3.3 . IMMUNOPREVENTION
INFECTIOUS DISEASES

PROCEDURE
PREVENTIVE VACCINATIONS

METHODOLOGICAL INSTRUCTIONS
MU 3.3.1889-04

3.3. IMMUNOPREVENTION OF INFECTIOUS DISEASES

1.3. The guidelines are intended for specialists from bodies and institutions of the state sanitary-epidemiological service and healthcare organizations, regardless of organizational, legal forms and forms of ownership, carrying out activities in the field of immunoprophylaxis in the prescribed manner.

2 . Basic provisions

Federal Law No. 157-FZ of September 17, 1998 “On the immunoprophylaxis of infectious diseases” provides for preventive vaccinations against tuberculosis, polio, measles, mumps, viral hepatitis B, rubella, diphtheria, whooping cough, tetanus, included in the national preventive calendar vaccinations and preventive vaccinations for epidemic indications.

Immunization within the framework of the national calendar of preventive vaccinations is carried out with vaccines of domestic and foreign production, registered and authorized for use in the prescribed manner in accordance with the instructions for their use.

When carrying out routine vaccination of the population, it is necessary to follow the procedure for administering vaccines in a certain sequence within a specified time frame. The combination of these factors makes up the national calendar of preventive vaccinations.

The national calendar is built taking into account the socio-economic significance of vaccine-preventable infections, domestic and international experience in the prevention of infectious diseases, as well as the availability of effective, safe, economically accessible vaccines in the country.

The next revision of the national calendar may be caused by the emergence of new generation drugs, the use of which reduces the number of drug administrations, changes the method of vaccine administration, as well as the cancellation of the next one or the introduction of additional vaccinations to optimize the management of the epidemic process of infection.

3 . General requirements for organizing and conducting preventive vaccinations

3.1. Preventive vaccinations for citizens are carried out in healthcare organizations, regardless of organizational and legal forms and forms of ownership, as well as by persons engaged in private medical practice, if they have a license for this type of activity in the field of immunoprophylaxis.

3.2. The work on carrying out preventive vaccinations is financed from the federal budget, budgets of the constituent entities of the Russian Federation, compulsory health insurance funds and other sources of funding in accordance with the legislation of the Russian Federation and the legislation of the constituent entities of the Russian Federation.

3.3. Financing of supplies of medical immunobiological preparations (MIBP) for carrying out preventive vaccinations within the framework of the national calendar is carried out from the federal budget in accordance with the Federal Law “On the supply of products for federal state needs” and the legislation of the Russian Federation, and supplies of MIBP for carrying out preventive vaccinations for epidemic indications - at the expense of the budgets of the constituent entities of the Russian Federation and extra-budgetary sources of financing in accordance with the Federal Law “On the supply of products for federal state needs” and the legislation of the constituent entities of the Russian Federation.

3.4. The organization and implementation of preventive vaccinations is ensured by the head of a medical and preventive organization that has a license for this type of activity in the field of immunoprophylaxis.

3.5. Preventive vaccinations are carried out for citizens who do not have medical contraindications, with the consent of citizens, parents or other legal representatives of minors and citizens declared incompetent in the manner established by the legislation of the Russian Federation.

3.6. Preventive vaccinations are carried out in strict accordance with the instructions for use of the drugs.

3.7. Medical personnel trained in the rules of vaccination techniques and emergency procedures in the event of post-vaccination reactions and complications are allowed to carry out preventive vaccinations. Medical personnel who have undergone appropriate training and have a special permit, renewed annually, are allowed to carry out immunization against tuberculosis.

3.8. Medical workers who provide vaccine prevention of infectious diseases must undergo annual training on organizing and conducting preventive vaccinations.

4 . The procedure for carrying out preventive vaccinations

4.1. Preventive vaccinations are carried out in vaccination rooms of medical and preventive organizations, preschool educational institutions, medical rooms of general education institutions (special educational institutions), health centers of organizations in strict compliance with the requirements established by regulatory and methodological documents.

4.2. If necessary, territorial executive authorities in the field of health care, in agreement with the centers of state sanitary and epidemiological surveillance, may decide to carry out preventive vaccinations at home or at the place of work using vaccination teams.

4.3. Preventive vaccinations are carried out as prescribed by a doctor (paramedic).

4.4. Before vaccination, anamnestic data is collected by studying medical documents, and a survey of the person to be immunized and/or his parents or guardians is conducted.

4.5. Persons who are to be immunized are first examined by a doctor (paramedic) taking into account anamnestic data (previous diseases, tolerability of previous vaccinations, the presence of allergic reactions to medications, products, etc.).

4.6. If necessary, a medical examination is carried out before vaccination.

4.7. Immediately before vaccination, thermometry is performed.

4.8. All preventive vaccinations are carried out with disposable syringes and disposable needles.

4.9. Preventive vaccinations are carried out by medical workers trained in the rules of organization and technique of vaccinations, as well as emergency procedures in case of post-vaccination complications.

4.10. Premises where preventive vaccinations are carried out must be provided with kits for emergency and anti-shock therapy with instructions for their use.

4.11. The storage and use of vaccines and other immunobiological preparations is carried out in strict compliance with the requirements of regulatory and methodological documents.

4.12. Preventive vaccinations are carried out in accordance with the approved preventive vaccination plan.

4.13. The room for carrying out preventive vaccinations is provided with the necessary equipment and equipment.

4.14. The office where preventive vaccinations are carried out must have the necessary documents.

4.15. Vaccinations against tuberculosis and tuberculin diagnostics are carried out in separate rooms, and in their absence - on a specially designated table, with separate instruments, which are used only for these purposes. A certain day or time is allocated for vaccination with BCG and bioassays.

4.16. Preventive vaccinations are not allowed in dressing rooms and treatment rooms.

4.17. The vaccination room is cleaned 2 times a day using disinfectants. The vaccination room is thoroughly cleaned once a week.

5 . Methodology for preventive vaccinations

5.1. Before carrying out preventive vaccinations, the medical worker responsible for its implementation visually checks the integrity of the ampoule or bottle, the quality of the administered drug and its labeling.

5.2. The opening of ampoules and the dissolution of lyophilized vaccines are carried out in accordance with the instructions with strict adherence to the rules of asepsis and cold chain.

5.3. Parenteral administration of immunobiological drugs is carried out with a disposable syringe and a disposable needle, subject to aseptic rules. In case of simultaneous administration of several vaccinations (except BCG), each vaccine is administered with a separate disposable syringe and disposable needle into different parts of the body.

5.4. The injection site of the vaccine is treated with 70% alcohol, unless otherwise indicated in the instructions for its use (with ether - when administering the Mantoux River or administering BCG) and other means approved for use in the prescribed manner for these purposes.

5.5. The vaccine is administered in a dose that strictly corresponds to the instructions for use of the drug, with the patient lying or sitting in order to avoid falling in case of fainting.

5.6. A patient who has received a preventive vaccination is placed under medical supervision for the period specified in the instructions for use of the drug (at least 30 minutes).

6 . Disposal of vaccine residues, used syringes, needles and scarifiers

6.1. Remains of vaccines in ampoules or vials, used disposable needles, syringes, scarifiers, cotton swabs, napkins, gloves after injection are discarded into containers with a disinfectant solution prepared in accordance with the instructions for its use.

6.2. After disinfection treatment, medical waste is disposed of in accordance with the sanitary rules and regulations of SanPiN 3.1.7.728-99 “Rules for the collection, storage and disposal of waste from medical institutions.”

7 . Storage and use of vaccines

7.1. The storage and use of vaccines in healthcare organizations, regardless of organizational and legal forms and forms of ownership, where preventive vaccinations are carried out, is carried out in accordance with the established requirements of SP 3.3.2.1120-02 “Sanitary and epidemiological requirements for the conditions of transportation, storage and release of medical immunobiological drugs to citizens drugs used for immunoprophylaxis by pharmacies and healthcare institutions.”

7.2. The maximum shelf life of vaccines in medical institutions where preventive vaccinations are carried out is 1 month. Maximum shelf life is based on ensuring that vaccines are stored safely at each level of the cold chain.

7.3. When using vaccines, the principle should be adhered to: vaccines received earlier should be used first. In practice, the main vaccine stock should be used before the maximum permissible shelf life.

7.4. In medical and preventive organizations where preventive vaccinations are carried out, it is necessary to have a supply of thermal containers and cold elements in case of departure of vaccination teams, as well as emergencies associated with the failure of refrigeration equipment or power supply interruptions.

8. The procedure for carrying out preventive vaccinations according to the national calendar of preventive vaccinations

8.1. National calendar of preventive vaccinations

	Name of vaccination
Newborns (in the first 12 hours of life)	First vaccination against viral hepatitis B
Newborns (3 - 7 days)	Vaccination against tuberculosis
	Second vaccination against viral hepatitis B
	First vaccination against diphtheria, whooping cough, tetanus, polio
4.5 months	Second vaccination against diphtheria, whooping cough, tetanus, polio
6 months	The third vaccination against diphtheria, whooping cough, tetanus, polio.
	Third vaccination against viral hepatitis B
12 months	Vaccination against measles, rubella, mumps
18 months	First revaccination against diphtheria, whooping cough, tetanus, polio
20 months	Second revaccination against polio
	Revaccination against measles, rubella, mumps
	Second revaccination against diphtheria, tetanus
	Vaccination against rubella (girls). Vaccination against viral hepatitis B (previously unvaccinated)
	Third revaccination against diphtheria, tetanus.
	Revaccination against tuberculosis.
	Third revaccination against polio
Adults	Revaccination against diphtheria, tetanus - every 10 years from the date of the last revaccination

If the timing of the start of vaccinations is violated, the latter are carried out according to the schemes provided for in this calendar and instructions for the use of drugs.

8.2. Immunization against whooping cough

8.2.1. The goal of pertussis vaccine prevention, according to WHO recommendations, should be to reduce the incidence by 2010 or earlier to a level of less than 1 per 100 thousand population. This can be achieved by ensuring at least 95% coverage of children aged 12 months with three-time vaccination. and the first revaccination of children at the age of 24 months.

8.2.2. Children from 3 months of age to 3 years 11 months 29 days are subject to vaccination against whooping cough. Vaccinations are carried out with DTP vaccine. The drug is administered intramuscularly into the upper outer quadrant of the buttock or the anterior outer region of the thigh in a dose of 0.5 ml.

8.2.3. The vaccination course consists of 3 vaccinations with an interval of 45 days. Reducing intervals is not allowed. If the interval between vaccinations increases, the next vaccination is carried out as soon as possible, determined by the child’s health status.

8.2.4. The first vaccination is carried out at the age of 3 months, the second - at 4.5 months, the third vaccination - at the age of 6 months.

8.2.5. Revaccination with DPT vaccine is carried out once every 12 months. after completed vaccination.

8.2.6. Vaccinations with the DPT vaccine can be carried out simultaneously with other vaccinations in the vaccination calendar, and the vaccines are administered with different syringes to different parts of the body.

8.3. Immunization against diphtheria

Vaccinations are carried out with DPT vaccine, toxoids ADS, ADS-M, AD-M.

