Currently, vaccination is the most effective and reliable way to prevent influenza in the population during seasonal epidemics. Influenza vaccination can be done using a variety of local and foreign vaccines, the list is reviewed annually by the Ministry of Health with the approval of a certain number of preparations containing strains of the influenza virus. Vaccination against influenza annually helps to prevent hundreds of thousands of cases of the disease or allows you to transfer the disease in a mild form without severe intoxication. We will also analyze the characteristics of drugs from various manufacturers - vaxigripp and other trade names.

What is the evidence base for vaccination?

Unfortunately, today there is not enough evidence of the effectiveness of influenza vaccination. This is easily explained by the fact that such studies have simply not been carried out. There is a lot of documented evidence of the safety of flu vaccines, but no evidence of how effective they are. That is, modern drugs are not able to protect 100% immune system, although they give confidence that the disease can proceed in a milder form and without complications.

According to consumer reviews, not every person after the first vaccination decides to re-administer medications. People explain this decision by the fact that after the injection, most of them experience lung symptoms malaise, or a disease following vaccination is observed, regardless of the vaccinated immunity from it.

Features of vaccine production

The modern vaccine is produced by growing the influenza virus on cultured chick embryo cells. Therefore, most of these immune remedies are contraindicated in patients who are allergic to chicken protein. All stages of production are strictly controlled, which allows you to get a really high-quality product at the end.

Today, the most famous manufacturers prefer to use only the latest technologies for cultivating living structures in mattress flasks, which makes it possible to obtain vaccines without allergenic protein. This gives real chances to warn a huge number side effects and make the vaccine solution even safer. Unfortunately, Russian enterprises do not yet have the opportunity to use this method of vaccine production, so they continue to cultivate strains on chicken eggs.

Viral spectrum: concept and principles of definition

Every year, experts give their forecasts regarding the risk of an outbreak of a particular influenza virus in certain areas. As a rule, virologists of the World Health Organization deal with this issue, they determine the range of diseases potentially dangerous for humanity in the season that is approaching. Based on these recommendations, manufacturers of pharmacological products make a decision on the advisability of creating really necessary vaccinations.

As proven in practice, the implementation of such a scheme does not always have a positive result. This is confirmed by the epidemiological situation that has arisen in the world in connection with the attack swine flu. There was no vaccine against the strain at the time of the outbreak, and therefore manufacturers of immunity-stimulating drugs had to deploy a new production of anti-flu solutions already in the midst of an infectious lesion. Among the consequences of this decision:

• accumulation of unused medicines in warehouses;
• late vaccination;
• mortality from the disease.

Influenza vaccines are called 3-vaccines and contain predominantly antigens to influenza viruses such as H1N1, H3N2, B.

Who is eligible for immunization?

The flu shot is optional and not included in vaccination schedules. It is recommended for a specific group of people. Among such potential victims of the disease are:

• elderly people over 60 years old, regardless of the presence of concomitant pathologies;
• adults and children suffering from chronic bronchitis, insufficiency of respiratory and cardiovascular function, frequent respiratory infections, bronchial asthma, bronchiectasis;
• requiring periodic visits medical institutions or subject to constant supervision of medical staff;
• doctors and junior staff of outpatient clinics, clinics, hospitals;
• people who are forced to stay in large groups of a closed type, where there are all conditions for the rapid spread of infection (for example, prisoners in prison, residents of hostels or nursing homes);
• pregnant women in the second or third trimester of pregnancy.

Timely prevention of influenza in the listed categories of the population makes it possible to avoid severe forms of the disease and makes it possible to protect weakened organisms from inevitable morbidity during the period of the spread of infectious agents.

Do I need to pay?

For representatives of risk groups, the flu vaccination is absolutely free of charge, provided that it is available in a medical institution. Anyone wishing to be immunized against the influenza virus must purchase the drug at the pharmacy network and come to the clinic to provide a service for its administration. Naturally, the doctor always reserves the right to refuse to vaccinate a person if he is not sure of the authenticity or quality of the remedy brought by the patient.

Is it advisable to buy a vaccine outside the walls of an institution where it will be injected? It is better to avoid such a scenario. After all, when buying a solution, you cannot be sure of compliance with the terms and conditions, its origin, as well as quality.

Sometimes people are faced with a situation where they are simply forced to get vaccinated. This takes place in polyclinics, as many district doctors strongly recommend that their visitors be immunized, scaring them with the terrible consequences of the illness and even death. Is it really? What is the goal of therapists? Often, doctors are forced to follow oral recommendations from higher authorities and in every way to persuade patients to immunize, thereby fulfilling immunization plans.

Some managers of large enterprises prefer to enter into special agreements with healthcare structures that involve the mass vaccination of all employees of the company or industrial production at the expense of the employer, and, of course, under the supervision of local doctors. This eliminates the opportunity for employees to turn their backs on vaccination and encourages more people in the country to be vaccinated.

There is a practice when in the autumn period all patients who came for a routine examination, consultation or for a sick leave to a local therapist are sent for vaccination. This trend has been going on for decades. This not only makes it possible to delay the increase in the rate of development of the epidemic, but also helps doctors to realize the stocks of the vaccine allocated by the state.

Are there contraindications?

Among the contraindications to the introduction of the vaccine are the following:

• the child has not reached the age of six;
• the child or adult is allergic to protein elements;
• the patient has a history of exacerbations caused by the introduction of a vaccine that protects against other diseases;
• acute ailments and chronic pathologies in the acute phase, when immunization should be postponed until complete recovery.

Any contraindications to immunization should not be ignored. Such actions can lead to the appearance of complex pathological conditions sometimes dangerous for the normal functioning of the body.

Complications

Complications after vaccination can be divided into two main groups, namely local and systemic pathological manifestations. Local pathological reactions appear in the area of ​​​​vaccination and take the form of swelling, redness of the skin, abscess formation, soreness (sometimes nasal vaccinations are given, then a runny nose, sore throat and cough may appear).

Systemic cases are extremely rare, but still occur in medical practice. It can be:

• migraine headaches;
• elevated body temperature with the appearance of symptoms of general intoxication;
• an adverse reaction in the form of an allergy;
• inflammatory processes of the head of the central nervous system;
• myositis;
• inflammation of the middle ear.

With the development of negative symptoms, you should immediately consult a doctor, he will conduct the necessary diagnosis of the patient's condition and recommend the most effective methods for getting rid of such complications.

Timing of immunization

The standard vaccination period is from October to November. It is during this time period that it is possible to form in people a strong immunity against the disease, until an epidemic occurs. As is known, in order to form reliable protection it takes about two weeks for the body to produce enough immune cells in the blood to engulf the infection. Immunity after vaccination lasts no more than three months, so it makes no sense to prevent influenza before October or later than December.

Influenza immunization at the time of the increase in the incidence is not only ineffective, but also contributes to a decrease in immune function, further undermining natural defenses.

How to enter correctly?

There are two ways to administer the vaccine suspension into the body:

• nasal route (rarely used), when the solution is instilled into the nasal passages, which gives more opportunities for the formation of local immunity and less likely to cause side effects;
• standard or injectable immunization, during which the influenza vaccine is administered intramuscularly or subcutaneously.

Children after 6 years of age, if they have not been previously vaccinated and have never had an influenza virus, an injection is given twice every 30 days at a dose that is ½ of an adult.

Types of drugs

Influenza vaccines are usually divided into two large groups, depending on their composition and quality characteristics:

• attenuated or live vaccine;
• inactivated drug.

Live suspensions contain unkilled virological strains of influenza, they are in a weakened or non-infectious state. The most well-known remedy from this group in our clinics is Microgen by a Russian manufacturer, which has a relative efficiency and a small number of undesirable consequences caused. The composition of the inactivated type vaccine includes killed pathogens or their fragments, which allows the development of temporary immunity.

Inactivated suspensions are:

• whole-cell (flu inactivated liquid);
• split vaccines (Grippol, Fluarix, Begrivak, Vaxigrip);
• subunit (Grippol plus, Influvac, Agrippal).

Whole cell vaccines with a complete viral cell that is in a killed state. They are well purified and are widely used for immunization of the population. Split vaccines or split solutions contain fragments of microorganisms, and are also devoid of chicken elements, and therefore do not cause specific hyperreactions. Subunit vaccines include exclusively surface protein structures such as hemagglutinin and neuraminidase.

On the territory of our country, the following list of drugs is certified:

• "Microgen" - anti-influenza dry live type allantoic vaccine, from a domestic manufacturer;
• "Microgen inactivated" - a liquid form for intramuscular injection;
• "Microgen Grippol";
• "" from Petrovaxpharm;
• "Fluariks";
• Dutch-made Influvac vaccine;
• Agrippal.

