Rules for vaccination at school. Rules for conducting preventive vaccinations in Russia. Preventive vaccination of children

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 preparation 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, chickenpox, 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 by 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 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 fever and paratyphoid fever 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 sodium chloride 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

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.

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 method. 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, prospecting, 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 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, oxolinic 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).

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.

Attachment 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 DPT, 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 No. from them"

1. Preventive vaccinations are carried out in medical institutions of the state, municipal, private healthcare systems.

2. Responsible for organizing and conducting preventive vaccinations are the head of a medical institution and persons involved in private medical practice who conduct vaccinations. 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.

3. 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. Tarasovich.

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

5. To ensure the timely conduct of preventive vaccinations, the nurse, orally or in writing, invites persons to be vaccinated (parents of children or persons replacing them) to the medical institution on the day determined for vaccination: in a children's institution - informs the parents of children in advance, subject to preventive vaccination.

6. Before the prophylactic vaccination, a medical examination is carried out to exclude an acute disease, mandatory thermometry. In the medical documentation, a corresponding record of the doctor (paramedic) about the vaccination is made.

7. Preventive vaccinations are carried out in strict accordance with the indications and contraindications for their implementation in accordance with the instructions attached to the vaccine preparation.

8. Preventive vaccinations should be carried out in the vaccination rooms of polyclinics, children's preschool educational institutions, medical rooms of general education educational institutions (special educational institutions), health centers of enterprises with strict observance of sanitary and hygienic requirements. In certain situations, health authorities may decide to administer vaccinations at home or at the place of work.

9. The room where preventive vaccinations are carried out should include: a refrigerator, a cabinet for tools 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 drugs that are used for vaccinations.

11. Each grafted injection is carried out with a separate syringe and a separate needle (disposable syringes).

12. Vaccinations against tuberculosis and tuberculin diagnostics should be carried out in separate rooms, and in their absence - on a specially allocated table. A separate cabinet is used to accommodate syringes and needles used for BCG vaccine and tuberculin. The use for other purposes of instruments intended for vaccination against tuberculosis is prohibited. On the day of BCG vaccination, all other manipulations to the child are not carried out.

13. Preventive vaccinations are carried out by medical workers who are trained in the rules for organizing and administering vaccinations, as well as emergency procedures in case of post-vaccination reactions and complications.

14. Seminars for doctors and paramedical workers on the theory of immunization and the technique of preventive vaccinations with mandatory certification should be held by the territorial health authorities at least once a year.

15. After the prophylactic vaccination, medical supervision must be provided for the period specified in the Instructions for the use of the corresponding vaccine preparation.

16. A record of the vaccination carried out is made in the work log of the vaccination room, the history of the development of the child (f. 112-y), the card of preventive vaccinations (f. 063-y), the medical record of a child attending a preschool educational institution, a general educational institution (f. 026-y), in the certificate of preventive vaccinations (f. 156/y-93). In this case, the necessary information is indicated: type of drug, dose, series, control number. In the case of using an imported drug, the original name of the drug in Russian is entered. The data entered in the certificate is certified by the signature of a doctor and the seal of a medical institution or a person engaged in private medical practice.

17. In medical documents, it is necessary to note the nature and timing of general and local reactions, if any.

18. With the development of an unusual reaction or complication to the introduction of the vaccine, it is necessary to immediately notify the head of the medical institution or a person engaged in private practice, and send an emergency notice (f-58) to the territorial center of the State Sanitary and Epidemiological Supervision.

19. The fact of refusal of vaccinations, with a note that the medical worker has given explanations about the consequences of such a refusal, is documented in the mentioned medical documents and signed by both the citizen and the medical worker.

