When it's tick season, many people are puzzled by how to protect themselves and their family members from infections carried by these parasites. The most dangerous of these infections is tick-borne encephalitis (TBE), since there are no means of etiotropic treatment for it today, and mortality among people who fall ill with it remains very high. Other infections carried by ticks are either extremely rare or can be treated quite successfully with timely access to a doctor (for example, tick-borne borreliosis).
Thus, vaccination against tick-borne encephalitis is a guarantee that being in nature will not pose a mortal danger to a person, and even an already attached tick found on the body will not cause alarm (it can simply be removed and thrown away, that is, if there is a vaccination you do not need to take the parasite for analysis).
It should be understood that in some cases there is no special need for vaccination against TBE, in other cases it is desirable, in others it is strictly required. It depends on a lot of factors, including those related to human health.
At the same time, even with all the indications, it may not be so easy to get vaccinated. The vaccination procedure is quite complicated, carried out in several stages and is not available in all clinics.
Let's see what the tick-borne encephalitis vaccine is, is it always effective, how to properly prepare for it, and, importantly, in which cases it should be abandoned even when in a potentially dangerous region ...
What is the tick-borne encephalitis vaccine for and how does it work?
The tick-borne encephalitis vaccine is a substance of many formalin-deactivated viral particles adsorbed on a special inert carrier - aluminum hydroxide. Manufacturers obtain viruses by multiplying them in chicken embryos in laboratories where the most favorable conditions are created for the formation of a large number of infectious agents. The virions are then killed with formalin and fixed on the carrier.
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It is important to note that there is virtually no formalin in the finished vaccine, since it goes through several stages of purification. But depending on the origin, the preparation may contain various excipients, including sucrose, some salts, as well as human albumin. The presence of the latter may be the cause of albeit relatively rare, but reliably registered cases of allergic reactions to vaccination.
For tick-borne encephalitis vaccines, the method of storage and transport plays a very important role. The standard shelf life for most of them, depending on the manufacturer, is 1-3 years. Transportation over long distances is possible only by air transport. They need to be stored at 2-8 degrees Celsius, and freezing is strictly prohibited.
In case of any violation of these storage rules, the vaccine is considered unsuitable for use.
It's important to know
If deviations from the vaccine storage mode were observed, this can be recorded visually - the suspension becomes heterogeneous, flakes become visible in it, which are not broken by shaking. Therefore, before the injection, it will not be superfluous to evaluate the appearance of the drug.
The mechanism of action of the vaccine is quite simple. Despite the fact that tick-borne encephalitis viruses have already been deactivated, their surface still contains antigens - special markers for the human immune system. They start the production of antibodies - special proteins that, if necessary, will attach to live TBE viruses, deactivate them and start the process of destruction, blocking the penetration into cells and replication of the virus in the body.
In fact, the vaccine acts in a standard way - it stimulates the production of a specific immune response specifically to the tick-borne encephalitis virus.
If in the future a vaccinated person is bitten by an encephalitis tick, then the viral particles that are in the body will be quickly identified and neutralized by the prepared immune system - the antibodies will bind to the antigens of the viruses and will not allow to cause the disease. If the encephalitis virus enters the bloodstream of a person who has neglected vaccination, a completely different picture is observed. The body of such a person is not yet familiar with the structure of the infectious agent, and it needs time to develop the necessary amount of protective proteins. During this period, the virus often already has time to multiply rapidly in the body of the infected, and the disease begins.
A vaccination delivered according to all the rules (or rather, a course of vaccinations), with a probability of 95%, provides protection against tick-borne encephalitis when the virus enters the body after a tick bite.Cases of the development of the disease after vaccination are extremely rare, but they also pass easily and without serious consequences.
However, it is important to remember that lifelong immunity to tick-borne encephalitis is not formed, and after a certain period of time, the concentration of antibodies to the virus in the blood drops. For this, revaccination is carried out every three years. The entire course of several injections does not need to be repeated, just one vaccination will be enough to re-form stable protection.
The effectiveness of vaccination against tick-borne encephalitis
As noted above, in 95 cases out of 100, vaccination provides guaranteed protection against the development of tick-borne encephalitis. In the remaining 5% of cases, the disease, if it develops, proceeds mildly, with a blurred symptomatic picture, and does not threaten the life of the patient.
