Vaccination in the first days of life, or what vaccinations are given to newborns in the maternity hospital

What vaccinations are given to newborns and is this vaccination mandatory? This question worries many young mothers who care about their baby and do not want to harm him. Moreover, today there is active propaganda that vaccinations are an evil that negatively affects the reduction of the body’s protective properties.

In the maternity hospital, the child receives the first two vaccinations - against hepatitis B and tuberculosis.

(BCG). A complete list of mandatory vaccinations will be provided to you at the children's clinic, where they will ensure that the child is vaccinated in accordance with the calendar. Today, vaccination is voluntary and no doctor can force parents to vaccinate their child by force. If you wish, you can write a refusal and place all responsibility for the baby’s health on yourself.

Advantages of vaccinating children under one year of age

The main advantage, of course, is the protection of a small child’s body from numerous infections. A baby is born with a very weak immune system that cannot cope with many existing viruses on its own. The child's body's resistance increases naturally during breastfeeding, but sometimes this protection is not enough.

For example, immunity to tuberculosis is not transmitted from mother to baby, and the epidemiological situation regarding this disease in the country is quite serious. This is why the tuberculosis vaccine is given in the maternity hospital, on days 3–7 of life.

A vaccinated child receives immunity to this disease for a certain period. The body produces antibodies, which are activated upon contact with sick people and protect the baby.

A vaccinated child, even if he gets sick, will cope with the disease more easily and will probably avoid complications.

What vaccinations are given to newborns in the maternity hospital?

Even before the baby is born, responsible parents should find out what vaccinations are given to newborns and make an informed decision about the need for immunization, since in the maternity hospital they will have to either agree to vaccination or refuse it.
All information about the timing of vaccination can be found by studying the vaccination calendar for the current year. According to him, the first preventive vaccination is given to an infant immediately after birth. This is a hepatitis B vaccine.

This virus is known to infect the liver. For infants, the most common route of infection is from the mother during childbirth. You should know that the hepatitis virus will not penetrate a normally functioning placental barrier. Therefore, during pregnancy, only children whose mothers have placental disorders can get hepatitis B.

But during childbirth, infection increases significantly. Doctors try to minimize this risk, but this is the case when a mother in labor is confirmed to be a carrier or the disease is diagnosed. It is almost impossible to detect a virus that is in the incubation stage, and it can be transmitted to the baby.

If a newborn becomes ill with hepatitis B, there is a high risk of an asymptomatic course, which then becomes incurable. For infants, the probability of this is 95%, so vaccination against hepatitis B is given first.

The next vaccination is BCG. This is protection against tuberculosis. It is indicated for placement on the 3-7th day of the baby’s life. Tuberculosis is very dangerous. There are many types of mycobacteria that spread infection.

A newborn can catch the bacilli anywhere, but the baby’s immune system is not yet strong enough to resist the disease. That is why vaccination is carried out so early.

Recently, immunization with a lighter version of the vaccine, BCG-M, has been practiced. Since the number of microbial bodies in its composition is greatly reduced, the drug is recommended for vaccination of premature babies.

Disadvantages of vaccinating children under one year of age

All the current disadvantages of vaccination are based on the fact that children do not feel their best after vaccinations, that is, what should improve the child’s health, on the contrary, leads to a deterioration in his condition.

A tiny toddler of 1–2 months can have a very painful time with the DTP vaccine (against diphtheria, tetanus and whooping cough). After vaccination, your temperature may rise.

The negative consequences of vaccinations given to children under one year of age include various allergic reactions, which is also very dangerous in infancy.

Preparing for vaccination

Since only healthy babies can be vaccinated, the main point of preparation should be to determine the health status of the baby. The baby must be examined by a doctor. If we are talking about vaccinations in the maternity hospital, then they are allowed to be carried out by a neonatologist. Vaccinations between the ages of 1 month and 3 years are prescribed by a local pediatrician, examining the child before each vaccination. If there are suspicions of health problems, then before vaccination the child should be shown to a neurologist or immunologist.

It is also recommended to donate the baby’s blood and urine for analysis. If your baby has an increased risk of an allergic reaction, you can start giving an antihistamine a few days before vaccination and continue taking it for two days after the injection.

National vaccination calendar for children under one year of age

Why vaccinate at 2 months?

