Health Advisor - FAQ

Definition

The vaccines are immune drugs. Live vaccines (attenuated) contain live pathogens of infectious diseases where specific procedures reduced ability to cause disease but retain the ability of multiplying in the cells and inducing immune responses in vaccinated individuals. Non-living vaccine (inactivated) contain the whole dead tree microorganisms or their components that cannot be copied, and who themselves do not cause disease but stimulates the immune response. Protein subunit vaccine - containing protein fragments of the virus are important for the creation of protective immunity, rather than whole virus particles. Recombinant vaccines are subunit by rDNA technology derived vaccines. Peptide vaccine – containing peptide (immunogenic epitopes) that can cause a strong immune response –when ingested in organism with carriers or adjuvants. Vaccines based on nucleic acid containing plasmid DNA vectors (rarely RNA) that encode for the antigen/antigens of interest, it expresses the antigen in situ and leads to the formation of specific immune responses.

Why Should Be Vaccinated

The vaccine antigen enters the body, which elicits an immune response, which results in the production of protective antibodies. These antibodies, in the case of contact with the cause of certain infectious diseases prevent illness or make that the disease, which can be developed, is much milder in character. The ultimate goal of immunization is eradication of certain infectious diseases. Vaccine can provide protection against -one infectious disease agent (monovalent) or against agents of more infectious diseases (polyvalent or combined). Vaccination is the greatest medical success of the 20th century, and vaccinations were rescued more lives than any other medical intervention in history.

Who Makes Vaccination Program in The Republic of Croatia and Responsibilities of The Chain in Vaccination

Minister of Health, upon the proposal of the Croatian National Institute of Public Health, makes a decision about the vaccination program. Supervision of the implementation of vaccination programs is in the domain of the Croatian National Institute of Public Health. Vaccinators are responsible for vaccinations, Croatian Institute for Health Insurance for the procurement of vaccines, and Institute of Immunology, Inc. is responsible for distribution of vaccines.

Is Vaccination Mandatory

Parents in a negligible number of cases refusing to vaccinate a child. Then, under the Act of protection of the population from infectious diseases, physicians are obliged parents to report sanitary inspection. Pursuant to Art. 77th the above Act, the penalty amounts to 2000 kunas for a parent or guardian who fails to immunization against the diseases set out in vaccination programs.

Why Is Vaccinated Important for All Healthy Children

It is important that all children are vaccinated because it indirectly protected the whole community, especially individuals who are not vaccinated due to age or due to underlying disease. The rate of vaccination of the community is especially expressed at a speed of containment of possible outbreaks.

Basic Requirements for Vaccines And Their Efficiency

Vaccines must be harmless (safe) and effective (immunogenic). Neither vaccine is not 100% efficiency. Less vaccine effectiveness may be due to underlying disease organism or the ongoing use of certain groups of drugs that suppress the immune system.

Immune Rasponse

Uobičajeno se imunološki odgovor organizma javlja oko dva tjedna nakon cijepljenja. Neka cjepiva treba dati u Typically, the immune response occurs about two weeks after vaccination. Some vaccines should be administered in several separate doses to achieve better and long-term immunity.

Duration of Protection

Immunity achieved by vaccination with a variety of vaccines is of varying duration. Therefore, some vaccines are administered in several separate doses over the determinated time period between them. The age when a child should be vaccinated is determined by the experience gained from naturally infected individuals and by the immune response to vaccine in clinical trials.

Delay of Postponement of Vaccination

In case of delay or postponement of the vaccination pursuant to the vaccination program, it should be adapted to each child or person individually. Most often the vaccinations will be continuated where it was interrupted and again should be given the previous dose.

Adverse Reactions

As any other medicine, vaccines may cause adverse reactions. As with other drugs, important is the odds of benefit of a vaccine against the risk of developing the disease being vaccinated against. Side effects of vaccination are much milder and less frequent then complications and mortality from diseases against which we vaccinate. Most often can appear mild local reactions: redness, swelling, induration and tenderness at the initiation site of the vaccine. The most common systemic (general) reactions are fever, lethargy or restlessness, vomiting. After immunization, child should be monitored. In the case of temperatures over 40 ° C, a disorder of consciousness or balance, general weakness, seizures (convulsions), changes in breathing or heart rate, should contact a physician.

Contraindications

Prior to vaccination, the physician should take a detailed medical history and determine whether there is a contraindication for vaccination. Delaying vaccination due to lack of medicaly justificated reason endangering child because it remain vulnerable to certain infectious diseases, but also the community, because it optimal vaccination was not achived. For each specific vaccine, there are specific contraindications.

Administration Site – Into the Muscle

It is recommended that children younger than 15 months sholud be vaccinated about 2 cm below the upper and middle thirds of thigh. Older children, adolescents and adults should be vaccinated in the upper third of the upper arm at an angle of 60-70 degrees to the highest point of the shoulder. Vaccine used in an inappropriate place and / or by poor application technique, can cause local reactions at the injection site, may be less absorbed and can cause a weaker immune response. At administering the vaccine in the thigh muscle in pre-school and younger school children should be used a needle length of 16 mm (23-25 G), for most adolescents and adults should apply the needle length of 25 mm (23-25 G), and for very obese persons may be used a needle length of 38 mm (21 G).