Immunization calendar

False contraindications to preventive vaccinations

Vaccination centers where you can get vaccinated against viral hepatitis B

Polyclinic No. 119 for children
(m. "Yugo-Zapadnaya") Vernadsky Ave., 101, building 4, office. eight; 23; 24
Opening hours: 9-18.
Tel.: 433-42-16, 434-56-66

Polyclinic No. 103 for children
(m. "Yasenevo") st. Golubinskaya, 21, building 2
Tel.: 422-66-00

Medical center "Mayby" City Clinical Hospital No. 31
(m. "Prospect Vernadsky") st. Lobachevsky, 42
Opening hours: 9-17
Tel.: 431-27-95, 431-17-05

Det. polyclinic No. 118
"Northern Butovo"; "Kondivaks" (m. "South") st. Kulikovskaya, 1-b
Tel.: 711-51-81, 711-79-18

Diavax LLC
(m. "Shabolovskaya", "Dobryninskaya") st. Lesteva, 5/7 (kennel No. 108)
Opening hours: 9-18
Tel.: 917-24-16, 917-46-09

Vaccination Center at the Institute of Immunology
(m. "Kashirskaya") Kashirskoe sh., 24/2
Opening hours: 9-17
Tel.: 111-83-28, 111-83-11

Scientific Medical Center "Medincourt"
Prospect Mira, 105
Tel.: 282-41-07

Institute of Pediatrics, Scientific Center for Children's Health, Russian Academy of Medical Sciences
(m. "Universitet") Lomonosovsky pr-t, 2/62
Opening hours: 10-16
Tel.: 134-20-92

"Medincenter"
(m. "Dobryninskaya"), 4th Dobryninsky per., 4
Tel.: 237-83-83, 237-83-38

Athens Medical Center
Michurinsky Ave, 6
Opening hours: 9-18
Tel.: 143-23-87, 147-91-21

JSC "Medicine"
(m. "Mayakovskaya") 2nd Tverskoy-Yamskoy per. ten
Opening hours: 8-20
Tel.: 250-02-78 (children), 251-79-82 (adults)

MONIKI
(m. "Prospect Mira") st. Shchepkina, 01/2, bldg. 54, 506 cab.
Opening hours: 10-15
Tel.: 284-58-83

"Mediclub" Canadian clinic
Michurinsky Ave, 56
Tel.: 921-98-65

Polyclinic No. 220
(m. "Krasnopresnenskaya") st. Zamorenova, 27, room. 411
Tel.: 255-09-77

Hematology Research Center
(m. "Dynamo") Novozykovsky pr., 4
Opening hours: 9-18
Tel.: 213-24-94, 212-80-92

Honey. Center "In Kolomenskoye"
(m. "Kolomenskaya") st. High, 19
Opening hours: 9-18
Tel.: 112-01-65, 112-91-62

Honey. Center "Healthy Generation"
(m. "Shabolovskaya") st. Lesteva, 20
Opening hours: 9-18
Tel.: 954-00-64

Honey. center of the Administration of the President of the Russian Federation
(metro station "Arbatskaya") Staropansky per., 3, building 2
Opening hours: 9-20
Tel.: 206-12-78 (vaccination of children only)

"Medep"
(m. "Universitet") Lomonosovsky pr-t, 43
Opening hours: 9-18
Tel.: 143-17-98, 143-63-43

Institute of Pediatrics and Pediatric Surgery, Ministry of Health of the Russian Federation
(m. "Petrovsko-Razumovskaya") st. Taldomskaya, 2 (vaccination at home is possible)
Opening hours: Tue, Fri. 10-13
Tel.: 487-10-51, 487-42-79

For preventive vaccinations in children, domestic and foreign vaccines registered in Russia are used. They must have a certificate of the National Control Body MIBP - GISK them. Tarasevich. Vaccinations are carried out in medical institutions of the state, municipal and private health systems. Vaccinations are carried out by an employee trained in the rules of organization and technique of vaccination, as well as emergency care in the event of the development of post-vaccination reactions and complications.

Before a preventive vaccination, a child needs a thorough medical examination with thermometry and evaluation of hemogram and urinalysis, followed by an assessment of the state of health. Vaccinations are given only to healthy children. In the history of the development of the child, the primary care pediatrician must make an appropriate entry in both cases that allow preventive vaccination and prohibit it. It is necessary to strictly observe the main contraindications to preventive vaccinations, both temporary and absolute.

