New vaccination calendar. National calendar of preventive vaccinations, mandatory or indicated for children and adults. National vaccination calendar in Russia

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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 for everyone - they are included in the national calendar (BCG, MMR, DTP, 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 possible components for a particular vaccine, any vaccine is able to 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 (DPT)	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 vaccination card, form 063 / y, is a medical document that contains information about all vaccinations and biological tests performed. 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 sheet (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.

Children from 1 to 18 years of age (inclusive) and adults under 35 years of age (inclusive), who have not been ill, not vaccinated, vaccinated once, who do not have information about vaccinations against measles; adults from 36 to 55 years old (inclusive) belonging to risk groups (employees of medical and educational organizations, trade, transport, municipal and social organizations; persons working on a rotational basis and employees of state control bodies at checkpoints across the state border of the Russian Federation) who have not been ill, not vaccinated, vaccinated once, do not have information about vaccinations against measles

Children from 6 months, students in grades 1-11;

students in professional educational organizations and educational institutions of higher education;

adults working in certain professions and positions (employees of medical and educational organizations, transport, public utilities);

pregnant women;

adults over 60;

persons subject to conscription for military service;

people with chronic diseases, including lung disease, cardiovascular disease, metabolic disorders and obesity

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*(1) The first, second and third vaccinations are given according to the 0-1-6 schedule (1 dose - at the time of vaccination, 2 dose - one month after vaccination 1, 3 dose - 6 months after the start of vaccination), except for children belonging to risk groups, vaccination against viral hepatitis B which is carried out according to the scheme 0-1-2-12 (1 dose - at the time of the start of vaccination, 2 dose - a month after 1 vaccination, 2 dose - 2 months after the start of vaccination, 3 dose - after 12 months from the start of vaccination).

*(2) Vaccination is carried out with a vaccine for the prevention of tuberculosis for gentle primary vaccination (BCG-M); in the subjects of the Russian Federation with incidence rates exceeding 80 per 100 thousand population, as well as in the presence of tuberculosis patients in the environment of a newborn - a vaccine for the prevention of tuberculosis (BCG).

*(3) Vaccination is carried out for children at risk (born to mothers of HBsAg carriers, patients with viral hepatitis B or who had viral hepatitis B in the third trimester of pregnancy, who do not have test results for hepatitis B markers, who use narcotic drugs or psychotropic substances, from families in which there is a carrier of HBsAg or a patient with acute viral hepatitis B and chronic viral hepatitis).

*(4) The first and second vaccinations are given with the polio vaccine (inactivated).

(5) Vaccination is carried out for children belonging to risk groups (with immunodeficiency conditions or anatomical defects leading to a sharply increased risk of developing a Haemophilus influenzae infection; with anomalies in the development of the intestine; with oncological diseases and / or receiving long-term immunosuppressive therapy; children born from mothers with HIV infection; HIV-infected children; premature and low birth-weight babies; children in orphanages).

(6) The third vaccination and subsequent revaccinations against poliomyelitis are given to children with a vaccine for the prevention of polio (live); children belonging to risk groups (with immunodeficiency conditions or anatomical defects that lead to a sharply increased risk of hemophilic infection; with anomalies in the development of the intestine; with oncological diseases and / or receiving immunosuppressive therapy for a long time; children born to mothers with HIV infection; children with HIV infection; premature and small children; children in orphanages) - a vaccine for the prevention of poliomyelitis (inactivated).

(6.1) Vaccination and revaccination of children at risk may be carried out with immunobiological medicinal products for the immunoprophylaxis of infectious diseases containing combinations of vaccines intended for use in appropriate age periods.

*(7) The second revaccination is carried out with toxoids with a reduced content of antigens.

*(8) Revaccination is carried out with a vaccine for the prevention of tuberculosis (BCG).

