The vaccination schedule for children (prophylactic vaccination calendar) 2018 in Russia provides for the protection of children and infants up to a year from the most dangerous diseases. Some vaccinations for children are performed directly at the maternity hospital, the rest can be done at the district clinic in accordance with the vaccination schedule.

Immunization calendar

Age	Vaccinations
Children in the first 24 hours	The first vaccination against the virus
Children 3 - 7 day	Vaccination against
Children at 1 month	Second vaccination against hepatitis B
Children at 2 months	Third vaccination against viral (risk groups) First vaccination against
Children at 3 months	First vaccination against First vaccination against First vaccination against (risk groups)
Children at 4.5 months	Second vaccination against Second vaccination against Haemophilus influenzae (risk group) Second vaccination against Second vaccination against
Children at 6 months	Third vaccination against The third vaccine against the virus Third vaccination against Third vaccination against Haemophilus influenzae (risk group)
Children at 12 months	Vaccination against Fourth vaccination against viral (risk groups)
Children at 15 months	Revaccination against
Children at 18 months	First revaccination against First revaccination against Revaccination against Haemophilus influenzae (risk groups)
Children at 20 months	Second revaccination against
Children at 6 years old	Revaccination against
Children at 6 - 7 years old	Second revaccination against Revaccination against tuberculosis
Children under 14	Third revaccination against Third revaccination against polio
Adults over 18 years old	Revaccination against - every 10 years from the last revaccination

Basic vaccinations up to a year

The general table of vaccinations by age from birth to 14 years of age suggests the organization of the maximum protection of the child's body from infancy and the support of immunity in adolescence. At the age of 12-14, a planned revaccination of poliomyelitis, measles, rubella, mumps is carried out. Measles, rubella and mumps can be combined into one vaccine without compromising quality. The polio vaccine is given separately, with a live vaccine in drops or inactivated with an injection in the shoulder.

1. . The first vaccination is carried out in the hospital. This is followed by revaccination at 1 month and at 6 months.
2. Tuberculosis. The vaccine is usually given at the hospital during the first week of a baby's life. Subsequent revaccinations are carried out in preparation for school and in high school.
3. DTP or analogues. Combined vaccine to protect an infant against whooping cough and diphtheria. In imported analogues of the vaccine, a Hib component is added to protect against inflammatory infections and meningitis. The first vaccination is performed at 3 months, then according to the vaccination schedule, depending on the selected vaccine.
4. Haemophilus influenzae or HIB component. May be part of a vaccine or performed separately.
5. Polio. Babies are vaccinated at 3 months. Re-vaccination at 4 and 6 months.
6. At 12 months, children are vaccinated against.

The first year of a child's life requires maximum protection. Vaccinations minimize the risk of infant mortality by causing the infant's body to produce antibodies to bacterial and viral infections.

A child's own immunity up to a year is too weak to resist dangerous diseases, innate immunity weakens by about 3-6 months. A baby can receive a certain amount of antibodies with mother's milk, but this is not enough to resist really dangerous diseases. It is at this time that it is necessary to strengthen the immunity of the child with the help of timely vaccination. The standard vaccination schedule for children is designed to take into account all possible risks and it is advisable to follow it.

After a series of vaccinations, the child may have a fever. Be sure to include paracetamol to reduce fever in your first aid kit. High temperature indicates the work of the body's defense systems, but does not affect the efficiency of antibody production. The temperature must be brought down immediately. For infants up to 6 months old, rectal suppositories with paracetamol can be used. Older children can take an antipyretic syrup. Paracetamol has maximum efficiency, but in some cases and with individual characteristics, it does not work. In this case, you need to apply a children's antipyretic with another active substance.

Do not limit your child's drinking after vaccination, take a handy bottle of water or baby soothing tea with you.

Vaccinations before kindergarten

In kindergarten, the child is in contact with a significant number of other children. It has been proven that it is in the children's environment that viruses and bacterial infections spread with maximum speed. To prevent the spread of dangerous diseases, it is necessary to perform vaccinations by age and provide documentary evidence of vaccinations.

• Flu shot. Performed annually, significantly reduces the likelihood of influenza in the autumn-winter period.
• Vaccination against pneumococcal infection. It is performed once, the vaccination must be performed at least one month before visiting the children's institution.
• Vaccination against viral meningitis. Performed from 18 months.
• Vaccination against hemophilic infection. From 18 months, with weakened immunity, vaccination is possible from 6 months.

The vaccination schedule for children is usually developed by an infectious disease specialist. In good children's vaccination centers, it is mandatory to examine babies on the day of vaccination to identify contraindications. It is undesirable to vaccinate at elevated temperature and exacerbation of chronic diseases, diathesis, herpes.

Vaccination at paid centers does not reduce some of the pain associated with adsorbed vaccines, but more complete kits can be selected to provide protection against more diseases per shot. The choice of combination vaccines provides maximum protection with minimum injury. This applies to vaccines such as Pentaxim, DTP and the like. In public clinics, this choice is often not possible due to the high cost of polyvalent vaccines.

Restoring the vaccination schedule

In case of violations of the standard vaccination schedule, you can create your own individual vaccination schedule on the recommendation of an infectious disease specialist. The characteristics of vaccines and standard vaccination or emergency vaccination schedules are taken into account.

For hepatitis B, the standard scheme is 0-1-6. This means that after the first vaccination, the second one follows a month later, followed by a revaccination six months later.

Vaccinations for children with immune diseases and HIV are carried out exclusively with inactivated vaccines or recombinant drugs with the replacement of a pathogenic protein.

Why you need to do mandatory vaccinations by age

An unvaccinated child who is constantly among vaccinated children most likely will not get sick precisely because of herd immunity. The virus simply does not have enough carriers to spread and further epidemiological infection. But is it ethical to use the immunity of other children to protect your own child? Yes, your child will not be pricked with a medical needle, he will not experience discomfort after vaccination, fever, weakness, will not whine and cry, unlike other children after vaccination. But when in contact with unvaccinated children, for example, from countries without mandatory vaccination, it is the unvaccinated child that is at maximum risk and can get sick.

Immunity does not get stronger by developing "naturally" and infant mortality rates are a clear confirmation of this fact. Modern medicine cannot oppose viruses with absolutely nothing, except for prevention and vaccinations, which form the body's resistance to infection and disease. Only the symptoms and consequences of viral diseases are treated.

Vaccination is generally effective against viruses. Get the age-appropriate vaccinations you need to keep your family healthy. Vaccination of adults is also desirable, especially with an active lifestyle and contact with people.

Can vaccines be combined?

In some polyclinics, simultaneous vaccination against polio and DTP is practiced. In fact, this practice is undesirable, especially when using a live polio vaccine. The decision on the possible combination of vaccines can only be made by an infectious disease specialist.

What is revaccination

Revaccination is the repeated administration of a vaccine to maintain the level of antibodies to the disease in the blood and to strengthen immunity. Usually, revaccination is easy and without any special reactions from the body. The only thing that can disturb is a microtrauma at the injection site. Together with the active substance of the vaccine, about 0.5 ml of an adsorbent is injected, which holds the vaccine inside the muscle. Unpleasant sensations from microtrauma are possible throughout the week.

The need to introduce an additional substance is due to the action of most vaccines. It is necessary that the active components enter the blood gradually and evenly, over a long period of time. This is necessary for the formation of proper and stable immunity. A small bruise, hematoma, swelling is possible at the injection site. This is normal for any intramuscular injections.

How immunity is formed

The formation of natural immunity occurs as a result of a viral disease and the production of appropriate antibodies in the body that contribute to resistance to infection. Immunity is not always developed after a single illness. It may take repeated illness or successive rounds of vaccinations to develop sustained immunity. After an illness, immunity can be greatly weakened and various complications arise, often more dangerous than the disease itself. Most often it is pneumonia, meningitis, otitis, for the treatment of which it is necessary to use strong antibiotics.

Infants are protected by maternal immunity, receiving antibodies along with mother's milk. It does not matter whether maternal immunity is developed by vaccination or has a "natural" basis. But the most dangerous diseases that form the basis of child and infant mortality require early vaccination. Hib infection, whooping cough, hepatitis B, diphtheria, tetanus, should be excluded from the dangers to the life of the child in the first year of life. Vaccinations form a full-fledged immunity from most infections that are fatal to an infant without disease.

Building the "natural" immunity advocated by environmentalists takes too long and can be life threatening. Vaccination contributes to the safest possible formation of full-fledged immunity.

The vaccination schedule is formed taking into account age requirements, the characteristics of the action of vaccines. It is advisable to keep within the time intervals prescribed by medicine between vaccinations for the full formation of immunity.

Voluntary vaccinations

In Russia, it is possible to refuse vaccination, for this it is necessary to sign the relevant documents. No one will be interested in the reasons for refusal and vaccinate children by force. Legal restrictions on failures are possible. There are a number of professions for which vaccinations are mandatory and refusal to vaccinate may be considered unsuitable. Teachers, employees of children's institutions, doctors and livestock breeders, veterinarians should be vaccinated so as not to become a source of infection.

It is also impossible to refuse vaccinations during epidemics and when visiting areas declared a disaster zone in connection with the epidemic. The list of diseases in epidemics of which vaccination or even urgent vaccination is carried out without the consent of a person is fixed by law. First of all, it is natural or black smallpox and tuberculosis. In the 1980s, smallpox vaccination was excluded from the list of mandatory vaccinations for children. The complete disappearance of the causative agent of the disease and the absence of foci of infection were assumed. However, in Siberia and China, at least 3 focal outbreaks of the disease have occurred since the refusal of vaccination. It may make sense to have the smallpox vaccination done in a private clinic. Smallpox vaccines are ordered in a special way, separately. For livestock breeders, vaccination against smallpox is mandatory.

Conclusion

All doctors recommend following the standard vaccination schedule for children whenever possible and maintaining immunity with timely vaccinations for adults. Recently, people have become more attentive to their health and visit vaccination centers with the whole family. Especially before joint trips, travel. Vaccinations and developed active immunity

Carrying out prophylactic vaccinations for FAP

General principles of preventive vaccinations

The concept of vaccination and immunization

Protective vaccinations(immunization, vaccination) creation of immunity to infectious diseases by introducing vaccines, toxoids, immunoglobulins, immune sera into the body. Preventive vaccinations are also carried out in order to create active immunity or short-term specific protection against the pathogen or its toxins (creation of passive immunity).

Actively acquired immunity results from the transfer of an infectious disease or the introduction of a vaccine into the body. It is formed 1-2 weeks after the introduction of the antigen and persists for years and tens of years (with measles for life). Passively acquired immunity occurs when antibodies are transferred from the mother to the fetus through the placenta, providing for several months the immunity of newborns to certain infectious diseases (for example, measles).

The same immunity is created artificially when immune sera containing antibodies against the corresponding microbes or toxins produced by bacteria are introduced into the body.

The high effectiveness of immunoprophylaxis, primarily for a number of infectious diseases with an airborne mechanism of pathogen transmission, not only led to a sharp decrease in the incidence rate, but also ensured the elimination of some common dangerous infectious diseases (for example, smallpox).

Immunization with vaccines (vaccine prophylaxis) and toxoids as a planned preventive measure is more effective than immunization with serum preparations (seroprophylaxis), as it provides protection for a longer period.

Serum immunization is carried out primarily to persons who have not been previously vaccinated due to contraindications, as well as to patients who are in serious condition. Immunization with sera is carried out as soon as possible after contact with the source of infection in the epidemic focus. To create passive immunity, immunoglobulins (vaccination preparations containing ready-made protective antibodies) are also introduced. Immunoglobulins are administered in cases where it is necessary to quickly increase the protective functions of the body, create temporary immunity to a particular infectious disease, or ease the severity of the onset of the disease.

To create active immunity, vaccines or toxoids are introduced into the human body. Vaccines contain killed or live, but weakened, disease-causing pathogens, in response to the introduction of which specific protective substances are produced, called antibodies. Toxoids are obtained by neutralizing microbial toxins (poisons) with formalin. In this case, the toxin loses its toxicity, but retains the ability to induce immunity.

Vaccines can be administered intradermally (tuberculosis vaccine), subcutaneously (typhoid and many others), intramuscularly (diphtheria-tetanus, measles, mumps, etc.); through the mouth (polio), intranasally (influenza).

For each vaccine, the most effective scheme has been established: the frequency of administration (once, twice or three times); intervals between injections, the dose of the drug. Anatoxins are administered subcutaneously or intramuscularly. To achieve a constant high intensity of immunity, in some cases, repeated vaccinations (revaccination) are carried out at various times after vaccination.

Given the ability of the human body to develop immunity simultaneously to several contagious diseases, complex vaccination preparations are widely used, which are a mixture of several vaccines and toxoids (for example, pertussis-diphtheria-tetanus vaccine, trivaccine - rubella, measles, mumps).

Vaccinations in order to obtain active immunity are carried out in a planned manner and according to epidemic indications. Routine vaccinations carried out by the preventive vaccination calendar established by the Ministry of Health, regardless of the epidemiological situation, include vaccinations against childhood infections (measles, whooping cough, poliomyelitis, parotitis, diphtheria, rubella, etc.).

