When to inoculate against tick-borne encephalitis, contraindications and possible side effects

When to inoculate against tick-borne encephalitis, contraindications and possible side effects

1 Not allowed for vaccination against tick-borne encephalitis

Immunizations from tick-borne encephalitis can be done both for children and adults. They are carried out in order to prevent such acute infectious virus disease as tick-borne encephalitis. This disease occurs due to a tick, but a person can get infected not only from his bite. So, the source can be mites infected with mites, usually goat, very rarely — cow. Tick-borne encephalitis is dangerous not at all times of the year, but after the heat comes, with the dissolution of the first kidneys. It is during this period that parasites wake up after the cold.

Of course, this vaccine plays a very important role, but still its effects can lead to side effects. To prevent this from happening, it is important to study contraindications, that is, those cases when this procedure can be dangerous to health.

So, first of all, the vaccination against tick-borne encephalitis can be contraindicated if a person is sick:

  • epilepsy;
  • rheumatism;
  • cardiovascular failure;
  • tuberculosis;
  • diabetes mellitus;
  • with kidney infection;
  • systemic connective tissue diseases that are inflammatory;
  • with blood diseases;
  • is an endocrine disruption;
  • malignant tumor;
  • is an allergy, especially if this reaction occurs on chicken eggs.

In addition, the vaccine is contraindicated in case a person is prone to strokes, has a heart problem or suffers from a chronic form of ischemic disease. Vaccination should not be done with liver diseases.

There are also temporary contraindications, which say that at this time a person is prohibited from doing this vaccination. This should include:

  • fever;
  • recently suffered from viral, respiratory, meningococcal infections or viral hepatitis;Fruit bearing.

There are several other cases when it is forbidden to do this injection. This applies to people who take certain medicines. Therefore, it is so important to first consult with a doctor. This procedure is contraindicated for women who have given birth to a child, and after birth 3 weeks have not passed. If a fever is observed in a person on the day of vaccination, then it is necessary to abandon the procedure for a while.

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Do not make this injection a year-old child. Vaccination can be carried out only if there is a high probability that the baby can get infected. These restrictions should apply to women in the situation and nursing mothers.

Certainly, such vaccinations are very important, but you should be prepared for the fact that a number of complications can develop that will have both a local and a general nature. So, the local will manifest after the dose has been introduced. As a rule, a person develops an allergic reaction to a vaccine in the form of a rash or a slightly enlarged lymph node. And as for general reactions, it’s pain in the head, in the muscles, the development of general malaise.

2 Adverse Reactions in Adults and Children

Like any other drug, graft from tick-borne encephalitis has its side effects. In this case, such a reaction can arise regardless of whether an imported or domestic drug is administered.

So, it concerns first of all puffiness and an erythema in that place where the nyxis has been made, sensations of a nausea. In addition, a person has fever, aches and pains in the muscles, pain in the head, inflammation in the lymph nodes, general weakness.

There are some manifestations that occur extremely rarely, but still they can be. This includes the formation of mental abnormalities, vomiting and even impaired vision.

Therefore, one should listen to methods that can prevent this, because a very important role for human health is played by vaccination against tick-borne encephalitis, the side effects at which are serious enough. So, it is important to adhere to a special instruction that contains several rules, and their compliance is simply necessary.

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This vaccine is only given if a person is in a healthy state. Therefore, if the patient has had a cold, then he will not be able to get vaccinated until 2 weeks later. And this is the case if a foreign preparation is used during the vaccination. When, for one reason or another, there is an opportunity to use only a domestic medicine, you should wait at least a month after a cold. But the best way is to proceed as follows. To pass analyzes and with them to come to the expert who on their basis, and also after inspection will reveal, it is safe for the person of an inoculation from an encephalitis.

In addition, it is recommended to use antiallergic drugs before and after vaccination against tick-borne encephalitis. And to prevent such an effect as heat or aches in the body, you should after the procedure take the funds with antipyretic effect.

Side effects in children are almost identical to those of adults, so if the vaccine is needed by a child, then you should also adhere to the rules that were mentioned above.

Vaccination is performed several times, it all depends on the drug that is used during the vaccination, so it is so important that this procedure is carried out by an experienced specialist.

