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Опубликовано: December 12, 2022 в 10:12 am

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Safe sleep for babies | Caring for kids

Good sleep habits are important for your baby’s physical health and emotional well-being. Safe sleep includes things such as where your baby sleeps, their sleeping position, the type of crib or bed, the type of mattress, and the home environment.

Creating a safe sleep environment for your baby will lower the risk of injury and sudden infant death syndrome (SIDS). SIDS is when a baby (less than 1 year old), that seems healthy dies suddenly in their sleep, and the cause of death cannot be explained. We don’t know what causes SIDS, so it cannot be prevented, but there are things you can do to help lower the risk.

Where should my baby sleep?  

For the first 6 months, the safest place for your baby to sleep is on their back, in a crib, cradle or bassinet that is in your room (room sharing). Having your baby close may help protect against SIDS, and will make nighttime feedings easier.

How can I create a safe sleep environment for my baby?

  • Parents and all caregivers, including grandparents and childcare providers, can help keep babies safe by following these steps:
  • Always place your baby on their back to sleep, for every sleep.
  • Create a safe sleep space that includes:
    • a firm, flat mattress with a tightly fitted bed sheet,
    • no gaps between the mattress and sides,
    • no loose, soft items, including blankets, pillows, bumper pads, mattress toppers, sleep positioners, or toys. 
  • Avoid waterbeds, air mattresses, or couches/sofas. Babies can turn onto their side or stomach and bury their face in these soft materials, not getting enough air to breathe.
  • If possible, breastfeed your baby (see Breastfeeding and safe sleep below).
  • Ensure your home is smoke free, before and after your baby is born (see Smoke and safe sleep below)
  • Make sure your baby is not too warm (see Overheating below).
  • Make sure that your baby’s crib, cradle or bassinet meets Health Canada’s most current safety standards.
  • Always follow the manufacturer’s instructions when putting together and using the crib, cradle or bassinet.
  • If you choose to swaddle your baby, follow a safe swaddling technique. Stop swaddling when your baby shows signs of rolling over.
  • Take off bibs, necklaces, items with ties or hoods, and hats before putting your baby to sleep to prevent strangulation.

In what position should my baby sleep?  

Placing your baby on their back for every sleep is one of the most important things you can do to reduce the risk of SIDS. Let everyone that helps take care of your baby know to always put them on their back for naptime, nighttime, at home, in childcare settings and when travelling. Even babies who spit up a lot are safer sleeping on their backs. Healthy babies will naturally swallow or cough up fluids.

Once your baby can roll over on their own, there is no need to put them back on their back if they roll onto their side or tummy while sleeping.

If you use a baby sling or carrier, use it safely.

  • Young or premature babies have poor neck control and are at higher risk of suffocating.
  • Always keep your baby’s face visible. Make sure it isn’t pressed into your body, clothes or the carrier.
  • Watch for overheating.

What is room sharing?

Room sharing means placing your baby to sleep in their own safe sleep space (a crib, cradle or bassinet), which is placed in your room next to your bed. Room sharing is recommended for your baby’s first 6 months—the time when the risk of SIDS is the highest.

What about bed sharing?

While room sharing is encouraged, bed sharing increases a baby’s risk of SIDS and suffocation. Bed sharing is when a baby sleeps on the same sleep surface as an adult or another child.

Understand the risks of bed sharing:

  • A baby can get trapped between the sleep surface and the wall, bedframe, or the body of an adult or other child.
  • An adult or an older child can roll over and suffocate a baby.  
  • Soft bedding can cover a baby’s head and cause them to overheat or suffocate.
  • In-bed sleeping products such as baby nests or pods don’t keep your baby safe when bed sharing. The padded sides increase the risk of suffocation.

If you bed share (even if you did not plan to) be sure to:

  • always put your baby on their back,
  • have a firm and flat sleep surface, with no gaps where your baby can get trapped,
  • keep soft loose bedding or other objects well away from your baby,
  • dress your baby so they do not overheat.

Overheating

Overheating increases your baby’s risk of SIDS. Here are some things to consider:

  • Your baby is safest when they sleep in a properly fitted sleepwear—like a one-piece sleeper. It should keep your baby comfortable at room temperature, so they do not get too hot.
  • Keep the room at a comfortable temperature. If it is comfortable for you, it will be comfortable for your baby too.
  • Babies do not need blankets when they sleep. Blankets can cause them to overheat or suffocate.
  • If you use a sleep sack, make sure it is the right size for your baby. If it’s too big, your baby’s head can slip down inside the sack, which can cause your baby to overheat or suffocate. If it’s too tight, your baby may not be able to move their hips and legs freely, which can be dangerous, especially if they roll onto their tummy.

Breastfeeding and safe sleep  

Breast milk is the best food you can offer your baby. The Canadian Paediatric Society recommends exclusive breastfeeding for the first 6 months of life. 

Breastfeeding can help protect your baby from SIDS. Breastfeeding for at least 2 months will lower the risk of SIDS by about half. The longer you can breastfeed, the more protection your baby will have.

Young babies feed often—including during the night. If you bring your baby into your bed to breastfeed, know which situations put babies at greatest risk when bed sharing so that you can avoid them (see section on Bed sharing above). Put your baby back in their crib, cradle or bassinet after each feeding.

Smoking and safe sleep

Being smoke-free, before and after birth, decreases your baby’s risk of SIDS. In fact, 1 out of 3 SIDS deaths could be prevented if pregnant women did not smoke. Even reducing the amount you smoke can lower the risk of SIDS. Other things to keep in mind:

  • Second-hand smoke (cigarette or cannabis) increases the risk of SIDS after your baby is born. Do not let anyone smoke around your baby.
  • Vaping products can expose your baby to nicotine and other harmful chemicals. Don’t vape while pregnant. After birth, make sure that no one vapes around your baby.

Products not recommended for safe sleep  

  • Bed-side sleepers (that attach to an adult bed)
  • Baby nests or pods
  • Inclined sleepers, baby hammocks, crib wedges/positioners
  • Playpens
    • If you use a playpen for your baby to sleep in while travelling, be sure to position it away from blind/curtain cords and electrical cords, which babies can strangle on.
    • Never add an extra mattress or padding.
    • Keep it free of soft items, bedding and toys when your baby sleeps.
  • High chairs, baby swings, bouncers, strollers, and car seats
    • Sleeping in a sitting position can cause your baby’s head to fall forward, which can make it hard to breathe.
    • If your baby falls asleep in a car seat or stroller, move them to a crib, cradle or bassinet when you arrive at your destination.

More information from the CPS

Additional resources

Reviewed by the following CPS committees

  • Community Paediatrics Committee

Last updated: October 2021

Cribs for Kids – Helping every baby sleep safer

Introducing our new safe sleeping environment for infants

National Infant Safe Sleep

Hospital Certification Program

The same safe, high-quality baby products on which Cribs for Kids was built are now available to the public!

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Portable playyard with safe sleep messaging exclusively available at Cribs for Kids!

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Safe Sleep Spotlight

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Serenity Kids® Baby Food // Because Every Bite Counts

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Fat fuels brain development and growth; our products are made with healthy fats from sources like olive oil & avocado oil.

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Every Bite Counts

We started Serenity Kids because we wanted the best for our baby, Della, and we didn’t like what we found on the market. Babies need protein and healthy fats to grow their brains and bodies, and no current baby food included these essential macronutrients. So we created our own to mimic the nutrients of breast milk. Made from pasture raised meats + high-quality organic vegetables, our purees are balanced blended savory meals that contain the most nutrition per bite for our little one, and yours.

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Learn more about Kids Mode in Microsoft Edge

Kids Mode is a convenient browsing mode inside Microsoft Edge that’s designed for kids. With its kid-friendly features and safety guardrails in place, Kids Mode is a great place for children to safely explore the web. Kids Mode includes features like custom browser themes, kid-friendly content, browsing based on an allow list, Bing SafeSearch set to strict, and a password requirement to exit. Also, Kids Mode doesn’t require a child account or profile.  

Currently, Kids Mode is limited to US English on Windows and MacOS.      

Start Kids Mode  


  1. org/ListItem”>

    Open the profile switcher in the browser frame and select Browse in Kids Mode.