Scheduled vaccinations in some cases are also carried out for the population in the territory of natural foci of zoonotic infections (gularemia, tick-borne encephalitis). Unscheduled (emergency) immunoprophylaxis is carried out by decision of the territorial health authorities and the state epidemiological surveillance service.

Organization and conduct of preventive vaccinations

Carrying out preventive vaccinationsrequires strict adherence to asepsis rules to prevent purulent-inflammatory diseases. Only healthy health workers who do not have even minor injuries on their hands, purulent lesions of the skin and mucous membranes, regardless of their location, are allowed to be vaccinated. After 30 injections, you must wash your hands with soap and then wipe them with alcohol. The health worker conducting the vaccination puts on a sterile clean gown, ironed with a hot iron, and a cap (scarf) on his head.

Preventive vaccinations are carried out only in medical institutions (polyclinic, FAP).

Each vaccination room (point) should have: a refrigerator, a cabinet for instruments and medicines, bixes with sterile material, a changing table and (or) a medical couch, tables for preparing preparations for use, a table for storing documentation, a container with a disinfectant solution. The office should have instructions for the use of all preparations for vaccination, as well as a tonometer, thermometers, disposable syringes, and ethyl alcohol. In case of an unusual reaction or anaphylactic shock, the vaccination room should have anti-shock therapy: 0.1% tavegil solution, 2.4% eufillin, 0.9% sodium chloride solution, cardiac glycosides (strophanthin, corglicon) , cordiamine, caffeine, hormonal drugs (prednisolone, hydrocortisone).

Vaccinations against tuberculosis and tuberculin diagnostics should be carried out in separate rooms or on specially allocated days. In the absence of a separate office, they are carried out on a specially dedicated table. A separate cabinet is used to accommodate syringes and needles allocated for BCG vaccine and tuberculin.

It is forbidden to use for other purposes tools intended for vaccination against tuberculosis. On the day of BCG vaccination, all other manipulations are not carried out.
For preventive vaccinations on the territory of the Russian Federation, vaccines are used that are registered in the Russian Federation and have a certificate from the National Authority for Control of Medical Immunobiological Preparations - GISK them. L. A. Tarasevich.

Transportation, storage and use of vaccines is carried out in compliance with the requirements of the "cold chain".

Preventive vaccinations are carried out medical workers trained in the rules of organization, storage and technique of vaccination, as well as the methods of necessary assistance in case of development of post-vaccination reactions and complications.

Seminars on the theory of immunization and the technique of preventive vaccinations with mandatory certification must be attended at least once a year.

Responsible for organizing and preventive vaccinations is the head of a medical institution (at the FAP - a paramedic). The procedure for planning and conducting preventive vaccinations is established by order of the head of the medical institution with a clear definition of the responsible and functional duties of medical workers involved in planning and conducting vaccinations.

The organization of primary work is based on:

Full and reliable accounting of the entire population (separately the child population) living in each territory;
availability of medical documentation (forms No. 063 / y, forms No. 026 / y, forms No. 112 / y, etc.);
planning preventive vaccinations of all those to be vaccinated, taking into account the calendar and existing contraindications;
providing the medical institution with all the necessary and high-quality vaccine preparations, subject to the rules of transportation and storage;
strict accounting of persons who received vaccinations and sera, as well as newcomers who do not have preventive vaccinations in accordance with the calendar;
carrying out reporting of the immune layer of the population (separately the child population) - monthly, quarterly, annual. A reliable population count is a prerequisite
not only for the planning of preventive vaccinations, but also for the organization of all preventive work at the FAP.

It is desirable to conduct a population census 2 times a year (spring-autumn); additionally, the lists of arrivals are amended to include arrivals and departures, as well as newborn children.

Upon completion of the population census, the lists are checked against the presence of existing registration forms, in the absence of the latter, they are drawn up. For all residents, the doctor starts a vaccination card file according to the registration form No. 063 / y. It is advisable to arrange the card index alphabetically, by year and by the groups they attend. The vaccination card file is stored in a separate office or cabinet; the paramedic at the FAP is responsible for the completeness and correctness of maintaining documents.

Immunization planning for the next year is carried out by the FAP paramedic or a medical worker responsible for immunoprophylaxis, while taking into account the entire population of the district, individual children who are subject to preventive vaccination according to the plan according to the “Vaccination Calendar” by age, and not vaccinated on time for various reasons.

Upon completion of planning, the total number of those vaccinated in the next year is calculated, a consolidated plan is drawn up, which is sent to the territorial bodies of sanitary and epidemiological supervision.

Based on the quantitative information contained in the plans about the persons to be vaccinated, an application is made for vaccine and serum preparations.

Vaccination tactics. Ways of administering vaccines
The selection of adults and children for vaccination is carried out by a paramedic at FAPs. Vaccinations are carried out by trained medical personnel.

Before vaccination, it is necessary to carefully check the quality of the drug, its labeling, the integrity of the ampoule (vial).

Vaccines should not be used:

With inappropriate physical properties;
with violation of the integrity of the ampoules;
with unclear or missing markings on the ampoule (vial);
adsorbed vaccines (in particular DPT, ADS, ADS-M) stored or transported in violation of the temperature regime, especially those subjected to freezing;
live (measles, mumps, rubella) exposed to temperatures above 8 °C; BCG - more than 4 gr. Celsius. The opening of ampoules, the dissolution of lyophilized vaccines (measles, mumps), the vaccination procedure is carried out in accordance with the instructions, with strict observance of asepsis rules.

The drug in the opened ampoule (bottle) is not subject to storage!
Vaccination tools (syringes, needles, scarifiers) must be disposable and rendered unusable in the presence of the person who was vaccinated or his parent.

When carrying out the vaccination procedure, it is necessary to strictly adhere to the relevant provisions of the "Instructions for the use of the drug".
Vaccination should be given in a lying or sitting position to avoid falling when fainting, which occurs during the procedure in adolescents and adults.

When carrying out immunoprophylaxis, the following methods of drug administration are used: cutaneous, intradermal, subcutaneous, intramuscular, enteral, intranasal.

Parenteral administration of drugs (cutaneous, intradermal, subcutaneous and intramuscular) can be carried out using scarifiers, syringes and needleless injectors. Needle-free injectors provide the introduction of vaccines, serum preparations with a warm jet through the skin under high pressure. The latter method is painless, they can be vaccinated up to 1500 people in 1 hour.

Before parenteral administration of an inactivated vaccine, the skin of the person being grafted in the injection area is wiped with alcohol or ether, and after vaccination, it is lubricated with 70% alcohol or 5% alcohol solution of iodine.

Intradermal vaccines are injected strictly into the skin of the inner side of the forearm or the outer side of the shoulder, injecting the needle with a cut downward at an angle of 10-15 ° C. An indicator of the correctness of the introduction is the formation on the skin at the injection site of a small, whitish, clearly defined and dense formation that looks like a lemon peel. When the vaccine is administered subcutaneously, the needle is injected at an angle of 45-50 ° C into the subcutaneous tissue of the subscapular region or the outer side of the shoulder (thigh), or into the lateral parts of the abdomen. Intramuscular injection of the vaccine is carried out in the upper outer quadrant of the buttock.

Before inoculation of live vaccines applied on the skin, the place where it is supposed to scarify the skin is treated with alcohol, then with ether. Then apply a few drops of the drug at such a distance from each other, as indicated in the instructions for this drug. After that, with the tip of a special scarifier (pen) through the applied drops, shallow skin incisions are made to the papillary layer (drops should appear - blood dewdrops). Then the vaccine should be wiped with the plane of the scarifier, allowed to dry for 5-10 minutes, and the area of ​​the incisions should be covered with a sterile napkin for 45-60 minutes.

When immunized with enteral vaccines that are administered through the mouth, liquid and tablet preparations are distributed with a spoon or tweezers, respectively, grafted, the polio vaccine is administered through the mouth with a special pipette.

Oral preparations are administered to the vaccinated only in the presence of a medical worker.

During intranasal immunization using a special nebulizer, before the introduction of the vaccine, each grafted nebulizer tip is wiped with 70% alcohol and injected to a depth of 0.5 cm into the nasal passages, previously cleared of mucus.

Violations of the technique or volume of the administered drug can lead to various complications and reactions in the vaccinated.

Observation of the vaccinated is carried out in accordance with the instructions for the use of drugs in the first 30 minutes after administration, since at this time it is theoretically possible to develop immediate reactions, including anaphylactic shock. Further, the vaccinated children are observed according to the appropriate preventive vaccination calendar after 24 hours, 48 ​​and 72 hours, after the introduction of live vaccines - on days 5-6 and 10-11, the child is vaccinated with BCG, the observation is carried out up to 9 months of age with a description of the general and local manifestations. If the frequency and intensity of general local reactions or the occurrence of unusual reactions exceed the allowable instructions for the use of this vaccine, the vaccination of this series of drugs is stopped and the territorial sanitary and epidemiological supervision authorities are informed about this.

According to the Law of the Russian Federation on the sanitary and epidemiological well-being of the population, vaccinations against tuberculosis, poliomyelitis, diphtheria, tetanus, whooping cough, measles, mumps are mandatory. Vaccinations are also obligatory for some occupational groups in case of an increased risk of infection for an employee in contact with its source, as well as in case of a risk of mass spread of infection by an employee (for example, a food unit).

A number of vaccinations are mandatory for citizens traveling abroad, especially to countries with a hot climate or an epidemiologically disadvantaged state.

Legal approach to immunoprophylaxis

The legal approach to immunoprophylaxis provides for a combination of rights, duties and responsibilities of the individual and the state; these principles, to some extent reflected in the legislation of many countries, provide for the following:

All citizens are provided by the state with the opportunity to receive all necessary vaccinations free of charge, as well as to receive information about the nature of the vaccination, its effectiveness, possible situations, etc. Vaccinations are carried out only with the consent of the vaccinated person or his parents (guardians), and the state guarantees free medical care, which may be needed if a reaction or complication develops;

Every citizen has the right to refuse vaccination for himself or his child (with the exception of vaccination against especially dangerous infections carried out according to epidemiological indications), which he must record in writing; if he refuses to sign, at least 2 health workers do it;

If an unvaccinated person (or his child) falls ill with the corresponding infection, he is not paid days of incapacity for work. Unvaccinated children are not allowed in children's institutions, health camps and educational institutions, as they can be sources of epidemic outbreaks. The manufacturer's liability is
with drug quality. Vaccinating medical workers are responsible for the correct determination of indications and contraindications, for achieving the necessary vaccinations, as well as for the correct storage of drugs, as well as for the technique of administering the vaccine and monitoring the vaccinated children according to the instructions.

Before vaccination, all vaccinated are examined by a paramedic in order to identify persons for whom it is contraindicated. Before the examination, thermometry is obligatory, and if necessary, preliminary laboratory tests and consultations of specialists. Mass-use vaccines have a minimum of contraindications and can be used without a special examination.

Modern medical practice is difficult to imagine without measures aimed at preventing diseases. The most well-known and effective measure of disease prevention is vaccination, which makes it possible to protect your body from infection of pathogens - the causative agents of a huge number of infectious pathologies. Vaccinations allow you to build resistance to infections from childhood, protect yourself from complications, and also eliminate the likelihood of death from the disease. The active substances of the drug, in response to an injection into the body of the vaccine, causes a reaction from its immune system. This reaction is similar to that which develops during infection, but much weaker. The meaning of this reaction is that the immune system, in response to the introduction of the vaccine, forms special cells called memory cells, they create resistance to infection.

What is a prophylactic vaccination?

Prophylactic vaccination is the most common method of immunization, based on the introduction of a vaccine into the body, which consists of various particles that can form a stable immune response against the disease. Vaccination is nothing more than a special solution, which contains live or killed microorganisms, their fragments, toxins. Acting as antigens, these components of drugs, after entering the bloodstream, trigger a chain of reactions aimed at the production of antibodies and, accordingly, stimulate the development of immunity to a particular disease.

All preventive vaccinations are conditionally divided into two large groups:

• the introduction of the vaccine to children and adults, which is carried out at a specific time and regardless of the epidemiological situation in certain areas;
• vaccination for epidemiological indications, when it is given to people living in a region with a registered outbreak of an infectious disease or an increased risk of its occurrence.

The vaccine helps to avoid infection of the body with complex forms of dangerous pathologies. According to studies, in a society where 95% of citizens are vaccinated, there is no favorable environment for the development of infections, and therefore their complete disappearance is observed. It was through mass vaccination of the population that mankind managed to withstand the plague and, and, by several hundred times, reduce the number of episodes of childhood diseases, poliomyelitis,.

Childhood infectious diseases are one of the most common phenomena in pediatric practice. Every year, an outbreak of a disease is recorded in our country, which can not only cause temporary disability of the population, but also increase mortality in the region. The most suitable environment for the spread and habitat of pathogens of such diseases is the children's team. That is why doctors strongly recommend that parents of babies get preventive vaccinations on time, which will protect the child from contagious infections and prevent their epidemics.

As you know, the list of mandatory vaccinations is formed by employees of the Ministry of Health and forms the basis for creating a national vaccination calendar. In addition to the national immunization plan, there is also a regional list of annual vaccinations, which may vary depending on the epidemiology of the designated area.