When the fixing prick is put, after it the immunity of a person will last 3 years. After this, it is necessary to resort to this procedure every 3 years, but in this case the vaccination will take place in stage 1.If one fixing procedure is missed, one inoculation will be necessary, and if a person misses two vaccines, then the vaccination will have to be repeated in several stages.

If we talk about how to carry out the procedure itself so as not to cause adverse reactions, then the vaccine is injected into the shoulder, namely the deltoid muscle, under the skin. It is very important to do this carefully so that the drug does not get into the blood vessels.

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Since mites can activate in both spring and fall, vaccination can be carried out at any time of the year. It is worthwhile foreseeing that mites can carry many different diseases that are very dangerous to health, but this vaccine can not save a person from them, since it is aimed only at tick-borne encephalitis.

In addition, infection can not be prevented with just one injection.

3 Complications after

procedure Not only contraindications that are important to take into account before grafting can force a person to give up an injection, but complications after vaccination against tick-borne encephalitis.

It is important to understand that this vaccination is not considered an obligatory procedure, besides it is not free, but if ignored, it can lead to unrecoverable results.

But nevertheless, there are a number of consequences, which can lead to an injection from tick-borne encephalitis. Of course, the complications can be quite serious. So, here should be attributed malfunctions that can occur in the work of the heart, may develop vascular pathology, and also develop angioedema, if previously a person was not intolerant drug. However, such consequences are extremely rare and only if the person is not familiar with the contraindications or the rules of vaccination.

In this case, doctors strongly recommend that such vaccinations be done to everyone, except for those who are forbidden from doing this because of contraindications.

But at the same time, the consequences that can occur in a person who has been diagnosed with encephalitis is much worse. This applies to the vegetative state, in which severe encephalitis develops. As a consequence, a person’s cortex is dying or its functions are violated. During this, a person can open his eyes, but he will remain unconscious. The patient may have weakness in the legs and arms, in some cases there is strabismus, and headaches will be permanent. This can lead to death.

4 Prevention measures

In order to avoid such serious consequences, it is necessary to make the specified injections, especially those who are going to visit the forest, forest belts, to spend their holidays in the forest glade. In this case, this procedure is simply necessary. But before it passes you should consult a specialist who will conduct the examination, help the patient weigh the pros and cons and only after that, following all the rules, will carry out vaccination against tick-borne encephalitis. In this case, you can not be afraid of contraindications, adverse reactions and any complications. In addition, such a vaccine is also carried out as a preventive measure, which the doctor must also perform.

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Japanese encephalitis

Vaccine

The inactivated mouse brain-derived (IMB) vaccine is now commonly replaced by cell culture-based vaccines.

A live attenuated vaccine based on the SA 14-14-2 strain of the JE virus is widely used in China and in an increasing number of countries within the Asian region, including India, the Republic of Korea, Sri Lanka, and Thailand.

A Vero cell-derived, inactivated and alum-adjuvanted JE vaccine based on the SA 14-14-2 strain was approved in 2009 in North America, Australia and various European countries. The primary two doses are administered 4 weeks apart. A booster dose is recommended 1–2 years after the primary immunization. This vaccine has been given concomitantly with hepatitis A vaccine without significant interference with the safety and immunogenicity of either vaccine. Data on concomitant administration with other vaccines frequently used in travellers are currently unavailable. The vaccine is licensed for use in individuals 17 years of age and older in the United States, and 18 years and above in other countries. Paediatric and post-marketing safety studies are under way.

Another Vero cell-derived inactivated JE vaccine was licensed by the Japanese authorities in February 2009 and a similar Japanese vaccine was licensed in 2011. These two vaccines use the same strain of JE virus (Beijing-1) as the mouse-brain-derived vaccine. Clinical trials have shown that the vaccines are safe and immunogenic, with seroconversion rates exceeding 95%.

In addition, a new live attenuated, JE–yellow fever chimeric vaccine has recently been licensed in Australia and Thailand. A single dose of this chimeric JE vaccine was found to be safe, highly immunogenic and capable of inducing long-lasting immunity in both preclinical and clinical trials.

Type of vaccine and schedules:
1) Live attenuated vaccine (SA 14-14-2 strain). In China, the first dose is given subcutaneously at age 8 months, followed by a booster dose at 2 years of age. In some areas, an additional booster is offered at 6–7 years of age. However, protection for several years may be achieved with a single dose of this vaccine, and in many countries one dose without subsequent boosters is recommended.