In cases of withdrawal from planned vaccination, the withdrawal should be justified in the form of an appropriate entry in the history of development and a new date for the vaccination should be set. In the history of the development of a child who has absolute contraindications to vaccination, there should be a record of the immunological commission of the polyclinic. Violations of the established terms of vaccination, revaccination and intervals between them are not allowed. It is necessary to notify parents in advance about the day of the upcoming preventive vaccination. Before sending a child for prophylactic vaccination, it is necessary to warn parents about the possibility and nature of local and general reactions after the introduction of a particular vaccine, the timing of their appearance, duration, as well as the measures that should be taken when the child reacts to the vaccine.

After the vaccination, the child should be observed by the nurse of the vaccination room for the first 30 minutes, since at this time the development of immediate reactions of the anaphylactic type is possible. A vaccinated child should be observed at home by a site nurse in the first 3 days after the introduction of an inactivated vaccine, on days 5-6 and 10-11 after the introduction of live vaccines.

With the simultaneous parenteral use of vaccines, they are administered with different syringes to different parts of the body. If the child has been vaccinated against any infection, immunization with another bacterial preparation can be carried out no earlier than 4 weeks later.

An exception are vaccinations against rabies and tetanus, which are carried out without taking into account the timing of previous vaccinations. If it is necessary to increase the intervals between vaccinations, the next vaccination should be carried out as soon as possible, determined by the state of health.

Before carrying out a preventive vaccination, parents need to find out the epidemic situation in the family, preschool and educational institutions, other groups, the timing of the last illness and its nature, the tolerance of previously administered vaccinations, reactions to them, the presence of allergic reactions to the introduction of various biological preparations, immunoglobulins, drugs blood, etc. Contact with an infectious patient is not a contraindication to vaccination or Mantoux test. Children who have had mild SARS and intestinal diseases are vaccinated immediately after the temperature normalizes. In severe cases - after 2-3 weeks.

Emergency vaccination according to the schedule 0, 7, 21 days, when a rapid formation of immune protection is necessary, for example, in the case of a planned planned surgical intervention or a trip to an area / country endemic for hepatitis B. The emergency immunization scheme ensures the formation of a protective level of antibodies in 85% of the vaccinated. In this regard, when using this scheme, the introduction of a booster dose is provided 12 months after the first dose.

Hepatitis B vaccine is administered intramuscularly only, in older children and adolescents it should be administered in the deltoid region, in young children and newborns it is preferable to administer the vaccine in the anterolateral thigh. As an exception, the vaccine can be administered subcutaneously to patients with thrombocytopenia or other diseases of the blood coagulation system, while antibody titers can be reduced.

post-vaccination immunity. Recombinant vaccines are highly immunogenic. According to different authors, triple administration of hepatitis B vaccine according to the standard scheme is accompanied by the formation of specific antibodies in protective titers in 95-99% of those vaccinated with a duration of protection of 15 years or more. According to the latest data, post-vaccination immunity persists throughout life.

vaccination reactions. Recombinant hepatitis B vaccines rarely cause side effects. In particular, an immediate allergic reaction occurs in 1 out of every 600,000 people who are vaccinated against hepatitis B.

There are no contraindications to hepatitis B vaccination. However, in persons with hypersensitivity to any component of the vaccine, as well as in the presence of a serious infectious disease, vaccination should be postponed or canceled.

PREVENTIVE VACATIONS

Second vaccination against viral hepatitis B

First vaccination against diphtheria, whooping cough, tetanus, polio

Revaccination against measles, rubella, mumps

Second revaccination against diphtheria, tetanus

Rubella vaccination (girls).

Vaccination against viral hepatitis B (previously unvaccinated)

The third revaccination against diphtheria, tetanus.

Revaccination against tuberculosis.

Third revaccination against polio

adults

Revaccination against diphtheria, tetanus - every 10 years from the last revaccination

In case of violations of the timing of the start of vaccinations, the latter are carried out according to the schemes provided for by this calendar and instructions for the use of drugs.

