National vaccination calendar. Vaccination calendar

Order of the Ministry of Health of the Russian Federation dated March 21, 2014 No. 252n

“On approval of the national calendar of preventive vaccinations and the calendar of preventive vaccinations for epidemic indications «

“National calendar of preventive vaccinations”

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1. Vaccination is also carried out to contact persons without age restrictions from foci of the disease who have not previously been ill, have not been vaccinated and do not have information about preventive vaccinations against measles or have been vaccinated once; adults from 36 to 55 years old, belonging to risk groups (employees of medical and educational organizations, trade, transport, public utilities and social spheres; persons working on a rotational basis and employees of state control bodies at checkpoints across the state border of the Russian Federation) who have not been sick, not previously vaccinated, vaccinated once, with no information about measles vaccinations.
2. Adults working in certain professions and positions (workers of medical and educational organizations, transport, public utilities); pregnant women, persons subject to conscription for military service; persons with chronic diseases, including lung diseases, cardiovascular diseases, metabolic disorders and obesity.
3. Infection prevention is included in the calendar for epidemic indications for risk groups.
4. Adults from risk groups, including those subject to military service.
5. Persons living in regions disadvantaged by the incidence of hepatitis A, as well as persons at occupational risk of infection (medical workers, public service workers employed in food industry enterprises, as well as those servicing water supply and sewerage facilities, equipment and networks).
   Persons traveling to disadvantaged countries (regions) where outbreaks of hepatitis A are registered.
   Contact persons in hepatitis A outbreaks.
6. In areas of meningococcal infection caused by meningococci of serogroups A or C. Vaccination is carried out in endemic regions, as well as in the event of an epidemic caused by meningococci of serogroups A or C.
   Persons subject to conscription for military service.
7. For preventive purposes, people who have a high risk of contracting rabies are vaccinated: people working with the “street” rabies virus, veterinarians, rangers, hunters, foresters, people performing work on catching and keeping animals.
8. In foci of goat-sheep type brucellosis, persons performing the following work: procurement, storage, processing of raw materials and livestock products obtained from farms where livestock diseases with brucellosis are registered; for the slaughter of livestock suffering from brucellosis, the procurement and processing of meat and meat products obtained from it; livestock breeders, veterinarians, livestock specialists in farms enzootic for brucellosis; persons working with live cultures of the causative agent of brucellosis.
9. Persons engaged in the field of municipal improvement (workers servicing sewer networks, structures and equipment, as well as organizations carrying out sanitary cleaning of populated areas, collection, transportation and disposal of household waste).
   Persons working with live cultures of typhoid pathogens. Population living in areas with chronic water epidemics of typhoid fever. Persons traveling to countries (regions) hyperendemic for typhoid fever.
   Contact persons in areas of typhoid fever for epidemic indications. According to epidemic indications, vaccinations are carried out when there is a threat of an epidemic or outbreak (natural disasters, major accidents in the water supply and sewerage networks), as well as during an epidemic, while mass vaccination of the population is carried out in the threatened region.
10. People at risk, including those subject to military service, who have not previously been vaccinated and have not had chickenpox.
11. Persons traveling outside the Russian Federation to countries (regions) enzootic for yellow fever. Persons working with live cultures of the yellow fever pathogen.
12. Persons living in areas where tick-borne viral encephalitis is endemic; persons traveling to areas endemic for tick-borne viral encephalitis, as well as persons arriving in these territories performing the following work: agricultural, irrigation, construction, excavation and movement of soil, procurement, fishing, geological, survey, expedition, deratization and disinfestation; for logging, clearing and landscaping of forests, health and recreation areas for the population. Persons working with live cultures of tick-borne encephalitis.
13. Persons performing the following work: procurement, storage, processing of raw materials and livestock products obtained from farms located in areas enzootic for leptospirosis; for the slaughter of livestock with leptospirosis, procurement and processing of meat and meat products obtained from animals with leptospirosis; on catching and keeping stray animals.
    Persons working with live cultures of the causative agent of leptospirosis.
14. Persons performing work on the procurement, storage, processing of raw materials and livestock products obtained from farms where Q fever diseases are registered.
    Persons performing work on the procurement, storage and processing of agricultural products in enzootic areas with Q fever.
    Persons working with live cultures of Q fever pathogens.
15. Contact persons in foci of polio, persons working with live poliovirus, with materials infected (potentially infected) with wild poliovirus, without age restrictions.
16. Persons performing the following work: livestock workers and other persons professionally engaged in pre-slaughter livestock maintenance, as well as slaughter, skinning and cutting of carcasses; collection, storage, transportation and primary processing of raw materials of animal origin; agricultural, drainage, construction, excavation and movement of soil, procurement, fishing, geological, survey, expedition in anthrax-enzootic territories.
    Persons working with material suspected of being infected with anthrax.
17. Persons living in territories enzootic for tularemia, as well as persons arriving in these territories performing the following work: agricultural, drainage, construction, other work on excavation and movement of soil, procurement, fishing, geological, survey, expedition, deratization and disinfestation; for logging, clearing and landscaping of forests, health and recreation areas for the population.
    Persons working with live cultures of the causative agent of tularemia.
18. Persons traveling to countries (regions) affected by cholera. Population of the constituent entities of the Russian Federation in the event of complications in the sanitary and epidemiological situation regarding cholera in neighboring countries, as well as on the territory of the Russian Federation.
19. Persons living in areas enzootic for plague. Persons working with live cultures of the plague pathogen.
20. Employees of medical organizations (their structural divisions) with an infectious disease profile. Persons engaged in the field of public catering and municipal improvement.
    According to epidemic indications, vaccinations are carried out when there is a threat of an epidemic or outbreak (natural disasters, major accidents in the water supply and sewerage networks), as well as during an epidemic, while mass vaccination of the population is carried out in the threatened region. Preventive vaccinations are preferably carried out before the seasonal increase in the incidence of shigellosis.
    Preventive vaccinations are preferably carried out before the seasonal increase in the incidence of shigellosis.
21. Contact persons from the outbreaks of the disease who have not been sick, have not been vaccinated and do not have information about preventive vaccinations against mumps.