*(9) Vaccination is carried out for children and adults who have not previously been vaccinated against viral hepatitis B according to the 0-1-6 scheme (1 dose - at the time of the start of vaccination, 2 dose - one month after 1 vaccination, 3 dose - 6 months after start of vaccination).

*(10) The interval between the first and second vaccinations must be at least 3 months.

The procedure for carrying out preventive vaccinations for citizens within the framework of the national calendar of preventive vaccinations

With changes and additions from:

1. Preventive vaccinations within the framework of the national calendar of preventive vaccinations are carried out for citizens in medical organizations if such organizations have a license that provides for the performance of works (services) for vaccination (carrying out preventive vaccinations).

2. Vaccination is carried out by medical workers who have been trained in the use of immunobiological drugs for the immunoprophylaxis of infectious diseases, the organization of vaccination, vaccination techniques, as well as in the provision of medical care in an emergency or urgent form.

3. Vaccination and revaccination within the framework of the national calendar of preventive vaccinations are carried out with immunobiological medicinal products for the immunoprophylaxis of infectious diseases, registered in accordance with the legislation of the Russian Federation, according to the instructions for their use.

In cases stipulated by the national calendar of preventive vaccinations, vaccination and revaccination with immunobiological medicinal products for the immunoprophylaxis of infectious diseases containing combinations of vaccines are allowed.

4. Before carrying out preventive vaccination, the person to be vaccinated, or his legal representative, is explained the need for immunoprophylaxis of infectious diseases, possible post-vaccination reactions and complications, as well as the consequences of refusing to carry out preventive vaccination, and informed voluntary consent to medical intervention is issued in accordance with the requirements of Article 20 of the Federal Law of November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in the Russian Federation" .

5. All persons who are to be vaccinated must first be examined by a doctor (paramedic).

6. When changing the timing of vaccination, it is carried out according to the schemes provided for by the national calendar of preventive vaccinations and in accordance with the instructions for the use of immunobiological drugs for the immunoprophylaxis of infectious diseases. It is allowed to administer vaccines (except vaccines for the prevention of tuberculosis) used within the framework of the national immunization calendar, on the same day with different syringes to different parts of the body.

7. Vaccination of children for whom immunoprophylaxis against pneumococcal infection was not started in the first 6 months of life is carried out twice with an interval between vaccinations of at least 2 months.

8. Vaccination of children born to mothers with HIV infection is carried out within the framework of the national calendar of preventive vaccinations in accordance with the instructions for the use of immunobiological drugs for the immunoprophylaxis of infectious diseases. When vaccinating such children, the following are taken into account: the HIV status of the child, the type of vaccine, indicators of the immune status, the age of the child, concomitant diseases.

9. Revaccination of children against tuberculosis, born to mothers with HIV infection and receiving three-stage chemoprophylaxis of HIV transmission from mother to child (during pregnancy, childbirth and in the neonatal period), is carried out in the maternity hospital with vaccines for the prevention of tuberculosis (for sparing primary vaccination). In children with HIV infection, as well as when HIV nucleic acids are detected in children by molecular methods, revaccination against tuberculosis is not carried out.

10. Vaccination with live vaccines within the framework of the national immunization schedule (with the exception of vaccines for the prevention of tuberculosis) is carried out for children with HIV infection with the 1st and 2nd immune categories (lack of immunodeficiency or moderate immunodeficiency).

11. If the diagnosis of HIV infection is excluded, children born to mothers with HIV infection are vaccinated with live vaccines without prior immunological examination.

12. Toxoids, killed and recombinant vaccines are administered to all children born to mothers with HIV infection as part of the national immunization schedule. For children with HIV infection, these immunobiological drugs for the immunoprophylaxis of infectious diseases are administered in the absence of severe and severe immunodeficiency.

13. When vaccinating the population, vaccines containing antigens that are relevant to the Russian Federation are used, which make it possible to ensure the maximum effectiveness of immunization.

14. When vaccinating against hepatitis B in children of the first year of life, against influenza of children from 6 months of age studying in general educational institutions, pregnant women, vaccines that do not contain preservatives are used.