8.2. Whooping cough immunization

8.2.1. The goal of whooping cough vaccination, according to WHO recommendations, should be to reduce the incidence by 2010 or earlier to a level of less than 1 per 100,000 population. This can be achieved by ensuring at least 95% coverage with three vaccinations of children at the age of 12 months. and the first revaccination of children at the age of 24 months.

8.2.2. Vaccination against pertussis is subject to children from 3 months of age to 3 years 11 months 29 days. Vaccinations are carried out with DTP vaccine. The drug is administered intramuscularly into the upper outer quadrant of the buttock or the anterolateral thigh at a dose of 0.5 ml.

8.2.3. The vaccination course consists of 3 vaccinations with an interval of 45 days. Shortening intervals is not allowed. In the event of an increase in the interval between vaccinations, the next vaccination is carried out as soon as possible, determined by the state of health of the child.

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

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

8.2.6. DTP vaccinations can be given at the same time as other vaccinations in the vaccination schedule, with the vaccines being administered with different syringes to different parts of the body.

8.3. Immunization against diphtheria

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

8.3.1. The goal of vaccination against diphtheria, as recommended by WHO, is to achieve by 2005 an incidence rate of 0.1 or less per 100,000 population. This will be possible by ensuring at least 95% coverage of completed vaccination of children at the age of 12 months, the first revaccination of children at the age of 24 months. and at least 90% vaccination coverage of the adult population.

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

8.3.3. The first vaccination is carried out at the age of 3 months, the second vaccination - at the age of 4.5 months, the third vaccination - at the age of 6 months. The first revaccination is carried out after 12 months. after completed vaccination. Children from 3 months of age to 3 years 11 months 29 days are subject to vaccination with DTP vaccine.

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

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

Whooping cough;

Over 4 years old, not previously vaccinated against diphtheria and tetanus.

8.3.4.1. The course of vaccination consists of 2 vaccinations with an interval of 45 days. Shortening intervals is not allowed. In the event of an increase in the interval between vaccinations, the next vaccination is carried out as soon as possible, determined by the state of health of the child.

8.3.4.2. The first revaccination with ADS-anatoxin is carried out once every 9-12 months. after completed vaccination.

8.3.5. DS-M-anatoxin is used:

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

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

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

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

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

8.4. Immunization against tetanus

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

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

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

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

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

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

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

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

8.4.9. Inoculations with DTP vaccine can be carried out simultaneously with other vaccinations of the vaccination schedule, while the vaccines are administered with different syringes in different parts of the body.

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

Whooping cough;

Having contraindications to the introduction of the DTP vaccine;

Over 4 years old, not previously vaccinated against tetanus.

8.4.10.1. The course of vaccination consists of 2 vaccinations with an interval of 45 days. Shortening intervals is not allowed. In the event of an increase in the interval between vaccinations, the next vaccination is carried out as soon as possible, determined by the state of health of the child.

8.4.10.2. The first revaccination with ADS-anatoxin is carried out once every 9-12 months. after completed vaccination.

8.4.11. ADS-M-anatoxin is used:

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

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

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

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

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

8.5. Immunization against measles, rubella, mumps

8.5.1. The WHO program provides:

Global elimination of measles by 2007;

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

Reducing the incidence of mumps to 1.0 or less per 100,000 population by 2010

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

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

8.5.3. Revaccination is subject to children from 6 years of age.

8.5.4. Rubella vaccination is for girls aged 13 years who have not previously been vaccinated or who have received one vaccination.

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

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

8.6. Immunization against polio

8.6.1. WHO's global goal is to eradicate poliomyelitis by 2005. Achievement of this goal is possible with coverage of three vaccinations of children 12 months old. life and revaccinations of children 24 months. life of at least 95%.

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

8.6.3. Vaccinations are subject to children from 3 months of age. Vaccination is carried out 3 times with an interval of 45 days. Shortening intervals is not allowed. When prolonging the intervals, vaccinations should be carried out as soon as possible.

