Should I get vaccinated or not?
Nikolay Briko: "Vaccines have become a victim of their success"
Against the background of today's epidemiological well-being, people have forgotten what infections are and how dangerous they are, and easily fall into the trap of those who invent stories about the allegedly negative consequences of vaccinations. However, the fact that vaccination is the most effective preventive measure is confirmed by history itself: in the XVIII century, the average life expectancy was 35 years. Over the XX century, life expectancy has increased by 30 years – largely due to vaccinations. Nikolay Briko, Head of the Department of Epidemiology and Evidence-Based Medicine of the I.M. Sechenov First Moscow State Medical University, Chief Freelance Epidemiologist of the Ministry of Health of Russia, told the Russian Agency of Medical and Social Information about the importance of immunoprophylaxis and the groundlessness of "anti-vaccination" arguments, the need to expand the National Vaccination Calendar and the emergence of new infections.
– Nikolai Ivanovich, in Russia, and throughout the world, a heated discussion has recently unfolded on the need and benefits of vaccination. What arguments can be drawn in favor of vaccines? Or maybe it makes sense to refuse any vaccinations? Perhaps vaccination is not so harmless?
– Should I get vaccinated or not? This issue has recently acquired almost global significance, although moms and dads themselves were vaccinated at one time without fail and in accordance with the immunization schedule. Since then, vaccines have been constantly improved, but the paradox is that many, having got rid of the fear of infections, have gained fear of vaccines that worked so effectively against these infections. Vaccines have become a victim of their success. Preventing the spread of infections through immunization is without a doubt one of the greatest achievements of mankind in the field of medicine. In 1999, the Center for Disease Control (CDC) The USA has published a list of the 10 greatest achievements of healthcare of the XX century. The first on this list is immunoprophylaxis.
There is no other healthcare program that has produced such impressive results. Almost during the life of one generation, more than 10 severe infections were eliminated or reduced to isolated cases. On a global scale, smallpox has been eliminated, polio has been eliminated in most regions.
At the same time, 220 years of experience in the use of vaccines has revealed the phenomenon of the so-called "vaccine dependence of the population". What does it mean? Not only the termination, but even a reduction in the coverage of the contingents subject to vaccination with routine immunization leads to an epidemic return of diseases controlled by means of vaccination prevention. If the level of vaccination coverage falls below the threshold, and 95% is considered to be such, there is a high risk of infection returning and an epidemic. There are many examples of this, including polio in Tajikistan in 2010, diphtheria in the CIS countries in the 90s, measles and whooping cough in Europe, Canada, England, the USA, etc.
Globalization in all spheres of human activity, intensive migration processes determine the danger of introducing the pathogen into those territories where it does not exist or it has already stopped its circulation. And with a low level of vaccination coverage, there is an imminent danger of epidemic spread of infection.
In the last decade, due to the emergence of new problems and challenges, interest in vaccination has increased significantly. WHO notes that the present century should become the century of vaccines, and immunization will become the main prevention strategy. Its tasks have significantly expanded in modern conditions: today it is not only reducing morbidity and mortality, but also ensuring active longevity. The importance of active immunization against influenza in reducing the mortality of the population from diseases of the circulatory system, as well as the frequency of relapses of chronic cardiovascular diseases, has been scientifically substantiated. The role of vaccination in preventing the development of cervical cancer, liver cirrhosis and hepatocarcinoma has been established.
I would especially like to note that in addition to its exceptional effectiveness, vaccination has also demonstrated its safety. All myths about the dangers of immunization do not stand up to criticism and do not correspond to reality. It should also be noted that the risk of some kind of severe reaction or post-vaccination complication is not comparable with the risk of complications and death in the disease. Even with a mild form of the disease, complications are not uncommon, which are difficult to prevent, since there are no specific treatments for a number of viral infections. And such a global danger as antibiotic resistance is increasingly reducing the effectiveness of treatment for bacterial infections. In such conditions, the importance of vaccination increases, since it provides effective protection even with subsequent infection with an antibiotic-resistant strain of the pathogen.
