Post-vaccination complications - disorders in the human body that developed after using the vaccine for preventive purposes. They can be local or general, and the consequences can be diagnosed based on clinical data, linking them with a recent vaccination. In this case, treatment is carried out in a complex, which includes etiotropic, symptomatic and local therapy.

Post-vaccination complications after vaccination

Such consequences caused by the vaccine can greatly affect the child’s health. Preventive vaccination in pediatrics is specifically aimed at creating immunity to certain pathogens. Also, the use of vaccines in a large number of the population helps to avoid epidemics and the spread of the disease.

Therefore, the country has a special vaccination calendar, which contains a list of necessary vaccinations and the time of their implementation, including for children. Harm after injection may occur in some cases as an abnormal response to the drug. Such reactions occur after certain vaccines, often the whooping cough, diphtheria and tetanus vaccinations. Vaccines against polio, measles and mumps have been added to this list in recent years.

Causes of complications

Negative consequences can arise for the following reasons:

• reactogenicity of the drug;
• characteristics of the body;
• technical errors and errors during drug administration.

Reactogenicity of a drug implies the body’s reaction to the components of the drug (bacterial toxins, preservatives, stabilizers, solvents, antibiotics). Different vaccines have different degrees of complications and the number of adverse reactions. The most reactogenic are considered to be: BCG, DTP vaccine, the least severe: vaccination against polio, hepatitis B, vaccine against rubella.

Post-vaccination reactions and complications that are determined by individual characteristics include background pathology, changes in the immune system response, genetic characteristics, and the presence of autoimmune pathologies. Nevertheless, doctors still talk about the reasons that may influence the occurrence of undesirable consequences.

Errors during vaccination very often cause post-vaccination complications in children; this occurs due to poor vaccination technique. These include the most common errors of medical personnel: incorrect administration of the drug, incorrect dilution of the vaccine and incorrect dosage, violation of asepsis during injection, mistaken use of other medications instead of the required ones.

Classification of complications after vaccination

Diseases that are accompanied by the vaccine process include:

1. Infections and chronic diseases that arose during the post-vaccination period;
2. Interaction with the body after using the vaccine;
3. Complications that occurred after the vaccine.

The occurrence of infections in the post-vaccination period can occur due to vaccination or due to immunodeficiency that occurs after vaccination. Most often, during this period, a child develops ARVI, influenza, pneumonia, and infections with disorders of the genitourinary system.

Local reactions that occur after the vaccine: hyperemia, swelling, infiltration. Common reactions include: fever, catarrhal symptoms, rashes (especially after measles vaccination), lymphadenitis. Post-vaccination complications are divided into: specific and nonspecific. They can also be general and local and depend on the severity of the disease.

When might a reaction occur?

The post-vaccination period and the moment when complications may occur can be easily calculated in time, taking into account the symptoms and timing of vaccination behavior. Since vaccination greatly affects the body’s protective functions, a child can easily get another disease during this period. Since weakened immunity is susceptible to the process. Typically, a reaction to vaccinations appears within 8 to 48 hours, and symptoms can last for several months (minor and not dangerous).
Interaction with the vaccine:

• general, which is provoked by toxoids, is considered very noticeable and appears after 8-12 hours, while this reaction disappears after 1-2 days;
• local, appears throughout the day, but can last up to 4 days;
• vaccination, where the injection is given subcutaneously, may appear on the second day, and symptoms appear gradually as the drug spreads throughout the body. The lump that forms at the injection site resolves within 30 days;
• complex vaccines can cause an allergic reaction to one of the drugs, while the others intensify the reaction.

If the reaction does not fit within a certain framework, you should consult a doctor. Symptoms may be post-vaccination complications or indicate the onset of another disease.
Do not self-medicate or give your child medications that may complicate the situation. Only a doctor can quickly eliminate all symptoms.

The course of post-vaccination changes

The severity of changes after vaccination can be expressed in an increase in body temperature, an increase and change in the size of the infiltrate. There are several classifications that help quickly identify deviations and changes:

1. General microreaction:

• a slight increase in temperature within 37.6 degrees;
• average severity – up to 38.5;
• severe reaction - above 38.5 degrees.

