Rules for vaccinations for children. The procedure for vaccinations
PREVENTIVE VACCINATIONS
Second vaccination against viral hepatitis B
First vaccination against diphtheria, whooping cough, tetanus, polio
Revaccination against measles, rubella, mumps
Second revaccination against diphtheria, tetanus
Vaccination against rubella (girls).
Vaccination against viral hepatitis B (not previously vaccinated)
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, and 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 DPT 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 condition.
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 DPT 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 DTP 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;
Those who have 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-anatoxin 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 - into 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 not infected 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 (N 0415) with a short cut.
9. The procedure for carrying out preventive vaccinations
according to 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 of July 17, 1999 N 825.
Immunization for epidemic indications is carried out by decision of the state sanitary and epidemiological surveillance 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 state sanitary and epidemiological surveillance 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 of 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 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, floodplain-marsh (and its variants), and foothill-stream types.
In meadow-field areas, 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 assigned 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);
For producers of game animal skins;
Employees of fur factories involved in the primary processing of skins;
Employees of the departments of especially dangerous infections of state sanitary and epidemiological surveillance 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 floodplain-marsh 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 state sanitary and epidemiological surveillance 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 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:
For permanent and temporary livestock workers - until the complete elimination of animals infected with Brucella of the goat-sheep species on farms;
To the personnel of organizations for the procurement, storage, processing of raw materials and livestock products - until the complete elimination of such animals in the 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 territorial centers of 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 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, expeditionary, construction, excavation and movement of soil, procurement, fishing;
For the slaughter of livestock infected with anthrax, the 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. Monitoring the timeliness and completeness of coverage of contingents with immunization against anthrax is carried out by territorial centers of state sanitary and epidemiological surveillance.
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 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 ensure 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 territorial centers of 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 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 state sanitary and epidemiological supervision.
9.6.2. Persons at increased risk of infection who perform the following work are subject to immunization:
For 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 state sanitary and epidemiological surveillance.
9.7. Immunoprophylaxis of yellow fever
9.7.1. A number of countries with territories enzootic for yellow fever require from persons traveling to these territories 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 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 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:
For the procurement, storage, processing of raw materials and livestock products obtained from farms where Q fever in small and large livestock is recorded;
On the procurement, storage, processing of agricultural products in enzootic areas for Q fever;
For the care of 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 are allowed to care for sick animals :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 territorial centers of 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 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 territorial centers of state sanitary and epidemiological surveillance.
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 by decision of the territorial centers of 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;
Workers in the public service sector, primarily employed in public catering organizations;
Workers maintaining 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 state sanitary and epidemiological surveillance.
9.12.3. Monitoring of immunization against hepatitis A is carried out by territorial centers of 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 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 - 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 state sanitary and epidemiological surveillance.
9.14.3. Control over the implementation of immunoprophylaxis is carried out by territorial centers of state sanitary and epidemiological supervision.
9.15. Immunoprophylaxis of mumps
9.15.1. Vaccinations against mumps are carried out to 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.
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 vaccinationsVaccination 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 former are not common and are most often a strong reaction to previous vaccinations.
In the fight against infectious diseases, specific prevention methods are becoming increasingly important.
From this article you will learn what vaccination of children is, what are the basic rules for vaccination and much other useful information about vaccination in Russia.
History of vaccination
Protection against infection through immunization has been known for hundreds of years. Thus, since ancient times, the Chinese have sucked dried and crushed crusts of smallpox patients into their noses. However, this method, called variolation, was associated with a great risk to life and health. In the 18th century, Edward Jenner first began vaccinating people to protect them from smallpox. He rubbed a drop of pus containing the harmless cowpox virus into the scarified (incised) skin. E. Jenner called the vaccination method vaccination (Latin vaccinatio; from vacca - cow), and the material taken from cow smallpox pustule - vaccine.
100 years later, Louis Pasteur developed the scientific basis for the creation and use of vaccines from living microbes. He showed that with the natural aging of cultures, the cultivation of pathogens of infectious diseases in unusual media, exposure to unfavorable environmental factors, as well as the passage of microbes through the body of immune animals, a sharp weakening (attenuation) of virulence is possible without a significant reduction in antigenicity.
Domestic researchers I. I. Mechnikov, P. Erlikh, P. F. Zdrodovsky, A. M. Bezredka, A. A. Smorodintsev and others made a great contribution to the development of vaccine prevention.
