In Hungary, there are certain types of vaccines which are not mandatory but recommended for children in order to prevent severe and life-threatening infections.
Vaccines against meningococcal infection
Meningococci bacteria called Neisseria meningitidis accounts for throat and pharyngeal inflammation in mild cases and might cause myelitis and encephalitis or blood stream infection (sepsis) in severe ones. The disease spreads among humans by droplets and occurs usually in early spring affecting infants. Asymptomatic, but carrier individuals also play an important role in its transmission. There are effective vaccines available against five variants of meningococci (A, B, C, W, Y). In Hungary, the B and C are the prevailing variants. It is most common in young infants and in the adolescents.
Vaccination is recommended for people below the age of 25, and for those who are at greater risk of getting infected because of their illnesses (people with asplenia or the immunocompromised) or traveling. Adequate protection can be achieved with a booster vaccine after the proper series of vaccination.
There are separate vaccines available against variant B and C, and another, combined, quadrivalent vaccine against A, C, W and Y types. The indication for booster vaccines should be evaluated individually based on their comorbidities. Vaccines against the C variant meningococci are available free of charge (but package fee must be paid) for infants at 2 and 4 months of age and usually at 15 months of age. Vaccines against the B variant are available for purchase at any pharmacies.
Vaccination for the adolescents is recommended above the age of 12 during the most “susceptive” period until the age of 26 and should be repeated in every 5 years. For outgoing individuals and for those pursuing studies abroad and studying at international institutions the quadrivalent (A, C, W, Y) vaccine and the vaccine against variant B is recommended.
Vaccines against tick-borne encephalitis
The virus causing tick-borne encephalitis is spread by ticks from wild rodents to humans and usually causes a disease with mild symptoms, but in some cases it might cause a very severe condition, called encephalitis, with paralysis or even lethal outcome. The course of the disease has two phases. The first phase is characterized by flu-like symptoms, while the second one shows the prevailing symptoms of encephalitis. Human infection can be caused not only by ticks but also consumption of the milk of infected goats or cows.
In Hungary, two types of vaccines are authorized (FSME-Immun, Encepur), both contain inactivated virus. In order to develop an immune response, a primary series of vaccination is necessary with 2 vaccines 1-3 months apart from each other, followed by a booster vaccine 5-12 months later. Immunological protection can be sustained on the long run with booster vaccines, first given 3 years after the first booster vaccine, then repeated in every 5th year.
It is recommended to start the primary series of vaccination during the cold seasons. Please note, that the vaccine does not protect against other tick-borne diseases, such as Lyme disease.
Contraindications:
- children younger than 1 year of age,
- it is advised to start the vaccination 1 month after the tick-bite.
HPV infections, cervical cancer and their prevention
Vaccine against HPV is the second available “anti-cancer” vaccine. The human papillomavirus group involves more than 150 genetic types of viruses. The virus gets into the body through skin and mucosal microlesions and causes lesions. One third of the HPVs can be accountable for cervical, uterine, vaginal and rectal cancers and genital warts.
The most common malignant types are the type 16, 18, 31, 33, 45, 52 and 58, while type 6 and 11 are less malignant. In Europe, the annual prevalence of HPV-related cervical cancers is 34.000 with 13.000 deaths, while in Hungary, the annual prevalence is 1 070 (according to epidemiological data collected in 2018). The appalling high number registered in Hungary is due to inadequate screening programs. In Hungary, instead of the necessary 2.5 million women, only 600.000 women participate in the screening for cervical cancer annually.
Human papillomavirus (HPV) vaccine types
Three types of vaccines are available against 2, 4 and 9 different HPV types:
- Cervarix: protects against type 16 and 18,
- Silgard: protects against type 6, 11, 16 and 18 (since 2018, it has been replaced with the 9-valent vaccine),
- Gardasil 9: protects against type 6, 11, 16, 18, 31, 33, 45, 52 and 58.
Children in Hungary can receive vaccination against HPV within the frameworks of school campaign vaccination in the 7th school year. Both girls and boys are eligible for the vaccination if they are at least 12 years old. Parents have to give their written declaration to claim the HPV vaccine for their children.
All three vaccines provide protection against type 16 and 18 which are accountable for cervical, vaginal, penile, rectal and vocal cord cancer in 70% of the cases. Type 6 and 11 are the ones which cause most frequently (90%) genital warts (condylomas). The vaccine containing the types of 31, 33, 45, 52 and 58 protects against 88% of malignant types. All three vaccines contain purified proteins of the virus; therefore, they do not cause disease.
Please note that vaccines do not treat the already developed disease. Depending on lifestyle (i.e. the number of sexual partners) vaccination is recommended in older age groups as well. HPV positive women can also be vaccinated, since the vaccines protect against more types of HPV.
Vaccination for men is also recommended, primarily with the 9-valent vaccine.
Important to note: vaccination does not substitute regular gynecological screening test!
Vaccines against severe rotavirus infections
Rotaviruses are accountable for the majority of diarrheal infections in infants and neonates. The first rotavirus infection is the most severe among children at 3-36 months of age, high fever, vomiting and diarrhea might lead to exsiccation within hours. Tens of thousands of children are treated in hospitals annually due to this infection.
We are affected by rotavirus infection multiple times during our lives, but these infection may be especially dangerous for children below the age of 3. Ninety-eight per cent of infants receiving vaccination develop immunity against the severe infection, and three-quarters of them never gets infected.
Two types of oral vaccines are authorized against rotavirus infections:
- RotaTeq vaccine has three doses:
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- it can be started at 6 weeks of age, 4 weeks apart,
- it is recommended to finish the vaccination series until 20-22 weeks of age, but no later than 32 weeks of age,
- infants above 8 months of age cannot get vaccinated.
- Rotarix vaccine has two doses:
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- the first dose can be started from 6 weeks of age (but must be administered before 16 weeks of age),
- the second dose must be administered no later than 24 weeks of age,
- vaccines must be administered at least 4 weeks apart,
- infants above 6 months of age cannot get vaccinated.
Contraindication for vaccination:
- high fever,
- diarrhea,
- severe acute disease.
Vaccination must be postponed in these cases. The immunocompromised (patients with malignant disease, with congenital immunodeficiency and those receiving steroids) and patients with congenital gastrointestinal abnormalities cannot be vaccinated.
Vaccines against influenza virus
Flu spreads as an epidemic and might cause severe disease. Since the virus is highly variable, it is necessary to administer flu shots annually. Vaccines contain the same type of virus around the whole world. In Hungary, flu shots contain inactivated viruses, therefore vaccinated individuals cannot get infected from the vaccine.
Flu shots are recommended for everyone above the age of 6 months and for individuals in the environment of children below the age of 6 months. It is also advised for pregnant women and for their relatives to get vaccinated, especially if the 2nd and 3rd trimester of their pregnancy overlaps with the flu epidemic.
Recommended vaccines’ administration schedule
Some of the recommended (but not mandatory) vaccines are available free of charge. The first step of applying for the vaccination is contacting your GP who will inform you about the vaccination (how many vaccines and their scheduling) and prescribes the vaccine for your child.
With the prescription, you will be able to purchase the vaccine in any pharmacies. After the purchase, the GP will administer the vaccine and they will also provide you the necessary documents that verifies the vaccination.