1. Local microreactions:

• the formation of a small lump, the diameter of which is 2.5 cm;
• medium compaction, size from 2.5 to 5 cm;
• severe reaction - when the lump is more than 5 centimeters in diameter.

After vaccination during the first day, the child needs constant monitoring. Even with small, insignificant reactions, you should consult a doctor. Sometimes the child may need resuscitation. It is prohibited to use traditional methods of treatment.

Reactions that can be classified as post-vaccination are rare. Most often, complications arise due to viral infections.

Post-vaccination reaction microbial 10

The allergic reaction, which is called microbial 10, has its own code T78. ICD 10 may include the following allergic reactions:

• Anaphylactic shock to food;
• Allergic reactions to food;
• Anaphylactic shock without a specific etiology;
• Quincke's edema;
• Unexplained reactive response of the body;
• Reactions that do not have a clear classification in other categories;
• Unfavorable response to various external factors.

To accurately diagnose the cause and manifestation of the disease, you need to take samples with allergens or use other diagnostic methods. If you quickly detect the pathogen, it will be much easier to eliminate the symptoms and begin recovery. Symptoms such as angioedema or anaphylactic shock may require immediate resuscitation of the patient.

ICD 10 reaction to vaccination is very rare. Since through natural contact it is very difficult to become infected with a large number of infectious diseases at once. DTP vaccination is carried out at the age of 3 months, where the disease of whooping cough or diphtheria or tetanus is significantly increased, vaccination can be carried out immediately after birth.

In this case, the child may only experience a loss of strength and activity, but no complications. But, there is no specific reaction to ICD 10, because everyone can react individually to a particular vaccine. Doctors say that the reaction may be stronger in those who have an exacerbation of chronic diseases, so during these periods you should not vaccinate.

Timely diagnosis

A post-vaccination complication or negative reaction to a vaccine can be diagnosed by a pediatrician based on the symptoms that appeared in the period after vaccination.
A mandatory diagnostic method is a full examination and certain tests: a general urine test, a blood test, a blood test for viruses and bacteria, and a stool test. Diagnostics allows us to exclude intrauterine infections, which include herpes, toxoplasmosis, and rubella. For children under 1 year of age, ELISA and PCR diagnostics are most often used.

By performing a biochemical blood test, it is possible to exclude the occurrence of seizures, which may indicate rickets or spasmophilia, the initial stage of diabetes mellitus. This is due to the fact that only a biochemical analysis can indicate a lack of calcium in the body.

If there are indications (for example, a disorder of the nervous system), an electroencephalogram or MRI of the brain may be prescribed. This is because some symptoms are very similar to those that occur with epilepsy, brain tumors or hydrocephalus. Diagnosing a post-vaccination complication is difficult, because a lot of time is spent collecting tests and excluding other diseases that cause similar symptoms.

How to treat complications after vaccination

Treatment involves complex therapy, which includes etiotropic and pathogenetic measures. It is mandatory to have a gentle regimen, as well as a proper diet, which includes a balanced consumption of vegetables and fruits, as well as cereals and dairy products. If treatment of the infiltrate is necessary, it is possible to apply ointments and bandages, as well as the mandatory use of physiotherapy for a quick recovery: UHF, ultrasound therapy.

If hyperemia is pronounced, you need to drink a large amount of water (it is important that the water is not cold), cool the body (wraps, ice on the head), use drugs to reduce fever (ibuprofen), and administer a glucose-salt solution. If post-vaccination complications cause severe allergies to the body, doctors prescribe a number of antihistamines, corticosteroids and glycosides.

If complications affect the central nervous system, medications are used that can eliminate seizures and also prevent inflammation. Treatment must be carried out by a phthisiatrician. Each individual case of treatment of post-vaccination complications is considered individually, and treatment may depend on individual characteristics, complexity of the disease and the presence of chronic diseases.

Preventive measures to avoid post-vaccination complications

Preventive measures for complications after vaccination have a certain complex, which indicates the correct selection of children for vaccination. This is the most important point to adhere to. It is for this purpose that a preliminary examination of all children is carried out by the treating pediatrician. If necessary, you should contact other specialists for advice. This could be a dermatologist, immunologist, neurologist, cardiologist and pulmonologist.