Prophylactic administration of vaccination in children is carried out in specially designated places. An instruction to vaccinate a child is given by a doctor after testing. Any fact of the introduction of vaccination is recorded in documentary forms that are stored in the institution and, if necessary, issued to the owner in the form of extracts or copies. It is important for parents to remember that without vaccinations, their child may be denied temporary access to educational institutions, sports clubs, or permanent residence in another country where vaccinations are a compulsory measure against diseases.

Vaccine video

Why is it necessary to vaccinate the population?

Vaccination is simply necessary in cases where an infectious disease is a danger, that is, it threatens his life and can provoke the development of irreparable complications. Vaccination allows you to create immunity to a number of diseases with a pronounced risk of mortality and eliminate complications. After all, it is precisely the complex variants of the course of disease processes that lead to the formation of persistent and detrimental consequences of diseases, the development of their deadly complications, and the transformation of the disease into a chronic form.

The introduction of a vaccine provides the body with the opportunity to form an immune system against most of the infections known today. After the vaccine, special cells (antibodies) begin to be synthesized in the body, which subsequently are able to protect the vaccinated organism from the penetration of dangerous microorganisms into it. Immunity is maintained over a certain time period. It could be months, years, decades. Naturally, the protection acquired in the usual way (after an illness) is stronger and more effective, but vaccinations can also reliably protect a person from microorganisms and their toxins.

What vaccinations are made in Russia?

The list of preventive vaccinations includes:

• mandatory vaccine injections;
• the recommended introduction of the vaccine, which is done according to individual indications.

• living in a region with an unfavorable epidemiological situation;
• work in enterprises where there is a risk of infection (livestock farms, slaughterhouses).

National calendar: concept and features

The preventive vaccination calendar is compiled by the Ministry of Health. When creating it, several points are taken into account, in particular, the significance of infections and the availability of a vaccine in the public domain. The calendar is valid throughout the country. According to it, it is necessary for every citizen living in Russia to be vaccinated, regardless of age and provided that he has no contraindications. In recent years, the plan has remained unchanged and has the following form:

Vaccine against	Age of the patient at the time of vaccination
Tuberculosis	Child 3-7 days after birth, children 7 and 14 years old
	Child on the first day of life, 1st month, 2nd month, 6th month, 1 year, every 5 years
DPT	Baby at 3 months, 4 months, half a year, 18 months
	7, 14, 18 years old
Polio	Child at 18-20 months and at 14 years
, rubella,	Child at 12 months and 6 years old
	A child from 11 years old every five years up to 18 (boys) and 25 (girls) years
measles infection	At age 15, every 5 years until age 35
flu	Child from six months of age each year

Regional calendar

The vaccination program for residents of a certain area is developed by local doctors working in outpatient medical institutions, kindergartens, and schools. This plan is being worked out taking into account registered citizens and fixing born children, people who left or arrived. The disease prevention scheme should cover all adult citizens and children who need a planned introduction of a vaccine or revaccination.

Each child has its own documentation, in particular, a card of preventive vaccinations, a medical card and a history of the development of the child. It is stored in the medical unit and, if necessary, can be handed out.

Vaccination

Preventive vaccinations should be carried out in special vaccination rooms, which are located in polyclinics, private clinics, and vaccination centers. For setting BCG, a separate room is required. There should be enough space in the treatment room. Here you should install tables for sterile instruments and disposable syringes, as well as containers for collecting garbage.

The vaccination room must comply with certain rules and sanitary standards. Any material that is used in the vaccination process is taken with a sterile forceps. Before this, it must be immersed in a solution of chlorhexidine, which should be changed daily. Used disposable instruments, as well as cotton wool, bandages and swabs, should be disposed of in a waste container with a disinfectant. The floor in such rooms is washed several times a day and using disinfectants.

The procedure for staging preventive vaccinations is regulated at the legislative level. Vaccination is carried out only by introducing certified preparations of domestic or foreign production.

Infectious diseases are vaccinated in the following order:

• vaccination is done in special institutions accredited for the introduction of vaccinations;
• if necessary, teams are formed to vaccinate the population at home;
• before vaccination, the patient excludes contraindications to injections and assesses the general state of health;
• before vaccination, body temperature should be measured and tested;
• injections are carried out using disposable instruments;
• vaccination can only be done by a specialist with the necessary education;
• there must be a kit for emergency medical care in the office;
• drugs are stored in accordance with the rules prescribed in the instructions;
• the introduction of the vaccine is not carried out in the dressing room or manipulation room;
• all documentation must be kept in the vaccination room;
• the room is cleaned twice a day with antiseptics.

Features of the holding technique

The technique of vaccinating patients against diseases is determined by regulatory documents and complies with the following plan:

• the ampoule with the drug is taken out of the refrigerator;
• the integrity of the vial, the appearance of the solution, its expiration dates are evaluated;
• the package is opened only with sterile gloves;
• the vaccine is drawn up and administered using disposable needles and syringes;
• the injection site must be wiped with an alcohol solution (for - ether);
• if it is necessary to administer several drugs, a separate toolkit is used for each of them;
• during the injection, the patient is forced to sit or lie down;
• after the injection, the doctor observes the patient for another 30 minutes.

Journal of inoculation of the population

The fact of preventive vaccinations is recorded by medical personnel in a special journal. It is always located in the medical institution where the injection was made, and is available for discharge in case the patient loses his individual card. The journal contains such data as last name, first name and patronymic, address of actual residence, age, occupation, name of the administered drug, date of implementation of primary vaccination and revaccination, method of setting. Separately, data on adverse reactions, the series and dose of the prophylactic agent are entered into the document.

The vaccination card has a special form - 063 / y. This is a document that contains information about vaccines administered to a patient. The card is filled in by a doctor in the institution where the vaccination was carried out, that is, in the clinic, at the FAP, preschool institution, etc.

Certificate

This document, which has the form 156 / y-93, is maintained throughout life and may be needed when leaving Russia, to participate in international sports competitions, and to find employment in some enterprises. It must be preserved until death, as it fully reflects his vaccinated immune profile.

It is very difficult to restore a certificate of preventive vaccinations after a loss. It should not contain corrections and blots. Otherwise, the document will most likely be invalidated.

Vaccination waiver form sample

According to the law, people have the right to refuse preventive vaccinations. Refusal is given in writing to the head of the institution where the population is immunized. It should indicate which vaccinations the person refuses to do, where he is registered and what is the reason for such a decision. At the end of the application, there must be a signature and the date of preparation of the form.

Chief Physician of Polyclinic No./or
School Principal No./or
Kindergarten manager No.
_______ district, __________ cities (villages, villages)
From __________ Full name of the applicant _____________________
Statement
I, ____________ full name, passport data ______________ refuse to do all preventive vaccinations (or indicate which specific vaccinations you refuse to do) to my child _______ full name of the child, date of birth _________, registered at polyclinic No. (or attending kindergarten No., or school No.). The legal basis is the legislation of the Russian Federation, namely “Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens” dated July 22, 1993 No. 5487-1, articles 32, 33 and 34 and “On the immunoprophylaxis of infectious diseases” dated September 17, 1998 No. 57 - Federal Law, articles 5 and 11.
Number
Signature with decryption

What is the danger of not being vaccinated?

Failure to vaccinate against infectious diseases entails a number of consequences, including:

• a ban on traveling abroad to live in another country, where, in accordance with local law, a citizen must have a mandatory vaccine minimum;
• temporary refusal for admission to an educational or health institution (this item applies to the period when an epidemic is declared in the region);
• refusal to register citizens for work or their removal from the performance of official duties, which is associated with a high risk of their exposure to infectious diseases.

Children without vaccinations may be forcibly dismissed from attending schools and kindergartens, and employees of enterprises may not be allowed to work. Often, unvaccinated individuals do not have the right to be in groups, especially during epidemics.

Vaccination notice

The preventive vaccination plan against infectious diseases is regulated by legal acts, in particular, by order No. 51n dated January 31, 2011 “On approval of the national. immunization calendar.

Prevention in kindergarten

Vaccinations in kindergartens are given only to those children whose parents or legal representatives have agreed to such actions by the medical staff. Activities should be organized and carried out individually. To do this, the medical worker of the institution draws up an immunization schedule with the inclusion of children to be vaccinated in it.

Immunization against diphtheria, whooping cough and tetanus [show]

Routine active immunization against diphtheria, whooping cough and tetanus is provided by several bacterial preparations:

1. Adsorbed pertussis-diphtheria-tetanus vaccine (DPT) contains concentrated and purified diphtheria 30 flocculating units (LF) and tetanus - 10 binding units (EC) toxoids, pertussis microbes of the first phase (20 mlrd. in 1.0 ml), killed with 0.1% formalin and aluminum hydroxide.

   Vaccinations with DPT - vaccine are carried out according to the following scheme: the vaccination course consists of three intramuscular injections of the drug (0.5 ml each) from 3 months of age with an interval of 45 days. Shortening intervals is not allowed.

   If it is necessary to lengthen the intervals after I or II vaccinations for more than 45 days, the next vaccination should be carried out as soon as possible, but not exceeding 6 months. In exceptional cases, the lengthening of the intervals is allowed up to 12 months.

   With the development of an unusual reaction in a child to I or II vaccinations, further use of this drug is stopped. Immunization can be continued with ADS - toxoid, which is administered once. If a child has received two DTP vaccinations, the vaccination cycle is considered complete with the vaccine.

   Revaccination with DPT - vaccine is carried out once at a dose of 0.5 ml 1.5-2 years after the vaccination is completed.

   At the age of 6 years, revaccination is carried out with ADS-M toxoid, also once at a dose of 0.5 ml.

2. Adsorbed diphtheria-tetanus toxoid with a reduced content of antigens (ADS-M toxoid) is a mixture of concentrated and purified diphtheria and tetanus toxoids adsorbed on aluminum hydroxide. 1 ml of the drug contains 10 flocculating units of diphtheria and 10 EU of tetanus toxoids.

   ADS-M toxoid is used:

   1. for revaccination of children with allergic reactivity once at a dose of 0.5 ml;
   2. for revaccination of children aged 12 years and older according to epidemic indications, who do not have documentary evidence of vaccinations (twice in 45 days but 0.5 ml.).
3. Adsorbed diphtheria toxoid (AD - toxoid)- purified, concentrated preparation adsorbed on aluminum hydroxide. 1 ml contains 00 flocculating units of diphtheria toxoid.

   AD - toxoid is used for children who have had diphtheria, according to epidemic indications and with a positive Shik reaction.

   Children who have recovered from diphtheria under the age of 11 are vaccinated once at a dose of 0.5 ml. Children under the age of 11 years with a weakly positive Shik reaction (± and +) are vaccinated once; with the intensity of the Schick reaction in 2 (+ +) or 3 (+++) crosses - twice in 45 days. Lengthening of intervals up to 6-12 months is allowed.

   Adolescents (12-19 years old), regardless of the intensity of the positive Schick reaction with a known vaccination history, are vaccinated once at a dose of 0.5 ml.

4. Adsorbed tetanus toxoid (AS)- is a purified, concentrated preparation sorbed on aluminum hydroxide containing 20 binding units (EC) per 1 ml. There are no age contraindications for active immunization against tetanus.

The following populations are required to be vaccinated against tetanus:

1. all children and adolescents in all areas of the Russian Federation at the age of 3 months. up to 16 years;
2. all citizens undergoing pre-conscription training and retraining (grades 9-10 of schools, GPTU, secondary educational institutions, technical schools, colleges;
3. girls over 16 years old;
4. the entire population in areas with tetanus incidence rates of 1.0 or more per 100,000 population;

According to epidemic indications, persons who have received an injury and who are in hospital for out-of-hospital abortions are subject to vaccination.

Assessment of immunity to diphtheria

The Shik reaction is a relative indicator of the state of immunity against diphtheria and is used to identify contingents susceptible to this infection among the child population. Shik's reaction is given to healthy children vaccinated against diphtheria, who have received complete vaccination and at least one revaccination, but not earlier than after 8-10 months. after the last booster. For persons aged 12 years and older, the Shik reaction can be diagnosed according to epidemic indications. Re-staging of the reaction is possible no earlier than after 1 year.

Shik's diphtheria toxin is used to perform the Shik test. The toxin is injected intradermally at 0.2 ml on the palmar surface of the middle third of the forearm. Shik's reaction was recorded after 96 hours. If a skin reaction in the form of redness and infiltration appears at the injection site of the toxin, the reaction is considered positive. The degree of reaction is indicated as ± (doubtful), the size of the redness and infiltration is from 0.5 to 1 cm in diameter; + (weakly positive), redness has a diameter of 1 to 1.5 cm; ++ (positive), redness in diameter from 1.5 to 3 cm; +++ (sharply positive) - redness in diameter over 3 cm.

Individuals with a positive Schick reaction are immunized with adsorbed diphtheria toxoid.

Passive immunization against diphtheria

Antidiphtheria serum - is used mainly for therapeutic purposes. The patient, depending on the severity, is administered from 5000 to 15000 international antitoxic units (IU). Before the introduction of serum to detect sensitivity to horse protein, an intradermal test is made with a specially diluted 1:100 serum.

Immunization against measles [show]

Live measles vaccine from strain Leningrad-16 (L-16 Smorodintseva)

The vaccine is produced in a dried state, before use it is diluted with the supplied solvent, as indicated in the instructions.