The main purpose of administering vaccines to a two-month-old baby is to protect against dangerous diseases. During immunization, a weakened type of infection is introduced. The immune system recognizes the “stranger” and produces protective substances against it – antibodies. From this moment on, the child’s body knows what the pathogen looks like and how it can be dealt with. If in the future the baby encounters an infection, the immune system will remember the “stranger” and send antibodies in response to his attack. In this way, the body learns to protect itself from dangerous and not so dangerous diseases.

The second reason explaining the need for vaccinations comes down to the ineffectiveness of medications against dangerous pathogens. Using the example of viral hepatitis, it can be argued that preventing its occurrence is much easier than curing it later. Despite the great capabilities of modern medicine, many diseases are treated symptomatically. This means that medications relieve bothersome symptoms, but do not affect the disease itself. As a result, the risk of complications that often occur in modern children increases.

By getting vaccinations at 2 months, parents will make life easier not only for their baby, but also for themselves. The baby's body will develop strong immunity against fatal diseases. It is important to consider that many vaccinations require revaccination, so the immunization that has started must be completed.

Individual vaccination schedule

No matter how hard you try to strictly adhere to this calendar, your baby may still have his own individual vaccination schedule. Sometimes children get sick with colds or suffer from some kind of allergic manifestations.

In these cases, vaccination dates have to be postponed. It is well known that vaccination should not be carried out if the baby is sick, otherwise complications may arise. After illness you need to wait 3-4 weeks. The fact that children are vaccinated individually may also be affected by interruptions in the supply of vaccines to some medical institutions.

Deviations from the calendar are possible subject to a number of general rules: for example, you cannot vaccinate before the recommended date; BCG at two months of age is done only after the Mantoux test; it is necessary to strictly observe the time intervals between vaccinations, etc.

How to vaccinate correctly to avoid complications

Vaccinations should be done according to the calendar. You can deviate from it only if there are contraindications to vaccination, including:

• fever and the presence of catarrhal manifestations on the day of vaccination;
• conditions after exacerbation of chronic pathologies;
• recent blood transfusion;
• state of prematurity, when the baby's weight does not exceed 2500 g.

If there are temporary contraindications, the child’s vaccination should be postponed for the time recommended by the doctor until the pathological symptoms are completely eliminated. Among the absolute contraindications to immunization are a pronounced hypersensitive reaction to the previous administration of a vaccine suspension or the presence of an immunodeficiency state in the child.

After excluding reasons for medical withdrawal, the child should be vaccinated in accordance with the following rules:

• before the procedure, the patient must be examined by a pediatrician;
• vaccination must comply with all parameters specified in regulatory legal acts;
• the mother herself chooses which vaccine will be administered to her tomboy, that is, if the parents do not want to take the injection offered at the clinic, they can independently purchase an imported vaccine at the pharmacy kiosk;
• before administration, you should make sure that the terms and conditions of this process were not violated during transportation and storage;
• The child should be vaccinated in the treatment room (this is done by a specially trained nurse), and after it all data about the vaccine, the time of vaccination and its features are entered into the child’s card.

Contraindications to vaccination are divided into:

• True ones
  are those listed in the instructions for the vaccines used, as well as in guidance documents (international recommendations and orders). Such contraindications are associated with certain components of vaccines;
• False
  - contraindications, the authorship of which belongs to the parents of young patients and some doctors. As a rule, such contraindications are formulated something like this: “he is so small, so sickly,” “if the family has had reactions to the vaccine, then he will too,” “since he gets sick often, it means his immunity is lowered,” etc.

Possible reactions in infants

In most cases, young patients tolerate routine vaccinations well. Most often, reactions appear after vaccination against whooping cough and pneumococcal infection. The baby may have slight swelling at the site of injection of the serum and an increase in body temperature. Parents notice that the baby becomes whiny, sleepy, and his appetite worsens. These complaints normally persist for up to 3 days, after which they disappear on their own.

After vaccination, you should provide rest for the little patient, give him more water and not force him to eat. If complaints persist for more than 3 days, intensify or unusual symptoms appear, you should contact your local pediatrician.

Examples of true contraindications

• If you have an allergic reaction to yeast dough, there may be contraindications to vaccination against hepatitis B, and if you are allergic to antibiotics - against rubella, polio and measles; if you are allergic to eggs - from influenza and measles;
• BCG vaccination is contraindicated in premature babies;
• For neurological diseases - convulsions, epilepsy, vaccination with the DTP vaccine, and specifically its pertussis component, is contraindicated;
• In case of severe immune disorders, cancer, severe forms of anemia, many vaccinations are contraindicated;
• Vaccinations cannot be given during the preoperative and postoperative period.