According to WHO experts, today there are all prerequisites (theoretical, organizational, economic and technological) for stopping the circulation of polio and measles viruses, which is laid down as a long-term goal of vaccination in the first decades of the XXI century. The solution of this problem will make it possible to cancel vaccination against infections caused by these pathogens. The XXI century, according to WHO definition, is called the century of struggle and elimination of some infectious diseases. There is every reason that in the 1st half of the XXI century, diseases such as measles, polio, neonatal tetanus, congenital rubella will disappear.
– According to Rospotrebnadzor, due to immunization, the incidence of measles in 2016 decreased by 5.2 times. At the same time, the incidence of whooping cough has increased by 28%, and the incidence of mumps is also growing (5.7 times). Why did vaccination not help to cope with these infections?
– In the pre-vaccination period, the incidence of infectious diseases changed in waves. With an increase in the number of people who had a particular infection, the frequency of this infection also decreased. However, a few years later, against the background of low morbidity, the layer of susceptible individuals increased, which led to an outbreak of infection. Periodic increases in morbidity (measles, rubella, etc.) were usually registered after 4-5 years and had no tendency to decrease before the start of mass vaccination. Vaccination led not only to a sharp decrease in morbidity, but also radically changed its annual dynamics, uniformity over the years, led to almost complete absence of seasonal increases in morbidity.
The complication of the measles and rubella epidemic in the countries of the European region is associated with a decrease in vaccination coverage of the child population. In Russia, by carrying out additional measures to immunize the population, including children, in 2015-2016, it was possible to stabilize the epidemic situation for measles and achieve the lowest rates of rubella incidence for all the years of observation. At the same time, despite the large coverage of children with vaccinations, conditions remain for the circulation of the causative agent of whooping cough. The incidence of whooping cough has been increasing over the past 10 years. New conditions have emerged for the development of the epidemic process, the peculiarity of which is the relative increase in the incidence of whooping cough in older age groups, which indicates the accumulation of non-immune individuals in this age group. The most pronounced rates of morbidity increase were observed in the age group of 6-10 years.
All of the above requires a change in the tactics of immunization against whooping cough: the introduction of a second revaccination in 6-7 years, immunization of adolescents, adults, persons surrounded by newborn children (cocoon technology) using vaccines containing an acellular pertussis component. In economically developed countries, revaccinations against whooping cough are carried out in 4-6 and 11-15 years, which reduces the incidence rates in schoolchildren. Revaccination against whooping cough can be recommended for adults with a high risk of whooping cough infection – medical workers, employees of preschool children's institutions and teachers.
The increase in the incidence of mumps is associated with shortcomings in the organization of vaccination of this infection in previous years in certain regions, which led to the accumulation of non-immune contingents among young adults and the formation of multiple foci of infection in families and collectives.
– Are there any objective arguments against vaccination? Why have there been more anti-vaccinators lately, according to subjective estimates?
– It was the fear of post-vaccination reactions and complications more than two centuries ago (immediately after the start of mass vaccination) that became the main cause of anti-vaccination moods. Addressing the population, anti-vaccination fighters operate with a set of cleverly packaged false information that defames vaccination in general and individual vaccines in particular. It is thanks to the mythical nature of anti–vaccination disinformation that circulates in the minds of the population - despite and simultaneously with the facts that refute it.
Vaccines are safe. In most cases, the vaccine causes a minor and temporary reaction, such as a painful sensation in the arm or a slight increase in temperature. Serious side effects are extremely rare and are carefully monitored and investigated. The chance of getting serious consequences as a result of a vaccine-preventable disease is much greater than from the vaccine itself. For example, in the case of polio, the disease can cause paralysis, measles can cause encephalitis and blindness, and some vaccine-preventable diseases can even cause death. Although any serious damage or death from vaccines is unacceptable, the benefits of vaccination far outweigh the risk, and without vaccines there will be significantly more cases of illness, disability and death.
