Is it necessary to isolate children vaccinated with live polio vaccine: pediatrician Sergei Butriy explains

Is it necessary to carry out

In Russia, polio vaccination for children under 14 years of age is mandatory, according to the resolution of the Ministry of Health.

The polio virus is dangerous mainly for young children under 5 years of age. The lower extremities suffer the most, and after being ill, the child may become disabled. In more than 5% of cases, paralysis affects the respiratory muscles, which can be fatal.

Poliomyelitis is spread by airborne droplets and household routes. A person can be a passive virus carrier, being a source of infection for others. There is no cure for polio, and the only effective method of protection is vaccination.

Second polio vaccine

However, despite the effectiveness of the Salk vaccine, the number of cases decreased slightly. It gradually became clear that the drug caused only short-term immunity to polio. Nevertheless, the huge scale of production made it possible to obtain funds for continued scientific research: much attention was paid to the mechanism of pathogen reproduction.

In 1958, virologist Sabin discovered an interesting fact: if the pathogen multiplies in low temperature conditions, the form that does not lead to disease survives. When such a virus is orally introduced into a living organism in combination with something sweet, polio does not develop, but antibodies are formed to it. It turns out that the virus is alive, but not pathogenic, while giving the desired immune response.

The resulting Sabin vaccine had significant advantages over the Salk drug. Firstly, an injection was not required - it was enough to drop a drop on the child’s tongue. Secondly, its production required lower financial costs. Thirdly, the resulting immunity lasted for a long time.

However, the US National Foundation rejected this idea, citing the fact that America already has a working vaccine, and using a live virus is unsafe.

Vaccination calendar

The population immunization schedule for the prevention of polio was established by the Order of the Ministry of Health of the Russian Federation of 2011. There are two types of vaccines used for vaccinations:

• IPV is an inactivated polio vaccine that is given by injection;
• OPV is an oral polio vaccine made from live strains of the virus.

The preparations contain 3 types of polio virus, the introduction of which becomes a reliable protection for a person against any form of the disease. There are also complex vaccines, such as Pentaxim, Infanrix Penta, which include several viruses at once.

The first vaccination against polio occurs at 3 months from birth. It is important to do it in a timely manner, since by this time the baby no longer has maternal immunity.

Table. Procedure for vaccinating children against polio.

It is believed that stable immunity is formed after a full range of vaccinations. Vaccination is provided free of charge at public clinics. The polio vaccine is given at the same time as DTP.

Vaccination can also be carried out in private clinics. To receive consultation and vaccination, you must make an appointment.

Development of the first vaccine

The first polio vaccine appeared in early 1952. Its creator was virologist Jonas Salk from the United States. By that time, the disease had spread throughout the globe - in America alone, during 1952, the virus killed more than 3,000 people, and left more than 21,000 paralyzed.

Dead viruses were taken as the basis, since by the time the polio vaccine was created, Jonas Salk was developing a flu vaccine, and while testing the drug on patients, he noticed that killed viruses also triggered a response from the immune system. Almost 20,000 monkeys were involved in the search process. However, the scientist understood that this was not enough, and for large-scale production it was necessary to somehow reproduce the pathogen in test tubes. To implement the idea, Salk took advantage of the achievements of Frederick Robbins, John Enders and Thomas Weller.

The scientist first administered the resulting drug to himself and his loved ones – his three sons and his wife. What was happening was recorded on photos and video cameras - these materials were later used to reassure the population during mass immunization. It turned out that the vaccine was safe and effective, and already in 1954, the untested composition was administered to five thousand school students. Not a single child got sick after vaccination.

Vaccinations for adults

If we are talking about immunization of adults, it is carried out according to the following schedule:

• 1st IPV vaccine;
• after 1-2 months, repeated introduction of IPV;
• after 6-12 months the 3rd vaccination is carried out.

Adults need to be vaccinated only in exceptional cases:

• if the person was not vaccinated in childhood;
• when planning a trip to countries where polio outbreaks have been reported;
• when working with infected people;
• after contact with a sick person.

Are there any restrictions

In some cases, vaccination cannot be done. Contraindications to immunization against polio:

• pregnancy;
• immunodeficiencies of various origins;
• allergy to the components of the drug (neomycin, streptomycin);
• severe reaction to a previous vaccination;
• colds, acute respiratory infections;
• exacerbation of chronic diseases.

In the last two cases, vaccination should be postponed until complete recovery. In a state of reduced immunity, vaccination can cause negative consequences.

Children with immunodeficiency cannot receive a vaccine based on live strains of the virus (OPV). In this case, the possibility of vaccinating them with an inactivated vaccine (IPV) is being discussed.

