Vaccine against pneumococcal infection

Vaccinations against pneumococcal infection will help prevent you from becoming infected with coronavirus or suffering from a mild form of the disease. Russian scientists told Izvestia that a twenty-three-valent vaccine is better for adults, and a thirteen-valent one for children and the elderly. The difference between them lies in the set of strains of dangerous bacteria against which protection is formed. According to experts, a timely injection will help avoid bacterial complications from COVID-19 and improve the condition of the immune system. This is confirmed by foreign scientific teams. For example, researchers from Italy showed that those vaccinated against pneumococcus last year were significantly less likely to test positive for a new infection.

SYNFLORIX ® / SYNFLORIX ®

(Vaccine for the prevention of pneumococcal infections)

Manufacturer: GlaxoSmithKline Biologicals S.A. (Belgium)

Composition: active substances: conjugate of Streptococcus pneumoniae type 1 polysaccharide and Haemophilus influenzae D-protein, conjugate of Streptococcus pneumoniae type 4 polysaccharide and Haemophilus influenzae D-protein, conjugate of Streptococcus pneumoniae type 5 polysaccharide and Haemophilus influenzae D-protein, polysaccharide conjugate Streptococcus pneumoniae type 6B and Haemophilus influenzae D-protein, conjugate of Streptococcus pneumoniae type 7F polysaccharide and Haemophilus influenzae D-protein, conjugate of Streptococcus pneumoniae type 9V polysaccharide and Haemophilus influenzae D-protein, conjugate of Streptococcus pneumoniae type 14 polysaccharide and Haemophilus influenzae D-protein, con polysaccharide jugate of Streptococcus pneumoniae type 18C and tetanus toxoid, conjugate of Streptococcus pneumoniae polysaccharide type 19F and diphtheria toxoid, conjugate of Streptococcus pneumoniae polysaccharide type 23F and Haemophilus influenzae D-protein, excipients: sodium chloride, aluminum phosphate, water for injection

Release form White suspension, which separates when standing into a colorless transparent liquid and a white precipitate, which completely breaks up when shaken. Unbreakable flakes are not allowed.

Indications for use: prevention of pneumococcal infection caused by Streptococcus pneumoniae serotypes 1, 4, 5, 6B,7F, 9V, 14,18C,19F and 23F (including sepsis, meningitis, pneumonia, bacteremia), and infection caused by Haemophilus influenzea (acute otitis media) in children from 6 weeks to two years of age

Vaccination schedule: Children from 6 weeks to 6 months - Three-dose primary vaccination To achieve optimal protection, it is recommended to administer 4 doses of Synflorix vaccine, 0.5 ml each. The primary vaccination course consists of three doses, given with a minimum interval of 1 month between doses. The vaccine is usually administered at 2 months of age, but it is possible to administer the vaccine at an earlier age, starting at 6 weeks of age. A booster dose is recommended at least 6 months after the last primary dose, preferably between 12 and 15 months of age - Two-dose primary As an alternative schedule, the following vaccination schedule may be used: first dose (0.5 ml) given at age 2 -x months, the second dose (0.5 ml) is prescribed 2 months after the first dose. A booster dose is recommended at least 6 months after the last dose of primary vaccination.

Children not previously vaccinated with pneumococcal vaccine - from 7 to 11 months The course of vaccination consists of two doses of 0.5 ml with a minimum interval of 1 month between doses. Administration of the third dose is recommended in the second year of life with an interval of at least 2 months between administrations after the 2nd dose - from 12 to 23 months. The vaccination course consists of two doses of 0.5 ml with a minimum interval of 2 months between doses. Official recommendations must be followed during immunization with Synflorix. It is strongly recommended that children who receive the first dose complete the full course prescribed for Synflorix vaccination

Contraindications: – known hypersensitivity to any component of the vaccine and reactions to previous administration of the Synflorix vaccine; – children up to 6 weeks of age; – acute infectious diseases of moderate and severe severity.

What causes pneumonia and can you get vaccinated against it?