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

8.6.5. Polio vaccinations can be combined with other routine vaccinations.

8.7. Immunization against viral hepatitis B

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

8.7.2. The second vaccination is given to children at the age of 1 month.

8.7.3. The third vaccination is given to children at the age of 6 months.

8.7.4. Children born to mothers carrying the hepatitis B virus or suffering from hepatitis B in the third trimester of pregnancy are vaccinated against hepatitis B according to the scheme 0 - 1 - 2 - 12 months.

8.7.5. Vaccination against hepatitis B in children at the age of 13 is carried out previously not vaccinated according to the scheme 0 - 1 - 6 months.

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

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

8.8. Immunization against tuberculosis

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

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

8.8.3. The first revaccination is carried out for children at the age of 7 years.

8.8.4. The second revaccination against tuberculosis at the age of 14 is carried out for tuberculin-negative children not infected with Mycobacterium tuberculosis, who have not received the vaccination at the age of 7.

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

8.8.6. The vaccine is injected strictly intradermally at the border of the upper and middle thirds of the outer surface of the left shoulder. The inoculation dose contains 0.05 mg BCG and 0.02 mg BCG-M in 0.1 ml of solvent. Vaccination and revaccination is carried out with one gram or tuberculin disposable syringes with fine needles (N 0415) with a short cut.

9. The procedure for conducting preventive vaccinations

according to epidemic indications

In the event of a threat of the emergence of infectious diseases, prophylactic vaccinations according to epidemic indications are carried out for the entire population or certain professional groups, contingents living or arriving in territories that are endemic or enzootic for plague, brucellosis, tularemia, anthrax, leptospirosis, tick-borne spring-summer encephalitis. The list of works, the performance of which is associated with a high risk of contracting infectious diseases and requires mandatory preventive vaccinations, was approved by Decree of the Government of the Russian Federation of July 17, 1999 N 825.

Immunization according to epidemic indications is carried out by decision of the centers of state sanitary and epidemiological supervision in the constituent entities of the Russian Federation and in agreement with the health authorities.

Endemic territory (with respect to human diseases) and enzootic (with respect to diseases common to humans and animals) are considered to be a territory or group of territories with a constant confinement of an infectious disease due to specific, local, natural and geographical conditions necessary for the constant circulation of the pathogen.

The list of enzootic territories is approved by the Ministry of Health of Russia on the proposal of the centers of state sanitary and epidemiological supervision in the constituent entities of the Russian Federation.

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

9.1. Plague Immunoprophylaxis

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

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

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

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

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

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

9.1.7. Preventive vaccinations are controlled by anti-plague institutions.

9.2. Immunoprophylaxis of tularemia

9.2.1. Vaccinations against tularemia are carried out on the basis of the decision of the territorial centers of the state sanitary and epidemiological supervision in agreement with the local health authorities.

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

9.2.3. Distinguish between scheduled and unscheduled vaccination against tularemia.

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

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

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

Hunters, fishermen (and members of their families), reindeer herders, shepherds, field farmers, meliorators;

Persons sent for temporary work (geologists, prospectors, etc.).

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

Grain and vegetable stores;

Sugar and alcohol factories;

Hemp and flax plants;

feed shops;

Livestock and poultry farms working with grain, fodder, etc.;

Hunters (members of their families);

Procurers of skins of game animals;

Employees of fur factories engaged in the primary processing of skins;

Employees of departments of especially dangerous infections of the centers of state sanitary and epidemiological supervision, anti-plague institutions;

Employees of deratization and disinfection services;

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

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

9.2.4.5. Vaccination according to epidemic indications is carried out:

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

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

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

In the territories of active natural foci of tularemia - to persons who come to carry out permanent or temporary work - hunters, foresters, meliorators, surveyors, peat miners, fur skins (water rats, hares, muskrats), geologists, members of scientific expeditions; persons sent for agricultural, construction, survey or other work, tourists, etc.