In a sense, vaccines have become victims of their own success. Diseases that once caused fear and a desire to get vaccinated are now rare. And therefore there was a false and dangerous sense of complacency among the population.
The most important direction is to ensure adherence to vaccination of medical workers, the population, opposition to the anti-vaccination movement. Even in the recent past, when infectious diseases were widespread and caused severe complications, and often fatal outcomes, the population did not think about the need for vaccination: the need for vaccinations was an axiom. Its effectiveness was evident. Today, the population hears about the positive role of vaccination only in "dry" statistics, and any case of post-vaccination complications, sometimes in the absence of a confirmed connection with vaccination, is "inflated" by the media, causing lively public interest.
The situation is also aggravated by the lack of commitment to vaccination among some medical professionals, which is unacceptable from the point of view of professional ethics. At the same time, the attitude of the population to vaccination, as sociological studies have shown, is formed by primary health care doctors.
In order to counteract the anti-vaccination movement, it is necessary to ensure the objectivity of the information provided in the media, reflecting the ratio of benefits and harm from preventive vaccinations, it is necessary to allocate targeted funds for the needs of vaccination work. The state should bear the costs of organizing and conducting a campaign against anti-vaccination propaganda, which is gaining strength against the background of epidemic well-being, and legislate the responsibility of medical workers for conducting anti-vaccination propaganda (deprivation of the right to engage in medical activities). Vaccination should not be a manipulation imposed from above, but a conscious necessity of everyone, an integral element of the common culture.
It should be noted the significant role in the pro–vaccination movement in the Russian Federation of the NASCA website (National Association of Specialists in the Control of Infections Related to the Provision of Medical Care) "I am vaccinated" and the marathon "Vaccination is a healthy nation!", implemented using state support funds allocated as a grant in accordance with the decree of the President of Russia.
Online seminars on topical issues of immunoprophylaxis with the participation of leading specialists of the country were held on this portal in the section "Specialists on vaccinations". In November 2016, the information portal was included in the list of WHO sites in the section "Vaccine Safety Network" – Vaccine Safety Net World Health Organization.
– As for mass vaccination, for example, influenza. In 2016, 40% of the Russian population participated in the campaign. Meanwhile, the incidence from January to December 2016 increased by 1.8 times compared to the same period in 2015. Why is the incidence increasing despite the expansion of the vaccinated base?
– The flu is much more than an unpleasant disease. This is a serious disease that annually claims 300-500 thousand human lives worldwide. Pregnant women, young children, the elderly with poor health and anyone with any pathology, such as asthma or heart disease, are at greater risk of severe infection and death. An additional positive effect of vaccination of pregnant women is the protection of newborns (currently there is no vaccine for infants under 6 months). Vaccination provides immunity against the three most common strains circulating in any given season. This is the best way to reduce the chance of getting a severe flu or infecting other people with it. Avoiding the flu means avoiding additional medical expenses and loss of income as a result of missed days of work or study.
I would like to emphasize the incorrectness of comparisons of the incidence of influenza in certain periods of the year. It is necessary to compare the incidence in epidemic seasons, and not by months of the year. Only on the basis of such data it is possible to draw conclusions about the level of morbidity and mortality from this infection, in which the seasonal rise is sharply pronounced, and the manifestations of the epidemic season differ both in the timing of the beginning and end, and the intensity of the epidemic process in certain periods of the year.
An analysis of the incidence of influenza in the population of the Russian Federation over the past 20 years has shown that influenza immunoprophylaxis leads to a significant reduction in morbidity, prevention of complications and reduction of mortality among the population. Annual immunization against influenza is the main effective way to reduce the intensity of seasonal epidemic upsurge, reduce the number of severe forms of the disease and mortality from influenza, and also helps to reduce the incidence of infections caused by respiratory viruses of non-influenza etiology.
