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Infectologist L.Jančorienė about influenza: young people even need an organ transplant after living illness

Recently, there are a growing number of prominent people who support vaccination, own immunizations and calling others. Maybe the vaccination curve has started to go up?

– Vaccination to protect a person from infectious diseases can be carried out for various reasons: according to the National Child Vaccination Schedule, before traveling to exotic lands, for some chronic diseases, in preparation for immunosuppressive treatment, or just to maintain one's health and prevent possible infectious diseases related with their presence in the natural or human environment, such as tick-borne encephalitis or meningococcal infection.

Vaccination is available to help the elderly prevent morbidity such as pneumococcal infection or shingles. Regarding vaccination of children according to the National Vaccination Schedule, the trend of decreasing vaccination coverage, possibly related to anti-vaccine activities, has been observed since 2010.

For example, coverage of vaccinations for measles, rubella, mumps vaccine in 2010 reached around 97 percent and in 2018 – only 92.2 percent. Now there is no doubt that gaps in public immunity, parents' refusal to vaccinate their children over the past few years have been increasing measles morbidity throughout Europe and other continents, and has triggered an outbreak of measles.

Vidmantas Balkūnas / 15 min. Photo / Ligita Jančorienė

Vidmantas Balkūnas / 15 min. Photo / Ligita Jančorienė

However, each stick has two ends. As children begin to suffer massive measles, with the announcement of the death of the baby, more information about the disease and vaccinations, parents begin to look for themselves and their children. This spring and early summer, vaccination rates in Lithuania have increased 47 times that of measles. Only rhetorical questions can be asked: is it necessary to wait for an outbreak to begin caring about how to protect it?

There is also a very positive trend in the attitude of vaccinations as more and more people come to preventive vaccinations who care about their health, are interested in the possibility of special precautions when traveling or studying abroad, sending children to summer camps, before scheduled procedures , before innovative medicines, immunosuppressive effects, prescribe or just protect your health and assess your quality of life.

Does that mean that begins watch more responsibly for vaccination?

– People have different views. There are anti-vaccine movements that spread evidence-based opinions and have their own followers. But at the clinic, I met different people. I see young people very motivated to get vaccinated.

We have a vaccination room that is attended by a number of people, patients come voluntarily, pay for the services they receive, receive vaccinations for various reasons – before traveling, before pregnancy, when they prepare various treatment procedures. It can be seen that some people have become more educated about vaccinations and are more responsible for their health.

I am very happy that for ten years now, business people have been calling, asking what flu vaccine is best for them because they want to vaccinate all employees at the expense of the company or institution. They are very objective in assessing what will happen if a sudden influenza outbreak causes 30%. the employee. As far as I know, it is now very common at work for employers to vaccinate their employees at their own expense.

You have been working in infectious diseases for a very long time, how is the situation, attitudes of people in general have changed?

– As for the benefits of vaccination, I have good experience with hepatitis B virus infection. When I came to work at the Infectious Disease Center 30 years ago, the unit was full of people with acute hepatitis B, mostly young people. This virus is usually transmitted sexually and gives the impression that, as soon as they have sex, young people become infected with a virus that causes acute liver inflammation.

It is very difficult to convince decision makers that routine vaccination of all newborns against hepatitis B virus infection is needed, because the bureaucratic apparatus asks questions about the economic benefits of vaccinating newborns and the benefits will only be felt after 'eighteen years'. However, since 1998, newborns have been vaccinated against hepatitis B virus infection in Lithuania, and since 2002 they have been vaccinated. twelve year old boy.

20 years passed very quickly and now we have almost no chance for our students to show patients with acute hepatitis B, although in the past these beds were filled with almost all 45 bed units.

When I came to work at the Infectious Disease Center 30 years ago, the unit was full of people with acute hepatitis B, mostly young people.

There are only a dozen cases of acute hepatitis B per year, when we counted hundreds beforehand. In this case, there is a clear economic effect of vaccination, not to mention its benefits for society. The hepatitis B vaccine is also known as the first anti-cancer vaccine in the world, so the hepatitis B vaccine has also reduced liver cancer.

Of course, not only is the range of vaccines developing, we can protect our patients from more infectious microorganisms or their poisons, and doctors' own attitudes towards vaccines change.

For example, 30 years ago, while I was studying, it was explained that after cancer, after transplantation, in other difficult cases where the immune system is weak, vaccination is not possible. All of these patients are now highly recommended for vaccination, especially against influenza and pneumococcal infections, because they become more susceptible to infections, become more sick, have more complications, and die more.

