Doctor Komarovsky's opinion on DPT vaccination. DPT vaccination - preparation, procedure, side effects, reviews DPT side reactions

After DTP vaccination, the baby may develop fever, anxiety, and tearfulness. The baby sleeps poorly and loses his appetite. The baby’s reaction to DPT can be different: it may occur in acute form or almost imperceptibly. We will tell you in more detail what reaction is considered normal and what mothers can expect.

Normal body reactions to vaccination

After DTP, children may experience the following reaction:

• increase in mercury on the thermometer to 38.5;
• redness or itching at the vaccination site;
• tearfulness or anxiety;
• decreased appetite;
• bad dream.

An increase in temperature in children up to 38 degrees in the first three days after DTP vaccination should not cause alarm among parents. This is the physiological reaction of the body to the administered drug. Worth giving to the baby antipyretic drug according to the plan and monitor his well-being.

Redness or itching at the vaccination site can cause great trouble for the baby. The reaction provokes poor sleep. To alleviate the condition, give your baby an antihistamine and lubricate the reddened area with Fenistil-gel. You can bandage the leg with a thin cotton cloth or gauze. If the baby stops scratching the reddened area, the itching will go away faster.

A child becomes whiny due to general malaise. Calm the baby, provide him with peace. You should not play with your baby active games, wrap up, overheat. The room should not be hot. Follow a daily routine. You cannot switch to new baits within 7 days. Give breastfeeding to infants more often, let the child suckle in small portions. Monitor your baby's weight.


If your baby doesn’t sleep well and often wakes up crying, you can try to alleviate the condition in known and simple ways:

1. Make an infusion of mint, lemon balm, and hawthorn. Dry collection (1 teaspoon) should be poured into 0.5 liters of boiling water and left in a warm place for 3 hours. Give the baby from a bottle 2–1.5 hours before bedtime. The child will calm down, the itching will go away, and sleep will return to normal.
2. Make a compress of honey and flour, apply it to the sore spot. The cake should not be warm, just at room temperature. Remember, you can’t heat the area after DTP, as this can cause inflammation.
3. If the reason for poor sleep after DTP heat, wipe the baby’s body with warm water. You can add alcohol to the water in a ratio of 5/1. You should not try to reduce the temperature by wiping with vodka or vinegar. The compositions are aggressive and can easily dry out the delicate skin.
4. Before going to bed, do easy for baby soothing massage. But do not rub the vaccination site. Help your baby relax, and then sleep will be calmer.
5. Before going to bed, ventilate the room and use a humidifier. If you don’t have a purchased device, you can simply hang a damp sheet or towel over the batteries.
6. Chamomile infusions are good for calming children. Dried flowers are brewed like tea and given to the baby from a bottle. Chamomile will help relieve itching, reduce inflammation and the baby will calm down.

It is important to monitor the general condition of children. If the temperature is high and the child is eating and sleeping well, then there is no reason to worry. When you have trouble sleeping and have a high temperature that is not brought down by antipyretic compounds, you should call a specialist.

How many days should you wait for a reaction after vaccination?

Children may not react immediately to vaccinations. Little ones react to the drug individually, so not everyone may have a reaction after the first vaccination. After the second vaccination, the picture can change dramatically - the temperature rises, appetite and sleep worsen.

It is impossible to say for sure that if children do not have a fever on the first day after DPT, then it will not rise on the second and third. Monitor your baby's condition and check the thermometer more often. We recommend giving your baby antipyretic drugs for three days after vaccination: Nurofen, Ibuklin, Paracetamol. For children infancy light candles: Viferon, Efferalgan. This will help the baby reduce the fever and allergic reaction will pass. The antihistamine is continued for 3-4 days after vaccination, according to the regimen prescribed by the pediatrician.

Each baby is individual, so the reaction in each case may be different. Some children have a fever for only a day, others are unwell for 3-4 days. But don’t prepare yourself for the worst; in 60% of cases, DTP vaccination is painless.

Poor sleep in a baby can be caused not by vaccination, but by nervous overexcitation. After vaccination, you should not immediately leave the clinic with a crying baby. Sit near the office for a while and let your child calm down. Place it on your chest and talk to it in a calm voice. The child will calm down and there will be fewer side effects.

If poor sleep is not accompanied by elevated temperature and repeats for 2-3 nights, then it is worth showing the baby to neurologists. In children, muscle tone may increase by nervous soil and vaccination has nothing to do with violations. The baby will be prescribed massage and physiotherapy.

Don’t worry if your child doesn’t sleep well for 1-2 nights after DPT, the temperature rises in the evening, and during the day the baby rests and eats well. Parents should be alert following signs in children:

• temperature is above 38.5 and does not subside;
• the DTP site is swollen and hot;
• an abscess has appeared on the leg, from which pus flows;
• after every meal the baby feels sick;
• sleep has disappeared, the child is crying incessantly;
• the skin has changed color to yellow or pale with blue.

Any reaction requires immediate medical attention. We recommend calling an ambulance.

What Dr. Komarovsky says about complications, we recommend watching the video:

The baby’s condition after DTP depends on the preparation. If you carry out the preparatory steps correctly and follow the doctor’s recommendations, then the baby will sleep well, and vaccination will not cause negative consequences.

DTP vaccination - when can you bathe your child?