    You don’t have to be signed into the browser to do this, but signing in will allow the Kids Mode settings to sync across your devices. 

    If this is your first time launching Kids Mode, you’ll see an explanation of what the feature is.

  2. Choose the appropriate age range to launch Kids Mode in.

    Otherwise, Kids Mode will now open in full screen.

Things to note: 


  • You can always change your age selection in edge://settings/family

  • org/ListItem”>

    After you select the appropriate age, your current browsing window will be saved and closed and a new window for Kids Mode opens in full screen.

  • Until you exit Kids Mode, Microsoft Edge will always launch in Kids Mode.

Exit Kids Mode 


You need your device password (the same password used to unlock your computer) to exit Kids Mode and resume browsing.

  1. Select the Kids Mode icon at the top of the browser.  

  2. Select Exit Kids Mode Window.  

  3. Enter your credentials.

Note: If you close the window through the taskbar or Close button at the top of the browser, Microsoft Edge will ask for your device credentials.


Choose a theme inside Kids Mode 


Kids can choose their own themes to personalize Kids Mode. The themes they apply in Kids Mode won’t be applied to your normal browsing windows.  

  1. Select Choose background and colors. 

  2. Choose a theme and select Done.

Grant website permissions in Kids Mode 


When a child visits a website not on the allow list, they’ll encounter a block page. Once approved, only the specific website link on the block page will be available in the browsing session. 

  1. To visit the website during the browsing session, select Get permission on the block page.

  2. The owner of the device will need to enter their credentials.

  3. The block page will refresh and the website will be allowed for the current browsing session. To permanently add the entire website onto the allow list, see below.

Make changes to the allow list or Kids Mode settings 


You can only make changes to the allow list when you’re outside of the Kids Mode browsing window and only from the profile that launches Kids Mode.  

  1. Go to Settings and more > Settings > Family. 

  2. Select Manage allowed sites in Kids Mode. You’ll see the pre-defined allow list that’s applied to Kids Mode. The list is listed in alphabetical order.

  3. org/ListItem”>

    To remove a site, click on the Close icon (X) beside it in the list. To add a website, select Add website.

We’re continuously improving the experience in Kids Mode to make it the best place for Kids to explore the web. If you have any feedback, go to Settings and more menu > Help and feedback > Send feedback. 


Change quick link tiles on the Kids Mode homepage 


In addition to the allow list, the quick link tiles on the home page of Kids Mode can be removed or updated.  



Remove a site 


  1. Hover over the quick link tile, and then select More options .

  2. org/ListItem”>

    From the menu, select Remove.

Add a new website


Privacy settings for Kids Mode 


To create a safer browsing space for kids, we’ve also enabled some privacy features by default when browsing in Kids Mode. These include setting Bing SafeSearch to Strict to help filter out inappropriate content from Bing search results, and setting tracking prevention to Strict to block a majority of trackers on sites. Clear browsing data on close has also been enabled which clears things like Cookies and other site data when Kids Mode closes. To clear browsing data at any time within Kids Mode, go to Settings > Privacy, search and services . Kids Mode will not collect data for personalization of the news feed or other Microsoft services. These privacy settings for Kids Mode cannot be changed.

Kids Mode also uses some of the privacy data settings from the profile of the adult who set it up, such as Windows Defender SmartScreen and diagnostic data settings. Windows Defender SmartScreen automatically blocks websites and content downloads that are reported to be malicious. For more information about diagnostic data and how to turn if off, see Learn more about diagnostic data collection in Microsoft Edge. These settings can be viewed and changed from the adult profile that launches Kids Mode. 


Prevent Type 2 Diabetes in Kids | Diabetes

There’s a growing type 2 diabetes problem in our young people. But parents can help turn the tide with healthy changes that are good for the whole family.

Until recently, young children and teens almost never got type 2 diabetes, which is why it used to be called adult-onset diabetes. Now, about one-third of American youth are overweight, a problem closely related to the increase in kids with type 2 diabetes, some as young as 10 years old.

Weight Matters

People who are overweight—especially if they have excess belly fat—are more likely to have insulin resistance, kids included. Insulin resistance is a major risk factor for type 2 diabetes.

Insulin is a hormone made by the pancreas that acts like a key to let blood sugar into cells for use as energy. Because of heredity (traits inherited from family members) or lifestyle (eating too much and moving too little), cells can stop responding normally to insulin. That causes the pancreas to make more insulin to try to get cells to respond and take in blood sugar.

As long as enough insulin is produced, blood sugar levels remain normal. This can go on for several years, but eventually the pancreas can’t keep up. Blood sugar starts to rise, first after meals and then all the time. Now the stage is set for type 2 diabetes.

Insulin resistance usually doesn’t have any symptoms, though some kids develop patches of thickened, dark, velvety skin called acanthosis nigricans, usually in body creases and folds such as the back of the neck or armpits. They may also have other conditions related to insulin resistance, including:

  • High blood pressure
  • High cholesterol
  • Polycystic ovary syndrome

Activity Matters

Being physically active lowers the risk for type 2 diabetes because it helps the body use insulin better, decreasing insulin resistance. Physical activity improves health in lots of other ways, too, from controlling blood pressure to boosting mental health.

Age Matters

Kids who get type 2 diabetes are usually diagnosed in their early teens. One reason is that hormones present during puberty make it harder for the body use insulin, especially for girls, who are more likely than boys to develop type 2 diabetes. That’s an important reason to help your kids take charge of their health while they’re young.

More Risk Factors

These factors also increase kids’ risk for type 2 diabetes:

  • Having a family member with type 2 diabetes.
  • Being born to a mom with gestational diabetes (diabetes while pregnant).
  • Being African American, Hispanic/Latino, Native American/Alaska Native, Asian American, or Pacific Islander.
  • Having one or more conditions related to insulin resistance.

If your child is overweight and has any two of the risk factors listed above, talk to your doctor about getting his or her blood sugar tested. Testing typically begins at 10 years old or when puberty starts, whichever is first, and is repeated every 3 years.

Take Charge, Family Style

Parents can do a lot to help their kids prevent type 2 diabetes. Set a new normal as a family—healthy changes become habits more easily when everyone does them together. Here are some tips to get started:

Mealtime Makeover

  • Drink more water and fewer sugary drinks.
  • Eat more fruits and vegetables.
  • Make favorite foods healthier.
  • Get kids involved in making healthier meals.
  • Eat slowly—it takes at least 20 minutes to start feeling full.
  • Eat at the dinner table only, not in front of the TV or computer.
  • Shop for food together.
  • Shop on a full stomach so you’re not tempted to buy unhealthy food.
  • Teach your kids to read food labels to understand which foods are healthiest.
  • Have meals together as a family as often as you can.
  • Don’t insist kids clean their plates.
  • Don’t put serving dishes on the table.
  • Serve small portions; let kids ask for seconds.
  • Reward kids with praise instead of food.

Getting Physical

  • Aim for your child to get 60 minutes of physical activity a day, in several 10- or 15-minute sessions or all at once.
  • Start slow and build up.
  • Keep it positive—focus on progress.
  • Take parent and kid fitness classes together.
  • Make physical activity more fun; try new things.
  • Ask kids what activities they like best—everyone is different.
  • Encourage kids to join a sports team.
  • Have a “fit kit” available—a jump rope, hand weights, resistance bands.
  • Limit screen time to 2 hours a day.
  • Plan active outings, like hiking or biking.
  • Take walks together.
  • Move more in and out of the house—vacuuming, raking leaves, gardening.
  • Turn chores into games, like racing to see how fast you can clean the house.

A recent study showed that when the amount of TV kids watched was limited, they lost weight—but not because they were more active when they weren’t watching. The difference was snacking: kids ate more when they were watching TV than when doing other activities, even sedentary (not physically active) ones.

Encourage your kids to reach for fruit, the original fast food.

Young kids and teens are still growing, so if they’re overweight the goal is to slow down weight gain while allowing normal growth and development. Don’t put them on a weight loss diet without talking to their doctor.

Tips for Parents: Helping Kids Maintain a Healthy Weight
How Much Physical Activity Do Kids Need?
How to Avoid Portion Size Pitfalls pdf icon[PDF – 779 KB]
My Plate Kid’s Placeexternal icon

12 Best Sunscreens for Kids and Babies 2022

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Why trust us?