Purpose of vaccination- creation of specific immunity to an infectious disease. Immunization must be harmless and effective.
Active post-vaccination immunity lasts for 5-10 years in those vaccinated against measles, diphtheria, tetanus, polio, or for several months in those vaccinated against influenza and typhoid fever. However, with timely revaccination, immunity can last throughout life.
Children born prematurely or with low body weight respond to immunization to the same extent as children born at term of the same age.
Immunology of the vaccine process
The immune response to the vaccine involves macrophages, T-lymphocytes (effector-cytotoxic, regulatory-helper, memory T-cells), B-lymphocytes (memory B-cells), antibodies produced by plasma cells (IgM, IgG, IgA), and also cytokines (monokines, lymphokines).
After vaccine administration, macrophages capture antigenic material, break it down intracellularly, and present antigen fragments on their surface in an immunogenic form (epitopes). T lymphocytes recognize the antigens presented by the macrophage and activate B lymphocytes, which turn into plasma cells.
The formation of antibodies in response to the primary introduction of an antigen is characterized by three periods:
The latent period, or “lag phase,” is the time interval between the introduction of an antigen (vaccine) into the body and the appearance of antibodies in the blood. Its duration ranges from several days to 2 weeks, depending on the type, dose, method of antigen administration, and the characteristics of the child’s immune system.
The growth period is characterized by a rapid increase in antibodies in the blood. The duration of this period can range from 4 days to 4 weeks: approximately 3 weeks in response to tetanus and diphtheria toxoids, 2 weeks in response to pertussis vaccine. After the administration of measles and mumps vaccines, specific antibodies increase quickly, which allows the use of active immunization for emergency prevention of measles and mumps in foci of infection (in the first 2-3 days from the moment of contact).
A period of decline occurs after the maximum level of antibodies in the blood is reached, and their number decreases initially quickly and then slowly over several years.
An essential component of the primary immune response is the production of immunoglobulin class M (IgM), while in the secondary immune response, antibodies are represented mainly by class immunoglobulin G (IgG). Repeated administration of the antigen leads to a faster and more intense immune response: the “lag phase” is absent or becomes shorter, the maximum level of antibodies is reached more quickly, and the persistence of antibodies is prolonged.
The optimal time interval between vaccine administrations is 1-2 months. Reducing the intervals contributes to the neutralization of antigens by preceding antibodies, lengthening them does not cause a decrease in the effectiveness of immunization, but leads to an increase in the non-immune layer of the population.
Children with an unfavorable allergy history may respond to the administration of immune drugs by developing allergic reactions. The pertussis component of the DPT vaccine, components of culture media and cell cultures on which vaccine strains of viruses are grown, as well as antibiotics used in the production of vaccines have an allergenic effect. However, the administration of the DPT vaccine, although it may cause a short-term increase in the level of total IgE in the blood, does not, as a rule, lead to a persistent increase. The use of toxoids in children with allergic diseases is usually not accompanied by an increase in specific Ig E antibodies to food, household and pollen allergens.
Types and characteristics of vaccines
Preparations used for immunization
Vaccines are preparations obtained from weakened, killed microorganisms or their metabolic products and used for active immunization for the purpose of specific prevention of infections.
Live vaccines are produced using live attenuated microorganisms with persistent avirulence. Vaccine strains multiply in the human body and induce cellular, humoral and local immunity. Live vaccines create highly intense and long-lasting immunity. The following live vaccines are used: BCG, oral polio Sabin, measles, mumps, rubella; vaccines against plague, tularemia, brucellosis, anthrax, KU fever. Live vaccines are contraindicated for immunization of children with immunodeficiencies, patients receiving glucocorticoids, immunosuppressants, radiotherapy, as well as patients with lymphomas and leukemia; they are contraindicated in pregnant women due to the risk of fetal damage.
Inactivated (killed) vaccines are obtained by neutralizing bacteria and viruses using chemical or physical action. Killed vaccines (pertussis, rabies, leptospirosis, polio Salka, etc.) create unstable humoral immunity; to achieve a protective level of specific antibodies, they must be re-administered.