8.3.1. The goal of vaccination against diphtheria, according to WHO recommendations, is to achieve an incidence rate of 0.1 or less per 100 thousand population by 2005. This will become possible by ensuring at least 95% coverage of completed vaccination of children at the age of 12 months, with the first revaccination of children at the age of 24 months. and at least 90% vaccination coverage of the adult population.

8.3.2. Children from 3 months of age, as well as adolescents and adults who have not previously been vaccinated against this infection are subject to vaccination against diphtheria. The drug is administered intramuscularly into the upper outer quadrant of the buttock or the anterior outer region of the thigh in a dose of 0.5 ml.

8.3.3. The first vaccination is carried out at the age of 3 months, the second vaccination - at the age of 4.5 months, the third vaccination - at the age of 6 months.

The first revaccination is carried out after 12 months. after completed vaccination. Children from 3 months of age to 3 years 11 months 29 days are subject to vaccination with the DTP vaccine.

Vaccination is carried out 3 times with an interval of 45 days. Reducing intervals is not allowed. If the interval is forced to increase, the next vaccination is carried out as soon as possible, determined by the state of health of the child. Skipping one vaccination does not entail repeating the entire vaccination cycle.

8.3.4. ADS toxoid is used to prevent diphtheria in children under 6 years of age:

· those who have had whooping cough;

· over 4 years of age, not previously vaccinated against diphtheria and tetanus.

8.3.4.1. The vaccination course consists of 2 vaccinations with an interval of 45 days. Reducing intervals is not allowed. If the interval between vaccinations increases, the next vaccination is carried out as soon as possible, determined by the child’s health status.

8.3.4.2. The first revaccination with ADS toxoid is carried out once after 9 to 12 months. after completed vaccination.

8.3.5. DS-M-anatoxin is used:

· for revaccination of children 7 years old, 14 years old and adults without age limit every 10 years;

· for vaccination against diphtheria and tetanus in children from 6 years of age who have not previously been vaccinated against diphtheria.

8.3.5.1. The vaccination course consists of 2 vaccinations with an interval of 45 days. Reducing intervals is not allowed. If it is necessary to increase the interval, the next vaccination should be carried out as soon as possible.

8.3.5.2. The first revaccination is carried out at intervals of 6 - 9 months. after completed vaccination once. Subsequent revaccinations are carried out in accordance with the national calendar.

8.3.5.3. Vaccinations with ADS-M toxoid can be carried out simultaneously with other vaccinations on the calendar. Vaccinations are carried out with different syringes in different parts of the body.

8.4. Immunization against tetanus

8.4.1. In the Russian Federation, tetanus in newborns has not been registered in recent years, and sporadic incidence of tetanus among other age groups of the population is recorded annually.

8.4.2. The goal of tetanus immunization is to prevent tetanus in the population.

8.4.3. This can be achieved by ensuring at least 95% coverage of children with three doses of vaccination by 12 months. life and subsequent age-related revaccinations by 24 months. life, at 7 years old and at 14 years old.

8.4.4. Vaccinations are carried out with DTP vaccine, ADS toxoids, ADS-M.

8.4.5. Children from 3 months of age are subject to vaccination against tetanus: the first vaccination is carried out at the age of 3 months, the second at 4.5 months, the third vaccination at the age of 6 months.

8.4.6. Vaccinations are carried out with DTP vaccine. The drug is administered intramuscularly into the upper outer quadrant of the buttock or the anterior outer region of the thigh in a dose of 0.5 ml.

8.4.7. The vaccination course consists of 3 vaccinations with an interval of 45 days. Reducing intervals is not allowed. If the interval is forced to increase, the next vaccination is carried out as soon as possible, determined by the state of health of the child. Skipping one vaccination does not entail repeating the entire vaccination cycle.

8.4.8. Revaccination against tetanus is carried out with DPT vaccine once every 12 months. after completed vaccination.

8.4.9. Vaccinations with the DPT vaccine can be carried out simultaneously with other vaccinations in the vaccination calendar, and the vaccines are administered with different syringes to different parts of the body.

8.4.10. ADS toxoid is used to prevent tetanus in children under 6 years of age:

· those who have had whooping cough;

· having contraindications to the administration of DTP vaccine;

· over 4 years of age, not previously vaccinated against tetanus.

8.4.10.1. The vaccination course consists of 2 vaccinations with an interval of 45 days. Reducing intervals is not allowed. If the interval between vaccinations increases, the next vaccination is carried out as soon as possible, determined by the child’s health condition.

8.4.10.2. The first revaccination with ADS toxoid is carried out once after 9 to 12 months. after completed vaccination.

8.4.11. ADS-M toxoid is used:

· for revaccination of children against tetanus at 7 years old, 14 years old and adults without age limit every 10 years;

· for vaccination against tetanus in children from 6 years of age who have not previously been vaccinated against tetanus.

8.4.11.1. The vaccination course consists of 2 vaccinations with an interval of 45 days. Reducing intervals is not allowed. If it is necessary to increase the interval, the next vaccination should be carried out as soon as possible.

8.4.11.2. The first revaccination is carried out at intervals of 6 - 9 months. after completed vaccination once. Subsequent revaccinations are carried out in accordance with the national calendar.

8.4.11.3. Vaccinations with ADS-M toxoid can be carried out simultaneously with other vaccinations on the calendar. Vaccinations are carried out with different syringes in different parts of the body.

8.5. Immunization against measles, rubella, mumps

8.5.1. The WHO program provides:

· global elimination of measles by 2007;

· prevention of cases of congenital rubella, the elimination of which, according to the WHO goal, is expected in 2005;

· reducing the incidence of mumps to a level of 1.0 or less per 100 thousand population by 2010.

This will become possible when at least 95% vaccination coverage of children is achieved by 24 months. life and revaccination against measles, rubella and mumps in children aged 6 years.

8.5.2. Children over the age of 12 months who have not had these infections are subject to vaccination against measles, rubella and mumps.

8.5.3. Children from 6 years of age are subject to revaccination.

8.5.4. Girls aged 13 years who have not previously been vaccinated or who have received one vaccination are subject to vaccination against rubella.

8.5.5. Vaccination and revaccination against measles, rubella, mumps are carried out with monovaccines and combined vaccines (measles, rubella, mumps).

8.5.6. The drugs are administered once subcutaneously in a dose of 0.5 ml under the shoulder blade or in the shoulder area. Simultaneous administration of vaccines with different syringes to different parts of the body is allowed.

8.6. Immunization against polio

8.6.1. WHO's global goal is to eradicate polio by 2005. Achieving this goal is possible if children 12 months of age are vaccinated three times. life and revaccinations of children 24 months. life at least 95%.

8.6.2. Vaccinations against polio are carried out with live oral polio vaccine.

8.6.3. Children from 3 months of age are subject to vaccination. Vaccination is carried out 3 times with an interval of 45 days. Reducing intervals is not allowed. If the intervals are extended, vaccinations should be carried out as soon as possible.

8.6.4. The first revaccination is carried out at the age of 18 months, the second revaccination at the age of 20 months, the third revaccination at 14 years.

8.6.5. Vaccinations against polio can be combined with other scheduled vaccinations.

8.7. Immunization against viral hepatitis B

8.7.1. The first vaccination is given to newborn children in the first 12 hours of life.

8.7.2. The second vaccination is given to children aged 1 month.

8.7.3. The third vaccination is given to children aged 6 months.

8.7.4. Children born to mothers who are carriers of the hepatitis B virus or patients with viral hepatitis B in the third trimester of pregnancy are vaccinated against viral hepatitis B according to the schedule of 0 - 1 - 2 - 12 months.

8.7.5. Vaccination against hepatitis B for children aged 13 years who have not previously been vaccinated is carried out according to the schedule of 0 - 1 - 6 months.

8.7.7. The vaccine is administered intramuscularly to newborns and young children in the anterolateral thigh, and to older children and adolescents in the deltoid muscle.

8.7.8. The dosage of the vaccine for vaccinations of people of different ages is carried out in strict accordance with the instructions for its use.

8.8. Immunization against tuberculosis

8.8.1. All newborns in the maternity hospital are subject to vaccination against tuberculosis on the 3rd-7th day of life.

8.8.2. Revaccination against tuberculosis is carried out for tuberculin-negative children not infected with Mycobacterium tuberculosis.

8.8.3. The first revaccination is given to children aged 7 years.

8.8.4. The second revaccination against tuberculosis at 14 years of age is carried out to tuberculin-negative children uninfected with Mycobacterium tuberculosis who did not receive the vaccine at 7 years of age.

8.8.5. Vaccination and revaccination are carried out with live anti-tuberculosis vaccine (BCG and BCG-M).

8.8.6. The vaccine is administered strictly intradermally at the border of the upper and middle third of the outer surface of the left shoulder. The vaccination dose contains 0.05 mg BCG and 0.02 mg BCG-M in 0.1 ml of solvent. Vaccination and revaccination are carried out with one-gram or tuberculin disposable syringes with thin needles (No. 0415) with a short cut.

9. The procedure for carrying out preventive vaccinations for epidemic indications

If there is a threat of infectious diseases, preventive vaccinations for epidemic indications are carried out to the entire population or individual professional groups, contingents living or visiting areas endemic or enzootic for plague, brucellosis, tularemia, anthrax, leptospirosis, tick-borne spring-summer encephalitis. The list of works, the performance of which is associated with a high risk of contracting infectious diseases and requires mandatory preventive vaccinations, was approved by Decree of the Government of the Russian Federation dated July 17, 1999 No. 825.

Immunization for epidemic indications is carried out by decision of the State Sanitary and Epidemiological Supervision centers in the constituent entities of the Russian Federation and in agreement with health authorities.

An endemic territory (in relation to human diseases) and enzootic (in relation to diseases common to humans and animals) is considered to be a territory or group of territories with a constant occurrence of an infectious disease, due to specific, local, natural-geographical conditions necessary for the constant circulation of the pathogen.

The list of enzootic territories is approved by the Russian Ministry of Health on the basis of the State Sanitary and Epidemiological Supervision centers in the constituent entities of the Russian Federation.

Emergency immunoprophylaxis is carried out by decision of the bodies and institutions of the state sanitary and epidemiological service and local health authorities in the constituent entities of the Russian Federation.

9.1. Immunoprophylaxis of plague

9.1.1. Preventive measures aimed at preventing infection of people in natural plague foci are provided by anti-plague institutions in cooperation with territorial institutions of the state sanitary and epidemiological service.

9.1.2. Vaccination against plague is carried out on the basis of the presence of an epizootic of plague among rodents, identification of domestic animals suffering from plague, the possibility of infection being introduced by a sick person and epidemiological analysis carried out by an anti-plague institution. The decision on immunization is made by the Chief State Sanitary Doctor for the constituent entity of the Russian Federation in consultation with health authorities.

9.1.3. Immunization is carried out in a strictly limited area to the entire population from 2 years of age or selectively to threatened populations (livestock breeders, agronomists, employees of geological parties, farmers, hunters, harvesters, etc.).

9.1.4. Vaccinations are carried out by local medical workers or specially organized vaccination teams with the instructional and methodological assistance of anti-plague institutions.

9.1.5. The plague vaccine provides immunity to those vaccinated for up to 1 year. Vaccination is carried out once, revaccination is carried out after 12 months. after the last vaccination.