It is important to understand that tick vaccination does not protect against all dangers potentially associated with tick bites, but only against a specific disease - tick-borne encephalitis. Ticks can bite a vaccinated person just as actively as they will bite an unvaccinated person - while in some cases there is a risk of transmission of other infections, such as Lyme borreliosis (see also borreliosis ticks). Therefore, even if vaccinated against TBE, precautions against tick bites, such as suitable clothing and special repellents, should not be neglected.
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Vaccines are produced by different countries, and, accordingly, developed for different strains of the tick-borne encephalitis virus.The difference in strains means that a virus that infects people in Austria, for example, will be slightly different from that in Altai, but both will cause the same disease.
Fortunately, there is no reason to worry that the European vaccine may not be effective somewhere in the taiga. According to medical tests, all existing anti-encephalitis vaccines are interchangeable today - their antigenic structure coincides by about 85%. And this means that, having been vaccinated, you can protect yourself from tick-borne encephalitis when traveling to any corner of the world.
The maximum period of protection after a course of anti-encephalitis vaccination is five years. But doctors recommend doing a second single injection of the vaccine more often:
- Once every three years after the primary course, if the vaccinated person lives in an epidemiologically dangerous area;
- Before the next trip to an epidemiologically dangerous region - this is relevant for tourists, hunters, workers whose activities take place in whole or in part in nature in dangerous regions and who travel here according to a certain schedule;
- Once a year for people who work in high-risk environments.
The entire vaccination course must be repeated anew if more than five years have passed since the last vaccination and a person needs to travel again to an area with an abundance of ticks and a high risk of contracting encephalitis.
It is important to remember that the first vaccination in a course does not provide sufficient protection against infection, and therefore it is necessary to plan vaccinations in advance. It is absolutely unacceptable to get vaccinated in Moscow today, and tomorrow fly to Yekaterinburg to enjoy the nature of the Ural forests.Traveling to areas potentially dangerous for tick-borne encephalitis should be carried out no earlier than two weeks after the second vaccination - after this period, a sufficient amount of antibodies capable of resisting the virus is already accumulating in the blood.
Who needs to be vaccinated
It is strictly necessary to vaccinate people living in regions that are unfavorable for tick-borne encephalitis - that is, in the area where this disease is recorded quite often. Information about such regions of Russia is available in many health care institutions (often the relevant posters are simply hung on the walls in polyclinics to inform the population).
The picture below shows the regions most dangerous for tick-borne encephalitis:
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The area of distribution of the tick-borne encephalitis virus is strictly limited to the areas of residence of its carriers - ixodid ticks. Moreover, not every tick is infected, and the percentage of infected individuals to the usual ones differs in different regions, and the probability of infection when bitten by a parasite also differs greatly from this. Moreover, even if a person is bitten by a tick infected with the TBE virus, the probability of getting sick without taking appropriate measures does not exceed 5-6%.
For more information on how a tick bites and what the likelihood of infection depends on, see a separate article: How a tick bites: details about the process when it digs into the skin.
However, even a relatively low risk of tick-borne encephalitis is associated with a risk of severe disability and even death.Therefore, even if a person does not live in a region dangerous for tick-borne encephalitis, but plans a short trip there (with a field trip), vaccination is also a strictly mandatory procedure.
Particular attention should be paid to people whose professional activities are related to work in the forest. These are, for example, gamekeepers, foresters, sawmill workers, tourist guides. For these people, due to their activities, vaccination against encephalitis can more than once save life and health.
And finally, children are considered a separate risk group. Due to their usual hyperactivity, love of outdoor play, small stature and thin skin, children are especially susceptible to tick bites and, as a result, tick-borne infections. Therefore, if there is a possibility of infection, for example, at a children's camp, on a picnic or fishing, vaccination is a necessary step.
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Children under three years of age without an extremely compelling need to be vaccinated against tick-borne encephalitis are not prescribed.
Thus, the main indication for vaccination is permanent or temporary stay in an area in which TBE is found relatively often. In the event that a person lives in a low-risk area and does not plan to travel to dangerous regions, there is no need for vaccination.
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Some people, worried about their pets, are interested in whether it is possible to vaccinate them against tick-borne encephalitis. Dogs and cats are not susceptible to the destructive effects of this virus, and therefore there is no vaccine specifically for TBE for pets.Incomparably more dangerous for animals is piroplasmosis, the pathogens of which are also carried by ixodid ticks.