Anatoxins are made from exotoxins of pathogens by treating them with a 0.3-0.4% formaldehyde solution at a temperature of +38-40 ° C for 3-4 weeks. Toxoids are adsorbed on aluminum hydroxide; they are easily dosed and combined with other vaccine preparations. When toxoids are administered, antitoxic immunity is developed. Diphtheria, tetanus, staphylococcal toxoids, as well as toxoids against botulism and gas gangrene are used.
Chemical (subcellular) vaccines contain antigenic fractions of killed microorganisms. These include: polyvalent polysaccharide pneumococcal vaccine, polysaccharide meningococcal A and A+C vaccines, TABTe (against typhoid fever, paratyphoid A and B, tetanus).
Recombinant vaccines (against viral hepatitis B, influenza, etc.) are created using the latest genetic engineering technologies. Inactivated vaccines, toxoids, chemical and recombinant vaccines contain an adjuvant (phosphate or aluminum hydroxide) that enhances the immune response.
There are mono-vaccines (contain one antigen), associated (have several antigens) and polyvalent vaccines (consist of different strains of the same type of microorganism). An example of an associated (combined) vaccine is the adsorbed pertussis-diphtheria-tetanus vaccine (DTP), containing killed pertussis bacteria, diphtheria and tetanus toxoids; polyvalent - Sabin's oral noliomyelitis vaccine, consisting of attenuated strains of poliovirus types 1, 2, 3.
Reactions to vaccines
The body's response to the vaccine
The introduction of a vaccine into a child’s body is accompanied by the development of the vaccination process, which, as a rule, is asymptomatic. It is possible that normal (usual) reactions (general and local) may occur after vaccination.
Assessment of the intensity of general reactions
To assess the intensity of general reactions, the following criteria are used:
- weak reaction - increase in body temperature to 37.5 ° C in the absence of symptoms of intoxication;
- medium strength - body temperature rises within 37.6-38.5 ° C with moderate symptoms of intoxication;
- a strong reaction - an increase in temperature above 38.5 ° C with pronounced but short-term symptoms of intoxication.
Assessment of the intensity of local reactions
To assess the intensity of local reactions, the following criteria are used:
- weak reaction - hyperemia at the injection site or hyperemia with infiltrate up to 2.5 cm in diameter;
- medium strength - infiltrate with a diameter of 2.6-5.0 cm with or without lymphangitis;
- severe reaction - infiltrate 5.0-8.0 cm in diameter; the presence of lymphangitis and lymphadenitis.
Usual general and local reactions after preventive vaccinations occur only in a portion of those vaccinated. The guidelines for the use of biological drugs define the permissible degree of their reactogenicity. If the frequency of pronounced (strong) reactions among vaccinated people exceeds the percentage allowed by the instructions, further use of this series of vaccines is not allowed. For example, vaccinations against measles are stopped if among those vaccinated there are more than 4% of people with a pronounced general reaction. The DPT vaccine is allowed for use if the number of strong reactions does not exceed 1%.
In some cases, after vaccination, the development of pathological reactions (complications) - general and local - is noted.
Vaccination rules
Before vaccination, the doctor analyzes the epidemiological history (information about contacts with infectious patients), carefully examines the child and measures body temperature. Laboratory examination and specialist consultations are carried out according to indications.
Children who have not been vaccinated due to temporary contraindications are vaccinated according to an individual schedule in accordance with the recommendations of relevant specialists and current instructions for the use of drugs.
The medical documentation records the doctor (paramedic) authorizing the vaccination with a specific drug.
How and where are children vaccinated?
All preventive vaccinations are done only with disposable syringes. Vaccinations should be given by health care workers who have undergone appropriate training and are also trained in how to provide emergency care for complications after vaccinations. Emergency medical care and anti-shock therapy kits must be available in the premises where vaccinations are carried out.
Vaccinations, especially live vaccines, are recommended to be carried out in the morning in a sitting or lying position (to prevent falling during fainting). Within 0.5-1 hour after vaccination, medical supervision of the child is necessary due to the possible development of immediate allergic reactions. Then, for 3 days, the child must be observed by a nurse at home (in an organized group). After vaccination with live vaccines, the child is additionally examined by a nurse on the 5-6th and 10-11th days, since reactions occur during these periods.
It is necessary to warn parents about possible reactions after administration of the vaccine, recommend a hyposensitizing diet and a protective regime.
Measles. Vaccination - at the age of 12 months. Revaccination - at the age of 6 years. The interval between administration of the polio-pertussis-diphtheria-tetanus vaccine and the measles vaccine should be at least two months. Vaccination and revaccination are carried out once.