The Influvac vaccine is especially popular among our citizens, which is explained by its availability, high quality and efficiency.

Whole cell and live solutions have the ability to generate a good immune response in children and adults. Despite this, these variants of solutions are characterized by increased reactogenicity, and therefore, after their introduction, negative, side effects immunization. These suspensions are reliable, but they are not recommended for injecting a child and patients with multiple concomitant pathological processes.

Split vaccines and subunit solutions are less aggressive, they contribute to the appearance of a sufficient number of immune complexes and do not tend to provoke undesirable effects of immunization. The first version of medicines is considered to be the gold standard, since it is he who helps to protect the body from the penetration of viruses and the appearance of severe consequences of intoxication.

At the moment, research is underway around the world aimed at creating attenuated vaccines with minimal risks of negative consequences. After all, an ideal drug should have a set of qualities, in particular, be safe, fit the maximum number of potential consumers, have a pronounced preventive effect and persistence of the immune response.

Price

The price of vaccines depends on several key points. Here the role is played by its origin, time of year, region of sale, seller's margin and much more.

1. Grippol - from 150 to 200 rubles.
2. - from 150 to 250 rubles.
3. - from 250 to 350 rubles.

Anti-influenza prophylaxis through immunization does not give a 100% guarantee that a person will be able to avoid infection during a period of mass morbidity. But, despite this, it significantly increases the chances of this or ensures the transfer of the disease in an almost imperceptible form. Vaccination has negative and positive sides, which are used in their arguments by its opponents and supporters. To be immunized or not is the choice of everyone, but, according to the statistics of recent years, an increasing number of our fellow citizens insist on the need for immunization.

Can you avoid the flu without getting vaccinated? This practice is doubtful, but still very common. In order to protect themselves from the disease without having to visit the vaccination room, people take antiviral medicines and immunomodulators in winter. preventive purposes. It is also recommended to enrich the diet with foods with vitamin C, which destroys the viral membrane and helps strengthen vascular wall. Among the known methods are wearing a mask, hot drinks, partial isolation.

It is important to understand that such diseases are among the pathologies for which there is no etiotropic treatment today. Since lethal cases of influenza are recorded annually, as well as numerous options for its consequences, it is better not to risk health, but to trust specialists and carry out the vaccination recommended by them, despite the existence of negative reviews, as well as the low likelihood of developing post-vaccination exacerbations.

Foreword from the author - I myself am a mother of two children, medical education I don’t, like everyone else, I like to google “symptoms and treatment” on the Internet. And I see only articles written by someone with unverified information.

Therefore, on important topics (and the topic of my children's health is the most important!) I find texts from real pediatricians. Below is a similar selection on the topic of vaccinating children against the flu.

For me, the question “to vaccinate yourself and your child against the flu or not” is not worth it. Do, of course. But this is my opinion, the opinion of doctors - you will learn from the text below.

In addition, I was interested in questions - what vaccine to choose and in what time frame to deliver, is it dangerous and what are the contraindications and reactions. And is it possible to do it later than October, because the child in the garden is constantly sick and it is very difficult to find such a period of time when he is without snot, does not cough and does not have a temperature. And what is behind the phrases “there are a lot of strains, but the vaccine is only from three or four, why is it needed at all?”

Let's deal with all these questions. For answers, I used materials from the blogs of the following expert doctors:

Gathered opinions about the differences between imported and Russian vaccines, about which vaccine to vaccinate children and yourself.

Sergey Butriy:

So, in order from good to bad.

1. Imported vaccines: Waxigrip And Influvac. There was also Fluarix, but withdrew registration from the Russian market. This is the best thing you can give your child and yourself. Made according to all WHO standards, these preparations contain strains relevant for this season, 15 mcg each. Approved for use from 6 months of life, produced for more than a decade, have earned full confidence.
2. Russian analogue, vaccine Ultrix. It is a complete copy of imported vaccines, contains 15 micrograms of antigens of three influenza strains recommended by WHO this season. Cons: it appeared recently, several years ago, there are few post-marketing studies on it, and therefore it is allowed for children only from the age of 6 and, like everything new, causes slight distrust. Nevertheless, this is the best that is now being released by the Russian Federation.
3. There is also a Russian Sovigripp, produced by Microgen, he is from the age of 18, and therefore he did not even delve into whether he was good, children should not.
4. Live nasal vaccines against influenza are not registered in our country, so there is nothing to talk about them.

Get vaccinated against the flu, if possible with imported vaccines. This is the best thing you can do to prevent the flu.

This topic was also well revealed by the pediatrician and neonatologist Anastasia Starostina :

Vaccines are either live or inactivated (killed). The latter, in turn, is divided into whole-cell, split (split) and subunit vaccines.

It is important that the vaccine contains the required amount of protective antigens (at least 15 mcg).

It is also important that the vaccine has good immunogenicity (i.e., produces immunity) and is low-reactogenic (i.e., causes fewer adverse reactions).

It is clear that live and whole-cell vaccines cause pronounced immunity, but are more reactogenic, while split and subunit vaccines cause the production of less pronounced, although sufficient immunity, and are practically non-reactogenic (if I may say so, they are “soft”).

For children and pregnant women, inactivated vaccines are used that do not contain merthiolate as a preservative.

Split and subunit vaccines are compatible with all other inactivated vaccines. It is recommended to administer them together with pneumococcal and Hib vaccines.(Pneumo-23, Prevenar 13, Synflorix, Akt-Khib and Hiberix).

Young children who have not had the flu and have not previously been vaccinated must receive some vaccines twice.

Vaccines registered in Russia.

• Live vaccines- contain attenuated (weakened) strains of the virus.
  Vaccine registered in Russia Ultravac(manufactured by Microgen). This is an intranasal dry influenza vaccine for children from 3 years and adults. It is dissolved with water and injected with a dispenser into each nasal passage. The vaccine is not very popular due to its more pronounced reactogenicity compared to the others, as well as a wide range of contraindications.
• Split vaccineWaxigrip(manufactured by Sanofi Pasteur, France) contains 15 mcg of 3 strains without preservatives. Available in syringe doses of 0.25 and 0.5 ml. It is administered intramuscularly to children aged 6 months-3 years, 0.25 ml twice with an interval of 4 weeks. 3-8 years 0.5 twice. From 9 years old and adults once. Fluarix(SmithKline Beecham-Biomed LLC, Russia)
  contains 15 mcg of 3 strains without preservatives. A single dose of Fluarix® vaccine is 0.25 ml for children aged 6 months to 3 years, and 0.5 ml for children from 3 years and adults.
  For children who have not previously been vaccinated and have not had influenza, it is recommended to administer the vaccine twice with an interval of 4 weeks.
• Subunit VaccinesInfluvac(Abbot Biologicals B.V. The Netherlands) contains 15 µg of 3 strains, no preservatives. A single dose of Influvac® vaccine is 0.25 ml for children aged 6 months to 3 years, and 0.5 ml for children from 3 years and adults. For children who have not previously been vaccinated, it is recommended to administer the vaccine twice with an interval of 4 weeks.

Related picture from Anna Levadnaya:

Anna Levadnaya:

Among all flu vaccines, choose split (SPLIT) or subunit vaccines.

Yes, you can buy the vaccine yourself and, observing all the necessary transportation rules (in the cold), bring it to the clinic and ask to vaccinate the child with it (if the medical staff of the clinic does not mind).

Personal opinion: I personally would opt for one of two vaccines: among split vaccines - vaxiflu, among subunit ones - influvac: they are without preservatives, contain a sufficient amount of antigens, are allowed from 6 months. This year I will make my influvac, in the past they were vaccinated with vaxiflu.

Ekaterina Poteryaeva:

Yaroslava Matveeva more loyal to the domestic manufacturer:

If you decide to get vaccinated against the flu, then you can choose any of the vaccines on the market, whether Russian or imported. Domestic and foreign vaccines include the same names of three influenza strains (two strains of group A and one strain of group B), selected as the most relevant for the upcoming season by observation around the world, including the Russian Federation.

A little more about the compatibility of vaccines from Ekaterina Poteryaeva :

Can other vaccines be given at the same time as the flu shot?

Yes, you can!

Children can receive any vaccine at the same time as the flu shot, except for BCG and yellow fever vaccine (any vaccine can be given to adults!). Moreover, if pneumococcal vaccination is indicated for a child (or adult), it is more convenient to administer it at the same time as the flu vaccine, just in different “shoulders”. This will reduce the risk of post-vaccination complications.

If it is decided to separate the vaccination against influenza and pneumococcal infection by time. First, a flu shot is given, and a month later, Pneumo-23.

Anna Levadnaya complements:

The vaccine is compatible (on the same day in a different thigh) with other vaccines with the exception of BCG and rabies vaccine (against rabies)

At what age can you be vaccinated and how often?