Short description

1. On the first day after birth, the child is vaccinated against hepatitis B, since there is a high risk of contracting such an infection from the mother or through medical procedures. The injection is performed in the first 12 hours of life. Vaccination against hepatitis is carried out 3 times up to a year - the second vaccination is given every month, and the third every six months. If the baby is classified as a risk group, there will be four vaccinations - the third vaccination is postponed to 2 months of age, and the fourth is performed a year. Babies who have not been vaccinated before one year of age can be vaccinated against hepatitis B at any time using the 0-1-6 schedule.
2. Also in the maternity hospital, the child receives another vaccination - against tuberculosis. Babies are vaccinated with BCG or its lighter version (BCG-M).
3. At 2 months of age, a cycle of vaccinations against pneumococcal infection begins. The first vaccination is carried out at 2-3 months, the second - after a month and a half (usually at 4.5 months). At 1 year 3 months, revaccination is performed to maintain protection against pneumococci.
4. Three-month-old babies receive several vaccines at once, among which one of the most important, but also the most often causing adverse reactions, is DPT. This vaccination will provide good protection against tetanus, whooping cough and diphtheria. The vaccine is administered three times at intervals of 30-45 days - usually at 3, 4.5 and 6 months.
5. At the same time, according to indications (if there are increased risks), they are vaccinated against Haemophilus influenzae. The vaccine is also administered three times at the same age as DPT. There are combination drugs that allow you to give only 1 injection, and if there are several vaccines, they are injected into different parts of the body. At 18 months, DTP and the vaccine against Haemophilus influenzae are administered again (the first revaccination is carried out). If the child has not been vaccinated against hemophilus influenzae infection before 6 months, the vaccination is performed twice at the age of 6 months to a year with an interval of a month, and revaccination is carried out according to the plan at 1.5 years. If a child has not been vaccinated against such an infection before the age of 1 year, vaccination is carried out only once at the age of 1-5 years.
6. Vaccination against polio begins simultaneously with DTP. The first two vaccinations at 3 months and at 4 and a half months are carried out using an inactivated vaccine (injection is given), and for the third vaccination at 6 months in healthy children a live vaccine is used (drops are given). Revaccination against this infection is carried out twice in the second year of life - at 1.5 years and at 20 months.
7. A one-year-old child is vaccinated against measles, mumps and rubella. One comprehensive vaccine provides protection against all these infections. If for some reason vaccination does not take place, vaccination against rubella and measles can be performed with separate preparations for children after one year at any time.
8. From the age of 6 months they begin to vaccinate against influenza. The vaccine is given annually some time before a possible epidemic (in the fall).

What diseases do vaccinations protect against?

From the table above you can already see what diseases vaccines are designed to protect children under one year of age. These are diseases such as polio, whooping cough, diphtheria, tetanus, etc.

It is especially worth mentioning vaccinations against such dangerous infections as viral hepatitis B, which is done in the first 24 hours of life, and tuberculosis (BCG vaccination) – on days 3–5 of life. In the future, vaccination against these serious diseases is repeated.

Recently, vaccination against hemophilus influenzae was added to the national vaccination calendar. Haemophilus influenzae can cause any disease in a child’s body, from a simple acute respiratory infection to meningitis and sepsis (blood poisoning), and at the same time it is very difficult to recognize.

List of diseases that vaccines protect against

The first vaccination is given to the child in the maternity hospital a few days after birth. Early immunization helps protect the baby from serious infections that can be contracted in the first month of life. All vaccines from birth to one year are administered as planned. According to the indications and wishes of the mother, the dates can be shifted.

Vaccines in the first year of life protect against the following infections:

If parents wish, this list can be expanded.

Moms and dads can vaccinate their child against other infections that are not included in the planned calendar. You will have to pay for such a service, since it is not financed from the budget. Parents often give their 1 year old child a serum for:

If a child of the first year of life travels with his parents and visits exotic countries, then he also needs immunization against dangerous diseases that are common there.