A mandatory activity in the post-vaccination period is constant monitoring of children who have been vaccinated. At the same time, only medical personnel should do this. It is the person who can recognize the symptoms before others and quickly provide medical assistance. Children who have had complications after a particular vaccine are not given it again. However, the planned preventive use of other vaccines is not prohibited.

A separate point in preventive measures should be the attention of parents. Only a caring parent will be able to control the quality of the vaccine and its correctness, according to the vaccination calendar. The same applies to the time after vaccination - the child should not be in crowded places for several days and not communicate with people who may have infectious diseases. The approach may reduce the possibility of complications. For additional insurance, you can write down all the reactions of the child’s body that appear after the administration of the drug. Even slight redness or an increase in temperature within normal limits should be controlled.

Complications that may arise after vaccination can have consequences and affect the functioning of the entire body. It is important to get tested first and get your doctor’s permission to get immunized. Different types of vaccines have different effects and can cause different complications. This may be slight redness at the injection site, or it may cause swelling and anaphylactic shock. For any reactions of the body, it is better to visit a doctor and not self-medicate. It is important to follow all the rules for vaccination, since failure to comply with safety rules during injection often causes complications and the appearance of diseases.

Post-vaccination reactions.

Local reactions– in the form of hyperemia with soft tissue swelling at the injection site up to 3 cm in diameter.

General reactions– in the form of an increase in temperature to 39.5ºС.

Allergic reactions– in children with allergies, skin syndrome may worsen and exudative manifestations may intensify.

Neurological reactions– in children with neurological pathology they manifest themselves as motor disinhibition, tearfulness, and restless sleep.

Post-vaccination reactions occur quite often (1-5%), do not pose a threat to life and health, do not require urgent measures, and are registered only in the territorial center of Rospotrebnadzor. The nature of the reactions is noted in the preventive vaccination card (form No. 063/u) and development history (form No. 112/u).

Post-vaccination complications.

Heavy local manifestations in the form of dense infiltrates more than 8 cm in diameter.

Overly strong general reactions in the form of fever 39.6ºС or more, febrile convulsions.

Allergic complications: acute urticaria, angioedema, anaphylactic shock. In children of the first year of life, the equivalent of anaphylactic shock is a collaptoid state: paleness, cyanosis, severe lethargy, drop in blood pressure, the appearance of sticky sweat, and sometimes loss of consciousness.

Neurological complications:

a continuous high-pitched “brain” scream (squeal) lasting for several hours, associated with increased intracranial pressure;

afebrile convulsions with loss of consciousness, sometimes in the form of “nods”, “pecking”, “absences”, stopping of gaze;

encephalitis, occurring with convulsions, prolonged loss of consciousness, fever, vomiting, and the development of focal symptoms.

Specific complications:

vaccine-associated polio (after OPV)

generalization of BCG, BCG-itis, regional abscess, osteomyelitis, keloid scar.

Post-vaccination complications are very rare (1:70000 – 1:5000000). A medical institution that has diagnosed a post-vaccination complication must send an emergency notification to the local territorial center of Rospotrebnadzor and to the State Research Institute for Standardization and Control of Medical Biological Preparations named after. L.A. Tarasevich (119002, Moscow, Sivtsev Vrazhek lane, 41). An internal investigation is carried out in each case.

Causes of post-vaccination complications

Complications associated with the disorder vaccination techniques, are few in number. Violations of sterility lead to the development of suppuration at the injection site; Exceeding the dose of the drug can cause severe toxicoallergic reactions.

Complications associated with vaccine quality: local (nonsterility) or general (toxic) - appear in several children vaccinated with the same series of vaccines.

Complications due to individual reaction.

Emergency care for post-vaccination complications at the prehospital stage.

Hyperthermia

The child should be lightly dressed, be in a well-ventilated area and receive plenty of fractional drinks in the amount of 80-120 ml/kg/day.