Experts say these are the safest sunblocks to protect your little ones from the sun’s harmful UV rays.

By
Brittany Risher Englert and Alisa Hrustic

Nadezhda1906Getty Images

We updated this article in May 2022 to add more information about each featured product, based on extensive research done by our team.

Wrestling with your toddler as you try to apply their sunscreen or arguing with them to put on SPF before they go to day camp is nobody’s idea of fun—but it’s essential to protect your little ones from the sun’s harmful UV rays.

No matter how your kid reacts to putting on sunscreen, with all of the lotions, sticks, sprays, and creams with “baby” or “kids” on the label, the hardest thing may be choosing which one to use. That’s why we consulted six dermatologists to find out exactly what you need to look for when buying, and named the best sunscreens for kids and babies in 2022.

Important reminder: If your infant is less than six months old, both the American Academy of Dermatology and the Skin Cancer Foundation recommend keeping your baby out of the sun (and avoiding sunscreen if you can), as their skin is highly sensitive and has too little melanin, making them more susceptible to sun damage. Instead, if you must have your infant out in the sun, dress them in lightweight long sleeves and pants, a wide-brimmed hat, and sunglasses to protect them from head to toe. Once your child is 6 months old, make sure you apply SPF liberally whenever they’re spending time in the sun.

How we chose the best sunscreens for kids

We consulted subject matter experts including Meghan Feely, M.D., a board-certified dermatologist in New Jersey and New York City who serves as a clinical instructor at Mount Sinai, Julia Tzu, M.D., founder and medical director of Wall Street Dermatology, Adam Friedman, M.D., professor of dermatology and residency program director at the George Washington School of Medicine and Health Sciences, and Joel Schlessinger, M. D., board-certified dermatologist and president of LovelySkin.com for expert input. We also scanned customer reviews to fine tune and curate our top picks.

Our top picks

  • BEST VALUE

    Pure & Simple Baby Mineral Sunscreen Lotion SPF 50
    Coppertone

    $9 AT AMAZON

    Read More

    $9 AT AMAZON

  • Rave Reviews

    Australian Baby Mineral Sunscreen SPF 50+
    BLUE LIZARD

    $13 AT AMAZON

    Read More

    $13 AT AMAZON

  • Best for the Whole Family

    Mineral KidCrème SPF 50
    MDSolarSciences

    $35 AT AMAZON

    Read More

    $35 AT AMAZON

  • Best for Sensitive Skin

    Baby Continuous Protection Sensitive Skin SPF 50
    Aveeno

    $9 AT AMAZON

    Read More

    $9 AT AMAZON

  • Best Reef-Friendly

    Baby Sunscreen Cream SPF 30
    Badger

    $40 AT AMAZON

    Read More

    $40 AT AMAZON

  • Best Overall

    Anthelios Melt-In Sunscreen Milk Body & Face Sunscreen
    La Roche-Posay

    $36 AT AMAZON

    Read More

    $36 AT AMAZON

  • Best for Babies

    Safe Sunscreen SPF 50+
    Thinkbaby

    $13 AT AMAZON

    Read More

    $13 AT AMAZON

  • Best Fast-Drying

    Hydrating Mineral Sunscreen SPF 50
    CeraVe

    $15 AT AMAZON

    Read More

    $15 AT AMAZON

  • Best Hydrating

    Mineral Sunscreen Lotion SPF 50
    Baby Bum

    $26 AT AMAZON

    Read More

    $26 AT AMAZON

  • Most Lightweight

    Baby Skin Mineral Sunscreen Lotion SPF 50
    Babo Botanicals

    $17 AT AMAZON

    Read More

    $17 AT AMAZON

    • Load More

    Show Less

Check out the best sunscreens for babies and children below, and remember to apply every two hours and more frequently if your little one is sweating or playing in the water.

BEST VALUE

Coppertone

Pure & Simple Baby Mineral Sunscreen Lotion SPF 50

Coppertone

Rave Reviews

BLUE LIZARD

Australian Baby Mineral Sunscreen SPF 50+

Blue Lizard

Best for the Whole Family

MDSolarSciences

Mineral KidCrème SPF 50

MDSolarSciences

Best for Sensitive Skin

Aveeno

Baby Continuous Protection Sensitive Skin SPF 50

Aveeno

Best Reef-Friendly

Badger

Baby Sunscreen Cream SPF 30

badger

$40 AT AMAZON

Best Overall

La Roche-Posay

Anthelios Melt-In Sunscreen Milk Body & Face Sunscreen

La Roche-Posay

Best for Babies

Thinkbaby

Safe Sunscreen SPF 50+

thinkbaby

Best Fast-Drying

CeraVe

Hydrating Mineral Sunscreen SPF 50

CeraVe

Best Hydrating

Baby Bum

Mineral Sunscreen Lotion SPF 50

sun bum

$26 AT AMAZON

Most Lightweight

Babo Botanicals

Baby Skin Mineral Sunscreen Lotion SPF 50

babo botanicals

Best Soothing

All Good Makes Everything Better

Kid’s Mineral Sunscreen SPF 30

All Good

Best Scented

Alba Botanica

Kids Sunscreen Lotion SPF 45

alba botanica

How to choose (and use) the best sunscreens for kids and babies

Use a high SPF: A water resistant, broad-spectrum sunscreen with an SPF of 30 or higher will be the safest choice for your kids. This ensures your sunscreen protects against both harmful UVA and UVB rays.

Choose mineral: Many dermatologists prefer physical (a.k.a. mineral) sunscreens made of titanium dioxide or zinc oxide, which deflect sun rays, whereas a chemical sunscreen absorbs them, says Dr. Feely. These natural sunscreens are often gentler on kids’ sensitive skin. (Mineral formulas are also reef-safe, so you’ll keep coral-damaging chemicals out of our oceans too.) “Babies and kids have thinner skin and a higher surface-to-volume ratio,” says Dr. Tzu. Because their skin absorbs more per unit of body weight than an adult does, “it’s important to make sure that whatever you put on their skin is ‘pure,’” she adds. Translation: Avoid using sunscreens with chemical ingredients (such as oxybenzone or avobenzone), as they have a higher risk for irritation.

Go for lotions: Although sprays are easy to apply, most people don’t apply them effectively. “Improper application can result in poor outcomes. You can’t spray it like perfume or spring water—the nozzle should be about 2 centimeters away from the skin and you should see the liquid on the skin,” says Dr. Friedman. “Sticks are also crowd favorites, but need four passes on each area of skin to have any effect,” he adds. The bottom line: Lotions tend to be best unless you can diligently apply a spray or stick sunscreen.

Brittany Risher Englert
Brittany Risher Englert is a writer, editor, and digital strategist specializing in health and lifestyle content.

DTP vaccination for an infant: purpose, interpretation, possible reactions

Contents:

    General vaccination of the population is one of the main tasks of modern medicine in the fight against infectious diseases. The infant is faced with prophylactic injections from the first days of life. DTP vaccination is designed to form primary immunity in the child’s body against the most common diseases:

    • measles;
    • diphtheria;
    • tetanus and other diseases.

    We must not forget that these diseases are extremely dangerous for infants, as they can lead to a sad outcome. Even modern innovations in drug development do not provide complete safety for the baby. For greater protection against infections, the child is vaccinated with DTP.

    Preparation. Appointment. Types of vaccines

    DTP vaccine (adsorbed pertussis-diphtheria-tetanus vaccine) – a complex of the most active elements to combat diseases:

    • infantile paralysis;
    • hemophilia;
    • hepatitis B;
    • diphtheria;
    • poliomyelitis;
    • whooping cough;
    • tetanus.

    If revaccination against only one or several infectious diseases is planned, varieties of DTP are used. These include AS, ADS-m, AD-m.

    Whether to vaccinate with DTP

    Children all over the world have been vaccinated with DTP since ancient times. For a long time, disputes have been going on about the need for such prevention. There are many pros and cons. In our country, no parent is required to do this. But there are plenty of arguments that speak of the need for vaccination. The body of the child, as a rule, copes well with vaccination. Possible reactions protect the baby from unwanted consequences. If negative effects appear in infants, then this indicates an incorrect administration of the drug or an overdue storage of the vaccine.

