Content:
- Editorial
- Child vaccination coverage of selected infectious diseases in the Czech Republic – Hana Cabrnochová, Roman Chlíbek, Ladislav Dušek
- Contraindications to vaccination againts covid-19 disease – Roman Chlíbek
- New strains of SARS-CoV-2 and second generation vaccine – Vanda Boštíková
Editorial
Vážení čtenáři, kolegové a kolegyně,
Vánoce rychle utekly a už tu máme poslední číslo roku 2021. Podobně jako ten předcházející byl i rok 2021 rokem hektickým, ve kterém jsme zejména v oblasti očkování proti SARS-CoV-2 zaznamenali řadu změn a nových poznatků, ne vždy pozitivních. Systémově velká diskuse zavládla po deklaraci některých zemí povinně proti covidu-19 očkovat, byť s některými výjimkami. Mezi země s povinností očkovat profesní skupiny a osoby nad 60 let věku se původně zařadila i Česká republika, nová politická reprezentace však již platnou vyhlášku zrušila. Asi je možné akceptovat argumenty, že pokud nemáme zcela korespondující vakcínu s variantami, které kolem cirkulují, neměla by být dána povinnost očkovat se. To platí zejména pro omikron. Na straně druhé by to nemělo vylučovat možný návrat k povinnému očkování v budoucnosti v případě cirkulace klinicky závažných variant a existence účinných vakcín proti nim.
Na rozdíl od ČR, náš soused Rakousko k povinnému očkování proti covidu- 19 směřuje mílovými kroky. Čas ukáže jednak odborné aspekty a důsledky tohoto opatření, ale i politické dopady. Takováto striktní opatření povedou nepochybně k další polarizaci již tak rozpolcené společnosti.
Vznikají sice nové léky, ty však mají k ideálu stále daleko. A i přes vysokou účinnost preparátu Paxlovid, která byla deklarována až na úrovni 89 %, je nutné připustit, že ne každý bude moci tento preparát užívat.
V současné době byla také schválena třetí dávka pro děti od 12 let. Možné je zatím použít pouze vakcínu Pfi zer v plném dávkovém objemu. Třetí dávka je vhodná všude tam, kde byly aplikovány dvě dávky a od poslední dávky uplynulo alespoň pět měsíců.
Poslední novinkou je možnost registrace pro zatím poslední covidovou vakcínu, kterou je vakcína společnosti Novavax. Jedná se o proteinovou vakcínu, kde se vlastní protein syntetizuje na hmyzích buňkách a do organismu je dodáván ve fi nální podobě. Řada osob si myslí, byť ne vždy zcela podloženě, že tato forma zajišťuje vyšší bezpečnost, a očekává se zvýšený zájem o očkování. Vakcína je zatím určena pouze pro základní schémata, ačkoliv existují studie jejího použití zkříženě u různých základních schémat. V novém roce přeji vše nejlepší a doufám, že omikron nás vyvede ze současné covidové krize.
Za redakční radu
prof. MUDr. Roman Prymula, CSc., Ph.D.
Child vaccination coverage of selected infectious disease in the Czech Republic
Summary:
Introduction: Vaccination control is performed by all European Union countries, but uniform standards for the collection of valid data are still lacking. The analysis of vaccination data is used to evaluate vaccination programs and their effectiveness in preventing the occurrence of infectious diseases at the national level. Vaccination information also helps to plan the required amount of vaccines in advance so that outages do not occur and deliveries are smooth. Various methods are used for the purpose of determining vaccination coverage, namely administrative methods, surveys, including seroprevalence or direct use of data from immunization programs. Methods based on the use of data from vaccination registers are another way of obtaining information about vaccinations. Thanks to the change in the payment of compulsory vaccination and the introduction of paid vaccination from health insurance, we have now had the opportunity in the Czech Republic to monitor and analyze data from health insurance companies on the vaccination of the population in selected preventable diseases. The data are managed by the Institute of Health Information and Statistics of the Czech Republic within the National Health Information System and national health registers. Data from health insurance companies on the number of reported vaccination doses, including used vaccines, are available in the National Register of Paid Health Services. The register contains data from health insurance companies in the inpatient and outpatient areas, including complete data on reported diagnoses, procedures and treatment. The national information system of the public administration enables the determination of the number of administered doses of the vaccine on the basis of the used registers, also in relation to the number of inhabitants of the given year of birth and their permanent residence.