In any country, the Ministry of Health has approved its own vaccination schedule for the population. The national vaccination calendar in Russia was finalized in 2014 and includes mandatory vaccinations for the population of any age. Minor changes have been made to the document. The regional Ministry of Health is developing the approved calendar to suit its own needs. This is due to the epidemiological characteristics of each region and material capabilities. Let's look at what vaccines our vaccination schedule includes.

Changes and innovations

At the end of 2014, Russia adopted the newest national calendar of preventive vaccinations. Changes have been made to it:

• Babies from 2 months of age will receive a preventive vaccination against pneumococcal infection. The injection will be given twice.
• Flu vaccinations are required for pregnant women. Previously, pregnant women were not vaccinated against seasonal viruses.
• Before a preventive vaccination, the doctor must conduct an informational conversation and explain to the patient why this or that vaccination is needed. If the patient writes a refusal, then he must be informed what consequences await him after infection. Previously, the doctor did not concentrate his attention and did not explain to the patient what complications may arise after vaccination and what the contraindications are.
• According to the principles of the Public Health Law, consent and refusal of preventive vaccination must be documented. Consent or refusal for minors is signed by their parents or guardians.
• Before any vaccination, the patient should receive a full medical examination. Previously, they simply asked the patient if there were any complaints; today the doctor is obliged to listen to the patient, examine the skin, nasopharyngeal mucosa, and listen to breathing.
• Medical workers in educational institutions are required to warn parents 6–7 days before vaccinating their children. Parents now have time to prepare their baby.

If one of the conditions before the preventive vaccination was not met, the doctor’s actions are considered illegal.

In small provinces, the transition to new rules is difficult. Doctors are used to working differently and do not always talk to the patient. On the other hand, a doctor can spend no more than 7 minutes examining 1 patient on a first-come, first-served basis. What can you tell us during this time? And there is no need to talk about quality inspection once again.

What vaccinations are included in the calendar

The new vaccination schedule includes vaccinations against diseases: Hepatitis B, Pneumococcal infection, Measles, Diphtheria, Whooping cough, Tetanus, Poliomyelitis, Haemophilus influenzae, Rubella.

Vaccinations are the infection of the body in a weak form, artificially obtained, dead or living bacteria or viruses. It takes place once or in several injections, at a certain interval.

So, Hepatitis B is vaccinated according to two schemes. The first is prescribed to children from the normal group (0/1/6), the second with a high risk of infection (0/1/2/12).

Revaccination is the support of the immunity that developed after the first vaccination.

Let's consider the stages of vaccination and revaccination according to the national calendar in the form of a table:

The population from 18 to 35 years old is also vaccinated against Measles. The interval between injections is maximum 2 months. The group includes those who have not been previously vaccinated or have not been vaccinated again. This also includes people at risk.

The vaccination schedule includes a flu vaccine. It is mandatory for pregnant women, school students, children in kindergartens, and the working part of the population in the public service. Private entrepreneurs can purchase the vaccine separately for their employees.