Mumps. Vaccination - at the age of 12 months. In the absence of a combined vaccine (measles, mumps, rubella), the vaccination is carried out together with the measles vaccination with different syringes in different parts of the body.
Rubella. Vaccination - at the age of 12 months. Revaccination - at the age of 15-16 years (girls). If a combined vaccine (measles, mumps, rubella) is available, vaccination is carried out at 12 months. Revaccination is carried out with a single vaccine at the age of 15-16 years, only for girls.
Hepatitis B. Vaccination - at the age of 1,2, 7 months. Newborns are subject to vaccination against viral hepatitis B, primarily children from mothers who are carriers of the hepatitis B virus. Vaccinations are carried out three times with an interval of one month after the first vaccination and 5-6 months after the second. The anti-hepatitis vaccine is prescribed in a dose of 0.5 ml for newborns, as well as older children, adolescents and persons under the age of 20 years, and in a dose of 1 ml for those over 20 years of age. Vaccination against hepatitis B does not depend on the timing of other vaccinations and is carried out both simultaneously and after the administration of vaccines and toxoids, which are included in the vaccination calendar.
Calendar of preventive vaccinations in Russia
In each country, routine immunization is carried out on time and according to the national vaccination calendar.
Calendar of preventive vaccinations in Russia in accordance with the order of the Ministry of Health of the Russian Federation No. 375 of 12/08/97.
Preventive vaccinations must be carried out strictly within the time limits indicated in the calendar. If the vaccination schedule is violated, it is permissible to simultaneously administer other vaccines with separate syringes to different parts of the body; for subsequent vaccinations, the minimum interval is 4 weeks.
To avoid contamination, it is unacceptable to combine tuberculosis vaccination with other parenteral procedures on the same day.
Since 1997, vaccination against viral hepatitis B has been introduced in Russia.
Contraindications to vaccination
There are situations when a child should not be vaccinated; in these cases, the doctor gives an exemption from vaccination. All vaccinations are carried out in strict accordance with the instructions. It is strictly forbidden to vaccinate at home. Parents are informed in advance about the timing of vaccinations for children in preschool and school institutions.
Contraindications to the administration of vaccines
Contraindications to vaccination are divided into permanent (absolute) and temporary (relative).
Absolute contraindications are rare.
Temporary contraindications. Routine vaccination is postponed until the end of acute manifestations of the disease and exacerbations of chronic diseases. Usually vaccination is carried out after 2-4 weeks. after recovery. After mild forms of ARVI, AII, children can be vaccinated immediately after body temperature normalizes.
False contraindications to preventive vaccinations are conditions that are not contraindications to vaccination. History of prematurity, sepsis, hyaline membrane disease, hemolytic disease of the newborn, complications after vaccination in the family, allergies or epilepsy in relatives, as well as conditions such as perinatal encephalopathy, stable neurological conditions, anemia, enlarged thymic shadow, allergies, asthma , eczema, congenital defects, dysbacteriosis, supportive drug therapy, local use of steroids are not a contraindication to vaccination, but are unreasonably used by pediatricians to issue medical exemptions.
Vaccination of children at risk
Children with various aggravating factors in their medical history are classified as “risk groups” for the possibility of developing post-vaccination complications. Before vaccination, the necessary additional examination is carried out and an individual immunization schedule is drawn up. Vaccination is carried out using gentle methods with preliminary preparation. There are four risk groups:
The risk group includes children with suspected damage to the central nervous system or with identified damage to the central nervous system. There are four subgroups:
- children with probable perinatal damage to the central nervous system;
- children with established perinatal damage to the central nervous system;
- children who have suffered various forms of acute neuroinfections, cerebral palsy, organic diseases of the nervous system;
- children with a history of convulsive attacks of various types or paroxysmal conditions (respiratory-affective seizures, fainting, etc.)
risk group - children prone to allergic reactions, with a history of allergic diseases of the skin or respiratory tract (allergic rashes, allergic dermatoses, Quincke's edema, various forms of respiratory allergosis).
risk group - children who repeatedly suffer from infections of the upper and lower respiratory tract, otitis, with chronic diseases (kidneys, liver, heart, etc.), with prolonged low-grade fever, stopping or insufficient weight gain, transient changes in urine.
risk group - children with local and general pathological reactions to vaccinations (history of post-vaccination complications).