    Contraindications for DTP vaccination for an infant

    Vaccination is an important medical event. Not every baby can be vaccinated due to contraindications for a small body. It is impossible to vaccinate if the child has congenital diseases, and they are in the acute stage.

    Vaccination is not allowed if the body is intolerant to one of the elements of DTP.

    If the child’s immune system is weak, then the vaccine can cause illness, as the body will not be able to cope with the infectious agent.

    Childhood leukemia is also a hindrance to the use of DTP. It is necessary to wait until the moment of full recovery.

    If the baby has a fever, the vaccination is not prohibited. But a prerequisite should be the absence of convulsive conditions, neuralgia. The composition of the drug should contain tetanus components and diphtheria.

    DTP vaccination may contain false type contraindications. What does it mean? In this case, vaccination should be carried out only after a thorough examination of the patient by a doctor. And also the relatives of the baby should undergo a detailed study.

    Preparing for vaccination

    DPT, like a vaccine, can provoke reactions in the body to vaccination. Therefore, it is necessary to carefully prepare the baby for the DTP procedure. Required:

    • refuse to visit friends;
    • will take long walks;
    • strictly adhere to the regime of the day.

    For all questions regarding DPT vaccination, the attending physician will give advice.

    Article author:
    Nosenko Tatyana Vladimirovna – chief physician of the medical center “Inpromed”, doctor of the first qualification category, 33 years of medical practice.

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    pediatrician, vaccine-prevention

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    Ivanova Zoe Alekseevna

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    Interested:

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    Vaccination against diphtheria, tetanus and whooping cough (DTP) and against polio

    Vaccination against whooping cough, diphtheria, tetanus, poliomyelitis begins at 3 months. In the National Calendar, protection against these infections was introduced in 1953, and against tetanus from 1966. The following vaccines are used for vaccination:

    – DPT is an adsorbed combined vaccine that contains a killed whole pertussis bacillus (which is why it is also called whole cell), diphtheria toxoid (detoxified toxin) and tetanus toxoid. This is a Russian vaccine (Microgen) and its use has virtually eliminated diphtheria and tetanus and markedly reduced the number of whooping cough cases.

    The only thing that many parents do not like is the rise in temperature on the first day – this is a variant of a normal reaction to vaccination, as the cells of the immune system begin to work actively in response to contact with fragments of whooping cough.

    But vaccine prophylaxis is constantly being improved, and acellular (or acellular) vaccines are currently being produced. These vaccines contain only 2 or 3 pertussis antigens, they do not contain a whole pertussis bacillus (up to 3000 pertussis antigens). But today, such vaccines are only foreign-made. Several similar vaccines are registered in Russia:

    – the first vaccine registered in Russia in the early 2000s – Infanrix (GlaxoSmithKline, Belgium). The vaccine contains 3 pertussis antigens, diphtheria and tetanus toxoids.

    – Infanrix hexa vaccine (GlaxoSmithKline, Belgium) was registered a little later. In addition to the composition of the previous vaccine, it also contains an inactivated vaccine against polio, hepatitis B and the Hiberix vaccine (against Haemophilus influenzae, which is the cause of complications in acute respiratory viral infections in young children).

    – Pentaxim (Sanofi, France), registered and successfully used in Russia since 2008. In its combination, this vaccine also contains an inactivated (killed) polio vaccine, a vaccine against Haemophilus influenzae.

    The revision of the main order for vaccination within the framework of the National Calendar N125n dated April 13, 2017 has the following additions – children at risk for vaccination against Haemophilus influenzae and the full course of vaccination with inactivated polio vaccine are identified:

    • With immunodeficiency states;
    • With anatomical defects leading to a sharply increased risk of hemophilic infection;
    • With malformations of the intestines;
    • With cancer and/or long-term immunosuppressive therapy;
    • born to mothers with HIV infection;
    • In orphanages;
    • Premature and low birth weight babies.

    Vaccination and revaccination of children at risk can be carried out with immunobiological drugs for the immunoprophylaxis of infectious diseases containing combinations of vaccines (for example, Pentaxim) intended for use in the appropriate age periods (edition of the order of the Ministry of Health of the Russian Federation N 175n of 04/13/2017 .

    Children who are not included in the risk group can, at the request of their parents, be vaccinated with acellular preparations for vaccination against whooping cough, diphtheria and tetanus for a fee. Information in this case can be obtained from the local pediatrician.

    There may be other options for vaccinating children, depending on the possibilities of the regional budget.

    In 2016, the vaccine Adacel (Sanofi, France) was registered in Russia, it also does not contain a whole pertussis bacillus, and the content of diphtheria and tetanus toxoids in the composition is less than in other preparations. This vaccine is mainly intended for revaccination of children over 4 years of age and adults (after 14 years it is possible every 10 years), since immunity against whooping cough is short-lived.

    For children who are not vaccinated on time and are over 4 years of age, according to the National calendar, they are vaccinated only against diphtheria and tetanus (DTP vaccination is carried out up to 4 years, Infanrix hexa up to 36 months), but vaccination can be performed at the request of parents and drugs Pentaxim and Infanrix, as they have no age restrictions.

    For vaccination against polio there are also changes in the National calendar since 2014.

    If earlier for mass vaccination since 1958-59 they used live attenuated Sabin vaccine (it contained 3 vaccine strains of poliovirus), then to prevent vaccine-associated poliomyelitis in vaccinated and in contact unvaccinated since 2014, the vaccination scheme has changed:

    -V1 and V2 All children receive an inactivated vaccine at 3 months. and at 4.5 months,

    -V3 at 6 months. and subsequent revaccinations at 1 g for 6 months, 1 g for 8 months. and at the age of 14 they receive the OPV oral polio vaccine, and since the spring of 2017 OPV contains only 2 strains of vaccination viruses – I and III – BiVac polio (FNCIRIP named after Chumakov, Russia).

    Inactivated vaccines registered in Russia:

    • Imovax Polio (Sanofi, France) – currently used as part of the combined Pentaxim vaccine,
    • Poliorix (GlaxoSmithKline, Belgium) – currently used as part of the combined vaccine Infanrix hexa,
    • Polymilex (Nanolek, Russia) – used for V1 and V2 against poliomyelitis since spring 2017.

    Diphtheria – is a serious infection affecting both adults and children. The cause of the infection is a diphtheria bacillus, which is transmitted by airborne droplets, sometimes through common toys, household items. Diphtheria affects the nose, pharynx, larynx, less often – the skin, eyes. The patient develops films in the pharynx, which can spread to the nose and larynx and block breathing. In children under one year old, films immediately pass to the larynx, vocal cords, croup appears (laryngeal edema). In these cases, urgent measures are required, otherwise the person will suffocate. In addition, diphtheria is fraught with serious complications – damage to the heart, kidneys, nervous system. It is possible to avoid the disease only with timely vaccination. Vaccination protects against the toxin produced by the diphtheria bacterium, which causes all life-threatening conditions.

    People who are vaccinated do not get severe, dangerous forms of diphtheria. They may develop a sore throat, but it is not life threatening.

    Tetanus (tetanus ) is an acute infection affecting the nervous system caused by a toxin that tetanus bacillus releases when it enters a wound from the ground. Tetanus is extremely severe and can develop at any age. The toxin affects the nervous system, causing muscle spasms and convulsions. Mortality with tetanus reaches 90%. Immunity during vaccination is formed against the toxin, as in diphtheria.

    Whooping cough is a disease with a special lesion of the respiratory system, characterized by paroxysmal “spasmodic” cough. The child “comes in” in a cough until vomiting, redness of the face and the appearance of small hemorrhages on the face, sclera of the eyes. Coughing attacks are especially disturbing at night and in the morning Whooping cough is dangerous with complications – pneumonia, and in young children – death due to apnea – respiratory arrest, convulsions and brain damage due to oxygen starvation

    Polio – caused by three types of polio viruses, transmitted with water and food. As a rule, they do not die from poliomyelitis, but paralysis or paresis can remain, more often than one leg, in which the limb gradually loses weight and shortens, and the child either limps heavily or cannot move at all without support. Sometimes paralysis of the respiratory muscles develops and a person cannot breathe without the help of special devices.