9.1.6. Measures to prevent the importation of plague from abroad are regulated by sanitary and epidemiological rules SP 3.4.1328-03 “Sanitary protection of the territory of the Russian Federation”.

9.1.7. Control over the implementation of preventive vaccinations is carried out by anti-plague institutions.

9.2. Immunoprophylaxis of tularemia

9.2.1. Vaccinations against tularemia are carried out based on the decision of the territorial centers of the State Sanitary and Epidemiological Supervision in coordination with local health authorities.

9.2.2. Planning and selection of groups to be vaccinated is carried out differentially, taking into account the degree of activity of natural foci.

9.2.3. There are scheduled and unscheduled vaccinations against tularemia.

9.2.4. Routine vaccination from the age of 7 is carried out for the population living in the territory with the presence of active natural foci of the steppe, name-swamp (and its variants), and foothill-stream types.

In areas of meadow-field type, vaccinations are carried out for the population from the age of 14, with the exception of pensioners, disabled people, people not engaged in agricultural work and who do not have livestock for personal use.

9.2.4.1. On the territory of natural foci of tundra and forest types, vaccinations are carried out only in risk groups:

· hunters, fishermen (and members of their families), reindeer herders, shepherds, field farmers, land reclamation workers;

· persons sent to temporary work (geologists, prospectors, etc.).

9.2.4.2. In cities directly adjacent to active foci of tularemia, as well as in areas with inactive natural foci of tularemia, vaccinations are carried out only to workers:

· grain and vegetable storage facilities;

· sugar and alcohol factories;

· hemp and flax plants;

· feed shops;

· livestock and poultry farms working with grain, fodder, etc.;

· hunters (members of their families);

· producers of game animal skins;

· workers of fur factories involved in the primary processing of skins;

· employees of the departments of especially dangerous infections of the State Sanitary and Epidemiological Supervision centers and anti-plague institutions;

· workers of deratization and disinfection services;

9.2.4.3. Revaccination is carried out after 5 years for contingents subject to routine immunization.

9.2.4.4. Cancellation of routine vaccinations is allowed only on the basis of materials indicating the absence of circulation of the tularemia pathogen in the biocenosis for 10 - 12 years.

9.2.4.5. Vaccination according to epidemic indications is carried out:

· in settlements located in territories previously considered free from tularemia, when people become ill (even isolated cases are registered) or tularemia cultures are isolated from any objects;

· in settlements located in the territories of active natural foci of tularemia, when a low immune layer is detected (less than 70% in meadow field foci and less than 90% in bog foci);

· in cities directly adjacent to active natural foci of tularemia, populations at risk of infection - members of horticultural cooperatives, owners (and members of their families) of personal vehicles and water transport, water transport workers, etc.;

· in the territories of active natural foci of tularemia - to persons coming to carry out permanent or temporary work - hunters, foresters, land reclamation workers, surveyors, peat developers, harvesters of fur skins (water rats, hares, muskrats), geologists, members of scientific expeditions; persons sent for agricultural, construction, survey or other work, tourists, etc.

Vaccination of the above-mentioned contingents is carried out by health care organizations in the places of their formation.

9.2.5. In special cases, persons at risk of contracting tularemia need to undergo emergency antibiotic prophylaxis, after which, but not earlier than 2 days after it, they are vaccinated with a tularemia vaccine.

9.2.6. Simultaneous cutaneous vaccination of adults against tularemia and brucellosis, tularemia and plague in different areas of the outer surface of the third of the shoulder is allowed.

9.2.7. The tularemia vaccine ensures the development of immunity lasting 5 years 20 to 30 days after vaccination.

9.2.8. Monitoring the timeliness and quality of vaccination against tularemia, as well as the state of immunity, is carried out by territorial centers of the State Sanitary and Epidemiological Supervision by selective examination of the adult working population using a tularin test or serological methods at least once every 5 years

9.3. Immunoprophylaxis of brucellosis

9.3.1. Vaccinations against brucellosis are carried out based on the decision of the territorial centers of the State Sanitary and Epidemiological Supervision in coordination with local health authorities. The indication for vaccination of people is the threat of infection by a pathogen of the goat-sheep species, as well as the migration of Brucella of this species to cattle or other animal species.

9.3.2. Vaccinations are carried out from the age of 18:

· permanent and temporary livestock workers - until the complete elimination of animals infected with Brucella of the goat-sheep species on farms;

· personnel of organizations for the procurement, storage, processing of raw materials and livestock products - until the complete elimination of such animals in farms from which livestock, raw materials and livestock products come;

· workers of bacteriological laboratories working with live cultures of Brucella;

· employees of organizations for the slaughter of livestock with brucellosis, procurement and processing of livestock products obtained from them, veterinary workers, livestock specialists in farms enzootic for brucellosis.

9.3.3. Persons with clear negative serological and allergic reactions to brucellosis are subject to vaccination and revaccination.

9.3.4. When determining the timing of vaccinations for workers on livestock farms, it is necessary to strictly follow the data on the time of lambing (early lambing, planned, unscheduled).

9.3.5. The brucellosis vaccine provides the highest intensity of immunity for 5 - 6 months.

9.3.6. Revaccination is carried out after 10 - 12 months. after vaccination.

9.3.7. Control over the planning and implementation of immunization is carried out by the territorial centers of the State Sanitary and Epidemiological Supervision.

9.4. Immunoprophylaxis of anthrax

9.4.1. Immunization of people against anthrax is carried out on the basis of a decision of the territorial centers of the State Sanitary and Epidemiological Supervision in coordination with local health authorities, taking into account epizootic and epidemiological indications.

9.4.2. Persons over 14 years of age who perform the following work in anthrax-enzootic areas are subject to vaccination:

· agricultural, drainage, survey, expedition, construction, excavation and movement of soil, procurement, fishing;

· for the slaughter of livestock suffering from anthrax, procurement and processing of meat and meat products obtained from it;

· with live cultures of the anthrax pathogen or with material suspected of being contaminated with the pathogen.

9.4.3. Persons who have had contact with anthrax-infected animals, raw materials and other products contaminated with anthrax pathogens during an epidemic outbreak are not recommended to undergo vaccination. They are given emergency prophylaxis with antibiotics or anti-anthrax immunoglobulin.

9.4.4. Revaccination with anthrax vaccine is carried out after 12 months. after the last vaccination.

9.4.5. Control over the timeliness and completeness of coverage of contingents with immunization against anthrax is carried out by the territorial centers of the State Sanitary and Epidemiological Supervision.

9.5. Immunoprophylaxis of tick-borne encephalitis

9.5.1. Vaccinations against tick-borne encephalitis are carried out based on the decision of the territorial centers of the State Sanitary and Epidemiological Supervision in coordination with local health authorities, taking into account the activity of the natural outbreak and epidemiological indications.

9.5.2. Proper planning and careful selection of populations at high risk of infection ensures the epidemiological effectiveness of vaccination.

9.5.3. The following are subject to vaccination against tick-borne encephalitis:

· population over 4 years of age living in areas enzootic for tick-borne encephalitis;

· persons arriving in territories enzootic for tick-borne encephalitis and performing the following work - agricultural, irrigation, construction, geological, survey, expedition; for excavation and movement of soil; procurement, fishing; deratization and disinfestation; for logging, clearing and landscaping of forests, health and recreation areas for the population; with live cultures of the causative agent of tick-borne encephalitis.

9.5.4. The maximum age of those vaccinated is not regulated; it is determined in each specific case, based on the advisability of vaccination and the health status of the person being vaccinated.

9.5.5. In case of violation of the vaccination course (lack of a documented full course), vaccination is carried out according to the primary vaccination schedule.

9.5.6. Revaccination is carried out after 12 months, and subsequently every 3 years.

9.5.7. Control over the planning and implementation of immunization against tick-borne encephalitis is carried out by the territorial centers of the State Sanitary and Epidemiological Supervision.

9.6. Immunoprophylaxis of leptospirosis

9.6.1. Vaccinations against leptospirosis are carried out based on the decision of the territorial centers of the State Sanitary and Epidemiological Supervision in coordination with local health authorities, taking into account the epidemiological situation and epizootological situation. Preventive vaccination is carried out for the population from 7 years of age according to epidemiological indications. The risk groups and timing of immunization are determined by the territorial centers of the State Sanitary and Epidemiological Supervision.

9.6.2. Persons at increased risk of infection who perform the following work are subject to immunization:

· on the procurement, storage, processing of raw materials and livestock products obtained from farms located in areas enzootic for leptospirosis;

· for the slaughter of livestock suffering from leptospirosis, the procurement and processing of meat and meat products obtained from it;

· on catching and keeping stray animals;

· with live cultures of the causative agent of leptospirosis;

· sent for construction and agricultural work in places of active natural and anthropourgic foci of leptospirosis (but no later than 1 month before the start of work in them).

9.6.4. Revaccination against leptospirosis is carried out after 12 months. after the last vaccination.

9.6.5. Control over immunization against leptospirosis of contingents at risk of infection and the population as a whole is carried out by territorial centers of the State Sanitary and Epidemiological Supervision.

9.7. Immunoprophylaxis of yellow fever

9.7.1. A number of countries with territories enzootic for yellow fever require that persons traveling to these territories have an international certificate of vaccination or revaccination against yellow fever.

9.7.2. Adults and children, starting from 9 months of age, traveling abroad to areas enzootic for yellow fever are subject to vaccination.

9.7.3. Vaccination is carried out no later than 10 days before departure to an enzootic area.

9.7.4. Persons working with live cultures of the yellow fever pathogen are subject to vaccination.

9.7.5. For persons over 15 years of age, the yellow fever vaccine can be combined with the cholera vaccine, provided that the drugs are administered to different parts of the body using different syringes, otherwise the interval should be at least one month.

9.7.6. Revaccination is carried out 10 years after the first vaccination.

9.7.7. Vaccinations against yellow fever are carried out only at vaccination points at clinics under the supervision of a doctor with the mandatory issuance of an international certificate of vaccination and revaccination against yellow fever.

9.7.8. The presence of an international certificate of vaccination against yellow fever is checked by officials at sanitary and quarantine points when crossing the state border in case of travel to countries that are unfavorable for the incidence of yellow fever.

9.8. Immunoprophylaxis of Q fever

9.8.1. Vaccinations against Q fever are carried out by decision of the territorial centers of the State Sanitary and Epidemiological Supervision in coordination with local health authorities, taking into account the epidemiological and epizootological situation.

9.8.2. Vaccinations are carried out to persons aged 14 years in areas affected by Q fever, as well as to professional groups performing work:

· on the procurement, storage, processing of raw materials and livestock products obtained from farms where Q fever diseases in small and large livestock are registered;

· on procurement, storage and processing of agricultural products in enzootic areas for Q fever;

· for caring for sick animals (persons who have recovered from Q fever or have a positive complement fixation reaction (CFR) in a dilution of no less than 1:10 and (or) a positive indirect immunofluorescence reaction (IRIF) in a titer of no less than 1:10 are allowed to care for sick animals 1:40);

· working with live cultures of Q fever pathogens.

9.8.3. Vaccination against Q fever can be carried out simultaneously with vaccination with a live vaccine against brucellosis using different syringes in different hands.

9.8.4. Revaccination against Q fever is carried out after 12 months.

9.8.5. Control over immunization against Q fever of the subject contingents is carried out by the territorial centers of the State Sanitary and Epidemiological Supervision.