In 2015-2016, almost 14 million people (about 10% of the Russian population) fell ill with SARS. 74,250 cases of influenza have been registered, of which 40,792 cases have been laboratory confirmed, which is 50.69 and 27.85 per 100 thousand population, respectively. At the same time, in the 2015 – 2016 season, the incidence of SARS in the unvaccinated population was 7.8 times higher, and influenza was 14.4 times higher than in the group vaccinated against influenza within the National Calendar of Preventive Vaccinations.
According to the analyzed data, in 2016-2017, almost 22.7 million people (about 15.5% of the Russian population) fell ill with SARS. 50,014 cases of influenza have been registered, of which 35,598 cases have been laboratory confirmed, which is 34.15 and 22.26 per 100 thousand population, respectively. I would like to emphasize that the incidence of influenza in the unvaccinated population was 15.6 times higher than in the group vaccinated against influenza within the National Calendar of Preventive Vaccinations, which confirms the significant impact of vaccination.
The mortality rate from influenza in the 2016-2017 season was more than 17 times lower than in 2015-2016. In preparation for the 2016-2017 epidemic season, influenza vaccination coverage amounted to 55.84 million people, i.e. 38% of the country's population (for comparison, 31.3% in 2015-2016). This is the maximum coverage of vaccinations for all years of immunization.
The analysis of fatal cases revealed the main causes that could lead to the death of patients: lack of immunization in 97-98% of the dead; late seeking medical help – later than the fifth day from the date of the disease; late hospitalization / refusal of hospitalization; the presence of severe concomitant pathology, especially combined.
It should also be noted that influenza vaccination today is not only a prevention of the spread of the disease, a reduction in mortality, but also the fight against drug resistance, as well as a factor in reducing the economic costs of healthcare to counteract annual influenza epidemics. The economic damage caused by the epidemic of influenza and SARS in Russia annually accounts for at least 80% of the economic losses caused by infectious diseases. In 2015, the economic losses associated with this group of infections amounted to 450 365 364.7 thousand rubles. The rating of economic damage from influenza decreased from second place in 2005 to tenth in 2015 (1,250,582.2 thousand rubles). The prevented economic damage from labor loss alone amounts to almost 8.5 billion rubles. excluding medical expenses.
– The percentage of post-vaccination complications is also growing: in 2016, they were registered by 7% more than in 2015. What is the reason?
– According to the WHO position, the identification of post-vaccination complications with their subsequent investigation and adoption of measures increases the perception of immunization by society and improves medical care. This, first of all, increases the coverage of the population with immunization, which leads to a decrease in morbidity. Even if the cause cannot be established or the disease was caused by a vaccine, the very fact of investigating a case of a post-vaccination complication by medical professionals increases public confidence in vaccinations.
The Russian system of registration and investigation of post-vaccination complications has existed for more than forty years. Post-vaccination complications (PVO) and unusual reactions after the use of medical immunobiological drugs are included in the list of mandatory detectable in each case and are the subject of an extraordinary report to Roszdravnadzor and Rospotrebnadzor. According to the law "On immunoprophylaxis of infectious diseases", information about air defense is subject to state statistical accounting. Almost all types of post-vaccination reactions are known, the possibility of their occurrence is recorded in the instructions for the use of vaccines. The possible frequency of their occurrence is also given.
Over the past 10 years, the number of post–vaccination complications (PVO) has decreased significantly: if in 2006-2012 their number was about 500-600 annually, then in 2015 202 cases were registered (among children 181 cases), and in 2016 - 221 (among children 202 cases) of adverse events in the post-vaccination period. Moreover, in terms of the number of vaccinations made (more than 110.6 million annually), the frequency of air defense is only 1 per 550 thousand vaccinations. It would be wrong to talk about an increase in their number, because the number of air defenses has changed insignificantly, in addition, the Ministry of Health is currently doing a lot of work to improve the system of accounting, registration and investigation of post-vaccination complications in the country. These actions may lead at first to an increase in their detectability.
