A post-vaccination reaction is commonly understood as a complication, which is an unfavorable outcome of prophylactic vaccinations. Most often, violations that have arisen as a result of immunization occur in children. In some cases, the post-vaccination reaction of the body can be foreseen and the vaccination should be abandoned in advance.
Consequences of vaccination as a diagnosis
In the International Classification of Diseases of the 10th revision (ICD-10), post-vaccination reactions do not have a separate heading. To designate a complication that has developed against the background of the action of a prophylactic drug, doctors resort to coding T78 or T88.
In the first rubric, adverse effects are noted that are not classified in other sections. According to the ICD, a post-vaccination reaction refers to complications caused by an unspecified or ill-defined cause. Category T78 "Adverse effects" completely excludes complications arising from surgical and therapeutic intervention. They haveanother code in ICD-10. A post-vaccination reaction is indicated by the code T88.8 when the he alth problems that have arisen after vaccination are persistent and severe. These categories mention post-vaccination reactions such as anaphylactic shock, giant urticaria, angioedema, sepsis, and rash.
Is it mandatory to get vaccinated
Prophylactic vaccination activities in modern therapy and pediatrics have the following goal: to help the patient's body develop immunity that will protect him from a specific infectious agent if there is repeated contact with him. Mass vaccination allows you to develop not only individual resistance to pathogens, but also create a collective defense against pathogens, designed to stop the circulation of infection and the development of epidemics in society.
In our country there is a National calendar of preventive vaccinations. This document is approved by the Ministry of He alth of the Russian Federation. It establishes a schedule for mandatory and additional vaccination of children of various ages from birth to adulthood.
In isolated cases, complications occur. If the body responds to the vaccine unexpectedly, this is regarded as an adverse post-vaccination reaction. The likelihood of developing complications after vaccination may be different, depending on its type and the drug used. The hardest thing for children to tolerate is DTP - vaccination against whooping cough, diphtheria and tetanus (A33-A35 - ICD code). A post-vaccination reaction that ends in death occurs in about one in a hundred thousand cases.
Causes of complications after immunization
The body's negative reaction to the drug may be caused by its reactogenicity. In none of the cases, the individual characteristics of the patient's body and manifestations of the so-called "human factor" (for example, errors and errors of medical staff during vaccination) are not excluded.
The ability of a drug to cause complications depends on its composition. The reactogenic qualities of most vaccines used in medicine are explained by the high content of bacterial toxins, preservatives, stabilizers, antibiotics and other substances. The immunological activity of the vaccine is also of great importance. According to the degree of reactogenicity, which determines the risk of severe side effects, DTP and BCG are considered the most dangerous. Post-vaccination reactions are rare after vaccinations against polio, hepatitis B, mumps, rubella.
Speaking about the individual characteristics of the organism, first of all, the presence of a background disease is implied. The pathological process determines the frequency and severity of post-vaccination reactions. ICD-10 also includes allergic reactions, skin sensitization, idiosyncrasy.
Based on cases that have occurred in medical practice, a common cause of post-vaccination complications is human error. Patients may experience local and general reactions of the body, requiringsubsequently therapeutic or surgical intervention, as a result of:
- violations of drug administration technique;
- incorrect dosage calculation;
- incorrect dilution of the vaccine;
- neglect of aseptic and antiseptic norms.
Types of complications after vaccination
The consequences of vaccination are of two types - local or general. The first group of violations is considered less dangerous for the he alth of the child. Local post-vaccination reactions include:
- local hyperemia of the skin;
- swelling at injection site;
- infiltrate formation;
- abscess;
- purulent lymphadenitis;
- keloid scar.
In some children, after vaccination, the body temperature rises, there are muscle pains, measles-like rashes all over the body. In this case, general post-vaccination reactions are implied. The most severe complications after immunization are:
- anaphylactic shock;
- encephalitis;
- meningitis;
- sepsis;
- vaccine-associated polio.