9.9. Immunoprophylaxis of rabies

9.9.1. Vaccinations against rabies are carried out according to the decision of the territorial centers of the State Sanitary and Epidemiological Supervision in coordination with local health authorities.

9.9.2. The following are subject to rabies vaccinations from the age of 16:

· persons performing work on catching and keeping stray animals;

· working with the “street” rabies virus;

· veterinarians, hunters, foresters, slaughterhouse workers, taxidermists.

9.9.3. Revaccination is carried out after 12 months. after vaccination, then every 3 years.

9.9.4. Persons exposed to the risk of infection with the rabies virus undergo a course of therapeutic and prophylactic immunization in accordance with regulatory and methodological documents on the prevention of rabies.

9.9.5. Control over the immunization of subject populations and persons at risk of infection with the rabies virus is carried out by the territorial centers of the State Sanitary and Epidemiological Supervision.

9.10. Immunoprophylaxis of typhoid fever

Preventive vaccinations against typhoid fever are carried out from the age of 3 to the population living in areas with a high incidence of typhoid fever, revaccination is carried out after 3 years.

9.11. Immunoprophylaxis of influenza

9.11.1. Immunoprophylaxis of influenza can significantly reduce the risk of disease, prevent negative consequences and impacts on public health.

9.11.2. Flu vaccinations are given to people at increased risk of infection (over 60 years of age, those suffering from chronic somatic diseases, those with frequent acute respiratory infections, preschool children, schoolchildren, medical workers, workers in the service sector, transport, and educational institutions).

9.11.3. Any citizen of the country can receive a flu vaccine if they wish, provided they have no medical contraindications.

9.11.4. Vaccinations against influenza are carried out annually in the fall (October-November) during the pre-epidemic period for influenza according to the decision of the territorial centers of the State Sanitary and Epidemiological Supervision.

9.12. Immunoprophylaxis of viral hepatitis A

9.12.1. Vaccinations against hepatitis A are subject to:

· children over 3 years of age living in areas with a high incidence of hepatitis A;

· medical workers, teachers and staff of preschool institutions;

· public service workers, primarily those employed in public catering organizations;

· workers servicing water supply and sewerage structures, equipment and networks;

· persons traveling to regions of Russia and the country that are hyperendemic for hepatitis A;

· persons who have been in contact with the patient(s) in hepatitis A outbreaks.

9.12.2. The need for immunization against hepatitis A is determined by the territorial centers of the State Sanitary and Epidemiological Supervision.

9.12.3. Control over immunization against hepatitis A is carried out by territorial centers of the State Sanitary and Epidemiological Supervision.

9.13. Immunoprophylaxis of viral hepatitis B

9.13.1. Vaccinations against hepatitis B are carried out:

· children and adults who have not previously been vaccinated, whose families include a carrier of HbsAg or a patient with chronic hepatitis;

· children of orphanages, orphanages and boarding schools;

· children and adults who regularly receive blood and its preparations, as well as those on hemodialysis and hematological oncology patients;

· persons who have had contact with material infected with the hepatitis B virus;

· medical workers who have contact with the blood of patients;

· persons involved in the production of immunobiological preparations from donor and placental blood;

· students of medical institutes and students of secondary medical educational institutions (primarily graduates);

· persons who inject drugs.

9.13.2. The need for immunoprophylaxis is determined by the territorial centers of the State Sanitary and Epidemiological Supervision, carrying out subsequent monitoring of immunization.

9.14. Immunoprophylaxis of meningococcal infection

9.14.1. Vaccinations against meningococcal infection are carried out:

· children over 2 years of age, adolescents, adults in areas of meningococcal infection caused by meningococcus serogroup A or C;

· persons at increased risk of infection - children from preschool institutions, students of 1st and 2nd grades of schools, teenagers of organized groups united by living in dormitories; children from family hostels placed in unfavorable sanitary and hygienic conditions with a 2-fold increase in incidence compared to the previous year.

9.14.2. The need for immunization against meningococcal infection is determined by the territorial centers of the State Sanitary and Epidemiological Supervision.

9.14.3. Control over the implementation of immunoprophylaxis is carried out by the territorial centers of the State Sanitary and Epidemiological Supervision.

9.15. Immunoprophylaxis of mumps

9.15.1. Vaccinations against mumps are carried out for persons over 12 months of age who have been in contact with the patient(s) in areas of mumps. up to 35 years of age, not previously vaccinated or vaccinated once and have not had this infection.

9.15.2. Vaccinations for epidemic indications in outbreaks of mumps are carried out no later than the 7th day from the moment the first case of the disease is detected in the outbreak.

9.15.3. Control over the implementation of immunoprophylaxis is carried out by the territorial centers of the State Sanitary and Epidemiological Supervision.

9.16. Measles immunoprophylaxis

9.16.1. Vaccinations against measles are carried out for persons over 12 months of age who have been in contact with the patient(s) in measles outbreaks. up to 35 years of age, not previously vaccinated or vaccinated once and have not had this infection.

9.16.2. Vaccinations according to epidemic indications in measles outbreaks are carried out no later than 72 hours from the moment the first case of the disease is detected in the outbreak.

9.16.3. Control over the implementation of immunization is carried out by territorial centers of the State Sanitary and Epidemiological Supervision.

9.17. Immunoprophylaxis of diphtheria

9.17.1. Vaccinations against diphtheria are given to persons who have not previously been vaccinated against diphtheria and who have been in contact with the source of the infectious agent in the foci of this infection.

9.17.2. Control over the implementation of immunoprophylaxis is carried out by the territorial centers of the State Sanitary and Epidemiological Supervision.

9.18. Immunoprophylaxis of cholera

9.18.1. Vaccinations against cholera are carried out by decision of the executive authority in the field of sanitary and epidemiological welfare of the population:

· to the population from 2 years of age living in the border regions of Russia in the event of an unfavorable cholera situation in the adjacent territory;

· persons traveling to cholera-prone countries.

9.18.2. Revaccination is carried out after 6 months.

9.18.3. Control over immunization of the population is carried out by territorial centers of the State Sanitary and Epidemiological Supervision.

10. Procedure for registering preventive vaccinations

10.1. The procedure for registering preventive vaccinations and registering a refusal to carry out preventive vaccinations is uniform and mandatory for all healthcare organizations, regardless of organizational, legal forms and forms of ownership.

10.2. The accuracy and reliability of the registration of vaccinations is ensured by the medical worker performing the vaccinations.

10.3. The results of the examination of the patient before vaccination are entered into the child’s development history (f. 112/u), the child’s medical record (f. 026/u) or (depending on the patient’s age) the outpatient medical record (f. 025/u)

10.4. The following information about the preventive vaccination performed is subject to recording: date of administration of the drug, name of the drug, batch number, dose, control number, expiration date, nature of the reaction to the administration. The listed data is entered into the registration forms of medical documents:

· for children - a card of preventive vaccinations (form 063/u), a history of the child's development (form 112/u), a certificate of preventive vaccinations (form 156/e-93), a medical card of the child (for schoolchildren) (form 026 /у);

· for adolescents - a loose leaf for a teenager to an outpatient medical record (form 025-1/u), a certificate of preventive vaccinations (form 156/e-93), a child’s medical record (for schoolchildren) (form 026/u) ;

· for adults - an outpatient card of the patient (form 025/u), a log of preventive vaccinations (form 064/u), a certificate of preventive vaccinations (form 156/e-93).

The information included in the certificate of preventive vaccinations (f. 156/e-93) is certified by the signature of a medical worker and the seal of a treatment and prevention organization.

10.5. All cases of uncomplicated strong local (including swelling, hyperemia > 8 cm in diameter) and strong general (including temperature > 40°, febrile convulsions) reactions to the vaccine, mild manifestations of skin and respiratory allergies are registered in registration forms of medical documents specified in clause 10.5.

10.6. A report on vaccinations carried out by a treatment and preventive organization is compiled in accordance with the instructions for filling out Form No. 5 of the Federal State Statistical Observation “Report on Preventive Vaccinations” (quarterly, annual) and Form No. 6 of the Federal State Statistical Observation “Information on the contingents of children, adolescents and adults vaccinated against infectious diseases as of December 31 of the previous year.”

11 . Registration of refusal to carry out preventive vaccinations

11.1. In accordance with the Federal Law of September 17, 1998 No. 157-FZ “On Immunoprophylaxis of Infectious Diseases,” citizens have the right to refuse preventive vaccinations, and in case of refusal of preventive vaccinations, citizens are required to confirm it in writing.

11.2. A medical worker of a medical and preventive organization serving the child population is obliged, in case of refusal to immunize, to warn the child’s parents about the possible consequences:

· temporary refusal to admit a child to educational and health institutions in the event of widespread infectious diseases or the threat of epidemics;

11.3. The local therapist or doctor at the adolescent office is obliged to warn the citizen (teenager, adult) about the following consequences of refusing preventive vaccinations:

· refusal to hire or removal from work, the performance of which is associated with a high risk of contracting infectious diseases;

· a ban on travel to countries where stay in, in accordance with international health regulations or international treaties of the Russian Federation, requires specific preventive vaccinations.

11.4. Refusal to undergo vaccinations must be made in writing. For this purpose, the medical worker of the treatment and prevention organization makes an appropriate entry (with a mandatory note warning about the consequences) in medical documents - the history of the child’s development (form 112/u) or the history of the development of the newborn (form 097/u); the child’s medical record (f. 026/u); outpatient medical record (f. 025-87). Citizens, parents or other legal representatives of minors are required to sign a record of refusal of preventive vaccination.

12 . Bibliographic data

1. Federal Law No. 52-FZ of March 30, 1999 “On the sanitary and epidemiological welfare of the population.”

2. Federal Law No. 157-FZ of September 17, 1998 “On immunoprophylaxis of infectious diseases.”

3. Sanitary and epidemiological rules SP 3.1.958-99 “Prevention of viral hepatitis. General requirements for epidemiological surveillance of viral hepatitis."

4. Sanitary and epidemiological rules SP 3.1.2.1108-02 “Prevention of diphtheria”.

5. Sanitary and epidemiological rules SP 3.1.1.1118-02 “Prevention of polio.”

6. Sanitary and epidemiological rules SP 3.1.2.1176-02 “Prevention of measles, rubella and mumps.”

7. Sanitary and epidemiological rules SP 3.3.2.1248-03 “Conditions for transportation and storage of medical immunobiological preparations.”

8. Sanitary and epidemiological rules SP 3.1.1295-03 “Prevention of tuberculosis.”

9. Sanitary and epidemiological rules SP 3.1.2.1319-03 “Influenza Prevention”. Sanitary and epidemiological rules SP 3.1.2.1382-03. Additions and changes to SP 3.1.2.1319-03 “Influenza Prevention”.

10. Sanitary and epidemiological rules SP 3.1.2.1320-03 “Prevention of pertussis infection.”

11. Sanitary and epidemiological rules SP 3.1.2.1321-03 “Prevention of meningococcal infection.”

12. Sanitary and epidemiological rules SP 3.4.1328-03 “Sanitary protection of the territories of the Russian Federation”.

