Calendar of preventive vaccinations

The national calendar of preventive vaccinations, adopted in Russia in 2002, provided protection against 9 controlled infections. It contained a provision on the simultaneous introduction of all vaccines laid down by the child in different parts of the body, based both on immunological data and on the data on the absence of an increase in the incidence of adverse reactions and complications. However, in order to avoid accidental contamination of syringes and needles, BCG is administered before or after other vaccines in a separate room.

This document did not specify the vaccines introduced at any given time, but the infections against which the vaccination is carried out. This opened the possibility of using in the National calendar of preventive vaccinations of the whole range of vaccines of domestic and foreign production registered and approved for use in Russia in accordance with the established procedure in accordance with the instructions for their use. All vaccines of the Calendar are interchangeable, incl. DTP and AaDS, but when using acellular pertussis vaccines (AaDS) it is desirable to use drugs with the same components.

During the period 2006-2007, In the framework of the National Project, additional vaccinations were launched against influenza, hepatitis B and rubella, which led to a reduction in the incidence of these infections.

By Order No. 673 of October 30, 2007, the National Immunoprophylaxis Calendar, adopted in Russia in 2002, was amended and amended in force since 2008.

The inclusion of vaccinations against measles, rubella and hepatitis in the Russian national calendar - actually "catch-up" - is an extremely important measure that helps eliminate the first 2 infections and a sharp decrease in the transmission of hepatitis B. The effectiveness of these measures is shown in the relevant sections, besides, they bring together the structure of our Calendar with the immunization schedules of the developed countries, where the "erasures" are indicated. In order to prevent vaccine-associated poliomyelitis (VAP), infants in Russia are vaccinated only with IPV, as many developed countries have done. This measure is also important for the future - after the end of poliomyelitis eradication in the world, it is easiest to stop vaccination with IPV, which does not threaten outbreaks of poliomyelitis caused by vaccine viruses-revertants.

In many (but not all) developed countries, vaccinations against pertussis, diphtheria, tetanus and poliomyelitis start at the age of 2 rather than 3 months in order to complete the initial series of vaccinations earlier (taking into account the higher incidence of children, starting from the age of six months).

Calendar of preventive vaccinations in Russia, 2008.

Age	Name of vaccination
Newborns (in the first 24 hours)	1st vaccination against hepatitis B
Newborns (3-7 days)	Vaccination against tuberculosis (BCG-M or BCG)
Children: 1 month	2nd vaccination against hepatitis B (children at risk)
2 month	The third vaccination against hepatitis B (children at risk)
3 months	2nd vaccination against viral hepatitis B, the first vaccination against diphtheria, whooping cough, tetanus, poliomyelitis
4,5 months	2nd vaccination of diphtheria, pertussis, tetanus, poliomyelitis
6 months	3rd vaccination of viral hepatitis B against diphtheria, pertussis, tetanus, poliomyelitis
12 months	4th vaccination against hepatitis B virus (children at risk), vaccination against measles, rubella, mumps
18 months	5th revaccination against diphtheria, pertussis, tetanus, 1st revaccination against poliomyelitis
20 months	2nd revaccination against poliomyelitis
6 years	Revaccination against measles, rubella, mumps
6-7 years	2nd revaccination against diphtheria, tetanus
7 years	Revaccination against tuberculosis (BCG)
14 years	3rd revaccination against diphtheria, tetanus, poliomyelitis, revaccination against tuberculosis (BCG)
Adults	Revaccination against diphtheria, tetanus - every 10 years

Children from 1 to 17 years old, adults from 18 to 55 years old, not vaccinated earlier	Against hepatitis B
Children from 1 to 17 years, girls from 18 to 25 years old, not sick, not vaccinated, vaccinated once against rubella	Against rubella
Children attending pre-school institutions; students of grades 1-11; students of higher and secondary vocational schools; adults working for certain professions and positions (medical and educational institutions, transport, communal sphere, etc.); adults over 60 years	Against the flu
Adolescents and adults under the age of 35 who are not ill, are not vaccinated and do not have information about measles vaccinations; contact persons from foci of the disease, who have not been sick, not vaccinated, and who have no information about measles vaccinations - no age limit	Against measles

Vaccination against hepatitis B is carried out by all newborns in the first 24 hours of life, incl. Children at risk: newborns from mothers with HBsAg carriers who are ill or have had hepatitis B in the third trimester of pregnancy who do not have HBsAg results from the drug risk group; from families where there is a carrier of HBsAg, a patient with acute hepatitis B or chronic viral hepatitis (hereinafter - at-risk groups).

Vaccination against hepatitis B in newborns and all children not belonging to risk groups is carried out according to the scheme 0-3-6 (1 dose - at the time of vaccination, 2 dose - after 3 months, 3 dose - 6 months after the 1st vaccination ).

Revaccination against hepatitis B in newborns and children from risk groups is carried out according to the scheme 0-1-2-12 (1st dose - in the first 24 hours of life, 2-ya at the age of 1 month, 3-ya at the age of 2 months, 4 th dose - at the age of 12 months)

Revaccination against tuberculosis is carried out by non-infected tuberculosis mycobacteria tuberculin-negative children at 7 and 14 years of age.