Drops or injection for polio: what to choose?

In Russia, parents have the opportunity to choose one of the immunization options: live attenuated vaccines, inactivated non-live vaccines, or their combined use.

The national vaccination calendar recommends the sequential use of killed and live polio vaccines:

• a vaccination cycle consisting of two vaccinations with a one and a half month interval is carried out with immunobiological preparations containing strains of non-living inactivated viruses;
• for the third, completing the course of vaccination, vaccinations and distant revaccinations at 18, 20 months and 14 years, live low-active strains of pathogens are used.

Consenting to immunization with polio drops or injections is essentially a choice between the use of a weakened live or inactivated vaccine and an assessment of the associated risks and benefits.

Immunization using the combined method within the framework of the National Calendar is carried out free of charge. The full cycle of immunoprophylaxis with inactivated biological products is carried out on a paid basis.

How is vaccination carried out?

Inactivated vaccine (IPV) is given in two ways - subcutaneously or in the upper arm (thigh). The method of administration depends on the manufacturer of the drug.

Live vaccines (OPV) are administered orally to the lymphoid tissue of the pharynx or palatine tonsils. The child is asked to throw back his head and open his mouth, where 2 and 4 drops are dripped, depending on the dosage of the drug. For an hour after the vaccine is administered, you should not eat or drink, including water.

For 24 hours after vaccination, you should not eat allergenic foods, get hypothermic, or communicate with sick people.

Is polio coming back?

Someone said that when a disease leaves, it looks back: is it possible to return?

1980 was the year of the official declaration of the eradication of smallpox, one of the most dangerous infectious diseases known to science in human history. For decades now, there has been a struggle to obtain the same status for another disease.

Polio. Today we are talking about him.

For reference. Poliomyelitis: what is this disease and how is it transmitted?

This is an infectious disease caused by poliovirus. The pathogen enters the body through water or food contaminated with fecal particles from an infected person. Multiplying in the intestines, it penetrates the blood and spreads throughout the body. Among the cells attacked by the virus are neurons of various parts of the central nervous system: the brain stem, cerebellum, and cerebral cortex. Its most preferred target is the so-called horns of the spinal cord: the neurons located here provide the movement of skeletal muscles.

The virus is also released into the environment through the intestines and can be transmitted further to other people.

In the language of numbers. Does polio still exist in Russia and the world?

According to open source data, cases of polio are periodically recorded in many countries around the world, including in our country. So, in 2015, after many years of “calm”, a single case of this disease was registered. Later, 4 more carriers of the virus were discovered.

As of the end of 2021, there is a risk of contracting polio due to a shortage of vaccine preparations.

Since the creation of the Global Polio Eradication Initiative (GPEI) in 1988, global polio incidence statistics have changed dramatically, as evidenced by an almost 100% decline in the number of cases.

Doesn't spare anyone. Which famous people suffered from polio?

Illness is the great equalizer. According to historical information, Franklin Roosevelt, the 32nd President of the United States, suffered from this illness. One day he simply swam in one of the many Canadian lakes. Roosevelt's symptoms of the disease were misinterpreted, which led to erroneous treatment tactics and the subsequent development of paralysis. Later, the correct diagnosis was made, but, unfortunately, the therapy did not lead to the restoration of leg function.

Frida Kahlo is a famous Mexican artist who suffered from this terrible disease at the age of six. Doctors managed to save the girl, but one of her legs became thinner and shorter than the other, which caused the development of lameness. Even as a child, the future artist fully realized what it meant to struggle, including with her illness. She played football with the boys, did boxing and swimming. Alas, polio was not the only serious test for body and spirit in her life...

In the name of salvation. How was the polio vaccine created?

The history of vaccination against this disease has been difficult. Shortly before the end of the 40s of the last century, a doctor from the University of Pittsburgh, Jonas Salk, headed the virology laboratory. In 1952, he brought together several types of polioviruses obtained from monkey kidney cultures. The viruses were treated with formaldehyde, after which they were unable to cause the development of the disease, but when introduced into the body, an immune response was developed to them. At the same time, he begins the first human trials of the vaccine and publishes the data obtained.

Perhaps the reader has a question: is it possible to get polio after vaccination? After all, it contains, although “killed,” viruses, they are still viruses? In the spring of 1954, the first vaccination campaign with Salka began, school-age children were vaccinated. Unfortunately, tragedy struck: several hundred of those immunized developed the disease, and deaths were also reported. Presumably, the vaccine viruses were not completely inactivated, which led to such consequences.

The vaccine was improved, and already in 1955, more than 4 million doses were used in the United States. Four years later it was already used in many countries around the world.