2) Inactivated, Vero cell-derived, alum-adjuvanted vaccine (SA 14- 14-2 strain). Primary immunization consists of two intramuscular doses, 4 weeks apart. A booster is recommended after 1 year.

3) Inactivated Vero cell-derived vaccines (Beijing-1 strain). Primary immunization consists of three doses at days 0, 7 and 28, or two doses given preferably 4 weeks apart (0.25 ml for children

4) Live chimeric vaccine (with yellow fever 17D as backbone). A single dose is recommended; the need for and timing of a possible booster dose have not yet been determined

Adverse reactions: Occasional mild local or systemic reactions

Contraindications and precautions:
A hypersensitivity reaction to a previous dose is a contraindication.

In principle, the live attenuated vaccine should be avoided in pregnancy unless there is a high risk of exposure to the infection.

Rare, but serious, neurological adverse events attributed to IMB vaccine have been reported, but no causal relationship has been confirmed.

As occasional allergic reactions to components of the vaccine may occur up to 2 weeks after administration, it is advisable to ensure that the complete course of vaccination is administered well in advance of departure.

www.who.int

Japanese Encephalitis

Vaccines Recommended for Travel and Some Specific Groups

Japanese encephalitis (JE) is a serious infection caused by the Japanese encephalitis virus.

  • It occurs mainly in rural parts of Asia.
  • It is spread through the bite of an infected mosquito. It does not spread from person to person.
  • Risk is very low for most travelers. It is higher for people living in areas where the disease is common, or for people traveling there for long periods of time.
  • Most people infected with JE virus don’t have any symptoms. Others might have symptoms as mild as a fever and headache, or as serious as encephalitis (brain infection).
  • A person with encephalitis can experience fever, neck stiffness, seizures, and coma. About 1 person in 4 with encephalitis dies. Up to half of those who don’t die have permanent disability.
  • It is believed that infection in a pregnant woman could harm her unborn baby.
  • JE vaccine can help protect travelers from JE disease.
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Basic information for people interested in the vaccine.

www.cdc.gov

Herpes Zoster Vaccination

Recommendations and Vaccine Specifics for Healthcare Professionals

Vaccination Recommendations

For the recommendations of the Advisory Committee on Immunization Practices (ACIP), see Zoster (Shingles) ACIP Vaccine Recommendations.

Routine Vaccination of People 60 Years of Age or Older

CDC recommends a single dose of herpes zoster vaccine for people 60 years of age or older, whether or not the person reported a prior episode of zoster. People with chronic medical conditions may be vaccinated unless a contraindication or precaution exists for their condition. Zoster vaccine, a live virus vaccine, can be administered concurrently with all other live and inactivated vaccines, including those routinely recommended for people 60 years of age or older, such as influenza and pneumococcal vaccines.

When administering zoster vaccine to people 60 years of age or older, there is no need to ask for a history of varicella or to conduct laboratory testing for serologic evidence of prior varicella-zoster virus infection. Almost all people 60 years of age or older who were born in the United States have had previous infection with varicella-zoster virus. Persons who report that they have not had varicella can still receive the zoster vaccine. Laboratory testing to determine if there is evidence of past infection with varicella zoster virus is not necessary. If serologic testing is conducted and there is evidence of varicella susceptibility, the patient should be offered varicella vaccine not zoster vaccine.

Persons with a reported history of zoster can be vaccinated. Repeated zoster has been confirmed in immunocompetent persons, including soon after a previous episode. Although the precise risk for and severity of zoster as a function of time following an earlier episode are unknown, some studies suggest it may be comparable to the risk in persons without a history of zoster. Furthermore, no laboratory evaluations exist to test for the previous occurrence of zoster, and any reported diagnosis or history might be erroneous. Although the safety and efficacy of zoster vaccine have not been assessed in persons with a history of zoster, different safety concerns are not expected in this group. There are no data to guide the timing of the administration of zoster vaccine after a prior episode of zoster. The general guideline for any vaccine is to wait until the acute stage of the illness is over and symptoms subside.

Vaccination of People 50 through 59 Years Old

In 2011, the Food and Drug Administration expanded the age indication for Zostavax® to include people 50 through 59 years old for preventing herpes zoster. This decision was based on a large study showing that the vaccine reduced the risk of zoster by approximately 70%. For people 50 through 59 years old, the risk of getting zoster and having prolonged pain from post-herpetic neuralgia caused by zoster is much lower than for people 60 years old and older.