The DTP vaccine should not be underestimated, much less avoided: before its invention in the 40s of the last century, infections with tetanus, diphtheria and whooping cough were the main causes of child death! With the improvement of living conditions, advances in medicine, the introduction mandatory vaccination, the danger from these diseases is no longer so serious. However, the risk always remains and refusing vaccinations is extremely unwise and dangerous. Although DPT vaccinations are fraught with side effects and reactions, this is a small price to pay before the danger of contracting tetanus or diphtheria. The national vaccination schedule in the Russian Federation establishes four main periods of DTP vaccination: the first vaccination in infancy (3–6 months), revaccination at the age of one and a half years, revaccination of diphtheria and tetanus at 6 years and vaccinations in adulthood (at 14 years and once every 19 years subsequently, only diphtheria with tetanus). The timing of DTP vaccination is clearly shown in the table below.

First vaccination

Without a doubt, the most important stage of formation immune defense children are the first months after birth. Children are much more susceptible to infection early in life dangerous viruses and microorganisms, and the body itself is not able to withstand severe infectious attacks. Therefore, the first DTP vaccination, as one of the primary ones, takes place already in the 3rd month of life. This stage consists of three vaccinations, one every 45 days - at 3, 4.5 and 6 months. It is very advisable to follow the schedule as accurately as possible, but if necessary (illness of children, temporary contraindications, etc.), the dates of vaccinations can be postponed for a short period of time, the success of developing immunity does not suffer from this.

Three days before the very first vaccination, doctors recommend giving the baby antihistamines for children - this will reduce the risk of allergies and reduce the reaction in general. In addition, it is necessary to stock up on antipyretic drugs.

The first injection is given at the age of 3 months, because the immunity transferred to children with mother's antibodies begins to disappear by this time. This process may take place differently in different children, but the ideal time for the first vaccination is different countries They consider the age to be from 2 to 4 months. As in subsequent times, the drug is introduced into the body by intramuscular injection. The best place for administration - the inner surface of the thigh, where the muscles are well developed even in newborn children. At the time of vaccination, the child must be healthy and fully examined for contraindications. The first stage of DPT is important because it can reveal a hidden allergic reaction and give an idea of ​​how the child’s body reacts to the components of the vaccine. It is important for parents to be especially vigilant in order to promptly notice any abnormal changes in the child’s condition.

Second vaccination DTP vaccines done 45 days after the first. The procedure is no different from the previous injection, but children often tolerate the vaccination much worse. In children, the temperature rises greatly, convulsions, drowsiness, or, conversely, prolonged high-pitched crying may occur. This happens because after the first vaccination the child has time to develop antibodies to the vaccine toxoids and during the second vaccination the baby’s body tries to protect itself from the practically harmless components of the vaccine. That is, the child’s condition during this period is a consequence of the internal struggle of the immune system against toxoids. Despite the fact that the process is normal, it cannot be left to chance - the baby needs to be given an antipyretic and his condition carefully monitored. An increase in temperature above 39.5 °C, severe convulsions that continue for more than a day, prolonged redness of the body and other strange phenomena are a reason to immediately consult a doctor. Doctors do not recommend changing the drug during vaccination, however, if after the first vaccination the child experienced a severe reaction (temperature 38.5 °C or higher, severe convulsions), it makes sense to give the second and subsequent injections a more expensive and safe imported drug.

Some DPT vaccinations coincide in timing with other vaccinations - in this case, combined ones can be used imported vaccines, this will reduce the number of painful injections.

The last of the three DPT vaccinations serves to fully strengthen immunity and is given to children at 6 months. If it was impossible to vaccinate at the required time, the scheme allows for the vaccination to be postponed up to two months in advance. It is also done intramuscularly and is relatively painless for children. If there were no negative reactions after the first two vaccinations, it is advisable to inject the same drug. Otherwise, it is permissible to change the vaccine to imported Infanrix or another.

Revaccination first

A single vaccine shot at one and a half years of age (18 months). The most common question parents ask before re-vaccination is: why is it needed? The DPT vaccine provides children with immunity from whooping cough, tetanus and diphtheria for more than 5 years, as many parents know. However, far fewer parents go into the intricacies of immunology, not suspecting that the first acquired immunity from whooping cough and tetanus disappears in 15–20% of cases within a year after vaccination. The body stops considering an infection real threat subsequently and gradually stops producing antibodies. To prevent this, children should receive another additional vaccination, which will give a 100% immune response for the required period. Many parents, without knowing this, refuse such a quick re-vaccination with DPT, especially if the baby had serious reactions the first time. Important: if the child nevertheless ends up in the 20% of children who have lost immunity after the first DTP injections, he will be defenseless against the three most dangerous infectious diseases up to 6 years of age. It is impossible to establish this for sure without a serious immunological study, so it is easier to simply do an extra vaccination.

In accordance with the national vaccination calendar, the anti-pertussis component is not administered to children over four years of age.

Second and subsequent revaccinations

Further vaccinations are separated by significantly longer time intervals and have important difference- the pertussis component is excluded from vaccination. For children over 4 years of age, domestic medicine completely excludes whole-cell whooping cough vaccinations (immunity is not developed; the vaccine will simply infect the child with whooping cough). Russia does not produce acellular pertussis vaccinations, so vaccination against it ends in the Russian Federation after 4 years. This is also justified by the fact that older children are much less susceptible to the disease, tolerate it more easily, and the mortality rate with proper care is zero. The drug DPT (adsorbed pertussis-diphtheria-tetanus) is not used in further vaccination because it contains a pertussis component. Up to 6 years of age, the drug ADS (adsorbed diphtheria-tetanus vaccine) is used to instill immunity against tetanus and diphtheria in children, and after that - ADS-M (an identical drug with a much lower content of active substances).