In subjects of the Russian Federation with incidence rates of tuberculosis below 40 per 100 thousand population, revaccination against tuberculosis at 14 years is performed by tuberculin-negative children who were not vaccinated at age 7.

Notes:

1. Preventive vaccination vaccines (except BCG, BCG-M) used during the National Calendar can be administered at intervals of 1 month or simultaneously with different syringes in different parts of the body.
2. In case of violation of the vaccination start date, they are carried out according to the schemes stipulated by the National Calendar of preventive vaccinations, and in accordance with the instructions for the use of drugs. Passing one inoculation from a series (hepatitis B, DTP, or polio) does not entail the repetition of the entire series, it continues as if the necessary interval had been maintained. Immunization of children born from HIV-infected mothers is carried out within the National calendar of preventive vaccinations (according to the individual vaccination schedule) and in accordance with the instructions for the use of vaccines and toxoids.
3. Immunization of children born from HIV-infected mothers is carried out taking into account the following factors: the type of vaccine (live, inactivated), the presence of immunodeficiency, taking into account the child's age, concomitant diseases.
4. All inactivated vaccines (including toxoids), recombinant vaccines are administered to children born to HIV-infected mothers, including HIV-infected children, regardless of the stage of the disease and the number of CD4 + lymphocytes.
5. Live vaccines are administered to children with an established diagnosis of "HIV infection" after an immunological examination to exclude immunodeficiency. In the absence of immunodeficiency, live vaccines are administered in accordance with the National Calendar of preventive vaccinations. In the presence of immunodeficiency, the introduction of live vaccines is contraindicated. 6. Six months after the initial introduction of live measles, mumps, rubella vaccines, HIV-infected patients are assessed for the level of specific antibodies and, if they are not present, a repeat dose of the vaccine with a preliminary laboratory control of the immune status is administered.

[1], [2], [3]

Vaccination in cases of violation of the calendar

Regardless of the start of vaccination, it is carried out at intervals indicated in the Calendar. As indicated above, skipping one vaccine from a series does not entail repeating the entire series. Delays with the primary series not only increases the risk of infection of the child at the most dangerous age, but also the development of adverse events, as in the second half of the year the overall incidence increases.

Orders of the Ministry of Health of the Russian Federation directly indicate that if the calendar is violated, simultaneous carrying out of all necessary vaccinations is allowed. For subsequent vaccinations, the minimum interval is 1 month (instead of 1.5 months, indicated for vaccinations, conducted in a timely manner).

For children (including refugees) whose vaccinal status is not known, vaccination against all infections is carried out according to the plan below:

1. Children of the first year of life are vaccinated according to the vaccination calendar.
2. Children from 1 year to 6 years receive three times with an interval of 30 days OPV (or IPV) + DTP (up to 3 years) or ADS (4-6 years - twice) + live viral vaccines (for example, first, rubella - with the second graft). Revaccination is performed 1 year after the first dose. The hepatitis B vaccine can be administered with the 1st and 2nd doses of DTP (better Bubo-Kok) and the 3rd dose at 6 months. After the first.
3. Children 7-14 years are vaccinated with a single OPV (or IPV), HCV + HPV and ADS-M (one-time) and after 30 days - rubella vaccine and ADS-M. Vaccinations against hepatitis B within the time frame as in the previous paragraph should be vaccinated with vaccine Bu-bo-M.
4. Adults are inoculated once with ADS-M.
5. The need for BCG is determined by the presence of a vaccine scab and r. Mantoux. When parenteral use of vaccines in one day they are injected with separate syringes into different parts of the body. To avoid contamination, one day BCG combination with other parenteral manipulations is not allowed; BCG should be administered the day before or the day after the introduction of other vaccines.

Schedule of preventive vaccinations according to epidemic indications

This calendar has not changed since 2002, in Table. 1.2 it is presented with amendments, as a number of its positions are reflected in the new National Calendar.

Calendar of preventive vaccinations according to epidemiological indications (with correction)
 