The calendar includes additional vaccinations, which are prescribed in regions with low epidemic rates, for people with professional activities at risk. These include: herpes zoster, tick-borne encephalitis. But anyone who wants can get these vaccinations at a clinic at their place of residence. But, it is worth understanding that in order to develop immunity to tick-borne encephalitis, you need to be vaccinated with three injections. The disease becomes active from April to July. All three injections must be given before the beginning of summer. The interval between them is no more than 1 month. More details in the video:

Some important vaccines are approved for use in Russia, but are not included in the national vaccination calendar. Nevertheless, they can be used to vaccinate a child either privately or for a fee in public clinics. Let's figure out what we're talking about.

Rotavirus: RotaTek vaccine (serotypes G1P, G2P, G3P, G4P and G9P)

Why get vaccinated?

Rotavirus, also known as the disease, is not only unpleasant (fever, vomiting, diarrhea, and aches usually affect all family members at the same time), but for infants under one year of age it is also deadly, since it is accompanied by a high risk of dehydration. At the same time, almost every child under the age of five goes through this virus - even if you don’t catch it on vacation, it is a frequent guest in children’s groups. Although the vaccine does not provide complete protection against the virus, it does protect against the worst consequence, severe rotavirus gastroenteritis, for at least two years (that is, at the most vulnerable age).

What is the degree of protection?

WHO notes 80-90% vaccine effectiveness against severe rotavirus gastroenteritis (RVGE)

When to do it?

Three doses of the vaccine are administered, the first from 6 weeks of life. The minimum interval between vaccinations is 4 weeks. It is important to keep in mind that this vaccine has a strict maximum age limit - the third dose is administered no later than 36 weeks.

Meningococcus

Vaccines are divided into two large groups:

Polysaccharide (meningococcal group A vaccine dry polysaccharide, polysaccharide meningococcal vaccine A+C, Meningo A+C, Mencevax ACWY)

Conjugated (“Menugate” (against ACWY serotypes) and “Menactra” (against ACWY serotypes)

Why get vaccinated?

Meningococcal is one of the most dangerous; it is a bacterial infection that within a matter of hours leads to damage to the lining of the brain and is often fatal. The difficulty is that there are quite a few serogroups of this infection and the likelihood of encountering one of them greatly depends on the region. But now there are vaccines that protect simultaneously against 4 serogroups, among them A and C, the most common in Russia. Conjugate vaccines are believed to produce a more robust immune response than conventional polysaccharide vaccines.

What is the degree of protection?

Various studies show an effectiveness of 85-90%, and in children it is even higher.

When to do it?

• Domestic vaccines - meningococcal A, A+C - are used from 18 months. These drugs can also be administered to children under 18 months of age if there is a family member with the disease, but this vaccination must be repeated after 18 months.
• Polysaccharide vaccines “Meningo A+C” and “Mencevax ACWY” are administered to children from 2 years of age
• Menactra can be used from 9 months (in this case it is prescribed twice with an interval of at least 3 months), or after 2 years it is given once.

Chickenpox: Varilrix vaccine (OKA strain)

Why get vaccinated?

One of the most contagious and common “childhood” diseases. While in some children it proceeds easily, others suffer from painful ulcers on all surfaces, including mucous membranes, or they rip off the sores, leaving scars. And it is important that the virus causes not only ordinary chickenpox rashes, but can later manifest itself in adulthood in the form of a dangerous shingles.

What is the degree of protection?

78% after the first dose of the vaccine and 99% after the second.

When to do it?

• Emergency vaccination is possible - you can vaccinate a child within 72-96 hours after contact with an infectious patient.
• Scheduled vaccination is possible from 12 months. More recently, the instructions for the drug provided for a single use, but now they still recommend two doses with an interval of 6-10 weeks

Tick-borne encephalitis

Vaccines Klesh-E-Vac (Sofin strain) EnceVir Neo (Far Eastern strain) FSME-Immun Junior (Neidorfl strain) Encepur (K23 strain)

It doesn’t matter which strain is used in the vaccine; it has been proven effective against others

Why get vaccinated?

On the one hand, tick-borne encephalitis is a terrible disease that is often found in our country (for example, in 2017, almost two thousand people were infected with tick-borne encephalitis, 201 of them children). Almost always, the disease leads to severe damage to the central nervous system, and never goes away without leaving a trace.

On the other hand, infected ticks do not live throughout Russia. For this reason, this vaccine is not included in the national calendar. Instead, vaccination may be provided in a specific region. Also, many parents are confused by the fact that this vaccination is not considered the easiest - even in adults, the encephalitis vaccine sometimes causes headaches and muscle aches.

What is the degree of protection?

When to do it?

