Children from 1 to 18 years old (inclusive) and adults up to 35 years old (inclusive), not sick, not vaccinated, vaccinated once, having no information # about measles vaccinations; adults from 36 to 55 years old (inclusive) belonging to risk groups (medical and educational organizations, organizations of trade, transport, communal and social spheres; persons working on a rotational basis and employees of state control bodies at checkpoints across the state border Russian Federation), not sick, not vaccinated, vaccinated once, having no information about measles vaccinations

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

students in professional educational organizations and educational organizations higher education;

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

pregnant women;

adults over 60;

persons subject to conscription for military service;

persons with chronic diseases, including those with lung diseases, cardiovascular diseases, metabolic disorders and obesity

* (1) The first, second and third vaccinations are carried out according to the 0-1-6 scheme (1 dose - at the beginning of vaccination, 2 dose - one month after 1 vaccination, 3 dose - 6 months after the start of vaccination), with the exception of children at risk, vaccination against viral hepatitis In which it is carried out according to the scheme 0-1-2-12 (1 dose - at the beginning of vaccination, 2 dose - a month after 1 vaccination, 2 dose - 2 months after the start of vaccination, 3 dose - 12 months after the start of vaccination) ...

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

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

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

* (5) Vaccination is carried out for children belonging to risk groups (with diseases nervous system, immunodeficiency states or anatomical defects leading to a sharply increased risk of hemophilic infection; with abnormalities in the development of the intestine; with oncological diseases and / or receiving immunosuppressive therapy for a long time; children born to mothers with HIV infection; children with HIV infection; premature and low birth weight children; children who are in children's homes).

* (6) The third vaccination and subsequent revaccinations against poliomyelitis are given to children with a vaccine for the prevention of poliomyelitis (live); children belonging to risk groups (with diseases of the nervous system, immunodeficiency states or anatomical defects leading to a sharply increased risk of hemophilic infection; with intestinal malformations; with cancer and / or long-term immunosuppressive therapy; children born to mothers with HIV - infection; children with HIV infection; premature and low birth weight children; children in children's homes) - vaccine for the prevention of poliomyelitis (inactivated).

* (6.1) Vaccination and revaccination of children belonging to risk groups may be carried out with immunobiological drugs for immunoprophylaxis of infectious diseases, containing combinations of vaccines intended for use at appropriate age periods.

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

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

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

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

Procedure for citizens preventive vaccinations within the framework of the national calendar of preventive vaccinations

With changes and additions from:

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

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

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

In the cases provided for by the national calendar of preventive vaccinations, vaccination and revaccination with immunobiological drugs for immunoprophylaxis of infectious diseases, containing combinations of vaccines, is allowed.

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

5. All persons who are to be vaccinated against preventive vaccinations are preliminarily examined by a doctor (paramedic).

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

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

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

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

10. Vaccination with live vaccines within the framework of the national calendar of preventive vaccinations (with the exception of vaccines for the prevention of tuberculosis) is carried out for children with HIV infection with the 1st and 2nd immune categories (no immunodeficiency or moderate immunodeficiency).

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

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

13. When vaccinating the population, vaccines containing antigens relevant for the Russian Federation are used to ensure the maximum effectiveness of immunization.

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

______________________________

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

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

The domestic health care system pays much attention to the prevention of diseases, among which infectious diseases occupy a special place. To prevent the epidemic process among the population, epidemiologists have developed a national calendar of preventive vaccinations. An official document regulates the age periods and types of vaccination, which is absolutely free. According to the social insurance program for the medical industry in the Russian Federation, starting from birth, every resident of our country must be vaccinated against 12 compulsory infectious pathologies.

National calendar preventive vaccination includes two main parts. In the initial appendix, the necessary vaccinations against the most common and potentially life-threatening pathologies are indicated, after what time they should be done and the dosage of drugs. In the second part, episodes of vaccination are indicated, which are prescribed in cases of need for epidemiological indications or at the risk of an epidemic in the region where people live.

The number of preventable diseases included in the list of compulsory vaccinations in different countries of the world

Most countries support the basic concepts of the policy of the World Health Organization and are its participants, have their own national calendars of preventive vaccinations. It is urgent preventive measure, allowing to prevent the popularization of the most dangerous ailments around the globe and to significantly reduce mortality among the population. In the Russian Federation, the national immunization calendar does not differ much from its foreign counterparts, although it does not contain some vaccinations, as in other countries. On the territory of Russia, it is not mandatory to vaccinate against viral hepatitis A, human papillomavirus, rotavirus or meningococcal invasion.

The United States of America boasts the most extended preventive vaccination calendar, where 16 diseases are included in the list of the document. In other states, this list is somewhat smaller. Germany prefers to vaccinate against 14 diseases, while Russia and the UK - only from 6 of them. In total, 30 pathologies are included in the national calendars and calendars of vaccination for epidemic indications in the world. These pathogens pose a particular danger to the normal existence of mankind.