Reactions of the body are not only local and general. Physicians apply another classification. Complications are divided into specific, that is, those that are directly associated with the vaccine, and non-specific, caused by the individual characteristics of the body.
Mechanism for the development of complications
The most common factor triggering the process of post-vaccination manifestations is an infectious disease. If the day of vaccination and illness,provoking the development of transient immunodeficiency, coincided, the likelihood of complications increases several times. In the first days after vaccination, children may develop SARS, obstructive bronchitis, pneumonia, infectious diseases of the kidneys and other serious illnesses.
Most often, post-vaccination reactions and complications are unstable disorders that persist for a short period and do not affect the vital activity of the organism. Their clinical manifestations are of the same type and, as a rule, do not affect the general condition of the child, disappear after two or three days without additional therapy.
Pathologies that may occur
Toxic reactions of the body that develop during the first three days after vaccination occur with pronounced signs of deterioration in the general condition of the child. In most cases, children's body temperature rises above 39.0 ° C, chills, lethargy, insomnia occur, appetite disappears, vomiting appears, nosebleeds. Most often, post-vaccination complications occur after immunization against whooping cough, the use of anti-influenza drugs and live measles vaccine. Sometimes hyperthermia is accompanied by convulsions and hallucinations.
Post-vaccination reactions that are of an allergic nature of origin are divided by doctors into general and local. The first category includes post-vaccination complications of a systemic nature, affecting the general condition and functioning of the body as a whole:
- anaphylactic shock;
- urticaria;
- Stevens-Johnson syndrome;
- exudative erythema;
- Quincke's edema;
- Lyell's syndrome;
- attack of bronchial asthma;
- atopic dermatitis.
The introduction of the vaccine can also cause severe immune complex reactions, which include serum sickness, hemorrhagic vasculitis, periarteritis nodosa, glomerulonephritis. Local complications after vaccination are redness, soreness and swelling of tissues that extend beyond the injection site. Local reactions after vaccination normally disappear after three days. The main allergic component in preparations for immunization is aluminum hydroxide sorbent. This sorbent is present in DTP vaccines, Tetrakok.
Autoimmune disorders can lead to post-vaccination complications, which are characterized by damage to the central and peripheral nervous system, heart, and joints. Vaccination can trigger the development of autoimmune hemolytic anemia, systemic lupus erythematosus, dermatomyositis, scleroderma and other pathologies.
Dangerous vaccines
Vaccinations scheduled in the National calendar for the first year of life provoke the greatest number of complications. The most painful for babies under six months are drugs with a pertussis component. After the introduction of the vaccine, the child may scream piercingly and monotonously for several more hours. The anxiety of children of the first year of life is explained by the fact that such vaccinations cause short-term changes inmicrocirculation of the brain and sudden increases in intracranial pressure.
Vaccine-associated diseases are the most severe in the nature of their course and post-vaccination consequences, which can be paralysis, poliomyelitis, inflammation of the meninges. Such complications are extremely rare. The risk of developing them increases after vaccination against measles, DTP, rubella, mumps (mumps).
Separately, it is worth noting post-vaccination reactions (the code from ICD-10 the doctor has the right to apply at his discretion) after BCG. Among the complications, local lesions caused by BCG infection are the most common. After vaccination in newborns, in isolated cases, lymphadenitis, skin ulcerations, abscesses, diseases of soft and hard tissues (keratitis, osteomyelitis, osteitis) occurred. Post-vaccination complications can even lead to death, especially with immunodeficiency.
What tests will I have to take
The assumption of a post-vaccination reaction occurs in a pediatrician when certain clinical symptoms appear during the immunization period. To confirm the fact of complications after vaccination, the child is sent for laboratory tests. Differential studies make it possible to exclude intrauterine infections, among which the greatest threat to the he alth of the fetus is posed by cytomegalovirus, herpes, toxoplasmosis, rubella, and chlamydia. Mandatory for a comprehensive examination are:
- general analysis of urine and blood;
- virological research;
- bacteriological tests of blood, urine, feces.