Anna Levadnaya about one season:

Children (the exact age depends on the vaccine used), who have not been previously vaccinated and have not had influenza, are vaccinated twice with an interval of 4 weeks, the rest - once.

Yaroslava Matveeva :

Inactivated influenza vaccines can be given to children 6 months of age and older.

• Children from the age of 6 months and older are vaccinated at a dosage of 0.25 ml.
• Children from 3 years of age and adults are vaccinated at a dosage of 0.5 ml
• The vaccine Vaxigrip has a special separate pediatric dosage of 0.25 ml without preservative (in the form of a ready-to-use filled syringe with a dosage of 0.25 ml) for administration to children from 6 months. up to 3 years.
• The remaining influenza vaccines are administered to children under 3 years of age as half the dose of the 0.5 ml vaccine.

All this must be repeated every year. Ekaterina Poteryaeva:

Why should you get vaccinated every year?

Firstly, because the composition of vaccines changes every year. Each year the composition will be relevant only for this epidemic season.

Secondly, because antibodies begin to decrease 6 months after vaccination and are practically not detected after 12 months. Accordingly, there is no immunity to influenza after 12 months.

What to do if the child was injected not with half the dose of the vaccine, but with the whole? Answer from an infectious disease specialist Evgenia Shcherbina :

The instructions for most flu vaccines indicate that children from 6 months to 2 years 11 months 29 days are not given 0.5 (full dose) ml, but 0.25 ml (half dose) of the vaccine. However, usually by mistake, a full dose may be administered to a child at this age, which often causes parents to panic.

So, I calm down. First, in the same instructions it is usually written that national calendars some countries require the introduction of children under the age of 3 years not 0.25 ml, but 0.5 ml. This does not lead to any serious consequences and, POSSIBLY (this is not yet certain), stimulate the immune system even more.

Secondly, if you are vaccinating your child for the first time against influenza and you need to do two doses with an interval of 1 month, and he was given a full dose by mistake, then you still need to follow the second vaccination in a month, but not 0.5 ml, but 0.25 ml, as required by the rules.

Who needs to be vaccinated? Indications

Anastasia Starostina:

Vaccination is indicated for all persons aged 6 months and older.

Especially:

• children
• People over 65
• Pregnant and lactating women
• Persons with cancer and immunodeficiency (not fictional, but real, with HIV infection, for example)
• Persons with chronic diseases such as asthma, COPD, heart defects, etc.
• Social workers, teachers, medical employees and everyone who, by occupation, communicates with people

In fact, everyone needs vaccination. After all, we are in contact and interact with others everywhere.

Pediatrician Ekaterina Poteryaeva:

Any chronic diseases, as well as oncological diseases, are an indication for vaccination against the flu.

SARS accompanied by lesions respiratory tract, including influenza, often lead to exacerbation of bronchial asthma and chronic bronchitis.

In patients with diabetes the likelihood of hospitalization with a diagnosis of influenza during the epidemic season is about 6 times higher than in people without diabetes, and the probability of death from pneumonia or influenza in this group is 3 times higher.

Children with oncohematological diseases are at a very high risk of severe influenza. They, and their caregivers, are encouraged to get an annual flu shot.

In addition, people from these groups should be vaccinated once against pneumococcal infection with a 23-valent pneumococcal vaccine (Pneumo-23).

When is the best time to get vaccinated?

Every year I try to get vaccinated in September, but the child gets sick as soon as he goes to the garden. He fell ill - recovered - received a certificate with exemption from vaccination for 14 days - during these two weeks he fell ill again. This is how the whole autumn goes. So is it possible to get a flu shot in November and December, or even January and February, and does it make sense?

Yaroslav Matveeva:

The production of antibodies (and hence the creation of antiviral immunity) takes time, from two weeks to one and a half months. This means that vaccination must be completed no later than the end of September-mid-October.

For those who are vaccinated annually, it is enough to visit the vaccination office once, and for those who are going to do it for the first time (especially children under 9 years old, in some cases 12-14 years old) it will be necessary to visit the doctor twice, with an interval of 4 weeks, and "inject".

Tatyana Neeshpapa:

• To create full-fledged protection after vaccination, the body needs from 14 to 30 days (antibody production time).
• The rise in the incidence of influenza in our region falls on November-February of each year. So, it is optimal to be vaccinated in September-October.
• If the vaccination was not carried out, and the thunder struck - and the epidemic began, as always, without prior notice to you personally? Anyway, you can get vaccinated even during this period.

Anastasia Starostina:

Flu season runs from October to May. In most cases, the peak incidence occurs at the end of December - beginning of March.

Influenza vaccinations are usually given from September to November. But due to interruptions in the supply of vaccines, it is possible to get vaccinated later, up to March.

Therefore, for those who have not yet had time to get vaccinated for some reason, there is an opportunity to get protection.

Here I want to remind myself. If a child has never been vaccinated before, he needs a double injection with a difference of a month, keep this in mind if you are going to be vaccinated in February. And if you have already vaccinated it before, then until you get sick, you can safely prick it 🙂

How is it determined which strains to vaccinate against?

Let's start with the fact that such a strain of vrius and what they are. The pediatrician wrote about this quite clearly. Sergei Butriy :

Influenza viruses are very heterogeneous. They are divided into groups A, B and C.
Group A- the most common, divided into subtypes. Group A viruses have two main weapons against us - the enzyme hemagglutinin (abbreviated H) and neuraminidase (abbreviated N). According to the combination of types of these enzymes, viruses of group A differ; for example, a virus with hemagglutinin type 2 and neuraminidase type 3 is called H2N3.

Influenza viruses tend to mutate because an individual who has been ill with influenza, say, H2N3, has strong immunity to it, but if the virus changes the type of enzymes, say, to H2N2, it can infect the same person again.

There are more than 10 types of influenza virus in each season, but lead, set the pace 2-3 of them. That is, these 2-3 species are the most severe, the most common. Against them, it is necessary to develop a vaccine.

I often hear why vaccination is meaningless - “doctors still don’t know exactly what strains of the virus will be! They may not guess." It’s the grandmothers at the entrance who guess and don’t guess, but in pharmaceuticals everything happens a little differently.

How - tells pediatrician Matveeva Yaroslava:

A large number of people every autumn are tormented by the question “Should I get vaccinated against the flu or not?” And “why does vaccination begin only in August-September?”

I'll try to answer.

Flu like most viral infections, has an annual cycle (and for most of you, I think this is not a secret).

• So the first wave of influenza falls on the month of March. It does not have epidemic proportions and often the increase in the incidence is attributed to spring beriberi.
• The second wave is June / July, when most of us go to our summer cottages? and therefore it also, most often, passes "by us."
• And the third wave, as you might guess, is October-December (the longest and largest wave). It is customary to prepare for the third wave of influenza every year: we buy pills / potions, dry vitamin teas in the summer, and we just try to fly away for the period of the epidemic to rest somewhere far away and warmer.

It is the virus that people have been ill with in the first two waves that “is going to” and forms the basis for the creation of an annual flu vaccine.

I will not delve into the course of microbiology, and I will not tell the principles of virus selection in chicken embryos, but I will only say that this takes time, at least a month. That is why the vaccine cannot be created before the end of August. But every year it is “fresh”!

Pulmonologist Elena Orlova - about mutating viruses:

The most common types of virus on our continent are included in the vaccine. Under the auspices of WHO, a lot of work is being done to monitor the situation with influenza viruses, to monitor how the virus behaves during a given season, whether genetic and immunological characteristics change. Based on these data and trends from previous years, a forecast is made for the next season.

Yes, the virus can change its characteristics (drift), even within the same season. However, in general, the WHO comprehensive forecast appears to be quite accurate. The exception, of course, is pandemics, when a virus appears with completely new characteristics, which it acquires as a result of the exchange of material with viruses circulating among animals. The last time this happened was in 2009/2010 with swine flu.

But even the production of antibodies against another type of virus gives protection to the body. For example, large Western studies have examined the rate of hospitalizations and deaths in the most vulnerable groups: among children, the elderly, people with chronic diseases. It is shown that among those vaccinated these figures are 70 percent or more lower.

That is why, despite all the shortcomings, vaccination is recognized as the most effective method protection against influenza virus.

And an addition according to the methodology - from Sergei Butria:

Which viruses will lead in the next season is the question of the year. There is a whole system of “prediction”: as the virus migrates around the planet with migratory birds, specially trained WHO experts catch them and take tests, then they conduct a statistical analysis and issue a verdict: these are the three types of influenza virus that should be included in the vaccine for next year. And the whole world, all countries, all manufacturers obey and release their vaccines with just such a composition.

