Prophylactic vaccinations
The organization of preventive vaccinations is a responsible part of the activities of the district pediatrician. The terms of active immunization of the child population are determined by the order of the Ministry of Health of the Russian Federation. Preventive vaccinations should be carried out in vaccination rooms of children's polyclinics. Categorically prohibited vaccinations at home.
As there is currently a tendency to increase the number of allergic diseases, and vaccinations themselves cause sensitization of the child's organism, preventive vaccinations need to take into account diseases that precede immunization, the tolerability of vaccinations in the anamnesis, allergic reactions to food, medicines, etc. A district pediatrician shouldhave lists of such children, indicating the nature and severity of allergic reactions. In this case, the "Card for prophylactic vaccinations"( form No. 063 / y) is marked with the presence and type of allergy. All children subject to active immunization are examined on the day of vaccinations by a physician with obligatory thermometry. To ensure adequate preparation for vaccinations for children with allergic mood, hypensensitizing and immunostimulating therapy is carried out, which is also recorded in the same registration form.
The issue of preventive vaccinations to children who are weak, suffering from chronic pathology, often sick, having allergic manifestations, is decided by the commission in the composition of the attending physician, immunologist or head of the pediatric department. Vaccinations, as a rule, should be performed in a polyclinic after a preliminary examination of the child by a doctor. After the vaccination, the child remains in the clinic for 1 hour to exclude the reaction to vaccination, if necessary - to provide assistance. In order to monitor the health status, clarify the nature of the response to vaccination and early detection of possible post-vaccination complications, the precinct nurse visits the child at home in the days following vaccination. The results of these visits should be reported to the district pediatrician, and information on the reaction to the vaccine should be recorded in the "History of Child Development".
The quality of vaccination work in a polyclinic depends to a large extent on the completeness and timeliness of the registration of children living in the area of its activity and subject to vaccination. For this purpose, the nurse visits house at home in October-November of every year, compiles lists of children on the site, checks in the Housing Administration, verifying them also according to development histories and preventive vaccination cards. The registration form No. 063 / u is completed for each newborn and for each new child under the supervision of a polyclinic. The contingent of children subject to vaccinations is regularly specified from the SES, where information is received about children who arrived in the region( city).In turn, the registry of the polyclinic informs SES about all those who have left.
The section of preventive work of the district nurse includes monitoring the timeliness of preventive vaccinations for children and their proper conduct. A special card for preventive vaccinations is prepared for each child - form No. 63. All the cards are contained in special boxes-card files but in sections. Inside the precinct card file they are distributed according to individual types of vaccinations( diphtheria, tuberculosis, etc.).The cards of the children who are to be vaccinated in the current year are especially highlighted. Cards of children who have a temporary withdrawal from vaccinations, are in the same file cabinet, but they are postponed separately. These children are monitored, and to eliminate contraindications they must be vaccinated. Thus, each nurse has a card file, divided into the indicated categories. She weekly reviews the cards of children who are subject to this or that inoculation in the current year. In case of failure to show the child at the appointed time for the vaccination, the district nurse calls the child to the polyclinic.
Vaccinations against diphtheria, pertussis, tetanus, tuberculosis, and poliomyelitis are among the mandatory vaccinations that are routinely administered to healthy children. Vaccination can be done to a child only after a preliminary examination by his doctor( in some cases - a paramedic).Vaccination is not allowed for sick children, and also for a month( sometimes more) after recovery. Children who have experienced epidemic hepatitis, the vaccine is contraindicated within three months after recovery.
When a child is examined, the doctor also finds out the epidemiological situation in the family: if someone has a family member with an infectious disease, in particular a respiratory infection, the vaccine should be postponed. Children suffering from rheumatic fever in the active phase, bronchial asthma and some other chronic diseases, from most vaccinations should be discarded.