Interesting fact. There is no vaccination against tuberculosis on the US vaccination calendar. American infectious disease specialists do not regard tuberculosis vaccine fluid as a reliable means of preventing it. Our doctors adhere to the opposite opinion and are convinced that it is precisely the anti-tuberculosis vaccination that makes it possible to reduce high level the incidence of tuberculosis among our fellow citizens. Today, vaccination against tuberculosis is among the mandatory anti-infectious measures in more than 100 countries.

Features of vaccination calendars in foreign countries

Each country has its own vaccination schedule. This list of vaccinations is approved at the legislative level and may be supplemented depending on epidemiological features region. On general form and the content of the national calendar is influenced by several factors:

• indicators of the overall incidence in the country;
• the presence of patients from so-called risk groups;
• territorial predisposition of the region to the spread of pathogenic agents (climate, population density, the presence of vectors, etc.);
• socio-economic level of wealth.

Table 1. Comparative content of vaccinations in several countries

The country	Russia	England	Germany	USA
List of diseases to be vaccinated	- tuberculosis - diphtheria bacillus - whooping cough - tetanus - hemophilic disease (only people at risk are vaccinated) - rubella - mumps - viral hepatitis B - polio - pneumococcal infection (since 2014)	- diphtheria lesion - whooping cough - tetanus infection - rubella - hemophilic disease - papillomavirus - meningococcus - polio — parotitis - Pneumococcus	- against diphtheria - tetanus - whooping cough - Haemophilus influenzae - Hepatitis B - papilloma virus - meningitis virus - pneumococcal infection - rubella - mumps - chickenpox - polio	- tetanus - diphtheria disease - mumps - whooping cough - rubella - hemophilic infection - viral hepatitis A - viral hepatitis B - chickenpox - polio - Pneumococcus - papillomavirus - rotavirus - meningococcus

Despite the fact that only 12 pathogens are vaccinated in Russia, each child under the age of two receives 14 injections of vaccine preparations. At the same time, babies from America and Germany up to 24 months are vaccinated 13 and 11 times, respectively. Through such a busy plan, there is always a risk of complications of immunization.

The Russian schedule differs from its foreign competitors in less saturation. It does not include vaccinations against HPV, rotavirus and chickenpox. In our country, vaccinations against acute hemophilic infection are given only to people at risk, and vaccination against hepatitis A is administered exclusively for epidemic indications. In addition, our doctors do not see the point in a second revaccination against pertussis agents and rarely give preference to combination vaccines. Most injections are given 3-12 months after birth.

National vaccination calendar

The vaccination schedule in our country is approved by the Ministry of Health and provides a list of vaccinations against the most unreliable diseases from an epidemiological point of view.

Table 2. Calendar of preventive vaccinations: content by month

Person's age (months and years)	Name
Newborn babies in the first day of life	1st vaccination against viral hepatitis B
Infants under 7 days of age	Immunization against tuberculosis infection
Babies at 1 month old	2nd vaccination against viral hepatitis B
Children in 2 months	First pneumococcal injection 3rd vaccination against hepatitis B (done only to infants at risk)
Children at 3 months	First vaccination against diphtheria, pertussis, tetanus The first polio vaccine First anti-hemophilic infection vaccine for at-risk children
Children at 4.5 months	Second vaccination to protect against diphtheria, pertussis, tetanus Second injection (after about 6 weeks), prescribed against hemophilic infection (given to at-risk babies) Second vaccination against polio Second immunization against pneumococcal infection
Children at 6 months	Third vaccination against the source of diphtheria, pertussis, tetanus Third vaccination for protection against viral hepatitis B Third immunization against polio Third shot for hemophilic infection
Children at 12 months	Vaccination against measles and rubella and mumps The fourth administration of the solution against viral hepatitis B (carried out for infants at risk)
Babies at 15 months	Revaccination against pneumococcal infection
One and a half year old children	The first revaccination against polio Revaccination against diphtheria, pertussis virus and tetanus infection Revaccination against Haemophilus influenzae in at-risk babies
Babies in 20 months	Second revaccination against polio
Children 6-7 years old	Revaccination against mumps, measles and rubella Revaccination against the causative agent of tuberculosis Another revaccination against the viral agents of diphtheria, pertussis and tetanus
Children under 14	The third revaccination, which allows you to create immunity against diphtheria, and with it, tetanus The next revaccination against polio
from 18 years old	Revaccination to maintain the immune response against diphtheria (every 10 years)

There are a number of vaccinations shown to several age categories at once:

• previously unvaccinated children from one year old and adults up to 55 years old, the first hepatitis vaccination is carried out at any time;
• rubella vaccination is given once to children over 12 months old, adult women from 18 to 25 years old, who have not had this disease and have not been previously vaccinated against it;
• against measles, children after twelve months and adults up to 35 years old, if they have not been previously vaccinated or immunized once and have not become infected with infectious diseases, are vaccinated once;
• children after six months, pupils of general education schools and higher educational institutions, adults from risk groups, pensioners over 60 years old with accompanying pathological conditions ARVI vaccination is carried out annually to avoid the spread of the epidemic.

