What do you need to bear in mind if you have Crohn's disease or you are caring for someone who does?

People with Crohn’s diseases must eat a varied and balanced diet, contributing energy and all the nutrients appropriate to the needs of each person according to age, gender, constitution and level of physical activity.

The balanced diet should be based on three rules:

• Daily food intake should provide the energy needed for the body to work properly.
• Each meal must provide the energy and non-energy nutrients to adequately cover the nutrition function.
• Nutrition should be consumed in suitable proportions.

Based on these rules, the Generalitat de Catalunya published its revised healthy food pyramid, based on the Mediterranean diet.

The Mediterranean diet is a model that has been recognised by the international scientific community as one of the healthiest and most balanced diets in the world. Based on the trilogy of wheat, vines and olive trees, it offers a variety of very important products that allow you to combine pleasure at the dinner table with nutritional and cultural balance.

Patients at the start of an outbreak and for as long as the outbreak continues, should follow a low-calorie diet. This will stop the inflammation in the intestines from getting worse. It is, therefore, necessary to personalise diets depending on the localisation, extent and type of lesions patients present.

Symptoms

Patients with traveller’s diarrhoea present with frequent and abundant liquid stools, which may contain blood and mucus.

Additionally, patients almost always experience abdominal pain, nausea, vomiting and often a high fever.

Who is affected by the condition?

Traveller's diarrhoea can affect anyone, especially those travelling to lesser developed countries.

It is most common in young travellers (20-35 years) and during long trips, usually occurring within the first few weeks.

Diagnosis

In most cases, since traveller's diarrhoea is self-limiting, no specific diagnostic measures are taken, but the symptoms are treated, especially with oral rehydration solutions to avoid dehydration.

Diagnosis by stool cultures that look for parasites, viruses or causative bacteria, is reserved for cases in which symptoms last more than a week.

Cases of traveller's diarrhoea usually occur on trips where healthcare is poor and oral rehydration should be started as soon as possible.

Standard treatment

The treatment of traveller's diarrhoea involves maintaining an adequate degree of hydration in order to maintain the amount of water, mineral salts and glucose that the body needs, and which are altered by the presence of diarrhoea and vomiting.

Oral rehydration solutions, either in liquid form or sachets for dissolving in clean water, are ideal in these cases. Degassed carbonated drinks may be a temporary solution if oral rehydration is not available.

If symptoms persist for more than four days, or are severe, medical advice should be sought, even in an area with poor healthcare.

The use of antibiotics in these cases has not been proven advantageous and is not advised.

The use of anti-diuretics is also debatable, as they may impede the expulsion of diarrhoea necessary to start the recovery process.

They are not always recommended.

Standard tests

Specific testing is not initially indicated.

Early treatment for diarrhoea with an oral rehydration solution is fundamental as previously indicated.

Prevention

Prevention is fundamental in order to avoid traveller’s diarrhoea though complete prevention is never possible.

Drinking water and water used for tooth-brushing must be bottled or sterilised with a sterilisation tablet for such use.

Only cooked foods should be consumed, never raw.

Salads must be avoided, above all.

Fruit should be eaten only after having been washed with clean water and peeled with a clean knife.

Basic recommendations

Do not let children in the kitchen while you are cooking.

Some of the utensils most associated with domestic accidents:

In the kitchen:

• Frying pans - hot oil or flame caused by oil
• Pressure pots and pans - hot liquids
• Glasses, mugs and plates - due to spillage of liquids
• Microwaves - due to liquids or depilatory wax
• Oven door - by contact, especially in children

In the bathroom:

• Unblockers - Sulphuric acid
• And caustic soda mixed or combined with bleach are highly dangerous, whether due to inhalation of the mixture or due to contact on explosion.
• Hot tap water: regulate boilers to prevent the water from causing burns. 

Rest of the house:

Electricity, plug sockets, electrical extension lead, clothes iron by contact or steam.

Other most common injuries

• Motorbike exhaust pipe
• Special attention when handling firecrackers and sparklers, (especially in children)
• Burning alcohol or gasoline in barbecues.
• Colognes or sprays near sources of heat (candles) 

What to do when you burn yourself, using some of the methods below:

• It is very important to move away from the source of the burn: flame, hot water, electricity, hot solid, steam, etc.
• Cool the affected area, thus halting the spread of the heat in the skin and body tissue, preventing the injury from getting any worse. This also works in acid burns as you will dilute the product and its impregnation into body tissue. Use cold water for 10 or 15 minutes depending on the agent that caused the injury.
• Once the area is cool, there may be some redness to the skin, with more or less pain or discomfort (hot water, superficial flame, sun burn).
• It can be soothed with water or cold cloths, and by applying moisturisers.