For hyperthermia with pallor, marbled skin, chills and cool extremities caused by spasm of peripheral vessels, antipyretics are prescribed:

healthy children - upon reaching body temperature > 38.5ºС;

for children with neurological pathology and a history of seizures – temperature >38.0ºС.

Enter paracetamol 10 mg/kg orally or in suppositories, if there is no effect - lytic mixtures intramuscularly:

Metamizole sodium 50% solution: up to 1 year – 0.01 ml/kg, over 1 year – 0.1 ml/year of life;

Diphenhydramine 1% solution (diphenhydramine): up to 1 year – 0.01 ml/kg, over 1 year – 0.1 ml/year of life;

Papaverine hydrochloride 2% - up to 1 year - 0.01 ml/kg; 0.1 ml/year of life;

30-40 minutes after taking or administering antipyretics, the “pale” fever should turn into “pink”, the peripheral vessels will dilate, the skin will become pink, the extremities will be hot, and sweating may begin. At this stage, increased heat transfer occurs, so most often it is enough to undress the child, ensuring the flow of fresh air.

", 2011 O.V. Shamsheva, Head of the Department of Infectious Diseases in Children, Moscow Faculty of the State Educational Institution of Higher Professional Education “Russian State Medical University named after. N.I. Pirogov" Ministry of Health and Social Development of the Russian Federation, Professor, Dr. med. sciences

Any vaccine can cause a response in the body, which usually does not lead to serious impairment. Vaccine reactions for inactivated vaccines are usually of the same type, while for live vaccines they are type specific. In cases where vaccine reactions manifest themselves as excessively strong (toxic), they move into the category of post-vaccination complications.

VACCINAL REACTIONS

They are divided into local and general. Local reactions include all manifestations that occur at the site of administration of the drug. Nonspecific local reactions appear during the first day after vaccination in the form of hyperemia not exceeding 8 cm in diameter, swelling, and sometimes pain at the injection site. When administering adsorbed drugs, especially subcutaneously, an infiltrate may form at the injection site. Local reactions develop on the day of vaccine administration (both live and inactivated), last no more than 2–3 days and, as a rule, do not require treatment.
A strong local reaction (hyperemia more than 8 cm, edema more than 5 cm in diameter) is a contraindication to the subsequent use of this drug. With repeated administration of toxoids, excessively strong local reactions may develop, spreading to the entire buttock, and sometimes involving the lower back and thigh. Apparently, these reactions are allergic in nature. In this case, the general condition of the child is not disturbed.
When live bacterial vaccines are administered, specific local reactions develop, which are caused by the infectious vaccine process at the site of application of the drug. They appear after a certain period of time after vaccination, and their presence is an indispensable condition for the development of immunity. Thus, with intradermal immunization of newborns with the BCG vaccine, a specific reaction develops at the injection site after 6–8 weeks in the form of an infiltrate with a diameter of 5–10 mm with a small nodule in the center and the formation of a crust, and in some cases pustulation is noted. This reaction is caused by the intracellular reproduction of living attenuated mycobacteria with residual virulence. The reverse development of changes occurs within 2–4 months, and sometimes over a longer period. A superficial scar measuring 3–10 mm remains at the site of the reaction. If the local reaction is of a different nature, the child should be consulted by a phthisiatrician.
The local reaction after cutaneous immunization with tularemia vaccine has a different picture. In almost all vaccinated people, from the 4th–5th day (less often until the 10th day), hyperemia and swelling with a diameter of up to 15 mm develop at the site of scarification; vesicles the size of millet grains appear along the incisions; from the 10th–15th day on the site vaccination forms a crust, after peeling it off a scar remains on the skin.
General reactions include a change in the child’s condition and behavior, usually accompanied by an increase in temperature. To the administration of inactivated vaccines, general reactions develop several hours after vaccination, their duration usually does not exceed 48 hours. Moreover, when the temperature rises to 38° C and above, they may be accompanied by anxiety, sleep disturbance, anorexia, and myalgia.
General vaccine reactions are divided into: weak - low-grade fever up to 37.5 ° C, in the absence of symptoms of intoxication;
medium strength – temperature from 37.6° C to 38.5° C, moderate intoxication; With
severe – fever above 38.6° C, severe manifestations of intoxication.