The EnceVir Neo vaccine can be used from 3 years of age, and Klesh-E-Vac, FSME Junior and Encepur from 1 year of age. In any case, vaccination will have to be started in advance before the start of the dangerous season (ideally in winter) and repeated several times. The second injection is given 1 month after the first and it is important to have time to do it 2 weeks before warming or leaving for an unfavorable territory (domestic vaccines allow a period of 3 months, instead of one, and imported ones - 7 months). And then the vaccination will need to be repeated after 12 months (9 for imported vaccines) and then every three years.

Human papillomavirus: vaccines Gardasil (HPV 16, 18, 6, 11) Cervarix (HPV 16 and 18)

Why get vaccinated?

Cervical cancer, which is caused by, is one of the four most common types of female cancer. In general, the incidence of cervical cancer in Russia is high and continues to grow. Treating cancer is difficult and expensive, they have not yet learned how to treat the virus itself, the only thing used in the world for protection is vaccination. While vaccines do not protect against all possible strains of the virus, even this is enough to combat 70% of cervical cancer cases.
There are especially many rumors and speculations around this vaccine, but it is included in the vaccination calendar in 74 countries, in some for more than 10 years, and so far the experience of its use is assessed as positive. Plus, one of the vaccines helps fight the types of HPV that cause anogenital warts (aka condylomas)

What is the degree of protection?

Protective antibodies are detected in 99% of vaccinated people. But there is no data yet on the real impact on the incidence of cervical cancer, since decades pass between infection and the development of the disease, with the forecast being a reduction of 63%.

When to do it?

From 9 years old with the Gardasil vaccine and from 10 years old with the Cervarix vaccine
The vaccination is done twice according to the schedule of 0-6 months (three times if the age at which vaccination starts is above 15 years)

Hepatitis A

Vaccines “Avaxim 80” (strain GMB), “Vakta” ​​(strain CR 326F), “GEP-A-in-VAK” (strain LBA-86), “Havrix 720” (strain HM 175)

Why get vaccinated?

“Everyone needs to be vaccinated against jaundice, from an elephant to a fly / Get vaccinated against jaundice” - although the poem from the cartoon about the Hippopotamus, who was afraid of vaccinations, is not entirely consistent with our national vaccination calendar, there is a grain of truth in it.

Hepatitis A (also known as Botkin's disease) is rarely fatal. However, recovery takes a long time, and the list of possible complications includes acute liver failure. Since this virus is transmitted through water and food, it is quite easy to encounter it, including in children's institutions and even more so when traveling to countries unaffected by hepatitis A.

What is the degree of protection?

90-95% after the first dose and 95-100% after the second (the second dose also extends the effect of the vaccine to 6-10 years)

When to do it?

Vaqta - from 2 years, revaccination after 6-18 months

Havrix 720 - from 12 months, revaccination after 6-18 months

Hep-A-in-VAK - from 3 years, revaccination after 6-12 months

Avaxim-80 - from 12 months, revaccination after 6-36 months

Tularemia: Live tularemia vaccine

Why get vaccinated?

Tularemia is an extremely unpleasant disease that rodents carry (it is even sometimes called the “lesser plague”). However, vaccination only makes sense for those who are at risk (live in rural areas and are associated with agriculture, or live near a disease outbreak). In general, several hundred cases of illness are registered annually

When to do it?

Vaccination is the main preventive measure to prevent infectious diseases. The procedure is carried out to strengthen the body’s natural resistance and prevent complications after a possible infection. In the Russian Federation, there is an official document - “Vaccination Calendar for Children”, which provides information on the types of vaccinations and timing. Vaccination is provided free of charge to all Russian citizens according to the compulsory health insurance policy.

All vaccinations in the preventive vaccination calendar for children are, although planned, only recommended. Parents have the right to refuse vaccination by confirming their refusal in writing.. In this case, the responsibility for the possible infection of children lies entirely with the parents.

The refusal is provided for in clause 4 of the Federal Law “On Immunoprophylaxis of Infectious Diseases” dated September 17, 1998 No. 157-FZ.

What are the consequences of refusal? Children who are not immunized are more susceptible to illness. Those who have not been vaccinated are more likely to experience complications than those who have been immunized.

There are administrative restrictions:

• a ban on travel to countries where stay requires certain preventive vaccinations due to the epidemiological situation;
• temporary refusal of admission to educational institutions in the event of a threat of epidemic or mass infection (in the absence of vaccinations against the very disease that provokes the epidemic).

Vaccination according to epidemic indications

In addition to the main planned vaccination activities, there is an additional list of preventive measures based on epidemic indicators.

