Introduction. Stable post-vaccination immunity and prediction of vaccination immunologic effectiveness are topical issues that require profound studies with their focus on the role in their formation that belongs to exogenous factors. The aim of this study was to establish pathogenetic peculiarities of the development of impairments of post-vaccination immunity to infections manageable by specific prevention in schoolchildren under combined exposure to chemical environmental factors as well as factors related to the educational process, lifestyle, and diet. Materials and methods. We analyzed laboratory test results and data obtained by questioning and analyzing diet records of one hundred eighty four children vaccinated against diphtheria, whooping cough, and measles. The children attended either a secondary school with standard educational programs (Reference Group) or a secondary school with profound studies of some subjects (Observation Group). Priority risk factors and etiopathogenetic peculiarities of the development of post-vaccination immunity impairments were identified by building one-factor logistic regression models and sequential modelling. Results. The schoolchildren from the School 2 had to study in an environment that did not conform to hygienic requirements to the management of the educational process; they did not consume biologically valuable foods in recommended quantities; their blood was contaminated with metals and aromatic hydrocarbons; they had high levels of digital activity but their physical activity was low. Given all this, intensity of their humoral post-vaccination immunity against diphtheria and whooping cough was 1.2–1.7 times lower than in the Reference Group. We identified determinants of advers effects produced on post-vaccination immunity development by the analyzed factors and determined their isolated and combined contributions to likelihood of a decline in intensity of humoral immunity to diphtheria (10–55% and 72%) and whooping cough (13–40% and 77%). We established pathogenetic peculiarities and marker laboratory indices of risk-associated impairments of post-vaccination immunity to diphtheria and whooping cough under combined exposure to the analyzed factors. Limitations. The study results were obtained without considering types of applied vaccines. Conclusion. The established pathogenetic aspects of risk-associated impairments of post-vaccination immunity to diphtheria and measles under combined exposure to the set of the analyzed factors are target ones for hygienic activities, prediction, and immunity correction.
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