Any person, regardless of age, for vaccination must be examined by a doctor who "gives the go-ahead" for vaccination. Such an examination is usually done right on the day of vaccination in order to ascertain the satisfactory state of health of the vaccinated patient. In this regard, it is useful to take into account some of the nuances of advance preparation for vaccination, which we will discuss later.
Preparation for vaccination
There are no strict rules for preparing for vaccination against tick-borne encephalitis - it is not a severe stress for the body, and in most cases it is tolerated quite easily.
However, there are a few recommendations that will help minimize possible side effects and quickly improve your immune system:
- Proper nutrition before vaccination (at least 3 days before the procedure and 3 days after). This refers to a varied and sufficiently high-calorie food, rich in vitamins and fiber, as well as a balanced combination of proteins, fats and carbohydrates. In other words, food should provide the necessary amount of energy and vitamins for the body. But overeating is harmful at the same time - it can to a certain extent complicate (slow down) the formation of immunity, since the main forces of the body will be thrown not into the production of antibodies, but into the digestive processes. The same applies to alcohol - drinking it before vaccination is not recommended, although a small amount of alcohol in the blood is not a strict contraindication to vaccination;
- Exclusion of contact with substances that are known to be strong allergens for the body.Today, many people suffer from allergic manifestations to certain foods or household substances. But since an allergy is inherently an immune response, during the period of its passage, the body may not respond adequately to the vaccine - a cascade of immune reactions can reduce the effectiveness of vaccination;
- The absence of somatic diseases in the acute stage. Going, for example, with the flu to get vaccinated against tick-borne encephalitis is not the best idea. The reason lies in the same overload of the immune system, the main forces of which at this time are thrown into the fight against SARS. Vaccination in this case can slow down recovery, and in the event of the development of adverse reactions, significantly aggravate the patient's condition.
In general, it is very important to bring your immunity to a stable state before vaccination - then the procedure will be effective and pass with minimal inconvenience.
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A mild cold is not a contraindication to vaccination, but a high temperature and frankly feeling unwell should certainly be a reason to postpone vaccination.
Types of anti-encephalitis vaccines
Today, there are 5 most famous vaccines on the market, three of which are Russian and two are imported. Despite the fact that they are called differently, the main active ingredient is the same in all and is an inactivated tick-borne encephalitis virus.
The Russian versions of the vaccine are specifically developed against the Sofyin strain, which causes one of the most severe forms of the disease, and the imported vaccines carry antigens of Western European strains of the tick-borne encephalitis virus, for example, K-23. Despite these differences, all five vaccines are interchangeable and effective against any strain of the virus.
The following are some of the features of today's popular anti-encephalitis vaccines:
- Klesch-E-Vak is a Russian vaccine registered in 2012. Among the excipients contains human albumin, sucrose, salts. It is recommended in two dosages, according to age: for children - from one to 16 years old, and for adults. In the description of the vaccine, common side effects include general malaise, weakness, redness of the injection site, temperature up to 37.5 ° C. It should be noted that in most patients all unpleasant symptoms disappear within 3 days after vaccination;
- Encevir is also a Russian-made vaccine, known on the market since 2004. The excipients are the same as those of the Klesch-E-Vac vaccine. There is no children's dosage in the official instructions for the drug; it is recommended for use only from 18 years of age. The main side effects are the same, and their symptoms also last no more than three days;
- Tick-borne encephalitis vaccine cultured purified concentrated inactivated dry is another domestic product registered in 2013. In terms of the number of excipients, it surpasses the two vaccines mentioned above - here, in addition to the classic additives, there are also bovine serum albumin, gelatin, protamine sulfate. The drug is designed for use in adults and children from three years. Adverse reactions and their frequency are the same as in previous analogues;
- FSME-Immun (for example, FSME-Immun Junior) is an Austrian anti-encephalitis vaccine known since the last century.There are only two excipients in it - human albumin and aluminum hydroxide. The instructions also indicate the presence of trace amounts of formaldehyde - thousandths of a milligram per 1 ml. Despite this, according to patients, this vaccine is more easily tolerated by Russians and causes fewer side effects. It exists in two versions: children can be used from 1 year to 16 years, and after reaching the age of 16 they are vaccinated in an adult dosage;
- Encepur is a vaccine produced in Germany since 1991. Despite the fact that it is the “eldest” of all the above, this is the only drug, after the correct use of which not a single case of tick-borne encephalitis has been recorded. Another indisputable advantage is the minimum of excipients. In particular, the vaccine does not contain either human or bovine albumin, which contributes to an easier recovery after vaccination with a minimum of negative effects. It is used both in adult dosage (from 12 years old) and in children's (from 1 to 12 years old).
