[cactus1972]

Обновленные рекомендации ААР по применению вакцины против полиомиелита

[Ссылки доступны только зарегистрированным пользователям ]

Основные положения

1. The standard schedule for IPV should be 4 doses administered at 2 months, 4 months, 6 through 18 months, and 4 through 6 years of age.

2. If there is risk of imminent exposure to circulating polioviruses,
such as travel to a country in which polio is endemic or there is an outbreak, then the minimum age and intervals for the first 3 doses of IPV
should be followed. Maternal antibodies can interfere with seroconversion in the first 6 months of life.
For this reason, the standard schedule in recommendation 1,
which calls for vaccine administration during periods when maternal
antibodies are likely to have waned substantially, should be implemented unless there is imminent exposure risk. Although not ideal,
the great majority of infants vaccinated at the minimum age with minimal intervals are protected from polio, and with imminent risk of exposure, the benefits of using the abbreviated schedule far outweigh any risks of failure to induce a protective immune response.
● The minimum interval from doses 3 to 4 should be 6 months.
● The minimum interval from doses 1 to 2 and from doses 2 to 3
should be 4 weeks.
● The minimum age for dose 1 is 6 weeks.

3. The final dose of IPV should be administered at 4 through 6 years of
age regardless of the number of doses administered before 4 years
of age. The final dose should be given at least 6 months after the
preceding dose.

4. When DTaP-IPV/Hib is used for the first 4 doses, a fifth dose of an IPVcontaining preparation (IPV alone or DTaP-IPV) should be administered on or after the fourth birthday. The minimal interval between doses 4 and 5 of IPV in this case should be 6 months.

5. IPV should be administered to immunocompromised and immunodeficient children using the same schedule as that for children with normal immune systems. Because the vaccine is inactivated, it is safe in children with abnormal immune systems. IPV might not be as effective in such children, depending on the disorder and degree of immunocompromise, compared with
protection rates in children with normal immune systems.

6. Adults who are at an increased risk of exposure to wild-type poliovirus
and who previously completed primary immunization with OPV or IPV
can receive a single dose of IPV.