In children, the causative agents of the bacterial form of this disease are:

Streptococcus pneumoniae is the most common cause of pneumonia. It causes 20-60% of all cases in children under 18 years of age, with the highest proportion occurring between 6 months and 7 years of age. In adults, S. pneumonae is responsible for 35-40% of cases. It has 91 varieties, but only 23 of them are responsible for 90% of human infections. Despite its name, S. pneumoniae causes more than just pneumonia: along with the meningococcus Neisseria meningitidis, it is one of the main causes of bacterial meningitis, which is sometimes transient and extremely life-threatening.
Vaccines – Prevenar 13, Pneumovax 23.
Mycoplasma pneumoniae, Mycoplasma pneumoniae, is a very small bacterium that causes 5-50% of cases of illness in children, depending on age. Mycoplasma pneumonias are atypical and community-acquired (as a rule, they develop outside the walls of a medical institution, since their diagnosis is very difficult).
There is no vaccine for it.
Chlamydia pneumoniae, Chlamydia pneumoniae, is an intracellular parasite that causes 5-15% of cases (as in the previous paragraph - atypical) in children, depending on age. Chlamydia trachomatis is responsible for another 3-10%.
There is no vaccine for chlamydia, but research is currently underway to make one possible in the future.
Haemophilus influenzae, Haemophilus influenzae, causes 3-10% of pneumonia in children.
May also cause meningitis and epiglottitis. In total, Haemophilus influenzae has 6 serotypes, of which type b is dangerous for humans.
Vaccines - Hiberix, Act-HIB, Pentaxim (combined, also includes antigens of whooping cough, diphtheria, tetanus and polio), Infanrix Hexa (combined, includes everything that Pentaxim does, + hepatitis B).

The remainder of the statistics accounts for infection with enterobacteriaceae, Staphylococcus aureus, group A streptococcus Streptococcus pyogenes, chlamydia Chlamydia psitacci (the causative agent of psittacosis) and Coxiella burnetti (the causative agent of Q fever). These are quite rare and specific variants in which, for example, rodents, birds and cattle act as carriers of the infection.

The statistics for adult patients are somewhat different from those for children. The risk group primarily includes older people: for example, Legionella pneumophila appears among the pathogens. 75-80% of recorded cases of infection occur in people over 50 years of age. However, the championship is still held by Streptococcus pneumoniae, responsible for 30-50% of pneumonia in adults.

Thus, it is possible to protect yourself from severe complications if you get vaccinated against Streptococcus pneumonia and Haemophilus influenza type b - this way you can prevent up to 70% of the chance of infection.

PNEUMO 23 / PNEUMO 23

(Polyvalent pneumococcal vaccine for the prevention of pneumococcal disease)

Manufacturer: Sanofi Pasteur S.A. (France)

Composition: each dose of the Pneumo 23 vaccine contains purified polysaccharides of pneumococci of 23 serotypes.

Release form: injection solution: one dose of vaccine in 0.5 ml syringes

Indicated for use: from 2 years of age for the prevention of pneumococcal infection, including diseases such as pneumonia, bronchitis, otitis media, meningitis, sepsis; forms specific immunity to various serological types of 23 bacteria Streptococcus pneumoniae.

Particularly indicated for: - patients suffering from congenital or acquired immune disorders, chronic diseases, especially the respiratory and cardiovascular systems, respiratory systems, diabetes mellitus, liver cirrhosis, chronic renal failure, Hodgkin's disease or who have undergone splenectomy (removal of the spleen) - (level mortality in this group reaches 50%); – frequently ill children (especially under 5 years of age); – children living in large groups (for example, in an orphanage or orphanages); – persons over the age of 65 years (mortality from pneumococcal pneumonia reaches more than 40% at this age) – patients with sickle cell anemia – HIV-infected “organized” patients (living in nursing homes, long-term care facilities, prisons).

Vaccination schedule: once from 2 years of age. It is recommended to be vaccinated at the same time as the flu shot. This provides comprehensive protection against two causes of pneumonia, which are (together) the 5th leading cause of death among older people. During your stay in a medical institution: in preparation for operations (removal of the spleen, organ transplantation), treatment for predisposing pathologies - once. Revaccination is carried out once, no earlier than 3 years after the 1st vaccination, with the exception of persons from a high-risk group or patients on immunosuppressive therapy.

Repeated vaccination is recommended for: – adults from high-risk groups (for example, with asplenia) who were vaccinated 5 years ago; – those who have a rapid decrease in pneumococcal antibody titers (patients with nephrotic syndrome, renal failure, those who have undergone organ transplantation) – after 3-5 years, children over 10 years old with nephrotic syndrome, asplenia and sickle cell anemia.