How are children with pathologies vaccinated?
Children with neurological diseases are vaccinated during the period of disappearance of neurological symptoms or during a period of stable remission. For patients with progressive diseases of the nervous system and a history of afebrile seizures, ADS is administered instead of DPT.
For children with a history of seizures, vaccinations are carried out using anticonvulsants (Seduxen, Relanium, Sibazon), which are prescribed 5-7 days before and 5-7 days after the administration of toxoids and from 1 to 14 days after measles and mumps vaccines. The administration of antipyretics is indicated within 1-3 days after vaccination with toxoids and 5-7 days when using live vaccines.
Vaccination of children with hypertensive-hydrocephalic syndrome, hydrocephalus is carried out in the absence of disease progression with dehydration therapy (diacarb, glyceryl, etc.).
Vaccination of children with allergic diseases is carried out during a period of stable remission. Children suffering from hay fever are not vaccinated during the entire flowering period of the plants. It is possible to lengthen the intervals between vaccinations and separate administration of vaccines. Strict adherence to a hypoallergenic diet is necessary for 1-2 weeks after vaccination. To vaccinate children at risk, antihistamines (Claritin, Tavegil, Suprastin) are prescribed.
Vaccination of children at risk for prevention
It is advisable to vaccinate children who often suffer from acute respiratory diseases (more than 6 times a year) during the period of the lowest prevalence of ARVI. In order to stimulate antibody formation, dibazol, methyluracil, and multivitamins are prescribed within 10 days after vaccination. For 2 weeks before and after vaccination, it is recommended to prescribe biogenic stimulants (Eleutherococcus extract, tincture of lure, ginseng). To prevent acute respiratory viral infections in children at risk in the post-vaccination period, intranasal interferon is indicated.
Vaccination work in the clinic is organized and carried out in accordance with the order, which approves the calendar of preventive vaccinations, instructions on immunization tactics, basic provisions on the organization and conduct of preventive vaccinations, a list of medical contraindications to immunization, and the procedure for registering information about complications from vaccinations.
Preventive vaccinations must be carried out within the time limits established by the calendar. In case of violation, simultaneous administration of several vaccines is allowed, but in different parts of the body and with separate syringes.
When vaccinations are carried out separately, the minimum interval should be at least a month. If vaccination against hepatitis B is not carried out on the same day as other vaccinations, then the interval between their administration is not regulated.
Preventive vaccinations are carried out in appropriately equipped vaccination rooms of clinics or other premises in strict compliance with sanitary and hygienic requirements.
Vaccination office at the clinic must consist of premises for vaccination and storage of vaccination records and have a refrigerator for storing vaccination preparations, a cabinet for instruments and a set of medications for emergency and anti-shock therapy, boxes with sterile material, a changing table or medical couch, a table for preparing vaccination preparations, a table for storage of medical records. The office should have instructions on the use of vaccinations and instructions on providing emergency care.
To avoid contamination, combining vaccinations against tuberculosis with vaccinations against other infections is prohibited. Vaccinations against tuberculosis and performing the Mantoux test at home are prohibited.
Preventive vaccinations are carried out by medical workers trained in the rules of vaccination techniques and emergency care techniques.
Medical workers are required to notify parents in advance about the day of preventive vaccinations. All persons subject to vaccinations must be examined by a doctor or paramedic, and anamnesis (previous diseases, allergic reactions to vaccinations, medications, foods) should be taken into account.
Immediately before vaccination, the child is examined and body temperature is measured to exclude acute illness. A record of the completed vaccination is made in the work log of the vaccination office, the history of the child’s development, the preventive vaccination card, the medical record of the child visiting the child care facility, and the preventive vaccination log. After vaccination and revaccination against tuberculosis, the nature of the papule, scar, and the condition of the regional lymph nodes are recorded after 1, 3, 6, 12 months.
Basic vaccines
First vaccination carried out within 24 hours after the birth of the child. This is immunization against hepatitis B.
The vaccine is administered intramuscularly into the deltoid muscle area for older children or into the anterolateral thigh area for newborns and young children.
As an exception, the vaccine can be administered subcutaneously to patients with thrombocytopenia and other diseases of the blood coagulation system.