And above all, if the burn is very painful, visit a health centre.

If blisters appear, there is loss of skin, or white or pearly blotches after cooling, you must keep the affected area covered with gauze, a towel, a sheet, etc.

If there is pain, cold water can be applied to this cover.

If the injuries only cover a small area, you should first go to a health centre. For more widespread injuries, go to the hospital accident and emergency department or 112 emergency services.

If the burn is on the face, neck, hands, major joints, groin or perineum (the area between the genitals and the anus), it should be assessed by a specialist.

Special care should be taken with children and the elderly as they may require special attention to their injuries.

What do you need to bear in mind if you or someone close to you is planning an international trip?

The World Health Organization aims to prevent the international spread of infectious diseases. For this reason, recommendations are issued to help prevent these diseases and to suggest the necessary vaccines according to the nature of the trip. It is important to take into account that the majority of these illnesses can be avoided.

When you are planning a trip you should bear in mind a number of risks so that you can enjoy a healthy trip and avoid getting an infection. You should think about:

• Who is going on the trip: age, gender, if they are pregnant or not, if they suffer any acute or chronic illnesses, immunodeficiency such as HIV infection, allergies and what medication they normally take.
• Where the trip will take place and what itinerary will be followed: country, area and route.
• When it will start and at what time of year.
• What the reason for travel is: business, tourism, adventure, etc.
• What type of trip it is: independent or organised tour.

Once the previous point has been assessed, it is a good idea to establish a series of preventive measures, in the following three stages:

1st stage: before the trip

• Trips to tropical/subtropical areas should be planned in advance.
• Wherever possible, you should think about medical aspects and/or other aspects related to the trip.
• A basic medical kit (painkillers, disinfectant, antidiarrhoeal) must be prepared.
• If you suffer from a chronic illness you must take sufficient medication with you and carry a medical report.
• You should take out medical travel insurance.

2nd stage: during the trip

1. Think about the condition of foods and drinks, as well as taking certain hygiene and safety measures, such as:

• Wash your hands frequently before meals or when you have been to the toilet.
• If possible, drink bottled water. Hot drinks and bottled drinks are safer.
• Do not use ice cubes of unknown origin.
• Drink bottled milk and duly sanitised derivatives.
• You should be careful with pastries, desserts and ice creams.
• Avoid seafood and raw fish. Bear in mind that in some regions eating cooked fish may also be risky.
• Meals should be properly cooked and served hot.
• Be careful with sauces and dips containing raw egg.
• Peel your own fruit and ensure vegetables are cooked before eating them.
• Avoid eating foods from street stalls.

2. Climatological and physical factors must be taken into account: 

• Exposure to sunlight in some tropical countries may cause sun stroke. Sun protection filters are therefore advised (sun cream, hats, sunglasses with UV protection, etc.).
• Exposure to high temperatures and humidity may cause dehydration. For this reason, you should drink plenty of water.
• Staying in high altitude areas can be dangerous for people with heart and lung problems. You should ascend gradually for better acclimatisation.
• Bathing in rivers and lakes may expose you to parasitic diseases.
• Traffic accidents are one of the leading causes of death in low-income per capita countries. It is necessary, therefore, to take precautionary measures as far as possible.

3. You should consider the presence of insects and other animals (protection or barrier measures should be taken):

• When outdoors, at night and in the morning, wearing long-sleeved clothes and light colours is recommended while perfumes should be avoided, as much as possible, as they attract mosquitoes. On unprotected parts of the body, insect repellents containing DEET (N, N-Diethyl-meta-toluamide) should be used every 6 hours or frequently.
• When indoors, use anti-mosquito sprays or coils and vaporisers that contain pyrethrins. Use rooms with mosquito screens on the doors and windows, as well as nets around the bed. Where possible, you are advised to sleep in an air conditioned room.
• Contact with any type of animal must be avoided, as they may be exempt from health checks. You are advised to wear closed footwear to avoid the risk of being bitten (for example by snakes or similar animals).