    DTP and inactivated polio vaccines are given intramuscularly in the anterolateral thigh.

    Vaccination plan.

    DPT and polio vaccination starts at 3 months. After vaccination and DPT revaccination (see below), according to the vaccination schedule, adults are revaccinated every 10 years (ADS-M vaccine).

    Vaccination of children according to the vaccination schedule:

    Age

    First vaccination with DTP and Polimilex

    3 months

    Second vaccination with DPT and Polimilex

    4.5 months

    Third vaccination with DPT and BiVac polio

    Revaccination 1 DPT and BiVac polio

    Revaccination 2 bivouac polio

    Revaccination 2 ADS-m

    Revaccination 3 ADS-m and BiVac polio

    6 months

    18 months

    20 months

    7 years

    14 years old

    Side effects.

    DTP vaccine causes moderate side effects: slight fever on the first day; moderate soreness, redness and swelling at the injection site may occur with V 3 or R 1. An increase in body temperature (usually not higher than 37.5 C) and slight malaise can also be observed within 1-2 days after vaccination, rarely (up to 4% may be rise t above 38). At t above 38.5, it is necessary to give antipyretic drugs at home on the recommendation of a doctor paracetamol or ibuprofen. In the event of a repeated rise in t or insufficient response to antipyretic drugs, you need to call a pediatrician or an ambulance and the doctor will prescribe the amount of necessary therapy. Wiping with vodka or alcohol is not recommended.

    Children who are prone to allergic reactions may develop a rash, so the pediatrician may prescribe antiallergic drugs before and after vaccination.

    Serious complications from DPT-immunization are rare; they occur in less than one percent of cases. It can be convulsions against a background of high fever, so it is recommended that children with a possible reaction be vaccinated against the background of antipyretics (paracetamol or ibuprofen).

    In order to reduce the number of side effects on the whole-cell DTP vaccine, it can be replaced with a combined analogue (Pentaxim, Infanrix vaccine), in which the whole-cell pertussis component (up to 3000 antigens) is replaced by a cell-free variant (2-3 antigens), which is practically does not cause adverse reactions. In addition, combined vaccines significantly reduce the injection load and reduce the total dose of additional substances (vaccine stabilizers, preservatives).

    After vaccination with whooping cough, immunity is short-term and after 5-7 years you can get whooping cough. For revaccination at 7 years, 14 years and beyond for 10 years, Adasel vaccine can be used. The only thing is that vaccinated people can get sick in a more erased form – bronchitis or pneumonia may sound in the diagnosis, there may not be characteristic bouts of spasmodic cough, but for the unvaccinated, such a patient is a source of infection.

    Infanrix diphtheria, whooping cough, tetanus vaccine

    Infanrix (Infanrix) is an imported vaccine against whooping cough, diphtheria and tetanus, an analogue of the domestic DPT. Manufacturer: GlaxoSmithKline Biologicals s.r.o. a., Belgium. Infanrix fully complies with WHO requirements, contains no preservatives and is one of the most widely used pertussis, diphtheria and tetanus vaccines in Europe.

    To vaccinate or not?

    The issue of childhood vaccinations causes among modern parents perhaps the most heated debate. “Vaccinators” appeal to the fact that vaccination is the only proven way to train the immune system to fight deadly infections, and it is obviously safer than a previous disease. “Anti-vaxxers” refers to unwanted side effects that are possible with vaccination. In fact, blind adherence to everything that is prescribed in the district clinic, and the categorical denial of all the achievements of modern medicine are equally meaningless. Most parents would still like to make a balanced, informed decision. This means that each specific vaccine should be considered separately.

    In this case, we are talking about vaccinating a child up to a year against whooping cough, diphtheria and tetanus. Is vaccination justified to prevent these diseases?

    Why vaccinate a child against tetanus

    Tetanus is extremely dangerous: mortality from this disease reaches 80% of the number of cases, among newborns – 95%. The course of tetanus is very painful: there are cases of such severe convulsions that the patient’s bones broke. Even if the patient survives, immunity to tetanus after the illness is not formed, and it can be re-infected, but damage to the central nervous system is already irreversible.

    The causative agent of tetanus is found in the intestines of humans and animals, from where it enters the ground along with the feces or bodies of dead animals. Hence the widespread belief that it is impossible to get tetanus if you do not play in mass graves of people or animals. This condition is hardly feasible: the causative agent of tetanus can persist in the soil for more than a hundred years, and the burial of domestic animals in Russia is often spontaneous.

    Why vaccinate your child against diphtheria

    Diphtheria (true croup, aka “suffocating disease”) is transmitted by airborne droplets and is highly contagious. This is one of the diseases for which population immunity is very important. So, since 1974, the disease was considered completely defeated due to mass vaccination, but in 1997, due to refusals to vaccinate, an outbreak of this disease was again recorded. Children are especially susceptible to diphtheria, about 25% of cases are very difficult. As complications, diphtheria can give paralysis, polyneuritis and myocarditis – inflammation of the heart muscle.

    At the same time, diphtheria toxoid is one of the safest vaccines. Severe reactions to it are observed quite rarely.

    Why vaccinate your child against whooping cough

    Whooping cough is especially dangerous for children under two years of age, as it can cause breathing to stop. At the same time, whooping cough refers to those diseases, antibodies against which are not transmitted with mother’s milk, even if the mother was vaccinated or had whooping cough. Even the transferred whooping cough does not give life-long stable immunity after recovery.

    Mortality from whooping cough among those who fell ill in the first year of life is 50-60%. In addition, whooping cough can cause complications such as pneumonia, cerebral hemorrhage, and rupture of the eardrum.

    How is Infanrix different from DTP?

    The “anti-vaccinators” have almost the most complaints about the DTP vaccination from the entire spectrum of vaccines that are administered to children in the first years of life. The reason for this is that DTP is quite difficult to tolerate by children. Many vaccinated people have a high temperature and feel unwell within a few days after vaccination. Strong side effects are associated with the pertussis component of DPT – which is why neurologists and pediatricians recommend ADS-M to weakened children instead of DTP, that is, only diphtheria-tetanus toxoid, without whooping cough. Infanrix, unlike its domestic counterpart, does not contain pertussis pathogen cells.

    To form an immune response, only three antigens (out of about three thousand) were extracted from these cells, which are used in the vaccine. This does not affect the effectiveness of Infanrix, but it is much less allergenic, much less often accompanied by fever and easier to tolerate.

    It also follows from this difference that when revaccinating or revaccinating, it is possible to switch to Infanrix after DTP, but vice versa – it is undesirable. If the first vaccinations contained only three antigens, it is not necessary to transfer the child to a vaccine containing whole cells of the whooping cough pathogen.

    Infanrix or Pentaxim?

    Infanrix is ​​not the only foreign-made vaccine that uses antigens isolated from the whooping cough pathogen instead of whole cells. According to the same scheme, Pentaxim is produced – also a very well-known foreign analogue of DTP. Which one to choose?

    They are very similar in composition and action, so it is logical to use the vaccine that is more available to you at the moment. However, there is one significant difference to be aware of. Infanrix contains only tetanus, whooping cough and diphtheria toxoids. Pentaxim, in addition, contains components for the prevention of hemophilic infection, as well as poliomyelitis, that is, it is a five-component vaccine. This means that if you have already chosen Infanrix or Pentaxim, at the next vaccination or revaccination you will not be able to change from one to the other, since the vaccination protocol against polio and Haemophilus influenzae will not be completed.

    Should I combine all five components or manage with three, preferring Infanrix? The choice is up to the parents. Some believe that multicomponent vaccines create too high a one-time antigenic load on the body. Others are guided by the National Immunization Schedule, which provides for simultaneous vaccination against several diseases (without specifying how many vaccines it is carried out). The Infanrix line has complementary vaccines – Infanrix IPV (whooping cough, diphtheria, tetanus, polio) and even Infanrix Hexa (the same four diseases plus hepatitis B and hemophilic infection). Domestic DTP also has expanded versions: Tetracoccus (DPT + polio) and Bubo Kok (DPT + hepatitis B).

    How is Infanrix administered?

    According to the National Immunization Schedule, the first preventive immunization against tetanus, diphtheria and whooping cough is carried out at three months. As a rule, it is preceded by an examination of the child by a neurologist, who “gives the go-ahead” for vaccination or, on the contrary, a withdrawal from it according to indications, and then by a pediatrician.