Second vaccination is carried out at the age of 1 month, the third - at 5 months, simultaneously with DPT and OPV. Premature children weighing less than 2 kg are vaccinated from two months with similar intervals between vaccinations.
Primary vaccination against tuberculosis is carried out on newborns on the 3rd-4th day of life. BCG vaccine is live dried bacteria of the BCG vaccine strain No. 1. One vaccination dose - 0.05 mg of BCG - is dissolved in 0.1 ml of solvent, administered intradermally at the border of the upper and middle third of the outer surface of the left shoulder.
Premature babies weighing less than 2 kg, as well as children who were not vaccinated in the maternity hospital due to medical contraindications, are vaccinated in the clinic with the BCG-M vaccine. Children older than two months who were not vaccinated during the neonatal period are vaccinated in the clinic after a tuberculin test is performed and the result is negative.
At the age of 7 years, children who have a negative reaction to the Mantoux test are subject to revaccination. The interval between the Mantoux test and revaccination should be at least 3 days and no more than 2 weeks.
Vaccination against polio is carried out with a live oral polio vaccine containing weakened strains of the human polio virus of three immunological types (I, II, III). The vaccine is available in the form of a solution and candy.
Vaccination is carried out from three months three times with an interval between vaccinations of a month, revaccination is carried out once at 18 months, 24 months and 7 years.
Vaccinations against diphtheria, whooping cough, and tetanus are carried out with the DTP vaccine (adsorbed pertussis-diphtheria-tetanus vaccine), which consists of a mixture of phase I pertussis microbes killed with formaldehyde or merthiolyte, purified and concentrated diphtheria and tetanus toxoids adsorbed on aluminum hydroxide.
Vaccinations with DTP vaccine are carried out simultaneously with immunization against polio. Revaccination is carried out once at 18 months. Vaccinations against whooping cough are given from 3 months to 4 years. Children who have contraindications to DTP are vaccinated with DTP toxoid according to the following schedule: vaccination at 3 and 4 months, revaccination after 9-12 months.
The second revaccination (6 years) is carried out with ADS-antitoxin once, the third (11 years) – with ADS-M-antoxin once. Children over 6 years of age who have not been vaccinated before are vaccinated with ADS-M toxoid: 2 vaccinations at intervals of a month, revaccination is carried out once after 9-12 months.
Children from 1 to 18 years of age (inclusive) and adults up to 35 years of age (inclusive), who have not been sick, have not been vaccinated, have been 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) who have not been sick, have not been vaccinated, have been vaccinated once, and have no information about measles vaccinations
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
*(1) 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 the 1st vaccination, 3 dose - 6 months after the start of vaccination), with the exception of children belonging to risk groups, 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 from the start of vaccination, 3rd dose - 12 months from the start of vaccination).
*(2) 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).
*(3) Vaccination is carried out for children belonging to risk groups (born from mothers of HBsAg carriers, patients with viral hepatitis B or those who had viral hepatitis B in the third trimester of pregnancy, who do not have test results for markers of hepatitis B, who consume narcotic drugs or psychotropic substances, from families in which there is a carrier of HBsAg or a patient with acute viral hepatitis B and chronic viral hepatitis).
*(4) The first and second vaccinations are carried out with a vaccine for the prevention of polio (inactivated).
*(5) Vaccination is carried out for children belonging to risk groups (with diseases of the nervous system, immunodeficiency conditions or anatomical defects leading to a sharply increased risk of contracting hemophilus influenzae infection; with abnormalities of intestinal development; with cancer and/or receiving immunosuppressive therapy for a long time; children born from mothers with HIV infection; children with HIV infection; premature and low birth weight children;
*(6) The third vaccination and subsequent revaccinations against polio are given to children with the vaccine for the prevention of polio (live); children belonging to risk groups (with diseases of the nervous system, immunodeficiency conditions or anatomical defects leading to a sharply increased risk of contracting hemophilus influenzae infection; with intestinal abnormalities; with cancer and/or receiving long-term immunosuppressive therapy; children born to mothers with HIV -infection; children with HIV infection; premature and low birth weight children; children in orphanages) - vaccine for the prevention of polio (inactivated).
*(6.1) Vaccination and revaccination for children belonging to risk groups can be carried out with immunobiological drugs for the immunoprophylaxis of infectious diseases, containing combinations of vaccines intended for use in appropriate age periods.
*(7) The second revaccination is carried out with toxoids with a reduced content of antigens.