All vaccines used in the Russian Federation undergo mandatory quality control in accordance with the established procedure. At the same time, during immunization, as with the use of most other medicines, it is impossible to exclude the possibility of complications and reactions, and therefore the law provides for social protection of citizens in the event of post-vaccination complications.
– What are the main causes of post-vaccination complications? And how to protect a child from them?
In some cases, after immunization, pathological processes occur that are not characteristic of the usual course of the vaccine reaction and are known as post-vaccination complications. They cause pronounced, sometimes severe disorders of the body's functions, sometimes threatening human life. Unlike post-vaccination reactions, complications rarely depend on the composition of vaccines, and their main causes are considered:
- violation of vaccine storage conditions (contamination of the vaccine, storage of diluted vaccine for more than 6 hours, overheating for a long time, hypothermia and freezing of vaccines that cannot be frozen);
- violation of the vaccine administration technique, violation of the instructions for the introduction of the vaccine. Subcutaneous administration of adsorbed vaccines can lead to the formation of aseptic infiltrates. The introduction of BCG subcutaneously usually leads to the development of an abscess;
- individual characteristics of the body (unexpectedly strong allergic reaction to repeated administration of the vaccine);
- infection attachment – purulent inflammation at the injection site and infections in the incubation period of which the vaccination was carried out).
A coincident infectious disease and vaccination can be mistaken for a post-vaccination complication. As a rule, the main preventive vaccinations within the framework of the National Calendar are carried out for young children and newborns when the incidence rate is high and symptoms of congenital or neurological diseases appear. At the same time, the vaccine or vaccination may be mistaken for the cause of these coincidentally coincident diseases or deaths.
All cases of complications and unusual reactions that have developed after the use of bacterial, viral and serum preparations are subject to special accounting and investigation. Most vaccines have been used for decades, so the typical reactions should also be taken into account. For example, the rubella vaccine cannot cause gastritis, but at the same time it can cause short-term swelling of the joints.
Usually, reactions to vaccinations with inactivated vaccines (DPT, ADS) occur on the 1-2 day after vaccination and pass independently within 1-2 days. After vaccination with live vaccines, reactions may appear later, on the 2nd-10th day, and also pass without treatment for 1-2 days.
The safety of vaccination from the position of the vaccinated is ensured by the use of a high-quality drug, proper selection for vaccination, compliance with vaccination techniques. Before vaccination, the doctor (paramedic) must carefully collect the patient's anamnesis (previous diseases, including chronic ones, the presence of reactions or complications to previous vaccinations, the presence of allergic reactions to medications, products, the presence of seizures, individual characteristics (prematurity, birth trauma, corticosteroid therapy, etc., contact with infectious patients in the family, including tubification, etc.), the timing of previous vaccinations, for women – the presence of pregnancy).
Persons with chronic diseases, allergic conditions, etc. if necessary, they are subjected to medical examination using laboratory and instrumental methods. If necessary, the doctor conducts individual preparation of the patient for immunization, including with the use of medications. Thermometry should be performed immediately before the preventive vaccination. The results of a doctor's examination, thermometry, laboratory and instrumental studies and permission to administer a specific vaccine should be recorded in the relevant medical documentation. Persons at risk of post-vaccination complications are prepared for vaccination under the supervision of an immunologist according to an individual scheme. After the vaccination, medical supervision of the vaccinated is mandatory for at least 30 minutes.
Preventive vaccinations are carried out by medical workers trained in the rules of organization and technique of vaccinations, as well as emergency care in case of post-vaccination complications and having documentary evidence of training. Medical workers who carry out vaccination should be healthy.
– Is it possible to predict which infectious diseases may become epidemic in the coming years?
