On November 1, 2022, Tajikistan began immunizing children against pneumococcal disease. Earlier in September, there was a large-scale, unscheduled vaccination of children against measles. Such frequent decisions by the country’s authorities to immunize children may cause parents concern. But the Ministry of Health claims that such measures help keep the country’s epidemiological situation under control.
Previously, Tajikistan did not vaccinate children against pneumococcal disease. The country has been waiting two years for a vaccine against this infection. With a representative from Tajikistan’s Republican Immunoprophylaxis Center, we talk about the new vaccine for children and what parents need to know before they vaccinate their children. This article also contains information from the Ministry of Health and WHO websites.
The vaccination calendar for every child born in Tajikistan currently includes vaccines for such diseases as tuberculosis, polio, hepatitis B, tetanus, measles, rubella, mumps, rotavirus, diphtheria, pertussis, and hemophilia form B. And from November 1, 2022, a new vaccine against pneumococcal infection was added to this list.
Many vaccines are complex and are given at the same time as part of a single injection. Most vaccines are given repeatedly and intermittently to develop more resistant immunity to these pathogens.
Thus, children in Tajikistan are vaccinated 21 times before the age of 16.
Over the past two years, Tajikistan has had several unscheduled vaccinations for children. In 2021 there was a risk of a poliovirus type 2 epidemic. At that time, WHO declared a level 2 emergency in the country. There is no cure for polio, which affects the brain and causes lifelong paralysis. The only protection is vaccination. In 2021, Tajikistan vaccinated children in two stages. After these measures, according to WHO, the circulation of poliovirus in Tajikistan has stopped.
In September 2022, the country held an unscheduled supplementary immunization of children from 6 months to 15 years of age with the MMR II vaccine. This is a comprehensive vaccine that can provide protection against three viruses at once: measles, rubella, and mumps.
“Such measures were necessary because there could have been a risk of a measles epidemic among children in Tajikistan. Measles has many severe consequences, which can occur even several years after a child has had the disease. Measles can cause blindness, deafness or encephalitis,” Navruz Jafarov, head of the Department of Epidemiological Security, Emergencies and Emergency Medical Care of the Ministry of Health and Social Protection of the Republic of Tajikistan, told CABAR.asia.
He noted that such measures taken by the government in the area of supplementary immunization are taken for a reason and only after analyzing the epidemiological situation in the country.
As of November 1, a new vaccine against pneumococcal disease has been added to the childhood vaccination calendar in Tajikistan.
The vaccine is called Synflorix, produced in Belgium and certified and recertified by the WHO. It is approved and authorized for use in European Union countries by the European Medicines Agency.
Synflorix is a 10-valent conjugate vaccine, which means that it can protect children against the 10 most common types of pneumococcal infection. These include diseases such as pneumonia, meningitis, sepsis, bronchitis, otitis media, and sinusitis that are caused by pneumococcal infection.
These diseases can cause serious consequences for a child, even death. That is why a vaccine against these diseases is on the immunization calendar in more than 160 countries around the world.
Synflorix was delivered to Tajikistan with the support of the World Health Organization (WHO) in 273,200 doses.
Tajikistan waited two years to include this vaccine in the national immunization calendar. The Republican Center for Immunoprophylaxis told CABAR.asia that a request to have the pneumococcal vaccine included in Tajikistan’s calendar of recommended vaccinations was sent to the Global Alliance for Vaccines and Immunization (GAVI) three years ago. The application was approved in 2020 and the Tajik Ministry of Health planned to use the pneumococcal conjugate vaccine starting in November 2022.
Not all children will be vaccinated against pneumococcal disease (PCV), but only those who are 2 months old in November and who are born after that. The vaccination will be administered three times: PCV-1 at 2 months, PCV-2 at 4 months, and PCV-3 at 12 months.
“As for other older children, analysis shows that children older than 12 months are already less susceptible to these diseases. But children under a year old are in the risk group and so it was decided to start vaccinating those who are more at risk. We are talking about more than 240 thousand children who are born in Tajikistan on average each year. However, I cannot yet say whether we will vaccinate older children,” said Navruz Jafarov.
Just like any other vaccine certified by the WHO, Synflorix has been through clinical trials. They show that the vaccine can be as effective as 90% when injected in three stages. The manufacturer warns that if the first vaccination is given, the second and third vaccinations are necessary for high efficacy.
Like other vaccines, Synflorix also has contraindications and side effects that the community hospitals should tell every parent about.
As stated in the instructions for use of this vaccine, after pneumococcal vaccination redness and swelling at the injection area may occur, the child may have a fever, become irritable and restless or sleepy, and rarely febrile and afebrile seizures may occur. Appetite may often worsen, but rarely there may be diarrhea and vomiting. In very rare cases, a child may have a fever of up to 40 degrees and experience rashes and hives.
A contraindication to any vaccination may be an individual intolerance to the components of the vaccine, which is manifested by severe reactions and complications after a previous vaccination. In addition, contraindications may include fever, a current infectious disease, immunodeficiency conditions (congenital or developed during life), malignant tumors, in some cases progressive diseases of the nervous system, and other chronic diseases of the child.
In the case of acute respiratory infections and intestinal infections, vaccinations are given 2-4 weeks after recovery.
The Republican Immunoprophylaxis Center explains that every health worker must tell a parent about side effects and contraindications before vaccination.
In addition, you are entitled to an answer to the question about the shelf life expiry date of the vaccine, its manufacturer, the components that make up the vaccines, the temperature at which a particular vaccine is contained, the side effects, and contraindications.
You should know that there are vaccines whose contents separate into white sediment and a clear liquid when stored, which is not an indication of deterioration of the vaccine.
Synflorix is one of these vaccines. The nurse shakes the vaccine container well before administering it until it forms a suspension.
However, there are some vaccines that should not be shaken. That’s why the nursing staff in charge of vaccinations get special training and instructions before they start administering vaccines.
The Republican Immunoprophylaxis Center explains that before you come for a vaccination, the child must be examined by a pediatrician and given permission to be vaccinated. The doctor will take the child’s temperature. Most importantly, the child going in for the vaccination must be in good health.
After the vaccination, stay in the clinic for another half hour and watch your child. If there are any repercussions, such as an allergic reaction, the nursing staff will provide first aid.
Ask your doctor at what temperature you can give your child an antipyretic, usually above 38 degrees. If the fever lasts more than three days, you need to contact your local doctor, who will give recommendations.