So, any flu vaccine contains three strains of the virus. Usually these are two types of influenza A and influenza B. WHO recommends not only the type of virus, but also the volume of each antigen in the vaccine - 15 micrograms. Let's keep this in mind and move on to considering vaccines on the Russian market.

So, the conclusion is that the question “how to find out which flu to vaccinate against” is not worth it, all vaccines in any country of production are made from the same strains.

The composition of vaccines for the season 2017/2018

Tatyana Neeshpapa:

Due to the variability of influenza A and B viruses, the composition of vaccines changes every year.

This year's vaccine contains: H3N2 (Hong Kong), Influenza A (Singapore), Michigan strain (H1N1), and B-type strain (Brisbane). Particular emphasis is placed this year on the H3N2 type (Hong Kong).

Effectiveness of influenza vaccination. Can I get sick from/after vaccination?

Some statistics from Dr. Yaroslav:

I want to cite data from studies conducted by WHO, as a result of which it was shown that

• in children under 5 years of age, vaccination with inactivated influenza vaccine reduces the incidence of laboratory-confirmed influenza cases by nearly 87%.
• in this age group, vaccination also significantly reduces the incidence of acute otitis media.
• The safety data for inactivated influenza vaccines has been rated as excellent, with no significant safety issues reported to date, even in infants.

If your child is still sick after the vaccine, that's normal because it could be any SARS besides the flu.

Tatyana Neeshpapa:

I often hear this phrase from patients: “I just got vaccinated, and then I was sick all winter!”.

• The flu shot only protects against influenza and does not protect against other viral infections;
• Vaccination may NOT contribute to more frequent colds in the future, and a decrease in immunity;
• The vaccine administered can NOT cause disease, and can NOT contribute to a more severe course of influenza and other acute respiratory viral infections;
• A vaccinated person is NOT contagious to others;
• The development of any disease in the early or late period after vaccination does NOT mean that this disease is provoked or caused by the vaccine; temporal association with a vaccine alone cannot be evidence of vaccine harm!

Anna Levadnaya:

Can you get the flu if your child is vaccinated?
Yes, you can: vaccination does not give a 100% guarantee that the child will not get the flu (about 96-98% of those vaccinated will not get sick), but it gives a 100% guarantee that the disease will be easier and reduce the risk of complications (otitis media, pneumonia, croup, etc.).

Vaccination reduces morbidity, risk of hospitalization, complications, and the risk of infecting other family members

Can I get the flu because I got vaccinated?

• There is no risk of getting the flu after vaccination with a non-live vaccine (a “killed” vaccine (see photo) does not contain an influenza virus that can cause illness; a live spray vaccine (Ultravac) is used very rarely)
• A vaccinated person is not dangerous to others
• Vaccination does not lead to a decrease in immunity or more frequent diseases (on the contrary, it "stimulates" immunity, as it leads to the production of protective antibodies).

Why did I still get the flu if I got vaccinated?

Possible options:

• The meeting with the influenza virus occurred during the period until protective cells had time to develop (2-3 weeks after vaccination)
• The disease is not caused by the flu, but by another virus
• The vaccine was ineffective, but, most likely, the child was ill easily and without complications.
• Vaccination was not carried out correctly (the storage conditions of the vaccine were violated, the expiration date was not entered correctly)

Pulmonologist Elena Orlova:

Quite often one hears phrases like “I got this flu shot and still had colds”, “I got a flu shot and after it as many as 4 times a year I got very sick with a temperature, it’s all because of the vaccination.” And for some reason, medical workers often say this, which reflects the level of understanding of the situation as a whole.

To be clear, the flu vaccine is directed against the flu virus and by no means promises to protect you from the myriad of viruses that cause colds. This is NOT a vaccine against SARS, common illnesses, colds, all viruses. If someone tells you that after this vaccination the child will not get sick at all, this is not true. Vaccination prevents the disease with influenza A and B, and if a person does get sick, then the disease is less severe than the unvaccinated (which has been proven in studies).

I think the confusion comes from the fact that many people refer to any cold as "the flu". Meanwhile, the flu is caused by a specific virus and most often has specific symptoms. Although very young children clinical picture is not so indicative, and adults in some cases can tolerate the flu with not very strong complaints and without an increase in body temperature, which makes it difficult to diagnose and contributes to the infection of others.

The influenza virus spreads rapidly, multiplies rapidly once it enters the body, and behaves quite aggressively there. It affects the respiratory system, and can penetrate into the smallest parts of the lungs, alveoli, causing severe complications.

Elderly people, children and people with chronic diseases (for example, bronchial asthma, heart disease, kidney disease, diabetes mellitus) are especially vulnerable. It is they who may have a severe course of the disease, requiring hospitalization, often in the intensive care unit. Common complications include pneumonia, myositis and rhabdomyolysis, and purulent meningitis. Despite high level today's medicine, deaths continue to be recorded annually.

No year is complete without a flu epidemic, it's just that the number of cases varies from season to season. In addition, I can say that in Russia the official statistics have definitely been reduced. After all, an accurate diagnosis can be made only with the help of laboratory diagnostics, and it is often carried out only upon admission to the hospital, and even then not always.

Evgeny Shcherbina:

There is such a myth: “if you got a flu shot, you would get sick, but if you didn’t, you would walk healthy.” I can’t tell you exactly where the legs of this myth grow from (more precisely, I can, but this is not a printed word), however, to understand the problem, you need to know the following.

There are two types of flu vaccines: live (nasal spray) and killed (shots). Live vaccines can, in principle, cause a so-called "minor disease" with the development of symptoms that vaguely resemble those of the flu, but these symptoms cannot be compared with a full-fledged disease and it no longer causes the same severe complications.

Killed vaccines, even theoretically, cannot cause a full-fledged flu, because there are no full-fledged viral units there - there are only pieces of viruses that are the most “immunogenic”, that is, they best stimulate our body to produce antibodies. This significantly reduces the side effects of the vaccine while maintaining its effectiveness. By the way, the same cunning trick was turned with DTP, turning it into AaDTP (Pentaxim, Infanrix, Infanrix Hexa, etc.).

Therefore, the answer to your question will sound like this: you can really endure influenza in a mild form, but only after a LIVE vaccine, which we practically do not have on the market, and killed subunit influenza vaccines cannot, in principle, cause influenza. Killed vaccines include Vaxigrip, Influvak, Grippol, Fluarix, Begrivak, Agrippal S1.

Anna Levadnaya:

• You can’t get sick from a vaccine: a non-live vaccine does not contain a virus and, in principle, cannot lead to infection (contains particles of a killed virus)
• The effectiveness of the flu vaccine, like any other, is not 100%. But it gives a 100% guarantee that the disease will be easier than if a person is not vaccinated.
• The incidence of influenza is huge. Every year about 8 million people fall ill with influenza in Russia (5% of the country's population)

Contraindications for influenza vaccination: true and false

Absolute contraindications

Matveeva Yaroslava:

Absolute contraindication for vaccination with any vaccine (and the flu vaccine is no exception) are allergic reactions immediate type (anaphylaxis) noted earlier with the introduction of vaccines.

Or if you are suffering severe (life-threatening) allergic reaction to hen's egg protein or another component of the vaccine, you should also refrain from vaccinating (so be sure to read the instructions for the vaccine before agreeing to be vaccinated!)

Anna Levadnaya:

Contraindications to vaccination: allergy to chicken protein and previous vaccines, Guillain-Barré syndrome, acute infectious diseases or exacerbation of chronic ones (for intranasal vaccines - rhinitis).

Although there is a more liberal opinion about the allergy to chicken protein from neonatologist Anastasia Starostina :

Previously, people with allergic reactions to eggs were vaccinated with caution. Modern knowledge says that the amount of allergen in the vaccine is so small that it is safe even for children with severe egg allergy.

Nevertheless, if you are afraid, then after vaccination, stay in a medical institution for 30-40 minutes for observation.

Daria Petrik about mortality statistics after vaccinations:

Is it possible to die after the flu vaccination?

There is a review of reports of adverse reactions to vaccination over the 15 years from 1990 to 2005, 747 million doses of influenza vaccine were administered in the United States, and there are 4 reports of deaths shortly after influenza vaccination, which put these cases on the register as a post-vaccination event.

No information on previous egg allergy was provided and no analysis was performed to confirm the association of influenza vaccination with this outcome.

So what is more dangerous for allergy sufferers - flu vaccination or illness? Many of these patients are also at higher risk of adverse outcome due to influenza (eg, age<2-х лет, астма в анамнезе) и, следовательно, только выиграют от вакцинации.

