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Screening of individuals for immunization
Last reviewed: 06.07.2025
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All persons who are to undergo preventive vaccinations are subject to a preliminary medical examination by a doctor (in rural areas - a paramedic). Before immunization, the doctor (paramedic) must carefully collect the patient's medical history in order to identify previous diseases, including chronic ones, the presence of reactions or complications to the previous administration of the drug, allergic reactions to drugs, foods, and identify individual characteristics of the body (prematurity, birth injury, convulsions). Clarify whether there are contacts with infectious patients, as well as the timing of previous vaccinations, for women - pregnancy.
Persons with chronic diseases, allergic conditions, etc., if necessary, undergo medical examination using laboratory and instrumental research methods.
Thermometry should be performed immediately before the prophylactic vaccination.
The results of the patient examination, thermometry, laboratory and instrumental studies, the specifics of the vaccination history, as well as permission to administer a specific vaccine with an indication of the type of vaccination or exemption from immunization for medical reasons must be recorded by the doctor (paramedic) in the relevant medical records.
Before vaccination, a conversation with the child's mother, thermometry and examination to exclude an acute condition are quite reliable screening. Calendar vaccines can be used without tests (urine, blood, etc.) and specialist consultations - subject to the indications and contraindications according to the instructions for the drug; a corresponding entry is made in the medical documentation.
The requirement for immunological testing before vaccinations, sometimes put forward in the media, is unfounded, since most parameters of the so-called immunological status do not indicate an increased risk of complications and cannot serve as a reason for refusing vaccinations. Screening for primary immunodeficiency would require more than 80 tests, often unreliable, and the dangers associated with taking blood with inevitable errors do not compare with the dangers that vaccination “threatens” without such screening.
Checking for the presence of specific antibodies before vaccination, indicated, for example, for individuals with an unknown vaccination history in SP 3.1.2 1108-2, makes sense only for individuals at risk for vaccination complications. In other cases, this measure is not justified, including from a deontological standpoint: maternal antibodies may still circulate in infants, and administering the vaccine to an immune child does not cause any harm. In addition, revaccination (for example, to diphtheria) is also indicated for individuals who have antibodies, and our knowledge of protective titers is incomplete. Individuals who have had mumps, measles or rubella should not, in principle, be vaccinated against these infections; however, if the fact of having had measles or mumps can be reliably established, there are always doubts regarding rubella due to its similarity to other exanthemas (ECHO, sudden exanthema, etc.).
[ Vaccinations on a paid basis
Scheduled vaccinations in Russia are carried out with vaccines purchased at the expense of federal funds, but this does not exclude the possibility of using alternative vaccines on a paid basis that have additional advantages - acellular, combined, vaccines against infections not included in the Calendar. Commercial Vaccine Prevention Centers satisfy the need for paid vaccinations, although taxes, rent, etc. increase their cost by 2-3 times.
Vaccinations are cheaper if the vaccine purchased by parents is administered in the vaccination room with a prescription. With this form of work, it is possible to carry out a significant number of vaccinations against influenza, Hib infection, hepatitis A, the acellular vaccine Infanrix, and the trivaccine at the expense of the population. Unfortunately, not all health departments have yet understood the importance of this approach and do not implement it (and sometimes hinder it).