The second revaccination (this time only against tetanus and diphtheria) takes place at 6 years of age. The child is given only one vaccination intramuscularly, the reaction from which should be minimal compared to all previous ones. If you still want to protect your child from whooping cough, it is permissible to use imported drug(Pentaxim, Tetraxim, Infanrix and others). There is little need - the disease from the age of 6 years is easier to tolerate than influenza, and after one case of the disease, the child will receive natural lifelong immunity.

The last revaccination for children is done at the age of 14 with the drug ADS-M, with a low content of active toxoids. The drug has been changed so as not to put unnecessary stress on the body; to maintain immunity in adulthood, several times smaller doses are sufficient active ingredients. ADS-M does not generate immunity in the body, but is only a “reminder” for the body to maintain it.

Revaccination for adults is done every 10 years, starting from the age of 24, with the drug ADS-M. Most people neglect it, since the risk of infection and the danger for an adult is much less than for children. But nevertheless, the risk remains quite high; infection with these infections can seriously undermine one’s health and even make a person disabled. Prevention of tetanus with diphtheria is especially recommended for people at risk: working with children, animals, and medical personnel.

Brief reminder

• Vaccination of whooping cough, tetanus, diphtheria takes place in two stages: two vaccinations in the period of 2-6 months, at 1.5 years and 6 years;
• Tetanus-diphtheria vaccinations are given separately at 6 and 14 years of age, as well as every subsequent 10 years of life;
• The vaccination schedule may be changed as necessary, with the approval of the doctor. The number of vaccinations does not change;
• All drugs certified in Russia, including imported ones, are interchangeable;
• The person being vaccinated must be healthy and have no contraindications to vaccination;
• An open, especially contaminated wound is a reason for urgent vaccination if it has not been done for more than 5 years;
• It is recommended to give children antihistamine at any stage, be sure to reduce the fever after vaccination;
• All vaccinations, including extraordinary ones, must be reflected in the vaccination card.

The DTP vaccination scheme is much more transparent after careful examination than many parents think. Carefully follow the doctor’s instructions and vaccination rules so that DTP does not leave behind anything but peace of mind for the health of your children!

Immunity plays a paramount role for human body, as it protects it from various unsafe diseases and infections. Therefore, from birth it is necessary to do everything possible so that the body can adequately resist harmful agents and bacteria. For this purpose, vaccination is carried out to prevent the development of the most undesirable and dangerous diseases.

For the first time, preventive vaccinations in Russia became introduced back in 1940. Initial procedures are carried out from the moment the child is born, that is, even in maternity hospital. Vaccination against tuberculosis, measles, polio, hepatitis and, of course, DTP vaccination are the first-priority vaccines that should be introduced into the human body during the first months of life.

As shown by many years medical practice, the DPT vaccine is one of the most difficult vaccinations for children to tolerate, so many parents are faced with a very difficult decision for them: is it even worth exposing their child to such painful suffering? No matter how bitter it may sound, the DTP vaccine, which some parents so fundamentally reject, vital children.

Yes, sometimes it is very difficult for parents to observe the reaction of their children’s body to a vaccine, but the benefits that the vaccine brings with it are so great that the consequences after its administration against this background become insignificant. If after the operation you follow all the recommendations of doctors and pediatricians, then suffering can be completely avoided.

DTP vaccine. Short description

Before considering very important questions and the nuances that concern almost every parent, it’s probably worth stopping at the DPT vaccine itself and discussing what it is?

IN modern world For many infections that are unsafe for the human body, there are vaccinations, the main purpose of which is prevention of disease development. The leading position is occupied by the DTP vaccine. This complex causes endless debate between doctors and parents, but no one denies its importance.

If we turn to the meaning of the word DTP vaccination itself, the decoding, as it turns out, is quite simple and means adsorbed pertussis-diphtheria-tetanus vaccine. Here it becomes clear what diseases this vaccination is carried out against. This:

Exactly these diseases are very dangerous For child's body. Complications and consequences, the probability of which is very high, can haunt the child throughout his entire subsequent life, and no matter how bitter it may sound, it is these diseases that cause the death of babies.

It follows that the DPT vaccine is useful thing, capable of preventing the development of the above-mentioned diseases and developing immunity to them for as long as 10 years.

Principles of action of the vaccine and its main varieties

This vaccine is a cloudy liquid that contains dead cells of dangerous pathogens of infectious diseases. The mechanism of action of the DTP vaccine is to create artificial immunity , since he is not yet able to independently fight the “advancing” infectious agents. After the killed cells are in the blood, a so-called disease simulation is created. That's when the body begins to show a defensive reaction. Active production of antibodies and phagocytes begins.

It should be noted that vaccination against whooping cough, diphtheria and tetanus is carried out not only in Russia, but in all countries of the world.

It turns out that the DPT vaccine exists in more than one form. It comes in two varieties.