14. Sanitary and epidemiological rules SP 3.1.7.13 80-03 “Prevention of plague.”

15. Sanitary and epidemiological rules SP 3.1.1381-03 “Prevention of tetanus”.

16. Sanitary rules and regulations SanPiN 2.1.7.728-99 “Rules for the collection, storage and disposal of waste from medical institutions.”

17. Order of the Ministry of Health of the Russian Federation No. 229 dated June 27, 2001 “On the national calendar of preventive vaccinations and the calendar of preventive vaccinations for epidemic indications.”

18. Order of the Ministry of Health of the Russian Federation No. 25 of January 25, 1998 “On strengthening measures to prevent influenza and other acute respiratory viral infections.”

19. Order of the Ministry of Health of the Russian Federation No. 24 dated January 25, 1999 “On strengthening work to implement the program for eradicating polio in the Russian Federation by 2000.”

20. Order of the Ministry of Health of Russia dated July 29, 1998 No. 230 “On increasing the readiness of bodies and institutions of the State Sanitary and Epidemiological Service of Russia to work in emergency situations.”

21. Federal target program “Vaccine prevention for 1999 - 2000 and for the period until 2005.”

22. Instructions for compiling state statistical reporting in form No. 5 “Report on preventive vaccinations”, No. 01-19/18-10 dated 10/02/92, “Information on preventive vaccinations”, form No. 5, Goskomstat of Russia No. 152 dated 14.09. 95.

23. Instructions for compiling state statistical reporting in form No. 6 “On the contingents of children, adolescents and adults vaccinated against infectious diseases”, No. 10-19/18-10 dated 09.21.95.

1. Scope of application. 1 2. Basic provisions. 1 3. General requirements for organizing and conducting preventive vaccinations. 2 4. The procedure for carrying out preventive vaccinations. 2 5. Methodology for carrying out preventive vaccinations. 3 6. Disposal of vaccine residues, used syringes, needles and scarifiers. 4 7. Storage and use of vaccines. 4 8. The procedure for carrying out preventive vaccinations according to the national calendar of preventive vaccinations. 4 8.1. National calendar of preventive vaccinations. 4 8.2. Immunization against whooping cough. 5 8.3. Immunization against diphtheria. 5 8.4. Immunization against tetanus. 6 8.5. Immunization against measles, rubella, mumps. 7 8.6. Immunization against polio. 8 8.7. Immunization against viral hepatitis B.. 8 8.8. Immunization against tuberculosis. 8 9. The procedure for carrying out preventive vaccinations for epidemic indications.. 8 9.1. Immunoprophylaxis of plague.. 9 9.2. Immunoprophylaxis of tularemia. 9 9.3. Immunoprophylaxis of brucellosis. 11 9.4. Immunoprophylaxis of anthrax.. 11 9.5. Immunoprophylaxis of tick-borne encephalitis. 12 9.6. Immunoprophylaxis of leptospirosis. 12 9.7. Immunoprophylaxis of yellow fever. 13 9.8. Immunoprophylaxis of Q fever. 13 9.9. Immunoprophylaxis of rabies. 14 9.10. Immunoprophylaxis of typhoid fever. 14 9.11. Immunoprophylaxis of influenza. 14 9.12. Immunoprophylaxis of viral hepatitis A... 14 9.13. Immunoprophylaxis of viral hepatitis B.. 15 9.14. Immunoprophylaxis of meningococcal infection. 15 9.15. Immunoprophylaxis of mumps. 15 9.16. Immunoprophylaxis of measles. 16 9.17. Immunoprophylaxis of diphtheria. 16 9.18. Immunoprophylaxis of cholera.. 16 10. The procedure for registering preventive vaccinations. 16 11. Registration of refusal to carry out preventive vaccinations. 17 12. Bibliographic data. 17

National vaccination calendar- a document approved by order of the Ministry of Health of the Russian Federation, which determines the timing and types of vaccinations (preventive vaccinations) carried out free of charge and on a large scale in accordance with the compulsory health insurance program (CHI).

The vaccination calendar is developed taking into account all age-related characteristics, including the most dangerous infectious diseases in children in the first year of life. Vaccinations, which are given as part of the National Calendar, can significantly reduce the risk of disease in children. And if the child does get sick, then the vaccination given will help the disease progress in a milder form and relieve serious complications, many of which are extremely life-threatening.

The national vaccination calendar is a system for the most rational use of vaccines, ensuring the development of intense immunity at the earliest (vulnerable) age in the shortest possible time. The vaccination calendar can be divided into two parts.

First part– National calendar of preventive vaccinations, which provides vaccination against widespread infections that affect almost the entire human population (airborne infections - measles, rubella, mumps, whooping cough, chicken pox, diphtheria, influenza), as well as infections that are characterized by a severe course with high mortality (tuberculosis, hepatitis B, diphtheria, tetanus, polio, hemophilus influenzae type b).

Second part– vaccinations for epidemic indications – against natural focal infections (tick-borne encephalitis, leptospirosis, etc.) and zoonotic infections (brucellosis, tularemia, anthrax). This category may also include vaccinations carried out in risk groups - persons with both a high possibility of infection and a high danger to others in the event of their illness (such diseases include hepatitis A, typhoid fever, cholera).

Today, more than 1.5 thousand infectious diseases are known in the world, but people have learned to prevent only the 30 most dangerous infections with the help of preventive vaccinations. Of these, 12 infections, which are the most dangerous (including due to their complications) and which easily affect children all over the world, are included in the National Calendar of Preventive Vaccinations of Russia. Another 16 from the list of dangerous diseases are included in the National Vaccination Calendar for epidemic indications.

Each WHO member country has its own vaccination schedule. The national vaccination calendar of Russia is not fundamentally different from the national vaccination calendars of developed countries. True, some of them provide for vaccinations against hepatitis A, meningococcal infection, human papillomavirus, rotavirus infection (for example, in the USA). Thus, for example, the US national vaccination calendar is more saturated than the Russian calendar. The vaccination calendar in our country is expanding - for example, since 2015, it has included vaccination against pneumococcal infection.

On the other hand, in some countries, the National Calendar does not provide for vaccination against tuberculosis, which in our country is forced by the high incidence of this infection. And to this day, vaccination against tuberculosis is included in the vaccination schedule of more than 100 countries, while many provide for its implementation in the first days after birth, as recommended by the WHO Vaccination Schedule.

National vaccination calendars of different countries

Infections	Russia	USA	United Kingdom	Germany	Number of countries using vaccine in NK
Tuberculosis	+				more than 100
Diphtheria	+	+	+	+	194
Tetanus	+	+	+	+	194
Whooping cough	+	+	+	+	194
Measles	+	+	+	+	111
Flu	+	+	+	+
Haemophilus influenzae type b/Hib infection	+ (risk groups)	+	+	+	189
Rubella	+	+	+	+	137
Hepatitis A		+
Hepatitis B	+	+		+	183
Polio	+	+	+	+	all countries
Mumps	+	+	+	+	120
Chicken pox		+		+
Pneumococcus	Since 2015	+	+	+	153
Human papillomavirus / CC		+	+	+	62
Rotavirus infection		+			75
Meningococcal infection		+	+	+
Total infections	12	16	12	14
Number of injections administered up to 2 years	14	13		11

In Russia The national calendar is less crowded than the vaccination calendars of countries such as the USA and a number of European countries:

• there are no vaccinations against rotavirus infection, HPV, chickenpox;
• vaccinations against Hib are carried out only in risk groups, hepatitis A - according to epidemiological indications;
• there is no 2nd revaccination against whooping cough;
• Combination vaccines are underused.

Registered with the Ministry of Justice of the Russian Federation on April 25, 2014. Registration No. 32115 Published: May 16, 2014 in "RG" - Federal issue No. 6381.

National calendar of preventive vaccinations

Categories and ages of citizens subject to mandatory vaccination	Name of preventive vaccination
Newborns in the first 24 hours of life	First vaccination against viral hepatitis B
Newborns on the 3rd - 7th day of life	Vaccination against tuberculosis Vaccination is carried out with a vaccine for the prevention of tuberculosis for gentle primary vaccination (BCG-M); in constituent entities of the Russian Federation with incidence rates exceeding 80 per 100 thousand population, as well as in the presence of tuberculosis patients around the newborn - the vaccine for the prevention of tuberculosis (BCG).
Children 1 month	Second vaccination against viral hepatitis B The first, second and third vaccinations are carried out according to the 0-1-6 scheme (1 dose - at the start of vaccination, 2 dose - a month after 1 vaccination, 3 dose - 6 months after the start of vaccination), with the exception of children belonging to groups risk, vaccination against viral hepatitis B is carried out according to the 0-1-2-12 scheme (1 dose - at the start of vaccination, 2 dose - a month after 1 vaccination, 2 dose - 2 months after the start of vaccination, 3 dose - after 12 months from the start of vaccination).
Children 2 months	Third vaccination against viral hepatitis B (risk groups)
	First vaccination against pneumococcal infection
Children 3 months	First vaccination against diphtheria, whooping cough, tetanus
	First vaccination against polio
	First vaccination against Haemophilus influenzae infection (risk group)
Children 4.5 months	Second vaccination against diphtheria, whooping cough, tetanus
	Second vaccination against Haemophilus influenzae infection (risk group) Vaccination is carried out for children belonging to risk groups (with immunodeficiency conditions or anatomical defects leading to a sharply increased risk of hemophilus influenzae infection; with oncohematological diseases and/or long-term immunosuppressive therapy; children born from mothers with HIV infection; children with HIV- infection; children in orphanages).
	Second vaccination against polio The first and second vaccinations are carried out with a vaccine for the prevention of polio (inactivated).
	Second vaccination against pneumococcal infection
Children 6 months	Third vaccination against diphtheria, whooping cough, tetanus
	Third vaccination against viral hepatitis B The first, second and third vaccinations are carried out according to the 0-1-6 scheme (1 dose - at the start of vaccination, 2 dose - a month after 1 vaccination, 3 dose - 6 months after the start of vaccination), with the exception of children belonging to groups risk, vaccination against viral hepatitis B is carried out according to the 0-1-2-12 scheme (1 dose - at the start of vaccination, 2 dose - a month after 1 vaccination, 2 dose - 2 months after the start of vaccination, 3 dose - after 12 months from the start of vaccination).
	Third vaccination against polio
	Third vaccination against Haemophilus influenzae (risk group) Vaccination is carried out for children belonging to risk groups (with immunodeficiency conditions or anatomical defects leading to a sharply increased risk of hemophilus influenzae infection; with oncohematological diseases and/or long-term immunosuppressive therapy; children born from mothers with HIV infection; children with HIV- infection; children in orphanages).
Children 12 months	Vaccination against measles, rubella, mumps
	Fourth vaccination against viral hepatitis B (risk groups) Vaccination is carried out for children belonging to risk groups (born from mothers who are carriers of HBsAg, patients with viral hepatitis B or who have had viral hepatitis B in the third trimester of pregnancy, who do not have test results for markers of hepatitis B, who use narcotic drugs or psychotropic substances, from families in which who are a carrier of HBsAg or a patient with acute viral hepatitis B and chronic viral hepatitis).
Children 15 months	Revaccination against pneumococcal infection
Children 18 months	First revaccination against polio The third vaccination and subsequent revaccinations against polio are given to children with the vaccine for the prevention of polio (live); children born to mothers with HIV infection, children with HIV infection, children in orphanages - a vaccine for the prevention of polio (inactivated).
	First revaccination against diphtheria, whooping cough, tetanus
	Revaccination against Haemophilus influenzae infection (risk groups)
Children 20 months	Second revaccination against polio The third vaccination and subsequent revaccinations against polio are given to children with the vaccine for the prevention of polio (live); children born to mothers with HIV infection, children with HIV infection, children in orphanages - a vaccine for the prevention of polio (inactivated).
Children 6 years old	Revaccination against measles, rubella, mumps
Children 6 - 7 years old	Second revaccination against diphtheria, tetanus
	Revaccination against tuberculosis Revaccination is carried out with a vaccine to prevent tuberculosis (BCG).
Children 14 years old	Third revaccination against diphtheria, tetanus The second revaccination is carried out with toxoids with a reduced content of antigens.
	Third revaccination against polio The third vaccination and subsequent revaccinations against polio are given to children with the vaccine for the prevention of polio (live); children born to mothers with HIV infection, children with HIV infection, children in orphanages - a vaccine for the prevention of polio (inactivated).
Adults over 18 years old	Revaccination against diphtheria, tetanus - every 10 years from the date of the last revaccination
Children from 1 year to 18 years old, adults from 18 to 55 years old, not previously vaccinated	Vaccination against viral hepatitis B Vaccination is carried out for children and adults who have not previously been vaccinated against viral hepatitis B, according to the 0-1-6 scheme (1 dose - at the start of vaccination, 2 dose - a month after 1 vaccination, 3 dose - 6 months after the start of vaccination).
Children from 1 year to 18 years, women from 18 to 25 years (inclusive), not sick, not vaccinated, vaccinated once against rubella, who have no information about vaccinations against rubella	Vaccination against rubella
Children from 1 year to 18 years inclusive and adults under 35 years of age (inclusive), who have not been sick, not vaccinated, vaccinated once, and have no information about measles vaccinations	Vaccination against measles The interval between the first and second vaccinations should be at least 3 months
Children from 6 months, students in grades 1 - 11; students studying in professional educational organizations and educational organizations of higher education; adults working in certain professions and positions (employees of medical and educational organizations, transport, public utilities); pregnant women; adults over 60 years of age; persons subject to conscription for military service; people with chronic diseases, including lung disease, cardiovascular disease, metabolic disorders and obesity	Flu vaccination

