Vaccination against tick-borne encephalitis

Tick-borne encephalitis is caused by flavivirus, transmitted by ixodid mites, and cases of infection through fresh milk are described. After a 10-day incubation period, catarrh, fever, headache, joint pain, CNS lesions (encephalitis - 30%, meningitis - 60%, meningoencephalitis - 10%). Endemic in forest and taiga zones. Vaccination from tick-borne encephalitis in endemic areas led to a reduction in morbidity: if in 2001 in Russia there were 6401 cases of tick-borne encephalitis (incidence of 4.38 per 100 000, in children, respectively, 976 and 3.67), then in 2007, 3162 people (2.21 per 100 000), incl. Children - 405 (1.86 per 100 000). It is necessary to vaccinate against tick-borne encephalitis, in addition to risk groups, also schoolchildren, which is conducted massively in a number of regions.

Indication, administration and dose

The vaccine against tick-borne encephalitis is a culture concentrate dry for children and adults. The course consists of 2 doses (0.5 ml each) in autumn and spring at intervals of 5-7 months (minimum allowed - 2 months). The first revaccination in 1 year, then every three years. The vaccine is injected subcutaneously into the subscapular region or intramuscularly into the deltoid muscle, children - from the age of 3 years.

EnceVir is applied from the age of 3 years. The course consists of 2 / m injections of 0.5 ml at intervals of 5-7 or 1-2 months (emergency schedule). The first revaccination - in 1 year, the next - in 3 years.

FSME-IMMUN® (cultured, highly purified, sorbed) is administered to persons over 16 years of age at a dose of 0.5 ml IM, it is possible to inject simultaneously with other vaccines into different parts of the body. Children 6 months to 16 years of age are given the FSME-IMMUN® junior vaccine. The main (standard) vaccination: 2 doses with an interval of 1-3 months, emergency vaccination - with an interval of 14 days. Booster after 5-12 months, then in 3 years. Children under one year are vaccinated at a high risk of infection. Shelf life - 30 months.

Encepure-adult is used from the age of 12 years. Two schemes are used. Traditional: 2 injections with an interval of 1-2 months, the third - after 9-12 months. After the second. The protective level of antibodies is reached 2 weeks after the 2nd vaccination. Emergency scheme: 0-7-21th day, 9-12 months. Revaccination - in 3-5 years. Effective protection 3 weeks after the start of the vaccine.

Encepur-children are administered to children 1-12 years of age according to the same two schemes indicated above.

Human immunoglobulin against tick-borne encephalitis (IG) is administered 96 hours prior to visiting the foci with no vaccinated - intramuscularly 1 time at a dose of 0.1 ml / kg. The protective effect begins after 24 hours and lasts about 4 weeks, after which the same dose is repeated

Vaccination against tick-borne encephalitis: characteristics of drugs

Vaccines against tick-borne encephalitis - inactivated, adsorbed on aluminum hydroxide, differ in the initial strains of the virus, the content of the antigen and protein. All vaccines are stored at 2-8 °.

Testicular encephalitis vaccines registered in Russia

Vaccine	Composition
Vaccine tick-borne encephalitis is dry for children and adults, Russia	Antigen (strain Sofin or 20S), kanamycin up to 75 mcg. Without a preservative. Protein up to 30 mcg. It is applied from 3 years.
EnceVir - liquid vaccine, Russia	Suspension of the virus (growth in the culture of cells of chick embryos). In 1 dose (0.5 ml) of chicken protein to 0.5 mcg, human albumin to 250 mcg, aluminum hydroxide 0.3-0.5 mg. Without antibiotics and preservatives. It is applied from 3 years.
FSME-IMMUN®-Baxter Vaccine AG, Austria. Junior (0,5-16 years)	In 1 dose (0.5 ml), 2.38 μg of Neudoerfl virus strain (growth in chicken embryonic cell culture), phosphate buffer, human albumin. Without preservatives, antibiotics and heterogeneous proteins. FSME-IMMUN® Junior - 0.25 ml / dose.
Encepure-adult, Encepur-child Novartis Vaccines and Diagnostics GmbH & Co., KG, Germany	In 0.5 ml (adult dose) 1.5 μg of antigen of the virus K23 strain, aluminum hydroxide (1 mg). Without preservatives, protein stabilizers and human blood components. Applied at the age of 1-11 years and over 12 years.

For emergency passive immunoprophylaxis, human immunoglobulins against tick-borne encephalitis are used.

Vaccination reactions and contraindications for vaccination against tick-borne encephalitis

At the injection site, soreness, swelling and denseness can occasionally be noted, sometimes with an increase in lymph nodes, and even less often a granuloma. After the 1 st dose, there is sometimes a brief increase in temperature, headache, pain in the extremities, nausea and vomiting, these doses are rarely seen on the following doses. Allergic reactions are extremely rare. According to the WHO, FSOME-Immun gives side effects with a frequency of 0.01-0.0001%. In the place of introduction of immunoglobulins, itching and pain are possible , very rarely - anaphylactic reactions.

Contraindications, in addition to common for all vaccines, are allergic to chicken eggs; Inoculation against tick-borne encephalitis is permissible after 2 weeks. After childbirth. The use of FSME-Immun is not contraindicated during pregnancy and lactation.

Post-exposure prophylaxis of tick-borne encephalitis

Human immunoglobulin (IG) is injected after sucking the tick (persons not vaccinated or vaccinated less than 10 days before the bite): in the first 96 hours, 0.1-0.2 ml / kg (slowly, deep into the muscle), 5 ml in different parts of the body. After 4 days for 28 days - the incubation of tick-borne encephalitis - the drug is not injected, tk. This can make the disease worse. For the same reason, in a number of countries, children under the age of 14 are not being injected. The drug in many countries is withdrawn from sale.

The interval between the administration of specific immunoglobulin and vaccination against tick-borne encephalitis should be at least 4 weeks.