General reactions after immunization with live vaccines develop at the height of the vaccine infectious process, usually on the 8th–12th day after vaccination, with fluctuations from the 4th to the 15th day. Moreover, in addition to the above symptoms, they may be accompanied by the appearance of catarrhal symptoms (measles, mumps, rubella vaccines), measles-like rash (measles vaccine), one- or bilateral inflammation of the salivary glands (mumps vaccine), lymphadenitis of the posterior cervical and occipital nodes (rubella vaccine).

With hyperthermic reactions, some children may develop febrile convulsions, which, as a rule, are short-lived. The frequency of development of convulsive (encephalitic) reactions, according to long-term observations of domestic pediatricians, for the DTP vaccine is 4:100,000, which is a significantly lower figure than when using foreign drugs containing pertussis microbial cells. Administration of DPT vaccine may also cause a high-pitched scream that lasts for several hours and appears to be associated with the development of intracranial hypertension. If strong general reactions occur, symptomatic therapy is prescribed.

POST-VACCINATION COMPLICATIONS

As for post-vaccination complications, pathological processes such as vaccine-associated poliomyelitis (VAP), generalized BCG infection, encephalitis after measles vaccination, meningitis after live mumps vaccine, occur in one case or less per million vaccinated people. The table shows complications that have a causal relationship with vaccination.

The very fact of the extremely rare development of post-vaccination complications indicates the importance of the individual reactivity of the vaccinated organism in the implementation of the side effects of a particular vaccine. This is especially evident when analyzing complications after the use of live vaccines. Thus, the frequency of vaccine-associated poliomyelitis in children of the first year of life with primary immunodeficiency is more than 2000 times higher than that in immunocompetent children of the same age (16.216 and 7.6 cases per 10 million vaccinated, respectively). Vaccination against polio with inactivated vaccine (IPV) at 3 and 4.5 months of life (according to the Russian vaccination calendar) solved the problem of VAP. Such a severe complication as generalized BCG infection, which occurs with a frequency of less than 1 case per 1 million primary vaccinated people, usually develops in children with severe disorders of cellular immunity (combined immunodeficiencies, cellular immune deficiency syndrome, chronic granulomatous disease). Therefore, all primary immunodeficiencies are a contraindication to the administration of live vaccines.
Vaccine-associated meningitis after vaccination with the mumps vaccine usually occurs between the 10th and 40th days after vaccination and is not much different from the disease serous meningitis caused by the mumps virus. In addition to the general cerebral syndrome (headache, vomiting), mild meningeal symptoms (stiff neck, Kernig's, Brudzinski's symptoms) can be detected. Cerebrospinal fluid tests show normal or slightly elevated amounts of protein and lymphocytic pleocytosis. To carry out a differential diagnosis with meningitis of other etiologies, virological and serological studies are carried out. Treatment consists of prescribing antiviral, detoxification and dehydration agents.

When injecting into the buttock area, traumatic damage to the sciatic nerve may occur, the clinical signs of which in the form of restlessness and sparing of the leg on the side of which the injection was made, are observed from the first day. These same signs after OPV administration may be a manifestation of vaccine-associated poliomyelitis.

Thrombocytopenia is one of the possible complications of rubella vaccine administration. A cause-and-effect relationship between thrombocytopenia and the administration of vaccine preparations containing the measles virus has been proven.

Table

Complications that are causally related to vaccination

ADVERSE REACTIONS It is necessary to identify adverse reactions that occur after the administration of live viral vaccines (measles, mumps, rubella, yellow fever). They are associated with the replication of the vaccine virus, develop from the 4th to the 15th day after vaccination and have nothing to do with post-vaccination complications. In this case, fever, malaise, as well as a rash (with the introduction of measles vaccine), swelling of the parotid glands (in children vaccinated against mumps), arthralgia and lymphadenopathy (with immunization with rubella vaccine) may be observed. As a rule, these reactions disappear within a few days after the administration of symptomatic therapy.