Population contingents subject to vaccination	Vaccinations against:	Vaccination	Revaccination
"The population in the enzootic territories, as well as those arriving in these territories who perform the following works: - agricultural, irrigation and drainage, construction, other work on excavating and moving soil, harvesting, fishing, geological, prospecting, expedition, deratization and disinsection work; - logging, clearing and improvement of the forest, recreation and recreation areas of the population. Persons working with live cultures of the pathogen of tularemia.	Tularemia	From the age of 7 (from age 14 in foci of the field type)	Every 5 years
The population residing in the enzootic territories of the plague. Persons working with live cultures of the causative agent of the plague.	The plague	From 2 years	After 1 year
Persons performing the following works: - farms that are enzootic for brucellosis - livestock keepers, veterinary workers, zootechnicians; - slaughter of livestock, brucellosis patient, harvesting and processing of meat and meat products obtained from it Livestock breeders, veterinarians, zootechnicians in farms, Enzootic in brucellosis. Persons working with live cultures of the causative agent of brucellosis.	Brucellosis (goat-sheep type)	From 18 years old	After 1 year
Persons performing the following work on the enzootic territories: - agricultural, irrigation and drainage, construction, excavation and transfer of soil, harvesting, fishing, geological, prospecting, expeditionary; - for harvesting, storage and processing of agricultural products; - slaughter of livestock, anthrax patient, harvesting and processing of meat and meat products obtained from it; Persons working with cultures of the causative agent of anthrax	Anthrax	From the age of 14	After 1 year
Persons performing work on catching and keeping unaccompanied Animals. Veterinarians, hunters, foresters, slaughter workers, taxidermists. Persons working with a "street" rabies virus.	Rabies	From the age of 16	After 1 g every 3 years
Persons performing the following works: - for the procurement, storage, processing of raw materials and livestock products from farms on enzootic sites on leptospirosis; - slaughter of livestock, a patient with leptospirosis, harvesting and processing of meat products obtained from it; - by catching and keeping neglected animals. . Persons working with live cultures of the causative agent of leptospirosis.	Leptospirosis	From the age of 7	After 1 year
Persons performing work on the procurement, storage, processing of raw materials and livestock products obtained from farms where cattle diseases are recorded with Ku fever; Persons performing work on harvesting and processing of agricultural products in the enzootic territories for the fever of Ku; Persons working with live cultures of causative agents of fever Ku	K fever	From the age of 14	After 1 year

Population to be vaccinated	Vaccinations against:	Vaccination	Revaccination
The population living in enzootic territories for tick-borne encephalitis, as well as persons arriving on this territory who perform the following works: - agricultural, irrigation and drainage, construction, ground, harvesting, fishing, geological, prospecting, deratization and disinsection; - logging, clearing and improvement of the forest, recreation and recreation areas of the population. Persons working with live tick-borne encephalitis virus	Tick-borne encephalitis	From the age of 4	After 1 year, then every 3 years
Persons going to endemic areas for yellow fever Persons working with live cultures of yellow fever	Yellow fever	From 9 months	After 10 years
Population living in areas with a high incidence of typhoid fever; Population living in territories with chronic aquatic epidemics of typhoid fever; Persons engaged in the maintenance of sewerage facilities, equipment, networks. Departing to hyperendemic regions and countries, as well as contingents in the outbreaks of epidemics; Persons working with live cultures of S. Typhi pathogens	Typhoid fever	From age 3, depending on the type of vaccine	3 years later
Children older than 2 years of age, adolescents, adults in the outbreaks of meningococcal infection caused by meningococcal serogroups A or C. Individuals at increased risk of infection (children from the DDU, students in grade 1-2, adolescents from organized groups, united in dormitories, children from family hostels in dysfunctional sanitary and hygienic conditions) with an increase in the incidence of 2 times compared with the previous year	Meningococcal infection	From 1 year	3 years later
Children in areas with a high incidence of hepatitis A. Medical workers, educators and personnel of the DDU. Employees of the service sector, primarily employed in catering organizations. Workers on maintenance of sewerage facilities, equipment and networks. Departing to hyperendemic regions and countries, as well as contact by epidemics.	Viral hepatitis A	From the age of 3
Persons suffering from chronic physical illness, often ill with ARI, children of preschool age	Influenza	From 6 months.	Annually
Contact in foci of mumps, not vaccinated and not affected	Epidaparotite	From 1 year
Contact in foci of diphtheria, previously ungrafted	Diphtheria	From 3 months.
Persons traveling to unfavorable countries according to the cholera (in agreement with the Department of the State Sanitary and Epidemiological Supervision of the Ministry of Health of Russia). The population of the border regions of Russia in the event of an unfavorable epidemic situation in the adjacent territory (according to the decision of the Russian Consumer Protection Agency)	Cholera	From 2 years old	In 6 months

Notes:

1. Vaccinations within the calendar of preventive vaccinations for epidemic indications are conducted by vaccines of domestic and foreign production, registered and disconnected to the application in accordance with the established procedure in accordance with the instructions for their use.
2. Inactivated vaccines (other than anti-rabies vaccines) used within the Calendar of preventive vaccinations for epidemic indications and inactivated vaccines of the National Schedule of preventive vaccinations can be administered simultaneously by different syringes to different parts of the body.

Additional vaccination

Improving immunization should include expanding the range of mass vaccinations by all licensed vaccines in Russia, which requires the publication of a consolidated set of vaccine recommendations (in addition to those included in the National Calendar and Schedule of Inoculations for epidemiological indications) shown to all children on the basis of alternative financing schemes. Such vaccines are introduced annually to tens of thousands of children, although official instructions on their use (feasibility, age, patterns of administration) are often absent. Of course, some information is in the instructions for the use of vaccines, there are recommendations of individual researchers and their groups, which we give below, but this is not enough in such a sensitive area as immunization is.