Thus, it can be noted that the differences between vaccines, in addition to the names, are in the range of additional components present in the composition, as well as in the features of dosages according to age. None of the anti-encephalitis vaccines can fully guarantee the absence of adverse reactions, but there is still a certain pattern in the tolerance of Russian and imported drugs (imported ones are better tolerated on average).
Technique and frequency of vaccination
A course of three vaccinations against tick-borne encephalitis should be carried out according to a special schedule within certain time intervals.Depending on the recommendations of the manufacturer of a particular vaccine, these schedules may vary slightly, but on average they are about the same.
There are two vaccination schedules: standard and emergency. The existence of the latter is due to the need to form immunity to the tick-borne encephalitis virus in a person as soon as possible, when necessary. But even in an emergency, a minimum of 1-1.5 months is required, so you can’t count on developing immunity in a couple of days.
The standard scheme includes an interval of 1 to 7 months between the first and second injections, and the third is carried out after 9-12 months. More precise timing between vaccinations for each type of vaccine is indicated in the instructions for use. It is usually considered ideal when the patient does the first vaccination in the fall, and the second - closer to May, six months later, just before the start of the period of activity of ticks (for more details about the season of activity of ticks and the stages when they are most dangerous to humans, see a separate article: When does tick season begin and end?).
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2 weeks after the second injection, the maximum level of protection is provided, and thus the person may not worry about encephalitis during the entire warm season. Revaccination is given as a single injection every three years after either of the two immunization options.
The emergency scheme is an order of magnitude faster.The interval between the first and second vaccinations is from a week to a month, which allows the immune system to prepare for a meeting with the virus already 21-45 days after the first vaccination (data are given taking into account the two-week period after the second injection). The third injection, in turn, as in the standard scheme, is carried out after 9-12 months.
Thus, when planning a trip to a region unfavorable for tick-borne encephalitis, you need to have a decent amount of time to prepare your health for possible risks.
Sometimes there are moments when it is not possible to make a second vaccination on the appointed date - the reason for this can be both an illness and other circumstances. But this does not always mean that the course will need to start over. For each vaccine, there are recommended periods of time after which the next vaccination should be given. If the delay does not exceed 1-2 months, there is no need to repeat the entire vaccination again, one injection will be enough. But if more time has passed, you will have to go through the entire course of vaccinations again.
If revaccination was missed, that is, more than three years have passed since the third vaccination, then before the expiration of the five-year period, you can still limit yourself to one shot of the vaccine. If more than five years have passed, then it is considered that the course must be carried out again.
It is important to note that it is better to wait with anti-encephalitis vaccination if any other vaccinations took place less than a month ago. A break of 4 weeks after the previous vaccination with any other drugs is considered optimal. However, the introduction of two different vaccines on the same day, if necessary, is allowed, but must be carried out in different parts of the body.In addition, the combination of anti-encephalitis vaccination with rabies vaccine is strictly contraindicated.
It's important to know
Emergency vaccination and emergency prevention of tick-borne encephalitis after a tick bite are completely different procedures that have nothing in common in terms of the composition of the drugs administered. For emergency prevention of TBE, ready-made antibodies (immunoglobulin) are injected into the victim of a tick bite, and in the case of vaccination, an inactivated virus is introduced so that the body gradually produces the necessary antibodies.
A person vaccinated according to all the rules, emergency prevention of tick-borne encephalitis is not only not needed, but can even seriously harm, causing severe immunological reactions (in rare cases, up to anaphylactic shock).
Vaccination contraindications and side effects
By itself, the inactivated tick-borne encephalitis virus can rarely cause complications after vaccination in a healthy person, but the auxiliary components of the vaccine can cause a whole range of adverse reactions.
It is worth noting that any vaccine undergoes rigorous medical testing before being introduced into general practice. Even isolated cases of deviations from the norm oblige the manufacturer to prescribe them in the instructions for the drug. The degree of purification of the vaccine components can affect the likelihood of developing complications - this is associated with easier tolerance of imported versions.
In general, the most common side effects are:
- Redness and swelling at the injection site;
- General malaise;
- Increasing the temperature to 37-38°C;
- Nausea;
- Headache.