Types of DTP vaccine

Despite the fact that the reaction to the DPT vaccine in some children is not entirely positive, most parents still decide to vaccinate their child. However, some adults are concerned about an important question: when should they vaccinate their baby? There is a certain vaccination schedule from whooping cough, tetanus and diphtheria, which boils down to the following:

• The first vaccination is given to the baby at the age of 3 months. It is then repeated at 4.5 months, after which it is carried out at 6 months;
• there must be a mandatory interval of 30-45 days between injections;
• if the child is over 4 years old, then he is given a drug without a pertussis component.

Schedule must be strictly observed according to the rules and regulations, however, if for some reason the child has not been vaccinated in a timely manner, then the second and third vaccinations can be given whenever possible. You should not exceed their number.

Revaccination schedule

We must not forget about such an important event as DPT revaccination. It occurs at the age of one and a half years.

It happens that a child does not receive DTP vaccination on time. Vaccination can also be done to an adult. These should be three injections with a break of three months.

Revaccination should take place at the age of seven, and then at the age of 14. In this case, the ADS-M vaccine or its analogues is used. The importance of this revaccination is very great, since its essence is to support immunity and the number of necessary antibodies. As for adults, revaccination against diphtheria and tetanus should be carried out every 10 years.

DTP is free vaccine, which is administered according to the vaccination calendar. But if parents have doubts about the domestic product, they can use a foreign-made vaccine. By the way, imported analogue does not contain a mercury compound.

An imported analogue of DPT means there is a huge chance that the child will not have to experience possible side effects and complications after vaccination.

When vaccination is not needed

Vaccination against tetanus and diphtheria, like any other medicine, has its own contraindications, which are discussed in mandatory The pediatrician or doctor should warn you. If you ignore them, the reaction of the child’s body can be unexpected and even deplorable.

Contraindications to vaccination

Side effects as a reason to refuse the DTP vaccine

Why are many parents afraid of the DPT vaccine? Side effects are the answer to this question. It is this factor that frightens adults who are very worried about their children.

Side effects of DTP vaccination

• Crying and hysterics. Probably no parent has ever been able to escape such a reaction from a child. But there is no need to be afraid. This is quite normal reaction scared baby.
• Appearance of lameness- here is another side effect that is very alarming to the parent. Many attribute this reaction of the child’s body to the lack of professionalism of doctors and the unsafe harm of the vaccine itself. However, there is no need to panic. It turns out that swelling and lameness are normal, although this reaction continues for quite a long time.
• Common cases of side effects from vaccination are: nausea and vomiting. As a result, many children lose their appetite, which leaves parents confused and horrified. However, even here doctors insist that this is a normal reaction of the child’s body to the vaccine. But this formulation does not console parents, because they perceive any side effect as a complication after DTP. However, even such consequences are not a reason to refuse the injection.
• Lethargy– the reaction of the baby’s body after vaccination, hearing about which parents are simply confused, is it worth doing it at all? Again, this is not a complication, but the body’s response to the administered drug. It is clear that the body devotes all its strength to coping with the disease and developing immunity. And if the child is weak, lethargic and inhibited, there is no need to panic. This will pass soon.
• Temperature increase also observed in many children after DTP vaccination. Moreover, this is often a very high rise, up to 40 degrees. But doctors look at such a consequence as a completely normal phenomenon, while for parents it is a complete disaster. The only recommendation in this case is the use of antipyretics.

Because of the above, most parents doubt the need for such vaccination. Yes, whether to get the DTP vaccine or not is everyone’s free choice and you can refuse it. However, such parents should take into account that the number of deaths from tetanus today is almost 85%, but almost half of the sick die from whooping cough.

Consequences of vaccination

Should be considered possible complications after the administration of the DTP vaccine, so that if unexpected reactions of the child’s body occur, parents do not panic, but act prudently.

Possible complications

Do I need to prepare my baby for vaccination?

All parents who decide to vaccinate their baby against dangerous diseases should prepare their baby for such an “operation” in advance.

The day before vaccination, it is necessary to ensure that the baby has a bowel movement. For this purpose, you can use a tool such as.

Preparing for DTP vaccination

• the vaccination is done on an empty stomach;
• There is no need to dress your baby very warmly. If your baby is still sweating upon arrival at the clinic, you can sit for a while and give him the opportunity to cool down;
• After vaccination, the child can be given some water.

Since for some children the DPT vaccination can become, so to speak, a difficult “test,” parents should take preparations for vaccination more seriously and responsibly.

Many parents worry about Is it possible to go for a walk after vaccination? DPT? After the child has visited the vaccination office, you need to sit for a while in the corridor and observe the general condition of the baby. If there are no unexpected reactions, you can safely go for a walk. If the temperature has risen, walking is not recommended.

Each parent has the right to decide independently whether their child needs the DTP vaccine. However, we must also remember that the diseases against which a child is vaccinated are very dangerous. Therefore, there is only hope that parents will be able to make the right and prudent choice, and the future of their baby will be healthy and happy.

Vaccinations for children

Currently, for the prevention of such serious diseases as whooping cough, tetanus and diphtheria, the World Health Organization (WHO) recommends the use of the DTP vaccine.

What is DPT vaccine?

Preventive vaccination DPT (adsorbed pertussis-diphtheria-tetanus) first began to be used abroad in the late 40s of the last century. A foreign analogue of the DTP vaccine is Infanrix. Both combination vaccines are classified as whole-cell vaccines, i.e. containing killed (inactivated) cells of the pathogens of whooping cough (4 IU*), tetanus (40 IU or 60 IU) and diphtheria (30 IU). This dosage of tetanus and diphtheria toxoids is determined by the need to achieve the desired intensity of the reaction immune system a child who is still imperfect and just being formed.