In 1957, another American researcher, Albert Sabin, reports a live oral vaccine. The microbiologist believed that the inactivated Salk vaccine was not able to prevent the development of epidemics. According to Sabin, his live vaccine was supposed to essentially reproduce the disease. For this purpose it was supposed to use a weakened form of the pathogen. As a result of numerous experiments, a rare type of pathogen was obtained that reproduces in the digestive system and does not attack the nervous system. A year later, the drug is tested in the United States, and a few years later the “sugar cube vaccine” becomes publicly available.

In the Soviet Union, Mikhail Chumakov, Anatoly Smorodintsev and others were involved in the development of the vaccine, its release and mass use. It was here that polio as a mass disease was eradicated for the first time in the world. Drug Research Institute named after. Chumakov was widely used in Japan and all socialist countries.

Be alert. Symptoms of polio in children and adults

Mostly children suffer from it. In adults, the disease is more severe. Manifestations of the disease are varied and include, in particular, increased body temperature, fatigue, vomiting, upset stool, sweating, variability in blood pressure, headache, tension in the occipital region, muscle pain, paresis and paralysis.

Can polio be cured?

Often the disease ends with complete recovery. Muscle strength begins to recover after a few days, increasing over the next 1-2 years. Some patients may have residual paralysis, which is permanent in 1 in 200 patients (usually in the legs). Between 5 and 10% of paralyzed patients die from paralysis of the respiratory muscles.

There is currently no specific antiviral drug for the developed disease.

Prevent and neutralize. At what age do children get the polio vaccine?

Typically, a child is vaccinated at three, four and a half, six, eighteen, twenty months, and then at 14 years.

A consultation with a pediatrician is required to assess the child’s condition, including his immune system, and to determine the type of vaccine that will be used. In particular, children with impaired immunity have their own vaccination characteristics.

Globally and on a large scale. How will the World Health Organization help eradicate polio?

Today, polio outbreaks are still possible. Activities to stop this disease include: improving routine immunization; improving epidemiological surveillance in high-risk areas; raising people's awareness; development of special events to reach migrant children, in conflict zones, remote areas, mobile population groups and some others.

What to do if deadlines are missed

If the vaccination schedule is disrupted, there is no need to do the entire series again. If the first vaccination is not administered on time or doses are missed, the entire schedule is shifted according to a certain algorithm.

The doctor will determine which vaccinations were missed and prescribe their administration, observing the minimum intervals between them:

• between 1st and 2nd – 30 days;
• between 2nd and 3rd – 30 days;
• between the 3rd and 4th and beyond – 6 months.

Thus, if the first vaccination was missed at 3 months, it will be given at 4 months. It is too early to do the second one within the prescribed period (4.5 months), you need to maintain a gap of 1 month. Thus, the second vaccination is given at 5 months.

A dose administered before the minimum interval has expired is not counted. Thus, the entire series of immunizations must be completed before age 14. After this age, vaccination is carried out only according to epidemiological indicators.

If vaccination information is lost, the child is considered unvaccinated and a full series of polio vaccinations is required.

Possible adverse reactions from vaccination

Often, vaccination is well tolerated without causing any side effects to the body. Some side effects may sometimes occur:

1. Mild intestinal upset that lasts about 2-3 days. If you have loose stools for a longer period of time and accompanying suspicious symptoms (poor appetite, lethargy), you should consult a doctor. This condition can be caused by an intestinal infection not associated with the administration of the vaccine.
2. An allergic reaction in the form of a rash or hives. Any such phenomenon requires medical consultation to exclude serious consequences, for example, Quincke's edema. The doctor will prescribe antiallergic medications (Zodak, Fenistil, Loratadine). If you are prone to allergies, you should start taking antihistamines a few days before the vaccination.
3. VAPP (vaccine-associated polio) occurs in one in a million cases. Most often, an abortive form is observed (without paralysis), accompanied by symptoms of acute respiratory infections, muscle twitching, pain in the back and limbs. Recovery occurs within a month. Severe paralytic forms are extremely rare.

To avoid complications, it is necessary to follow the rules of preparation and behavior after vaccination. However, side effects are often observed due to poor-quality material or non-compliance with the technique of its administration.

Anti-polio candy – tasty and healthy

The polio virus does not multiply in the mouth; for this process it must penetrate the intestines. To ensure complete “delivery” of the pathogen to the desired part of the gastrointestinal tract, Chumakov came up with the idea of ​​​​producing the vaccine in the form of a dragee candy.

Anti-poliomyelitis pills were small capsules weighing only one gram. The outside was covered with wax, and inside, in addition to the virus, there was sugar and molasses. Such candies were produced at Marat's factory from the late 50s to the late 60s.