In the case of influenza infection, there is a nationally defined category of people who receive a free flu vaccine. This is a risk group for influenza complications – all over 65 with chronic conditions such as bronchial asthma, diabetes, heart or kidney failure, oncology or other immunosuppressive conditions, pregnant women, health workers.

It is important to mention that vaccination against pregnancy protects not only the pregnant woman but also the baby who will come if she is born during the flu season, because maternal antibodies cross the placenta during the third trimester of pregnancy, which is still present for 6 months. after birth protect babies from infectious diseases that make the woman who gave birth to her immune. So in this case, one vaccine provides complicated flu protection for pregnant women and their babies.

Immunization of pregnant women against influenza not only protects pregnant women but also babies who will be born.

There is an opinion that influenza vaccine is not needed for healthy people because of good immunity.

– Interviews with young people who are waiting for a heart or kidney transplant because of heart or kidney failure are often heard on television. What is the most common reason? They are healthy, athletic, and healthy people who "pass the flu". And this results in damage to the function of organs that cannot be recovered, loss of function, in this case the only way to save lives is to carry out organ transplants that don't work.

Influenza is indeed a very dangerous disease, and natural immunity or a healthy lifestyle alone may not prevent complicated diseases from occurring, because the course of the disease may depend on many different factors, from the dose of infection to the state of the human immune system or individual genetic factors.

Photo by Žygimantas Gedvilos / 15 minutes / Captain

Photo by Žygimantas Gedvilos / 15 minutes / Captain

There is already talk of a new flu season coming. Kokay with the vaccine? Are people very interested in vaccination options?

– There are currently two choices for flu vaccinations. People belonging to risk groups established by the state can consult with a family doctor to get a free flu vaccine. Other no-risk populations can receive commercial flu vaccines for a fee. Even when it is possible to get a free flu vaccine, we often find people who don't use it.

Of course, it is regrettable that these people, who suffer from severe flu, go to the hospital and experience a lot of stress themselves, and complicated state flu care incur high costs, and when asked why a patient ignores influenza vaccination, don't think it might be relevant to him. Among people who die from serious flu complications, there is almost no vaccine.

There is already plenty of evidence that influenza viruses often trigger myocardial infarction, respiratory failure, and worsen diabetes due to a severe inflammatory response, and therefore prevention of influenza infection requires special care in people with cardiovascular, kidney, lung, or chronic endocrine disorders. .

We are now witnessing a somewhat changed situation with increasing interest in influenza vaccination, with an increasing number of people asking about influenza vaccinations and seeking family vaccinations.

This year, the state sick fund has purchased the latest quadrivalent influenza vaccine, which contains antigens from four types of flu viruses, to vaccinate at-risk groups, which means we will be immunized against four different influenza virus subtypes after vaccination.

There is plenty of evidence that influenza viruses are often a factor in myocardial infarction, respiratory failure, and exacerbation of diabetes mellitus.

Influenza virus infections reach us every year, and never before has there been a smaller or larger influenza epidemic. This is one of the most common viral respiratory infections caused by influenza A or B.

There are years when there are even some influenza infection disorders during the flu season, so the spread of this infection needs to be prepared, and one of the most important tools for gaining specific immunity is the flu vaccine. However, it must be emphasized that vaccination against influenza vaccine does not guarantee that people will get the flu, but that the primary mission of the vaccine, especially for individuals at risk, is to protect against serious forms of illness, complications and death.

Vaccination has a high likelihood that a person will not have the flu, and if that happens, the form of the disease is milder, the duration of the disease will be shorter, less medication needed and prolonged disability will be avoided.

How is the situation with vaccinations in Lithuania compared to other countries?

– The highest flu vaccination rates in Western European and North American countries (US, Canada), where up to 70-80% of vaccines are vaccinated. parents. We are indeed lagging behind, but the situation is improving, the number of people receiving vaccines replaced by the state is increasing, and I think the number of people who are self-financing has increased.

2018-2019 Only about 13 percent of people are at risk of being vaccinated during the flu season in Lithuania. only 0.6% of all parents, and the lowest risk group among pregnant women.

In developed countries, in fact, there are far fewer questions about whether to get a flu shot. Annual influenza vaccine vaccinations are recommended for almost all populations except children under 6 months. This recommendation is always based on scientific evidence.

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