To achieve the maximum epidemiological effect of vaccination, it is necessary to ensure the most complete coverage of the population susceptible to measles, since the presence of 90-95% of immune children (who have been ill and vaccinated) drastically reduces the possibility of virus circulation and significantly reduces the risk of infection for children who remain unvaccinated, in especially for medical reasons.

Live measles vaccine is given to children aged 15-18 months. up to 14 years, except for those who have had measles and have medical indications. The measles vaccine is administered once at a dose of 0.5 ml.

Vaccinated children are not contagious to others, and contact with vaccinated susceptible children cannot cause measles in the latter.

The introduction of a live measles vaccine is usually not accompanied by a reaction after vaccination. Clinical manifestations of the vaccination process may occur from 7 to 21 days. Therefore, to account for post-vaccination reactions, a medical examination of vaccinated children should be carried out on 7, 14, 21 days after vaccination. The examination data are recorded in the history of the development of the child (form No. 112-y) and the individual card of the child's development (Medical card of the child f.026 / y-2000).

The use of live measles vaccine has some peculiarities:

• during quarantine in children's institutions for any infection (diphtheria, whooping cough, mumps, chicken pox, etc.), measles vaccinations are given only to children who have had the above infections;
• in order to urgently prevent measles and stop outbreaks in organized groups (preschool children's institutions, schools, vocational schools, etc., secondary educational institutions), urgent vaccination is carried out for all contacts who have no information about measles or vaccination. It is allowed to administer gamma globulin for emergency prophylaxis only to those contacts who have contraindications to vaccinations;
• vaccinations can be carried out at a later date, even in established foci, but their effectiveness will decrease as the period from contact lengthens;
• it is allowed to carry out revaccination in case of an increase in the incidence in the region of more than 5% among those vaccinated with one series of the vaccine, as well as all identified seronegative children.

Immunization against tuberculosis [show]

Dry BCG vaccine. The vaccine is dried live bacteria of the BCG vaccine strain. The vaccine is administered intradermally.

Primary vaccination by the intradermal method is carried out for all healthy children on the 5th-7th day of life if they have no contraindications. All clinically healthy children, adolescents and adults under the age of 30 are subject to revaccination. who have a negative reaction or a papule not exceeding 4 mm in diameter (hyperemia is not taken into account) to the intradermal administration of alttuberculin diluted in a ratio of 1:2000 or tuberculin standard solutions (PPD-L at a dose of 2TE).

The first intradermal revaccination of children vaccinated at birth is carried out at the age of 7 (first grade students). The second revaccination - at the age of 11-12 (students of the fifth grade), the third - at the age of 16-17 (students of the 10th grade, before leaving school). Subsequent revaccinations are carried out at intervals of 5-7 years for the entire adult population in the absence of contraindications (at 22-23 and 27-30 years).

The selection of contingents for revaccination is carried out under the control of the river. Mantoux (intradermal allergy test). The interval between the Mantoux test and revaccination should be at least 3 days and not more than 2 weeks. The Mantoux test for children and adolescents is carried out from the age of 12 months, once a year, regardless of the previous result.

All necessary items for vaccination (syringes, needles, beakers, etc.) are stored in a special locker. The vaccine is applied immediately after dilution. Complications after vaccination and revaccination are usually local in nature and are relatively rare.

Observation of vaccinated and revaccinated children, adolescents, adults is carried out by doctors and nurses of the general medical network, who after 1, 3, 12 months should carry out a vaccination reaction with registration of the size and nature of the local reaction (papule, pustule, pigmentation, etc.) . This information should be recorded for children and adolescents attending organized groups in form 063 / y and form 026 / y-2000, for unorganized children - in form 063 / y and the history of the child's development (form No. 112-y).

Immunization against polio [show]

Live polio vaccine. The vaccine is prepared from attenuated strains of the poliomyelitis virus of 3 serotypes (I, II, III) obtained by the American scientist L. Sabin. The development of vaccine production technology in the USSR is associated with the names of L. A. Smorodintsev and M. P. Chumakov. The polyvalent polio vaccine was produced in the USSR in candy and liquid form. Currently, a liquid alcohol vaccine is used.

Liquid vaccine is a clear reddish-orange liquid, without opalescence, odor. Slightly bitter in taste. It is produced in vials ready for use and is used, depending on the titer, either 2 drops each (when bottling the vaccine 5 ml - 50 doses, that is, 1 dose of the vaccine in a volume of 0.1 ml), or 4 drops each (when bottling the vaccine 5 ml - 25 doses or 2 ml - 10 doses) per reception. The report of drops of a vaccine is made by the dropper attached to a bottle or a pipette. The vaccination dose of the vaccine is instilled into the mouth one hour before meals.

It is not allowed to drink the vaccine with water or other liquid, as well as eat and drink within 1 hour after vaccination, as this may prevent the adsorption of the vaccine virus by the cell system of the lymphoepithelial ring of the nasopharynx.

Vaccination is carried out for children from 3 months of age three times with an interval between vaccinations of 1.5 months. The first two revaccinations are carried out twice (for each year of life: from 1 to 2 years and from 2 to 3 years) with an interval between vaccinations of 1.5 months. Revaccination of older ages (3rd and 4th: from 7 to 8 years and from 15-16 years, respectively) is carried out once.

When immunized with a live polio vaccine, local and general reactions are absent. The vaccine should not be given for gastrointestinal disorders, severe forms of dystrophy, dyspepsia, exacerbation of the tuberculosis process and decompensation of cardiac activity.

Immunization against typhoid fever [show]

Vaccinations against typhoid and paratyphoid are carried out in a planned manner to decreed contingents (persons working in food enterprises, in the catering and food trade networks, in cleaning populated areas from garbage and sewage, in collection points and warehouses, in recycling enterprises, in laundries , employees of infectious diseases hospitals and bacteriological laboratories).

Scheduled vaccinations are carried out in the collectives of enterprises and institutions, in state farms, collective farms and individual groups of the population. Scheduled vaccinations are carried out in the spring months before the seasonal rise in the incidence. According to epidemic indications, vaccinations are carried out at any time of the year for the entire population.

For immunization of the population against typhoid-paratyphoid diseases, the following are used: Typhoid vaccine with sexta-anatoxin, chemical adsorbed typhoid-paratyphoid-tetanus vaccine (TAVT) and typhoid alcohol vaccine enriched with V-antigen

• Typhoid vaccine with sextatoxin. The chemical adsorbed vaccine is a liquid preparation that includes: a complex (O- and Vi-) antigen of typhoid bacteria and purified concentrated toxoids of the causative agents of botulism types A, B and E, tetanus and gas gangrene (perfringens type A and edematiens), sorbed on aluminum hydroxide. The pentatoxoid vaccine contains the same components except for tetanus toxoid. The tetraanatoxin vaccine consists of typhoid antigen, botulinum toxoids A, B, and E, and tetanus toxoid. The vaccine with toxoid, in addition to the typhoid antigen, contains botulinum toxoids of types A, B, E.

  The sextaanatoxin vaccine is intended for active immunization against typhoid fever, botulism, tetanus and gas gangrene. Vaccinating doses of vaccines with sexta- and pentaanatoxin are 1.0 ml, vaccines with tetra- and trianatoxin - 0.5 ml for each vaccination.

  Adults from 16 to 60 years old (women under 55 years old) are subject to immunization. Primary immunization is carried out by two injections of the vaccine with an interval of 25-30 days between injections. After 6-9 months, the vaccinated are revaccinated. Subsequent revaccinations are carried out every 5 years or as indicated.

• Chemical adsorbed typhoid-paratyphoid-tetanus vaccine (TAVT). Typhoid, paratyphoid antigens and tetanus toxoid are sorbed on aluminum hydroxide. The vaccine is a colorless liquid with an amorphous precipitate suspended in it, easily breaking up when shaken. The vaccine is only given to adults between the ages of 15 and 55. Vaccination single, subcutaneous (in the subscapular region) at a dose of 1.0 ml. Revaccination, if necessary, is carried out no earlier than 6 months after the primary vaccination.

  Persons vaccinated with TAVT and who have not previously received a completed course of immunization against tetanus - a double vaccination and at least a single revaccination with tetanus toxoid (TT), after 30-40 days, 0.5 ml of AU is injected subcutaneously, and after 9-12 months. they are revaccinated against tetanus with 1 ml of AS.

  The issue of selection of grafted TAVT should be given special attention. Before vaccinations, it is necessary to conduct a thorough examination and questioning of the vaccinated and thermometry. At a body temperature above 37 degrees, vaccinations are contraindicated.

• Typhoid alcohol vaccine enriched with VI antigen. The VI antigen vaccine is a purified preparation of the VI antigen of typhoid bacteria in isotonic saline solution (concentration of 200 micrograms in 1 ml). The drug has the appearance of a transparent or slightly opalescent liquid. The vaccine is used to prevent typhoid fever among children from 7 years of age, as well as adults (men under 60 years old, women under 55 years old).

  The dose of the drug for adults is 1.5 ml, for children - 1.0 ml, (from 3 to 7 years) from 7 to 15 years - 1.2 ml. Children who have been vaccinated against any infection can be vaccinated with V-antigen but earlier than 2 months after vaccination. After the introduction of the vaccine, the vaccinated should be under medical supervision.

• Typhoid bacteriophage. Dry tableted typhoid bacteriophage is given for prophylactic purposes to persons who have been in contact with patients or bacteria carriers. Applied as directed by an epidemiologist in 2 cycles:
  • The 1st cycle is carried out immediately after the identification of the patient or the onset of the outbreak. Bacteriophage is given 3 times every 5 days;
  • The 2nd cycle of phage is carried out after the return of convalescents in the team three times with 5-day intervals.

  Dosage of bacteriophage: children aged 6 months. up to 3 years, 1 tablet per appointment; from 3 years and adults, 2 tablets. at the reception (tablets can be dissolved in water or milk).

  All typhoid convalescents discharged from the hospital are given typhoid bacteriophage for 3 consecutive days at the doses indicated above.

Immunoprophylaxis of viral hepatitis [show]

Viral hepatitis is a family that consists of at least five viral hepatitis (A, B, E, C, D) that are completely different in terms of symptoms and severity of consequences. They cause five different diseases. Currently, only vaccines against hepatitis A and B are used in clinical practice. Effective vaccines against other types of viral hepatitis do not currently exist in medicine.

Hepatitis A It is transmitted, as a rule, by household means and refers to intestinal viral infections. It does not give serious consequences for the body. While hepatitis B can only be contracted through the blood. It is dangerous with complications in the form of cirrhosis and liver cancer.

Vaccination against hepatitis A is indicated for adults and children (from 3 years old) who have not previously had this disease, as well as for almost all people with liver diseases. This vaccine has no side effects and is completely safe. This vaccine should be given twice, 6-12 months apart. Antibodies to the hepatitis A virus are produced in the body after the first dose of the vaccine, after about 2 weeks. Protection against this disease thanks to such a vaccination is provided for 6-10 years.

Hepatitis A vaccine is especially important for people who are at increased risk of contracting the disease:

• children and adults living or sent to areas with a high incidence of hepatitis A (tourists, contract servicemen);
• persons with blood diseases or chronic liver diseases;
• workers of water supply and public catering;
• medical personnel of infectious diseases departments;
• preschool staff
• traveling to hyperendemic regions and countries for hepatitis A, as well as contacts in foci according to epidemiological indications

Vaccination against viral hepatitis B is carried out for newborn children, as well as for children from one to 18 years old and adults from 18 to 55 years old who have not been vaccinated before. Vaccination consists of three vaccinations, which are administered according to the scheme: 1 dose - at the time of the start of vaccination, 2 dose - 1 month after 1 vaccination, 3 dose - 6 months after the start of immunization. As a rule, this vaccine is administered by injection.

Vaccinations are subject to:

• Children and adults with a family history of HBsAg carrier or chronic hepatitis B.
• Children of orphanages, orphanages and boarding schools.
• Children and adults who regularly receive blood and its preparations, as well as those on hemodialysis and oncohematological patients.
• Persons who have come into 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 schools (primarily graduates).
• People who inject drugs and have promiscuous relationships.

A course of vaccination leads to the formation of specific antibodies to the hepatitis B virus in a protective titer in more than 90% of the vaccinated and reliably protects against the hepatitis B virus for 8 years or more, and sometimes throughout life.

Gamma globulin. The drug is a gamma globulin fraction of human blood serum. It is used for prophylactic purposes and according to epidemic indications.

For prophylactic purposes, gamma globulin is administered before the start of the seasonal rise in the incidence of the most affected age groups (children of preschool groups and first grades of schools). In case of a lack of gamma globulin, it is administered for prophylactic purposes in the pre-epidemic season to half of the children of each class, group.

According to epidemic indications, gamma globulin is prescribed to persons who have been in contact with patients with infectious hepatitis, and primarily to children under the age of 10 years and pregnant women.

Gamma globulin must be administered as early as possible from the start of contact (in the first 10 days), counting from the first day of the disease, and not jaundice. The introduction of gamma globulin at a later date after contact is less effective.