Vaccination in children: Full-term infants born from 1 January 2018 are vaccinated with a combined vaccine against diphtheria, tetanus, pertussis, viral hepatitis B, poliomyelitis and invasive infections caused by Haemophilus influenzae type b (hexavaccine) in scheme 2 + 1, unlike the original 3 + 1 dose, which remains valid for premature babies born before the 37th gestational week of pregnancy. The National Register of Paid Health Services data were used to monitor vaccination coverage. Vaccination in the case of hexavaccine in infants born in 2018 reached 94.8%, in children born in 2019 then 95.2% with the monitored parameter of administration of at least one dose of vaccine up to one year of age. A similar change of the scheme to 2 + 1 occurred in the case of optional vaccination against pneumococcal infections in infants, where we observe an increase in vaccination coverage from 66.9% in chlidren born in 2017 to 73% in children born in 2019 when monitoring the administration of at least one dose up to one year of age. In the case of the combined measles, mumps and rubella (MMR) vaccine, above 90% (90.3%) of twoyear- olds born in 2018 receive a first dose vaccination. The revaccination against tetanus, diphtheria and pertussis (Tdap) in five-year-olds in 2019 reached 90%, in the previous year 2018 it was 91.2%. In the case of revaccination of children aged 10–11 years with the combined vaccine together with revaccination against poliomyelitis (Tdap-IPV), based on the data for 2020, the vaccination coverage reached 91.7%, while in the previous year of children it was 94.5%. In the case of vaccination against human papillomavirus (HPV) diseases, there is a slight increase in the number of vaccinated girls and boys, with a current vaccination prediction of 63.6% for girls in 2020 and 42.6% for boys. In addition, in 2020, thanks to the amendment to Act No. 48/1997 Coll. on public health insurance, we managed to launch optional paid vaccinations for infants and toddlers against meningococcal infections and thus extend the national immunization program to include additional vaccinations. Despite this spread, there has been no decrease in vaccination coverage in infants and toddlers with other vaccines.
Conclusion: Despite the ongoing epidemic of covid-19, preventive child care was maintained in the Czech Republic in 2020 and there was no decrease in vaccination coverage for compulsory and optional (paid) vaccinations for infants and toddlers. On the contrary, we managed to implement additional optional vaccinations paid for from public health insurance funds, also thanks to the acceleration of the legislative process within the declared state of emergency. The epidemic shows the importance of adherence to preventive measures and the need for early prevention of the disease using vaccination programs. Unfortunately, the burden of the epidemics has been delayed by the possibility of repeated publication of updated data on vaccination coverage of children from the national registers of paid health care and are thus published at a delay. The lack of data obtained in this way still remains, the method is limited only for paid vaccinations from public health insurance funds, ie without records of vaccinations paid for by the parents of children. In the future, we will not do without registers of vaccinations based on information obtained from medical records of vaccinated individuals in the form of electronic vaccination records.
Keywords:
vaccination coverage, mandatory vaccinations, voluntary vaccinations, hexavaccine, vaccination against tetanus, measles, rubella and mumps vaccination, vaccination against pneumococcal infections, human papilomavirus (HPV)
Hana Cabrnochova,1,2 Roman Chlibek,3 Ladislav Dušek4
1Katedra praktického lékařství pro děti a dorost IPVZ Praha,
2Pediatrická klinika 1. LF UK a FTN Praha, Očkovací centrum pro děti
3Katedra epidemiologie, Fakulta vojenského zdravotnictví Univerzity obrany, Hradec Králové
4Ústav zdravotnických informací a statistiky ČR, Praha
Contraindications to vaccination againts covid-19 disease
Summary:
Contraindications to vaccination are conditions that may increase the risk of a serious adverse reaction; therefore, vaccines should not be administered in these cases. Because most contraindications are temporary, vaccination can often be given at a later date when the condition leading to the contraindication no longer exists.
Contraindications may thus be temporary or permanent. However, some conditions are commonly misunderstood as contraindications (i.e. are not valid reasons for delaying vaccination) not only by those seeking vaccination, but often also by vaccinating health professionals. As a result, these unjustified contraindications lead to vaccines not being recommended and withheld. As a result, incorrect contraindications to vaccination can put a person at risk of covid-19 disease, with a serious course and even death. The list of contraindications has been compiled on the basis of input and opinions from professional medical societies that recommended using the following contraindications for vaccination against covid-19 disease with vaccines available in the Czech Republic.
Keywords:
contraindication, vaccination, covid-19, permanent contraindication, temporary contraindication
Roman Chlíbek
Katedra epidemiologie, Fakulta vojenského zdravotnictví Univerzity obrany, Hradec Králové
New strains of SARS-CoV-2 and second generation vaccines
Summary:
About two years ago, at the end of 2019, a seizure of a cluster of atypical pneumonias of unclear origin was reported from the Chinese metropolis of Wuhan. The common denominator was the incidence in patients who worked or visited the so-called wet markets, where live fish, seafood, chickens, bats, birds, but also rodents and many other animal or plant products are sold, and where they are processed and consumed. The initial outbreak quickly spread from Wuhan, China to other parts of China and later around the world. On January 30, 2020, the World Health Organization (WHO) declared a global state of emergency. A few weeks later, specifically on March 11, 2020, the organization later declared the spread of the new coronavirus a pandemic, a mass outbreak of a large-scale infectious disease affecting multiple continents. The first case of the disease, named COVID-19, was detected in the Czech Republic on March 1, 2020.
Keywords:
coronaviruses, SARS-CoV-2, variant, mutation, vaccine, omicron, ihu, strain
Vanda Boštíková
Katedra epidemiologie, Fakulta vojenského zdravotnictví Univerzity obrany, Hradec Králové