Normal reactions to vaccination

Matveeva Yaroslava:

In people vaccinated against influenza (especially for the first time), reactions such as fever, malaise, muscle pain and other general clinical symptoms can sometimes occur. These reactions (if they are not severe) indicate a good immune system in humans, are not dangerous and are not a contraindication to further vaccination.

Tatyana Neeshpapa:

Anastasia Starostina:

In most cases, the flu shot is well tolerated. Sometimes there is some soreness or swelling at the injection site, which is quite normal and does not need treatment. Some people may have a mild fever and headache.

But these minor annoyances are nothing compared to the flu.

Anna Levadnaya:

What reactions to a vaccination can be?

• Influenza vaccine - vaccines with a relatively low reactogenicity (the reaction to the vaccine fades within 1-3 days).
• Local reactions: malaise, redness of the injection site, redness, swelling, soreness at the injection site.
• General reactions: headache, allergic reactions, fever, chills, feeling of weakness, otitis media, myositis.
• For nasal vaccines - runny nose, cough, sore throat.

In what cases is it worth delaying the vaccination?

Yaroslav Matveeva:

If you get sick!

Persons with acute illnesses must recover before receiving influenza vaccinations.

Residual effects after acute respiratory infections in the form of cough and runny nose are not a withdrawal from vaccination.

It is also not a contraindication for vaccination of the disease in other family members, including contact with chickenpox, AII, and so on.

Do I need to be vaccinated and why?

Although this has been brought up in all the posts above, here are some more opinions from doctors. And not from strangers on the Internet who "I refused vaccinations because my daughter was sick all the time after them, and I do not advise you."

Sergey Butriy:

Please do not refuse vaccination without good reasons, unless in favor of a better vaccine (instead of the standard vaccination in the garden, it is better to administer Influvac to the child in a private center).

Vaccination is not complete, but the best of all possible, protecting your family from the flu epidemic. The last season was quite tough: a lot of complications, several deaths in Ivanovo and the region, protracted cases, overcrowded hospitals, announcements at the entrance to pharmacies “NO masks and oxoline!” etc.

Immunomodulators do not work, oxolinic / viferon ointments do not work, wearing masks by healthy people does not help, garlic on the neck does not work, room quartzizers hardly help. All this is just a manifestation of the low awareness of the population. The risk of infection and complications of the flu can ONLY be reduced by: vaccination, hygiene (treating hands with alcohol antiseptics, using only paper tissues, sneezing into the elbow and not into the palm of your hand, etc.) and avoiding visiting crowded places during an epidemic.

Also keep in mind that children who receive the flu vaccine for the first time in their lives are subject to TWICE vaccinations, with an interval of a month - for many this comes as an unpleasant surprise. This is only the first time, from next year until old age, one dose of the vaccine is administered in the fall.

Ekaterina Poteryaeva:

So why get the flu shot?
For starters, it is the body's defense against this evil virus. With the current level of medicine, having modern antibiotics at hand, up to 500 thousand people worldwide die from influenza every year. Vaccination is by far the most effective way to prevent influenza.

Komarovsky also adheres to the principles of evidence-based medicine, so I boldly recommend watching his video (if you don’t want to watch everything, I’ll tell you - of course, you need to be vaccinated):

So that you don’t fall for “the baby is still small, wait up to a year, then vaccinate,” I will quote the pediatrician Elena Orlova :

From 6 months is allowed. Small ones are just better to be vaccinated, for them the flu is very dangerous.

And I also got a question on the blog Ekaterina Poteryaeva :

The pediatrician urges not to vaccinate the child at 1 year old, referring to the fact that "the vaccine is heavy for the baby." This is right?

I always wonder why many people think that if a child is small and weak, then he will more easily endure a severe infection. Vaccinate your child twice and sleep better.

Dermatologist Svetlana Yakubovskaya:

This topic is definitely very hot! But I just couldn't resist writing about it.

To be honest, before the birth of my children, I was quite skeptical about flu shots, so to speak, with a slight smirk.

In every team where I worked (my husband is in the military, and I had to travel around the country for him), they treated the mass vaccination, which began every autumn, in the same way. Few were vaccinated (and this is us, doctors, who always talk about the need for vaccinations and the danger of influenza).

I vaccinate my eldest daughter against the flu every year. We do not spend money on imported expensive vaccines. We are vaccinated for free in kindergarten.

And this fall, I somehow quite by chance asked my daughter: how many children are being vaccinated from her group? The answer, honestly, shocked me a little: 2-3 people and 1 of them is my daughter. No, in no case, I will not now “foam at the mouth” convince everyone who is against vaccinations, and prove how important it is, and what danger we expose our children to by refusing to vaccinate.

I will only describe my point of view and explain why a few years later I changed my position in relation to flu shots.

My children are still too young to know what is bad and what is good; what to choose is more necessary and correct; what is loss and even death ...

I, as a doctor, have come across this, albeit in my still very small experience, more than once. And a good part of these heavy losses passed before my eyes during the “swine flu” period. And every time, taking up night duty, going around the wards overflowing with patients with pneumonia, I, honestly, even then, deep down, was afraid that I could also get sick.

My children are still too young to make the right choice, even in favor of “possible” health. And while it is I who make this choice for them. And, as a mom, I can only choose to be warned.

“Doctor, do I need a flu vaccine?”

There is no definite answer here, because this vaccine has its own indications, postulated by WHO. Unlike most vaccines included in the vaccination calendar, the flu shot is not recommended for everyone. There are several reasons for this:

1) Even if everyone is vaccinated, the flu is not going anywhere. By massively vaccinating children against polio or hepatitis B, we aim to eliminate these terrible pandemics. Influenza, on the other hand, is a hodgepodge of many strains, and these viruses regularly change their antigenic properties, so that the vaccine that forms immunity against the 3 strains included in the annual vaccination does not play any role in the elimination of influenza as a whole.

2) The flu shot works through B-cell immunity, and therefore lasts no more than a year. After this period, you again find yourself defenseless against previously vaccinated strains. In this regard, transmitted influenza results in long-term, almost lifelong T-cell immunity, which protects the population both against the transmitted variety and against all related influenza strains within the subtype. It was thanks to the developed population immunity against strains of the H1N1 subtype that adults relatively easily endured the newly-minted "swine" flu. Therefore, if you are generally healthy and do not meet the WHO criteria for influenza vaccination, you do not need to be vaccinated.

I will clarify that the mentioned WHO criteria were described above, in the paragraph for whom vaccination is indicated. Children - shown! And if you are a parent, then you may not be hard pressed by the flu, but consider that you can infect your children with it.

Can pregnant and lactating women be vaccinated?

A separate article on pregnancy and influenza vaccinations, also on the opinions of doctors and WHO.

Here I will bring Anna Levadnaya with the most complete answer. But ALL other doctors say the same thing - yes, you can and should.

Is vaccination allowed while breastfeeding?

Allowed with the exception of vaccines for which studies have not been conducted (Ultrix, Fluarix) and live vaccines (Pandeflu, Ultravac, inactivated influenza vaccine)

Are pregnant women allowed to be vaccinated?

• For most vaccines (influvac, grippol, influenza-neo, influenza-plus vaxigripp, begrivac, agrippal, fluvaxin), studies have been conducted that have not revealed an embryotoxic or teratogenic effect on the fetus.
• Vaccination of pregnant women is not allowed with live vaccines or vaccines for which studies have not been conducted: Ultrix, Fluarix and Pandeflu, Ultravac, inactivated influenza vaccine.
• The decision to vaccinate pregnant women in any case should be made jointly with your doctor and individually, taking into account the risk of influenza infection and possible complications of influenza infection.
• The safest vaccination is in the II and III trimesters with split or subunit vaccines, but if the pregnant woman has medical indications (the woman is at risk of developing complications), vaccination is recommended at any stage of pregnancy.

All this information is in the instructions for vaccines, and the instructions are publicly available online.

Sergey Butriy:

Is it possible to vaccinate those planning a pregnancy? Can! After the vaccine, one month should be protected.

Ekaterina Poteryaeva:

If a breastfeeding mother gets vaccinated against the flu, will the baby get antibodies to protect against the flu through breast milk?

No, he won't!

Breast milk contains group A immunoglobulins (IgA), which in some way protect the baby from respiratory and intestinal diseases while he is breastfeeding. Immunoglobulins G (IgG), which are formed in the mother after vaccination, also enter breast milk, but are not absorbed in the baby's stomach, but are digested like ordinary proteins.
Vaccinating only the mother will protect the baby in the sense that it is unlikely to be a source of infection for him.

Frequently asked questions about vaccinations and school/kindergarten

Ekaterina Poteryaeva:

CAN A CHILD UNVACCATED AGAINST INFLUENZA WHEN INCREASING THE INCIDENTITY OF INFLUENIA ON LEGAL REASONS NOT BE ACCEPTED IN A CHILDREN'S EDUCATIONAL OR HEALTH INSTITUTION (kindergarten, school)?