– Prognosis is a complicated matter, especially with regard to infectious diseases, the incidence of which is determined by the influence of a complex of socio–economic and climatic factors. Today's period is characterized by new challenges associated with the emergence of new infections, changes in the clinical and epidemiological manifestations of long-known diseases, the formation of global antibiotic resistance of microorganisms.
The danger of infectious diseases is associated not only with the "restoration" of well-known, but already forgotten diseases, but also with the emergence of new, previously unknown to mankind infectious diseases. In recent decades, 1-2 new infectious diseases or new pathogens have been discovered annually, over the years more than forty new pathogens have been isolated and identified – from the deadly Ebola hemorrhagic fever virus to rotaviruses, which, as it turned out, are becoming the most common causative agents of diarrhea in children.
Many of these new infections are characterized by severe course, high mortality, lack of reliable methods of diagnosis and prevention. At the same time, the spectrum of possible pathogens in humans (including chronic infections) will continue to expand over time. Thus, less than 4% of 5 thousand species of viruses known in the world have been identified. Described only 2 thousand species of bacteria out of a million existing, according to estimates, on earth. Less than 1% of all ocean bacteria have been described.
In this regard, it is appropriate to talk about X-infections, i.e. diseases that are currently still practically unknown or have just been described, but will certainly be widely diagnosed in the 21st century. For example, only in the last 10 years we have learned about new pathogens of viral infections, such as metapneumovirus, bokavirus, coronavirus and influenza, including "avian" and "swine" flu.
Laboratory surveillance of the influenza virus is of particular importance, since there is a risk of the emergence of new pandemic viruses with an unknown antigenic structure. It is extremely rare for the same type/subtype of virus to act as the dominant agent during several flu epidemics in a row. Taking into account the suddenness and unpredictability of the emergence of new pathogens of the influenza pandemic, WHO experts have identified the most dangerous, from the point of view of the development of the pandemic, influenza viruses of animals (birds), periodically infecting people with direct contact with sick or infected animals with the development of severe respiratory diseases, in 30-60% of cases ending in fatal outcomes. These include potentially pandemic influenza viruses of subtypes A(H5N1), A(H7N9), A(H9N2), as well as the causative agent of the previous pandemic A(H2N2), immunity to which the population has completely lost. It should be noted that in the last decade, the most pathogenic of the above subtypes – the influenza A(H5N1) virus – has spread widely in the world with the formation of endemic foci in Egypt and some countries of Southeast Asia (Vietnam, Indonesia, etc.). Seasonal rises of sporadic influenza A(H7N9) diseases are noted annually in China. Human influenza diseases caused by strain A(H10N8) have been noted.
The situation is aggravated by the growing resistance of microorganisms to the drugs and disinfectants used. Due to the resistance of pathogens of malaria, tuberculosis, meningitis and pneumonia to drugs, millions of people die every year in the world. Widespread uncontrolled use of antibiotics causes a change in the microbial biocenosis of a person, reduces his resistance to microorganisms. The deteriorating environmental situation and large psycho-emotional loads have led to a significant increase in the prevalence of immunodeficiency. This resulted in a significant increase in the epidemic significance of opportunistic microorganisms and an increase in the incidence of opportunistic infections (herpetic, CMV infection, toxoplasmosis, mycoplasmosis, cryptococcosis, cryptosporidiosis, etc.). Unusual combinations of known infections are increasingly being registered. In clinical and experimental studies, many facts have been accumulated on the peculiarities of the course of associative diseases. In some cases, such diseases are more severe, and in others – more favorable.
It is necessary to note the significant evolution of scientific views on the problem of global elimination of infections. And if in the 1950s and 1960s WHO set tasks to eliminate a wide list of diseases, then modern ideas about the patterns of the epidemic process, the ecology of pathogens, the interaction of macro- and micro-organism indicate not only the impossibility, but also the inexpediency of eliminating many infections. Currently, the goal is to reduce the incidence of vaccine-controlled infections to a sporadic level, and only some of them are subject to elimination if there are certain prerequisites.
