In the first year of life, children receive vaccines that prevent measles, rubella, diphtheria, pertussis, hepatitis B, pneumonia, meningitis, rotavirus and poliomyelitis, among others. most of them injectable. In order to reduce the number of injections at the same time, the combined vaccines, such as the pentavalent vaccine, were developed.
The pentavalent vaccine is composed of diphtheria and tetanus toxoids, inactivated Bordetella pertussis cell suspension, surface antigen (HBs-Ag), and Haemophilus influenzae conjugated oligosaccharides of type b.
Three-fold bacterial, hepatitis B vaccine, haemophilus influenzae type b vaccine
Diseases that the vaccine prevents
Diphtheria, a disease caused by a toxicogenic bacillus, is often lodged in the tonsils, pharynx, larynx, nose, and occasionally other mucosa and skin. Transmission is by direct contact of a sick person or persons with a susceptible person, through droplets of respiratory secretion, eliminated by coughing, sneezing or speaking. In rare cases, contamination by shared objects can occur.
Tetanus is a non-contagious, transmissible disease that presents two forms of occurrence: accidental and neonatal. The first form usually affects people who come in contact with the tetanus bacillus when handling the ground or through injuries or injuries from contaminated materials, skin or mucosal injuries. Neonatal tetanus is caused by contamination during the umbilical cord section by the use of improperly sterilized or unsterilized sharp instruments or hemostasis by the use of contaminated substances in the umbilical stump such as spider web, coffee powder, smoke,
Whooping cough is an acute infectious disease, respiratory transmission, universal distribution, immunopreventable and notifiable. It specifically compromises the respiratory tract (trachea and bronchi), and is characterized by a strong dry cough. Transmission occurs mainly through direct contact of a sick person with a susceptible person, by eliminating droplets of oropharyngeal secretion eliminated by coughing, talking, or sneezing. It is rare, but transmission can also occur from objects contaminated with the patient's secretions. The etiological agent of pertussis is Bordetella pertussis, a bacterium that has man as the main reservoir.
Hepatitis B is the irritation and swelling (inflammation) of the liver due to infection with the hepatitis B virus (HBV). Hepatitis B infection can be transmitted by contact with blood, semen, vaginal fluids, and other body fluids from someone who already has hepatitis B infection. Most hepatitis B damage occurs because of how the body responds to infection . When the body's immune system detects the infection, it sends in special cells to fight it. However, these disease-fighting cells can cause inflammation of the liver.
Haemophilus influenzae type b bacteria causes such conditions as pneumonia, inflammation in the epiglottis, otitis, infections in the bloodstream, and meningitis. inflammation of the meninges, membranes that surround our brain. Pneumonia is an infection that sets in the lungs. It can affect the region of the pulmonary alveoli, where they terminate the terminal branches of the bronchi and sometimes the space between one alveolus and another. It is a lung infection more common in babies and may even lead to hospitalization. Acute otitis media is an ear infection in the inner part of the structure, which causes a lot of pain. They are more common in children and infants, because a structure called the Eustachian tube becomes more easily congested in them. At least 30% of otitis are caused by this bacteria.
Indications for the pentavalent vaccine
The pentavalent vaccine is indicated for the active immunization of children aged two months and older against diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae type b diseases.
With the introduction of the vaccine pentavalent vaccine, it is emphasized that in all indications for separate vaccines in special situations, the recommendations of the Standard for Special Immunobiological Reference Centers should be maintained.
Can pregnant women take this vaccine?
For pregnant women , the contraindication only loses its place if it is at risk of exposure to a disease.
Necessary doses of the vaccine
The basic vaccination consists of the application of three doses, with interval of 60 days (minimum of 30 days), the from two months of age.
The two necessary reinforcements will be performed with the DTP vaccine (diphtheria, tetanus and pertussis). The first reinforcement to those of 15 months of age and the second reinforcement to 4 years.