Yes they can!

According to Article 5, paragraph 2 of the Federal Law of September 17, 1998 N 157-FZ "On Immunoprophylaxis of Infectious Diseases" "The absence of preventive vaccinations entails:

• prohibition for citizens to travel to countries where stay in accordance with international health regulations or international treaties of the Russian Federation requires specific preventive vaccinations;
• temporary refusal to admit citizens to educational organizations and health-improving institutions in the event of mass infectious diseases or the threat of epidemics; (as amended by Federal Law No. 185-FZ of July 2, 2013)

Can a child be forced to get a flu shot and on what basis?

No, they can't!

According to the same Federal Law of September 17, 1998 N 157-ФЗ “On Immunization of Infectious Diseases”, Article 5 “Rights and Obligations of Citizens in the Implementation of Immunoprophylaxis” in paragraph 1 states - “Citizens in the implementation of immunoprophylaxis have the right to: ... refuse preventive vaccinations.”

Vaccine options

The first influenza vaccines were made from killed or neutralized viruses, they are called whole-virion, as well as from attenuated strains, the so-called live vaccines. Almost all modern vaccinations for the prevention of influenza are inactivated (killed) vaccines with a replaceable strain composition. Influenza viruses for all vaccinations without exception are grown on chicken embryos, which is reflected in the lists of contraindications for vaccination.

Most inactivated whole-virion influenza vaccines consist of purified and concentrated viruses cultured in chick embryos, inactivated with formalin or UV irradiation. Inactivated vaccinations, in turn, are divided into whole-virion vaccines, which are based on undestroyed whole influenza viruses; previously killed and purified, split, or split vaccines, which include particles of destroyed virions, that is, a complete antigenic composition (external and internal proteins). Subunit influenza vaccines are also used, which consist of a mixture of two viral proteins: hemagglutinin and neuraminidase. Therefore, these vaccines have a minimum number of adverse reactions.

Virosome vaccines are a new technology in the production of grafting material. These vaccines contain an inactivated virosomal complex with surface antigens of the influenza virus. Virosomes enhance the immune response to vaccination. The virosomal vaccine does not contain preservatives (thiomersal) and is well tolerated.

In Russia, the following inactivated trivalent influenza vaccinations are mainly used: Grippovak, Vaxigrip, Begrivak, Agrippal S1, Grippol, Grippol Plus, Influvac, Fluarix, Inflexal V (virsomal vaccine). A total of 18 vaccinations have been registered in Russia.

Classification of trivalent influenza vaccines

Generation and type	Compound	Main characteristics	Examples
Live vaccines
Whole virion vaccines	Live attenuated crude virus	High reactogenicity Scope is limited	Ultravac (Microgen)
Inactivated vaccines
I - whole virion vaccines	Whole virus that has undergone inactivation and minor purification	Good indicators of immunogenicity High reactogenicity	Ultrix (Fort) Microflu (SPbNIIVS) Fluvaxin (Changchun Changsheng Life Sciences Ltd, China)
II - split (split) vaccines	Particles of the destroyed virus, surface and internal proteins and lipids	Contain 15 mcg of antigens of each strain of the influenza virus and reactogenic lipoproteins of the cell wall of the virus Effective but relatively reactive	Vaxigripp (Sanofi) Fluarix (GSK) Begrivak (Novartis)
III - subunit vaccines	Highly purified influenza virus surface antigens (hemagglutinin and neuraminidase)	Contain 15 micrograms of antigens of each strain of influenza virus Effective, least reactive	Influvac (Abbott) Agrippal (Novartis)
IV - subunit adjuvant vaccines	Highly purified influenza virus surface antigens and effective safe immunoadjuvant Polyoxidonium	Contain three times less antigens (5 μg of GA of each strain, for Grippol - 11 μg of type B strain) Efficient, have the highest safety profile Vaccination is allowed until the beginning of the epidemic rise in the incidence	Grippol plus (Petrovax) Grippol (Microgen, SPbNIIVS)
	Highly purified influenza virus surface antigens embedded in liposomes	The classic content of hemagglutinin (15 mcg each) Effective for the elderly	Inflexal V (Berna Biotech)
	Highly purified influenza virus surface antigens and adjuvant Sovidon	Contain a reduced amount of antigens (5 µg of type A HA and 11 µg of type B) Efficacy and safety not clear (no experience), only approved for people over 18 years of age	Sovigripp (Microgen)

Principles and goals of vaccination

Vaccination is especially important for people at higher risk of developing serious complications from influenza, and for people who live with or care for people at high risk. WHO recommends annual influenza vaccination for the following populations: pregnant women at any stage of pregnancy; children from 6 months to 5 years; elderly people 65 years and older; people with chronic diseases; healthcare workers.

Since 2006, influenza vaccination has been included in the National Immunization Schedule of the Russian Federation. The following are subject to annual vaccination: children from 6 months old, children attending preschool institutions, students of grades 1-11, students of higher vocational and secondary vocational educational institutions, adults working in certain professions and positions (employees of medical and educational institutions, transport, public utilities, etc.), adults over 60 years old.

It is important to note that the composition of vaccines changes every year. This is done to provide maximum protection against the "wild" influenza virus. This process is carried out under the supervision of the World Health Organization. It is she who is engaged in predicting the strains of the influenza virus that will circulate in the expected season, and sends these strains to vaccine manufacturers. In most countries, influenza vaccination is given annually.

Vaccine effectiveness

The use of influenza vaccination reduces the incidence rate by 1.4-1.7 times, helps to reduce the severity of the disease, and prevents the development of severe complications and deaths. The vaccine is effective in all age groups in about 70-90% of cases.

Immunization results in a 40% reduction in hospital admissions for pneumonia in healthy adults and a 45-85% reduction in older adults. In addition, the frequency of otitis media is reduced by 36-69%, exacerbations of chronic bronchitis by 20%, and the number of exacerbations of bronchial asthma is reduced by 60-70%. In organized groups of older people (nursing homes, boarding schools), influenza mortality is reduced by 80%.

Immunity after the introduction of the vaccine is formed after 14 days and persists throughout the season. Unfortunately, the immunity produced after vaccination is short-lived. This is largely due to the high variability of the circulating influenza virus, the emergence of a new or even the return of an old subtype of the virus. In this regard, the anti-influenza immunity developed in the previous year does not save from the disease in the current year. Therefore, an annual immunization is necessary, using only the current year of production. Vaccination with last year's vaccines is effective only in 20-40%.

Post-vaccination reactions

Whole virion influenza vaccinations have a relatively high reactogenicity. Therefore, when they are used, general reactions may develop in the form of fever, headache, weakness, as well as local reactions in the form of swelling, redness and soreness at the injection site. Usually these reactions are mild and go away on their own.

The subunit, split, and virosomal vaccines are the least reactogenic of all influenza vaccines. Only in 3% of cases, vaccinated people are allowed to develop adverse reactions.

Risk of post-vaccination complications

Hypersensitivity to certain components of the flu vaccine may cause itching, hives, or other rashes. Extremely rarely, severe (systemic) allergic reactions such as anaphylactic shock can occur. From the nervous system: often - headache, rarely - paresthesia, convulsions. However, there is no convincing evidence that these reactions are related to vaccination.

Contraindications

For all influenza vaccines:

• hypersensitivity to chicken protein or any other component of the vaccine
• severe temperature or allergic reactions after a previous vaccination with influenza vaccines.

Influenza vaccination is delayed until the end of acute manifestations of the disease and exacerbation of chronic diseases. For non-severe acute respiratory viral infections, acute intestinal and other diseases, vaccination is carried out immediately after the patient has a normal temperature.

The live vaccine is not suitable for children under 3 years of age, pregnant women and people with impaired immunity.

When to vaccinate?

Children can start flu shots at 6 months of age. Influenza vaccination is carried out annually.

Children from 6 months to 3 years of age who have not previously been vaccinated against influenza are vaccinated 2 times at 0.25 ml with an interval of 1 month.

Ask a question to a specialist

A question for vaccine experts

Questions and answers

I heard that if you get a flu shot, then you have to do it all the time, because. your immune system no longer works. Is it so?

No, it's not. Annual influenza vaccination is carried out due to the variability of the virus and therefore the renewal of the vaccine. In addition, post-vaccination immunity is not long-lasting and gradually fades away. Given the above, annual vaccination is required.

An international study was conducted summarizing the meta-analysis of 52 studies comparing the immune response in the first and re-vaccinated, in which a total of more than 12 thousand people took part, the study showed that influenza vaccination does not reduce immunity.