4. Bear in mind time zone changes (jet lag)

• Jet lag consists of the physical and mental symptoms associated with changing time zone.
• The symptoms that may appear are: insomnia, irritability, loss of appetite and exhaustion. This factor affects both the journey out and the return trip.

5. Do not forget prevention of sexually transmitted disease

• The most effective way of avoided sexually transmitted disease is the condom.

6. It is important to respect the culture and customs of the countries you are visiting

3rd stage: after travelling

Should the person who has travelled have any health issues after returning from the trip or during travel, it is advisable for them to be medically assessed (at a primary care centre or a specialised travel clinic).

Likewise, you are advised to have a medical evaluation three months after travelling, since there are diseases that do not manifest themselves immediately. Healthcare staff will also need to be informed of you having travelled to a tropical zone up to 12 months after having done so.

Breastfeeding

Breast milk let-down may take 2 to 5 days after birth and the breasts may become swollen, hot, and may hurt. The best remedy is to breastfeed the baby to relieve symptoms and prevent breast engorgement or inflammation of the breasts. Mild discomfort is alleviated with a gentle self-massage towards the nipple, to facilitate emptying of the breast prior to breastfeeding. If the discomfort worsens and / or fever appears, you should consult the midwife or go to the emergency room. 

Care in case of an episiotomy or tear

If an episiotomy is performed or the perineum is torn, for the care of the stitches, the area should be washed with water and neutral soap once a day, keep the area dry, use cotton pads without plastic and change them frequently. 

An episiotomy heals 7-10 days after delivery and the stitches usually fall out on their own. In case of caesarean section, there is no problem with showering, as long as the stitches are dried well. The wound will heal in 5 or 6 days (full healing will take a few more days) and the stitches or staples will be removed between the sixth and the seventh day by the midwife at the health centre.

Postpartum bleeding 

Lochia is bleeding that occurs in the postpartum period and lasts 6 to 8 weeks after delivery. It changes colour and decreases in quantity over the days. The smell of this discharge is similar to that of menstrual flow. In the event that a bad odour occurs, it is recommended you visit the health centre or hospital to rule out the existence of an infection. 

Healthy habits and exercise

• It is important to maintain adequate fluid intake and a varied and balanced diet. The postpartum period is not a good time to follow restrictive diets (weight loss). 
• It is recommended you increase your daily intake of fibre and water to promote intestinal transit. 
• Rest should also be encouraged whenever possible, taking advantage of the baby's sleep periods and organising visits from family and friends. 
• A daily 30-minute walk will help decrease swelling in your legs and feet and prevent the risk of circulatory complications, which is greater during this stage. 
• It is recommended that Kegel exercises are begun, which help to strengthen the pelvic floor muscles, progressively, increasing the frequency and intensity to adapt to the mother's physical state and customising them in each case,
• It is important to start practising sports gradually and to leave moderate or intense exercise for later.

Postpartum depression 

In the postpartum period, feelings of sadness and frequent mood changes (sadness, crying and euphoria) may occur. It is a normal adaptive reaction to changes and is known as maternity blues or postpartum depression. 

It can occur between the 3rd and 5th day after delivery and disappears after approximately 15 days. If this situation lengthens over time or symptoms worsen, the midwife or the nearest qualified professional should be consulted. 

Reviews  

The first postpartum review with the midwife is usually carried out around the seventh day after delivery. It is advisable to attend with your partner, in order to assess the adaptation and resolve any doubts or difficulties, and with the baby, to be able to assess breastfeeding.  

After 6 or 8 weeks following delivery, another routine visit is carried out, where the general physical and psychological state of the mother and breastfeeding are assessed. It is a good time to consider contraception, and the condition of the pelvic floor and its musculature should be assessed.  

It is necessary to attend the baby’s monitoring visits with your paediatrician and with the infirmary. 

Quarantine

During "quarantine" it is recommended you avoid:

• immersions in water;
• the use of tampons.

If the woman wants to have sex, this can be restarted during this period. It is recommended that a condom is used.

The first menstruation appears around 40 days after delivery in mothers who are not breastfeeding. Those who breastfeed their children do not generally resume their menstrual cycle until weaning, although they are not, even so, without risk of pregnancy.

Contraceptive methods

It is recommended you find out about contraceptive methods from the midwife of the primary care centre. It must be customised in each case and take into account whether there is breastfeeding or artificial feeding, since this, along with other health history, will help define the most appropriate method. Emergency contraception is a valid option also for this period.