Administration Site - Into the Skin

Injection into the skin should to be applied, avoiding the surrounding bone, blood vessels and nerves. The most common is used in the upper arm at an angle of application of 30-45°, with the needle which is not longer than 16 mm.

Tiomersal

Thiomersal is a mercury compound used as a preservative. Contained in multi-dose vials allows vaccines to all doses from the bottle does not have to be administered at once and can be stored after taking the first dose during the prescribed time at the prescribed temperature. Does not contain methyl mercury, which causes toxic effects in humans. Thiomersal contains ethyl mercury, which does not accumulate in the body, but is metabolized and removed from the body faster than methyl mercury. Numerous scientific studies examined the safety of tiomersal and there was no evidence of toxicity in children or adults, including pregnant women. Thiomersal can cause allergic reactions at the injection site after more than 48-72 hours after vaccination.

Adjuvants

Adjuvants are substances that enhance the effectiveness of the vaccine causing enhanced immune response. In the production of some vaccines are used for decades. The purpose of their use is to reduce the amount of antigen in a dose of vaccine and production of greater number of doses, which is useful in the event of a pandemic.

Beginning of Vaccination in Croatia

In 1791st the surgeon, Dr. Ferdinand Hadvig in Jastrebarsko spent vaccination against smallpox. At that time one of the three infected people died from the that disease. Dr. Hadvig has already realized the importance of preventing healthy people and inoculated all persons who were not suffered from smallpox. For children, sought the consent of their mothers and gave them advice on prevention and guidance on vaccinations. Dr. Hadvig it did five years before Edward Jenner in England, which in Europe are considered the "father of vaccination".

Vaccination Against Infectious Diseases in Croatia

Thanks to the use of high immunogenic vaccines and broad coverage of the population in Croatia has almost completely eradicated measles, rubella and mumps. In the last ten years has been reported less than ten cases of measles and rubella vaccine annually. The exceptions were small outbreaks of rubella in Dubrovnik 2007 and in spring 2008. The genotype of the virus, which was isolated from those patients, has never before been present in Croatia, which indicates that it was an epidemic caused by input from other countries. A short course of these epidemics has shown that the immunity of community was high.

Before the introduction of mumps vaccine, mumps was the main cause of deafness in children with prevalence 1 in 20 000 patients.

Last case of wild (natural) polio recorded in Croatia in 1989.

Tetanus occurs very rarely, usually after injury in the elderly, who weremostly completely vaccinated, but since the last dose passed more than 20 years.

Pertusiss occurs in less than 2% of the population. Namely, the germ of diphtheria is present in the human pharynx and may become toxigenic if came under the influence of bacterial virus, called bacteriophages.

The incidence of tuberculosis was 219 cases per 100,000 people. The rate of ilness in Croatia is lower than the European average of 40 patients per 100,000 people, but higher than in countries with the best epidemiological situation with 10 patients per 100,000 inhabitants.

Therefore, the vaccination and monitoring of these diseases should continue.

Vaccination Against Infectious Diseases in the World

In Africa, where most children have no possibility of vaccination, measles each year, carry thousands of lives. Remembering the football championship in 2008 when were in Austria, Switzerland and Germany smaller outbreaks of measles because of lack of vaccination of the population caused by the collective theories of pointlessness vaccination.

2010 broke out an epidemic of measles and rubella in Vietnam, Ukraine, Russia, Liberia, Nigeria, Sudan, Pakistan, Canada and the Philippines. In February, 2011 was confirmed 20 cases of measles in the United States. Of patients, 17 people traveled to the Dominican Republic, France, India and Britain. Vaccination against rubella is especially important for unvaccinated women who may become pregnant because of a serious risk for the disorder of intrauterine life and health of the child. In 2004 and 2005 rubella epidemic broke out in the Netherlands (400 patients) and Canada (309 patients). In the Netherlands, all 32 infected pregnant women were orthodox Protestant, of which 30 refused vaccination because of religious beliefs.

Japan, which not spend the immunization against mumps, has an epidemic with the prevalence of permanent deafness 1/1000. From June 2009 to January of 2010, at least 1,500 people in New York suffed from mumps, during the epidemic, which started in the children's summer camp. Before that, 2006 the epidemic of mumps was affected 6600 people.

2009 in Great Britain is registered 7400 cases of mumps.

In 2007 World Health Organization was declared European region as polio-free. Polio is not eradicated worldwide, and vaccinatation sholud not be stopped. 2010 there have been outbreaks in Central Asia, the Congo, Russian Federation (184 affected with 85 deaths) and Angola.

In the period from 1990 to 1993 was broken up a centralized system of vaccination of the former Soviet Union, which has been resulted in a figure from 30,000 to 40,000 cases of diphtheria. Epidemic of diphtheria was broke out in 1994 in Thailand, in 2003 in Afghanistan, and the last were in 2010, the first after the catastrophic earthquake and tsunami in the capital of Haiti, and another, smaller in Java.

The largest number of new cases of tuberculosis reported in India, China, Indonesia, South Africa and Nigeria. World Health Organization has set the target that all cases of tuberculosis has to be diagnosed and treated. After 2006 concern was expressed about the growing number of cases of disease that are resistant to various drugs, as well as the often lethal combination of tuberculosis and HIV infection. World Health Organization has reported that in some Eastern European countries due to inadequate treatment has been spread out resistant tuberculosis up to 14%. In Croatia, the resistance to the medication is about 2%.