ANAMNESIS

In order to find out whether the deterioration of the child’s condition was a consequence of the addition of an intercurrent disease or a complication of vaccination, it is necessary to carefully collect information about infectious diseases in the family and in the children's team. Simultaneously with the study of the medical history, it is necessary to pay attention to the epidemiological situation, i.e., the presence of infectious diseases in the child’s environment. This is of great importance, since the addition of intercurrent infections in the post-vaccination period aggravates its course and can cause various complications, and also reduces the development of specific immunity. In young children, these intercurrent diseases most often include acute respiratory infections (mono- and mixed infections): influenza, parainfluenza, respiratory syncytial, adenovirus, mycoplasma, pneumococcal, staphylococcal and other infections. If vaccination is carried out during the incubation period of these diseases, the latter can be complicated by sore throat, sinusitis, otitis, croup syndrome, obstructive bronchitis, bronchiolitis, pneumonia, etc.

DIFFERENTIAL DIAGNOSIS

In terms of differential diagnosis, one should remember the need to exclude intercurrent enterovirus infection (ECHO, Coxsackie), which is characterized by an acute onset with a rise in temperature to 39–40 ° C, accompanied by headache, pain in the eyeballs, vomiting, dizziness, sleep disturbance, herpetic sore throat , exanthema, symptoms of damage to the meningeal membranes and gastrointestinal tract. The disease has a pronounced spring-summer seasonality (“summer flu”) and can spread not only by airborne droplets, but also by the fecal-oral route.

In the post-vaccination period, intestinal infections may occur, which are characterized by a combination of general intoxication with vomiting, diarrhea and other manifestations of damage to the gastrointestinal tract. Severe anxiety, abdominal pain, vomiting, and lack of stool require a differential diagnosis with intussusception.

After vaccination, a urinary tract infection may be detected for the first time, characterized by an acute onset, high fever and changes in urine tests. Thus, taking into account the possibility of complications arising from the administration of various vaccines, it should be borne in mind that the development of a pathological process in the post-vaccination period is not always associated with vaccination. Therefore, it is legitimate to make a diagnosis of a post-vaccination complication only after all other possible causes that led to the development of a particular pathology have been rejected.

PREVENTION

It is important to consider constant medical monitoring of vaccinated people in the post-vaccination period, to protect them from excessive physical and mental stress. It is also necessary to pay attention to the nutrition of children before and after vaccination. This is especially important for children with food allergies. During the vaccination period, they should not receive food that has previously caused allergic reactions, as well as foods that have not been consumed before and contain obligate allergens (eggs, chocolate, citrus fruits, caviar, fish, etc.).

Prevention of infectious diseases in the post-vaccination period is of decisive importance. Parents should not raise the question of immediate vaccinations before or immediately after their child enters a child care or preschool institution. In a children's institution, a child finds himself in conditions of high microbial and viral contamination, his usual routine changes, emotional stress arises, all this adversely affects his health and is therefore incompatible with vaccination.

The choice of time of year for vaccination may have a certain significance. It has been shown that in the warm season, children tolerate the vaccination process more easily, since their body is more saturated with vitamins, which are so necessary in the immunization process. Autumn and winter are a time of high incidence of acute respiratory viral infections, the occurrence of which in the post-vaccination period is extremely undesirable.

It is better to vaccinate children who often suffer from acute respiratory infections in the warm season, while it is better to vaccinate children with allergies in winter; vaccinating them in spring and summer is undesirable, since pollen allergies are possible.

There is evidence that when carrying out vaccination in order to prevent post-vaccination pathology, daily biological rhythms should be taken into account. It is recommended that vaccinations be carried out in the morning (before 12 o'clock).

Measures to prevent post-vaccination complications include a constant review of the vaccination calendar, which is carried out at the state level, using the latest scientific achievements in the field of immunoprophylaxis. Rationalization of the timing and sequence of immunization should be done by each pediatrician when drawing up an individual vaccination calendar. Immunoprophylaxis according to an individual calendar is carried out, as a rule, for children with a complicated medical history.

In conclusion, it should be said that in order to avoid the development of post-vaccination pathology, it is necessary to strictly follow the instructions for the vaccine, which provide recommendations regarding doses, regimens and contraindications for the administration of the drug.