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* Collection of Legislation of the Russian Federation, 2012, N 26, art. 3442; No. 26, art. 3446; 2013, N 27, art. 3459; No. 27, Art. 3477; No. 30, Art. 4038; No. 39, Art. 4883; No. 48, art. 6165; No. 52, art. 6951.

** Order of the Ministry of Health and Social Development of the Russian Federation of March 23, 2012 N 252n "On approval of the procedure for assigning a paramedic, a midwife to the head of a medical organization when organizing the provision of primary health care and emergency medical care of certain functions of the attending physician for the direct provision of medical assistance to the patient during the period of observation and treatment, including the prescription and use of drugs, including narcotic drugs and psychotropic drugs" (registered by the Ministry of Justice of the Russian Federation on April 28, 2012, registration number N 23971).

Others are against, while others are in thought. Before joining any of the groups, it is necessary to understand the concept of "vaccination" and familiarize yourself with the material presented. We will consider all the main vaccinations up to a year (which are mandatory and which are additional), and also get acquainted with the list of vaccines carried out after reaching the age of one.

History of the development of vaccination

The first records of vaccinations date back to the 8th century. At that time, Ayurveda physicians discovered that smallpox inoculation induces immunity to its severe form. But due to the lack of knowledge about the varieties of the disease, the result of vaccination was often fatal.

For centuries, scientists from different countries have dealt with the issue of disease prevention through vaccination, conducted research, and wrote scientific papers. But it wasn't until the late 19th century that Louis Pasteur (a French immunologist) was able to get close enough to developing vaccines for various infectious diseases.

Since the beginning of the 20th century, more than 100 different vaccines have been developed to protect against forty infections caused by bacteria, viruses, and protozoa.

What is vaccination?

Vaccination is a synthetic method, by introducing a special material into the human body to increase its resistance to various infectious diseases. Vaccinations are done for preventive and therapeutic purposes.

Classification of vaccines

Vaccines
By the nature of microorganisms	According to the manufacturing method	The nature of the immunogen
Bacterial	Live attenuated pathogens	Genetically engineered vaccines
		Chimeric, vector, or recombinant vaccines	The gene that controls the synthesis of a protective protein is inserted into a safe microorganism
Viral	Killed microorganisms	Whole microbial or whole virion vaccines	Consist of bacteria or viruses that retain their structure during the production process
Rickettsial		Chemical vaccines, toxoids	Produced from the waste products of a microorganism or its aggregate components
		Synthetic vaccines	An immunogen is a chemical analogue of a protective protein obtained by direct chemical synthesis.

Vaccination methods

Children are vaccinated in the following ways:

Intramuscular injections. The most preferred method of administering vaccines, since in this case it dissolves faster, immunity begins to develop faster, while the risk of allergic reactions is reduced.
Oral way. Thus, a vaccine against enterovirus infections is introduced, which is swallowed by the patient in the form of drops, with sugar or a cracker. The disadvantage of this method is that the correct dosage may not be observed.
Intradermal. Vaccines such as antituberculosis BCG, live tularemia and smallpox are administered in this way.
The method is preferred for many inactivated and "live" vaccines (for rubella, measles, mumps, yellow fever, and others).
intranasal method. Involves the introduction of a vaccine through the nose and represents a method of combating diseases spread by airborne droplets.

Mandatory and optional vaccinations

On the territory of the Russian Federation up to a year includes mandatory and additional vaccination.

Mandatory vaccination - vaccinations against infections and diseases of the most severe forms. They are also included in the national and regional vaccination schedules. Additional vaccination is carried out at the request of the patient, for example, before traveling.

The last time the national calendar up to a year and older was approved by the Order of the Ministry of Health and Social Development of the Russian Federation dated February 31, 2011, No. 51n “On Approval of the National Calendar of Preventive Immunizations for Epidemic Indications”. The approved vaccination schedule up to a year and older provides for the introduction of vaccines against such major infectious viral and bacterial diseases as tuberculosis, polio, diphtheria, whooping cough, tetanus, mumps and others.