The implementation of the calendar of preventive vaccinations should take place in the approved manner and in compliance with the rules prescribed in the legislation:

• vaccinations against an infectious disease in childhood and older age are given only in medical organizations if they have an appropriate license from the Ministry of Health of the Russian Federation;
• vaccination is carried out by a specially trained worker who has completed a course of special training and is able to use immunobiological drugs, and, if necessary, provide first medical and emergency aid;
• immunization against pathologies from the list, as well as revaccination against similar painful conditions, is carried out with vaccines certified in the country, according to official instructions;
• before vaccination, all patients or their legal representatives receive an explanation about possible consequences procedures, risks in case of refusal from it;
• vaccination is carried out after a medical examination;
• vaccination against pneumococcal-associated infection in children without vaccination in six months should be carried out outside the schedule, twice with an interval between injections, lasting 2 months;
• children of the first year of life are vaccinated against hepatitis and influenza with vaccine solutions that do not contain preservatives.

In addition to the generally accepted rules for vaccination against the most dangerous pathologies, there is a list of recommendations regarding the vaccination of HIV-infected patients. This group of people needs special measures prevention, since more than others it is susceptible to the effects of pathogenic microorganisms. When immunizing HIV-infected adults and children, it is important to use the following equipment:

• vaccination against diseases in HIV-infected babies is carried out according to the immunization schedule and in accordance with the recommendations attached to the annotations to immunobiological forms of infection prevention in a child (the type of vaccine, the baby's HIV status, age, and the presence of concomitant pathologies are taken into account);
• revaccination against tubercle bacillus in children born to HIV-positive mothers who have received threefold prophylaxis of virus transmission from a woman to a child is carried out in a maternity hospital with sparing vaccines for primary vaccination;
• children with the HIV virus are not re-vaccinated against infection with Koch's bacillus;
• live vaccines for HIV infection in young patients, vaccination is carried out in the absence of immunodeficiency or weak degree its development;
• toxoids and killed vaccines are administered to a child with HIV infection only in the absence of severe immunodeficiency.

In addition to the national immunization schedule, there is a calendar of preventive vaccinations for epidemic indications. This schedule is approved at the legal level and allows you to prevent infection in a child or adult patient belonging to certain groups at risk of infection.

The schedule of preventive vaccinations for epidemic indications includes a list of pathologies and people who are more at risk of infection than others:

• vaccination against tularemia is indicated for people living or working in areas unfavorable in terms of morbidity;
• vaccination against plague is given to persons living in areas dangerous in terms of contamination or working with live plague pathogens;
• the brucellosis vaccine is administered to patients from foci of the disease, workers at enterprises for the procurement, processing and storage of raw materials obtained from farms where brucellosis was previously registered, veterinarians, livestock specialists, developers of an anti-brucellosis vaccine;
• persons are vaccinated against anthrax, labor activity which is associated with pre-slaughter livestock, slaughter, processing of skins, geologists and construction workers sent to areas where episodes of the virus were recorded;
• foresters are vaccinated against rabies, veterinarians, hunters, persons involved in the capture of wild or homeless animals, laboratory workers where the virus is stored;
• vaccination against leptospirosis is shown to workers in the field of animal husbandry in regions unfavorable for leptospirosis, slaughters of infected livestock, individuals working with weakened, but live cultural strains of the pathogen;
• vaccination against tick-borne viral encephalitis is indicated for people registered in endemic zones with an unfavorable situation in terms of infection, construction workers and geologists, forwarders to typical tick habitats, exterminators, foresters;
• vaccination against Q fever is carried out for workers in the field of harvesting, cutting and processing of livestock products obtained from farms with registered cases of the disease and in contact with live cultures of the pathogen;
• against yellow fever, a prophylactic vaccination for epidemic indications is given to subjects who are going to visit enzootic regions and who have contact with the causative virus;
• from cholera, citizens visiting countries with an unfavorable situation in terms of infection with cholera vibrio, and residents of regions of our country where incidents of the disease are recorded;
• from viral hepatitis A, residents of disadvantaged areas, workers in the food industry and the service sector, service personnel of sewage and water supply systems, contact persons in regions with outbreaks of the virus are immunized;
• anti-meningococcal vaccination is recommended for children under 18 years of age and adult members of society living in endemic areas or have come into contact with sick people, and conscripts;
• from measles immunize unvaccinated individuals of all age groups who are in contact with infected people and have not previously been sick;
• against viral hepatitis B, it is necessary to vaccinate people in the foci of infection who do not have data on previous vaccinations, facts of the disease;
• an anti-diphtheria injection is given to persons who do not have information about the injections done, which form protection against diphtheria;
• mumps is warned in unvaccinated persons, regardless of their age, motivating actions with information about their lack of confirmation of the fact of vaccination;
• children who are not immunized in the first year of life are vaccinated against hemophilic infection;
• early infection caused by rotaviruses is warned if there is a risk of infection.