Vaccination of the above contingents is carried out by healthcare organizations in the places of their formation.

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

9.2.6. Simultaneous skin vaccination of adults against tularemia and brucellosis, tularemia and plague on different parts of the outer surface of a third of the shoulder is allowed.

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

9.2.8. Monitoring the timeliness and quality of vaccination against tularemia, as well as the state of immunity, is carried out by the territorial centers of the state sanitary and epidemiological surveillance by sampling the adult working population using a tularin test or serological methods at least 1 time in 5 years.

9.3. Immunoprophylaxis of brucellosis

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

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

For permanent and temporary livestock workers - until the complete elimination of animals infected with goat-sheep species brucella in farms;

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

Employees of bacteriological laboratories working with live cultures of Brucella;

Employees of organizations for the slaughter of livestock with brucellosis, the procurement and processing of livestock products received from it, veterinary workers, livestock specialists in farms enzootic for brucellosis.

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

9.3.4. When determining the timing of vaccinations, workers in livestock farms must be strictly guided by the data on the time of lambing (early lambing, scheduled, unscheduled).

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

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

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

9.4. Immunoprophylaxis of anthrax

9.4.1. Immunization of people against anthrax is carried out on the basis of the decision of the territorial centers of state sanitary and epidemiological supervision in coordination with local health authorities, taking into account epizootological and epidemiological indications.

9.4.2. Vaccinations are subject to persons from the age of 14 who perform the following works in the territories enzootic for anthrax:

Agricultural, irrigation and drainage, surveying, forwarding, construction, excavation and movement of soil, procurement, commercial;

Slaughtering livestock with anthrax, harvesting and processing meat and meat products obtained from it;

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

9.4.3. Vaccination is not recommended for persons who had contact with animals with anthrax, raw materials and other products infected with the anthrax pathogen against the background of an epidemic outbreak. They are given emergency prophylaxis with antibiotics or anthrax immunoglobulin.

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

9.4.5. Control over the timeliness and completeness of the coverage of contingents with immunization against anthrax is carried out by the territorial centers of the state sanitary and epidemiological supervision.

9.5. Immunoprophylaxis of tick-borne encephalitis

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

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

9.5.3. Vaccinations against tick-borne encephalitis are subject to:

Population from the age of 4 living in enzootic areas for tick-borne encephalitis;

Persons arriving in the territory, enzootic for tick-borne encephalitis, and performing the following work - agricultural, hydro-reclamation, construction, geological, exploration, forwarding; excavation and movement of soil; procurement, trade; deratization and disinsection; on logging, clearing and landscaping of forests, zones of improvement and recreation of the population; with live cultures of the causative agent of tick-borne encephalitis.

9.5.4. The maximum age of the vaccinated is not regulated, it is determined in each case based on the appropriateness of vaccination and the state of health of the vaccinated.

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

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

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

9.6. Immunoprophylaxis of leptospirosis

9.6.1. Vaccinations against leptospirosis are carried out on the basis of the decision of the territorial centers of the state sanitary and epidemiological supervision in coordination with the local health authorities, taking into account the epidemiological situation and the epizootic situation. Preventive vaccination of the population is carried out from the age of 7 according to epidemiological indications. The contingents of risk and the timing of immunization are determined by the territorial centers of the state sanitary and epidemiological supervision.

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

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

Slaughtering of cattle suffering from leptospirosis, procurement and processing of meat and meat products obtained from it;

Capturing and keeping neglected animals;

With live cultures of the causative agent of leptospirosis;

Sent for construction and agricultural work in places of active natural and anthropurgic foci of leptospirosis (but not later than 1 month before the start of work in them).

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

9.6.5. Control over immunization against leptospirosis of contingents at risk of infection and the population as a whole is carried out by territorial centers of state sanitary and epidemiological supervision.

9.7. Immunoprophylaxis of yellow fever

9.7.1. A number of countries with yellow fever enzootic territories require international yellow fever vaccination or revaccination certificates from persons traveling to these territories.