Contraindications: – hypersensitivity, severe allergic reaction to the previous administration of the vaccine; – anti-pneumococcal vaccination less than 3 years before the intended vaccination (except for special indications); – pregnancy (I-II trimester) except in cases where vaccination is indicated; – hyperthermia, acute infectious and non-infectious diseases or exacerbation of chronic diseases (in these cases, vaccination should be postponed).

Advantages: – Pneumo23 is the only vaccine registered in Russia for the specific prevention of pneumococcal infection; – it protects against the 23 most common types of pneumococci and the diseases they cause, including pneumonia (pneumonia), bronchitis, otitis media, meningitis, sepsis; – duration of protection up to 5 years after a single vaccination with the Pneumo 23 vaccine; – the effectiveness of the vaccine, proven by Russian experience – a 6-fold reduction in the number of cases of pneumonia in risk groups; – contains most of the serotypes circulating in Europe that are resistant to penicillin; – available in convenient disposable individual syringe doses; – it is possible to effectively combine vaccination with the Pneumo 23 vaccine with vaccination against influenza for the comprehensive prevention of influenza and its complications; – Pneumo 23 vaccination can be carried out during breastfeeding; – only one dose of the vaccine is needed for effective protection.

Application experience: According to foreign studies, the Pneumo 23 vaccine is effective against 90% of pneumococci that are insensitive to penicillin and 96% of pneumococci that cause disease. The Pneumo23 vaccine is registered in many European countries. When registering the vaccine in Russia, tests were carried out, during which the high preventive effectiveness of the Pneumo 23 vaccine in risk groups was demonstrated: a reduction in the incidence of acute respiratory diseases by 2 times, bronchitis by 12 times and pneumonia by 6 times compared to those who were not vaccinated. The high safety of the Pneumo23 vaccine was also confirmed: local reactions were recorded (hardening, redness at the injection site), which were observed in only 5% of those vaccinated. All adverse reactions resolved without treatment within 24-48 hours from the moment of their onset. General reactions (fever, malaise, etc.) are generally not typical for this vaccine and occur in no more than 2% of immunized individuals.

For adults and children

Currently, two types of pneumococcal vaccines are widely used throughout the world: PPV13 (thirteen-valent), that is, directed against 13 serotypes of pneumococcus, and PPV23

(twenty-three valent). There is also PPV7 and PPV10, but they are considered obsolete and are used extremely rarely.

— I strongly recommend that adults get vaccinated against pneumococcus during a pandemic, especially if they are people with chronic diseases and smokers. PPV23 is suitable for them,” infectious disease specialist and vaccinologist Evgeny Timakov explained to Izvestia. — But children should do PPV13. The first acts on a larger number of subspecies of pneumococcus, but is less purified and may be more difficult to tolerate.

Course of injections

Building of the Russian Ministry of Health, Moscow

Photo: IZVESTIA/Konstantin Kokoshkin

The end of the world: the installation will destroy SARS-CoV-2 in running water

The pulsed radiation used in the new device destroys all pathogens in tenths of a second

Chief Epidemiologist of the Russian Ministry of Health, Head of the Department of Epidemiology and Evidence-Based Medicine, Director of the Institute of Public Health named after. F.F. Erisman Sechenov University (the university is a participant in the project to increase the competitiveness of education “5-100”) Nikolai Briko told Izvestia that it is too early to say which vaccine is more effective in reducing mortality and the number of severe cases of coronavirus infection, since no one has yet conducted them comparative analysis within the pandemic. However, there are indeed recommendations that clearly state who is indicated for which drug.

“For children under two years of age, it is recommended to use the thirteen-valent conjugate vaccine,” the specialist noted. — For people over 65 years of age, as well as patients with chronic diseases, we recommend starting with the same vaccine, and a year later being vaccinated with the twenty-three-valent one. The twenty-three-valent vaccine is recommended for healthy adults.

Prevenar 13

(13-valent pneumococcal polysaccharide conjugated adsorbed vaccine for the prevention of diseases caused by Streptococcus pneumoniae)

Manufacturer: NPO Petrovax Pharm LLC (Russia)

Composition: each dose of the Prevenar vaccine contains purified polysaccharides of pneumococci of 13 serotypes, individually conjugated to the diphtheria carrier protein CRM197, and adsorbed on aluminum phosphate.

Release form: 0.5 ml of the drug in disposable syringes made of transparent, colorless borosilicate glass.