– How would you reform the National Vaccination Calendar? Imagine an ideal situation: resources are limitless and you are given complete freedom of action…
– I would like to note that our National Calendar is constantly being improved and has undergone significant changes in recent years: the range of infections regulated by the vaccination calendar has been expanded (vaccinations against hemophilic and pneumococcal infections have been introduced), indications for the use of BCG-M vaccine have been expanded, the second revaccination against tuberculosis for children aged 14 years has been canceled, the first 2 vaccinations are carried out with inactivated polio vaccines, the transition from a 3-valent live polio vaccine to a bivalent one has been carried out, the list of contingents subject to vaccination against influenza has been expanded to include pregnant women and persons subject to conscription for military service. Recommendations are given on the preferential use of vaccines containing antigens relevant to the Russian Federation and not containing preservatives (when immunizing children under one year and pregnant women).
At the same time, we vaccinate against hemophilic infection of type B only in children at risk, against rotavirus infection, menigococcal infection and chickenpox, hepatitis A – only according to epidemiological indications. Vaccination against papillomavirus infection is completely absent from the calendar, the role of which is very significant in the violation of the reproductive health of the population and creates problems in solving demographic problems. In the national calendars of a number of countries (Canada, USA, Australia, Austria, New Zealand), immunization against meningococcal infection is recommended not only for young children, but also for risk groups such as people with immunodeficiency, asplenia, organ and stem cell transplantation, HIV-infected. The inclusion of vaccinations against meningococcal infection in the National Vaccination Calendar will make it possible to transfer this severe infection to the category of manageable.
It seems very important to focus efforts on the development and domestic production of vaccines such as chickenpox, rotavirus, papillomavirus, acellular pertussis, which have to be purchased abroad so far.
A busy schedule of the vaccination calendar, especially for young children, leads to an increase in the injection load, creates a lot of difficulties for medical personnel, requires large material costs, leads to significant emotional stress for both the child and the mother, which requires the development of combined vaccines. Unfortunately, there are very few domestic combined vaccines today, which complicates the further expansion of the calendar. Therefore, the development and implementation of combined vaccines of domestic production for vaccinations within the National Calendar is relevant. It is also important to improve production technology in order to improve the safety and effectiveness of existing vaccines (JMP), modernization of enterprises, localization of production in the territory of the Russian Federation, technology transfer.
In order to ensure equal access of every citizen of our country to vaccines registered in the Russian Federation, it is necessary to expand the private market of vaccine prophylaxis in accordance with the established procedure. To continue the practice of vaccine prophylaxis within the framework of Federal and regional programs, to grant regions the right to expand the National Vaccination Calendar at the expense of local budgets, supplementing it with vaccines registered in Russia and relevant for the regions. It is more widespread to attract extra-budgetary, non-state funds (insurance, charitable foundations, funds of enterprises and institutions, personal funds of citizens), as well as funds of the Federal Migration Service, the Federal Migration Service, the Pension Fund to finance regional vaccination programs.
– The Ministry of Health announced the inclusion of vaccinations against chickenpox and rotovirus infection in the National Calendar. When should this happen?
– These infections have already been included in the National Vaccination Calendar at the end of 2014 (Order of the Ministry of Health of the Russian Federation No. 125n of 21.03.2014) in the section of the calendar for epidemic indications, i.e. in areas with a high incidence rate, with worsening of the epidemic situation, contact in the epidemic focus, etc. Against chickenpox, as well as against pneumococcal infection, influenza and meningococcal infection, persons subject to conscription are vaccinated. The task is to ensure that all children receive vaccinations against chickenpox, meningococcal and rotavirus infections on a planned basis at the expense of the federal budget. I hope that this will happen soon.
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07.06.2017