Do not refuse vaccination
"Vaccines never reduce immunity"
laboratory of Vaccine Prophylaxis and Immunotherapy of allergic Diseases of the Department of Allergology of the I. I. Mechnikov Research Institute of Vaccines and Serums Mikhail Kostinov.
Photo: Parus newspaper
From mass vaccination to individual vaccination– Mikhail Petrovich, doctors have been giving less and less medical withdrawals from vaccinations lately.
In Soviet times, this was stricter.
– I have been searching for approaches to vaccination of people with various diseases all my life. When I entered the residency in the mid-80s, my supervisor – a well–known pediatric allergist, member of the Russian Academy of Medical Sciences Ivan Ivanovich Balabolkin - offered me to deal with the problem of vaccination of allergy sufferers and gave me complete freedom of action. In our country, it was absolutely not accepted at that time – it was considered very dangerous, everyone was afraid of the development of shock, allergic reactions. But publications have already appeared in the foreign scientific press that it is possible to vaccinate allergy sufferers. And we began to study this experience and think about how to change the mentality.
What we were "lucky" with in this work is that in 1994 an epidemic of diphtheria began in Russia. The fact is that along with perestroika, chaos began in medicine, including in immunoprophylaxis. But when the question of saving children arose, we began to act more boldly. There was no other way out. There is such a thing in medicine – to take risks "for vital reasons." And the results of our work confirmed what the whole world already knew – that it is possible and necessary to vaccinate allergy sufferers. But it was empirical knowledge. And we have also proved with new evidence-based facts that such vaccination is really safe. We described in detail what happens in the body, how the immune system is formed, how long it lasts, how the vaccination affects the patient's condition.
If we talk about strategy, you can vaccinate any person, regardless of his nosology. But, of course, nothing can be done mechanically. It's a shame to say, but Russia leaves much to be desired with regard to vaccination. Because we have been taught all our lives that it is impossible to vaccinate sick people. And when we began to approach international standards, and realized that it could be done if we carefully approach a person, it turned out that neither the medical community nor the population was ready for this.
When a person is healthy, it is, of course, easier with him. In a patient, the moment of vaccination may coincide with an exacerbation of the disease. Therefore, it is necessary to select a specific set of vaccines and special approaches for each child and adult. The main goal is to determine the optimal approaches, and over the past decade we have been moving from mass vaccination to individual vaccination.
What to vaccinate pregnant women against– But after all, vaccination weakens the immune activity of the whole body, which is why we are at risk of the spread of many other diseases?
– This is a false idea, vaccines never reduce immunity. The vaccine acts as an antigen, like any drug like bronchomunal, ribomunil, IRS-19. They stimulate both cellular immunity and humoral immunity. And thanks to this, on the contrary, the degree of protection against various infections increases.
We monitored thousands of children. Among them were those who were vaccinated according to the national vaccination calendar, and those whose parents refused vaccination. In the year and a half following the vaccination, we studied the dynamics of the morbidity of these children. And it turned out that the vaccinated children had pneumonia, acute respiratory infections, otitis media, sinusitis, exacerbations of diseases of the genitourinary system significantly less than those who did not receive the vaccine.
Another interesting problem was how to protect children who are often ill, allergic and have chronic diseases (kidneys, liver, nervous system) from contracting an infection during a visit to a polyclinic. And here Russian science was also the first to prove that if parts of immunocorrectors are used in the vaccination process in such children (otherwise they are also called immunomodulators), then a double effect is achieved. On the one hand, immunity to specific vaccines is developed quickly and persists for a long time. On the other hand, the frequency of exacerbations of chronic diseases decreases. But, of course, this cannot be done often and left-to-right.
– Is it possible to vaccinate pregnant women?
– During the flu period, the first place in mortality is occupied by pregnant women. Starting from the third trimester, a pregnant woman has the same risk of complications as if she suffered from severe bronchial asthma. At the same time, vaccination does not affect the course of pregnancy, the development of the fetus. But women and newborn babies are protected from the flu in the first six months of life. And to date, vaccination of pregnant women against influenza in the second or third trimester has already been included in the vaccination calendar.
This has been done in the world for 25 years. And the Russian contribution is that we have proposed a new generation vaccine – with an immunoadjuvant (a substance capable of improving immune responses to vaccine antigens – ed.). There are no immunoadjuvant vaccines anywhere in the world. The essence of the method is that the concentration of the antigen (virus strain) is reduced three times, but due to this drug – an immunoadjuvant – a good immunological effect is created, which lasts longer. Here, not only its humoral link is included in the immune system, but also the cellular part, which is formed by immunological memory.
There are fewer and fewer people protected from measlesOf course, there are still a lot of unclear questions and areas for research.
Both theoretical, related, for example, to the transfer of immunity from mother to child, and practical, concerning the immune layer of measles. Today, women aged 25 to 35 have a low level of immunity to measles. Approximately 25% of them are seronegative, and, accordingly, they themselves can get sick during pregnancy, and children are born unprotected. And measles vaccination is done from the year, because it is believed that until that time the child retains maternal antibodies. But now it is clear that this is not the case. Up to a year, the child's immunity was preserved if his mother either had measles or was vaccinated twice (and this condition was not always met – and people lose immunity).
25% of newborns not protected from measles is a rather large figure that makes you think. In addition, it has already been proven that where there is a pathology of pregnancy, especially the pathology of the placenta, from where the fetus is fed, the child has very poor immunity. We have described the mechanisms of how a placental feeding disorder affects the transmission of antibodies to measles. Even if the mother is immune and protected from measles, the child is born without protection.
The era of therapeutic vaccines– In recent years, there has been evidence that some vaccines have not only preventive, but also curative properties
- Yes. A new era came when previously unknown vaccines against pneumococcal infection appeared. Initially, these vaccines were intended only for the prevention of infections. And we in Russia discovered their new properties, proved for the first time that they have a therapeutic effect with a specific nosology. Experimental data on this subject appeared abroad only 10 years after we received the patent.
Vaccines can have a therapeutic effect if they are vaccinated in people who already have this microbe. In such cases, a person may be either a carrier of a microbe, or already have a pathology in which microbes play a leading role in exacerbating the disease (kidney, bronchopulmonary system, diabetes mellitus, autoimmune diseases). The antibiotic helps to get rid of the microbe for a month and a half, after which it is repopulated in the body. The effect of the vaccine lasts up to 5 years. This applies to vaccines against pneumococcal and hemophilic infection.
For the last 7-10 years, WHO has been considering vaccination not as a means of reducing morbidity (it has already decreased on the planet), but as a means of maintaining health. Vaccines of a different class are already being used for this: pneumococcal, hemophilic, against human papillomavirus, against rotavirus infection. And the use of therapeutic vaccines in the treatment of many diseases is also expanding. Such vaccines can be prescribed simultaneously with antibiotics.
Russia also has its own antibacterial vaccine – Immunovac, VP4. It has been tested for a long time and has been used for scientific purposes for the last 30 years in children and adults suffering from various diseases. However, in practice it cannot be used, since there is still a debate about who and how it will be produced. Unlike foreign analogues – Bronchomunal, Bronchovaxone, Ribomunil – our vaccine is much stronger and also stimulates innate immunity. With an acute illness, the recovery process is faster, and with a chronic one, a stable remission is achieved. Vaccinoprophylaxis and vaccine therapy is the most innovative approach to preserving the health of the nation.
Portal "Eternal youth" http://vechnayamolodost.ru27.04.2015