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Cijepljenje protiv gripe u pandemiji?

Cijepljenje protiv gripe u pandemiji?

napisao/la Glavni Urednik - Broj odgovora: 12



Gripa je jedna od najučestalijih zaraznih bolesti koju uzrokuje virus gripe (influence), a definiramo je kao visoku zaraznu bolest naglog početka. Ova sezona zimskih mjeseci nam nosi veliku nepoznanicu jer nam uz očekivanu gripu, zasigurno (bar u nekom obliku) stiže i infekcija korona virusom. Do sada se pokazalo da COVID-19 infekcije nemaju neki predvidivi tijek i obrazac pojavljivanja pa možemo samo nagađati kako će izgledati ova sezona respiratornih infekcija. Ono oko čega se svi stručnjaci slažu je da se, više nego ikada, preporuča cijepljenje protiv gripe.


TKO IMA NAJVEĆI PRIORITET KOD CIJEPLJENJA?

WHO je istaknuo nekoliko stanja koja su povezana s povišenim rizikom od komplikacija infekcije virusom gripe. To su ujedno i skupine kod kojih se preporuča cijepljenje. Te skupine uključuju trudnice, djecu u dobi od 6 mjeseci do 5 godina, starije osobe, osobe sa specifičnim kroničnim zdravstvenim stanjima i zdravstvene radnike. Za zemlje koje razmišljaju o pokretanju ili proširenju programa za sezonsko cijepljenje protiv gripe, WHO preporučuje da trudnice imaju najveći prioritet! 


KAKO CIJEPITI DJECU?

Djeca od 6 mjeseci do 8 godina, čiji cjepni status nije poznat, koja se do sada nisu cijepila protiv gripe, ili koja su do sada cijepljena samo jednom dozom cjepiva, trebaju dobiti 2 doze cjepiva u razmaku od 4 tjedna. 

Za sve ostale spomenute prioritetne i neprioritetne skupine dovoljna je jedna doza.


USPJEŠNOST CIJEPLJENJA

Aktualizacijom teme gripe, otvaraju se i dobro poznata pitanja o uspješnosti cijepljenja. Poznato je da ovisno o površinskim antigenima hemaglutininu (H) i neuraminidazi (N), razlikujemo podtipove virusa gripe A (H1N1, H3N2, H5N1 i dr.). Stalne manje promjene u antigenima virusa uzrokuju stalnu cirkulaciju virusa u prirodi, a kod većih promjena dolazi do novih podtipova. Uspješnost cijepljenja dakle ovisi, ne samo o procijepljenosti populacije, broju oboljelih, hospitaliziranih i slično, nego i uspješno 'pogođenom' cjepivu za tu sezonu. U Hrvatskoj je od prošle godine dostupno četverovalentno cjepivo na teret HZZO-a, koje sadrži dva podtipa virusa gripe A (H1N1 i H3N2) i dva tipa virusa gripe B. Time postoje velike šanse da se cjepni soj dobro podudara sa sojem u populaciji. Radi li se o zdravoj odrasloj osobi djelotvornost cjepiva se kreće u prosjeku oko 70%, dok će kod starijih osoba i osoba sa kroničnom bolešću djelotvornost cjepiva biti niža, i u nekim 'lošije pogođenim' sezonama kretati se od 20-30%. 

Najveća uspješnost cijepljenja je kod male djece (6 mjeseci do 7 godina). Studija iz 2014.godine je pokazala da cijepljenje djece protiv gripe, smanjuje 74% rizik od prijema djece u jedinice intenzivne skrbi za vrijeme sezone gripe.


ZANIMLJIVOST – ZAŠTO SE MI TREBAMO CIJEPITI

U Velikoj Britaniji provedeno je veliko istraživanje o gripi 'Flu Watch'. Radi se o nacionalnom prospektivnom kohortnom istraživanju gripe u engleskim kućanstvima.

