✓ Vaccinations for adolescence provided for in the Vaccine Prevention Plan

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Vaccinations for adolescence

Adolescence is that period in which young people begin to experience life, to have new experiences and to make new friends. Children already feel "grown up", but parents still have the most significant task, that of protecting them and making some decisions for protect their health. One of the most important gestures to guarantee the well-being of children is always vaccination which allows them not to contract potentially very dangerous infectious diseases.

Do you think that until a few years ago most of the vaccination cycles ended in infancy and there were no specific vaccinations for adolescents. Thus in the vaccination calendars of the 90s the 11-18 age group had only a marginal role. Thanks to scientific research, we then came to the formulation of new vaccines, safe and well tolerated, suitable for the adolescent phase.

Today, according to the Ministry of Health, adolescence is a very important moment for the administration of boosters of vaccinations already carried out in childhood, and for new vaccinations to be carried out in this period of life such as that against meningococcus ACYW and against papilloma human virus (HPV). Let's see what are all the vaccinations for adolescence provided by the Vaccine Prevention Plan.

The importance of vaccinations for adolescence

In recent years, even if this is anything but a new phenomenon, the spread of messages with an unfairly alarming tone about the possible adverse effects of vaccines has meant that vaccination coverage did not reach the 95% threshold recommended by the World Health Organization. Without reaching this threshold it is not possible to guarantee the so-called herd immunity which also serves to protect all those people who cannot be vaccinated for health reasons. Thus, the typical childhood diseases, preventable with vaccination, have also moved towards adolescence and adulthood with non-negligible consequences. In this way, the teenager becomes the carrier of some diseases infectious that can affect unvaccinated subjects, such as children under 3 months, or very frail such as the elderly.

Furthermore, adolescence, despite the fact that in this particular historical moment the boys are deprived of the main moments of sociality, it remains a period in which young people go out and meet very often with their peers in places such as schools, gyms and discos (when they were still open) where an infection is more likely to spread.

It is therefore important to pay particular attention to adolescence, which has become crucial for vaccination campaigns that aim to protect not only the individual child, but the entire community made up of infants, children, adults and the elderly.

Read also: How to understand teenagers and really open up to them

The pandemic and the decline in vaccinations

Among the side effects of the pandemic, according to the Del Paesena Society of Pediatrics (SIP), there would also be the drop in vaccination coverage, especially in the adolescent age group where there has been a real collapse in vaccinations. Initially the blame was to be attributed to the lockdown, but as also highlighted in the SIP press release, many vaccinations have not been recovered.

The decline was particularly affected by vaccination against the papilloma virus, both in males and females, and vaccinations against various types of meningococcus. According to the President of SIP, Alberto Villani, this is a serious problem that cannot be overlooked, especially since vaccination, in addition to being a health device, allows doctors to interact with the kids, particularly tried by this period and the lack of sociality.

Villani is keen to remember that vaccinations are always important and if any were missed "you can and must always recover".

Read also: Adolescence: what it is and when it starts

What the Vaccine Prevention Plan provides

According to the National Vaccine Prevention Plan (at the moment the 2022-2022 one is still active):

immunization against diphtheria, tetanus, pertussis and poliomyelitis is recommended for all adolescents using combined vaccines with the adult dosages;
is critical check the vaccination status for measles, mumps, rubella and chicken pox and initiate or complete any incomplete vaccination courses by administering 1 or 2 doses of the vaccine depending on the situation;
Vaccination is recommended for both males and females against human papilloma virus (HPV) from the age of 12;
Quadrivalent vaccination against meningococcus ACYW135;
in the risk groups vaccinations against pneumococcus and hepatitis A are recommended, if not previously carried out, and that against seasonal flu.

Now let's see in detail all the vaccinations to be carried out during adolescence.

Read also: Compulsory and voluntary vaccinations. The calendar

The quadrivalent vaccine against diphtheria, tetanus, pertussis and polio (dTpa-IPV)

The National Vaccine Prevention Plan provides for the booster vaccination against pertussis, diphtheria, tetanus and polio for adolescents. The vaccine to be administered in this case will be the quadrivalent dTpa-IPV, a combined vaccine with the dosages foreseen for adulthood.

The diseases from which the dTpa-IPV vaccine protects

POLIO: an infectious disease caused by 3 different types of viruses that enter the body and invade the central nervous system. It is a very dangerous disease that can cause in severe cases paralysis and sometimes even death. Although the country was declared "Polio-free" in 2002 by the WHO, it is important to continue vaccinating children and young people not only because there has been a lowering of the antibody titre, but also because of the risk of import cases, such as for example from Syria where the infection has returned to circulate.

DIPHTHERIA: it is an infectious disease that is transmitted mostly by air. It is caused by a bacterium that causes very serious injury to organs and tissues and causes the formation of particular membranes in the nose, throat and larynx that can lead to suffocation, so much so that about 1-2 in 10 cases can be fatal.