Vaccination is not carried out during an acute infectious disease. A contraindication to the administration of live vaccines is primary immunodeficiency. A pathological reaction caused by vaccination is a contraindication to the future use of this vaccine.

– these are severe and/or persistent health problems due to preventive vaccination.

The disease can be considered a post-vaccination complication if:

• a temporary connection between development and the height of the vaccination process has been proven;
• there is a dose-dependent relationship;
• this state can be reproduced in experiment;
• alternative reasons have been taken into account and their inconsistency has been statistically proven;
• the strength of the association of the disease with vaccination was calculated using the method of determining the relative risk;
• when the use of the vaccine is discontinued, PVO is not recorded.

All diseases in the post-vaccination period are divided into:

1. Post-vaccination complications(conditions that arise as a result of vaccination have an obvious or proven connection with vaccination, but are not characteristic of the normal course of the vaccination process):

• allergic (local and general);
• involving the nervous system;
• rare forms.

1. Complicated course of the post-vaccination period(various diseases that coincided with the vaccine in time, but do not have an etiological or pathogenetic connection with it).

Allergic complications

Local allergic complications

Local allergic complications are more often recorded after the administration of non-live vaccines containing aluminum hydroxide as a sorbent: DPT, Tetracoc, toxoids, recombinant vaccines. When using live vaccines, they are observed less frequently and are associated with additional substances (proteins, stabilizers) included in the drug.

Local complications are characterized by the appearance of hyperemia, edema, compaction more than 8 cm in diameter at the injection site of the vaccine preparation, or pain, hyperemia, edema (regardless of size), persisting for more than 3 days. In rare cases, when using vaccines containing aluminum hydroxide, the formation of an aseptic abscess is possible. The period for the appearance of local allergic complications for non-live and live vaccines is the first 1-3 days after immunization.

Common allergic complications

The rare and most severe complications of vaccination include anaphylactic shock and anaphylactoid reaction.

Anaphylactic shock, which occurs more often after repeated administration of the vaccine, is the most dangerous, although extremely rare, complication. It develops more often 30-60 minutes after vaccination, less often - after 3-4 hours (up to 5-6 hours). If medical personnel are not prepared to provide adequate medical care, this complication can be fatal.

Anaphylactoid reaction develops acutely, but more delayed in time than anaphylactic shock, during the first 2-12 hours after the administration of all vaccines and is manifested by acute circulatory decompensation, acute respiratory failure as a result of obstruction. Additional clinical manifestations are skin lesions (widespread urticaria, Quincke's edema or generalized angioedema) and gastrointestinal tract (colic, vomiting, diarrhea).

In children of the first year of life, the equivalent of anaphylactic shock is a collaptoid state: severe pallor, lethargy, adynamia, drop in blood pressure, less often - cyanosis, cold sweat, loss of consciousness. The most common manifestations of general allergic complications are skin rashes - rashes, including urticaria, angioedema, which appear when non-live vaccines are administered in the first 1-3 days after vaccination, when live vaccines are administered - from 4-5 to 14 days (in vaccination period).

Quincke's edema and serum sickness, occur mainly in children after repeated DTP vaccinations, more often in children who had similar reactions to the administration of previous doses. Rare, severe variants of an allergic reaction are toxic-allergic dermatitis (Stevens-Johnson, Lyell syndromes), the timing of their appearance coincides with the height of the vaccination process.

Complications involving the nervous system

The most common manifestation of post-vaccination complications from the nervous system are seizures.

Convulsive syndrome against the background of hyperthermia (febrile convulsions) occurs in the form of: generalized tonic, clonic-tonic, clonic attacks, single or repeated, usually short-term. Febrile seizures may develop after all vaccines have been administered. The period of occurrence when using non-live vaccines is 1-3 days after vaccination, when vaccination with live vaccines - at the height of the vaccine reaction - 5-12 days after vaccination. In older children, the equivalent of seizures is hallucinatory syndrome. Some authors do not consider febrile seizures to be a post-vaccination complication. Since children in the first three years of life are predisposed to convulsive states with fever caused by various causes, these researchers consider febrile convulsions after vaccination as a reaction of such children to

rise in temperature.