Angažirano je ukupno 5484 sudionika iz 2205 kućanstava koja su nasumce odabrana iz ambulanti općih/obiteljskih praksi koje sudjeluju u istraživanju. Otkriveno je da se svake zime zarazi 18% necijepljenih ljudi (bris nazofarinksa PCR metodom) a da je do 75% tih infekcija bilo asimptomatsko. Upravo iz ovih razloga je iznimno važno cijepiti zdravstvene radnike, posebice timove obiteljske medicine koji su svakodnevno u kontaktu s brojnim kroničnim bolesnicima. Na taj način se izbjegava mogućnost prijenosa gripe sa asimptomatskog zdravstvenog radnika na kroničnog bolesnika što može imati pogubne posljedice za njihovo zdravlje


ZAKLJUČAK

Cijepite se, zaštite sebe i svoje pacijente! Promovirajte cijepljenje kao najučinkovitiju preventivnu mjeru u povijesti medicine! 



1.Fiore AE, Uyeki TM, Broder K, et al. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010 [published correction appears in MMWR Recomm Rep. 2010 Aug 13;59(31):993] [published correction appears in MMWR Recomm Rep. 2010 Sep 10;59(35):1147]. MMWR Recomm Rep. 2010;59(RR-8):1-62.

2.Edward A. Belongia, Danuta M. Skowronski, Huong Q. McLean et al. Repeated annual influenza vaccination and vaccine effectiveness: review of evidence. Expert Review of Vaccines. 2017 Jun; 16(7): 723-36. doi: 10.1080/14760584.2017.1334554.external icon

3.Marc Rondy, Nathalie El Omeiri, Mark G. Thompson, et al. Effectiveness of influenza vaccines in preventing severe influenza illness among adults: A systemic review and meta-analysis of test-negative design case-control studies. Journal of Infection. Sept 2017; 65: 381-394. doi: 10.1016/j.jinf.2017.09.010external icon

4. Osterholm MT, Kelley NS, Sommer A, Belongia EA. Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis [published correction appears in Lancet Infect Dis. 2012 Sep;12(9):655]. Lancet Infect Dis. 2012;12(1):36-44. doi:10.1016/S1473-3099(11)70295-X

5. Ellen B Fragaszy, Charlotte Warren-Gash, Lili Wang, Andrew Copas, Oliver Dukes, W John Edmunds, Nilu Goonetilleke, Gabrielle Harvey, Anne M Johnson, Jana Kovar, Megan SC Lim, Andrew McMichael, Elizabeth RC Millett, Irwin Nazareth, Jonathan S Nguyen-Van-Tam, Faiza Tabassum, John M Watson, Fatima Wurie, Maria Zambon, Andrew C Hayward, on behalf of the Flu Watch Group, Cohort Profile: The Flu Watch Study, International Journal of Epidemiology, Volume 46, Issue 2, April 2017, Page e18,

6. https://www.ecdc.europa.eu/en/seasonal-influenza/prevention-and-control/vaccine-effectiveness

7. https://www.who.int/influenza/vaccines/virus/recommendations/en/ 



Odgovor na Glavni Urednik

Re: Cijepljenje protiv gripe u pandemiji?

napisao/la Henrik Domes -

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Re: Cijepljenje protiv gripe u pandemiji?

napisao/la Hadiya Sulyan -
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Re: Cijepljenje protiv gripe u pandemiji?

napisao/la Brian Sheppard -
This flu season is especially tricky. Vaccination is key, particularly for pregnant women, young children, the elderly, and healthcare workers. Speaking of accuracy, remembering to get vaccinated is like aiming precisely in Ragdoll archers . One well-placed shot can make all the difference. Don't let this season catch you off guard; protect yourself and others!
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Re: Cijepljenje protiv gripe u pandemiji?

napisao/la Molly Lawrence -
This is a really helpful reminder about flu season, especially with COVID still around. Getting vaccinated seems like the smartest move. It's interesting how the WHO prioritizes pregnant women for vaccination. Makes you think about prioritizing your health like mastering a controlled drift in a game like Drift Hunters, but this is real life! Taking care of ourselves is crucial, especially during these times. Thanks for sharing this important information.

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Re: Cijepljenje protiv gripe u pandemiji?

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Odgovor na Glavni Urednik

Re: Cijepljenje protiv gripe u pandemiji?

napisao/la Grace Davidson -
This is a really helpful reminder, especially with the unpredictable nature of respiratory illnesses these days. It's good to see the emphasis on vaccination, particularly for at-risk groups. Staying healthy feels more important than ever, almost like trying to master the slopes in Snow Rider 3D - you need to be prepared for anything! Hopefully, with increased awareness and vaccination, we can navigate this season with fewer complications. Thanks for sharing this important information!

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