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

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

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

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

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

9.7.7. Vaccinations against yellow fever are carried out only in vaccination stations at polyclinics under the supervision of a doctor with the obligatory issuance of an international certificate of vaccination and revaccination against yellow fever.

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

9.8. Q fever immunoprophylaxis

9.8.1. Vaccinations against Q fever are carried out by decision of the territorial centers of state sanitary and epidemiological supervision in coordination with local health authorities, taking into account the epidemiological and epizootic situation.

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

For the procurement, storage, processing of raw materials and livestock products obtained from farms where Q fever diseases of small and large cattle are recorded;

For harvesting, storage, processing of agricultural products in enzootic territories for Q fever;

For the care of sick animals (persons who have recovered from Q fever or who have a positive complement fixation test (CFR) in a dilution of at least 1:10 and (or) a positive indirect immunofluorescence test (RNIF) in a titer of at least 1 are allowed to care for sick animals :40);

Working with live cultures of Q fever pathogens.

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

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

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

9.9. Immunoprophylaxis of rabies

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

9.9.2. Vaccinations against rabies from the age of 16 are subject to:

Persons performing work on catching and keeping neglected animals;

Working with "street" rabies virus;

Veterinarians, hunters, foresters, slaughterhouse workers, taxidermists.

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

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

9.9.5. Control over the immunization of eligible contingents and persons at risk of infection with the rabies virus is carried out by territorial centers of state sanitary and epidemiological supervision.

9.10. Immunoprophylaxis of typhoid fever

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

9.11. Influenza Immunoprophylaxis

9.11.1. Influenza immunoprophylaxis can significantly reduce the risk of the disease, prevent negative consequences and effects on public health.

9.11.2. Influenza vaccination is carried out for persons at increased risk of infection (over 60 years of age, suffering from chronic somatic diseases, often ill with acute respiratory infections, preschool children, schoolchildren, medical workers, workers in the service sector, transport, educational institutions).

9.11.3. Any citizen of the country can receive a flu shot at will, if he has no medical contraindications.

9.11.4. Influenza vaccinations are carried out annually in the fall (October-November) during the pre-epidemic influenza period by decision of the territorial centers of the State Sanitary and Epidemiological Supervision.

9.12. Immunoprophylaxis of viral hepatitis A

9.12.1. Vaccinations against hepatitis A are subject to:

Children from 3 years of age living in areas with a high incidence of hepatitis A;

Medical workers, educators and staff of preschool institutions;

Public service workers, primarily employed in public catering organizations;

Workers for the maintenance of water and sewer facilities, equipment and networks;

Persons traveling to hepatitis A hyperendemic regions of Russia and the country;

Persons in contact with the patient (patients) in the foci of hepatitis A.

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

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

9.13. Immunoprophylaxis of viral hepatitis B

9.13.1. Vaccinations against hepatitis B are carried out:

Children and adults who have not been previously vaccinated, in whose families there is a carrier of HbsAg or a patient with chronic hepatitis;

Children of orphanages, orphanages and boarding schools;

Children and adults who regularly receive blood and its preparations, as well as those on hemodialysis, and oncohematological patients;

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

Medical workers who have contact with the blood of patients;

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

Students of medical institutes and students of secondary medical schools (primarily graduates);

People who inject drugs.

9.13.2. The need for immunoprophylaxis is determined by the territorial centers of the State Sanitary and Epidemiological Surveillance, exercising subsequent control over immunization.

9.14. Immunoprophylaxis of meningococcal infection

9.14.1. Vaccinations against meningococcal infection are carried out:

Children over 2 years old, adolescents, adults in the foci of meningococcal infection caused by meningococcus serogroup A or C;

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

9.14.2. The need for immunization against meningococcal infection is determined by the territorial centers of state sanitary and epidemiological supervision.

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

9.15. Immunoprophylaxis of mumps

9.15.1. Vaccinations against mumps are carried out in contact with the patient (sick) in the foci of mumps to persons aged 12 months. up to 35 years old, previously not vaccinated or once vaccinated and not sick with this infection.