    Infanrix allows in this case shifts in the timing of vaccination. It will not affect its effectiveness.

    The second stage of immunization falls on 4.5 months.

    The third is for six months.

    This first course of three treatments builds up immunity one month after vaccination. Its effectiveness is 99% for diphtheria and tetanus, 95% for whooping cough.

    Revaccination against whooping cough, diphtheria and tetanus is carried out at 18 months (one and a half years). During revaccination, a secondary response of the immune system is formed, which reinforces the effect of the primary vaccination. Revaccination against diphtheria and tetanus is also given to children aged 7 and 14 years. In an adult, immunity against diphtheria and tetanus, acquired as a result of vaccination, lasts about 10 years.

    How is Infanrix injected?

    Infanrix is ​​administered intramuscularly into the anterior thigh. During the course of vaccination, the legs should be alternated. Injections should not be given in the buttock, so as not to damage the sciatic nerve of the child (there are no important vessels and nerves in the front of the thigh that could be affected by vaccination, so it is completely safe), and in no case should it be administered intravenously. The volume of the vaccine is 0.5 ml.

    Possible side effects of Infanrix

    The instructions for the drug mention the following side effects of the vaccine as the most common: drowsiness, loss of appetite, irritability, anxiety, fever, itching and swelling at the injection site, vomiting, diarrhea. Infrequently, vaccination may be followed by headache, cough, rash, induration at the injection site.

    Adverse reactions occurring in more than 1% of those vaccinated are considered frequent. Any vaccine can cause an allergic reaction. Therefore, after the introduction of the vaccine, it is not recommended to leave the clinic for 30-40 minutes: in any office where vaccinations are given, there is a first aid kit for a quick response to a possible anaphylactic shock. After the expiration of this time, an acute allergic reaction to the drug will no longer occur, and you can safely go home.

    If the child has a fever after vaccination, it is recommended to ventilate the room in which he is located and maintain the humidity level in it above 70%. At temperatures above 38.5 ° C, it is better to give an antipyretic, and if it rises above 40 ° C, you should immediately call an ambulance. Be sure to give your child more fluids.

    If any of the adverse reactions persist for more than two days, you should consult a doctor. This can happen when vaccinated with a low-quality vaccine (improperly stored or expired) or if the vaccination itself was done incorrectly, in violation of sterility.

    How to prepare for vaccination with Infanrix

    The likelihood of adverse reactions, as well as their severity, can be reduced by preparing for vaccination. First, you need to make sure that the child is healthy. Even mild SARS without fever is a temporary contraindication to vaccination. If the child is healthy, but one of the relatives who has been in contact with the child for several days before vaccination is sick, it is also better to postpone the vaccination.

    It is better to postpone the vaccination if it is very hot or, conversely, very cold outside. In general, mild conditions are indicated on the day of vaccination and for several days after. Stress factors, including walking in the heat and cold, must be excluded.

    It is recommended not to overload the stomach on the day of vaccination, the vaccination should be done at least one hour after eating. On the day of vaccination, no new complementary foods should be introduced. It is recommended to pay attention to whether the child had a stool during the day before the vaccination, and if not, to give him an enema to help empty the intestines.

    On the day the vaccination is scheduled, you can give your child an antihistamine.

    Contraindications to vaccination with Infanrix

    If the child has previously shown signs of allergy to the pertussis, tetanus and diphtheria vaccine, this is an absolute contraindication to further vaccination.

    If encephalopathy was manifested in a child after the DPT preparation, the pertussis component should be excluded from vaccination. In this case, leave only the vaccine against diphtheria and tetanus.

    If the side effects were very pronounced – the temperature rose to 40 ° C, there was severe swelling, convulsions, it is also better to refuse vaccination.

    This is not an exhaustive list of contraindications. In any case, the medical exemption from vaccination should be given by a neurologist or pediatrician based on the results of a comprehensive examination of the child and analysis of his medical record.

    What to do if you have a fever after DTP vaccination: practical advice for parents

    When administering a vaccine, doctors always warn patients that the risk of hyperthermia is high. This is a natural process, as foreign antigens are introduced into the body. The time that the fever will last depends on the type of vaccine, the disease against which the vaccine was given, and the individual characteristics of the organism. It is important to understand when to bring down the temperature, and when to wait.

    What is DPT vaccine

    DTP is a turbid liquid containing microorganisms of tetanus, diphtheria, whooping cough. It is injected intramuscularly into the thigh or deltoid muscle. This allows you to create artificial immunity in a child to dangerous diseases. It is permissible to make an imported vaccine, a domestic one. In this case, the choice depends on the preferences of the parents.

    Body reaction to the administration of Ag

    Introduced antigen enter the blood. The body begins to actively develop immunity through the synthesis of antibodies, phagocytes, interferon. Thus, leukocytes remember the pathogenic agent. As soon as the pathogen enters the body, the immune system recognizes it and begins to develop protective functions. All this provokes the formation of reactions, both local and physiological. Hyperemia at the injection site, swelling, soreness are considered local. In addition, a violation of the motor functions of the limb where the drug was injected is not excluded.

    Systemic reactions include:

    • increase in body temperature;
    • anxiety, tearfulness, irritability;
    • drowsiness, lethargy;
    • violation of the chair;
    • loss of appetite, vomiting.

    Fever in a child after DTP

    The temperature after DTP vaccination is a normal response of the body. It is worth noting that high temperature does not contribute to the formation of immunity. Therefore, it must be knocked down. In cases where the temperature exceeds 39degrees, you need to call a doctor at home. The temperature after DPT is considered to be 38-38.5 degrees. WHO recommends bringing down the temperature after this vaccination. Normally, the temperature after vaccination lasts no more than 3 days. In most cases, the child’s health condition returns to normal in a day.

    Clinical signs normally develop within the first three days after vaccination. If symptoms appear later, this indicates the presence of an infection that coincided with the vaccination. If you are in doubt about the symptoms, please consult our doctors. They will remotely tell you what to do, which specialists to contact, and will be in touch at any time of the day.

    How to bring down the temperature after vaccination

    After immunization, doctors advise to abandon water procedures, walks for three days. It is advisable to use the following drugs as needed:

    • antipyretic;
    • restoring water and electrolyte balance.

    Rubbing and compresses with chamomile are suitable. The use of vodka for these purposes is impractical, as it dries the delicate skin of the baby. Aspirin is prohibited for young children.

    Complications after immunization

    The reaction of the child’s body to the introduction of foreign Ag is individual. Some children tolerate vaccines well, some have complications in the form of:

    Name

    Description

    Quincke’s edema

    It is considered a severe form of an allergic reaction, in which the larynx, nasopharynx swell. occurs immediately after vaccination

    Anaphylactic shock

    In this case, the blood pressure indicators fall, the rhythm and heart rate decrease, the child may lose consciousness. Occurs an hour after immunization. In this case, resuscitation is indicated;

    Seizures without fever

    Occurs as a result of brain damage

    encephalopathy

    It does not occur immediately, it is characterized by brain damage. the child is sent to the hospital for health monitoring

    Important! An immunological and complete examination is required before vaccination. Only after the received data on the body’s readiness for the administration of the drug, it is possible to make an informed decision.

    Contraindications for vaccination

    immunization is a burden on the child’s body. It is done at the indicated time in the vaccination calendar. However, there are situations when it is impossible to be vaccinated. These include:

    • acute and chronic diseases;
    • allergy;
    • immunodeficiency;
    • prematurity, if the body weight of the newborn is less than 2000 g;
    • blood pathology;
    • neoplasms;
    • neurological abnormalities accompanied by seizures.

    Complications from DPT are rare. But if you notice that the child’s health has deteriorated, please contact our doctors for a remote consultation. They will draw up a clinical picture over the phone, advise specialists and clinics where you can undergo the necessary examination.

    Do I need a medical diversion at high temperature after the first dose of vaccine

    If the body temperature after the first vaccination has risen to critical values ​​\u200b\u200bof 40 degrees, then the second one should wait. Such hyperthermia is a reason for medical withdrawal. If the temperature is below 40 degrees, there are no neurological manifestations, then the medical withdrawal is not given.