TETANUS: tetanus is an acute non-contagious infectious disease caused by a toxin produced in turn by a bacterium, Clostridium tetani. The spores of the bacterium can survive in the external environment even for years, contaminating dust and soil, and can enter the human organism through a trivial wound. Once the toxin reaches the central nervous system, it causes diffuse contractions and spasms. Tetanus often leads to long hospital stays in intensive care units and can cause death in about 4 out of 10 cases.

PERTOSSE: it is a highly contagious infectious disease of bacterial origin that is transmitted by air. Whooping cough usually heals without consequences, but it can cause complications such as ear infections, laryngitis, pneumonia, convulsions and brain damage. Unlike other infectious diseases, the immunity conferred by whooping cough is not definitive but decreases over time, which is why vaccination is important. Furthermore, according to the Del Paesena Society of Adolescent Medicine, the epidemiology of pertussis is changing in Del Paese and the disease is concentrated in adolescents and adults who have lost immunity and who can therefore transmit it to the most fragile categories such as infants.

Read also: Whooping cough and vaccine: 10 things to know

When the vaccine is given

As indicated in the Vaccinal Calendar for Life 2022 by the Higher Institute of Health, "la timing with which the dTpa vaccine should be administered is every 10 years for life, but the first dose is recommended at 12 years, together with IPV polio vaccination (dTpa-IPV), that is 7-8 years after the fourth dose of DTPa vaccine (the formulation for children ed). If a subject has carried out the basic vaccination correctly, a booster dose is sufficient even if more than 10 years have passed since the last dose ".

Vaccination against diphtheria, tetanus, pertussis and polio in our country is compulsory and free up to the age of 16. With some rare exceptions, the dTpa-IPV vaccination is also free for adults.

Possible side effects

The dTpa-IPV vaccine is well tolerated and most reactions are mild. Fever is one of the most frequent side effects, and a transient local reaction may occur at the site where the vaccine was administered, manifesting as swelling, redness and pain. These effects typically occur within 48 hours of vaccination.

The human papilloma virus (HPV) vaccine

HPV vaccination is actively offered (at the invitation of the competent ASL or the Health Office) during the 12th year of age for both boys and girls with the aim of protecting adolescents before onset of sexual activity.

HPV infection

Human papilloma virus (Human papilloma Virus) is the more common than sexually transmitted infections and in fact it is estimated that over 80% of sexually active people become infected in the course of life. The risk of becoming infected begins with the first sexual contact and can last for a lifetime. In most people, HPV infection is transient (the virus is cleared by the immune system), asymptomatic (those infected do not notice anything) and heals spontaneously (resolution within 1-2 years of infection). In 10% of cases, however, the infection becomes persistent and in these cases it could cause cellular degeneration and tumor progression.

They exist beyond 100 types in HPV which can infect the human species and are distinguished on the basis of their carcinogenic risk. Papilloma viruses are responsible for 70% of cervical cancers, but they can also cause anogenital and oropharyngeal cancers in both women and men, hence the need to vaccinate adolescents, both boys and girls. Prevention is also about benign lesions but very annoying like warts.

The vaccine against papilloma virus

Vaccines used to prevent papillomavirus infection contain only particles of the external viral envelope and therefore cannot cause or transmit the disease. These are vaccines highly effective (90-100%) in both girls and boys before a possible infection. According to statistics from the US Centers for Disease Control and Prevention (CDC), published in a study in the journal Pediatrics, ten years of vaccination against human papilloma virus have cases of infection decreased by 64% virus among teenage girls.

The vaccination schedule provides for the administration of:

2 doses of vaccine 6 months apart in adolescents up to 13/14 years;
3 doses with a distance of 1-2 months (the second dose) and 6 months (the third) from the first dose for older children.

The Circular of the Ministry of Health of 24 April 2022 provides that the anti-HPV vaccination can also be offered to older boys and girls.

Read also: Sex and adolescents: the infection warning

For whom is vaccination free

In the 2022-2022 Vaccine Prevention Plan and in the new Essential Levels of Assistance (LEA), vaccination against human papilloma virus is offered free of charge to boys and girls over the age of 12. In Del Paese, most regions also provide for the facilitated payment for other age groups.

The possible side effects of the HPV vaccine

The HPV vaccines available in the country have a high safety profile, and safety is also confirmed by the results of the surveillance of the population that has been vaccinated for several years now. However, as with all medicines, some side effects may occur: the most frequent are redness, pain and swelling where the vaccine is injected; fever, headache, muscle and joint pain, gastrointestinal symptoms, itching, rash and hives may also appear. However, these symptoms are modest and of short duration.

Read also: HPV vaccine: 13 answers to the most common questions

The meningococcal vaccine

It is very important that a dose of quadrivalent meningococcal vaccine is also given during adolescence ACYW135, both to those who have never undergone the anti-meningococcal C or quadrivalent ACYW135 vaccination in childhood, and to those who have already received a dose because the number of antibodies tends to decrease with the passage of time.