Watch out for warning signs

It is necessary to go to the emergency department or consult your midwife upon the occurrence during the postpartum of these warning signs:

• Fever of 38°C or higher. 
• Large clots and increased vaginal bleeding.
• Pain in the lower belly area.
• Bad smell of lochia (bleeding that occurs during postpartum).
• Pain, tension and redness in the area of the stitches.
• Hot, burning discomfort when urinating...
• Redness, pain and warmth in the breasts that is not relieved after breastfeeding the baby. 
• Chest pain, with a feeling of shortness of breath.
• Pain in the calves or thighs (with redness, pain and heat).
• Severe depression after two weeks.

-  Help your children to build up their self-esteem, independence and responsibility. We need to show them how to be able to say no, how to deal with frustration and the desire for immediate gratification, and how to accept refusals. We need to talk to them and to listen from a very young age, and we need to be aware of their friendships and encourage them to take up a healthy lifestyle and healthy habits (sport, food, sleep, hygiene etc.)

-  Having all these internal resources at hand will help them to successfully face situations where they feel exposed to consumption.

-  Ask them what they know about cannabis and spot their mistakes.

-  Demystify the beneficial use of cannabis and debunk myths:

• there is an urban legend doing the rounds that claims tobacco is more harmful than cannabis.
• Tell them how, despite having some sedative effects, cannabis can cause anxiety in the long term.
• Tell them how joints must not be seen as an easy way of relating to or creating a group of friends, and that there are other healthier forms of leisure.
• Tell them that it must not be seen as a form of identity or rebellion, but as something that can actually harm them.
• Give them information on the true benefits of some cannabinoids prescribed in a regulated way. Compare that information with the harm that cannabis can cause: whoever mixes it with tobacco will also be inhaling toxic tobacco substances, which will harm them all the more if smoked without a filter.
• When it is illegally sold:
  • as a product it can be adulterated with harmful substances
  • it can lead to legal action, fines etc.
  • it can make it easier for a child to consume other illegal drugs that are also on sale in the black market
  • it can stunt a child’s physical, social and emotional growth
  • it can alter the functioning of a child's nervous system, with the physical and psychological consequences that this entails, etc.

-  Maintain a climate of trust with your children, make communication easy, talk when necessary about the consumption of substances.

-  Make the most of the questions and comments that arise around the consumption of cannabis, but you don’t need to exhaust the topic in one day.

-  Create doubts for your children to reflect on and be critical over. 

How to detect cannabis cunsumption among teenagers:

Adolescence is a time of numerous changes, all to prepare us for the transition from child to adult. But taking on all that is no easy matter. It is when our mind and body develop at breakneck speed and it can be difficult to make sense of it all.

That’s why it’s a key stage in life: it’s easier for risky behaviour to be adopted here that puts people’s health in danger. Sexual relations can occur without protection that lead to unwanted pregnancies or STD infections. But there is also another danger that usually starts at this time of life: the consumption of drugs.

If we focus on joints, the substance that is smoked in them is hashish. This is a brown-coloured ball- or bar-shaped paste that is prepared from cannabis resin. It is mixed with tobacco and rolled up in cigarette paper for consumption. In general, hashish is consumed because it relaxes people and lowers their inhibitions, which is why it can help improve relations with others.

What can we do if we “detect” our child is smoking joints?

• Avoid searching their clothes/room or questioning their friends, etc.
• Don’t prejudge them, tell them off, punish them or make accusations against them. Faced with imposed information or prohibitions, they will tend to reject instructions and any other information you may wish to give them.
• Speak to them directly, explain what you’re worried about and listen to their opinion.
• Don’t broach the topic if they’re under the influence of cannabis.
• Talk to them about it in private, in an intimate, comfortable space.
• Find a time to speak calmly.
• Assess how much they are consuming (trying it is not the same thing as smoking it when they go to a party or on a daily basis).
• If they're having problems from smoking, take the opportunity to broach the subject and help them to see its negative effects.
• Don’t make drastic or hasty decisions, make them together.
• Finally, if necessary, ask for professional advice or help and negotiate possible solutions with your child. 