Indicated for use: for the prevention of diseases caused by Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F and 23F (including sepsis, meningitis, pneumonia, bacteremia and acute otitis media ) in children aged 2 months to 5 years.

Vaccination schedule:

children aged 2 to 6 months . for individual vaccination according to the 3 + 1 revaccination scheme: 3 doses with an interval of at least 1 month, 1 dose is usually administered at the age of 2 months, the 4th dose (booster) is recommended to be administered at the 2nd year of life, optimally at 12-15 months; for mass vaccination according to the national vaccination calendar according to the 2+1 scheme: 1st dose at 2 months, 2nd at 4.5 months, revaccination at 15 months of life

children aged 7 to 11 months . according to the 2 + 1 revaccination scheme: 2 doses with an interval of at least 1 month, the 3rd dose is recommended to be administered at the 2nd year of life;

children aged 12 to 23 months . twice: 2 doses with intervals between doses of at least 2 months;

children aged 2 to 5 years once: 1 dose.

Contraindications: – hypersensitivity due to previous administration of the vaccine; – hypersensitivity to excipients and/or diphtheria toxoid; – acute infectious and non-infectious diseases, exacerbation of chronic diseases (in these cases, vaccination is carried out after recovery or in remission).

Advantages: – pneumococcal vaccine for newborns – helps protect the most vulnerable age group from the most common serotypes of pneumococcus, causing up to 80% of invasive pneumococcal infections; – the presence of a population effect has been proven—a reduction in morbidity among unvaccinated children and adults due to the formation of stable collective immunity; – one of the advantages of the drug is the binding of polysaccharides from the outer layer of the pathogenic bacterium to the “carrier” protein, which gives the vaccine permanent memory properties against many different types of pneumococci, including those that cause meningitis and pneumonia.

Prevenar can be administered to children simultaneously (on the same day) with other vaccines included in the National Vaccination Schedule (with the exception of BCG), as well as with the vaccine against Hemophilus influenzae type b (Hib), according to the prescribed immunization schedule.

Application experience : since 2000, it has been registered and used in 90 countries of the world, 38 countries have included Prevenar in the National Childhood Vaccination Calendars, more than 260 million doses of the vaccine have already been administered in the world. Use of this vaccine in the United States has resulted in a significant reduction in the incidence of pneumococcal disease not only among immunized children but also among the nonimmunized population by reducing transmission. The effectiveness of the new vaccination is especially high in preventing infection in the family with inflammatory diseases of the pharynx and ears. The vaccine protects against 40% of all known types of pneumococci. The safety of the vaccine is high and side effects are rare. They are common - this is temperature, and local - this is swelling, temperature and pain at the injection site.

Registered in Russia since 2011.

Immunization against pneumococcus

The article was prepared by pediatrician Yulia Aleksandrovna Ermolaeva

Vaccination against pneumococcal infection causes the least number of refusals and disputes among parents, since many have heard about the widespread prevalence of pneumococcus.

Its carriage reaches 70% in the population. Pneumococcal infection causes not only acute respiratory infections, pneumonia, otitis, but also such serious diseases as meningitis, arthritis, myocarditis, sepsis, which are difficult to treat.

Self-healing from pneumococcal infection is quite rare and more often there is a need for long courses of antibiotic therapy. Difficulties in treatment will be explained by the resistance of this microbe to antibiotics, due to the widespread use of this group of drugs in recent years.

This reason is the main one determining the need for vaccination. Please note that vaccination with pneumococcal vaccines does not protect against all acute respiratory infections; immunity is formed only to a specific type of pathogen that is included in the vaccine. Accordingly, if the causative agent of the disease is a virus or another bacterial agent, it is incorrect to attribute the disease to the ineffectiveness of this vaccination.

Which vaccine is better Prevenar 13 or Pneumo 23?

There are 96 known serotypes of pneumococci, of which only 20 cause severe illness, the rest, for the most part, do not pose a threat to human health. Vaccination with pneumococcal vaccines protects only against those pneumococci whose serotypes are included in the vaccine.

There are 2 types of vaccines currently registered in the Russian Federation:

conjugated (Prevenar13, Russia, USA, Netherlands)
polysaccharide (Pneumovax 23, Netherlands and Pneumo 23, France)

Conjugate vaccines contain 13 serotypes, and polysaccharide vaccines contain 23 serotypes. The Synflorix vaccine has also been developed, which, in addition to 10 serotypes of pneumococcus, includes ADS + Haemophilus influenzae. A natural question arises which vaccine is better to choose.

