine or toxoids most noticeably manifests itself 8–12 hours after administration and completely disappears after 1–2 days;
• local reactions reach their maximum after a day and can last up to four days;
• Subcutaneous vaccination from sorbed preparations proceeds rather slowly and the first reaction can occur only one and a half to two days after vaccination. After the changes in the body, they can pass passively for up to a week, and the subcutaneous “bump” after vaccination will resolve within 20–30 days;
• complex antiviral drugs, consisting of 2-4 vaccinations always give a reaction to the first vaccination - the rest can only slightly strengthen it, or cause an allergy.

A cause for concern should be considered if the body's reaction does not fit into the standard time frame for changes. This means either serious post-vaccination complications or a disease of another kind - in this case, you should immediately take the child to the doctor for a detailed examination.

If there are any significant deviations from the normal course of the reaction after vaccination, you should immediately consult a doctor. Ask in medical institution Information brochures to monitor your child's condition at home.

Severity of the leak

An indicator of the severity of post-vaccination changes is considered to be an increase in the body temperature of children relative to normal for general reactions, and the size and inflammation (infiltrate) at the site of administration of the drug for local. Both are conventionally divided into three groups, depending on the severity of the post-vaccination complication.

General reactions to vaccination:

• minor reaction - temperature does not exceed 37.6 °C;
• moderate reaction - from 37.6 °C to 38.5 °C;
• severe reaction - from 38.5 °C or more.

Local (local) reactions to vaccination:

• a weak reaction is an infiltrate or lump no larger than 2.5 cm in diameter;
• moderate reaction - compaction measuring from 2.5 to 5 cm in diameter;
• severe reaction - the size of the infiltrate is more than 5 cm.

It is imperative to monitor changes in the condition of children in the first few days after vaccination and immediately consult a doctor at the first manifestations of moderate or severe post-vaccination complications. If children quickly develop one or more signs of a severe reaction to a vaccine, resuscitation procedures may be required. Mild and moderate reactions can be alleviated proper care and special medications, antipyretic or general strengthening, the use of which must be consulted with the supervising physician immediately before vaccination. It is absolutely prohibited to use in these cases traditional methods self-medication, questionable remedies or incorrect medications. The health of children can be undermined for a long time if, against the background of a general post-vaccination weakening, we also use chemicals, which are not necessary.

Post-vaccination reactions and complications occur in medical practice hundreds of times less common than cases of infection with viral diseases.

How to avoid

Despite the large amount of contradictory and frightening information about vaccination, especially for children, it should be remembered: a correctly administered vaccine and proper care will reduce the risk of even the most minor complications to an absolute minimum. The main reason for such troubles can always be indicated:

• low quality of the administered drug, incorrectly selected vaccine;
• inattention or lack of professionalism of medical personnel, which can often be found in conditions of conveyor belt free medicine;
• improper care, self-medication;
• infection with a bacteriological disease against the background of weakened immunity of children;
• unaccounted for individual intolerance or allergic reaction.

It's not worth saving. It would be very reasonable to use the services of a paid institution if your clinic clearly does not meet the standards of medical care.

All these factors are easy for an attentive and caring parent to track, which means that the risk of serious post-vaccination complications for their children is several times lower. Quantity viral diseases per hundred thousand children grows annually by 1.2–4% according to State statistics and represents hundreds of times more cases than post-vaccination reactions are observed. And of course, the vast majority of those sick did not receive the necessary vaccination.

Live vaccines - vaccination from weakened viruses