The child receives the first vaccinations according to the National Calendar in the maternity hospital - this is the very first vaccination against hepatitis B, which is given in the first hours of life. Often the first vaccination against tuberculosis is also carried out within the walls of the maternity hospital. Before one year of age, children are vaccinated against hemophilus influenzae, whooping cough, polio, diphtheria, tetanus, and pneumococcal infection. From the age of six months, you can vaccinate your child against influenza. Older children, at the age of 12 months, receive vaccination protection against measles, rubella, and mumps.

Vaccinations with polysaccharide vaccines (Pneumo23, meningococcal vaccine, etc.) should begin after 2 years of age, since the child’s body does not respond by producing antibodies to these antigens. For younger children, conjugate vaccines (polysaccharide with protein) are recommended.

Ask a question to a specialist

Question for vaccination experts

Vaccinations are a way to prevent infectious diseases that have serious consequences. A vaccine causes a reaction that produces immunity against a specific disease.

Schedules for preventive vaccinations

Vaccination can be planned or for epidemiological reasons. The latter is carried out in cases of outbreaks of dangerous diseases in a certain region. But most often people are faced with routine preventive vaccinations. They are performed according to a specific schedule.

Some vaccinations are mandatory for everyone. These include BCG, CCP, DTP. Others are carried out exclusively for those who have an increased risk of contracting any disease, for example, due to work. It could be typhus, plague.

The vaccination calendar is developed taking into account many factors. Experts have provided different drug administration regimens and the possibility of combining them. The national calendar is valid throughout the country. It may be revised to reflect any new data.

In Russia, the national calendar includes all necessary vaccinations for all ages.

There are also regional calendars. For example, residents of Western Siberia are given additional doses because this infection is widespread there.

In Ukraine, the vaccination schedule is slightly different.

The procedure for carrying out preventive vaccinations

In order to administer a vaccine to a child or adult, a number of conditions must be met. The organization and implementation of preventive vaccinations is regulated by regulatory documents. The procedure can be carried out exclusively in clinics or specialized private medical institutions. The establishment must have a separate vaccination room for such manipulations, which must also meet certain requirements:

• it should contain: a refrigerator, sterile instruments, a changing table, a table, a cabinet for medicines, a disinfection solution;
• all used material and tools must be placed in a container with a disinfectant solution;
• It is necessary to have medications for anti-shock therapy;
• It is necessary to keep instructions for all medications;
• The office must be cleaned twice a day.

It is also important that vaccination against tuberculosis (BCG) should be carried out either in a separate room or exclusively on certain days.

Before the procedure, the patient must pass the necessary tests and be examined by a doctor. During the appointment, the doctor asks about your current health status and checks for any reactions to previous vaccinations. Based on this information, the doctor issues permission for the procedure.

The patient may be manipulated if contraindications to preventive vaccinations are identified. They can be permanent or temporary.

The first ones are not common and are most often a strong reaction to previous vaccinations.

Preventive vaccinations for children and adults are carried out in order to prevent them from becoming infected with infectious diseases, limit the spread of infections and completely eliminate infectious diseases on the territory of the Russian Federation.

Basic concepts and terms

In order to freely navigate this section of our website, you need to know the basic terms and concepts related to vaccinations.

Immunoprophylaxis of infectious diseases is a set of measures aimed at preventing, limiting the spread and eliminating infectious diseases through preventive vaccinations for the population.

Preventive vaccinations are the introduction of immunobiological drugs into the human body for immunoprophylaxis in order to create specific immunity (immunity) to certain infections.

Immunobiological drugs for immunoprophylaxis are vaccines, immunoglobulins, toxoids and other drugs intended to create specific immunity to infectious diseases in humans.

As a rule, a single injection of a vaccine is not enough to form full immunity. Therefore, immunoprophylaxis consists of successive stages, such as:

• vaccination is the primary administration of a vaccine, which can be either single or multiple. As a result of completed vaccination, the body’s stable immunity to infection is formed, but for a certain period of time for each disease. Subsequently, this immunity begins to weaken;
• Revaccination is the repeated administration of a vaccine at a distant but strictly designated time after vaccination. Revaccination can also be either single or multiple. It is designed to consolidate and strengthen the immunity created by vaccination.

The national calendar of preventive vaccinations is a normative legal act that establishes the timing and procedure for carrying out preventive vaccinations to citizens.

The calendar of preventive vaccinations for epidemic indications is a normative legal act that establishes the timing and procedure for carrying out preventive vaccinations for citizens according to epidemic indications.

Certificate of preventive vaccinations (vaccination certificate) is a document in which preventive vaccinations of a citizen are recorded throughout his life.

Consent to vaccination is the informed voluntary consent (IDS) of a citizen or his legal representative to a medical intervention, namely, to a preventive vaccination. IDS is one of the forms of mandatory medical documentation and has legal significance. There is a regulated procedure for its registration. The citizen to be vaccinated or his legal representative signs the IDS only after the medical worker provides complete information about the upcoming vaccination in an accessible form.

Refusal to vaccinate is a refusal of a citizen or his legal representative to receive a preventive vaccination. Every citizen of the Russian Federation has the right to refuse vaccination, but only after the possible health consequences and legal consequences of refusal are explained to him in a form accessible to him.

Contraindications to preventive vaccinations are certain diseases and conditions that increase the risk of developing post-vaccination complications. They are set out in detail in the guidelines “Medical contraindications for preventive vaccinations with drugs from the national vaccination calendar”, approved by the Chief State Sanitary Doctor of the Russian Federation on January 9, 2002.

Documents regulating immunoprophylaxis of infectious diseases in the Russian Federation

Preventive vaccinations are carried out to citizens in accordance with the legislation of the Russian Federation.

The legal basis for vaccination in the Russian Federation is as follows:

• The Constitution of the Russian Federation and Federal laws, the main one of which is the Federal Law of September 17, 1998 N 157-FZ “On the immunoprophylaxis of infectious diseases”.
• Resolutions and orders of the Government of the Russian Federation, for example, on approval of the list of post-vaccination complications, on the procedure for paying state one-time benefits and monthly monetary compensation to citizens if they experience post-vaccination complications, etc.
• Regulatory acts of the Ministry of Health and Social Development of the Russian Federation, including Order of the Ministry of Health of Russia dated March 21, 2014 N 125n “On approval of the national calendar of preventive vaccinations and the calendar of preventive vaccinations for epidemic indications”, etc.
• Regulatory acts of the Chief State Sanitary Doctor of the Russian Federation are sanitary and epidemiological rules, regulations, methodological recommendations and instructions.
• Regional legal acts are laws, regulations, orders adopted by individual subjects of the Russian Federation and valid on their territory.

Preventive vaccinations are carried out for citizens who do not have medical contraindications in medical organizations if they have licenses for medical activities. It is mandatory to have the informed voluntary consent of the citizen or his legal representative for medical intervention. Vaccination is carried out by medical workers who have undergone special training. All persons subject to vaccination are first examined by a doctor (paramedic).

National calendar of preventive vaccinations

The national calendar of preventive vaccinations is a document regulating the procedure and timing of mandatory vaccination of certain categories of citizens against certain infectious diseases. It indicates the names of vaccinations and the age when this or that vaccination/re-vaccination is carried out.

The national calendar of preventive vaccinations today provides for mandatory immunization of twelve infections, including the following:

• tuberculosis;
• viral hepatitis B;
• hemophilus influenzae infection;
• polio;
• mumps;
• rubella;
• measles;
• flu;
• pneumococcal infection.

Calendar of vaccinations carried out according to epidemic indications

The calendar of vaccinations carried out according to epidemic indications is a document that indicates the categories and ages of citizens who, if there is a threat of an infectious disease, are required to be vaccinated against this disease.

The vaccination calendar carried out according to epidemic indications includes the following infections:

• typhoid fever;
• yellow fever;
• tick-borne viral encephalitis;
• viral hepatitis A;
• viral hepatitis B;
• shigellosis;
• measles;
• polio;
• mumps;
• chicken pox;
• pneumococcal infection;
• rotavirus infection;
• hemophilus infection.

Decisions on carrying out preventive vaccinations for epidemic indications are made by the Chief State Sanitary Doctor and the chief state sanitary doctors of the constituent entities of the Russian Federation.

Classification of vaccines, requirements for them and methods of their administration

A vaccine is a drug intended to create artificial active immunity against the pathogen (or its toxin) of a specific infectious disease. Vaccines are obtained from viruses, bacteria, protozoa, fungi and their metabolic products. The active ingredients of vaccines can be:

• live or inactivated microorganisms;
• antigens with pronounced immunogenic properties;
• toxins - waste products of microorganisms;
• antigens obtained by chemical synthesis or using genetic engineering methods.

There are three types of vaccines based on the composition of the antigens they contain:

• monovaccines;
• polyvaccines;
• complex, combined or associated.

Based on their nature, physical condition and method of obtaining the antigen, vaccines are divided into:

• living - attenuated and divergent;
• inactivated (non-living) - these are corpuscular and molecular;
• recombinant.