The maximum age for application of DTP is six years 11 months and 29 days. It is also worth noting that the first dose in the first 24 hours, preferably in the first 12 hours, with the hepatitis B vaccine (recombinant) will be part of this scheme for newborns.
Administration of the pentavalent vaccine
Administer dose of 0.5 mL of the vaccine intramuscularly in the vastus lateralis muscle of the thigh in children less than two years of age and in the deltoid region in children over two years of age. It can also be administered in the ventro-gluteal (more lateral) region, because it is free of important anatomical structures (no blood vessels or significant nerves) and is indicated for any age group.
The vaccine should not be administered region (more posterior), due to the risk of sciatic nerve injury (Villarejo and Pascaul, 1993; Pigot, 1988) and the possibility of injecting the vaccine into fat instead of muscle.
Should not be given to children:
- With known hypersensitivity to any component of the vaccine or to show signs of hypersensitivity following prior administration of diphtheria , tetanus, whooping cough, hepatitis B or haemophilus influenzae B
- Children with active neurological conditions
- Children who presented, after previous dose, any of the following: high fever at 39 ° C) within 48 hours of vaccination (and not due to other identifiable causes), seizures up to 72 hours after administration of the vaccine; circulatory collapse, with a shock-like state or with a hypotonic-hyporesponsive episode (HHH), up to 48 hours after the administration of a previous vaccine; encephalopathy within the first 7 days after administration of the previous vaccine, post-vaccinal thrombocytopenic purpura.
Possible adverse effects
The type and frequency of adverse events of the vaccine do not differ significantly from the vaccine reactions described separately. For diphtheria, tetanus, and pertussis vaccine with whole cells, mild local or systemic reactions are common. Temporary edema, increased sensitivity and erythema (redness) at the site of injection together with fever occur in a large proportion of cases. Occasionally severe reactions of high fever, irritability and unchanged crying may appear within 24 hours of administration. Hypotonic-hyporesponsive episode (HHH) and febrile seizures have been reported at a rate of one per 12,500 doses given. A study in the UK showed a small increase in acute encephalopathy (mainly seizures) following immunization with diphtheria, tetanus, and pertussis vaccine, however, detailed reviews of all available studies by specialist groups of the Institute of Medicine and the Advisory Committee on Immunization Practices (ACIP) in the United States, the pediatric associations of Australia, Canada, the United Kingdom concluded that the results did not demonstrate a causal relationship between the DTP vaccine and chronic dysfunction of the nervous system. Thus, there is no scientific evidence that these reactions lead to permanent consequences for children.The hepatitis B vaccine is a well tolerated vaccine. In placebo-controlled studies, except for local pain, symptoms such as myalgia and transient fever have not been more frequent than in the placebo group. Reports of severe anaphylactic reactions are very rare. General manifestations such as fever, irritability, fatigue, dizziness, headache, gastrointestinal discomfort, can also occur within the first 24 hours and with benign progression. Idiopathic thrombocytopenic purpura (ITP) after the vaccine is a rare event whose causal relationship is difficult to prove. The latency time between onset of symptoms that is usually from a few days to two months suggests this relationship. The available data do not indicate a causal association between hepatitis B vaccine and serious neurological adverse events such as Guillain-Barré syndrome (GBS), demyelinating diseases including multiple sclerosis, and there are no epidemiological data to support a causal association between this vaccine and chronic fatigue syndrome, arthritis, autoimmune diseases, asthma, sudden infant death syndrome (SIDS) or diabetes.
With the Haemophilus influenzae type b vaccine localized, mild and transient reactions can occur within 24 hours after vaccination , such as pain and increased sensitivity at the injection site, which in most cases disappear spontaneously within 2 to 3 days. Local abscesses may occasionally occur due to secondary bacterial contamination due to technical failure of vaccine application. General manifestations such as fever rarely occur and more serious reactions are very rare, and a causal relationship between more serious reactions and the vaccine has not been established.
Where to find the pentavalent vaccine
The vaccine is available on public networks and private. Some medical covenants cover this vaccine in the private healthcare system.