Prevention of botulism [show]

For the prevention of botulism, the serum of horses hyperimmunized with toxoid or toxins of the corresponding microbes is used. Anti-botulinum serum of 4 types A, B, C, E is used. They are produced monovalent or polyvalent. Because antibotulinum sera are heterologous, they are administered after equine susceptibility has been determined. Serums are used for preventive and therapeutic purposes. The introduction of serum may be accompanied by an immediate reaction, early (4-6 days) and remote (on the 2nd week). The reaction is manifested by chills, fever, rash, disorder of the cardiovascular system. In rare cases, the introduction of serum may be accompanied by a state of shock.

Immunization against cholera [show]

For immunization against cholera, a killed cholera vaccine and cholerogen toxoid are used. The cholera vaccine is prepared from killed vibrios. Available in liquid and dry form. To dissolve the dry vaccine, 2 ml of a sterile solution (physiological) is added to the ampoule and shaken until a uniform suspension is obtained. Vaccinations against cholera are obligatory for persons traveling to cholera-prone countries. When there is a threat of cholera introduction, first of all, vaccinations cover groups of the population that are susceptible to infection due to their professional activities (medical workers of a number of specialties, workers engaged in cleaning up the territory from sewage and garbage, laundry personnel, etc.). The cholera vaccine is administered subcutaneously twice with an interval of 7-10 days in doses according to the following table (see table)

Revaccination is carried out after 6 months once, the dose is similar to the 1st vaccination during vaccination.

Cholerogen toxoid is a purified and concentrated preparation obtained from the centrifugate of the broth culture of Vibrio cholerae strain 569b, neutralized with formalin. Produced in dry and liquid form, it is used for vaccination and revaccination of people against cholera. Cholerogen toxoid is administered subcutaneously both with a syringe and with a needleless injector.

For subcutaneous administration of vaccines using a sterile syringe, only a dry preparation in ampoules is used; pre-diluted 0.85 percent. ampoule sterile sodium chloride solution.

For subcutaneous administration of the vaccine using a sterile needleless injector, a liquid preparation in vials is used. Cholerogen-anatoxin is injected with a needleless injector to the upper third of the shoulder. Diluted, as well as dry, and liquid preparation in vials can be used for 3 hours at room temperature storage.

Cholerogen-anatoxin is administered once a year. Revaccination is carried out according to epidemic indications no earlier than 3 months after primary immunization. Before vaccination, the vaccinated person undergoes a medical examination with a mandatory temperature measurement. Vaccination is carried out by a doctor or paramedic under the supervision of a doctor.

The size of the dose of cholerogen-toxoid for vaccination and revaccination is presented in the table (see table). Immunization against rabies [show]

Rabies vaccinations, in fact, are the only way to save people infected with the rabies virus from death, since there are no other, more effective means to prevent the development of the disease.

To prevent rabies in humans, the Fermi-type rabies vaccine, culture-inactivated rabies vaccine, and rabies gamma globulin are used.

• Fermi-type rabies vaccine is made from the brain of sheep (of the Fermi type) or suckers of white rats - MIVP, infected with a fixed rabies virus. The vaccine is a 5% suspension of brain tissue, contains 3.75% sucrose and less than 0.25% phenol. Prepared dry. Each vial of dry vaccine comes with 3 ml of saline or distilled water. Storage of the diluted vaccine is prohibited.
• Anti-rabies culture inactivated lyophilized vaccine is produced on the culture of primary kidney cells of the Syrian hamster, infected with attenuated vaccine rabies virus (Vnukovo-32 strain). The virus is inactivated by ultraviolet rays. The vaccine is lyophilized from a frozen state with gelatin (1% sucrose (7.5%). It is a pinkish-white porous tablet, after dissolving in distilled water, a slightly opalescent liquid of a reddish-pink color.
• Anti-rabies gamma globulin is a gamma globulin fraction of horse serum hyperimmunized with a fixed rabies virus; anti-rabies gamma globulin is available in liquid form in ampoules or vials containing 5 or 10 ml of the drug.

The procedure for the appointment and conduct of vaccinations. Rabies vaccinations are used for preventive and therapeutic purposes. For preventive immunization, they are prescribed to persons at risk of infection with a wild virus: dog catchers, hunters, veterinarians, laboratory workers for the diagnosis of rabies, employees of nature reserves, postmen in places unfavorable for rabies among animals.

Vaccination for prophylactic purposes consists of 2 injections of the vaccine, 5 ml each, with an interval of 10 days, followed by a single annual revaccination of 4 ml of the vaccine. Vaccinations are not prescribed for bites through intact tight or layered clothing; in case of injury by non-predatory birds, in case of accidental consumption of milk or meat of rabid animals, in case of rabies.

Vaccinations for therapeutic purposes against rabies are prescribed by a surgeon at a trauma center, where persons bitten by animals should seek help. Physicians should have special training in antirabies. Depending on the circumstances, a conditional or unconditional course of vaccinations is prescribed.

The conditional course consists in carrying out 2-4 injections of the vaccine to persons bitten by apparently healthy animals, for whom it is possible to establish observation for 10 days. If the animal fell ill, died or disappeared before the 10th day from the moment of the bite or saliva, then the vaccinations are continued according to the unconditional course scheme.

An unconditional course is a complete course of vaccination given to persons bitten, licked, or scratched by rabid or unknown animals.

Along with the introduction of the anti-rabies vaccine according to the scheme, in certain cases, combined immunization with the anti-rabies vaccine and anti-rabies gamma globulin is provided. The dosage of the vaccine and gamma globulin, the immunization scheme depend on the nature, injury, location of the bite and other conditions. The vaccination scheme with anti-rabies vaccine and anti-rabies gamma globulin is presented in tal. one.

SCHEME
therapeutic vaccinations with anti-rabies gamma globulin and inactivated cultural anti-rabies vaccine

Table 1

Contact nature	Animal data		Vaccinations	Dosage and duration of the course of vaccination against rabies. vaccine and rabies gamma globulin
	at the time of the bite	within 10 days of observation
drooling
Intact skin	a) healthy b) healthy	healthy fell ill, died or disappeared	Not assigned	3 ml x 7 days
Damaged skin and intact mucous membranes	a) healthy b) healthy c) sick with rabies, ran away, killed, unknown animal	healthy fell ill, died or disappeared	Not assigned Start vaccinations immediately or continue	3 ml x 12 days
Bites are light
Single superficial bites on the shoulder, forearm, lower extremities, or torso	a) healthy	healthy		On one day, 3 ml of the vaccine is administered 2 times with an interval of 30 minutes
	b) healthy			3 ml x 12 days
	c) sick with rabies, ran away, unknown animal	fell ill, died or disappeared	Start vaccinations immediately or continue	and 3 ml of vaccine on the 10th and 20th day from the end of the vaccination course
Moderate bites
Superficial single bites of the hand, scratches, excluding fingers, salivation of damaged mucous membranes	a) healthy	healthy	Not assigned with favorable data In case of unfavorable data, start vaccinations immediately	3 ml of vaccine 2 times with an interval of 30 minutes
	b) healthy	sick, dead	Start vaccinations immediately	Combined administration of anti-rabies gamma globulin (0.25 ml per 1 kg of adult weight) and vaccination every 24 hours: 5 ml x 21 days, a break of 10 days, and then 5 ml on days 10 and 20 and 35 . In rabies-free areas, administer the vaccine at a dose of 3 ml for 10 days: a break for 10 days and then 3 ml of the vaccine on the 10th and 20th day.
Heavy bites
Any bites to the head, face, neck, fingers, multiple or extensive bites, and any bites inflicted by carnivores	a) healthy	healthy	Start vaccinations immediately	A vaccine is administered in 5 ml for 3-4 days or anti-rabies gamma globulin at a dose of 0.25 ml per 1 kg of adult weight
	b) healthy	fell ill, died or disappeared	Continue vaccinations	Regardless of the conditional course conducted, conduct a combined course
	c) sick with rabies, escaped or killed, unknown animal		Start vaccinations immediately	Combined administration of gamma globulin (0.5 ml per 1 kg of adult weight) and after 24 hours vaccination, 5 ml x 25 days, a break of 10 days, and then 5 ml on days 10 and 20 and 35. In prosperous areas, the vaccine is administered: 5 ml x 10, 3 ml for 10-15 days.

Note:

1. The dosage of the vaccine is indicated for adults and for children over 10 years of age. For children under 3 years old, half the dose is prescribed, for children from 3 to 10 years old - 75% of the adult dose. For children after the introduction of anti-rabies gamma globulin, the dose of the vaccine is determined depending on age.
2. Doses of anti-rabies gamma globulin for children under 12 years of age:
   • according to unconditional indications - 5 ml + the number of years of the child
   • according to conditional indications up to 2 years - 4 ml, from 3 to 12 years - 2 ml + number of years.

Immunization against mumps [show]

A live attenuated vaccine against mumps, measles and rubella is used.

Lyophilized combined preparation of attenuated measles (Schwarz), mumps (RIT 43/85, derived from Jeryl Lynn) and rubella (Wistar RA 27/3) vaccine strains cultivated separately in chick embryo cell culture (measles and mumps viruses) and diploid cells human (rubella virus). The vaccine meets the WHO requirements for the production of biological drugs, the requirements for vaccines against measles, mumps, rubella and live combined vaccines. Antibodies to the measles virus were found in 98% of those vaccinated, to the mumps virus in 96.1% and to the rubella virus in 99.3%. A year after vaccination, all seropositive individuals retained a protective titer of antibodies to measles and rubella, and 88.4% to the mumps virus.

This drug is administered from the age of 12 months s / c or / m at a dose of 0.5 ml (before use, the lyophilisate is diluted with the supplied solvent).

Immunization against brucellosis [show]

Brucellosis vaccinations are given to the following persons:

• personnel working in livestock farms, 2-3 months before the calving of animals;
• persons working at meat processing plants, slaughterhouses and other enterprises related to livestock products, 1-2 months before mass slaughter or mass receipt of raw materials;
• to newly arriving persons within the specified terms of the enterprise, at least 3 weeks before the start of work;
• veterinary and zootechnical workers of livestock farms;
• persons working with live virulent cultures of brucella in the laboratory or with animals infected with brucellosis.

Dry live cutaneous brucellosis vaccine. Vaccinations are carried out by the skin method, once, on the outer surface of the middle third of the shoulder. The dose for adults is 0.05 ml, or 2 drops of the vaccine; children under 15 years of age are vaccinated with half the adult dose, that is, one drop of the drug is applied.

Revaccination is carried out 8-12 months after vaccination. Starting from the 3rd revaccination, it is carried out for persons who react negatively to the Burne test. Revaccination is carried out with half the dose established for vaccination.

Burne test. Brucellin is used to set up an allergic intradermal test by Burne. This is a filtrate from a 3 week old brucella broth culture. Used as a diagnostic reaction. The result of the reaction is taken into account after 24-48 hours. The formation of an oval-shaped redness and swelling indicates a person's infection and is a contraindication for vaccination.

Immunization against typhus [show]

Dry live combined typhoid vaccine E (ZHKSV-E) is a suspension of Provachek rickettsia Madrid-E strain dried in sterile skimmed milk together with dissolved antigen from killed Provachek rickettsia. ZhKSV-E is available in ampoules with a different number of doses.

Immunization is carried out once subcutaneously in the subscapular region at a dose of 0.25 ml. The vaccine is dissolved before use with sterile saline. The dissolved vaccine is usable within 30 minutes. Revaccination is carried out in the presence of a negative complement fixation reaction and vaccinated no earlier than 2 years after vaccination. The vaccine for revaccination is used in the same dose as for primary immunization. Both local reactions, slight swelling or tissue infiltration, and general reactions, a slight increase in temperature, headache, and sometimes dizziness, are possible.

Immunization against tularemia [show]

Dry live tularemia vaccine- NIIEG was proposed in 1946 by M. M. Faybich and T. S. Tamarina. The vaccine has high immunogenicity and stability.

Scheduled preventive vaccination has been carried out in the USSR since 1946. The entire population is subject to vaccination, starting from the age of 7 in areas enzootic for tularemia. Workers of grain, vegetable storages, elevators, mills, sugar factories, persons traveling to places unfavorable for tularemia, to work in floodplains, as well as to harvest the skins of water rats, are vaccinated without fail. Mandatory vaccination also covers employees of departments of especially dangerous infections and laboratories. Vaccinations are carried out in a planned manner and according to epidemic indications. Vaccination is carried out once by the skin method on the outer surface of the middle third of the shoulder. The vaccine is applied one drop at a time in two places, placing these drops at a distance of 3-4 cm. 2 parallel cuts 0.8-1 cm long are made through each drop. more than 0.5 cm. The result of vaccination is evaluated 5-7 days after vaccination. If there is no reaction for 12-15 days, the vaccination is repeated.

Revaccination for tularemia is carried out every 5 years in a planned manner for persons with a negative tularin test. People are subject to revaccination after a shorter time if there is doubt about the quality of the vaccination and also after a test with tularin. The quality of the vaccinations and the presence of immunity in the vaccinated is assessed by testing with tularin.

The tularin test is placed intradermally and cutaneously with the appropriate preparations. To perform an intradermal test, tularin is administered on the palmar surface of the forearm at a dose of 0.1 ml. A positive reaction manifests itself after 48 hours in the form of a pronounced infiltrate and hyperemia.

For a skin test, tularin is used, made from a vaccine strain containing 2 billion microbial bodies in 1 ml. A positive reaction is manifested by swelling and redness of the skin around the notches.