All laboratory procedures are carried out by PCR, RNGA, ELISA, RSK methods. Additionally, a biochemical study of blood and urine may be required, especially if the child has convulsions after vaccination. The results of biochemistry allow to exclude rickets and hypoglycemia in diabetes mellitus.
If a post-vaccination reaction has led to CNS disorders, the child is prescribed a lumbar puncture and a CSF sample is taken for laboratory study, electroencephalography, electromyography, neurosonography and MRI of the brain are prescribed. Complications after vaccination in their manifestations are similar to the clinical picture in epilepsy, hydrocephalus, benign and malignant brain tumors. It is possible to diagnose post-vaccination complications only when all possible causes of the violation of the child's condition are refuted.
What to do in case of complications after vaccination
Any change in a child's well-being after immunization requires a doctor's consultation. It is impossible to give medicines or take other actions on your own without the consent of the doctors. Depending on the type of reaction, the patient may be prescribed etiotropic therapy. Post-vaccination complications require the organization of a sparing regimen, careful care of the injection site and adherence to a rational diet.
Treatment of local suppuration, scarring, abscess involves the application of an ointment bandage and the appointment of a course of physiotherapy procedures (ultrasound and shock wave therapy). If the consequence of vaccinationis a high temperature, drinking plenty of fluids, taking antipyretics, wiping and applying ice to physically cool the body is recommended.
In the event of a sudden allergic post-vaccination reaction (in the 10th edition of the ICD is indicated by the code T88.7), a loading dose of an antihistamine is administered. With severe inflammation, hormonal agents, adrenomimetics, cardiac glycosides are prescribed. If post-vaccination complications are observed from the nervous system, the child is prescribed symptomatic treatment (for example, anticonvulsants, antiemetics, dehydration drugs, and adsorbents). In case of complications after the BCG vaccine, treatment is prescribed by a pediatric phthisiatrician.
How to prevent a painful reaction after vaccination
The main condition for successful prevention of post-vaccination complications is the inadmissibility of immunization in the presence of contraindications to vaccination. Doctors should pay great attention to the selection of children to be vaccinated. For this purpose, pediatricians conduct a preliminary examination of patients and, if necessary, refer them for a consultation with other specialists (allergist, immunologist, neuropathologist, cardiologist, nephrologist, pulmonologist, phthisiatrician). During the post-vaccination period, it is necessary to monitor the condition of the child.
Equally important is the professionalism of the medical staff admitted to vaccinate. Children should be vaccinated by an experienced and qualified specialist. In case of post-vaccination complicationsre-introduction of the vaccine is not allowed even after several months. At the same time, other types of immunization are not contraindicated for the child.
Protection against post-vaccination reactions largely depends on how responsibly parents approach the issue of immunizing their children. If a child has complaints of feeling unwell, this cannot be kept silent, it is necessary to inform the doctor. Do not get vaccinated if you have symptoms of a cold or other infectious disease. Every child should be screened before being vaccinated.
In the predominant number of cases, complications are observed due to violations of the storage conditions of the vaccine. At the same time, the likelihood of developing post-vaccination complications due to the individual characteristics of the organism is minimal. In addition, we must not forget that the risk of children becoming infected with dangerous viral diseases is much higher than the risk of developing post-vaccination reactions.
Vaccination complications are a reason to see a doctor. In case of reactions of mild and moderate severity, it is enough to provide proper care for the infiltrate and monitor body temperature, and if it exceeds 38 ° C, give the child an antipyretic. After vaccination and for the next three days, an antihistamine is prescribed to the child to prevent allergic reactions.
In case of an adverse post-vaccination reaction to the vaccine, you can not use alternative methods of treatment or give the child pharmaceutical medicines at your discretion. The consequence of this careless attitude towards the immunization process canbecome a serious weakening of he alth.