*(8) Revaccination is carried out with a vaccine to prevent tuberculosis (BCG).
*(9) 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 start of vaccination).
*(10) The interval between the first and second vaccinations must be at least 3 months.
The procedure for carrying out preventive vaccinations for citizens within the framework of the national calendar of preventive vaccinations
With changes and additions from:
1. Preventive vaccinations within the framework of the national calendar of preventive vaccinations 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 organization of vaccination, vaccination techniques, as well as in the provision of emergency or emergency medical care.
3. Vaccination and revaccination within the framework of the national calendar of preventive vaccinations are 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.
In cases provided for by the national calendar of preventive vaccinations, vaccination and revaccination with immunobiological drugs for the immunoprophylaxis of infectious diseases containing combinations of vaccines are allowed.
4. Before carrying out a preventive vaccination, the person subject to vaccination or his legal representative is explained the need for immunoprophylaxis of infectious diseases, possible post-vaccination reactions and complications, as well as the consequences of refusal to carry out a preventive vaccination, and informed voluntary consent to medical intervention is drawn up in accordance with the requirements of Article 20 of the Federal Law of November 21, 2011 N 323-FZ "On the fundamentals of protecting the health of citizens in the Russian Federation".
5. All persons who should receive preventive vaccinations are first examined by a doctor (paramedic).
6. If the timing of vaccination changes, it is carried out according to the schemes provided for in the national calendar of preventive vaccinations and in accordance with the instructions for the use of immunobiological drugs for the immunoprophylaxis of infectious diseases. It is allowed to administer vaccines (except for vaccines for the prevention of tuberculosis), used within the framework of the national calendar of preventive vaccinations, on the same day with different syringes in different parts of the body.
7. Vaccination of children for whom immunoprophylaxis against pneumococcal infection was not started in the first 6 months of life is carried out twice with an interval between vaccinations of at least 2 months.
8. Vaccination of children born to mothers with HIV infection is carried out within the framework of the national calendar of preventive vaccinations in accordance with the instructions for the use of immunobiological drugs for the immunoprevention of infectious diseases. When vaccinating such children, the following are taken into account: the child’s HIV status, the type of vaccine, indicators of immune status, the child’s age, and concomitant diseases.
9. Revaccination of children against tuberculosis born from mothers with HIV infection and who received three-stage chemoprophylaxis for mother-to-child transmission of HIV (during pregnancy, childbirth and the neonatal period) is carried out in the maternity hospital with vaccines for the prevention of tuberculosis (for gentle primary vaccination). In children with HIV infection, as well as when HIV nucleic acids are detected in children by molecular methods, revaccination against tuberculosis is not carried out.
10. Vaccination with live vaccines within the framework of the national schedule of preventive vaccinations (with the exception of vaccines for the prevention of tuberculosis) is carried out for children with HIV infection with immune categories 1 and 2 (no immunodeficiency or moderate immunodeficiency).
11. If the diagnosis of HIV infection is excluded, children born to mothers with HIV infection are vaccinated with live vaccines without a preliminary immunological examination.
12. Toxoids, killed and recombinant vaccines are administered to all children born to mothers with HIV infection as part of the national schedule of preventive vaccinations. For children with HIV infection, the specified immunobiological drugs for immunoprophylaxis of infectious diseases are administered in the absence of pronounced and severe immunodeficiency.
13. When vaccinating the population, vaccines containing antigens relevant to the Russian Federation are used to ensure maximum effectiveness of immunization.
14. When vaccinating against hepatitis B in children of the first year of life, against influenza in children from 6 months of age, studying in educational institutions, and pregnant women, vaccines that do not contain preservatives are used.
______________________________* Collection of Legislation of the Russian Federation, 2012, No. 26, Art. 3442; N 26, art. 3446; 2013, N 27, art. 3459; N 27, art. 3477; N 30, art. 4038; N 39, Art. 4883; N 48, art. 6165; N 52, Art. 6951.
** Order of the Ministry of Health and Social Development of the Russian Federation dated March 23, 2012 N 252n "On approval of the Procedure for assigning to a paramedic, 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 assistance to the patient during the period of observation and treatment, including the prescription and use of medications, including narcotic drugs and psychotropic drugs" (registered by the Ministry of Justice of the Russian Federation on April 28, 2012, registration number N 23971).