Mandatory vaccinations for children under one year old - schedule

Below is a list of vaccinations that are mandatory for a child up to a year old.

Vaccination table up to a year - mandatory vaccination

Vaccination against	Start of vaccination	Timing of revaccination			Note	Name of vaccines
Vaccination against	Start of vaccination				Note	Name of vaccines
Hepatitis B	First 24 hours of life	In the 1st month	At 2 months		Children at risk	Euwax V, Engerix V, Eberbiovak, H-B-Vax II, Hepatect, Hepatitis B Vaccine, Specific Human Immunoglobulins
Hepatitis B	First 24 hours of life	In the 1st month		At six months	Children outside the risk group
Tuberculosis	3-7th day of life				Active prevention of tuberculosis	BCG, BCG-M
Whooping cough, diphtheria, tetanus		At 18 months			Up to 18 months of age, vaccines that include whooping cough are used, and starting from 6 years old, non-pertussis vaccines with a smaller composition of antigens are used (for children of each age group)	DTP, Infanrix; ADS, ADS-M, Dr. T. Adult, Imovaks
Haemophilus influenzae	1 to 5 years	At 18 months			Carried out according to the instructions only for children at risk	Act-HIB (inactivated PRT-T vaccine)
Polio		At 18 months	At 20 months			MMR-II, Priorix

The vaccination schedule up to a year may shift slightly, for example, children who weighed less than 2000 grams at birth are given later, as they have very thin skin.

Vaccinations for children under one year old - 2014

Vaccination against	To whom is done	Months
Vaccination against	To whom is done
Tuberculosis		on the 3rd-7th day
Hepatitis B	All children in this age group	first inoculation	vaccination				re-vaccination
Hepatitis B	Children at risk	first inoculation	vaccination	re-vaccination			re-vaccination
Pneumococcal infection	All children in this age group		first vaccination			re-vaccination
	All children in this age group				first vaccination	re-vaccination	re-vaccination
Diphtheria
Tetanus
Polio	All children in this age group					Inactivated polio vaccine	Oral polio vaccine
Polio	Children at risk					Inactivated polio vaccine	non-activated polio vaccine
Haemophilus infection	Children at risk				first vaccination	re-vaccination	re-vaccination
							Annually

Additional vaccinations

The list of preventive vaccinations is quite large, so the most common ones will be mentioned below.

Vaccination table up to a year and older - additional vaccination

Vaccination against	Risk group	Name of vaccines
hepatitis A	Children attending kindergartens, schools, camps, as well as moving to other cities and countries	Aquasim 80, Havrix 720, Vakta 25
pneumococcal infections	Children of any age
meningococcal infection	Children aged 1 to 5 years due to their body's inability to form immunity against infection	Vaccine against meningococcal infection A, A and C, Meningo A + C
tick-borne encephalitis	Children of all ages who are often in nature	FSME-IMMUNE Junior, Encepur, MPO Viri, immunoglobulin FSME-Bulin, immunoglobulin against tick-borne encephalitis

What vaccinations per year are mandatory for a child

After a comprehensive vaccination at 6 months, the child is vaccinated at 1 year. It includes vaccination against rubella, measles and mumps.

Measles is a viral disease spread by airborne droplets (during conversation, coughing, sneezing, etc.). The temperature rises to 39-40 ° C. The symptoms are as follows: intoxication, rash, damage to the mucous membrane of the nose and larynx (runny nose, cough, sneezing, photophobia).

Rubella is a viral infection. It spreads by airborne droplets. Children are easier than adults to endure the disease. Symptoms are as follows: mild fever, rash, swollen lymph nodes. If a child gets rubella in the womb, then there is a high risk of miscarriage or the development of congenital malformations of its development.