The whole world (including our country) lives according to WHO recommendations, which state that "the recommended vaccination schedule is one dose of inactivated vaccine annually, with the exception of previously unvaccinated preschoolers, who are indicated to receive two doses of influenza vaccine with an interval of 1 month.

We would like to adopt our 2 year old daughter. 11 months Vaxigrippom and combine with Act-Hib vaccine. But the daughter after bronchitis. There is residual cough in the morning and during the day. Do you need to get vaccinated twice a month apart? The second vaccination will be on New Year's holidays. Is it better to put it later or earlier?

Harit Susanna Mikhailovna answers

For vaccination, the child must be healthy for at least 2 weeks. Vaccination against influenza (if the child has not had the flu and has not been vaccinated against influenza before) at your age is carried out twice, can be combined with vaccination against Haemophilus influenzae. Be careful, the flu is already registered in our country and now there is a risk of contracting this infection, since immunity is not developed earlier than 2 weeks after vaccination.

Can I opt out of the flu shot? Does an employer have the right to fire an employee who refuses to be vaccinated?

Harit Susanna Mikhailovna answers

According to the National Immunization Schedule, adults who work in certain professions and positions are subject to influenza vaccination. The list can be viewed at the link http://docs.cntd.ru/document/901738896 On approval of the list of works, the performance of which is associated with a high risk of contracting infectious diseases and requires mandatory preventive vaccinations (as amended as of December 24, 2014).

In accordance with the law, those citizens who ignore the law, really, TEMPORARY, and in a certain epidemic situation, may not be allowed to work if a certain set of vaccinations has not been made, incl. seasonal from influenza - on the basis of part 2 of Art. 76 of the Labor Code of the Russian Federation, the employer suspends (does not allow to work) the employee for the entire period of time until the circumstances that are the basis for suspension from work or exclusion from work are eliminated.

Yes, it is not always possible to get vaccinated for health reasons on the day of vaccination or for medical reasons. It is worth considering that a medical examination is mandatory on the day of vaccination, the results of which are recorded in writing. If a person has a runny nose, body temperature or pressure is elevated, the vaccine is not given, but postponed until recovery. The employer pays for the vaccination.

Who, when and for what reason included employees of higher educational institutions in Russia in the group of people who are required to be vaccinated against influenza? Under current law, university professors can be fired if they have medical contraindications and cannot be vaccinated. Who came up with this? People worked for 20 years without any vaccinations, and now they have to be fired? In the WHO recommendations on groups that need to be vaccinated against influenza, I do not even see school workers, not to mention universities.

Answered by Polibin Roman Vladimirovich

Teachers - the so-called decreed contingent. There is a law on immunoprophylaxis of the Russian Federation dated July 15, 1999 N 825. It contains a "List of works, the implementation of which is associated with a high risk of contracting infectious diseases and requires mandatory preventive vaccinations." Paragraph No. 12 defines that risky infections include "work in all types and types of educational institutions." And in accordance with the Federal Law of June 30, 2006 N 91-FZ “On Amendments to Art. 9 of the Federal Law "On the Immunoprophylaxis of Infectious Diseases", the national calendar of preventive vaccinations also includes vaccinations against influenza. So in the epidemiological sense, teachers are at risk. And in accordance with the law, those citizens who ignore the law, really, TEMPORARY, and in a certain epidemic situation, may not be allowed to work if a certain set of vaccinations has not been made, incl. seasonal from influenza (on the basis of part 2 of article 76 of the Labor Code of the Russian Federation, the employer suspends (does not allow to work) the employee for the entire period of time until the circumstances that were the basis for suspension from work or exclusion from work are eliminated). Yes, it is not always possible to get vaccinated for health reasons on the day of vaccination or for medical reasons. On the day of vaccination, a medical examination is mandatory, the results of which are recorded in writing. If a person has a runny nose, body temperature or pressure is elevated, the vaccine is not given, but postponed until recovery. The employer pays for the vaccination.

The eldest child, 13 years old, was diagnosed with bronchial asthma, allergic rhinitis, polynoses, hr. pancreatitis. Do I need to get a flu shot, and if so, which one is better?

Harit Susanna Mikhailovna answers

It is a must - you can use Grippol plus, it has been studied for use in children with asthma and food allergies at the Scientific Center for Children's Health.

The child is 5 years old. First time vaccinated against the flu. Vaccine Vaxigrip. 0.5 ml was injected once. Is it necessary to re-administer the vaccine at a dosage of 0.5 ml after 4 weeks?

Harit Susanna Mikhailovna answers

Yes, this is how children up to 9 years old who have not been previously vaccinated and have not had the flu are vaccinated with this vaccine.

Can breastfeeding moms get the flu shot?

Harit Susanna Mikhailovna answers

It can be a non-live vaccine, one that is vaccinated in children from 6 months of age.

The flu threatens us every winter. In the last century, thousands of people died from this disease. Now the flu is dangerous not so much with a fatal outcome as with severe complications. In our time of high technology, humanity has learned not only to alleviate the course of this disease, but also to completely prevent it with the help of vaccination.

But at the same time, there is the problem of choosing a specific vaccination among the many available. The flu virus is constantly changing and mutating, so there is no vaccine with a constant composition. But the WHO annually forecasts the upcoming diversity of viruses for each season. Based on it, vaccine manufacturers make their vaccinations. In this article, we will consider one of them called "Influvac". What is included in its composition? How to do it, and, most importantly, when will its action begin? Can children be vaccinated? What are the contraindications and side effects?

"Influvac" - what kind of vaccine is this?

"Influvac" (Influvac) is a flu vaccine containing killed strains of viruses, or rather, only their surface antigens. Viruses are first cultured in chicken embryos, then selected, inactivated (killed) with formaldehyde. Then, using a special technology, surface particles containing antigens are separated from them. Everything else is subject to high-quality cleaning. Such a vaccine is called a subunit vaccine. It contains only hemagglutinin and neuraminidase, which are on the surface of the virus.

"Influvak" - whose production? This vaccine is produced in the Netherlands. Since 1988, it has been registered and approved for use in the Russian Federation. Influvac is manufactured by Abbott Biologicals BV.

Influvac contains purified antigens of influenza A and B viruses. It is impossible to get sick from these particles, but they cause strong immunity. The composition of the vaccine is updated every year depending on what kind of flu is expected. Therefore, the instructions for Influvac always indicate the season (for example, 2015-2016). The effect of the vaccine is also limited to the specified time. Further, the action of "Influvak" ends. Influenza vaccination is recommended annually.

"Influvac" refers to three-component vaccines. Most often, it contains particles of influenza viruses:

• A (H3N2);
• A (H1N1);

In addition to viral particles, the vaccine contains:

• sucrose sodium citrate;
• sodium and potassium chlorides;
• polysorbate;
• formaldehyde;
• calcium chloride dihydrate;
• sodium phosphate dihydrate;
• chicken protein.

Since Influvac does not contain live viral bodies, and therefore will not cause a strong reaction of the body, it can be prescribed to children from the age of six months and to all adults.

All people need to get vaccinated against the flu, but vaccination is especially indicated for:

• people who often suffer from ARVI;
• people over 65;
• patients with diseases of the heart and blood vessels;
• with diabetes;
• with a decrease in immunity (HIV, taking hormones, immunosuppressants);
• children who often take aspirin (in such children, when infected with the influenza virus, there is a high probability of the so-called Reye's syndrome - a life-threatening liver disease);
• in the second half of pregnancy.

How does Influvak work?

When ingested, surface antigens elicit an immune response. Two weeks later, specific antibodies accumulate. If an influenza virus with the same surface antigens enters the vaccinated organism, the antibodies will destroy the shell and cause the death of the viral particle.

Clinical studies were conducted on this drug in 2000-2001, which showed that the vaccine is effective in 90% of cases. This means high immunogenicity and therefore a high degree of protection against disease. There is some evidence that after vaccination, the incidence of not only influenza, but also acute respiratory infections decreases. This is likely because many respiratory viruses share the same surface antigens as influenza.

Immunity against influenza from vaccination is formed after two weeks and lasts all year. Therefore, it is advisable to vaccinate in early autumn.

How and where to enter "Influvak"

The drug is available in disposable syringes. Therefore, there is no need to dissolve and type anything. The dose contains 0.5 ml of the vaccine. Adults, adolescents and children from 3 to 14 years of age are given one dose once. "Influvac" for children from 6 months to three years is recommended in half the dose. If the child has not been previously vaccinated, then the vaccine is given twice in 0.25 ml with an interval of a month.

Where to prick "Influvak"? The drug is administered deep under the skin or intramuscularly. Good for the shoulder or hip area. Introduction to the gluteal region is not practiced due to the large thickness of the subcutaneous fat in this place. Intravenous administration is strictly prohibited. Before administration, it is necessary to visually check the vaccine for suspensions and foreign particles, as well as pay attention to the expiration date and storage conditions. It is also recommended to warm the drug to room temperature.