*) IU - international unit

Why is DPT vaccine needed?

Whooping cough, diphtheria and tetanus are very dangerous and are severe in young children. Whooping cough is insidious with severe complications: pneumonia (pneumonia) and encephalopathy (brain damage). A convulsive cough can even lead to respiratory arrest. After the vaccine is administered, the immune system produces antibodies from which memory cells are formed. If in the future the body again encounters the causative agent of the disease (whooping cough), the immune system seems to “remember” that it is already familiar with the virus and begins to actively turn on protective reactions.

The peculiarity of tetanus and diphtheria is that the development of the disease, its course and complications are associated not with microbes, but with its toxins. In other words, to avoid a severe form of the disease, it is necessary to create immunity in the body against the toxin, and not against the virus as a whole. Thus, the vaccination is designed to form antitoxic immunity of the body.

When and how often should I get the DTP vaccine?

There is a vaccination schedule, which in Russia is determined by the national one. DTP vaccine - Infanrix standard scheme consists of 4 vaccinations: the first is given at the age of 2-3 months, the next two are given at an interval of 1-2 months and the fourth is given 12 months after the third vaccination (DPT revaccination).

If the child was vaccinated later than 3 months, then vaccines with a pertussis component are administered to him 3 times with an interval of 1.5 months, and the fourth time - 1 year from the date of the last vaccine administration. Subsequent revaccinations in Russia are provided only against tetanus and diphtheria. They are carried out at 7, 14 and then every 10 years throughout life.

The use of the domestic DTP vaccine has some peculiarities. According to current instructions, this vaccine can only be vaccinated in children up to 4 years of age. When a child reaches 4 years of age, the unfinished course of DTP vaccination is completed with the use of ADS vaccine (up to 6 years) or ADS-M (after 6 years). This restriction does not apply to foreign DTP (Infanrix).

The reaction of the child’s body after vaccination and possible complications

Any vaccination affects the body heavy load, a complex restructuring of the immune system occurs. No one in the world has yet managed to create indifferent to the body medications, not to mention vaccines.

If we consider the reaction of the child’s body to vaccination as a whole, then the presence of mild side effects it could be considered normal occurrence, indirectly indicating the correct formation of immunity. But even in case complete absence reactions should not be taken as an alarm signal - this may be the result of efforts to minimize adverse reactions.

The DTP vaccine is quite difficult for a child’s body. The DTP reaction can manifest itself in the first three days in the form of pain at the injection site, irritability and low to moderate fever (rectal 37.8-40 ° C). These are the most common manifestations. Local DTP reaction presents as redness and swelling at the injection site. Sometimes the swelling reaches 8 cm in diameter (but no more!). This is noticeable immediately after vaccination and can persist for 2-3 days. General reaction DTP is expressed as a malaise: the child may lose appetite, become drowsy and, much less frequently, experience slight vomiting and diarrhea.

There is a weak reaction to vaccination (temperature up to 37.5 ° C and minor violations general condition), moderate (temperature not higher than 38.5 °C) and strong DPT reaction (temperature higher than 38.6 °C and pronounced disturbances in general condition).

The development of common adverse vaccine reactions does not depend on how many doses of the vaccine are administered to the child. But with the frequency of administration of the DPT vaccine, some children may experience an increase in the manifestations of allergic reactions (most often local). This is due to heredity and the child’s predisposition to allergies.

Of course, absolutely safe vaccinations does not exist. Rarely, but some complications are possible after DTP vaccination. This must be remembered, as well as remember that the consequences of diseases such as whooping cough, diphtheria and tetanus are hundreds of times more dangerous.

Possible complications are divided into local and general. Local complication is expressed by increased compaction and a significant increase in swelling at the injection site with a diameter of over 8 cm. This can persist for 1-2 days.

General complications after DTP vaccination are expressed in the baby's shrill cry, reaching the point of squealing, which can appear within a few hours after vaccination and last about 3 hours or more. Also, the DTP reaction is accompanied by restless behavior of the child and an increase in temperature. Such symptoms should go away on their own within a few hours.

Sometimes it appears convulsive syndrome. High temperature after DPT (above 38.0 °C) can provoke febrile convulsions in the first three days after vaccination. Afebrile seizures occur less frequently (with normal temperature and subfebrile up to 38.0 ° C), which may indicate a previous organic lesion nervous system child.

Complications can also be expressed by an allergic reaction: Quincke's edema, urticaria and anaphylactic shock- the rarest and most serious complication that manifests itself immediately or 20-30 minutes after the administration of the vaccine.

Contraindications

TO general contraindications include exacerbation chronic disease, fever, allergy to vaccine components and severe immunodeficiency. DPT vaccination is temporarily or absolutely contraindicated if the baby has had convulsions not associated with fever, or there is a progressive pathology of the nervous system. Then children are vaccinated with a vaccine that does not contain a pertussis component.

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DTP is a preventive vaccination, which stands for adsorbed pertussis-diphtheria-tetanus. This drug is combined and is used to combat, respectively, diphtheria, whooping cough and tetanus. It is made from toxoids of these bacteria and from other antigens. The peculiarity of tetanus and diphtheria is that the development of the disease, its course and complications are associated not with microbes, but with its toxins. In other words, to avoid a severe form of the disease, it is necessary to create immunity in the body against the toxin, and not against the virus as a whole. Thus, the vaccination is designed to form antitoxic immunity of the body.

