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Selection of persons for vaccination
Last reviewed: 23.04.2024
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All persons to whom preventive vaccinations should be subjected are first subjected to a medical examination by a doctor (in rural areas - by a medical assistant). Before the immunization, the doctor (paramedic) should carefully collect anamnesis in the patient in order to identify previous diseases, including chronic ones, the presence of reactions or complications for the previous administration of the drug, allergic reactions to medications, products, to reveal the individual characteristics of the organism (prematurity, birth trauma, convulsions). Clarify whether there are contacts with infectious patients, as well as the terms of previous vaccinations, for women - the presence of pregnancy.
Persons with chronic diseases, allergic conditions, etc., if necessary, undergo medical examination using laboratory and instrumental methods of investigation.
Immediately before the prophylactic vaccination, a thermometry should be carried out.
The results of the examination of the patient, thermometry, laboratory and instrumental studies, peculiarities of vaccination history, as well as permission for the introduction of a specific vaccine indicating the type of vaccination or withdrawal from immunization for medical reasons should be recorded by the physician (paramedic) in the relevant medical records.
Before the vaccination, a conversation with the mother of the child, thermometry and examination to exclude the acute condition is a completely reliable screening. Vaccines of the Calendar can be used without conducting tests (urine, blood, etc.) and consultations of specialists - if the indications and contraindications are observed according to the instructions to the drug; a record is made in the medical records.
The requirement to conduct immunological examination before vaccinations, sometimes put forward in the mass media, is groundless, since most parameters of the so-called immunological status do not indicate an increased risk of complications and can not serve as an excuse for withdrawing from vaccinations. Screening for primary immunodeficiency would require more than 80 tests, often unreliable, and the risks associated with taking blood with unavoidable mistakes, do not go to any comparison with the dangers that "threaten" vaccination without such screening.
The verification of the presence of specific antibodies before vaccination, indicated, for example, for persons with unknown vaccination history in JV 3.1.2 1108-2, makes sense only to persons at risk for vaccination complications. In other cases this measure is not justified, incl. And from deontological positions: in infants, maternal antibodies can still circulate, and the introduction of a vaccine to an immune child does not do any harm. In addition, revaccination (for example, to diphtheria) is shown to people with antibodies, and our knowledge of protective titles is incomplete. Persons who have had parotitis, measles or rubella, in principle, should not be vaccinated against these infections; However, if the fact of transferred measles or mumps can be established reliably, there are always doubts regarding rubella due to its similarity with other exanthems (ECHO, sudden exanthema, etc.).
[Vaccinations on a fee basis
Calendar vaccinations in Russia are carried out with vaccines purchased from federal funds, but this does not exclude the possibility of using on a paid basis alternative vaccines with additional merits - cell-free, combined, vaccines against infections not included in the Calendar. Commercial Vaccine Prevention Centers meet the need for paid vaccinations, although taxes, rent, etc. Are 2-3 times more expensive for their cost.
Reduces the cost of vaccines introduction in the vaccination room bought by parents on a prescription vaccine. With this form of work, it is possible at the expense of the population to conduct a significant number of vaccinations against influenza, Hib infection, hepatitis A, Acellular vaccine Infanriks, trivaccine. Unfortunately, not all health professionals have understood the importance of this approach and do not implement it (and sometimes hinder it).