Additionally, vaccination is carried out among the population who live in areas with an increased risk of epidemics.

Additional vaccination is carried out among the population who live in areas with an increased risk of various epidemics.

The list of epidemic zones has been approved by the Ministry of Health. Depending on the characteristic spread of certain infections, vaccination in these territories is carried out against:

• tick-borne spring-summer encephalitis;
• Q fever;
• leptospirosis;
• plague;
• tularemia;
• anthrax;
• brucellosis.

Preventive vaccination is carried out when there is a risk of epidemics.

Features of the formation of immunity

Immunization is carried out by introducing (intramuscularly, orally) antigenic material to produce antibodies to a specific virus or infection.

Antigenic substances include:

• weakened strains of living microbes or viruses;
• killed or inactive microbes;
• proteins of infectious microorganisms;
• synthetic vaccines.

When antigenic material is introduced, the immune system begins an active fight against the irritant. The body's resistance is strengthened due to specific fighting mechanisms.

National calendar of preventive vaccinations for children

The calendar of preventive vaccinations for 2018 differs from the similar calendar for 2017 in minor amendments (dated April 13, 2017 No. 175n).

The calendar is determined by order of the Ministry of Health of the Russian Federation dated March 21, 2014 No. 125n “On approval of the national calendar of preventive vaccinations and the calendar of preventive vaccinations for epidemic indications.”

The 2018 vaccination calendar contains certified domestically produced drugs and several foreign high-quality vaccines. More details are given about vaccinations for children under 1 year of age.

Preparing for vaccination

There are several rules that parents must follow before vaccination.

Mixed-fed babies should not be introduced to new complementary foods 10-12 days before the vaccination date

5 mandatory rules of preparation:

• Children who are prone to allergies are recommended to be given antihistamines 3 days before the procedure. Such prevention will reduce possible allergic reactions after vaccination.
• It is strictly prohibited to introduce new foods to children under 1 year of age 10-12 days before vaccination.
• Breastfeeding mothers must follow a strict diet to eliminate the body’s negative reaction to breast milk.
• It is not recommended to start hardening 2-3 weeks before vaccination if the baby has not previously undergone the procedure.
• It is necessary to often be in the fresh air, including doing exercises, but avoid overheating or hypothermia.

An important role for successful vaccination is played by the psychological attitude. Parents should gradually prepare their children for the need for the procedure. At an earlier age, when persuasion is ineffective, it is recommended to think about how to distract the baby’s attention during vaccination (toy, song, cartoon on the phone, etc.).

If the preparation rules are followed, the risks of adverse reactions are minimized. However, it should be remembered that a post-vaccination reaction can occur regardless of the above reasons, under the influence of external and internal factors, as well as the individual sensitivity of the body.

Before vaccination, the baby is examined by a pediatrician. If there are no signs of various diseases (allergies) and normal body temperature, the doctor will allow you to undergo the vaccination procedure according to the vaccination schedule.

Is it possible to reschedule vaccination dates?

There are no negative consequences from postponing vaccinations. Each person has an individual schedule.

There is no set maximum interval between treatments other than DTP.

However, even vaccination against whooping cough, diphtheria, and tetanus can be carried out with a shift in timing. The main thing is that the first 3 vaccinations are given within 1 year.

It is strictly forbidden to vaccinate a sick person, even if the symptoms are mild. Children's bodies are weakened during illness, and antigenic bodies can cause a lot of negative immune reactions.

After a forced break, immunization can be resumed. After the examination, the pediatrician will give the necessary recommendations for subsequent vaccinations and the timing of the procedure according to the 2018 vaccination calendar.

What are the side effects and complications?

There are two types of post-vaccination reactions - natural, complicated. Natural reactions include short-term weakness, lethargy, loss of appetite, and an increase in body temperature to 38 degrees or higher.

Such symptoms occur rarely and only with some vaccines. Doctors at the clinic must warn parents about possible complications. Natural reactions disappear within 1-2 days after the procedure.

Complicated reactions:

• body temperature above 38 degrees for a long time - more than 2 days (taking antipyretic drugs, for example);
• anaphylactic reactions, difficulty breathing, spasms;
• convulsive muscle contraction at normal body temperature;
• rashes on exposed skin and redness at the injection site;
• neurological disorders.

If you have symptoms of a complicated post-vaccination reaction, you should immediately call emergency help.

Conclusion

Only the people closest to him - his parents - are concerned about the health and well-being of the child. The issue of vaccination should be approached with a cool mind. Before deciding to carry out the procedure, familiarize yourself with all the adverse reactions of vaccines and learn about their harmful effects on the baby’s body.