The DTP vaccine is classified internationally as DTP.
A foreign analogue of the DTP vaccine is Infanrix. Both combination vaccines are whole cell, i.e. contain killed (inactivated) cells of the pathogens of whooping cough (4 IU), tetanus (40 IU or 60 IU) and diphtheria (30 IU). This dosage of tetanus and diphtheria toxoids is due to the need to achieve the required intensity of the reaction of the child’s immune system, which is still imperfect and is just being formed.

Diphtheria, tetanus and whooping cough

- Diphtheria. This is an acute infectious disease caused by Corinebacterium diphtheriae (Corinebacterium bacteria), transmitted by airborne droplets; characterized by lobar or diphtheritic inflammation of the mucous membranes of the pharynx, nose, larynx, trachea, and less commonly other organs with the formation of fibrinous films and general intoxication. When only the skin is involved, it is known as cutaneous diphtheria, and is probably caused by a non-toxic strain. If the toxic strain affects mucous structures in the body, such as the throat, diphtheria becomes life-threatening.

- Tetanus. Tetanus is a disease that causes severe muscle contractions and cramps. It is caused by a powerful toxin released by the Clostridium bacterium. This anaerobic bacteria, which means they survive without oxygen. People can become infected with these dangerous bacteria through skin wounds. Tetanus is fatal in 15-40% of cases.

- Whooping cough. Whooping cough was a very common childhood illness throughout the first half of the 1900s. The disease is very easily transmitted from one person to another, and it is most severe in infants. The incidence has increased in Lately, up to 25,827 cases reported in 2004, but decreased to 10,454 in 2007. Vaccine benefit softens towards adolescence. Thus, more cases are seen in adults. Such cases may be significantly underestimated. The younger the patient, the higher the risk of developing severe complications, including pneumonia, seizures, severe cough and even death. Children younger than 6 months are at particular risk because even with vaccination, their protection is incomplete due to their immature immune systems.

Vaccinations against diphtheria, tetanus and whooping cough

Primary vaccination. Vaccination against diphtheria, tetanus and whooping cough has been routinely given to children since 1940. The standard vaccines now are DTP. DTP uses the “pertussis component” form, which consists of one weakened pertussis toxoid. DPT is just as effective but has fewer side effects than previous vaccines (DTP).

Protection against diphtheria and tetanus lasts about 10 years. During this period, the vaccine (Td) may be given against tetanus and diphtheria. The Td vaccine contains a standard dose against tetanus and a less potent dose against diphtheria. It does not contain whooping cough components.

The childhood whooping cough vaccine may begin to lose its effectiveness after about 5 years, and some previously immunized adolescents and adults may develop light form diseases. Now two pertussis-containing accelerators are approved for adolescents and adults.

Types of DTP vaccine

Basically, as part of vaccination on the territory of the Russian Federation, adsorbed liquid tetanus is used - DPT produced by the Federal State Unitary Enterprise NPO Microgen of the Ministry of Health of the Russian Federation, Russia.

As mentioned earlier, foreign analogue The domestic DTP vaccine is Infanrix™, produced by GlaxoSmithKline Biologicals S.A., Belgium. It is presented in the following types

Infanrix IPV (analogue of DTaP + inactivated polio vaccine). Whooping cough, diphtheria, tetanus, polio.
- Infanrix Penta (analogue of DTaP + hepatitis B + inactivated polio vaccine). Whooping cough, diphtheria, tetanus, hepatitis B, polio.
- Infanrix Hexa (analogue of DTaP + hepatitis B + inactivated polio vaccine + Hiberix), instructions. Whooping cough, diphtheria, tetanus, hepatitis B, polio, Haemophilus influenzae type b infection.

The following analogues of DPT are drugs produced by Sanofi Pasteur S.A., France:

D.T.KOK (analogue of DPT). Whooping cough, diphtheria, tetanus.
- Tetraxim (analogue of AAKDS). Whooping cough, diphtheria, tetanus.
- Pentaxim (analogue of DTaP + inactivated polio vaccine + Act-HIB), instructions. Whooping cough, diphtheria, tetanus, polio, Haemophilus influenzae type b infection.
- Hexavak (analog of DTaP + hepatitis B + inactivated polio vaccine + Act-HIB). Whooping cough, diphtheria, tetanus, hepatitis B, polio, Haemophilus influenzae type b infection.

Monovalent (single-component) vaccines against whooping cough have been developed abroad and in Russia, but until now they have not entered into everyday vaccination practice due to the presence of a combined vaccine and a number of conditions limiting their use.

The Bubo-Kok vaccine is presented on the Russian pharmaceutical market - a vaccine against whooping cough, diphtheria, tetanus, and hepatitis B. Its manufacturer is the Scientific and Production Company Combiotech CJSC.