There are different ways of avoiding burns:

• Sunbathe with sun protection and avoid exposure in the middle of the day.
• Use plug socket covers for children.
• Do not overload plug sockets.
• Do not use equipment or home appliances with cables in poor condition or extension leads in poor condition.
• Prevent children from being able to reach cables so that they cannot hurt themselves by biting them.
• Always follow the specific safety guidelines for each electrical device.
• Check electronic toys regularly to detect signs of wear and tear.
• Sparking appliances should be repaired or thrown away, as should those that overheat when turned on or smell odd.
• Electric heaters should be placed at least one metre away from beds, curtains or any other flammable object.
• Fire retardant sleepwear (polyester or treated cotton) should be used. Generally, clothing that is not classified as sleepwear is not fire retardant.
• Explain to little ones that glass doors on ovens or fireplaces can get very hot and burn you, so they are not to touch them.
• Do not leave children alone in the kitchen if someone is cooking. Keep children away from the hob or ceramic rings.
• Turn pan handles so that they do not stick out and such that children cannot reach them.
• You should not be holding or carrying a child while you are cooking.
• Do not drink hot drinks with a child on your lap.
• Do not carry hot liquids if you do not know where your children are, to avoid stumbling.
• The hot water thermostat should be set at 49°C or a low-medium level.
• Always check bath water temperature before putting your child in.
• Always turn on the cold tap before the hot tap and turn off the cold before turning off the hot. 
• In the bathtub, children should be placed with their back to the tap, so that it is less likely that they will accidentally turn on the hot water.
• Disconnect electrical devices in the bathroom when they are not in use.
• Avoid using steam therapy. Its effectiveness has not been proven, but its association with the risk of being burned has, especially in children under three years.
• No home fire (fireplace, barbecue, fondue) should be lit or revived by throwing flammable liquid directly from the bottle (for example, fuel alcohol).
• Do not use petrol to light a fireplace or barbecue. There are systems especially designed for this purpose.
• Have chimneys cleaned regularly.
• Do not smoke in bed, especially if you are tired or taking medication that makes you drowsy.
• Candles should not be lit at bed time. 
• Lighters, matches, chemicals and candles must be kept out of the reach of children. If necessary, locks or security systems may be placed on cupboards where cleaning products are stored.
• Always store cleaning products or similar in their original containers, never in plastic milk or water bottles.
• Always follows the instructions for use when using chemical products.

1. Exercise

When the body starts doing exercise the level of endorphins increases.

Choose your favourite kind of exercise. If you don't like going to the gym, try walking or running, which will bring you lots of physical and mental benefits without having to spend money. It can also give you a certain sense of freedom.

2. Eating a balanced diet

Diet has a fundamental influence on your mood, for example, if you do not ingest enough protein, it will be harder for you to secrete endorphins.

Enjoy meals and the accompanying sensations (smells, flavours, etc.), company, etc.

3. Getting enough rest

Try to sleep at least seven hours a night, which is the amount of time the body and mind require "to repair themselves" and to feel refreshed.

4. Alternative ways of managing stress and depression

Practise yoga, pilates, relaxation techniques such as guided meditation, mindfulness, visualisation, Jacobson's progressive relaxation technique, chromotherapy, aromatherapy, music therapy, and so on.

Practising these activities removes muscular contractions and causes you to experience a feeling of well-being and profound relaxation.

5. Communicate your emotions to the people you trust most

Expressing your difficult thoughts or feelings will take a weight off and your mood will improve significantly. The caresses and hugs of your loved ones can also help increase your well-being.

6. Think, speak and act positively

Try to see the positive things that surround you and use nice words to convey them. Be grateful.

Learn to forgive and forget, you will have a calmer life without accumulated resentment.

Enjoy the little everyday things, try to escape from routine and boredom. Always leave a door open to new projects.

Think that the unpleasant situation that you may be experiencing is just a momentary obstacle and this will help you to tackle problems with more motivation.

Avoid toxic comments or situations in which negativity predominates (complaints, gossip, etc.).

7. Write a diary or journal

If there is no-one close by with whom you can offload, starting to write is a good way of freeing yourself of negative thoughts. Express your thoughts and feelings in writing.

8. Spend time in contact with nature and enjoy the small things

The sun is an excellent anti-depressant. Look for sunny places so that your brain can continue secreting the happiness hormone: the beach, the mountains, etc.

Also, observe carefully everything around you in the place you have chosen (the colour of the sea, the clouds, the intense green of the trees, the sound of the waves, the birds...)