    Hyperthermia after immunization is considered normal in cases where there are no side effects.

    Read also
    Whether to vaccinate a child

    Child health monitoring after immunization

    After vaccination, doctors advise to monitor the baby:

    • take thermometry several times a day;
    • bring down the fever;
    • provide plenty of warm drink;
    • do not insist on eating in case of refusal.

    Parents need to observe the appearance of negative consequences in the form of allergies, seizures.

    Example

    At three months, the parents vaccinated their son with DTP. The temperature rose the next day and lasted 9 days. Six months later, the child stopped talking and communicating with his parents. After long examinations, doctors found that the process of destruction of brain neurons is underway. This applies to post-vaccination complications. This process can take up to 1.5 years. At the end of all examinations and consultations with various specialists, the child was diagnosed with an autism spectrum disorder.

    FAQ

    What to do if the child has a fever after DTP?

    +

    If the temperature has risen in the first three days and does not exceed 38.5, you should not worry. You can give antipyretics to the baby and observe. At a temperature above 38. 5 degrees, convulsions, allergic reactions – you should consult a doctor.

    How many days does the temperature last after DPT?

    +

    Normally, hyperthermia does not exceed three days. the reaction depends on the individual characteristics of the organism, the manufacturer of the vaccine, the conditions of its storage, transportation.

    What should be done to avoid a rise in temperature from DTP?

    +

    Before immunoprophylaxis, it is necessary to undergo examinations. Avoid vaccination if contraindicated. Before vaccination, the day before the child is recommended to give antihistamines.

    Why does the temperature rise after DTP?

    +

    As already mentioned, this is the response of the immune system to the administration of the drug. At the same time, the protective functions of the body are launched. Some pathogens die at high body temperature. That is, its increase is a defensive reaction. That is why in some cases it is not recommended to knock it down. In cases with vaccinations, this is necessary, since hyperthermia interferes with the formation of immunity to infections.

    Expert opinion

    If the temperature rises after DTP vaccination, this is a normal response of the immune system to the introduction of a foreign antigen. It is worth paying attention to the temperature after DTP more than 39 degrees and holding for a long time. Including a reaction is considered pathological if hyperthermia in an infant begins a week after vaccination and lasts for a long time.

    We publish only verified information

    Article author

    Pruzhinin Mark Yulievich

    pediatrician

    Experience 30 years

    Consultations 1572

    Articles 104

    An experienced pediatrician with extensive experience and clinical experience in various medical organizations in the field of general pediatrics, resuscitation-anesthesiology and neuroinfection. Works with leading experts, attends international and Russian conferences.

    Immunization coverage

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      • Immunization coverage

      WHO/H. Dicko

      A child is being vaccinated orally in Borno state, Nigeria

      ©
      A photo

      Highlights

      • Global reach down from 86% in 2019to 83% in 2020
      • An estimated 23 million children under 1 year of age have not received essential vaccines, the highest number since 2009. 4 million.
      • Only 19 vaccine introductions were reported in 2020, less than half of any year in the last two decades.
      • In 2020, 1.6 million more girls were not fully protected against human papillomavirus (HPV) compared to the previous year.

      Background

      Although immunization is one of the most successful public health interventions, there has been little progress in this area over the past decade. The COVID-19 pandemic and related disruptions have put pressure on health systems: in 2020,
      23 million children were unvaccinated, 3. 7 million more than in 2019 and the highest since 2009. three doses of the diphtheria-tetanus-pertussis (DTP3) vaccine, which protected them from infectious diseases that can cause great suffering and disability
      or death.

      There were only 19 vaccine introductions in 2020 (not including COVID-19 vaccine introductions), less than half of any year in the last two decades. This slowdown is likely to continue as countries focus
      on continued efforts to combat the COVID-19 pandemic and on the introduction of COVID-19 vaccines.

      Global immunization coverage 2020

      The following is a summary of global immunization coverage in 2020.

      Haemophilus influenzae bacillus type b (Hib) causes meningitis and pneumonia. By the end of 2020, the Haemophilus influenzae type b vaccine had been introduced in 192 Member States. Global coverage with three doses of haemophilus influenzae vaccine
      influenza type b is estimated at 70%. Coverage levels vary widely across regions. Coverage is estimated at 83% in the WHO South-East Asia Region, while coverage in the WHO Western Pacific Region is
      only 25%.

      Hepatitis B is a viral infection that affects the liver. By the end of 2020, hepatitis B vaccine for infants had been introduced nationwide in 190 Member States. Global coverage with three doses of hepatitis B vaccine estimated
      at the level of 83%. In addition, 113 Member States have introduced immunization of newborns with a single dose of hepatitis B vaccine during the first 24 hours of life. Global coverage is 42% and reaches 84% ​​in the Western Pacific Region
      WHO, while it is estimated that in the countries of the WHO African Region it is only 6%.

      Human papillomavirus (HPV) is the most common viral infection of the genital tract and can cause cervical cancer in women and other types of cancer, as well as genital warts in men and women. By the end of 2020
      HPV vaccine has been introduced in 111 Member States. As vaccine coverage has not yet been introduced in many major countries, and vaccination coverage has declined in many countries in 2020, global HPV end-dose coverage is currently being estimated.
      at the level of 13%. This is a proportionately large decline from the 15% level seen in 2019d.

      Meningitis A is an infection that is often fatal and causes long-term severe aftereffects in every fifth person who has been ill. Prior to the 2010 introduction of MenAfriVac, a revolutionary vaccine
      – 80–85% of meningitis epidemics in African meningitis belt countries were caused by serogroup A meningitis. By the end of 2020, nearly 350 million people in 24 of the 26 meningitis-affected countries had received MenAfriVac through campaigns.
      belts. By 2020, 11 countries have included MenAfriVac in their routine immunization schedule.

      Measles is a highly contagious disease caused by a virus that is usually accompanied by high fever and rash and can lead to blindness, encephalitis and death. By the end of 2020, 84% of children received one dose containing
      measles vaccine component before their second birthday, 179 Member States included a second dose as part of their routine immunization programs and 70% of children received two doses of measles vaccine through their national programs
      immunization.

      Mumps is a highly contagious viral infection that causes painful swelling of the parotid glands, high fever, headache and muscle pain. It can lead to the development of viral meningitis. By the end of 2020 mumps vaccine
      has been introduced at the national level in 123 Member States.

      Pneumococcal infections include pneumonia, meningitis, and febrile bacteremia, as well as otitis media, sinusitis, and bronchitis. By the end of 2020, pneumococcal vaccine had been introduced in 151 Member States, three of which were using part of it
      territory, and global coverage with the third dose of the vaccine was estimated at 49%.

      Polio is a highly contagious viral disease that can cause permanent paralysis. In 2020, 83% of infants worldwide were covered with three doses of polio vaccine. As of 2020 coverage of infants,
      receiving the first dose of inactivated polio vaccine (IPV) in countries still using oral polio vaccine (OPV) is estimated at 80%. Transmission of polio targeted for global eradication has been halted in all countries except
      Afghanistan and Pakistan. Until poliovirus transmission is interrupted in these countries, the risk of importation of poliomyelitis will threaten all countries, especially those that are vulnerable due to underdeveloped social systems.
      health and immunization services; and the existence of passenger or trade links with polio-endemic countries.

      Rotavirus is the most common cause of severe diarrheal disease in young children worldwide. By the end of 2020, the rotavirus vaccine had been introduced in 114 countries, including three countries where
      it is used in part of the territory. Global coverage was estimated at 46%.

      Rubella is a viral disease that is usually mild in children, but if infected early in pregnancy can lead to fetal death or congenital rubella syndrome, which can cause brain damage
      and cardiovascular system, visual and hearing disorders. By the end of 2020, rubella vaccine had been introduced nationally in 173 Member States, with coverage estimated at 70%.

      Tetanus is caused by bacteria that thrive in the absence of oxygen, such as in infected wounds or a poorly treated umbilical cord. Spores of bacteria C. tetani are present in the environment in all regions of the world. They produce
      a toxin that can cause serious complications or death. Maternal and neonatal tetanus is still an ongoing public health problem in 12 countries, mainly in Africa and Asia.

