Combined vaccines

All vaccines given to a child at a given age should be administered simultaneously in different syringes to different parts of the body, since manipulation of syringes and vaccines is fraught with technical errors.

This requirement has been retained by WHO and after the inactivation of measles vaccine in a mixture with DTP was proven, even if stored for several days. Manufacturers allow the introduction of one syringe of their vaccines DTP and HIB. In order to reduce the psychotrauma for a child, it is advisable to administer 2 vaccines at the same time (two sisters inject a shot in a moment).

Admissible combinations of vaccines at one-time administration

Vaccines	Admissible combinations
ADS, ADS-M, AD-M	Abdominal Against yellow fever live
Anti-Rabies	Tetanus toxoid
Brucellosis live	Against the Ku-fever, plague and tularemia live
Abdominal	ADS, ADS-M and AD-M
Ku-fever live vaccine	Brucellosis live
Hepatitis A	Leptospirosis + tularemia
Flu	Pneumo23, Bacterial lysates
Against yellow fever live	ADS, ADS-M, AD-M
Tick-borne encephalitis	Hepatitis A, ADS-M
Tularemia live	Plague alive (all ages) Brucellosis alive (adults)
Plague alive	Brucellosis and tularemia live

Simultaneous introduction of "calendar" vaccines allows maximum coverage of children with vaccinations with a minimum of their visits to the polyclinic.

However, simultaneous vaccination does not solve the problem of reducing traumatic vaccinations for a child. The number of injections with the use of DTP and monovaccine is 14-15 for the first 18 months. Child's life, the inclusion of influenza, Hib and pneumococcal vaccines in the calendar, will make this number prohibitive.

The way out is to use 5-7 component vaccines. We have registered DTP + HBV (Bubo-Kok) vaccine, parotitis, HBV + HAV (Twinrix), AaCD + IPV + Hib (Pentaxim), in which, however, the hepatitis component is absent. Vaccines AACDS + IPV (Tetraczyme), AaCDS + IPV + HBV (Infarriks-penta) and AaCD + + IPV + HBV + Hib (Infanrix-hexa) are in the registration stage, but their mass use will depend on the allocation for vaccination. But without switching to combined vaccines, the number of injections will inhibit the expansion of immunization.

Use of the vaccine Pentaxim in children at risk will reduce the number of injections by 4. In the main group of children, the use of DTP + HBV vaccines at the age of 3-6 months. Will reduce the number of injections by 2, while Pentaxim - by 3, while it provides additional benefits, because it contains acellular pertussis and Hib components. For vaccinations against measles-rubella-mumps at the age of 1 year and 6 years, a transition to the use of trivaccine is necessary, as it is done all over the world.

Often asked about the possible "excessive" introduction of one of the components of a combination vaccine to a child who received a full course of vaccination (for example, an introduction for the prevention of rubella and mumps in a trivaccine to a teenager who received 2 injections of measles vaccine). This practice is justified, especially if the introduction of a combination vaccine reduces the number of injections.

The organization of immunoprophylaxis is regulated by a large number of regulatory documents; they are collected in a collection published in 2007. The provisions of this chapter comply with the provisions of the Sanitary and Epidemiological Regulations for the Safety of Vaccination.

[1], [2], [3], [4], [5], [6],