Mumps is the virus that causes mumps. When it enters a healthy body by airborne droplets and through contaminated objects, it begins to multiply rapidly in the salivary glands. Symptoms: fever, enlarged salivary glands, general malaise, loss of appetite.

A comprehensive vaccination is given a year under the shoulder blade. Revaccination occurs at 6 years of age. Vaccination at 1 year forms immune protection against measles, rubella and mumps for 25 years.

The difference between state vaccinations and paid ones

Recently, cases have become more frequent when doctors at polyclinics offer parents to receive both state free vaccinations and paid ones. At the same time, there is no absolute statement that a paid vaccine is better.

Most often, paid vaccinations for children under one year old are a vaccine that contains components against several diseases, for example, diphtheria, whooping cough, hepatitis B, poliomyelitis, type B influenza. A free vaccination differs in that one or more components are missing. This does not mean that it will be ineffective. It’s just that the vaccination schedule for up to a year provides for vaccination in several ways, for example, the polio vaccine is given separately (not intramuscularly, but orally).

Also, due to the large number of vaccines after paid vaccinations, there is a share of the likelihood of side effects that would not be in the case of a standard vaccination. All vaccines, paid and public, are included in the list recommended and licensed by the World Health Organization (WHO).

Contraindications for vaccination

There are the following contraindications for vaccination:

True, that is, those that have been proven by various studies and are listed in official Russian and international instructions.
False, created by opponents of vaccination.
Absolute - refer to true contraindications, in which vaccination is completely excluded.
Conditional (relative) - refer to true contraindications, in which the decision to vaccinate is made by the doctor, based on the history of the patient's clinical record and the current epidemic situation.
Temporary, that is, the patient has the following symptoms at the time of vaccination: fever, unacceptable results of blood and urine tests, overestimated or underestimated clinical norm, weakness, presence of inflammatory processes.
Permanent - those that are not removed even after the passage of time.
Particular contraindications relate to a specific vaccine.

More information about contraindications can be found by examining the table below.

Vaccination table up to a year and older - contraindications

Vaccine	Existing contraindications
Any vaccine	Post-vaccination complication to the first vaccination or acute reaction to the introduction
All live vaccines	Malignant tumors Pregnancy
	Developing diseases of the nervous system, temperature cramps
	Baby weighs less than 2000 grams at birth Keloid scar, including after the first time
Against viral hepatitis B	Hypersensitivity (allergy) to baker's yeast
Vaccines ADS, AD-M and ADS-M	Severe reaction or post-vaccination complication to the first vaccination Immune malaise at first vaccination Malignant neoplasms Pregnancy
Live mumps and measles vaccines, rubella, combined di- and trivaccines	Severe hypersensitivity (allergy) to aminoglycosides Anaphylactic reaction to egg white (except rubella vaccine)

The provided list of contraindications tends to be reduced. This is due to the improvement of vaccines in recent years.

In order for the vaccine to fulfill its purpose, and not cause harm, and the child is not afraid of this procedure in the future, there are the following recommendations:

it is necessary to do blood and urine tests;
obtain the conclusions of a pediatric neuropathologist and an allergist;
do not feed the child before vaccination with a new food for him;
do not scare the baby with vaccinations, even if it is a comic form;
take your child’s favorite toy and a clean diaper or sheet with you for vaccination;
don't forget (if any);
Discuss any questions or concerns with your doctor;
on the day of the vaccination itself, measure the baby's body temperature;
try not to worry yourself and not show your anxiety to the child;
if during vaccination the child began to cry, then let him cry, and then let the baby take a deep and slow breath.

After vaccination, remember the following:

stay for half an hour in the clinic to stabilize the child's condition;
in case of DTP vaccination during a hot season, give the child an antipyretic;
on the day of vaccination, avoid water procedures and long walks.

Also, do not forget that you can change the baby's usual diet no earlier than 3 days after the vaccination. Side effects do not necessarily appear immediately, some may appear only on the 5th day.