The following are the side effects indicated in the instructions for the FSME-Immun vaccine:
The severity and duration of symptoms may vary, depending on the susceptibility of the organism and the type of vaccine used. In order to minimize the likelihood of unpleasant phenomena after vaccination, it is worth following virtually the same recommendations as when preparing for it - eat nutritious fortified food (without overeating), minimize the risk of contracting other infections by limiting contact with patients, and spend more time on fresh air.
Contact with water is a separate issue - in fact, you can wash after vaccination and wet it. Another issue is that you do not need to rub the injection site with a washcloth, as well as lie in a hot bath, steaming the skin - all this can cause an increase in adverse reactions. But you can wash yourself under a slightly warm shower, and you should not worry about this.
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Within an hour after the first vaccination, you cannot leave the medical facility, but you should remain under the supervision of a doctor. The fact is that it is during this time that there is an insignificant, but still real, probability of developing anaphylactic shock. Therefore, vaccination hospitals are equipped to provide emergency care at the first symptoms of severe allergies.
When does it make sense to refuse vaccination even in a potentially dangerous region?
Neglecting vaccination without good reason is an extremely risky undertaking for health. People who refuse to be vaccinated on moral grounds and principles, or who believe in conspiracy theories on the subject, are completely unjustifiably putting their lives in real danger.
Parents who endlessly write refusals of all vaccinations for their children according to a single model may greatly regret it in the future, when faced with a disease in a child in practice. Therefore, when deciding whether to vaccinate or not, one should think about how many hundreds of thousands of people over the past years the vaccine has saved from death and disability.
So, only in Russia every year from 2000 to 3000 people fall ill with tick-borne encephalitis. After recovery, 10-20% of them have lifelong mental or neurological consequences (up to severe mental and nervous diseases leading to disability), and approximately 12% of cases of the disease end in death. The vaccine and a special technique for its administration were developed precisely in order to reduce these indicators and protect people of all ages from the disease, and in the future, to eliminate the risk of this infection altogether.
However, there are situations where vaccination is strictly contraindicated. In such cases, the potential risks outweigh the benefits. Among the contraindications are all diseases in the acute stage, the presence of bronchial asthma, as well as a severe reaction to a previous vaccination.
It is not recommended to vaccinate women during pregnancy and caution should be exercised when vaccinating against TBE during lactation. There is no unambiguous evidence of the harm of the vaccine, but safety has not been finally confirmed, so each case is considered individually.
The same applies to children under three years of age. Despite the fact that children's vaccines are on the market, due to the poor study of the effect on a vulnerable child's body, they are still recommended for use no earlier than 2-3 years of age.
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Interestingly, the anti-encephalitis vaccine is included in the preventive vaccination schedule for epidemic indications. And this means that in a region unfavorable for tick-borne encephalitis, any person should be vaccinated for free with the provision of a compulsory medical insurance policy (CHI). But in practice, not every hospital has everything you need, and in the case of a free vaccination course, it will not be possible to choose the type of vaccine.
If there is a desire to vaccinate on a paid basis, then you can buy a vaccine at a pharmacy only with a prescription (for example, in Moscow and St. Petersburg, Kleshch-E-Vak costs about 600 rubles). Usually, it is immediately provided at a medical institution, while the cost of an imported vaccine will be approximately twice the price of a Russian drug.
It is important to remember that simple prejudices about vaccinations, not justified by real contraindications, can lead to the development of a serious illness with irreversible consequences. If there are good reasons to get vaccinated, then this must be done.
For people who permanently live in regions that are unfavorable for tick-borne encephalitis (or who are going to travel to such a region), vaccination is not only desirable, but a necessary step. Tick-borne encephalitis is too serious a disease to neglect preventive measures and rely only on the strength of your own body. Properly carried out complex of vaccinations allows you to save the life and health of thousands of people every year.
At the same time, one should not forget that the vaccine protects only against the TBE virus, but not against other diseases that parasites can also carry.Therefore, be careful in places where ticks may accumulate, as well as control your condition after the bite itself, in any case.
If you have personal experience of vaccinating against tick-borne encephalitis, be sure to share the information by leaving your review at the bottom of this page. What vaccine did you use, was the injection painful, were there any side effects after it - any details will be useful for readers.
Does the vaccine really protect against tick-borne encephalitis?
And this video clearly shows what the neglect of vaccination can lead to ...