According to epidemiological indications, the vaccine against poliomyelitis is offered to contact people in the foci of the rapid spread of the virus, which allows patients to avoid possible infection. These categories include:

• children after three months, since their pathology leads to irreparable consequences (the vaccine is used once);
• health workers are vaccinated against poliomyelitis once;
• people without a permanent place of residence;
• children from disadvantaged areas;
• people in contact with potentially dangerous people in terms of infection.

The painful process in babies often occurs under the mask. colds and is often determined at the stage of pronounced clinical manifestations or complications. Therefore, it is better to vaccinate babies according to the national vaccination schedule recommended by the country's leading immunologists.

A large number of bacterial and viral diseases forces us to actively use preventive measures, that is, actions that are aimed at preventing the occurrence of these diseases. Vaccination is one of the most common ways to prevent infectious diseases. They are an effective measure for the prevention of diseases (diseases) caused by bacterial and some viral infections (pathogens).

The Russian calendar is one of the best in the world

The Russian government cares about the health of its citizens, which is why the fundamental document governing the vaccination procedure for the population of our country - the national vaccination calendar - is reviewed and updated annually.

The Russian vaccination calendar is considered one of the best in the world. So, looking into it, any mother will be able to determine the date of vaccination of her child. It is known that in order to form stable immunity, it is necessary to carefully observe the terms in which the repeated vaccination should be carried out, and the vaccination calendar makes it easy to track the time of the next vaccination.

Features of the calendar for the year:

• when compiling it, the increased risks of the likelihood of outbreaks of certain diseases were taken into account;
• special attention is paid to the prevention of dangerous diseases.

Nowadays, anyone can choose medical institution, in which he will be treated, including being vaccinated. Among the large number medical centers it is difficult to make the right choice.

Prevention is the best way to prevent disease

When applying for vaccinations to the network of family medicine clinics "Medius", you will be pleasantly surprised by the highest quality of service. Experienced specialists will provide advisory practical help... A benevolent attitude towards each patient is the motto of the work medical staff clinics "Medius": only highly qualified doctors and nurses, to whom you can safely entrust the care of your health and the health of your child.

Health is an invaluable gift that should be cherished from childhood. The network of family medicine clinics "Medius" provides wide range medical services, which includes routine vaccinations, and helps you maintain your health for years to come.

The current version of the National Calendar of Preventive Vaccinations was adopted by Order No. 125n of the Ministry of Health of the Russian Federation dated March 21, 2014 and includes the following vaccinations:

National vaccination calendar

Age	Vaccination name	Vaccine
Newborns (in the first 24 hours of life)	First vaccination against viral hepatitis B
Newborns (3-7 days)	Vaccination against tuberculosis	BCG-M
1 month	Second vaccination against viral hepatitis B
2 month	Third vaccination against viral hepatitis B First vaccination against pneumococcal infection
3 month	First vaccination against diphtheria, pertussis, tetanus First vaccination against haemophilus influenzae First vaccination against polio	DTP
4.5 months	Second vaccination against diphtheria, pertussis, tetanus Second vaccination against haemophilus influenzae Second vaccination against polio Second vaccination against pneumococcal infection	DTP
6 months	Third vaccination against diphtheria, pertussis, tetanus Third Haemophilus influenza vaccination Third polio vaccination The fourth vaccination against viral hepatitis B	DTP
12 months	Vaccination against measles, rubella, mumps The fourth vaccination against viral hepatitis B
18 months	The first revaccination against diphtheria, pertussis, tetanus, poliomyelitis Revaccination against Haemophilus influenzae	DTP
20 months	Second revaccination against polio
6 years	Revaccination against measles, rubella, mumps
7 years	Revaccination against tuberculosis Second revaccination against diphtheria, BCG tetanus	ADS
13 years old	Rubella vaccination (girls) Vaccination against viral hepatitis B (previously not vaccinated)
14 years	The third revaccination against diphtheria, tetanus The third revaccination against poliomyelitis	ADS
Adults	Revaccination against diphtheria, tetanus - every 10 years from the moment of the last revaccination	ADS