In any country, the Ministry of Health has approved its own vaccination schedule for the population. The national vaccination schedule in Russia was finalized in 2014 and includes mandatory vaccinations for the population of any age. Minor changes have been made to the document. The regional Ministry of Health is working on the approved calendar according to its own characteristics. This is due to the epidemiological characteristics of each region, material resources. Consider which vaccines our vaccination calendar includes.

Changes and innovations

At the end of 2014, the newest national calendar of preventive vaccinations was adopted in Russia. It has been amended:

Babies from 2 months will be vaccinated against pneumococcal infection. The injection will be given twice.
Flu shots should be given to pregnant women. Previously, pregnant women were not vaccinated against seasonal viruses.
Before a prophylactic vaccination, the doctor should conduct an informational conversation and explain to the patient why this or that vaccination is needed. If the patient writes a refusal, then he should be informed what consequences await after infection. Previously, the doctor did not concentrate his attention and did not explain to the patient what complications may occur after vaccination and what are the contraindications.
According to the basics of the law "Protection of public health", consent and refusal of preventive vaccination must be documented. Consent or refusal for minors is signed by their parents or guardians.
Before any vaccination, the patient must receive a complete physical examination. Previously, they simply asked the patient if there were any complaints, today the doctor is obliged to listen to the patient, examine the skin, nasopharyngeal mucosa, and listen to breathing.
Medical workers in educational institutions are required to notify parents 6-7 days before vaccinating children. Parents have time to prepare the baby.

If one of the conditions before the prophylactic vaccination was not met, the doctor's actions are considered illegal.

In small provinces, the transition to the new rules is difficult. Doctors are used to working differently and do not always have a conversation with the patient. On the other hand, for the examination of 1 patient in turn, the doctor can devote no more than 7 minutes. What can be said during this time? And there is no need to talk about quality inspection once again.

What vaccinations are included in the calendar

The new vaccination schedule includes vaccinations against diseases: Hepatitis B, Pneumococcal infection, Measles, Diphtheria, Whooping cough, Tetanus, Poliomyelitis, Haemophilus influenzae, Rubella.

Vaccination is the infection of the body in a weak form, artificially obtained, dead or live bacteria or virus. Passes once or for several injections, with a certain interval.

So, Hepatitis B is vaccinated according to two schemes. The first is assigned to children from the usual group (0/1/6), the second with a high risk of infection (0/1/2/12).

Revaccination is the support of immunity, which was developed after the first vaccination.

Consider the stages of vaccination and revaccination according to the national calendar in the form of a table:

Age group	Name of the disease to be vaccinated	Stage	Injection features
Children the first day after birth	Hepatitis B	first vaccination	the vaccine for injection can be used by any manufacturer, without preservatives, it is given to all children, including those at risk.
Children aged 3-7 days	Tuberculosis	vaccination	carried out in regions where the epidemic threshold is above 80 thousand, is mandatory for children at risk (when there are infected people in the family or the mother was not vaccinated).
1 month	Hepatitis B	second vaccination	everyone, including the risk group;
			The vaccine is the same as the first injection.
2 months	Hepatitis B	third vaccination	for children at risk.
3 months	pneumococcal infection	first	any kids
Complex (diphtheria, whooping cough, tetanus)	first	_
Polio	first	any kids;
		with non-living bacteria.
Hemophilus infection	first	children at risk: HIV-infected, immunocompromised, cancer patients. To everyone from the baby house without exception.
4.5 months	whooping cough, diphtheria, tetanus	second	any kids
Polio	second	to all children;
		only dead bacteria.
Pneumococcus	second	to all children
Hemophilus infection	second	children at risk
half a year	whooping cough, tetanus, diphtheria	third	_
Polio	third	an immunocompromised baby from parents with HIV living in baby homes;
		carried out by live bacteria.
Hepatitis B	third	_
Hemophilus infection	third	for kids at risk
Year	Mumps, Measles, Rubella	vaccination	_
Hepatitis B	fourth	children from families with a high risk of getting sick
Year and 3 months	Measles, Mumps, Rubella	revaccination	any children
One and half year	whooping cough, tetanus, diphtheria	revaccination	_
Polio	revaccination first	everyone, with the help of live bacteria
Hemophilus infection	revaccination	children at risk
Year and 8 months	Polio	second revaccination	everyone;
			with live bacteria
6 years	Rubella, Measles, Mumps	revaccination	_
6–7 years	tetanus, diphtheria	second revaccination	vaccine with fewer antigens.
	Tuberculosis (BCG)	revaccination	everyone;
			drug for prevention
14 years	tetanus, diphtheria	third revaccination	vaccine with less antigen.
	Polio	third revaccination	any teenager;
			live bacteria
Over 18 years old	tetanus, diphtheria	revaccination	repeat every 10 years.
18 to 25	Rubella	vaccination	population who was not vaccinated or was, but once.
18 to 55	Hepatitis B	vaccination	once every 10 years.