Populations to be vaccinated	Name of vaccination	Timing of vaccination	Timing of revaccination
The population living in the territories enzootic for tularemia, as well as persons who arrived in these territories and perform the following work: agricultural, irrigation and drainage, construction, other works on excavation and movement of soil, procurement, commercial, geological, surveying, forwarding, deratization and pest control; for logging, clearing and landscaping of forests, recreation and recreation areas for the population. Persons working with live cultures of the tularemia pathogen	Against tularemia	From 7 years old (from 14 years old in field-type foci)	Every 5 years

Immunization against Q fever [show]

Immunization against KU fever is carried out with a live vaccine from an attenuated strain of Rickettsia Berirta (option M-44), developed under the guidance of P. F. Brodovsky. The vaccine has low reactogenicity and reduced immunogenicity.

It is applied subcutaneously at a dose of 0.5 ml, cutaneously - by application of 1 drop in 2 areas of the skin of the shoulder with three cross-shaped notches 1 cm long.

Immunization against plague [show]

Live vaccine from the EB strain. The vaccine is a suspension of live bacteria of the vaccine strain of the plague microbe dried in a sucrose-gelatin medium.

Immunization is carried out by subcutaneous and cutaneous methods. Subcutaneous vaccinations give more pronounced post-vaccination reactions. Therefore, children from 2 to 7 years old and pregnant and lactating women are recommended to be vaccinated only by the skin method.

Revaccination is carried out after 6-12 months in the same doses.

Immunization is accompanied by both general and local reactions. The local reaction is expressed in the form of reddening of the skin, thickening at the injection site, the reaction develops 6-10 hours after vaccination.

The general reaction is expressed by malaise, headache, temperature, occurs during the first day and ends after 2 days.

Immunization against anthrax [show]

STI vaccine. In 1936, in the USSR, N. N. Gindburg and L. L. Tamarin obtained vaccine strains from which the modern anthrax vaccine (AN) is being prepared. The STI vaccine is a suspension of spores of the vaccine strain dried under vacuum. The vaccine should be stored in a dry, dark place at a temperature of 4 degrees C. The shelf life of the vaccine is 2 years from the date of issue.

Vaccinations are carried out among the most threatened contingents: persons performing the following work in anthrax enzootic territories: agricultural, hydro-reclamation, construction, excavation and movement of soil, procurement, commercial, geological, surveying, expeditionary; procurement, storage and processing of agricultural products; for the slaughter of livestock suffering from anthrax, the procurement and processing of meat and meat products obtained from it. In addition, people who work with live cultures of the anthrax pathogen are vaccinated.

Vaccination is carried out once, by the skin method. Revaccination - in a year. Before inoculation, the dry STI vaccine is diluted in 1 ml with 30 percent. aqueous solution of glycerin. An opened ampoule with a diluted vaccine is allowed to be stored for no more than 4 hours.

Vaccination of the vaccine during vaccination and revaccination is usually assessed after 48-72-96 hours and on the 8th day after vaccination (+). The reaction is assessed as positive if there is pronounced redness and swelling along the notch.

Anti-anthrax gamma globulin. For prophylactic purposes, the drug is administered as soon as possible after contact with infected material: to persons caring for sick animals that have eaten meat, an anthrax patient, if no more than 10 days have passed since the contact (in case of possible infection of the skin) or no more than 5 days after eating the meat of an animal with anthrax.

20-25 ml of gamma globulin is administered intramuscularly to an adult, 12 ml to adolescents 14-17 years old, and 5-8 ml to children. Before the introduction of gamma globulin, using an intradermal test, the individual sensitivity of the patient to horse protein is checked. A sensitivity test is carried out by introducing 0.1 ml of gamma globulin diluted 100 times with saline. The test is considered positive if after 20 minutes a papule of 1-3 cm or more develops, surrounded by a zone of hyperemia. With positive samples, gamma globulin is administered only according to unconditional indications.

Immunization against leptospirosis [show]

For the specific prevention of leptospirosis, a heat-killed vaccine is used, which contains three types of leptospirosis antigen: influenza typhoid, pomona, and icterohemorrhagic.

Vaccinations against leptospirosis are carried out in a planned manner and according to epidemic indications. Scheduled vaccinations are carried out in anthropurgic and natural foci, regardless of the presence of registered diseases; according to epidemic indications - with the threat of the spread of infection among people.

Scheduled and unscheduled vaccinations are carried out for both adults and children aged 7 years and older.

The vaccine is administered subcutaneously twice, with an interval of 7-10 days: the first dose is 2 ml, the second is 2.5 ml. A year later, revaccination is carried out at a dose of 2 ml.

Immunization against tick-borne encephalitis [show]

Killed culture vaccine against tick-borne encephalitis. The vaccine against tick-borne encephalitis is a sterile suspension of the TBE virus antigen, inactivated with formalin 1:2000 in a nutrient medium used in cell culture. The drug has a pinkish-violet or pinkish-orange color.

Cultural encephalitis vaccine is intended for preventive immunization of the population against diseases caused by tick-borne encephalitis complex viruses.

The vaccine is administered subcutaneously. The vaccination dose for adults and children 7 years and older is 1 ml per vaccination, and for children 4-5 years old, 0.5 ml per vaccination.

1. The primary course of vaccination against tick-borne encephalitis consists of 4 injections of the drug. The first 3 injections are carried out in September-October with an interval of 7-10 days between the first and 2 vaccinations and 14-20 days later between the 2nd and 3rd. The fourth vaccination should be done after 4-6 months. after the third in March-April, but no later than 10 days before visiting the outbreak.
2. Annual single revaccinations are carried out for the duration of 3 years in March-April.
3. Long-term single revaccinations are carried out every 4 years. If one of the mandatory annual revaccinations is missed, it is allowed to continue vaccinations according to the described scheme without resuming the primary course, but if two revaccinations are missed, it is necessary to resume the entire course again.

According to epidemic indications, vaccination against tick-borne encephalitis is carried out:

1. In foci with a high risk of infection (immunize the entire population aged 4 to 65 years);
2. In foci with a moderate risk of infection (the following groups are vaccinated: schoolchildren, forestry and agricultural workers, etc. to contingents in accordance with the incidence structure).

Gamma globulin against tick-borne encephalitis used for therapeutic and prophylactic purposes.

For prophylactic purposes, gamma globulin is used in cases of sucking ticks in endemic foci of the disease. It is administered to adults in the amount of 3 ml, to children under the age of 12 - 1.5 ml, from 12 to 16 years - 2.0 ml, from 16 years and older - 3.0 ml.

With a therapeutic purpose, gamma globulin is administered in doses of 3-6 ml for 2-3 days in a row in the acute period of the disease (in the first 3-5 days of the disease) and in some cases with a chronically progressive course.

Influenza Immunization [show]

For the prevention of influenza, live and inactivated vaccines, donor and placental gamma globulin and polyglobulin, leukocyte interferon, oxolin ointment, rimantadine are used.

Influenza vaccines and oxolinic ointment are used exclusively for prophylactic purposes. Interferon, gamma globulin and rimantadine have both preventive and curative effects.

Live allantoic (egg) vaccine. It is produced in the form of monopreparations from epidemiologically relevant strains of the influenza virus. Used for immunization of adolescents and adults. Vaccination is carried out twice with an interval of 25-30 days intranasally using a Smirnov sprayer. In people who are especially susceptible to influenza, it gives a local reaction and even an increase in body temperature to 37.6 degrees and above. Contraindicated in children (under 15 years of age), with a number of chronic diseases and pregnant women.

Live tissue oral vaccine does not cause any adverse reactions, and therefore it is advisable to use it for immunization of children from 1 to 16 years of age. For adults, the vaccine is less effective. The vaccination dose is 2 ml per dose, three times with an interval of 10-15 days.

inactivated vaccines. They are produced from whole virus particles purified from ballast substances and concentrated (virion vaccine) or from viruses split and adsorbed on aluminum hydroxide - adsorbed influenza chemical (AHC) vaccine. Currently used for immunization, mainly adults. Vaccinations are carried out once, intradermally at a dose of 0.1-0.2 ml using a needleless injector (jet method). If necessary, the vaccine can be administered subcutaneously by conventional injection through a syringe at a dose of 0.5 ml (for individual vaccinations).

Inactivated vaccines should be used to protect workers and employees of large enterprises against influenza, as they are the most convenient and effective for mass immunization. AHC - the vaccine is best used for contraindications to live influenza vaccine and for individual vaccination. For immunization of schoolchildren in grades 1-8, only a live oral vaccine should be used, for schoolchildren in grades 9-10 - live intranasal or inactivated vaccines. The live tissue oral vaccine is also widely recommended for immunization of children in kindergartens and nurseries for children less than 1 year old.

Donor anti-influenza gamma globulin or polyglobulin. It is intended for the treatment of the most severe and toxic forms of influenza, especially in children. For each patient, an average of 3 ampoules of the drug is consumed. In the presence of a sufficient amount and for emergency prevention of influenza, it can be used in children under 1 year old.

Leukocyte interferon it is advisable to use for planned, emergency prevention of influenza in children's nurseries with an annual consumption of 1.0 ml of the drug for each child for 30 days.

Remantadine has antiviral activity against a wide range of strains of the influenza virus serotype A. It is used for therapeutic and prophylactic purposes. For therapeutic purposes, it is especially effective to use the drug from the first hours of the disease. It is used 1 tablet (0.05 g) 3-6 times a day after meals for 3 days. Do not use after the 3rd day of illness, children and pregnant women. In order to prevent influenza, take 1 tablet in the morning after meals daily for 2-3 weeks.

Oxolinic ointment is a universal drug for planned and focal emergency prevention of influenza type A and B among adults and children. It should be recommended to the general population for independent use, regardless of vaccinations and other means of protection against influenza (except for interferon).

POST-VACCINATION COMPLICATIONS

The introduction into the body of any vaccine, which is a foreign protein, which in some cases has residual toxicity, on the one hand, causes a chain of closely related reactions. In addition to the immunological effect, preventive vaccinations affect nonspecific immunity, nervous system functions, various biochemical parameters, protein spectrum, coagulation system and other processes. In healthy people, these changes are shallow and relatively short-lived. In weakened persons, especially in children burdened with various pathological conditions, in convalescents, they can go beyond physiological reactions (EM Ptashka, 1978).

Clinical observations and special studies have established that in response to the introduction of various vaccines, reactions specific to the corresponding drug may occur, characterized by rapid and complete regression. Therefore, when analyzing adverse reactions and post-vaccination complications, a critical approach to their evaluation in each individual case is important in order to avoid errors that could be detrimental to the further improvement of active immunization.

Post-vaccination complications are very diverse and, according to the classification of S. D. Nosov and V. P. Braginskaya (1972), are divided into the following groups:

1. Unusual and complicated local reactions
2. Secondary (inoculated) vaccination
3. Unusual General Reactions and Complications

Among the concepts regarding the causes and pathogenetic mechanisms underlying the side effects of vaccines, of interest is the systematics and post-vaccination complications of A. A. Vorobyov and A. S. Prighoda (1976), which allows not only to determine the nature of the complication, its genesis and causes, but also measures to prevent side effects (Table 3).

Systematics, etiology, genesis, as well as possible measures to reduce and eliminate post-vaccination reactions and complications when vaccinated with various antigens (according to A. A. Vorobyeva, A. S. Prigoda, 1976)
The nature of the side effect	Etiology and genesis	Possible manifestations	Antigens with side effects	Measures to reduce and eliminate side effects
Post-vaccination complications
By type of non-infectious allergy	The reaction between specific antibodies and a specific antigen in a sensitized organism, causing the damaging effect of immune complexes on cells	Reaction of the immediate and delayed type. Polymorphism of manifestation: skin rash, joint pain, anaphylactic shock Severe neuropathy, paralysis. Miscarriages in pregnant women. autoimmune disorders.	Possible with the introduction, especially repeated, of toxoids, heterogeneous sera of some animals and killed vaccines	Consider vaccination history. Carry out a test for sensitivity to the administered drug Apply desensitizing therapy. Maximally clear antigens from substances of a proteic nature.
Paraallergic processes	The relationship between the antibodies in the patient's serum and the injected antigen has not been established. The most common cause is non-specific sensitization due to hidden diseases and allergic status.	According to the type of immediate during the first 2-3 hours, anaphylactogenic reactions, especially in persons with severe clinical symptoms of sensitization: bronchial asthma, rheumatic heart disease, etc.	Possible with the introduction of any drugs, but especially those that have increased resolving activity: DPT, typhoid-paratyphoid vaccine, etc.	Careful selection of vaccinated contingents, exclusion from their number of persons with allergic diseases, as well as convalescents. Improving vaccines. Use of low-allergenic methods of application, for example, enteral
By type of infectious allergy	They do not depend on the reaction between specific antibodies and antigen and are infectious-toxic in nature. Relationship with the properties of the vaccine agent (residual virulence, dose, etc.). Insufficient attenuation of the vaccine strain Presence of underneutralized exotoxin in toxoid	Most often proceed in a slow manner. neurological disorders. Decreased immunological reactivity.	Live vaccines, especially smallpox, BCG vaccine Anatoxins (in case of insufficient neutralization of exotoxin)	Use of highly attenuated strains. Use of enteral associated vaccine and chemical antigens Carrying out immunization against tuberculosis, brucellosis, tularemia, plague under the control of skin reaction to specific allergens
Possible oncogenic risk	The presence in the composition of the vaccine of viruses-contaminants with tumorigenic properties. The ability (supposed) of the active agent itself to cause oncogenic transformation of cells	Tumor induction	Vaccines prepared on the basis of embryonic materials and transplanted cell cultures	Strict control to detect contaminants. use of animal tissues - gnobionts, human and animal diploid cells as a substrate for creating vaccines
Other complications	Vaccine mistakes Reversal of the pathogenic properties of the vaccine agent	Anaphylactic shock, the so-called "syringe injections" (malaria, serum hepatitis, etc.) Occurrence of a disease not dissimilar to that caused by a virulent strain	Any vaccinations if certain requirements are not met Live vaccines with little-studied properties	Careful immunoprophylaxis; the use of needle-free and enteral methods of application, guaranteeing against "syringe infections". A long and comprehensive study of the properties of a candidate for vaccine strains.