Additional immunization of the population against hepatitis B, rubella, poliomyelitis inactivated vaccineas well as against the flu

Age	Vaccination name	Vaccine
Children from 1 to 18 years old, adults from 18 to 55 years old, not previously vaccinated	Vaccination against viral hepatitis B
Children from 1 to 18 years old, not sick, not vaccinated, vaccinated once against rubella; girls from 18 to 25 years old, not sick, not previously vaccinated	Rubella immunization
Children early age with clinical signs of an immunodeficiency state (frequent pustular diseases); HIV-infected or born to HIV-Vaccination against poliomyelitis with inactivated vaccine infected mothers; with an established diagnosis of oncohematological diseases and / or receiving immunosuppressive therapy for a long time; children who are at the 2nd stage of nursing and have reached 3 months of age; inmates of orphanages (regardless of health status); children from families where there are patients with immunodeficiency diseases	Vaccination against poliomyelitis with inactivated vaccine
Children from 6 months of age, children attending preschool institutions, students in grades 1-11, students of higher and secondary special educational institutions, medical workers, employees of educational institutions, adults over 60	Influenza vaccination

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

The vaccination calendar is developed taking into account all age characteristics, including the most dangerous infectious diseases in children of the first year of life. Vaccinations, which are given within the framework of the National Calendar, can significantly reduce the risk of illness in children. And if the child nevertheless falls ill, then the vaccination given will contribute to the course of the disease in more mild form and will save you from serious complications, many of which are extremely life-threatening.

The National Immunization Schedule is the most rational use vaccines, ensuring the development of intense immunity at the earliest (vulnerable) age as soon as possible. The vaccination calendar can be divided into two parts.

First part- National calendar of preventive vaccinations, which provides for vaccination against ubiquitous infections that almost the entire human population gets sick (airborne infections - measles, rubella, mumps, whooping cough, chickenpox, diphtheria, influenza), as well as infections that are characterized by a severe course with high mortality (tuberculosis, hepatitis B, diphtheria, tetanus, poliomyelitis, hemophilic infection type b).

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

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

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

On the other hand, in some countries, within the framework of the National Calendar, vaccination against tuberculosis is not provided, which in our country is made by the high incidence of this infection. And until now, vaccination against tuberculosis is included in the vaccination calendar of more than 100 countries, while many provide for it in the first days after birth, as recommended by the WHO Vaccination Calendar.

National vaccination calendars of different countries

Infections	Russia	USA	Great Britain	Germany	Countries using vaccine in NK
Tuberculosis	+				more than 100
Diphtheria	+	+	+	+	194
Tetanus	+	+	+	+	194
Whooping cough	+	+	+	+	194
Measles	+	+	+	+	111
Flu	+	+	+	+
Hemophilic infection type b / Hib	+ (risk groups)	+	+	+	189
Rubella	+	+	+	+	137
Hepatitis A		+
Hepatitis B	+	+		+	183
Polio	+	+	+	+	all countries
Parotitis	+	+	+	+	120
Chickenpox		+		+
Pneumococcus	Since 2015	+	+	+	153
Human papillomavirus / cervical cancer		+	+	+	62
Company viral infection		+			75
Meningococcal infection		+	+	+
Total infections	12	16	12	14
Number of injections administered up to 2 years	14	13		11