The vaccination schedule is no longer relevant: here are the vaccinations your child really needs

In the week leading up to the writing of this chapter, social media was rocked by another wave of panic over a new case of a child dying from meningococcal infection. Parents rushed en masse to vaccinate their children with Menactra; they even brought children with completely empty vaccination certificates to me for vaccination with Menactra. The offer to vaccinate against other infections, to administer at least Infanrix Hexa with a second injection today with Menactra, was refused; Menactra is more important, the rest will come later. But why is it more important? Do only children's deaths make an impression? Sorry, but this is not the behavior of sane adults - this is infantilism in its purest form.

Didn't you know until last week that infectious diseases maim and kill children? What exactly is why vaccines are being developed against them, diseases? That competent pediatricians constantly suggest that you get vaccinated precisely so that your children do not become next? Of course, shocking tragedies are very motivating, but get ready for full protection right away, otherwise what kind of “pothole repair” is this: a neighbor’s child fell out of the window - I’ll install locks on the windows at home, a colleague was crippled in an accident due to the lack of a car seat - I’ll buy one for my car seat. With this approach, sooner or later you will become these unfortunate neighbors and bitter examples.

World Meningitis Day has passed - wasn’t this a reason to vaccinate your child with Menactra? Not catchy? Do we really need children's deaths? Well, please open my blog, just over the last year I wrote in it about:

• death of a child from epiglottitis;
• deaths from pneumococcal meningitis;
• deaths from measles;
• deaths from whooping cough;
• death from tetanus (tetanus! The twenty-first century is just around the corner!).

And so on, I think there is enough nonsense for one chapter, this is enough to illustrate my point.

All of these deaths could have been prevented by timely and complete vaccination. I already wrote a post a year ago about how to fully vaccinate a child, and not just “just to get them into kindergarten,” but the situation has changed a little, and the schedule needed to be adjusted. In addition, it did not contain the trade names of the vaccines and was therefore not entirely convenient. It's time to refresh it, before the next death of a child is forgotten and you again decide not to vaccinate your children.

Expanded vaccination schedule

Why do we need an extended vaccination schedule if there is a Russian national vaccination calendar; Why not just follow the national calendar? The fact is that the Russian national calendar is not at all optimal; it does not even reach the “basic protection” level. In its current form, it resembles the financial subsistence minimum, which is also determined by the state, but everyone knows that in reality one cannot live on it. To bring the vaccination schedule to the level of “basic protection”, I would add to it all children vaccines against Haemophilus influenzae type b and vaccines against meningococcus groups A, C, Y, W-135. And to raise it to the level of “protection adequate to the current epidemiological situation,” I would add vaccinations against rotavirus infection, chickenpox, hepatitis A, human papillomavirus infection, and in endemic regions - against tick-borne encephalitis, against group B meningococcus, but now it is not even planned register in the Russian Federation, so for now this is only possible through vaccine tourism.

So, in order to optimally protect the baby from vaccine-preventable infections in the current Russian conditions, I would recommend the following scheme:

1. At least three months before the first (or the one in which they realized it) pregnancy, a woman should be given vaccines against measles and rubella (M-M-P II, Priorix, etc.).
2. A pregnant woman should be vaccinated against influenza (Influvac or Vaxigrip) and whooping cough (Adasel), once.
3. In the maternity hospital, give the child the first dose against hepatitis B and tuberculosis (BCG).
4. In the first month, administer the second dose (V2) against hepatitis B.
5. In the second month, introduce V1 “Prevenar 13” (against pneumococcal infection) + V1 “RotaTek” (against rotavirus infection).
6. At three months, introduce V1 “Pentaxim” (AaDTS + IPV + HIB) + V2 “RotaTek”.
7. At 4.5 months, introduce V2 "Pentaxim" (AaDPT + IPV + HIB) + V3 "RotaTek" + V2 "Prevenar 13".
8. At six months, administer V3 “Infanrix Hexa” (AADT + IPV + HBV + Hib) + V3 “Prevenar 13” (according to the Russian calendar, the third vaccination dose against pneumococcus is not needed, but this is only for economic reasons; in developed countries it is administered three times).
9. At nine months, introduce V1 "Menactra".
10. At twelve months, perform a Mantoux test, evaluate it three days later and administer V2 “Menactra” + V “Priorix Tetra” (or separately, vaccines against measles, rubella and mumps, for example M-M-R II + vaccine against chickenpox "Varilrix")
11. In one year and three months, introduce R “Prevenar 13” + V2 “Varilrix” + V1 against hepatitis A (“Avaxim 80” or “Havrix 720”).
12. Introduce R “Pentaxim” (AaDPT + IPV + Hib) at one year and six months.
13. At one year and nine months, administer R2 BiVac Polio (live polio vaccine) + V2 Avaxim 80 or Havrix 720.
14. All. Until six years of age, only annual Mantoux tests and flu vaccinations in the fall (optimally in September - October from six months of life; twice in the first autumn, then once every year). Additionally, think about vaccination against tick-borne encephalitis: “Tick-E-Vac” or FSME “Immune Junior”; two doses are administered at a minimum interval of a month before the first season, one before the second season and then once every three years, one at a time.
15. At six years of age, introduce a booster vaccination against measles, rubella and mumps (MMR II).
16. At 6.5 years old, administer R2 “Adasel” (whooping cough in an adult dose, diphtheria and tetanus) or R2 ADS-m (only against diphtheria and tetanus) + R1 “Menactra”.
17. At the age of nine - the vaccine against human papillomavirus infection V1 "Gardasil" or "Cervarix" (especially important for girls, but boys should too).
18. At nine years and six months - V2 Gardasil or Cervarix.
19. At the age of 14, R3 ADS-m + R3 BiVac Polio + R2 Menactra.
20. Until the age of 18, do not forget about the annual Mantoux test (or Diaskintest) and flu vaccinations every fall.