The population aged 18 to 35 are also vaccinated against measles. The interval between injections is a maximum of 2 months. The group includes not previously vaccinated or without re-vaccination. This also includes people at risk.

The vaccination schedule included getting used to the flu. It is made mandatory for pregnant women, schoolchildren, children in kindergartens, the working part of the population in the public service. Private entrepreneurs, for their employees, can purchase the vaccine separately.

The calendar includes additional vaccinations, which are prescribed in regions with a low epidemic rate, for people with professional activities from the risk group. These include: herpes zoster, tick-borne encephalitis. But everyone who wants can get these vaccinations for themselves at the clinic, at the place of residence. But, it is worthwhile to understand that in order to develop immunity to tick-borne encephalitis, it is necessary to vaccinate from three injections. The disease is activated from April to July. All three injections must be delivered before the beginning of summer. The interval between them is not more than 1 month. More in the video:

The National Immunization Calendar is approved by our Ministry of Health and includes only proven injections. In the regions they are purchased and introduced to the population free of charge. Without vaccinations, the population on the planet would be 2 times smaller. Therefore, before writing a refusal, think about what part you and your family members fall into!

Immunization Schedule for Adults - Vaccination Schedule Vaccination table by age from birth to 14 years Immunization schedule for adults and children from different countries Vaccination Schedule: Polio.