The vaccine must meet established international standards, namely:

• cause the formation of strong and possibly long-lasting immunity;
• be absolutely safe for the body;
• have low reactogenicity, that is, the ability to cause post-vaccination reactions and complications;
• do not cause unwanted side reactions;
• be stable during storage.

There are several ways to administer vaccines:

• cutaneous;
• intradermal;
• subcutaneous;
• intramuscular;
• needleless (jet);
• oral (through the mouth);
• intranasal (spraying or instillation).

List of vaccines registered and approved for use in the Russian Federation

For immunoprophylaxis, domestic and foreign immunobiological drugs registered in accordance with the legislation of the Russian Federation are used. They are subject to mandatory certification or declaration of conformity in the manner established by the legislation of the Russian Federation.

List of vaccines and other immunobiological drugs for immunoprophylaxis, registered and approved for use in the Russian Federation:

• Influenza virus type A allantoic antigen - inactivated vaccine for the prevention of influenza;
• Tick-borne encephalitis vaccine, culture purified, concentrated, inactivated, dry, for the prevention of tick-borne encephalitis;
• Purified acellular pertussis vaccine for the prevention of whooping cough;
• Menugate is a group C oligosaccharide conjugated meningococcal vaccine for the prevention of meningococcal infections;
• MonoGrippol Neo - monovalent inactivated subunit adjuvant influenza vaccine for the prevention of influenza;
• Hepatitis B virus surface antigen (HBsAg) purified concentrated - vaccine for the prevention of viral hepatitis B;
• Poliorix is ​​an inactivated vaccine for the prevention of polio;
• Tetraanatoxin purified adsorbed liquid (botulinum toxoid + tetanus toxoid) for the prevention of botulism and tetanus;
• Typhim-VI - a vaccine for the prevention of typhoid fever;
• TEOWak - live embryonic smallpox vaccine for the prevention of smallpox;
• FSME-Immun Inject - a vaccine for the prevention of tick-borne encephalitis;
• FSME-Bulin - immunoglobulin against tick-borne encephalitis;
• Encepur for children - inactivated purified vaccine against tick-borne encephalitis with an adjuvant;
• Encepur adult - inactivated purified vaccine against tick-borne encephalitis with adjuvant;
• Ervevax is a vaccine for the prevention of rubella;
• Euvax B - recombinant vaccine for the prevention of hepatitis B;

Vaccinations for children

Children who have no contraindications are vaccinated according to the national calendar, which includes all mandatory vaccinations. Consent to vaccination is given and signed by the legal representative of the minor.

Already in the maternity hospital, each newborn baby receives two vaccinations - against tuberculosis and the first against viral hepatitis B. After discharge from the maternity hospital, the child is placed under the supervision of a pediatrician and a local nurse at the children's clinic. They provide him with timely immunoprophylaxis of infectious diseases before entering kindergarten.

Before the start of routine immunization at the clinic, the pediatrician refers the child for blood and urine tests. If a child has contraindications, the doctor issues a medical exemption from vaccinations and draws up an individual plan for immunoprophylaxis. Some children, such as those with allergies or neurological conditions, often need special preparation for vaccinations, so the doctor may prescribe antihistamines for them several days before vaccination. Immediately before vaccination, each child is subject to a medical examination. After vaccination, the local nurse monitors how the post-vaccination period progresses, and if a reaction to the vaccine occurs, informs the doctor about it.

At the time of registration for kindergarten (on average by 2.5 years), according to the national calendar, the child must have the following mandatory vaccinations:

• full vaccination against viral hepatitis B;
• vaccination and revaccination against pneumococcal infection;
• vaccination and two revaccinations against polio;
• vaccination and first revaccination against whooping cough, diphtheria and tetanus;
• vaccination and revaccination against Haemophilus influenzae infection;
• vaccination against measles, rubella, mumps.

At school, immunization issues are dealt with by the school doctor and the school nurse. Before entering school or already in the first grade (at 6-7 years old), the child receives a revaccination against measles, rubella, mumps, a revaccination against tuberculosis and a second revaccination against diphtheria and tetanus. At the age of 14, the child is vaccinated against polio (third revaccination) and against diphtheria and tetanus (third revaccination). All schoolchildren receive flu vaccinations every year.

Doctor's advice: at any of the listed stages of immunoprophylaxis, the pediatrician will answer all your questions regarding preventive vaccinations for your child. Therefore, do not hesitate to ask your doctor when you can go for a walk after vaccination, whether you can or cannot wet the vaccine injection site, what to do if your child has a fever after vaccination, etc.

If an epidemic-hazardous situation arises, when there is a high probability of the occurrence and spread of some infectious disease, all children, along with adults, are subject to vaccination according to the preventive vaccination calendar for epidemic indications.

Vaccinations for adults, including pregnant women

Vaccinations given in childhood do not protect against dangerous infections for life. Therefore, in order to maintain immunity or to create it (if vaccinations have not been done previously), the adult population is also subject to immunoprophylaxis of infectious diseases.

Vaccinations for adults against certain diseases are included in the national calendar of preventive vaccinations as mandatory, namely:

• against diphtheria and tetanus;
• against rubella. This vaccination is especially recommended for all women under 40-45 years of age who are planning pregnancy;
• against viral hepatitis B;
• against measles;
• against the flu. This is an annual vaccination that is carried out, including for pregnant women in the 2nd-3rd trimester of pregnancy.

In addition to mandatory vaccinations, adults are recommended to protect themselves by vaccination against diseases such as:

• chicken pox;
• pneumococcal infection;
• human papillomavirus, some types of which cause cervical cancer, genital warts and some other diseases;
• tick-borne encephalitis;
• viral hepatitis A;
• meningococcal infection;
• mumps;
• hemophilus influenzae infection;
• polio;
• herpetic infection.

To date, no effective vaccine against HIV infection has been created, just like a vaccine against cancer. The trials of the once sensational Britov vaccine ended before they even began.

If epidemic indications arise, all adults are vaccinated against infectious diseases according to the calendar of preventive vaccinations according to epidemic indications.

In addition, Decree of the Government of the Russian Federation dated July 15, 1999 N 825 approved a list of works, the implementation of which requires mandatory preventive vaccinations.

Possible post-vaccination reactions and complications

The human body can react differently to the introduction of a vaccine, which depends on its individual characteristics and the reactogenicity of the administered drug.

There are two types of reactions to the administration of immunobiological drugs:

• 1st: post-vaccination reactions (local and general) are various unstable changes in the state of the body that go away on their own;
• 2nd: post-vaccination complications - severe and/or persistent health problems due to preventive vaccinations.

Russian legislation guarantees citizens social support in the event of post-vaccination complications.

Intradermal tests, their difference from vaccinations

Intradermal tests, namely the Mantoux reaction and Diaskintest, are often mistakenly classified as vaccinations.

The Mantoux reaction is a diagnostic tuberculin test for the presence of tuberculosis infection in the human body. It has nothing to do with preventive vaccinations. It is carried out once a year for all children until they graduate from school. If indicated, it may be re-prescribed. Tuberculin, which is administered intradermally during the Mantoux test, is absolutely safe for the child’s health.

Diaskintest is a drug for diagnosing tuberculosis. The Diaskintest test is considered more specific than the Mantoux reaction. Tuberculin reacts both to the components of the previously administered BCG vaccine and to all mycobacteria (not only tuberculosis) present in the body. Diaskintest reacts exclusively to Mycobacterium tuberculosis, so its results are more reliable. The test with Diaskintest is also completely safe for health and has nothing to do with preventive vaccinations.

Vaccinations for persons traveling to foreign countries

Travel lovers are a separate category of citizens. They must remember that the human body cannot always withstand the onslaught of bacteria and viruses that “live” in exotic countries. Therefore, it makes sense to take care of your health in advance for tourists intending to visit countries such as:

• Thailand;
• India, including Goa;
• African states, including Kenya, Morocco, Tunisia, Tanzania, Zanzibar, etc.;
• Brazil;
• China;
• Vietnam;
• Sri Lanka;
• Malaysia;
• Indonesia, including the island of Bali;
• Dominican Republic

If you can protect yourself from yellow fever, meningococcal infection, typhoid fever, cholera and many other infections with preventive vaccinations, you cannot protect yourself from malaria. There is no vaccine against malaria.

Is it necessary and possible to get vaccinated?

Discussions on this topic are unlikely to ever stop. Despite the need and importance of immunoprophylaxis of infectious diseases, confirmed over decades, there are always its opponents, such as G.P. Chervonskaya (Soviet virologist, candidate of biological sciences, member of the Russian National Committee on Bioethics of the Russian Academy of Sciences). It was she who stood at the origins of anti-vaccination propaganda.

It makes no sense to put possible post-vaccination reactions and complications on the left side of the scale, and the consequences of severe infectious diseases on the right side. Child and adult mortality from infections, disability of those who have been ill, and incurable complications will drag the right cup “to the bottom.”

Thanks to the explanatory work that is constantly carried out by epidemiologists, immunologists, and practicing doctors of various specialties (E.O. Komarovsky, etc.), the medical literacy of the population in terms of immunoprophylaxis is growing. Adult citizens are increasingly willing to vaccinate themselves and vaccinate their children against dangerous infections. And that's very good. Only through the joint efforts of medical workers and the population can the epidemic situation in the country be improved and the level of infectious diseases reduced.

Order of the Ministry of Health of the Russian Federation dated March 21, 2014 No. 252n

“On approval of the national calendar of preventive vaccinations and the calendar of preventive vaccinations for epidemic indications «

“National calendar of preventive vaccinations”