The conjugate vaccine includes 13 of the most common serotypes; this type of vaccine causes lasting immunity, unlike polysaccharide vaccines, and is approved for use from 2 months of age.

The duration of the immune response when administered polysaccharide vaccines is no more than 5 years, and therefore revaccination with this vaccine is required every 5 years.

But polysaccharide vaccines contain a larger number of serotypes, so frequently ill children, patients with chronic diseases, immunodeficiency conditions, and the elderly can be recommended to administer an additional dose of Pneumo 23 after vaccination with Prevenar 13!

When combining 2 types of pneumococcal vaccines, immunity against pneumococcus will be durable and protect against almost all major pathogenic serotypes of pneumococcus.

Can I get pneumococcal infection after vaccination?

No. Pneumococcal vaccines are non-live; they contain only bacterial antigens, so they do not cause disease.

When is the best time to get vaccinated?

The vaccination schedule against pneumococcal infection has a clear tendency to decrease the number of vaccinations with the age of the child. So, when vaccination starts at 2 months, to create sufficient immunity and carry out a full course of vaccination, 3 administrations of this vaccine will be required, and for children over 2 years old - only one, according to the national calendar of the Russian Federation.

Therefore, many parents ask the question: “why torture a child so much at an early age, he already has a heavy vaccination burden?” The answer is simple. Pneumococcus can strike at any age, but infections in early childhood are much more severe. That is why vaccination against pneumococcus was one of the first to be introduced into the national calendar and is recommended from 2 months of life.

Regarding polysaccharide vaccines, their use is allowed only from 2 years of age.

How to vaccinate correctly if the timing of administration is not met?

Below will be presented vaccination schedules with pneumococcal vaccines in accordance with Order of the Ministry of Health of the Russian Federation No. 125n dated March 21, 2014 as part of the calendar of preventive vaccinations for epidemiological indications. Please note that individual vaccination schedules differ.

Vaccination with conjugate vaccines:

Basic vaccination schedule: 2 months, 4.5 months + revaccination at 15 months.
Start of vaccination after 6 months: twice with revaccination in the 2nd year of life. Revaccination is carried out no earlier than 6 months from the last administration.
Start of vaccination at the age of 12 – 23 months: twice with an interval of at least 8 weeks.
Over 2 years old without age limit: once.
Premature babies are vaccinated from 6 weeks according to the following schedule: 3 doses at monthly intervals and revaccination at 12-15 months.

Missed vaccinations with conjugate vaccines do not require repetition; the schedule is determined based on the child’s age. Examples of missed vaccination dates:

- 1 dose up to a year. For children aged 12-23 months, 2 doses are administered at an interval of 8 weeks; over 2 years, one dose is administered once.

- 1 dose at 12-23 months of age, then only one dose is required in any case.

Further revaccinations are not required when receiving the full course of Prevenar 13. Formed immunity is stable.

Polysaccharide vaccines are recommended to be included in a sequential vaccination regimen. At the first stage, a full course of vaccination is carried out with a conjugate vaccine, and at the second - with a polysaccharide vaccine.

The optimal interval between administrations is 12 months, but for children aged 12–18 years and adults in special situations, the interval can be shortened to 8 weeks.

Revaccination with polysaccharide vaccines, if indicated, is carried out with an interval between doses of at least 5 years.

Can the pneumococcal vaccine be combined with other vaccinations?

Yes. Pneumococcal vaccines can be administered simultaneously with any vaccines from the national calendar, except BCG, but in different parts of the body.

Contraindications to vaccination with pneumococcal vaccines:

severe, severe systemic reactions to previous vaccine administration
(anaphylactic reactions);
hypersensitivity to any component of the vaccine;
acute infectious diseases or exacerbation of chronic ones.

So, the main conclusions:

Vaccination against pneumococcal infection is mandatory.
For children and adults at risk for developing pneumococcal infection, a sequential course of immunization is recommended, consisting of the initial administration of a conjugate vaccine (Prevenar 13) followed by the use of a polysaccharide vaccine (Pneumo 23, Pneumovax).
Vaccination starts from 2 months of age - with a conjugate vaccine (Prevenar 13), from 2 years - with a polysaccharide vaccine (Pneumo 23, Pneumovax).

MAKE AN APPOINTMENT WITH A PEDIATOR