Many people wonder - is it possible to wash after the Influvac vaccination? Doctors do not recommend wetting the injection site during the day to recognize the presence of a local reaction to the vaccine.

Contraindications

The following contraindications are listed in the instructions for use of Influvac:

• individual intolerance;
• allergy to other components of the vaccine;
• acute processes in the body (for example, SARS, exacerbation of a chronic disease);
• children up to 6 months.

Contraindications for Influvac are typical for all vaccines in this category and are quite logical. If the manifestations of SARS are weak, or the exacerbation of the disease is slightly pronounced, then you can be vaccinated as soon as the body temperature returns to normal.

It is advisable not to combine several vaccinations on the same day. This may increase the risk of complications. If, nevertheless, there is such a need, then it is advisable to make vaccines in different limbs.

Side effects

After the introduction of the influenza vaccine "Influvac" side effects are possible:

• locally: redness, swelling, soreness in the injection area, dense infiltrate;
• sweating;
• pain in muscles and joints;
• fever, chills;
• weakness, fatigue;
• transient enlargement of lymph nodes;
• allergies up to anaphylactic shock;
• convulsions, pain along the nerves;
• vasculitis;
• itching, rash all over the body.

According to Russian statistics, complications after the introduction of Influvac are most often expressed in local reactions. They occur in 4% of cases, the most common of which is redness. General manifestations were detected in 1% of cases. Basically it was a headache, less often an increase in body temperature. There were no severe reactions to the drug. The fever lasted no more than 1 day, and the redness persisted for 1–2 days. Treatment is usually not required.

The most dangerous complication is an anaphylactic reaction. Therefore, in the office where vaccination is carried out, there should always be an anti-shock first aid kit, which includes adrenaline or epinephrine.

After the administration of the drug, it is possible that false-positive results will appear in the serological examination for HIV and hepatitis C. Therefore, it is recommended to take tests some time after vaccination.

The compatibility of the Influvac vaccine with alcohol has not been studied. About whether it is possible to drink alcohol-containing drinks after vaccination, one thing can be said: it is possible, but there is a measure for everything.

In children and the elderly, as well as in patients receiving immunosuppressive therapy, a weak specific immune response occurs.

The use of "Influvac" for children and during pregnancy

As mentioned above, "Influvac" can be prescribed to children from the age of six months.

In children, a reaction to the Influvac vaccine is more common than in adults. In addition to the typical fever, they may have a cough, nasal congestion. This is especially true for breasts. This condition may continue for several weeks. Such reactions are not indicated in the instructions, but some mothers noted them in their reviews.

The Influvac vaccine during pregnancy is officially approved for use starting from the second trimester. It is so purified that it does not have a harmful effect on the fetus. And if a woman is at risk for the incidence of influenza, then you can be vaccinated regardless of the gestational age. Nursing mothers are also allowed to vaccinate with Influvac.

Analogues of the vaccine "Influvac"

The disadvantage of the Influvac flu vaccine is its cost. The price is quite high, and it is not allocated for state medical institutions.

There are the following analogues of "Influvak".

1. Agrippal (Italy) is a subunit vaccine, like Influvac.
2. "Grippol" (Russia) - split vaccine.
3. "Grippol Plus" (Russia). This is an improved analogue of the Grippol vaccination, which is safer. Belongs to the same group as Influvac.
4. Fluarix (Belgium) refers to split vaccines and contains not only surface antigens, but also internal virus molecules.
5. Vaxigrip (France) - split vaccine.
6. "Begrivak" (Germany) - split vaccine.

What vaccination to do is a personal choice for everyone. All of them are approximately the same in composition, action, frequency of side effects.

As a result, we recall that everyone is recommended to get vaccinated against influenza, especially people at risk. The pharmaceutical market presents a huge selection of influenza vaccines. One of them is the trivalent vaccine "Influvac". Due to high-quality purification, the vaccine contains nothing but the surface antigens of viruses. This reduces the number of side effects and contraindications to a minimum. This vaccine is approved for pregnant women, children from 6 months old, breastfeeding and people with immunosuppression. This fact once again proves how safe it is. Clinical studies were conducted on Influvac, which showed its high efficiency - 90% of those vaccinated receive high immune protection for a year. The most common side effects are headache and redness at the injection site. But they are also quite rare.

That imported flu vaccines are not available in Russia. Now most medical institutions and pharmacies stock only Russian vaccines, but many doctors question their quality. About how imported vaccines differ from domestic ones and whether their absence is dangerous for the population, pediatricians and social activists told Takim Dela.

Photo: Nikolay Khizhnyak/RIA Novosti

Why criticize free domestic vaccines?

Now Russians can get vaccinated against influenza free of charge with domestic vaccines Grippol Plus and Sovigripp. This year, the Ministry of Health purchased 62 million doses of free vaccines, four million more than in the previous season.

“The vaccines that the Ministry of Health buys and offers to the population free of charge, at the expense of taxes, unfortunately do not meet WHO standards. The number of antigens - proteins that, in fact, develop immunity - in these vaccines is three times less than in the recommended formulation used throughout the world, ”says Alexei Yakovlev, chairman of the National Society of Industrial Medicine.

The expert explained that the optimal amount of antigens for one vaccine is 15 micrograms, while preparations with a reduced antigen content are used for public procurement. As an adjuvant ( a substance used to enhance the immune response - approx. TD) an immunomodulator is added. The manufacturer assures that it is able to stimulate the immune system and compensate for the low antigen content in vaccines. However, there are no high-quality comparative tests proving that this works, Alexey Yakovlev points out.

In his blog, he says that the immunomodulator polyoxidonium, which was patented in the 90s as a remedy for worms, was added to the Grippol Plus vaccine to stimulate the immune response. Such a composition for vaccination against seasonal influenza is not used anywhere in the world, but it significantly reduces the cost of the product.

In a conversation with TD, Yakovlev noted that Russia produces a vaccine that meets WHO standards, but the state does not provide it for free ( he did not indicate its name, - approx. TD). “As a doctor, I recommend making a flu vaccine containing 15 micrograms of antigens, and especially for people at risk: children under five, the elderly, pregnant women and people with chronic diseases,” the expert added.

According to the pediatrician of the GMS clinic Fedor Katasonov, apparently, domestic vaccines with the addition of an immunomodulator are safe, but he stressed that there are few studies on this topic.

Why are imported vaccines missing?

This year, the French-made Vaxigripp vaccine was imported in the same volume as in 2017, according to representatives of the manufacturing company who handed over the products to distributors.

Employees of the Medsi clinic said that they have the French-made Vaxigripp vaccine, but due to the production load on suppliers, only 200,000 doses were brought to Russia. At the same time, the most popular Dutch-made influenza vaccine Influvac was no longer supplied to Russia at all. Medsi noted that it is no longer "not and will not be."

The manufacturer Influvac did not import the vaccine into Russia. Officially, the company stated that the production was fully loaded and it was not possible to provide additional supplies for Russia. Alexei Yakovlev, in his blog, attributes this to the fact that this year it has become unprofitable for foreign suppliers to import vaccines to the Russian market due to the depreciation of the ruble.

The Moscow network of clinics "Chaika" does not have foreign vaccines. Instead, she offers for vaccination the domestic drug Ultrix, which, according to the website, is similar to Vaxigripp.

Do I need to be vaccinated?

As the head of the department of outpatient and emergency pediatrics Boris Blokhin emphasized, it is imperative to vaccinate and use only high-quality drugs for this. “The only domestically produced vaccine that contains a sufficient amount of antigens is Ultrix,” Blokhin said.

“Ultrix is ​​an analogue of Vaxigripp and complies with WHO standards,” says pediatrician Fedor Katasonov. "Grippol may be working, but we don't know - there's little data and it doesn't meet standards."

It is worth considering that the vaccine only works for one season, then immunity is completely lost. “Seasonal influenza does not pose a serious epidemiological threat to the population of healthy young people who, on average, get sick with a clinically advanced form of the disease two to three times during the working period. At the same time, I strongly recommend people from risk groups to be vaccinated to prevent complications, including fatal ones,” Alexei Yakovlev emphasized.

Influenza vaccination in Russia begins annually at the end of August and lasts until December. The peak incidence of influenza occurs in January-March.

The recommendations of the World Health Organization (WHO) indicate that vaccination is the main means of preventing influenza. According to the organization's monitoring data, the flu infects 5% of adults and 20% of children every year.

Experts recommend vaccination annually before the start of the epidemiological season for people at risk. It includes women at any stage of pregnancy, children six months to five years old, the elderly, people with chronic illnesses and health care workers.