9. Go back to doing what has made you happy in the past or try to find something thaht will make you happy now

If you feel yourself beginning to feel sad or anxious, you can do activities that you know make you feel good when you are emotionally stable.

You may not want to start doing them again right away, but think about the result you obtained when you used to do it. If you liked going to the cinema before and now you don't like it, try to remember how much you enjoyed watching a good film... maybe this will encourage you to try again.

If you're not sure about what you like most and what gives you most satisfaction in life, try different activities such as doing a cooking workshop, gardening, drawing, playing an instrument, dance lessons, singing...

10. Join a group

Being part of a group often has good results for keeping you healthy and preventing possible depression. So, travel, walk, go for dinner or to the cinema with a group of people.

11. Do something to help others

Respect the environment, be more supportive, help your neighbour...

For example, signing up for volunteering will increase your self esteem. Helping others brings with it a feeling of physical, emotional and intellectual well-being.

12. Learn to spend time with yourself

Do something that you like and that makes you feel better. For example, a relaxing massage or a hot shower will cause the nerves of your skin to release endorphins; eat something that you like, walk along the beach or park, sunbathe, if you have a pet, go outside with it, watch a film, start a good book...

13. Adopt a pet

It can help keep you company and focus your attention on something else. Animals provide unconditional love and they can be useful in less motivated moments.

Stroking your cat or dog can make you feel very good.

14. Record your dialy activities

Record all the activities you do throughout the day. It's important to assess the good times in the day and make an effort to change the less good ones.

15. Cultivate your sense of humour

Smile and laugh, and if you cannot find anything to laugh at, join laughter therapy workshops. Laughter is undoubtedly one of the factors that increases our levels of endorphins.

Laughter makes your soul grow and gives you a simpler life perspective, without overwhelming problems or unpleasant situations.

Give up smoking

1. Make a list of reasons to stop smoking.

2. Set a day you want to stop by and get ready to achieve your goal.

3. Tell your friends and family the day you have chosen.

4. Cut down on unnecessary cigarettes.

5. Think of strategies to handle difficult situations.

6. Throw away any tobacco you have.

7. Avoid going to places where there is tobacco smoke.

8. Set yourself a daily challenge of not smoking.

9. Ask for help.

10. Look into pharmacological treatment options

What are the side effects of vaccines?

Most reactions to vaccinations are mild and do not last long (pain and redness at the site of injection, a high temperature, etc.). Vaccines are very safe and are subjected to very rigorous controls, at both the research and the manufacturing stage. The authorisation and subsequent marketing of new vaccines are regulated in Europe by the European Medicines Agency (EMA) and in Spain by the Spanish Agency of Medicines and Medical Devices (AEMPS). The benefits of vaccines far outweigh their risks.

Why do we need to vaccinate against diseases that are not found in our country?

Thanks to the success of vaccinations, some diseases have been eradicated and others are on the verge of being eliminated. It is, however, very important to continue vaccinating so that such diseases do not reappear. The resurgence of measles in Europe in the last few years is a good example of what can happen when vaccination coverage decreases.

Do vaccines contain mercury?

No, the vaccines administered in Catalonia do not contain mercury. Thiomersal is a derivative of mercury that is used as a preservative. The vaccines administered in Catalonia are in single dose form and therefore do not contain the preservative. 

Do vaccines contain aluminium?

Vaccines contain a small amount of aluminium (0.5 mg), which is not damaging to health. It is estimated that we ingest 8 mg of aluminium in our diet on a daily basis without causing us any issues.

Is it true that vaccines cause autism?

There is no connection between autism and vaccines. This false relationship comes from a study that was later shown to be fraudulent. Methodologically correct studies have found no connection between vaccines and autism.

Are too many vaccines administered to children in the first year of their lives?

No, the vaccines included in the systematic vaccination schedule protect against common, serious illnesses, and they are administered at the recommended ages and at the ideal intervals to favour a correct immune response. It is a myth that vaccinating small children overloads their immune system or that there are more adverse reactions.

Why is the Systematic Vaccination Schedule in Catalonia changed so often?

The Systematic Vaccination Schedule is constantly updated to reflect new scientific research and advances related to vaccines. Before a vaccine is included in the Schedule a scientific and financial assessment is done in order to implement the vaccination based on well established criteria.