Frequently Asked Questions
Are there tests that can identify if we are immunized?
Live pathogen vaccines, which can cause the disease, can be identified by means of blood tests - but this is not medically relevant. This is because the only way to prove that a person is vaccinated is by not presenting the record on the card. The Ministry of Health only considers a valid vaccine the one in which the record has been properly accredited by an authorized corporation.
Can I update my vaccination card at any age?
Not only can it, as it should. Although it is best to follow the vaccination schedule and immunize at the recommended ages, it is important to take the vaccines that are delayed. However, this rule only applies to vaccines that continue to be recommended in adulthood, such as hepatitis B, tetanus, pertussis, and diphtheria. Even classical childhood diseases, such as mumps, measles and rubella, continue to have the vaccine recommendation for adults and need to be taken. However, vaccines you should have taken during childhood only, and that miss the recommendation for adults, because the risk of the disease no longer exists, do not need to be taken. One example is rotavirus, a disease that is very serious in childhood and must be vaccinated in the period, but which for adults does not cause impact beyond room, losing the need for vaccination.
If I do not remember having taken the vaccine, can I go to the clinic and repeat the dose?
Yes. The best measure to do in these cases is to check the vaccination card. But if you missed it for some reason, or thought you were vaccinated, but it is not on the record, the best thing to do is to get vaccinated, albeit repeatedly.
If I took the combination vaccine, do I need to take it individually?
Combined vaccines such as MMR (mumps, measles and rubella) and pentavalent (threefold plus haemophilus and hepatitis B) are a set of several vaccines in one , as the name itself says. When you take it, you are already properly immunized for all diseases listed in the vaccine, not needing to be vaccinated for a disease in isolation - an example would be to take the triple viral and then a tetanus-only vaccine. "However, you may be asked to take the vaccine again in isolation if there is a need to strengthen it by time or exposure to one of the particular pathogens, such as a measles epidemic," says general practitioner Eduardo.Can I take the vaccines before the specified time?
No, the minimum ages must be respected. There is probably no risk of being vaccinated early, but there are no safety studies for that age group, and there is no indication of the vaccine. Age indications take into account the epidemiological recommendation, that is, the period of life in which you are most at risk of suffering from that disease or its complications. That is why some childhood vaccines no longer need to be given to adults because the risk period has passed. The logic is the same for vaccines given only in adults. "An example is the triple virus (diphtheria, tetanus and pertussis), that the child's immature immune system may not be enough to contain live viruses, and the child may become severely ill," says clinical practitioner Eduardo Finger. > Can I update the entire vaccination card at once?
If you are a healthy person, who does not have a weakened immune system, there is no impediment. The only problem is the discomfort of being vaccinated several times in a row. There are also those vaccines that are separated in doses, and ideally they should be respected so that the immune system's response is long-lasting.
People with a vaccine allergy will not be able to take it any more?
No Overall, it is very difficult for a person to be allergic to the vaccine itself, but to the other elements that are within it. Contraindications are available only to people who have already suffered an anaphylactic shock in the following cases: for measles, measles, rubella, and yellow fever vaccines for egg anaphylaxis, as these live viruses are cultured in the food before going to the vaccine; in cases of mercury anaphylaxis are contraindicated vaccines with this element, in general those administered by SUS; and whoever has had anaphylactic latex shock should know about the vaccines at their standard vaccination site, as some may contain remnants of the substance.
If I lose my card, will I have to vaccinate again?
Yes, because vaccine is only that vaccine that has been registered. If you take your vaccines at a private clinic, the location will likely record a history of your vaccines, so you do not have to take it again. However, the public network has not yet been able to computerize these data, so a person who is vaccinated in the public network and loses his or her card will need to take all recommended adult vaccines again.
Ministry of Health
Clinical General Eduardo Finger (CRM: SP72161), coordinator of the research and development department of SalomãoZoppi Diagnósticos.
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