The likelihood that you will be able to strictly follow this schedule is quite low. And because in Russia there are now interruptions in the supply of not only imported, but even Russian/national calendar vaccines, and because the child may get sick, and vaccinations will have to be postponed during the illness, and due to the fact that unforeseen everyday obstacles also no one canceled. But you need to strive for this schedule.

If desired (if there is a lack of money or there is no opportunity to get vaccinated in private centers), the lion's share of these vaccines can be obtained at the clinic. For example, “Prevenar 13” there is exactly the same as in the private center. But most likely there are no imported vaccines there, and, say, in order to introduce a replacement for the Infanrix Hexa vaccine, the pediatrician will have to inject the child with three vaccines: Bubo-Kok (DPT + HBV), Polimilex (IPV) + vaccine against hemophilus influenzae type B (for example, Hiberix).

Add to this the constant interruptions in the supply of vaccines in clinics, endless unreasonable medical withdrawals, as well as the panicky fear of many pediatricians to administer more than two vaccines in one visit, and you will understand how difficult the quest “vaccinate your child from everything that is needed at the clinic on time” is. You also need to remember that in the clinic they usually administer whole-cell DPT, and in private centers - acellular. Nevertheless, Russian vaccines are not at all a creature of hell, they are less convenient than imported ones, they are more difficult to tolerate, they are not available against all diseases, but being vaccinated with Russian ones is much better than not being vaccinated with anything.

And, of course, in a clinic (at least outside the Moscow Ring Road) you almost certainly will not be able to get vaccines beyond the national calendar (against rotavirus, Haemophilus influenzae type b, meningococcus, hepatitis A, tick-borne encephalitis, human papillomavirus infection, chickenpox, etc.) , after all, this is the place where they give out the same living wage, and if you want more, you can’t do without an immunization center.

If you do not vaccinate your child against meningococcal disease, and then he dies from meningococcal meningitis, you, in addition to the unbearable pain of loss, will be crushed by an enormous sense of guilt. If you don’t vaccinate against rotavirus, and then he gets gastroenteritis on vacation abroad, the vacation will be ruined. If you don’t get vaccinated against chickenpox, you will get sick, will have scars on your face, will look for ways to remove them, etc. It is impossible to protect against everything, but not saving from what we can prevent is very stupid. Do what you must, and come what may.

I regularly receive questions like “My husband and I were anti-vaxxers, now we started reading your blog and decided to start vaccinating; The child is now five years old, what is the scheme?” It's impossible to answer a question like this with a blog post or book chapter; there are too many variables in the equation. This section of pediatrics is called “catch-up immunization”; in the vaccination calendar of developed countries it is included in a separate section, but in Russia there is no single document on this topic; this leads to confusion even among doctors, not to mention patients. Therefore, to draw up a catch-up vaccination schedule, it is better for you to contact a competent pediatrician or immunologist. If you still want to figure it out for yourself, look at my blog post entitled “Video presentation on “catch-up” vaccination of children.”