The illness

Meningococcus (Neisseria meningitidis) can be present in the throat and nose of many people without ever causing discomfort but, in some cases, it can reach the meninges or spread throughout the body causing very serious infections (meningitis or sepsis) or more rarely pneumonia, arthritis, otitis and epiglottitis.

Transmission occurs through droplets emitted from the nose and mouth of infected or carrier people. The age group most affected by far is the one under the age of 5 followed by teenagers and young adults. The high number of cases of meningitis among children and adults under 25 is due to lifestyle (gatherings in closed and crowded places, exchanges of glasses, bottles or cigarettes).

They know each other 13 strains of meningococcus, but only five (A, B, C, W-135, Y) are capable of causing invasive diseases and epidemics. Of these, two (B and C) are responsible for the majority of cases in Del Paese, Europe and the Americas, although cases from types Y and W135 are also on the rise.

Vaccination against meningococcus

Vaccines against meningococci are obtained with fragments of the bacterium and therefore cannot cause disease. Vaccination against meningococcus according to the National Vaccine Prevention Plan 2022-2022, carried out with tetravalent vaccine ACYW135, is recommended for both adolescents who did not have meningococcal C vaccination in childhood and those who did.

The second booster dose for children vaccinated in infancy should be given to 13 14-years of age.

Meningococcal C vaccination with ACYW135 quadrivalent vaccine is participation for all children up to the age of 18.

Possible side effects of the ACYW135 quadrivalent vaccine

The vaccine is well tolerated and sometimes disorders such as redness, swelling and pain at the administration site occur. Headaches, muscle or joint pains and fever, sometimes high, may also appear transiently.

Read also: Meningitis in Del Paese: everything you need to know

The measles, mumps, rubella and chicken pox vaccine

In adolescents it is very important to check the status of infectious diseases such as measles, mumps, rubella and chickenpox because their danger increases if they are contracted during adolescence or in adulthood. Viruses that cause measles, mumps, rubella and chickenpox continue to circulate throughout Europe, which is why vaccination is important.

The National Vaccination Prevention Plan provides that children who are not immunized or who have not completed the vaccination cycle are vaccinated. The Plan also provides that children who are not immunized naturally or that we have not previously received vaccination are vaccinated at age 12 with 2 doses of chickenpox vaccine.

Vaccination against measles, mumps, rubella and chicken pox is compulsory and free up to 16 years of age.

The possible side effects of the measles, mumps, rubella and chicken pox vaccine

Typically the vaccine is well tolerated, the most frequent side effects are redness and swelling at the point of administration, which however disappear quickly.

At a distance of 5 14-days from vaccination, fever or other symptoms related to diseases such as rash and swelling of the parotids may appear. Very rarely instead they can manifest themselves febrile seizures.

At a distance of 1 3-weeks from vaccination in adolescent and adult women, joint pains may appear which resolve in a short time. Even rarer is a transient drop in platelets (thrombocytopenia) in the 2 months following vaccination, complication ten times more frequent if you get sick naturally.

It has been scientifically proven that the measles, mumps, rubella (MMR) vaccine does not cause, stimulate, or contribute in any way to the onset of autism spectrum syndromes.

Read also: The situation of measles and chickenpox in Del Paese and vaccination hesitation

Vaccinations against influenza, pneumococcus and hepatitis A

Finally, vaccinations against pneumococcus and hepatitis A (if not previously carried out) and against the flu are recommended and offered for free by the Ministry of Health for individuals belonging to risk groups.

In particular, vaccination against hepatitis A is very important for adolescents because due to their lifestyle they may be more exposed to this virus that is transmitted via the fecal-oral route, just think of the ease with which boys and girls drink from the same glass or from the same bottle.

What to do after vaccinations

- serious adverse events vaccinations are really related very rare, but not impossible, and that is why immediately after the administration of a vaccine it is important that the children together with the parent who accompanied them remain in the waiting room for half an hour. In this way, if adverse reactions occur, medical personnel can intervene immediately.

In very rare cases, in fact, immediately after vaccination, as well as after the administration of a drug, serious allergic reactions (anaphylactic shock) may occur that doctors are prepared to manage.

More common after vaccination are reactions such as:

fever;
pain at the injection site;
fatigue and loss of appetite;
muscle aches.

Reactions such as vomiting and diarrhea are less frequent.

In any case, all possible adverse reactions to the vaccine are reported and evaluated by the competent bodies, according to the precautionary principle: even events not necessarily related to vaccination are in any case recorded and analyzed.

Sources used:

Ministry of Health, National Vaccine Prevention Plan 2022-2022
Epicenter - National Institute of Health, tetanus
Epicenter - Higher Institute of Health, diphtheria
Epicenter - Higher Institute of Health, whooping cough
Epicenter - National Institute of Health, poliomyelitis
Epicenter - National Institute of Health, meningitis
Epicenter - Istituto Superiore Sanità, measles
Epicenter - Higher Health Institute, HPV

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Vaccinations for adolescence provided for in the Vaccine Prevention Plan