Age	Name of vaccination	Vaccines
Newborns (in the first 24 hours of life)	First vaccination against viral hepatitis B¹	Euvax B 0.5
Newborns (3-7days)	Vaccination against tuberculosis 2	BCG-M
Children 1 month	Second vaccination against viral hepatitis B 1	Engerix B 0.5 Euvax B 0.5
Children 2 months	Third vaccination against viral hepatitis B (risk groups) 1 First vaccination against pneumococcal infection	Euvax B 0.5
Children 3 months	First vaccination against diphtheria, whooping cough, tetanus First vaccination against polio 4	Infanrix Poliorix Pentaxim
	First vaccination against Haemophilus influenzae infection (risk group) 5	Act-HIB Hiberix Pentaxim
4.5 months	Second vaccination against diphtheria, whooping cough, tetanus Second vaccination against polio 4 Second vaccination against pneumococcal infection	Infanrix Poliorix Pentaxim Prevenar 13
	Second vaccination against Haemophilus influenzae infection (risk group) 5	Act-HIB Hiberix Pentaxim
6 months	Third vaccination against viral hepatitis B 1	Euvax B 0.5 Infanrix Hexa
	Third vaccination against diphtheria, whooping cough, tetanus Third vaccination against polio 6	Infanrix Poliorix Pentaxim Infanrix Hexa
	Third vaccination against Haemophilus influenzae (risk group) 5	Act-HIB Hiberix Pentaxim Infanrix Hexa
12 months	Fourth vaccination against viral hepatitis B (risk groups) 1	Measles Rubella
	15 months	Revaccination against pneumococcal infection	Prevenar 13
18 months	First revaccination against diphtheria, whooping cough, tetanus First revaccination against polio 6	Infanrix Poliorix Pentaxim
	Revaccination against Haemophilus influenzae infection (risk group) 5	Act-HIB Hiberix
20 months	Second revaccination against polio 6	OPV
6 years	Revaccination against measles, rubella, mumps	Priorix Measles Rubella
6-7 years	Second revaccination against diphtheria, tetanus 7	ADS-M
	Revaccination against tuberculosis 8	BCG-M
14 years old	Third revaccination against diphtheria, tetanus 7
	Third revaccination against polio 6	Poliorix
Adults over 18 years old	Revaccination against diphtheria, tetanus - every 10 years from the date of the last revaccination	ADS-M
Children from 1 year to 18 years old, adults from 18 to 55 years old, not previously vaccinated	Vaccination against viral hepatitis B 9	Engerix B 0.5 Euvax B 0.5 Engerix V 1,0
Children from 1 year to 18 years (inclusive), women from 18 to 25 years (inclusive), who have not been sick, not vaccinated, vaccinated once against rubella, who do not have information about vaccinations against rubella	Vaccination against rubella, revaccination against rubella	Rubella
Children from 1 year to 18 years (inclusive) and adults up to 35 years (inclusive), who have not been sick, not vaccinated, vaccinated once, and have no information about vaccinations against measles; adults from 36 to 55 years (inclusive) belonging to risk groups (employees of medical and educational organizations, trade, transport, public utilities and social spheres; persons working on a rotational basis, and employees of state control bodies at checkpoints across the state border of the Russian Federation ), not sick, not vaccinated, vaccinated once, with no information about measles vaccinations	Vaccination against measles, revaccination against measles	Measles
Children from 6 months; students in grades 1-11; students studying in professional educational organizations and educational organizations of higher education; adults working in certain professions and positions (employees of medical and educational organizations, transport, public utilities); pregnant women; adults over 60 years of age; persons subject to conscription for military service; people with chronic diseases, including lung disease, cardiovascular disease, metabolic disorders and obesity	Flu vaccination	Vaxigrip Influvac Grippol+ Grippol quadrivalent Ultrix
	Pneumococcal	Pneumo 23 Prevenar 13
Children and adults according to epidemiological indications	Meningococcal	Calendar of preventive vaccinations for epidemic indications Name of vaccination Categories of citizens subject to preventive vaccinations for epidemic indications and the procedure for their implementation Against tularemia Persons living in territories enzootic for tularemia, as well as those arriving in these territories - agricultural, drainage, construction, other work on excavation and movement of soil, procurement, fishing, geological, survey, expedition, deratization and disinfestation; * Persons working with live cultures of the causative agent of tularemia. Against the plague Persons living in areas enzootic for plague. Persons working with live cultures of the plague pathogen. Against brucellosis In foci of goat-sheep type brucellosis, persons performing the following work: — on the procurement, storage, processing of raw materials and livestock products obtained from farms where livestock diseases with brucellosis are registered; — for the slaughter of livestock suffering from brucellosis, the procurement and processing of meat and meat products obtained from it. Livestock breeders, veterinarians, livestock specialists in farms enzootic for brucellosis. Persons working with live cultures of the causative agent of brucellosis. Against anthrax Persons performing the following work: — livestock workers and other persons professionally engaged in pre-slaughter livestock maintenance, as well as slaughter, skinning and cutting of carcasses; — collection, storage, transportation and primary processing of raw materials of animal origin; - agricultural, drainage, construction, excavation and movement of soil, procurement, fishing, geological, survey, expedition in anthrax-enzootic territories. Persons working with material suspected of being infected with anthrax. Against rabies For preventive purposes, people at high risk of contracting rabies are vaccinated: — persons working with the “street” rabies virus; — veterinary workers; huntsmen, hunters, foresters; persons performing work on catching and keeping animals. Against leptospirosis Persons performing the following work: — on the procurement, storage, processing of raw materials and livestock products obtained from farms located in areas enzootic for leptospirosis; — for the slaughter of livestock with leptospirosis, the procurement and processing of meat and meat products obtained from animals with leptospirosis; - on catching and keeping stray animals. Persons working with live cultures of the causative agent of leptospirosis. Against tick-borne viral encephalitis Persons living in areas endemic for tick-borne viral encephalitis, as well as persons arriving in these territories performing the following work: — agricultural, drainage, construction, excavation and movement of soil, procurement, fishing, geological, survey, expedition, deratization and disinfestation; — logging, clearing and landscaping of forests, health and recreation areas for the population. Persons working with live cultures of tick-borne encephalitis. Against Q fever Persons performing work on the procurement, storage, processing of raw materials and livestock products obtained from farms where diseases of cattle Q fever are registered; Persons performing work on the procurement, storage and processing of agricultural products in enzootic areas with Q fever. Persons working with live cultures of Q fever pathogens. Against yellow fever Persons traveling outside the Russian Federation to countries (regions) enzootic for yellow fever. Persons working with live cultures of the yellow fever pathogen. Against cholera Persons traveling to cholera-prone countries (regions). The population of the constituent entities of the Russian Federation in the event of complications of the sanitary and epidemiological situation regarding cholera in neighboring countries, as well as on the territory of the Russian Federation. Against typhoid fever Persons engaged in the field of municipal improvement (workers servicing sewer networks, structures and equipment, as well as organizations carrying out sanitary cleaning of populated areas, collection, transportation and disposal of household waste. Persons working with live cultures of typhoid pathogens. Population living in areas with chronic water epidemics of typhoid fever. Persons traveling to countries (regions) that are hyperendemic for typhoid fever. Contact persons in areas of typhoid fever according to epidemiological indications. According to epidemic indications, vaccinations are carried out when there is a threat of an epidemic or outbreak (natural disasters, major accidents in the water supply and sewerage networks), as well as during an epidemic, while mass vaccination of the population is carried out in the threatened area. Against viral hepatitis A Persons living in regions disadvantaged by the incidence of hepatitis A, as well as persons at occupational risk of infection (medical workers, public service workers employed in food industry enterprises, as well as those servicing water supply and sewerage facilities, equipment and networks). Persons traveling to disadvantaged countries (regions) where outbreaks of hepatitis A are registered. Contacts in foci of hepatitis A. Against shigellosis Employees of medical organizations (their structural divisions) with an infectious disease profile. Persons engaged in the field of public catering and municipal improvement. Children attending preschool educational institutions and going to organizations providing treatment, rehabilitation and (or) recreation (as indicated). According to epidemic indications, vaccinations are carried out when there is a threat of an epidemic or outbreak (natural disasters, major accidents in the water supply and sewerage networks), as well as during an epidemic, while mass vaccination of the population is carried out in the threatened area. Preventive vaccinations are preferably carried out before the seasonal increase in the incidence of shigellosis. Against meningococcal infection Children and adults in areas of meningococcal infection caused by meningococci of serogroups A or C. Vaccination is carried out in endemic regions, as well as in the event of an epidemic caused by meningococci of serogroups A or C. Persons subject to conscription for military service. Against measles Contact persons without age restrictions from the outbreaks of the disease, who have not previously been ill, have not been vaccinated and do not have information about preventive vaccinations against measles, or have been vaccinated once. Against hepatitis B Contact persons from the outbreaks of the disease who have not been sick, have not been vaccinated and do not have information about preventive vaccinations against hepatitis B. Against diphtheria Contact persons from the outbreaks of the disease who have not been sick, have not been vaccinated and do not have information about preventive vaccinations against diphtheria. Against mumps Contact persons from the foci of the disease who have not been sick, have not been vaccinated and do not have information about preventive vaccinations against mumps. Against polio Contact persons in foci of polio, including those caused by wild poliovirus (or if the disease is suspected): - children from 3 months to 18 years - once; - medical workers - once; - children arriving from endemic areas (disadvantaged) for polio in countries (regions), from 3 months to 15 years - once (if there is reliable data on previous vaccinations) or three times (if there are none); - persons without a fixed place of residence (if identified) from 3 months to 15 years - once (if there is reliable data on previous vaccinations) or three times (if they are absent); — persons who had contact with those arriving from endemic areas (disadvantaged) for polio of countries (regions), from 3 months of life without age limit - once; - persons working with live poliovirus, with materials infected (potentially infected) with wild poliovirus without age limit - once upon hiring Against pneumococcal infection Children aged 2 to 5 years, adults from risk groups, including persons subject to conscription for military service. Against rotavirus infection Children for active vaccination to prevent diseases caused by rotaviruses. Against chicken pox Children and adults from risk groups, including those subject to conscription for military service, who have not previously been vaccinated and have not had chickenpox. Against hemophilus influenzae Children who were not vaccinated against hemophilus influenzae in the first year of life The procedure for carrying out preventive vaccinations for citizens within the framework of the preventive vaccination calendar for epidemic indications 1. Preventive vaccinations within the framework of the calendar of preventive vaccinations for epidemic indications are carried out to citizens in medical organizations if such organizations have a license providing for the performance of work (services) on vaccination (carrying out preventive vaccinations). 2. Vaccination is carried out by medical workers who have been trained in the use of immunobiological drugs for the immunoprophylaxis of infectious diseases, the rules of organization and technique of vaccination, as well as in the provision of emergency or emergency medical care. 3. Vaccination and revaccination within the framework of the preventive vaccination calendar for epidemic indications is carried out with immunobiological drugs for the immunoprophylaxis of infectious diseases, registered in accordance with the legislation of the Russian Federation, in accordance with the instructions for their use. 4. Before carrying out a preventive vaccination, the need for immunoprophylaxis of infectious diseases, possible post-vaccination reactions and complications, as well as the consequences of refusing immunization is explained to the person to be vaccinated or his legal representative (guardians), and informed voluntary consent to medical intervention is drawn up in accordance with the requirements of Article 20 of the Federal Law dated November 21, 2011 No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation.” 11 11 Collection of Legislation of the Russian Federation, 2012, No. 26, Art. 3442; No. 26, art. 3446; 2013, No. 27, art. 3459; No. 27, art. 3477; No. 30, art. 4038; No. 48, art. 6165; No. 52, art. 6951. 5. All persons who should receive preventive vaccinations are first examined by a doctor (paramedic). 12 12 Order of the Ministry of Health and Social Development of the Russian Federation dated March 23, 2012 No. 252n “On approval of the Procedure for assigning to a paramedic and midwife the head of a medical organization when organizing the provision of primary health care and emergency medical care of certain functions of the attending physician for the direct provision of medical care to the patient during the period of observation and treatment, including the prescription and use of medications, including narcotic drugs and psychotropic drugs." (registered Ministry of Justice of the Russian Federation April 28, 2012, registration number No. 23971). 6. It is allowed to administer vaccines on the same day with different syringes to different parts of the body. The interval between vaccinations against different infections when administered separately (not on the same day) should be at least 1 month. 7. Vaccination against polio according to epidemic indications is carried out with oral polio vaccine. Indications for vaccinating children with oral polio vaccine for epidemic indications are registration of a case of polio caused by wild poliovirus, isolation of wild poliovirus in human biosamples or from environmental objects. In these cases, vaccination is carried out in accordance with the decree of the chief state sanitary doctor of the constituent entity of the Russian Federation, which determines the age of children to be vaccinated, the timing, procedure and frequency of its implementation.