Vaccination against diphtheria

The goal of the WHO Regional Committee for Europe is "to reduce the incidence of diphtheria to 0.1 or less per 100 000 population by 2020 or earlier." In 2006, 182 cases were identified (incidence of 0.13). Despite this, the importance of efforts to reach children with vaccination against diphtheria is obvious. Since more than 10 years have passed since mass vaccination of adults, another mass revaccination is needed.

Indications and method of introduction of vaccination against diphtheria

Anatoxins (all drugs) are administered to children of early and preschool age only intramuscularly at a dose of 0.5 ml, older children and adults can be injected deeply subcutaneously.

ADP is administered to children from 3 months. Up to 6 years, who have contraindications to the introduction of DTP or whooping pertussis. The course of vaccination - 2 doses with an interval of 30-45 days, revaccination - once every 9-12 months. (reached the age of 6 years, revaccinate ADS-M). If the child who had suffered pertussis had already received 1 DTP vaccine, 1 dose of ADP was administered to him with a booster at 9-12 months, if he received 2 DTP vaccinations, only revascularization of ADS after 9-12 months.

ADS-M is used for revaccination of children at 7 years, adolescents 14 years and adults every 10 years, as well as for vaccination of previously ungrafted persons over 6 years old (2 inoculations with an interval of 30-45 days, first revaccination at 6-9 months, - in 5 years, then - every 10 years). ADS-M is used in foci of diphtheria.

AD-M is used for planned age-related revaccinations to persons who have received AS in connection with emergency prevention of tetanus.

Vaccination from diphtheria: characteristics of drugs

Diphtheria toxoid registered in Russia

Anatoxin	Content	Dosage
ADS - diphtheria-tetanus toxoid, Microgen, Russia	In 1 ml of 60 LF diphtheria and 20 EC tetanus AT	Enter in / m children under 6 years of 0.5 ml (> 30 MIE diphtheria and> 40 MIE tetanus AT)
ADS-M - diphtheria-tetanus toxoid, Microgen, Russia	In 1 ml of 10 LF diphtheria and 10 EC tetanus AT	Enter 0.5 ml IM in children over 6 years and adults, the primary series - 2 doses + booster
AD-M-diphtheria toxoid, Microgen, Russia	In 1 ml of 10 LF diphtheria toxoid	Enter 0.5 ml IM in children over 6 years and adults, the primary series - 2 doses + booster

Licensed in Russia, diphtheria toxoins are adsorbed on aluminum hydroxide, preservative-mertiolate (0.01%). Storage at 2-8 °. Frozen drugs are not suitable. Shelf life 3 years. In addition, anatoxins are part of DTP, Tetrakok, Infanriks, Pentaxim, and also Bubo-M, Bubo-Kok.

Immunity and vaccination of the sick

The introduction of drugs according to the above schemes leads to the formation of antitoxic antibodies that prevent the development of symptoms of diphtheria (or dramatically softening them) and tetanus in 95-100% of the vaccinated.

Diphtheria disease of any form in non-vaccinated children and adolescents is regarded as the first vaccination against diphtheria, who received one vaccine before the disease - as a second vaccination. Further vaccination against diphtheria is carried out according to the current calendar. Children and adolescents who received complete vaccination, one or more revaccinations, as well as adults after a disease of mild diphtheria without complications, are not subject to additional vaccination. Children and adolescents grafted two or more times and suffered severe forms of diphtheria should be vaccinated once in a dose of 0.5 ml, and adults - twice, but not earlier than 6 months. After the transferred disease. Follow-up revaccinations in all cases should be performed according to the calendar.

Post-exposure prophylaxis of diphtheria

Immediate vaccination with close contact with a diphtheria patient is not due to persons vaccinated against diphtheria, as well as children and adolescents who have had the next revaccination period, and adults vaccinated, according to the documentation, 10 years or more ago. Vaccination is also subject to persons who have not found protective titers of diphtheria antibodies (1:20 or more) during screening.

WHO recommends chemoprophylaxis to persons who have close (family, sexual) contact with the diphtheria patient before receiving negative seeding results, which prevents the spread of the infection. Assign oral drugs (Ospen, macrolides), which, if positive planting, is administered 10 days, or benzathine-penicillin intramuscularly once in a dose of 600,000 units for children under 6 years and 1,200,000 ED for the elder.

Contraindications to vaccination against diphtheria

Absolute contraindications to vaccination from diphtheria are absent. When developing allergic reactions, the next dose is injected against the background of corticosteroid preparations. Pregnant vaccinations are not recommended. Vaccination from diphtheria in chronically ill patients is performed in the period of remission, including on the background of maintenance therapy.

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Side effects and complications after vaccination against diphtheria

Anatoxins are weakly reactogenic, rare reactions - local hyperemia and denseness, short-term subfebrile condition and malaise. Children with febrile convulsions in the history before the vaccination should be given paracetamol. Individual cases of anaphylactic shock, neurological reactions are described. Local allergic reaction occurs in persons who have repeatedly received AS.