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Vaccination is also carried out for contact persons without age restrictions from the foci of the disease, who have not previously been ill, not vaccinated and who do not have information about prophylactic vaccinations against measles or once vaccinated; adults from 36 to 55 years old, belonging to risk groups (employees of medical and educational organizations, organizations of trade, transport, public utilities and social services; persons working on a rotational basis and employees of state control bodies at checkpoints across the state border of the Russian Federation) who were not ill, not previously vaccinated, vaccinated once, not having measles vaccination history.
Adults working in certain professions and positions (employees of medical and educational organizations, transport, utilities); pregnant women, persons subject to conscription for military service; persons with chronic diseases, including lung diseases, cardiovascular diseases, metabolic disorders and obesity.
Prevention of infections is included in the calendar according to epidemic indications for risk groups.
Adults at risk, including those subject to conscription for military service.
Persons living in regions that are unfavorable for the incidence of hepatitis A, as well as persons at occupational risk of infection (medical workers, public service workers employed in the food industry, as well as serving water and sewer facilities, equipment and networks).
Persons traveling to disadvantaged countries (regions) where an outbreak of hepatitis A is recorded.
Contact persons in the foci of hepatitis A.
In foci of meningococcal infection caused by serogroups A or C meningococci. Vaccination is carried out in endemic regions, as well as in case of an epidemic caused by serogroups A or C meningococci.
Persons subject to conscription for military service.
For prophylactic purposes, people who are at high risk of contracting rabies are vaccinated: people working with the “street” rabies virus, veterinarians, rangers, hunters, foresters, people who work on catching and keeping animals.
In foci of goat-sheep type of brucellosis, persons performing the following work: procurement, storage, processing of raw materials and livestock products obtained from farms where livestock diseases with brucellosis are recorded; on slaughter of cattle suffering from brucellosis, procurement and processing of meat and meat products obtained from it; livestock breeders, veterinarians, livestock specialists in farms enzootic for brucellosis; persons working with live cultures of the causative agent of brucellosis.
Persons employed in the field of communal improvement (employees servicing sewer networks, facilities and equipment, as well as organizations engaged in sanitary cleaning of populated areas, collection, transportation and disposal of household waste).
Persons working with live cultures of typhoid pathogens. Population living in areas with chronic waterborne epidemics of typhoid fever. Persons traveling to countries (regions) hyperendemic for typhoid fever.
Contact persons in the foci of typhoid fever according to epidemic indications. According to epidemic indications, vaccinations are carried out when there is a threat of an epidemic or outbreak (natural disasters, major accidents on the water supply and sewerage network), as well as during an epidemic, while mass vaccination of the population is carried out in the threatened region.
People at risk, including those subject to conscription for military service, who have not previously been vaccinated and have not had chickenpox.
Persons traveling outside the Russian Federation to countries (regions) enzootic for yellow fever. Persons working with live cultures of the yellow fever pathogen.
Persons living in areas endemic for tick-borne viral encephalitis; persons traveling to territories endemic for tick-borne viral encephalitis, as well as persons arriving in these territories performing the following works: agricultural, hydro-reclamation, construction, 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 causative agent of tick-borne encephalitis.
Persons performing the following work: procurement, storage, processing of raw materials and livestock products obtained from farms located in areas enzootic for leptospirosis; on slaughter of cattle suffering from leptospirosis, procurement and processing of meat and meat products obtained from animals suffering from leptospirosis; on catching and keeping neglected animals.
Persons working with live cultures of the causative agent of leptospirosis.
Persons performing work on the procurement, storage, processing of raw materials and livestock products obtained from farms where Q fever diseases are recorded.
Persons performing work on the preparation, storage and processing of agricultural products in the enzootic territories for Q fever.
Persons working with live cultures of Q fever pathogens.
Contact persons in polio outbreaks, persons working with live poliovirus, with materials infected (potentially infected) with wild poliovirus, without age restrictions.
Persons performing the following work: zookeepers and other persons professionally engaged in pre-slaughter keeping of livestock, as well as slaughtering, skinning and butchering carcasses; collection, storage, transportation and primary processing of raw materials of animal origin; agricultural, irrigation and drainage, construction, excavation and movement of soil, procurement, commercial, geological, prospecting, forwarding in anthrax enzootic territories.
Persons working with material suspected of being infected with anthrax.
Persons living in territories enzootic for tularemia, as well as persons who arrived in these territories and perform the following works: agricultural, hydro-reclamation, 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.
Persons traveling to cholera-prone countries (regions). The population of the constituent entities of the Russian Federation in case of complication of the sanitary and epidemiological situation for cholera in neighboring countries, as well as on the territory of the Russian Federation.
Persons residing in plague-enzootic territories. Persons working with live cultures of the plague pathogen.
Employees of medical organizations (their structural divisions) of an infectious profile. Persons employed in the field of public catering and public amenities.
According to epidemic indications, vaccinations are carried out when there is a threat of an epidemic or outbreak (natural disasters, major accidents on the water supply and sewerage network), as well as during an epidemic, while mass vaccination of the population is carried out in the threatened region. Preventive vaccinations are preferably carried out before the seasonal rise in the incidence of shigellosis.
Preventive vaccinations are preferably carried out before the seasonal rise in the incidence of shigellosis.
Contact persons from the foci of the disease who have not been ill, not vaccinated and do not have information about preventive vaccinations against mumps.