pediatrician

Questions were asked by Antonina Kyabeleva

In March 2023, a case of measles infection, an extremely dangerous viral disease, was detected in Kostomuksha. Since the beginning of 2023, about 800 cases have been identified in Russia. According to Rospotrebnadzor, measles was detected in 44 regions of the country.

Measles is transmitted by airborne droplets. It is one of the most contagious diseases in the world, its contagiousness (contagiousness) is 90 percent. The situation is aggravated by a long incubation period – from 8 to 14 days. Signs of measles are high fever up to 38-40 degrees, weakness, cough, runny nose, conjunctivitis, skin rash all over the body.

How to protect yourself from a dangerous disease, when should you be vaccinated, who is at risk? Doctor of Medical Sciences, Head of the Department of Pediatrics and Pediatric Surgery of the PetrSU Medical Institute, pediatrician Yulia Zaripova told about this.

– Yulia Rafaelievna, What is the cause of the measles outbreak in Russia in 2023, and how dangerous is it?

– Unfortunately, since 2017, Russia has been considered a measles endemic country again. This is due to the mass migration of the population and the decrease in herd immunity. Vaccination coverage is less than 90 percent. In 2019, there was already an increase in measles cases, but the tough restrictive measures introduced in 2020 in connection with the COVID-19 pandemic helped to cope with the situation for a while. However, there are still a large number of people who do not have immunity to this infection. At the beginning of the coronavirus pandemic, routine vaccinations were temporarily suspended. This may have contributed to the decline in vaccination coverage. In addition, the anti-vaccination movement has recently intensified, which negatively affects vaccination not only against measles, but also against other vaccine-preventable infections.

There are myths that it is better to recover from measles by arranging “measles parties”, that vaccination leads to the development of autism in children, that those who have had measles are protected from cancer. These myths have no scientific basis. About these and other fables, about the fears of parents, about decisions made under the influence of fear, an excellent book was written by the American pediatrician Paul Offit, “A Deadly Choice. What the fight against vaccines threatens us all,” which I recommend reading to anyone who faces this choice.

– Who is at risk?

Measles is a highly contagious and severe disease caused by the measles virus. What does highly contagious mean? This means that if a person who is not ill and not vaccinated meets with measles, the probability that he will get sick is one hundred percent.

According to the World Health Organization (WHO), measles is very dangerous for children in the first five years of life. In 2017, it claimed the lives of 110 thousand people. The saddest thing is that these are mostly children under the age of five.

Most deaths are due to complications of measles: brain damage, blindness, ear infections, pneumonia, and dehydration due to severe diarrhoea. Complications most often develop in children under the age of five, in adults over thirty years of age, and in immunocompromised individuals.

First of all, unvaccinated young children fall into the risk zone. Unvaccinated pregnant women are also at risk. In principle, any person who does not have immunity is at risk – one who has not been vaccinated.

Who should be vaccinated and how often?

– According to the National Immunization Schedule of the Russian Federation, the first vaccination against measles is carried out at the age of one year, the second vaccination at the age of six years. Thus, there should be two vaccinations during a lifetime. There is a nuance. There was a period when pregnant women were examined for the presence of antibodies against measles, and in their absence or low titer, their children were vaccinated up to one year. This dose is called “zero” and is not taken into account. The child should receive two more vaccinations.

If a child aged 1 to 17 years inclusive or an adult aged 18 to 35 years has not had measles, has not been vaccinated, has been vaccinated once, or does not know if he has been vaccinated, then he should be vaccinated twice with a minimum an interval of 3 months.

The risk zone includes adults from 36 to 55 years old if they work with a large number of people. These are employees of medical, educational organizations, trade, transport, communal and social spheres, shift workers, employees of border crossing points. They must follow the same rule: if they have not been ill, have not been vaccinated, have been vaccinated once, or do not know if a vaccination has been given, then they need to get two vaccinations with a minimum interval of three months.

After 55 years, you can also be vaccinated, but in this case, the vaccination will have to be done on a paid basis.

In general, if there is no evidence that you have been vaccinated twice, you must definitely get vaccinated.

– How safe is the measles vaccine?

– In our country, there is a monovaccine against measles, a divaccine against measles (two-component: measles + mumps) and a three-component vaccine (three-component: measles + rubella + mumps). The measles vaccine is an attenuated live vaccine. It has been used worldwide for more than 50 years and is safe, effective and inexpensive, both as a single vaccine and in a combined form. There is currently no specific treatment for measles, so measles vaccinations work and protect better than any other preventive or therapeutic tactic.

– Is there a vaccine in Karelia?

– The vaccine for children against measles is available in sufficient quantities in medical organizations of the Republic of Karelia.

– Do they give the vaccine for free, or do you have to pay for it?

– The vaccination is included in the National Immunization Calendar and is free of charge for citizens under 35 years of age and persons under 55 years of age from the risk group. For the rest, it is paid. In addition, free vaccination for people over 35 years of age is carried out in epidemic conditions according to epidemic indications.

How many times do you need to be revaccinated?

– Lifetime revaccination is not needed. There is no question of any frequency of vaccination against measles for adults every 5, 10 or, say, 15 years. In official documents, there are only two vaccinations.

How do you know if a person has been vaccinated or not?

– Information about vaccinations can be obtained from your medical records at the clinic where you live. Unfortunately, this information was not always preserved, especially if an adult took care of this issue. Therefore, many donate blood for antibodies to find out if immunity is present. However, the absence of antibodies does not indicate a loss of immunity.

Antibodies are just one part of the immune system. After vaccination, a stable and versatile immunity is formed. When an infection enters the body, an instant synthesis of antibodies will start. A blood test for antibodies to measles is of no value.

If there is no information about the vaccinations made, then a simple rule applies – get vaccinated again.

– One case of infection was detected in Kostomuksha, what is the situation today?

– Currently, no new confirmed cases of measles have been registered in our republic.

– In Karelia, it is planned to conduct a cleansing immunization against measles. What will it look like in practice?

– In order to create collective immunity in Russia, cleansing immunization is being carried out. This means that the vaccine will be given to those who have not been vaccinated, do not have information about previous vaccinations and have not had measles. Migrant workers who have not been vaccinated and have not been ill with measles also fall under the clean-up immunization.

Previously, medical institutions will analyze the documentation and identify those who have not been vaccinated. In parallel, explanatory work is being carried out among the population and employers who have hired foreigners. Clean-up vaccination has been started in Karelia: lists of citizens to be vaccinated have been formed, needs for the vaccine have been calculated, it is being purchased and vaccination teams are being formed.