The most common post-vaccination complications occur after immunization with DTP vaccine, measles, typhoid vaccine, rabies vaccine and BCG vaccine.

Whooping cough, diphtheria, tetanus. With the introduction of DPT - vaccines, accelerated reactions can develop after 4-8 hours, and after the injection - immediate ones. Accelerated reactions are expressed in the form of tearfulness, sleep disturbances, irritability, and loss of appetite in the child. With immediate reactions, there is a headache, swelling of the joints, swelling of the face, itching.

On the 8-15th day from the moment of administration of the drug, complications may occur in the form of nephrotic syndrome. Extremely rare post-vaccination complications such as encephalopathy, encephalitis, serum sickness.

Complications from the nervous system to the introduction of the DPT vaccine are noted in children with a history of birth trauma, with impaired cerebral circulation. In this case, encephalic reactions appear as early as 2-3 days, often at normal temperature, are polymorphic in nature.

Measles. Post-vaccination complications to the introduction of live measles vaccine are recorded extremely rarely and are observed in children with altered immunological reactivity in the form of convulsions, temperature reaction, post-vaccination encephalitis. There have been cases of hemorrhagic and asthmatic syndromes, disorders of the kidneys, leukemia, dissemination of tuberculosis infection, paroxysmal cold hemoglobinuria (V. P. Braginskaya, 1969; E. A. Lokotkina, M. I. Yakobson, 1971). As a possible complication during immunization against measles, subacute sclerosing panencephalitis is called (VM Bolotovsky, 1976).

Typhoid fever. The occurrence of complications in the introduction of typhoid vaccines was noted by many researchers. In addition to short-lived local and general reactions (fever, chills, headache), rather severe complications from the central nervous system in the form of radiculitis, myelitis, encephalitis can occur in the longer term. Such post-vaccination complications often develop after repeated vaccinations and, despite the severity of the course, lethal outcomes are rare. In some cases, residual effects are possible.

Tuberculosis. Among the registered complications for the introduction of the BCG vaccine, there are 3 groups of complications: specific, nonspecific and toxic-allergic. The former are more common and present clinically as ulcers, cold abscesses, or enlarged regional lymph nodes.

About a third (1/3) of complications after the introduction of the BCG vaccine are non-specific, but the clinical picture differs little from complications of a specific nature.

Rabies. The frequency of complications after immunization with the rabies vaccine is quite high. Some of the complications are related to the actions of the rabies virus. Others are due to an immunological reaction that occurs in response to the injected medulla. There are complications that occur with signs of damage to the central nervous system in the form of myelitis, encephalomyelitis, poly, and mononeuritis. Mental disorders are much less common, manifested in the form of apathy, depression or agitation.

What are the causes of post-vaccination complications?

The occurrence of post-vaccination complications can be associated with various factors:

• with the properties of the vaccine preparation itself and the impurities present in it (sorbent);
• with defects in immunization technique;
• with exacerbation of existing protracted and chronic diseases, as well as with the "revival" of a latent infection;
• with layering during the vaccination process of any intercurrent infection (respiratory, viral, intestinal infection, bacterial pyogenic flora, etc.);
• with a decrease in the protective and adaptive reactions of the body, with a state of allergic reactivity in the presence of specific and nonspecific sensitization.

Of great importance is the initial condition of the child before vaccination and care for him after it. To prevent post-vaccination complications, a medical examination and selection of contingents to be vaccinated should be carefully carried out, taking into account the anamnestic data on the child's tendency to allergic reactions, reactions to vaccinations in the past, diseases suffered over the past 2 months, etc.

After vaccination, it is necessary to comply with the home regimen, proper nutrition. It is very important in the post-vaccination period to protect the child from hypothermia, nervous strain, communication with infectious patients.

In order to reduce the possibility of complications after vaccination, various medications are used. The frequency and intensity of post-vaccination complications can be reduced by the prescription of drugs recommended for a particular vaccination (aspirin, dibazol, novocaine, pyramidon, adrenaline, metisazon, cortisone, tavegil, suprastin, pipolfen, seduxen, etc.).

A beneficial effect in immunization with individual vaccines (for example, against smallpox, rabies) is the use of titrated gamma globulin. It has been proven that with the simultaneous administration of the rabies vaccine and donor gamma globulin, the number of post-vaccination complications is significantly reduced. However, gamma globulin should not be used immediately before immunization against measles, mumps, etc., as this will adversely affect the production of antibodies in the child's body.

It should be taken into account that the number of children with a potential tendency to post-vaccination complications has increased (quoted by E. M. Ptashka, 1978). This prompted the Institute of Pediatrics of the USSR Academy of Medical Sciences, together with the Research Institute of M3 Virus Preparations of the USSR, to recommend sparing methods of immunization for the vaccination of children with conditional contraindications. Their use will reduce the number of children unvaccinated due to medical contraindications and increase the level of herd immunity.

Annex 1.

"On permissible intervals between the administration of gamma globulin from human blood serum and preventive vaccinations"
(From the Order of the Ministry of Health of the USSR No. 50 of 01/14/80)

1. The interval between the introduction of gamma globulin and subsequent preventive vaccinations:
   1. After the introduction of gamma globulin in the order of pre-season prevention of infectious hepatitis:
      • vaccinations with DTP, BCG, cholera, typhoid vaccines and other toxoids can be carried out at intervals of at least 4 weeks;
      • vaccinations with measles, mumps, full myelitis and influenza vaccines can be carried out at intervals of at least 6 weeks.
   2. After the introduction of gamma globulin according to epidemiological indications (in contact with an infectious patient), vaccinations can be carried out at intervals of at least 2 months.
   3. When a specific gamma globulin is administered simultaneously with active immunization (tetanus toxoid, rabies vaccine, etc.), subsequent vaccination with another drug can be carried out at intervals of at least 2 months.
   4. After the introduction of gamma globulin for therapeutic purposes, the interval is determined by the above provisions and a list of contraindications to the use of the corresponding drugs.
2. The interval between prophylactic vaccinations and the subsequent administration of gamma globulin.
   1. After immunization with DTP, BCG, cholera typhoid, measles, full myelitis, influenza vaccines, ADS, AS, and other toxoids, gamma globulin can be administered at intervals of at least 2 weeks as a seasonal prevention of infectious hepatitis;
   2. The introduction of gamma globulin for epidemiological indications, for therapeutic purposes, as well as specific anti-tetanus gamma globulin for emergency prevention of tetanus and specific gamma globulin against rabies is carried out regardless of the period of the previous vaccination.

More on the topic: Decree of the Government of the Russian Federation N 825 of 07/15/1999 "On approval of the list of works, the implementation of which is associated with a high risk of contracting infectious diseases and requires mandatory preventive vaccinations" Decree of the Government of the Russian Federation N 885 of 08/02/1999 On approval of the list of post-vaccination complications caused by preventive vaccinations included in the national calendar of preventive vaccinations and preventive vaccinations for epidemic indications, giving citizens the right to receive state lump-sum benefits Order of the Ministry of Health and Social Development N 19n of January 26, 2009 "On the recommended sample of voluntary informed consent to preventive vaccinations for children or refusal from them"

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Today vaccinations have already firmly entered our lives as a highly effective means of preventing dangerous infectious diseases, which has negative consequences in the form of complications, or even death. In modern medical practice, they are made either to form immunity to dangerous infections, or to treat an infected person at an early stage. Accordingly, all vaccinations are usually divided into preventive and therapeutic. Basically, a person is faced with preventive vaccinations that are given in childhood, and then re-immunized if necessary. An example of a curative vaccination is the introduction of tetanus toxoid, etc.

What are preventive vaccinations?

Preventive vaccinations are a method of immunizing a person against certain infectious diseases, during which various particles are introduced into the body that can lead to the development of a stable immunity to pathology. All preventive vaccinations involve the introduction of a vaccine, which is an immunobiological preparation.

The vaccine is a weakened whole microbes - pathogens, parts of the membranes or genetic material of pathogenic microorganisms, or their toxins. These components of the vaccine cause a specific immune response, during which antibodies are produced against the causative agent of an infectious disease. Subsequently, it is these antibodies that provide protection against infection.

To date, all preventive vaccinations are classified into:
1. Planned.
2. Conducted according to epidemiological indications.

Scheduled vaccinations are given to children and adults at a specific time and at a specific age, regardless of whether an epidemic focus of infection has been identified in a given region or not. And vaccination according to epidemiological indications is done to people who are in a region in which there is a danger of an outbreak of a dangerous infectious disease (for example, anthrax, plague, cholera, etc.).

Among the planned vaccinations, there are mandatory ones for everyone - they are included in the national calendar (BCG, MMR, DPT, against polio), and there is a category of vaccines that are administered only to people at risk of contracting infections due to the specifics of their work (for example, against typhoid, tularemia , brucellosis, rabies, plague, etc.). All scheduled vaccinations are carefully worked out, the timing of their setting, age and time are set. There are developed schemes for the introduction of vaccine preparations, the possibility of combining and the sequence of immunization, which is reflected in the regulations and guidelines, as well as in the vaccination schedules.

Preventive vaccination of children

For children, preventive vaccinations are necessary to protect vulnerable babies from dangerous infectious diseases that can be fatal even when treated with modern high-quality drugs. The entire list of preventive vaccinations for children is developed and approved by the Ministry of Health of Russia, and then, for ease of use, is drawn up in the form of a national calendar.

In addition to those indicated in the national calendar, there are a number of preventive vaccines that are recommended for children. The recommendation to vaccinate is given by the child's attending physician on the basis of an analysis of the state of health. In some regions, they also introduce their own vaccinations, which are necessary, since the epidemiological situation for these infections is unfavorable, and there is a risk of an outbreak.

Preventive vaccinations for children - video

The value of preventive vaccinations

Despite the different structure of the possible components for a particular vaccine, any vaccine can form immunity to infection, reduce the incidence and prevalence of pathology, which is its main purpose. The active components of the drugs, in response to the introduction into the body of any person, cause a reaction from his immune system. This reaction is in all respects similar to that which develops when infected with an infectious disease, but much weaker. The meaning of such a weak reaction of the immune system in response to the administration of the drug is that special cells are formed, which are called memory cells, which provide further immunity to infection.

Memory cells can be stored in the human body for a different period of time - from several months to many years. Memory cells that live only a few months are short-lived, but vaccination is necessary to form a different type of memory cell - long-lived. Each such cell is formed only in response to a specific pathogen, that is, a cell formed against rubella will not be able to provide immunity to tetanus.

For the formation of any memory cell - long or short-lived, a certain period of time is required - from several hours to a whole week. When the causative agent of the disease enters the human body for the first time, then all manifestations of the infection are due precisely to the activity of this microbe. During this period, the cells of the immune system "get acquainted" with the pathogenic microbe, after which the activation of B-lymphocytes occurs, which begin to produce antibodies that have the ability to kill the pathogen. Each microbe needs its own specific antibodies.

Recovery and relief of the symptoms of infection begins only from the moment when antibodies are produced and the destruction of the pathogenic microorganism begins. After the destruction of the microbe, some of the antibodies are destroyed, and some become short-lived memory cells. B-lymphocytes, which produced antibodies, go into the tissues and become the same memory cells. Subsequently, when the same pathogenic microbe enters the body, the memory cells against it are immediately mobilized, producing antibodies that quickly and effectively destroy the infectious agent. Since the pathogen is quickly destroyed, an infectious disease does not develop.

Against infections that the human body is able to cope with, it makes no sense to be vaccinated. But if the infection is dangerous, the mortality of sick people is very high - it is necessary to vaccinate. Vaccinations are simply a carrier of the antigen of the microbe - the pathogen, on which memory cells are produced. There are two possible outcomes when contracting a dangerous infection - recovery with the formation of immunity, or death. Vaccination also ensures the formation of this immunity without a mortal risk and the need to endure a severe course of infection with extremely painful symptoms.

Quite naturally, in response to vaccination, the process of formation of memory cells during the activation of the immune system is accompanied by a number of reactions. The most common reactions are at the injection site, and some are common (for example, fever for several days, weakness, malaise, etc.).