Convulsive syndrome against the background of normal or subfebrile body temperature (up to 38.0C), with disturbances of consciousness and behavior. Afebrile convulsive seizures are distinguished by the polymorphism of manifestations from generalized to minor seizures (“absences,” “nods,” “pecking,” “freezing,” twitching of individual muscle groups, gaze stopping). Petite seizures are usually repeated (serial) and develop when the child falls asleep and wakes up. Afebrile seizures are detected more often after administration of whole-cell pertussis vaccine (DPT, Tetracok). The timing of their appearance may be more distant - 1-2 weeks after vaccination. The development of afebrile seizures indicates the presence of an organic lesion of the nervous system in the child, which was not detected in a timely manner, and vaccination serves as a provoking factor for an already latent disease of the central nervous system. In the WHO system, afebrile seizures are not considered etiologically related to vaccination.

High-pitched scream. A persistent monotonous cry in children in the first six months of life, which occurs a few hours after vaccination and lasts from 3 to 5 hours.

Encephalopathy

Encephalitis

Vaccine-associated diseases

The most severe lesions of the nervous system are vaccine-associated diseases. They develop extremely rarely and only when using live vaccines.

Vaccine-associated paralytic poliomyelitis(VAPP). The disease is caused by damage to the anterior horns of the spinal cord, occurs, as a rule, in the form of damage to one limb, with typical neurological disorders, lasts for at least 2 months, and leaves behind pronounced consequences.

Vaccine-associated encephalitis– encephalitis caused by live vaccine viruses that are tropic to nervous tissue (measles, rubella).

Treatment of post-vaccination pathology

Post-vaccination reactions in most cases do not require special treatment and resolve on their own within a few hours or days. When the temperature rises to high numbers, large fractional drinks, physical cooling methods and antipyretic drugs (Panadol, Tylenol, paracetamol, brufen syrup, etc.) are prescribed. If an allergic rash occurs after vaccination, you can use one of the anti-mediator drugs (fenkarol, tavegil, peritol , diazolin) 3 times a day in an age-appropriate dosage for 2-3 days. Post-vaccination complications requiring etiotropic therapy include some forms of complications after administration of the BCG vaccine. The most severe complications of immunization with the BCG vaccine include a generalized infection with mycobacteria of the vaccine strain, which developed against the background of impaired cellular immunity. Treatment is usually carried out in a specialized hospital, and 2-3 anti-tuberculosis drugs are prescribed for at least 2-3 months.

The vast majority of civilized society are vaccinated at some point in their lives. In most cases, the introduction of the necessary vaccines occurs in infancy - children are most defenseless against 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 in disease-prone 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.

Vaccine	Possible reaction	Chance of occurrence (case per count - in vaccinated people)
Tetanus	Anaphylactic shock, brachial neuritis	2/100000
DTP	Convulsions, decreased blood pressure, loss of consciousness, anaphylactic shock, encephalopathy	4/27000
Measles, rubella	Allergy, anaphylactic shock, encephalopathy, convulsions, fever, decreased platelets in the blood	5/43000
Hepatitis B	Anaphylactic shock	less than 1/600000
Polio vaccine (drops)	Vaccine-associated polio	1/2000000
BCG	Inflammation of lymph vessels, osteitis, BCG infection	1/11000

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 of medical procedure were not taken into account. 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. The most likely reason is a violation of the storage conditions of the drug. Incorrect injection site, failure to identify contraindications and allergic reactions, improper care of 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 backdrop 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 your health care provider for informational brochures to help you 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 drug administration for local ones. 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 with proper care and special medications, antipyretics or general tonics, the use of which must be consulted with the supervising physician immediately before vaccination. In these cases, it is absolutely prohibited to use traditional methods of self-medication, dubious remedies or the wrong medications. The health of children can be undermined for a long time if, against the background of general post-vaccination weakening, we also use chemicals that are not necessary.

Post-vaccination reactions and complications occur in medical practice hundreds of times less often 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. The number of 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