Generality
Vaccines in children are a fundamental and effective means of preventing the onset of serious infectious diseases, the complications of which can be very serious and sometimes even fatal.
What are Vaccines?
Vaccines are special preparations, administered parenterally or orally to induce immunization against certain types of microorganisms.
The vaccine may contain the microorganism against which immunization is desired, or it may contain proteins or toxins deriving from this same micro-organism.
Basically, there are three different types of vaccines:
- Live attenuated vaccines : they contain live microorganisms (bacteria or viruses) against which immunization is desired, but whose pathogenic power has been diminished.
- Inactivated vaccines : they contain the bacteria or viruses against which the patient is to be immunized; however - unlike what happens for live attenuated vaccines - their ability to cause disease has been eliminated in these microorganisms.
- Vaccines purified as subunits : they contain proteins or toxins deriving from the microorganisms against which the immunization of the individual is to be achieved.
Once the vaccine has been administered, an immune response is activated in the individual characterized by the production of antibodies (or immunoglobulins, if you prefer) by the lymphocytes.
Generally, to reach complete immunization, a period of time is needed, indicatively, from two to four weeks.
However, for more detailed information about vaccines and their mechanism of action, see the article on "Vaccine - Vaccination".
Mandatory and Recommended Vaccines
In Italy, there is the possibility of vaccinating children for free against different types of infectious diseases considered to be serious. For some of these diseases, compulsory vaccination has been introduced, while for others the obligation is not foreseen, but the Ministry of Health recommends vaccination in any case.
The list of free vaccinations provided by the State, as well as the timing with which these must be carried out are present within the so-called vaccination calendar .
The vaccination schedule and the lists of mandatory and recommended vaccines in children are listed on the website of the Ministry of Health and can be consulted at the following link.
Mandatory Vaccines
Until 2017, there were only four vaccines in children made compulsory by the Ministry of Health in Italy; in particular, those aimed at preventing the following diseases:
- Diphtheria : diphtheria is caused by the bacterium Corynebacterium diphtheriae, which infects the airways and skin causing cardiac, renal and neurological complications. The infection sustained by C. diphtheriae can be fatal if it is not promptly and adequately treated.
The vaccine - consisting of the diphtheria toxin (rendered harmless by special techniques) produced by the bacterium responsible for the infection - must be administered in three doses during the first year of life, followed by two calls made one at 5-6 years and the other between 11 and 18 years. Later, it is recommended to make further reminders every 10 years.
- Hepatitis B : hepatitis B is a disease that affects the liver, triggered by a viral infection sustained by the hepatitis B virus (or HBV). Many of the children who contract the virus show no symptoms, but can become chronic carriers.
The hepatitis B vaccine contains a protein typically produced by the virus and synthesized through recombinant DNA techniques.
The vaccination schedule includes the administration of the vaccine in three doses: the first to the third month of life, the second to the fifth month of life and the third between the eleventh and thirteenth month of life.
- Poliomyelitis : poliomyelitis is an infectious disease caused by poliovirus. Indeed, in most cases poliovirus infection is asymptomatic. However, there are still cases in which the infection manages to affect the nervous system, causing muscle weakness and paralysis, even permanent. In severe cases, poliomyelitis can even lead to the death of the patient.
The polio vaccine contains the inactivated virus and must be administered in three doses during the first year of the child's life, after which a recall will have to be made between five and six years.
- Tetanus : tetanus is an infectious disease caused by toxins produced by beating Clostridium tetani . This infection affects the nervous system and the musculoskeletal system, causing the so-called spastic paralysis, which, if not properly treated, can lead to death.
The tetanus vaccine contains the tetanus toxin rendered harmless.
The vaccination calendar requires that this tetanus vaccine is administered in three doses within the first year of the child's life, followed by two reminders to be carried out, respectively, between the ages of 5 and 6 and between 11 and 18 years.
Usually, the tetanus vaccine is administered concomitantly with the diphtheria vaccine.
What changes since 2017
With the decree law on the prevention of vaccination for minors from zero to 16 years, approved on 07.28.2017, mandatory and free vaccinations go from four to ten ; in addition to those already seen
- anti-poliomelitica;
- anti-diphtheria;
- anti-tetanus;
- anti-hepatitis B;
the obligatory vaccination is added for those vaccinations which, previously, were not mandatory but nevertheless strongly recommended:
- whooping cough
- meningitis (Haemophilus influenzae ditipo B)
- measles;
- rubella;
- mumps;
- varicella
Please also note that:
- the ten compulsory vaccinations become a requirement for admission to daycare and nursery schools (for children aged 0 to 6)
- the violation of the vaccination obligation involves the application of significant financial penalties .
The ten vaccinations listed must all be administered to those born from 2017. For those born before 2017, see the next chapter.
Before 2017
Those born between 2001 and 2016 must be given vaccinations contained in the National Vaccine Calendar for each year of birth . Precisely:
- those born from 2001 to 2004, must carry out (if they have not already done so) the four vaccinations already imposed by law (anti-hepatitis B; anti-tetanus; anti-poliomyelitis; anti-diphtheria) and the anti-measles, the anti-mumps, anti-rubella, anti-pertussis and anti- Haemophilus influenzae type b, recommended by the 1999-2000 National Vaccines Plan
- those born between 2005 and 2011 must carry out, in addition to the four vaccinations already imposed by law, anti-measles, anti-mumps, anti-rubella, anti-cough and anti- Haemophilus influenzae type b, provided for by the vaccination calendar included in the 2005-2007 National Vaccine Plan
- those born between 2012 and 2016 must carry out, in addition to the four vaccinations already imposed by law, anti-measles, anti-mumps, anti-rubella, anti-pertussis and anti- Haemophilus influenzae type b, included in the vaccination calendar included in the 2012-2014 National Vaccine Prevention Plan
They are exempted from the vaccination requirement :
- subjects immunized due to natural disease . For example, children who have already had chickenpox should not be vaccinated against this disease
- subjects who are in specific documented clinical conditions, attested by the general practitioner or freely chosen pediatrician. For example, for those who have had previous severe allergic reactions to the vaccine or to one of its components
Recommended vaccines
As mentioned, some vaccines against certain infectious diseases are not mandatory, but the Ministry of Health recommends however to carry them out, since these diseases can have very serious complications.
As with mandatory vaccines, the recommended vaccines are free.
The infectious diseases for which the Ministry of Health recommends vaccinations in childhood are:
- Meningitis (vaccines must be administered against the pneumococcus, against meningococcus C and against Haemophilus influenzae type B);
- Measles;
- Mumps;
- Pertussis;
- Rubella;
- Chickenpox.
- Rotavirus infections
As we have seen, some of these vaccinations have become mandatory for children born in recent times (see previous chapter).
Furthermore, the Ministry of Health recommends to carry out the vaccine against human Papillomavirus (or HPV) infections in girls and makes their administration free within the twelfth year of age.
Infection with Papillomavirus, in fact, is a sexually transmitted infection that in women can cause lesions that then lead to the onset of cervical cancer. It is precisely for this reason that the vaccination must be carried out within the twelve years, therefore before the beginning of the sexual life of the woman.