The Advisory Committee on Immunization Practices (ACIP) continues to recommend zoster vaccine (Zostavax®) for people age 60 years or older. Healthcare providers considering zoster vaccine for certain people 50 through 59 years old should discuss the risks and benefits of vaccination with their patients. Although the vaccine has short-term efficacy, there have been no long-term studies of vaccine protection in this age group. In people vaccinated at 60 years old or older, vaccine efficacy wanes within the first 5 years after vaccination, and protection beyond 5 years is uncertain. Therefore, people who receive the vaccine before 60 years old might not be protected when their risks for zoster and its complications are highest.

Also, healthcare providers may want to first consider whether the patients 50 through 59 years old would have poor tolerance to zoster or post-herpetic neuralgia symptoms. For example, if the patient has

  • preexisting chronic pain, severe depression, or other co-morbidities,
  • intolerance to treatment medications due to hypersensitivity or interactions with other medications, or
  • extenuating employment-related factors.

No data are available about the effectiveness of zoster vaccine in adults who become immunosuppressed after their vaccination.

Contraindications and Precautions for Zoster Vaccination

Zoster vaccine should not be administered to:

  • A person who has ever had a life-threatening or severe allergic reaction to gelatin, the antibiotic neomycin, or any other component of shingles vaccine. Tell your doctor if you have any severe allergies.
  • A person who has a weakened immune system because of:
    • HIV/AIDS or another disease that affects the immune system,
    • treatment with drugs that affect the immune system, such as steroids,
    • cancer treatment such as radiation or chemotherapy, or
    • cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma.
  • Women who are or might be pregnant. Women should not become pregnant until at least 4 weeks after getting zoster vaccine.

Someone with a minor acute illness, such as a cold, may be vaccinated. But anyone with a moderate or severe acute illness should usually wait until they recover before getting the vaccine. This includes anyone with a temperature of 101.3°F or higher.

This information was taken directly from the Shingles Vaccine Information Statement (VIS) dated 10/06/2009.

For more information on herpes zoster and immunization, visit:

Administration with Other Vaccines

Zoster vaccine, a live virus vaccine, can be administered concurrently with all other live and inactivated vaccines, including those routinely recommended for people 60 years of age or older, such as influenza and pneumococcal vaccines.

To avoid introducing barriers to vaccination, CDC continues to recommend that zoster vaccine and pneumococcal polysaccharide vaccine (PPSV) be administered at the same visit if the person is eligible for both vaccines.

Vaccine Administration Errors

Zoster vaccine should not be used in children and should not be used in place of varicella vaccine. Also, varicella vaccine should not be used in place of zoster vaccine. Administration of zoster vaccine to a child who was supposed to be vaccinated with varicella vaccine is a serious vaccine administration error. The event should be documented and procedures put in place to prevent this from happening again. This event should be reported to the Vaccine Adverse Event Reporting System (VAERS) by phone 800-822-7967 or through the website external icon .

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If a dose of zoster vaccine was given accidentally in place of varicella vaccine (Varivax) for a child or an adult, then that dose of zoster vaccine should be counted the same as a single valid dose of varicella vaccine. That’s because the level of protection against varicella would probably be at least the same from zoster vaccine as for the conventional dose of varicella vaccine. If the erroneous dose was administered in lieu of the first dose of varicella vaccine, a second dose of varicella vaccine is required at the normal time a second dose would be given.

In the event that varicella vaccine was accidentally administered to an adult 60 years of age or older instead of zoster vaccine, Advisory Committee on Immunization Practices states: “If a provider mistakenly administers varicella vaccine to a person for whom zoster vaccine is indicated, no specific safety concerns exist, but the dose should not be considered valid and the patient should be administered a dose of zoster vaccine during that same visit. If the error is not immediately detected, a dose of zoster vaccine should be administered as soon as possible but not within 28 days of the varicella vaccine dose to prevent potential interference of 2 doses of live attenuated virus.” The event should be documented and procedures put in place to prevent this from happening again.

Vaccine Specifics

Vaccine Composition, Dosage, and Administration

Zoster vaccine, when reconstituted as directed on the package insert external icon using the supplied diluent, contains a minimum of 19,400 PFU of Oka/Merck strain of varicella zoster virus. The minimum potency of zoster vaccine is at least 14 times the potency of varicella vaccine (Varivax®), which contains a minimum of 1,350 PFU, and is similar in potency to the varicella zoster virus content of measles-mumps-rubella-varicella vaccine (ProQuad®).

