Коллегам. Очень часто возникают вопросы по ротавирусной вакцине: почему ее нельзя начинать вводить в возрасте старше 12 недель, чем обусловлен такой запрет, чем нарушение этих сроков грозит ребенку?
Сделал маленькую подборку цитат из авторитетных источников, они все объяснят. Переводить лень, кто не знает английский - гугл-переводчик поможет
1) Infants 6 to 32 weeks of age: RotaTeq: A total of three 2 mL doses, the first dose given at 6 to 12 weeks of age, followed by subsequent doses at 4- to 10-week intervals. Administer all doses by 32 weeks of age.
ACIP recommendations (CDC/ACIP [Cortese, 2009]): The first dose can be given at 6 to 14 weeks of age. The series should not be started in infants ≥15 weeks. The final dose in the series should be administered by 8 months 0 days of age. The minimum interval between doses is 4 weeks. RotaTeq should be given in 3 doses administered at 2-, 4-, and 6 months of age. Rotarix should be given in 2 doses administered at 2- and 4 months of age. For infants inadvertently administered rotavirus vaccine at ≥15 weeks of age, the vaccine series may be completed according to schedule. The ACIP recommends to complete the vaccine series with the same product whenever possible. If continuing with same product will cause vaccination to be deferred, or if product used previously is unknown, vaccination should be completed with the product available. If RotaTeq was used in any previous doses, or if the specific product used was unknown, a total of 3 doses should be given. Infants who have had rotavirus gastroenteritis before getting the full course of vaccine should still initiate or complete the recommended schedule; initial infection provides only partial immunity.
https://www.drugs.com/ppa/rotavirus-vaccine.html
2) Why can't older babies have the rotavirus vaccination?
The oral vaccine is only licensed for infants up to 24 weeks of age. Older children have very often already had a rotavirus infection, so there is no point in vaccinating them.
Also, as they get older, some babies get a condition that causes a blockage in their lower gut, called intussusception, though this is rare. It's extremely rare before 12 weeks, and most cases happen between five months and a year old.
There's a very small chance (around 5 in every 100,000 babies vaccinated) that the first dose of the vaccine might also cause this blockage to develop.
To reduce the risk of this happening, the first dose of the vaccine should not be given to babies older than 15 weeks of age.
https://www.nhs.uk/conditions/vaccinations/rotavirus-vaccine-questions-answers/
3) We have a 20-week-old infant who was born prematurely. The infant has never received rotavirus vaccine and is technically past the maximum age for first dose. Should we give rotavirus vaccine to this infant?
ACIP recommends vaccination of preterm infants according to the same schedule and precautions as full-term infants. In preterm infants (as in full-term infants), the maximum chronological age for the first dose is 14 weeks 6 days. Vaccination should not be initiated for infants aged 15 weeks 0 days or older because of insufficient data on safety of dose 1 of rotavirus vaccine in older infants. For more information, see page 19 of ACIP's recommendations on rotavirus vaccination.
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If the first dose of rotavirus vaccine is inadvertently given to a child age 15 weeks 0 days or older, should the series be continued?
Infants for whom the first dose of rotavirus vaccine was inadvertently administered at age 15 weeks or older should receive the remaining doses of the series at the routinely recommended intervals. Timing of the first dose should not affect the safety and efficacy of the remaining doses. Rotavirus vaccine should not be given after age 8 months 0 days even if the series is incomplete.
http://www.immunize.org/askexperts/experts_rota.asp
4) В то же время ВОЗ говорит "можно, только осторожно", и не ставит никаких верхних пределов. Но это жесткий офф-лейб, я старше 15ти недель всегда отказываю в вакцинации
It h
Сделал маленькую подборку цитат из авторитетных источников, они все объяснят. Переводить лень, кто не знает английский - гугл-переводчик поможет
1) Infants 6 to 32 weeks of age: RotaTeq: A total of three 2 mL doses, the first dose given at 6 to 12 weeks of age, followed by subsequent doses at 4- to 10-week intervals. Administer all doses by 32 weeks of age.
ACIP recommendations (CDC/ACIP [Cortese, 2009]): The first dose can be given at 6 to 14 weeks of age. The series should not be started in infants ≥15 weeks. The final dose in the series should be administered by 8 months 0 days of age. The minimum interval between doses is 4 weeks. RotaTeq should be given in 3 doses administered at 2-, 4-, and 6 months of age. Rotarix should be given in 2 doses administered at 2- and 4 months of age. For infants inadvertently administered rotavirus vaccine at ≥15 weeks of age, the vaccine series may be completed according to schedule. The ACIP recommends to complete the vaccine series with the same product whenever possible. If continuing with same product will cause vaccination to be deferred, or if product used previously is unknown, vaccination should be completed with the product available. If RotaTeq was used in any previous doses, or if the specific product used was unknown, a total of 3 doses should be given. Infants who have had rotavirus gastroenteritis before getting the full course of vaccine should still initiate or complete the recommended schedule; initial infection provides only partial immunity.
https://www.drugs.com/ppa/rotavirus-vaccine.html
2) Why can't older babies have the rotavirus vaccination?
The oral vaccine is only licensed for infants up to 24 weeks of age. Older children have very often already had a rotavirus infection, so there is no point in vaccinating them.
Also, as they get older, some babies get a condition that causes a blockage in their lower gut, called intussusception, though this is rare. It's extremely rare before 12 weeks, and most cases happen between five months and a year old.
There's a very small chance (around 5 in every 100,000 babies vaccinated) that the first dose of the vaccine might also cause this blockage to develop.
To reduce the risk of this happening, the first dose of the vaccine should not be given to babies older than 15 weeks of age.
https://www.nhs.uk/conditions/vaccinations/rotavirus-vaccine-questions-answers/
3) We have a 20-week-old infant who was born prematurely. The infant has never received rotavirus vaccine and is technically past the maximum age for first dose. Should we give rotavirus vaccine to this infant?
ACIP recommends vaccination of preterm infants according to the same schedule and precautions as full-term infants. In preterm infants (as in full-term infants), the maximum chronological age for the first dose is 14 weeks 6 days. Vaccination should not be initiated for infants aged 15 weeks 0 days or older because of insufficient data on safety of dose 1 of rotavirus vaccine in older infants. For more information, see page 19 of ACIP's recommendations on rotavirus vaccination.
***
If the first dose of rotavirus vaccine is inadvertently given to a child age 15 weeks 0 days or older, should the series be continued?
Infants for whom the first dose of rotavirus vaccine was inadvertently administered at age 15 weeks or older should receive the remaining doses of the series at the routinely recommended intervals. Timing of the first dose should not affect the safety and efficacy of the remaining doses. Rotavirus vaccine should not be given after age 8 months 0 days even if the series is incomplete.
http://www.immunize.org/askexperts/experts_rota.asp
4) В то же время ВОЗ говорит "можно, только осторожно", и не ставит никаких верхних пределов. Но это жесткий офф-лейб, я старше 15ти недель всегда отказываю в вакцинации
It h