      Yellow fever is an acute viral hemorrhagic disease transmitted by infected mosquitoes. As of 2019, yellow fever vaccine was included in routine infant immunization programs in 36 out of 40 countries
      and areas of Africa and the Americas at risk of yellow fever. Vaccination coverage in these 40 countries and territories is estimated at 45%.

      Key challenges

      In 2020, 17.1 million infants did not receive their first dose of DTP vaccine, and another 5. 6 million infants were only partially vaccinated, indicating a lack of access to vaccinations and other health services. Of these 23 million children, more than 60%
      lives in 10 countries: Angola, Brazil, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Mexico, Nigeria, Pakistan and the Philippines.

      Monitoring data at subnational
      level.

      WHO action

      WHO is working with countries and partners to increase global vaccination coverage, including through initiatives endorsed by the World Health Assembly in August 2020.

      2030 Immunization Action Agenda

      The 2030 Immunization Action Agenda sets ambitious and comprehensive goals and strategic targets for vaccines and immunization for the decade 2021–2030. It has been developed from several
      thousands of testimonials from countries and organizations around the world. It builds on experience gained over the past decade and highlights ongoing and emerging challenges posed by infectious diseases (e. g. Ebola, COVID-19).

      The strategy was developed to serve the interests of each country and is designed to guide and align the activities of public, national, regional and global stakeholders towards achieving a world in which every person
      everywhere fully enjoys vaccines for health and well-being. The 2030 Immunization Action Agenda is being implemented through regional and national strategies and accountability mechanisms
      and accountability, as well as a monitoring and evaluation system designed to guide its implementation in countries.

      • Immunization Agenda 2030: A Global Strategy to Leave No One Behind
        (The 2030 Immunization Agenda. Leaving no one behind global strategy
        )
      • Implementing the Immunization Agenda 2030: A Framework for Action

      Global strategy to accelerate the elimination of cervical cancer as a public health problem

      In 2020, the World Health Assembly adopted a global strategy to accelerate the elimination of cervical cancer. The first of the three components of this strategy is to introduce the HPV vaccine in all countries and achieve the target
      coverage of this vaccine at the level of 90%. As HPV vaccine is now introduced in 57% of Member States, meeting the 2030 targets and achieving the target of 90% vaccine coverage
      in high- and low-income countries over the next 10 years will require significant funding for vaccine introduction in low- and middle-income countries, as well as efforts to improve the effectiveness of immunization programs.

      The need for preventive vaccinations / News / Children’s polyclinic No. 1

      Now there are a lot of talks about whether or not to vaccinate a baby. Disputes do not subside, each side provides its own arguments, each of which sounds quite convincing. And what can we say about the examples: somewhere the child had complications due to the vaccination, and somewhere the child fell ill with an infection against which he was not vaccinated.

      Unfortunately, the statistics do not speak in favor of the side that denies the need for prophylactic vaccinations. Having once seen a child with whooping cough, or, say, diphtheria, the question of the need for vaccination from parents would not even arise, because these diseases are considered very serious, and the clinical picture is terrifying with the suffering of the baby. Many diseases, especially diphtheria, have a very high mortality rate. On the wave of refusals, the number of such diseases has increased and, unfortunately, cases with a sad outcome are sometimes recorded. It should be clearly understood that the group of diseases against which vaccination is carried out is dangerous. There is a real risk of infection because these diseases are not considered “defeated” like smallpox, against which vaccinations are no longer available at the moment. By the way, smallpox was defeated precisely with the help of vaccination.

      As for complications, a competent approach of doctors and, if necessary, other specialists is needed in order to prescribe an individual vaccination plan.

      Vaccination permit
      Before vaccination, the child must be shown to the pediatrician. Pay attention to yourself if the child has any symptoms that disturb you (for example, a runny nose or cough). Tell your doctor if you have any symptoms. Before vaccination (especially for DPT), sometimes a child must pass a complete blood count and a complete urinalysis. Unfortunately, this rule is not always followed. If these tests are not prescribed for you, bring this to the attention of your local pediatrician yourself. Also, before the DTP vaccination, the child should be examined by a neurologist. If necessary, the pediatrician can refer the child for consultation and to other specialists. In some cases, if the child has a health problem or has had severe reactions to previous vaccinations, permission to vaccinate is given by the immunological commission. With a pronounced reaction to a previous vaccination, vaccination may no longer be carried out.

      In some cases, a child needs a medical exemption from vaccinations, because by the time of vaccination the child must be healthy! Past illnesses are also important, since after recovery a certain amount of time must pass (often about 2 weeks). If the child had a medical exemption for vaccination, then the next vaccinations are already done according to an individual schedule, since there must be a certain interval between some vaccinations (in particular, this applies to DTP).

      Vaccine refusal
      If you decide not to be vaccinated, no one can stop you. There is a law that citizens have the right to refuse preventive vaccinations (for children, of course, parents decide). Before you write a refusal, carefully read about those diseases against which your child will not have immunity. Pay attention to this particular issue, because in many disputes it turns out that the awareness of parents about diseases (and in particular their treatment and complications) is extremely small. Before any vaccination, you must be given a document where you need to sign (meaning that you agree to the vaccination). In case of refusal, this document is not signed, a refusal is made in writing. Two such documents are required. One is given to your doctor and kept in the child’s medical record, while the other copy remains in the hands of the parents. If you made such a decision before the birth of the child, then the refusal should be made already upon admission to the maternity hospital, since the first planned BCG vaccination is carried out there. If the child is not vaccinated, he can attend a kindergarten or school and they do not have the right to refuse him admission. If you are faced with such a problem, then you can contact higher organizations.

      Remember that only you are responsible for the health of your child!

      Recently there has been a lot of propaganda against vaccinations. And every responsible mother asks an almost Shakespearean question, to do or not to do. I choose to do for my child. Why? I will try to express my opinion, taking into account the fact that I am still a doctor, and I know a little more than a person far from medicine. To begin with, let’s try to dream up, and let there be no vaccinations at all. And all those terrible diseases that our children are vaccinated against are again walking free. And this is whooping cough, and polio, and tuberculosis, and tetanus, and diphtheria, and measles, and much more. All these diseases are either dangerous themselves or lead to complications that can threaten the life of the baby or lead to disability. I would not really like to know how this disease will proceed in my child, whether the treatment will be effective. And the more unvaccinated children, the more space for all these infections to “live”. Of course, I will not claim that there are no complications after vaccination. Although I have not met them during my work, they are described in the literature. I have many acquaintances of young mothers who are trying to understand this topic, so in the article I will rely on their questions.

      The main thing here is to understand a few things.

      First. Vaccination is a “little” disease. Vaccines contain either live and attenuated viruses and bacteria, or genetically engineered parts of them.

      Once in the body, they cause reactions similar to the disease. This is the process of developing a normal immune response. Therefore, there is a temperature, weakness, and there may be specific symptoms for this infection (for example, a rash with measles, rubella). Such post-vaccination reactions are more typical for live vaccines. Vaccines containing only single components of pathogens practically do not have such an effect (against hepatitis B, against influenza, pneumococcus, Haemophilus influenzae).

      Second. The response to the vaccine depends on the health of the child’s immune system at the time of vaccination. And therefore it is impossible to 100% predict how the body will react. It is also impossible to say how the same disease will proceed in two different people, although there are general patterns. Therefore, do not rely on the experience of friends. At the time of vaccination, the child should be as healthy as possible (for children with chronic diseases – without exacerbation). This will reduce the likelihood of complications and develop good immunity.

      Third. There is a lot of talk about the preservatives used to extend the shelf life of vaccines. Their number is very small, and studies have not noted their detrimental effects. Much more substances are contained in the air, soil, products, it’s just that attention is not focused on this, but this is already a matter of ecology. And I’ll add right there, if the child is treated, then how much will enter the body?

      Fourth. I would like to touch on children with frequent illnesses and children with chronic diseases. Many parents say: “He is already sick with us, where should he be vaccinated …”. That is, the child’s immunity is reduced, which means that if he gets sick, the disease will be more difficult, and the risk of complications is higher than in healthy children. It is better for such babies to vaccinate at a time when there are no exacerbations, against the background of adequate basic therapy, if necessary, in compliance with precautionary measures (which depend on the specific disease.