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

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

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

National vaccination calendar

Categories and age of citizens subject to compulsory vaccination	Prophylactic vaccination name
Newborns in the first 24 hours of life	First vaccination against viral hepatitis B
Newborns 3 - 7 days old	Vaccination against tuberculosis Vaccination is carried out with a vaccine for the prevention of tuberculosis for the sparing primary vaccination (BCG-M); in the constituent entities of the Russian Federation with morbidity rates exceeding 80 per 100 thousand of the population, as well as in the presence of tuberculosis patients in the environment of a newborn - a vaccine for the prevention of tuberculosis (BCG).
Children 1 month	Second vaccination against viral hepatitis B The first, second and third vaccinations are carried out according to the 0-1-6 scheme (1 dose - at the beginning of vaccination, 2 dose - one month after 1 vaccination, 3 dose - 6 months after the start of vaccination), with the exception of children belonging to the groups risk, vaccination against viral hepatitis B of which is carried out according to the scheme 0-1-2-12 (1 dose - at the beginning of vaccination, 2 dose - one month after 1 vaccination, 2 dose - 2 months after the start of vaccination, 3 dose - after 12 months from the start of vaccination).
Children 2 months	Third vaccination against viral hepatitis B (risk groups)
	First vaccination against pneumococcal infection
Children 3 months	First vaccination against diphtheria, pertussis, tetanus
	First vaccination against polio
	First vaccination against haemophilus influenzae (risk groups)
Children 4.5 months	Second vaccination against diphtheria, pertussis, tetanus
	Second vaccination against haemophilus influenzae (risk groups) Vaccination is carried out for children belonging to risk groups (with immunodeficiency conditions or anatomical defects leading to a sharply increased risk of hemophilic infection; with oncohematological diseases and / or receiving immunosuppressive therapy for a long time; children born to mothers with HIV infection; children with HIV infection; children in children's homes).
	Second vaccination against polio The first and second vaccinations are given with the polio vaccine (inactivated).
	Second vaccination against pneumococcal infection
Children 6 months	Third vaccination against diphtheria, pertussis, tetanus
	Third vaccination against viral hepatitis B The first, second and third vaccinations are carried out according to the 0-1-6 scheme (1 dose - at the beginning of vaccination, 2 dose - one month after 1 vaccination, 3 dose - 6 months after the start of vaccination), with the exception of children belonging to the groups risk, vaccination against viral hepatitis B of which is carried out according to the scheme 0-1-2-12 (1 dose - at the beginning of vaccination, 2 dose - one month after 1 vaccination, 2 dose - 2 months after the start of vaccination, 3 dose - after 12 months from the start of vaccination).
	Third polio vaccination
	Third vaccination against haemophilus influenzae (risk group) Vaccination is carried out for children belonging to risk groups (with immunodeficiency conditions or anatomical defects leading to a sharply increased risk of hemophilic infection; with oncohematological diseases and / or receiving immunosuppressive therapy for a long time; children born to mothers with HIV infection; children with HIV infection; children in children's homes).
Children 12 months	Vaccination against measles, rubella, mumps
	The fourth vaccination against viral hepatitis B (risk groups) Vaccination is carried out for children belonging to risk groups (born to mothers - carriers of HBsAg, patients with viral hepatitis B or who have had viral hepatitis B in the third trimester of pregnancy, who do not have test results for markers of hepatitis B, who use narcotic drugs or psychotropic substances, from families in who have an HBsAg carrier or a patient with acute viral hepatitis B and chronic viral hepatitis).
Children 15 months	Revaccination against pneumococcal infection
Children 18 months	The first revaccination against poliomyelitis The third vaccination and subsequent revaccinations against poliomyelitis are given to children with the vaccine for the prevention of poliomyelitis (live); children born to mothers with HIV infection, children with HIV infection, children in orphanages - the polio prophylaxis vaccine (inactivated).
	The first revaccination against diphtheria, pertussis, tetanus
	Revaccination against Haemophilus influenzae (risk groups)
Children 20 months	Second revaccination against polio The third vaccination and subsequent revaccinations against poliomyelitis are given to children with the vaccine for the prevention of poliomyelitis (live); children born to mothers with HIV infection, children with HIV infection, children in orphanages - the polio prophylaxis vaccine (inactivated).
Children 6 years old	Revaccination against measles, rubella, mumps
Children 6 - 7 years old	Second revaccination against diphtheria, tetanus
	Revaccination against tuberculosis Revaccination is carried out with a vaccine for the prevention of tuberculosis (BCG).
Children 14 years old	The third revaccination against diphtheria, tetanus The second revaccination is carried out with toxoids with a reduced antigen content.
	The third revaccination against poliomyelitis The third vaccination and subsequent revaccinations against poliomyelitis are given to children with the vaccine for the prevention of poliomyelitis (live); children born to mothers with HIV infection, children with HIV infection, children in orphanages - the polio prophylaxis vaccine (inactivated).
Adults from 18 years old	Revaccination against diphtheria, tetanus - every 10 years from the moment of the last revaccination
Children from 1 to 18 years old, adults from 18 to 55 years old, not previously vaccinated	Vaccination against viral hepatitis B Vaccination is carried out for children and adults who have not previously been vaccinated against viral hepatitis B, according to the 0-1-6 scheme (1 dose - at the start of vaccination, 2 dose - a month after 1 vaccination, 3 dose - 6 months after the start of vaccination).
Children from 1 to 18 years old, women from 18 to 25 years old (inclusive), not sick, not vaccinated, vaccinated against rubella once, having no information about rubella vaccinations	Rubella vaccination
Children from 1 to 18 years old inclusive and adults under 35 years old (inclusive), not sick, not vaccinated, vaccinated once, having no information about measles vaccinations	Measles vaccination The interval between the first and second vaccinations must be at least 3 months
Children from 6 months, students in grades 1 - 11; students in professional educational institutions and educational institutions of higher education; adults working in certain professions and positions (employees of medical and educational organizations, transport, utilities); pregnant women; adults over 60; persons subject to conscription for military service; persons with chronic diseases, including those with lung diseases, cardiovascular diseases, metabolic disorders and obesity	Influenza vaccination

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

Vaccinations with a polysaccharide vaccine (pneumo23, meningococcal vaccine, etc.) should be started after 2 years of age, since the child's body does not respond by producing antibodies to these antigens. Conjugate vaccines (polysaccharide with protein) are recommended for younger children.