List of preventive vaccinations

So, today in Russia the list of preventive vaccinations includes the following vaccines, which are given to children and adults:

• against hepatitis B;
• against tuberculosis - only for children;
• ... tetanus;
• ... Haemophilus influenzae;
• ... poliomyelitis;
• ... rubella;
• ... mumps (mumps);
• ... meningococcal infection;
• ... tularemia;
• ... tetanus;
• ... plague;
• ... brucellosis;
• ... anthrax;
• ... rabies;
• ... tick-borne encephalitis;
• ... Q fever;
• ... yellow fever;
• ... cholera;
• ... typhus;
• ... hepatitis A;
• ... shigellosis.

This list includes mandatory vaccinations that are given to all people, and those performed according to epidemiological indications. Epidemiological indications can be different - for example, living or temporarily staying in the focus of an outbreak of a dangerous infection, leaving for regions with an unfavorable situation, or working with dangerous microbes - pathogens or with livestock, which is a carrier of a number of pathologies.

National calendar of preventive vaccinations (2013, 2012, 2011)

The vaccination schedule is compiled and approved based on the significance of the infections against which vaccination is carried out, as well as the availability of drugs. The calendar may be revised if any circumstances change - for example, the emergence of new vaccines that have different rules for use, or the risk of an outbreak that requires urgent and urgent immunization.

In Russia, a vaccination calendar for children and adults has been approved, which is valid throughout the country. This calendar has not changed in recent years, so for 2011, 2012 and 2013 it is the same. Vaccinations included in this calendar are performed for all people. Vaccines from the national calendar are shown in the table:

Vaccine	Age at which vaccination is given
Against hepatitis B	The first day after birth, at 1 month, at 2 months, at half a year, at a year, then every 5-7 years
Against tuberculosis (BCG)	Children on 3 - 7 days after birth, at 7 years old, at 14 years old
Against diphtheria, whooping cough and tetanus (DTP)	At 3 months, at 4 - 5 months, at six months, at one and a half years, at 6 - 7 years, at 14 years, at 18 years
Against Haemophilus influenzae	At 3 months, at 4-5 months, at six months, at one and a half years
Against polio	At 3 months, at 4-5 months, at six months, at one and a half years, at 20 months, at 14 years
Against measles, rubella and mumps	At 1 year old, at 6 years old
Rubella	From 11 years old every five years until the age of 18 for boys and up to 25 years for girls
against measles	At 15-17 years old, then every five years until age 35
Against the flu	Children from the age of 6 months, vaccinated every year

These vaccinations are given to all children at the specified time. If vaccination has not been carried out, then the dates are postponed taking into account the condition of the child, but the scheme of procedures remains the same.

Regional calendar of preventive vaccinations

The regional calendar of preventive vaccinations is developed and approved by the local authorities of the Ministry of Health, taking into account specific circumstances and the epidemiological situation. All vaccines from the national one must be included in the regional calendar of preventive vaccinations, and the necessary ones are added.

An individual program of preventive vaccinations for a child is developed and reflected in the following medical records:
1. Preventive vaccination card - form 063 / y.
2. The history of the development of the child - form 112 / y.
3. Medical card of the child - form 026 / y.
4. An insert for an outpatient medical record - form 025 / y (for adolescents).

These documents are created for each child living in the area, attending a kindergarten, school, college or college.

The preventive vaccination program is compiled separately for adults. This work is carried out by specialists - physicians from polyclinics. Preventive vaccinations for adults cover everyone who is eligible for vaccination, regardless of whether the person is working. Adults are included in the immunization plan based on the data on the vaccinations performed and their statute of limitations.

Carrying out preventive vaccinations

Preventive vaccinations can be carried out in a state medical institution (polyclinic), or in specialized centers for immunization of the population, or in private clinics licensed to carry out this type of medical manipulation. Preventive vaccinations are directly administered in the vaccination room, which must meet certain requirements and standards.

In institutions where the BCG vaccine is administered, it is necessary to have two vaccination rooms. One of them is designed exclusively to work with the BCG vaccine, and the other is for all other vaccinations.

The vaccination room must have:

• sterile instruments and materials;
• disposable syringes and needles for intradermal and intramuscular injections;
• forceps (tweezers);
• containers in which used tools and garbage are collected.

Also, there should be a sufficient number of tables in the office, each of which is intended for setting only one type of vaccine. The table must be marked, syringes, needles and sterile materials are prepared on it.

Any sterile material must be taken with sterile forceps, which are stored in containers with chloramine or chlorhexidine. The solution is changed daily, and the forceps and containers themselves are sterilized every day.

All used syringes, needles, ampoules, drug residues, cotton wool or swabs are thrown into a container with a disinfectant solution.

Organization and procedure for vaccination

The organization of preventive vaccinations and the procedure for their implementation was developed and prescribed in the Guidelines MU 3.3.1889-04, which were approved by the Chief State Sanitary Doctor of the Russian Federation on March 4, 2004. These rules are still valid today.

What kind of preventive vaccinations are given is prescribed in the national and regional calendars. For vaccination, all institutions use only registered domestic or imported drugs that are approved for use.

All preventive vaccinations are organized and carried out in accordance with the following requirements and instructions:

• Any vaccination is carried out only in a specialized institution accredited to perform immunizations (vaccination rooms in polyclinics, kindergartens, schools, colleges, schools, health centers, FAPs).
• If necessary, special teams are formed, and procedures are carried out at home.
• Prophylactic vaccines are given only as prescribed by a doctor or paramedic.
• Immediately before the planned vaccination, the data on the condition of the child or adult are carefully ascertained, on the basis of which permission is given for manipulation.
• Before the planned immunization, the child or adult is examined by a doctor, the presence of contraindications, allergies or strong reactions to previously administered drugs is found out.
• Before injection measure the temperature.
• Before the planned vaccination, the necessary tests are given.
• Vaccine injection is performed only with disposable syringes and needles.
• Vaccinations can only be done by a specialist - a physician who owns injection techniques, as well as emergency care skills.
• In the vaccination room, there is a mandatory kit for emergency care.
• All vaccines must be stored according to the rules and regulations.
• All documentation must be in the vaccination room.
• In no case should vaccination be carried out in a treatment room or dressing room.
• The vaccination room is cleaned twice a day, using disinfectant solutions.

Technique for preventive vaccinations

Preventive vaccinations must be carried out following a certain technique. General rules and methods for the introduction of prophylactic vaccines are determined by regulatory documents. So, the sequence of actions of a medical worker when administering a vaccine should correspond to the following plan:

1. The ampoule with the vaccine preparation is taken out of the refrigerator and its appearance is examined. It is necessary to fix the integrity of the ampoule, the labeling on the vial, as well as the quality of the liquid inside. Vaccine preparations must not contain flakes, lumps, turbidity, etc.
2. Ampoules are opened with sterile gloves in the cold.
3. The vaccine is administered exclusively with a disposable syringe and needle.
4. If several vaccines are administered at a time, it is necessary to inject each drug into different places, and collect the vaccine in a separate syringe.
5. The injection site is wiped with alcohol or other antiseptics.
6. The injection site of the BCG vaccine or Mantoux test is treated with ether.
7. The vaccine is administered to the patient in a sitting or lying position.
8. After the administration of the drug, the patient remains under observation for half an hour.

Journal of preventive vaccination

All vaccinations made by a medical worker must be entered in a special register. In case of loss of an individual card or moving to another place, all data can be restored by contacting the medical institution where the vaccination was performed, where they will make an extract from such logs stored in the archives. Also, based on the entries in the journal, preventive immunization plans are drawn up, in which the names of the people to be vaccinated are entered.

The preventive vaccination journal is a standard form of medical documentation 064 / y, which reflects the following data:

• surname, name and patronymic of the person being vaccinated;
• the patient's address;
• year of birth;
• place of study or work;
• name of the vaccine preparation;
• primary vaccination or revaccination;
• method of vaccine administration (subcutaneously, intramuscularly, by mouth, etc.).

In addition, vaccination information is recorded for each patient, which takes into account the following data:
1. Date of administration, series of drug and dose.
2. All reactions that were observed after vaccination.
3. Any atypical manifestations or questionable points.

The register of preventive vaccinations is stitched, the pages are numbered. The form of the magazine is usually ordered from a printing house, which prints them according to a model approved by the Ministry of Health.

Immunization card, form 063

The card of preventive vaccinations, form 063 / y is a medical document in which information about all vaccinations and biological samples carried out is entered. This document is often referred to simply as a "vaccination sheet". The document must record the date of vaccination, numbers and series of the drug.

The vaccination card is filled out by medical specialists in the clinic, FAP, school or kindergarten. Moreover, when conducting immunization at a school or kindergarten, other documentation can be used, from which information about vaccinations is transferred to the vaccination card in the form 063 / y. Vaccination sheet form 063 / y can be issued to the parents of the child if it is necessary to provide information about the availability of vaccinations for the baby to any authorities (for example, the visa department, hospitals, etc.). One copy of the vaccination list is stored in the archives of the medical institution for 5 years.

The preventive vaccination card is printed in a typographical way, and is filled out individually for each child.

Certificate

The certificate of preventive vaccinations is entered into the register of state documents, and has the form 156 / y - 93. Today, the vaccination certificate is a medical document that is maintained throughout a person's life. A certificate of preventive vaccinations is required for people traveling abroad, working in hazardous conditions or the food industry, as well as athletes, and for the implementation of scheduled medical examinations. Today in Russia there is no common federal database of vaccinations, so it is almost impossible to restore a lost certificate.

A certificate of preventive vaccinations is issued to a person in a maternity hospital, clinic, medical unit or health center. Each vaccination carried out is entered into the vaccination certificate, which displays the date, the name of the clinic, the signature of the medical worker who carried out the manipulation, and the seal of the healthcare institution is affixed. The vaccination certificate should not contain any blots or corrections. Any corrections or blank fields will invalidate the certificate. The document does not include contraindications or reasons for not vaccinating.

A vaccination certificate is required for admission to kindergarten, school, work, the army, when visiting a doctor, when undergoing treatment in a hospital. The certificate of preventive vaccinations must be kept by the owner until death.

Refusal of preventive vaccinations, sample form

To date, every adult, or guardian - a representative of a minor, has the right to refuse vaccination. The basis for this is provided by the Law of the Ministry of Health of the Russian Federation No. 157 F3 of September 17, 1998, Article 5. Regarding vaccinations for children, a parent can refuse them on the basis of the same law, only Article 11, which states that the child is vaccinated only with the consent of his legal representatives, that is, parents, guardians, etc.

Refusal of vaccinations must be submitted in writing to the head of the medical and preventive, preschool children's institution or school. A sample waiver form that can be used as a form and template is provided below:

Chief Physician of Polyclinic No./or
School Principal No./or
Kindergarten manager No.
_______ district, __________ cities (villages, villages)
From __________ Full name of the applicant _____________________

Statement
I, ____________ full name, passport data ______________ refuse to do all preventive vaccinations (or indicate which specific vaccinations you refuse to do) to my child _______ full name of the child, date of birth _________, registered at polyclinic No. (or attending kindergarten No., or school No.). The legal basis is the legislation of the Russian Federation, namely "Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens" dated July 22, 1993 No. 5487-1, articles 32, 33 and 34 and "On the immunoprophylaxis of infectious diseases" dated September 17, 1998 No. 57 - Federal Law, articles 5 and 11.
Number
Signature with decryption

What does the lack of preventive vaccination entail?

The absence of preventive vaccinations entails the following consequences, according to the law of the Ministry of Health of the Russian Federation No. 157 F3 of September 17, 1998, article 5:
1. Prohibition for citizens to travel to countries where stay, in accordance with international health regulations or international treaties of the Russian Federation, requires specific preventive vaccinations.
2. Temporary refusal to admit citizens to educational and health institutions in case of mass infectious diseases, or in case of the threat of epidemics.
3. Refusal to hire citizens for work or removal of citizens from work, the performance of which is associated with a high risk of contracting infectious diseases. The list of works, the performance of which is associated with a high risk of contracting infectious diseases, requires mandatory preventive vaccinations, is established by the federal executive body authorized by the Government of the Russian Federation.

As can be seen from the law, a child or an adult may not be allowed to visit a children's institution, and an employee - to the workplace, if there are no vaccinations, and the epidemiological situation is unfavorable. In other words, when Rospotrebnadzor announces the danger of an epidemic, or the transition to quarantine, then unvaccinated children and adults are not allowed into groups. During the rest of the year, children and adults can work, study and attend kindergartens without restrictions.

Order on preventive vaccinations

Today, in Russia, there is an order No. 51n dated January 31, 2011 "On the approval of the national calendar of preventive vaccinations and the calendar of preventive vaccinations for epidemic indications." It is according to this order that the current national vaccination calendar was approved.

Preventive vaccination in kindergarten

Children can be vaccinated individually or organized. Vaccinations are organized in an organized manner for children attending kindergartens and schools, where immunization specialists come with ready-made preparations. In this case, the health workers of the children's institution draw up vaccination plans, which include those children who need them. All information about the manipulations performed in kindergarten is recorded in a special vaccination list (form 063 / y) or in a medical record (form 026 / y - 2000).

Vaccinations in kindergarten are carried out only with the consent of the parents or other legal representatives of the child. If you wish to refuse vaccinations for your child, you must register your refusal in writing with the office of the institution, and notify the nurse.

Before use, you should consult with a specialist.