DTP schedule for children

There is a vaccination schedule, which in Russia is determined national calendar preventive vaccinations

All children under 7 years of age should receive the DTP vaccine. Vaccinations are done as follows:

Infants receive a series of three vaccinations at 2, 4, and 6 months of age. The only reason to postpone vaccination for now in children with suspected neurological problems is to clarify the situation. Children with corrected neurological problems can be vaccinated (this vaccine should be provided no later than the child's first birthday - that is, when he is no more than 1 year old);
- the fourth dose is administered from 15 to 18 months, 12 months after the third vaccination (DPT revaccination). For high-risk infants—those exposed to whooping cough outbreaks—this vaccine may be given earlier;
- If the child was vaccinated later than 3 months, then vaccines with a pertussis component are administered to him 3 times with an interval of 1.5 months, and the fourth time - 1 year from the date of the last vaccine administration.
- Subsequent revaccinations in Russia are provided only against tetanus and diphtheria. They are carried out at 7, 14 and then every 10 years throughout life.

The use of the domestic DTP vaccine has some peculiarities. According to the current instructions, this vaccine can only be vaccinated in children up to 4 years of age. When a child reaches 4 years of age, the unfinished course of DTP vaccination is completed with the use of ADS vaccine (up to 6 years) or ADS-M (after 6 years). This restriction does not apply to foreign DTP (Infanrix).

If a child has moderate or severe health problems or has recently had a fever associated with an illness, vaccination should be delayed until he or she has recovered. Colds and other lungs respiratory infections should not be a reason for delay. Parents should not be overly concerned if the interval between doses is longer than recommended. Immunity from any previous vaccination is maintained, and the doctor does not have to start a new series from scratch.

All adults who have been fully vaccinated, either as children or as adults, should have Td boosters at least every 10 years. If they have not received a DPT vaccination after age 19, they will need to receive it before the next one, but not after. Adults who have regular contact with infants under 12 months of age should receive a disposable Td booster.

Adults who have not previously been vaccinated against diphtheria, tetanus, and whooping cough at any age:

Must receive a three-dose series of tetanus, diphtheria, and pertussis (DTP) vaccines;
- a woman, if pregnant, should receive the DTP vaccine after 20 weeks of pregnancy;
- any patient who requires health care from any wound, may be a candidate for tetanus vaccine. Wounds that place patients at high risk for tetanus are puncture wounds or contaminated wounds. Some considerations regarding tetanus vaccination for the wounded:
- vaccination is necessary if the last dose was given 5 or more years before the injury;
- children under 7 years of age are usually given DTP if they are not fully vaccinated;
- Patients who have not completed the primary tetanus vaccination and people who have experienced an allergic reaction to previous tetanus boosters may be given immune globulin.

Preparing for DTP vaccination

DTP vaccines can provoke numerous adverse drug reactions. This is explained as high content antigens, and the reactogenic properties of the components included in the vaccine. For this reason, before vaccination with the DTP vaccine, medicinal preparation of the child is recommended.

Without exception, all DPT vaccines should be administered while taking antipyretics. This allows, on the one hand, to prevent a possible uncontrolled increase in temperature, on the other hand, to eliminate the risk of temperature cramps in young children that occur against a background of high temperature, regardless of what caused it. In addition, all antipyretic drugs have anti-inflammatory and analgesic properties, which is especially important in preventing pain at the injection site, which can be quite severe. In addition, this will help protect the child from severe swelling at the site of vaccine administration.

If your child has allergic disorders such as atopic dermatitis or diathesis, the use of antiallergic drugs is also recommended.

Neither antipyretics nor antihistamines affect the development of immunity, i.e. effectiveness of vaccination.

When choosing an antipyretic drug for your child, pay attention to the following aspects:

When purchasing medications, pay attention to this form release was suitable for your child’s age;
- Make a choice in favor rectal suppositories, since flavorings in syrups can provoke additional allergic reactions;
- Administer antipyretics in advance, without waiting for the temperature to rise after vaccination. The temperature may rise too quickly to be controlled;
- Never give your child aspirin ( acetylsalicylic acid)!
- If the maximum permissible dosage of an antipyretic is exceeded and the effect is not achieved, then switch to a drug with another active substance(for example, from paracetamol to ibuprofen);
- If a child had no reactions to the previous vaccination, this does not mean that there will be no reaction to the subsequent vaccination either. Adverse reactions are more common after repeated administrations vaccines, so do not neglect preparation for vaccination;
- In any doubtful cases, consult your doctor. Feel free to call " ambulance";
- If the vaccination was done at a paid vaccination center, do not hesitate to take the doctor’s contact information in case of adverse reactions.

An approximate scheme for preparing a child for vaccination with DTP vaccines:

1-2 days before vaccination. If your child has diathesis or other allergic disorders, start taking antihistamines in a maintenance dosage;

After vaccination. Immediately after returning home, give your child a suppository containing an antipyretic. This will prevent some reactions that develop in the first hours after vaccination (prolonged crying, swelling at the injection site, etc.). If the temperature rises during the day, introduce another suppository. A candle at night is a must. If the baby wakes up at night for feedings, check the temperature and if it rises, introduce another suppository. Continue taking your antihistamine.

Day 1 after vaccination. If the temperature is elevated in the morning, introduce the first suppository. If the temperature rises during the day, introduce another suppository. You may need to introduce another suppository at night. Continue taking your antihistamine.

Day 2 after vaccination. Use antipyretics only if the child has a fever. If its increase is insignificant, you can refuse antipyretics. Continue taking your antihistamine.

Day 3 after vaccination. The appearance on the 3rd day (and later) of an increase in body temperature and reactions at the vaccination site is not typical for inactivated vaccines. If the temperature does rise, you should look for another reason (teething, acute respiratory infections, etc.).