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Diagnostic reference book of the immunologist Polushkina Nadezhda Nikolaevna

Chapter 8 Other infections not included in the national immunization schedule

Hemophilia type B infection (HIB infection)

Hemophilia type B infection in children under 5 years of age causes meningitis, pneumonia, epilotitis, fasciitis. Carriage of the capsule form is often noted in children. HIB vaccination is carried out in more than 100 countries (Table 39). WHO recommends that all countries in the world introduce HIB vaccination into their national immunization schedules.

Table 39. HIB vaccines

Tetanus toxoid, which is included in the vaccine as a protein conjugate, does not create immunity and tetanus. Post-vaccination reaction

Minor, sometimes hyperemia and induration appear at the injection site. General reactions are rare.

Dysentery Sonne

Dysentery is an infectious disease caused by Sonne's Shigella with the phenomenon of damage to the distal colon, gastroenteritis and intoxication.

Currently, a vaccine has been developed for the prevention of Zonne's dysentery in children from the age of three and in adults (Table 40).

Table 40. Vaccine for the prevention of dysentery Sonne

Post-vaccination reaction

Reactions to the vaccine are rare and are manifested by pain at the injection site and low-grade fever.

Chickenpox and shingles

Chickenpox is caused by a virus from the herpesvirus group, characteristic symptom is a papulovesicular rash.

Chickenpox is an anthroponosis. The source of infection is a sick person, the infection is transmitted by airborne droplets. People of any age who do not have immunity to the pathogen get sick. The entrance gate for infection is the mucous membranes of the upper respiratory tract... The virus enters the bloodstream through the lymphatic pathways, the virus has a tropism to the skin, where the typical chickenpox element appears. Scars may remain on the skin. In severe forms, lesions are possible internal organs and the development of encephalitis.

Under the influence of various external influences, the virus can be located in the ganglia and become active in an adult in the form of shingles. In many countries, vaccination against chickenpox (Table 41) is included in the vaccination calendar (Japan, USA, Germany, etc.).

Table 41. Chickenpox vaccines

With the introduction of the vaccine in the first 3 days after contact, the effect occurs in 90% of cases. Post-vaccination reaction

The reaction to the vaccine is rare and manifests itself in the form of vesicular and macular rashes.

Contraindications

Same as other vaccines, plus leukopenia. In the latter case, it is recommended to take aspirin within 4 weeks after vaccination.

Rotavirus infection

Rotavirus infection - a viral infection with symptoms of gastroenteritis, high temperature, vomiting. Endemic outbreaks occur in the winter-autumn period in children, especially at an early age.

There are many serotypes of the virus. Recombination of genetic material was used to create vaccines (Table 42).

Table 42. Vaccines against rotavirus infection

Contraindications

Vaccination against rotavirus infection is contraindicated in the following categories of persons:

1) children with hypersensitivity to vaccine components;

2) children who have experienced a reaction to a previous vaccine administration;

3) children with gastrointestinal tract defects;

4) children with immunodeficiency.

A temporary contraindication is diseases of the gastrointestinal tract, accompanied by intestinal disorders.

Human papillomavirus infection

In the course of numerous studies, it has been established that the main cause of cancer of the cervix, vulva, vagina, precancerous dysplastic conditions, cervical neoplasia II and III degrees, genital warts is infection and further carriage of human papillomaviruses.

Human papillomavirus is now known to cause a number of cancer precursors. Human papillomaviruses are divided into 2 groups: high and low oncogenic risk.

A large number of types of the virus (18, 31, 33, etc.) are at high risk. They condition many oncological diseases female genital area. Low activity viruses in children and adults cause respiratory recurrent papillomatosis.

Papillomatous vaccines include Gardasil (Netherlands) and Cervarix (Belgium).

Gardasil vaccine

It is a vaccine against human papillomavirus (types 6, 11, 16, 18). It is produced in the form of a suspension for intramuscular injection... This is a sterile suspension prepared from a mixture of highly purified particles of the recombinant basic colloidal protein of the papilloma virus strains 6, 11, 16 and 18.

The active ingredients of the vaccine are immunogens (recombinant antigens), human papillomavirus protein in the ratios: type 6 - 20 µg, type 16–40 µg, type 18–20 µg. It also contains auxiliary substances - aluminum adjuvant, hydrogen phosphate sulfate, sodium chloride, L-histidine, polysorbate, sodium borate.

During immunization, specific antibodies to 4 types of papilloma virus are formed for a period of at least 36 months in all age groups.