Zoster vaccine is administered subcutaneously as a single dose. The vaccine should not be injected intramuscularly. However, it is not necessary to repeat vaccination if it is administered intramuscularly.

The vaccine should be administered immediately after reconstitution to minimize loss of potency. Any unused vaccine should be discarded if not used within 30 minutes.

Vaccine Effectiveness and Duration of Protection

In a large clinical trial involving more than 38,000 people 60 years of age or older, zoster vaccine reduced the overall incidence of zoster by 51% and the incidence of post-herpetic neuralgia by 67%. The efficacy of the vaccine in preventing zoster was higher in people 60 through 69 years of age than in people older than 70 years (64% versus 38%). Zoster vaccine efficacy wanes within the first 5 years after vaccination, and protection beyond 5 years is uncertain.

Studies are ongoing to assess the duration of protection from one dose of zoster vaccine and the need, if any, for booster doses.

There are no comprehensive data on the effectiveness of zoster vaccine in treating shingles once it occurs, and the vaccine is not licensed for this use.

www.cdc.gov

Japanese Encephalitis Vaccine

Inactivated Vero cell culture-derived Japanese encephalitis (JE) vaccine (manufactured as IXIARO) is the only JE vaccine licensed and available in the United States. This vaccine was approved in March 2009 for use in people aged 17 years and older and in May 2013 for use in children 2 months through 16 years of age. Other JE vaccines are manufactured and used in other countries but are not licensed for use in the United States.

IXIARO is given as a two-dose series, with the doses spaced 28 days apart. Adults aged 18–65 years can get the second dose as early as 7 days after the first dose. The last dose should be given at least 1 week before travel. A booster dose (third dose) should be given if a person has received the two-dose primary vaccination series one year or more previously and there is a continued risk for JE virus infection or potential for reexposure.

For adults and children aged 3 years or older, each dose of IXIARO is 0.5 mL. For children aged 2 months through 2 years, each dose is 0.25 mL.

JE Vaccine for Travelers

JE is a very low risk disease for most travelers to JE-endemic countries. However, some travelers will be at increased risk of infection based on factors including longer periods of travel, travel during the JE virus transmission season, spending time in rural areas, participating in a lot of outdoor activities, and staying in accommodations without air conditioning, screens, or bed nets.

All travelers to JE-endemic countries should take steps to avoid mosquito bites, and discuss the need for vaccination with their healthcare provider. The discussion should include the risks related to the specific travel itinerary, the likelihood of future travel to countries where JE occurs, the possible severe outcomes of JE disease, and information about the vaccine including cost and possible side effects.

JE Vaccine Recommendations

JE vaccine is recommended for persons moving to a JE-endemic country to live, longer-term (e.g., 1 month or longer) travelers, and frequent travelers to JE-endemic areas. JE vaccine also should be considered for shorter-term (e.g., less than 1 month) travelers with an increased risk of JE based on planned travel duration, season, location, activities, and accommodations. Vaccination also should be considered for travelers to endemic areas who are uncertain of specific duration of travel, destinations, or activities.

JE vaccine is not recommended for travelers with very low risk itineraries, such as shorter-term travel limited to urban areas or travel that occurs outside of a well-defined JE virus transmission season.

Precautions and Contraindications

  • A serious allergic reaction after a previous dose of IXIARO, after any other JE vaccine, or after any component of IXIARO is a contraindication to further doses. The vaccine contains protamine sulfate, a compound known to cause allergic reactions in some people.
  • No studies of IXIARO in pregnant women have been conducted. Therefore, administration of IXIARO to pregnant women usually should be deferred. However, pregnant women who must travel to an area where risk for infection is high should be vaccinated when the theoretical risk of immunization is outweighed by the risk of infection.

Reactions to JE Vaccine

Reactions to IXIARO are generally mild and include pain and tenderness, mild headaches, myalgia (muscle aches), and low-grade fevers.

Healthcare providers are encouraged to report all adverse events that might be caused by vaccination to the CDC/FDA Vaccine Adverse Events Reporting System (VAERS external icon ) by one of the following methods:

www.cdc.gov

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