Before using any medications exact dosages, dosage regimens, list and names of specific medications can and should be recommended only by the attending pediatrician who directly examined your child. It is important. Don't self-medicate!

Side effects of DTP - vaccines against diphtheria, tetanus and whooping cough

Allergic reactions. In rare cases, a person may be allergic to diphtheria, tetanus and whooping cough. Parents should tell their doctor if their children have allergies. Newer DTP vaccines may carry a slightly greater risk of an allergic reaction than older DTP vaccines. Children with serious reactions should not receive additional vaccinations. A rash that occurs after a dose of DTP does not have special significance. In fact, this usually does not indicate an allergic reaction, but only a temporary immune reaction, and usually does not recur later. It should be noted that in response to the DTP vaccine there was not a single case of death from allergic reactions, even severe ones (anaphylactic).

Pain and swelling at the injection site. Children may feel pain at the injection site. In some cases, the small lump or bump may remain in place for several weeks. Using a clean, cool washcloth over any swollen, hot, or red area may help. Children should not be covered or tightly wrapped in clothing or blankets. The risk of swelling of the sore or the entire arm or leg increases with subsequent injections - particularly with the fourth and fifth doses. Whenever possible, parents should require that their children receive the same brand of vaccine each time to reduce the risk of side effects.
- Fever and other symptoms. After the injection, the child may develop: mild fever, irritability, drowsiness, loss of appetite.

Conditions that should cause concern:

Very high temperature (over 39°C), which causes seizures in children. Such cases should be reported to your doctor immediately. New DPT vaccines significantly reduce the risk of this side effect compared to older vaccines. Although such fever and associated seizures are rare and have almost no long-term consequences. Relapses after subsequent vaccination are very unlikely;
- fever that develops 24 hours after vaccination, or fever that persists for more than 24 hours, most likely caused by causes other than vaccination;
- hypotension and unresponsiveness (HHE). HHE is an uncommon response to the pertussis component and occurs within 48 hours of injection in children under 2 years of age. The child usually develops a fever, becomes irritable, and then becomes pale, weak, lethargic, and taciturn. Breathing will be shallow and the baby's skin may appear bluish. The reaction lasts on average 6 hours and, although it looks scary, almost all children soon return to normal. normal condition. This is a rare side effect after receiving the DTP vaccine, but it can happen;
- neurological effects in the whooping cough component. Of concern are several reports of permanent neurological damage that have occurred after children have been vaccinated. Symptoms: attention deficit disorder, learning disorders, autism, brain damage (encephalopathy) and sometimes even death.

It is well known that diphtheria and tetanus components do not cause adverse neurological effects, so some people suspect a whooping cough component. However, many large studies have found no causal relationship between neurological problems and whooping cough vaccination. Studies of the new DTP indicate that it is not completely safe today.

Studies show that in cases where neurological problems were closely related to vaccination, high fever was observed when not immunized.
Children with neurological disorders may also be at risk for a flare-up of symptoms 2 or 3 days after vaccination. Such a temporary worsening of their illness rarely poses a particular danger to the child. Children who have new neurological reactions after vaccination may have a pre-existing but unknown condition, such as epilepsy, that reacts to the vaccine. To date, there is no evidence that the whooping cough vaccine causes these neurological reactions, which are rare in any case.

Important note. Unreasonable fears of side effects from vaccination can be dangerous. In England, such concerns have led to a significant decline in immunization rates since 1970. As a result, outbreaks of whooping cough occurred and brain damage and deaths increased in many children. Young children are especially at risk if they become infected from older, unvaccinated children (who usually have a milder course of the disease).

Contraindications to DTP

Temporary contraindications to DTP vaccination are:.

Infectious disease. Any spicy infection- from ARVI to severe infections and sepsis. Upon recovery, the period of medical withdrawal is decided individually by the doctor, taking into account the duration and severity of the disease - that is, if it was minor snot, vaccination can be done 5-7 days after recovery. But after pneumonia you should wait a month.

Exacerbation of chronic diseases. In this case, vaccination is carried out after all manifestations have subsided. Plus another medical exemption for a month.

In order to prevent vaccinations for an initially unhealthy baby. On the day of vaccination, the baby should be carefully examined by a doctor and the temperature taken. And if there are any doubts, it is necessary to conduct a more in-depth examination - blood and urine this goes without saying, but if necessary, involve specialists for consultation. Stress. You should not vaccinate if there are sick people in the family. acute infections or under stress (death of relatives, moving, divorce, scandals). This is of course not entirely medical contraindications

, but stress can have a very negative impact on vaccination results. Absolute contraindications

to DTP are: Allergy to the vaccine.

Strong reaction to previous vaccination. You cannot administer DTP if the previous dose had a temperature rise above 39.5-40C, or the child had convulsions.

Diseases of the nervous system. Whole-cell vaccines DPT or Tetracok should not be administered to children with progressive diseases of the nervous system. They should also not be administered to children who have had episodes of afebrile seizures.

Immunity disorders. Severe congenital or acquired immunodeficiency is a complete contraindication to DTP vaccination.

Whooping cough, diphtheria, tetanus. If a child has suffered whooping cough, then he is no longer given the DPT vaccination, but the administration of ADS or ADS-m is continued; if he has had diphtheria, he will begin to be vaccinated with the last dose, and if he has tetanus, he will be vaccinated after past illness on a new one.