The Gardasil vaccine is intended for vaccination of children and adolescents from 9 to 17 years old, young women aged 18 to 26 years to prevent following diseases:

- cancer of the cervix, vagina;

- genital warts.

The vaccine is also prescribed in the following cases:

- precancerous dysplastic conditions;

- adenoma of the cervix;

- cervical intraepithelial neoplasia;

- intraepithelial neoplasia of the vulva;

- vaginal intraepithelial neoplasia II, III degree;

- cervical intraepithelial neoplasia.

Application and route of administration

The vaccine is injected intramuscularly into the deltoid muscle or anterolateral thigh muscle. Vaccination schedule: "0-2 - 6" months.

The first dose is on the appointed day; the second - 2 months after the first; the third - 6 months after the first.

For the introduction of the vaccine, a single dose is used, the vaccine is injected with syringes with a single dose of the vaccine.

Post-vaccination reaction

A local reaction manifests itself as redness, swelling, soreness, and itching at the injection site. Lasts, as a rule, no more than 5 days.

Symptoms of a general reaction are headache, short-term increase in body temperature. Rarely are the phenomena of gastroenteritis, inflammation of the pelvic organs.

Due to the possibility of developing immediate reactions to the administration of the vaccine, the vaccinated person is monitored for 30 minutes after vaccination.

Contraindications

These include:

1) hypersensitivity to the active components of the vaccine;

2) allergic reactions for the introduction of a previous vaccination;

3) disorders of the blood coagulation system in hemophilia, thrombocytopenia.

The vaccination is compatible with other vaccinations in accordance with the current instructions.

Vaccine Cervarix (Belgium)

The vaccine is a suspension for intramuscular administration. 1 dose is 0.5 ml.

The vaccine contains the following components:

- L1 protein of human papillomavirus type 16 (HPV1621) - 20 μg;

- L1 protein of human papillomavirus type 18 (HHV-18L) - 20 μg;

- excipients: 3-0-deacyl-4-monophosphoryl lipid (50 μg), aluminum hydroxide (0.5 mg), sodium chloride (4.4 mg), sodium dihydrogen phosphate dihydrate (0.624 mg), water for injection (0, 5 ml).

The main properties of the vaccine

Since human papillomaviruses 16 and 18 are responsible for the occurrence of the cervical virus, vaccination with the Cervarix vaccine helps to reduce the incidence of human papillomavirus infection, as well as the occurrence of cervical infection, providing protection against the development of viral papillomavirus infection.

Vaccination provides cross-protection in 40% of those vaccinated against any manifestation of viral human papilloma.

Within 18 months after the introduction of the vaccine, antigens to HPV-16, HPV-18 are formed age group from 10 to 25 years old.

Indications for vaccination:

1) prevention of the cervix;

2) prevention of acute and chronic infections caused by the human papillomavirus.

Contraindications

1) hypersensitivity to any component of the drug;

2) reactions to the introduction of previous doses of the vaccine;

3) acute diseases and exacerbation of chronic diseases;

4) pregnancy and lactation.

Method of administration and dosage

The vaccine is injected intramuscularly into the deltoid muscle.

Before administration, shake the vial or syringe to obtain an opaque, off-white suspension.

If there are foreign particles in the vaccine, it must be destroyed.

A single dose for girls over 10 years old and women is 0.5 ml.

The vaccine is administered according to the "0-1 - 6 months" scheme.

Post-vaccination reactions

Most often, pain appears at the injection site. On the part of the nervous system, headache, dizziness are recorded.

Nausea, vomiting, abdominal pain, diarrhea may appear.

A rash, itching, urticaria appears on the skin. From the side of the musculoskeletal system, pain in muscles and joints is possible, muscle weakness may appear.

Of general reactions fever is noted.

Acute respiratory diseases

To reduce the incidence respiratory infections there are a large number of medicines.

These include preparations of the thymus (taktivin, etc.), vitamins, trace elements, homeopathic medicines (for example, anaferon, aflubin, etc.), funds vegetable origin (eleutherococcus, etc.) and stimulants (pentoxil, etc.).

There are also bacterial lysates (bacterial vaccines) consisting of refined microbial cells. These are drugs similar to vaccines. Their essence lies in the fact that they lead to stimulation of the immune response, an increase in the concentration of interferon gamma, form immunological memory, stimulate the production of cytokines, increase the production of JgA, lysozyme and suppress the production of JgE and antibodies of this class (Table 43).

All this helps to reduce the incidence of respiratory infections.

Table 43. Bacterial vaccines (lysates)

Contraindicationto the appointment of these drugs is hypersensitivity to their components. Post-vaccination reaction Reaction to the administration of lysates can manifest itself in the form of subfebrile temperature, the appearance of catarrhal phenomena (nasal congestion, cough). In some cases, rhinorrhea worsens.

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