National Vaccination Schedule Research Articles

National Concept of Development of Vaccine Prophylaxis in Russia

The article is dedicated to outlining the conceptual directions for the development of vaccination in the Russian Federation. The provisions of the concept are formulated based on the authors' years of research on vaccination issues and analysis of data from domestic and foreign scientific literature. The main provisions of the concept aim at strengthening the state policy in the field of vaccination, reconstructing and expanding enterprises for the production of domestic vaccines, developing and improving immunobiological medicinal products against current infections, refining the National Immunization Schedule and Vaccination Schedule according to epidemiological indications; further promoting the WHO's "lifelong immunization" strategy; developing regional immunization programs; implementing a risk-oriented approach in the development of immunization programs; developing a system for monitoring post-vaccination complications; implementing epidemiological surveillance of vaccination as a methodology for assessing the strategy and tactics of immunization in accordance with the epidemiological situation; ensuring commitment to vaccination among the population, healthcare workers, and legislative and executive authorities.

Proportional of wheezing events in asthmatic children post-vaccination of annual flu vaccine

Background: The common childhood chronic disease asthma causes hospitalisation and exacerbations due to respiratory tract viral infections like influenza. Due to uncertainty about the benefits and role of influenza vaccines in preventing asthma exacerbations, many children with asthma do not receive them, despite recommendations from organisations like the Canadian National Advisory Committee on Immunisation. There are two main types of influenza vaccines: intramuscular trivalent inactivated and intranasal cold-adapted, live attenuated. Both vaccines are highly immunogenic and induce an adequate immune response, but their clinical efficacy varies by season and age. Aim: The aim of this study was to investigate the occurrence of increased wheeze rates in stable asthmatic children who received the annual flu vaccine, compared to a control group of asthmatic children who did not receive the vaccine. Methods: A retrospective study at the Queen Rania Abdullah for Children Hospital in Amman, Jordan, examined the vaccination status of 200 asthmatic children aged 3-14. The study focused on recurrent wheezing episodes and the minimum 12-month period between the last annual flu vaccination and asthmatic exacerbation. The study excluded uncontrolled or partially controlled patients for the past 12 months. Data was collected from demographic information, vaccination history, and past wheezing episodes. The children were divided into two groups, one without the flu vaccine and the other with the flu vaccine. A comprehensive questionnaire was used to assess sociodemographic and disease-related factors. If children received the vaccination as per the National Vaccination Schedule, their vaccination status was considered complete. Results: A study of 200 asthmatic children in Jordan found that 35% did not receive a flu vaccine, placing them in Group I. 65% had received a flu vaccine in the previous year. Males had higher distribution rates in both flu-based groups, with a statistically insignificant positive correlation. Age categories showed similar distribution rates, with 21.0% for 3-6 years, 34.0% for 6-9 years, 37.5% for 9-12 years, and 7.5% for 12-15 years. No significant correlation was found between receiving the flu vaccine and wheezing rates in the last seasonal year. Frequent wheezing episodes were higher in experienced groups than in naïve groups.

Features of the epidemiological surveillance system of rabies and monkeypox in the Republic of Cameroon

The prevention and control of zoonotic infections remain a problem in most countries. However, this problem has become particularly relevant in recent decades, when the occurrence and pandemic spread of zoonotic diseases have become more frequent. All spheres of the national economy that ensure the fight against infections of this group (healthcare systems, veterinary medicine, and ecology) are trying to jointly find appropriate solutions to ensure antiepidemic protection of the population by taking adequate measures to prevent and combat infectious zoonoses. According to the World Health Organization, the spread of zoonotic infections is observed on all continents, particularly in Asia and Africa. The epidemiological significance of zoonoses depends on their effects on the population (morbidity and mortality), their ability to overcome interspecific barriers, and the individual characteristics of pathogens. It is also influenced by factors such as geographical location, climate, population density, economic growth rates, and development level of private and industrial livestock and poultry farming. The epidemiological surveillance systems in Cameroon are compared with the surveillance system in Russia and with the standards set by international organizations such as the World Health Organization and the Food and Agriculture Organization of the United Nations. The emergence and spread of current zoonotic infections in the Republic of Cameroon are presented. The study showed the geographical, social, administrative, economic, and health characteristics of Cameroon, which may influence the emergence and spread of infectious zoonosis in the country. Zoonotic diseases have only begun to receive special attention in Cameroon’s health system in 2014–2016, following an outbreak of monkeypox (mpox) in Cameroon. Moreover, the study described the epidemiological surveillance system and a classification of epidemic events monitored by the Cameroon Disease, Epidemic and Pandemic Control Authority. In general, the surveillance system for human and animal zoonoses in Cameroon was designed to ensure a rapid response during an epidemic. However, some shortcomings exist, such as low data for some zoonotic diseases and insufficient or virtually nonexistent surveillance in some regions of the country. To intensify the fight against the epidemic spread of these zoonotic infections, the capacity of health workers and technical means for detection and monitoring must be improved. The update of the national vaccination schedule should consider diseases such as rabies, given its endemic nature in the country; this may be possible through the establishment of a service or office responsible for surveillance, detection, and response to infectious zoonotic diseases.

Results and prospects of rotavirus immunisation in the Russian Federation

Scientific relevance. Rotavirus disease and its consequences remain a leading vaccine-preventable cause of mortality in young children. Russia has not yet included rotavirus immunisation in the national vaccination schedule, but paediatric rotavirus vaccines are provided under several regional immunisation programmes.Aim. The authors aimed to review literature covering Russian clinical evidence of the safety and effectiveness of rotavirus vaccines and to analyse the prospects for the development of the national immunisation programme for young children using the available rotavirus vaccines and considering promising pipeline ones.Discussion. Local epidemiological studies on a range of pathogens suggest that rotaviruses are the most common cause of acute intestinal infections, especially in children under 3 years of age. Since Russia’s first rotavirus vaccine approval in 2012, the healthcare system has acquired sufficient experience with rotavirus vaccines to evaluate the safety and effectiveness of rotavirus immunisation. Long-term monitoring of the rotavirus A genotypes circulating in the country shows that currently available rotavirus vaccines cover the majority of identified rotavirus isolates. Local observational studies confirm the favourable safety profile of rotavirus vaccines and demonstrate notable effectiveness of vaccination. In the regions with high immunisation coverage, the overall morbidity has declined dramatically in vaccinated children compared to unvaccinated children; some of these regions have reported only individual hospital visits or admissions for acute intestinal infections.Conclusion. This review demonstrates that rotavirus immunisation should be included in the Russian National Immunisation Schedule.

How does diabetes type 1 affects immune response to hepatitis B virus vaccine in pediatric population? Evaluation of a booster dose in unresponsive subjects with type 1 diabetes.

Hepatitis B virus (HBV) vaccine reduced the incidence of Hepatitis B worldwide. Genetic variability, by the presence of specific haplotypes of HLA system (HLA-DR3, HLA-DR4), influences the response to the vaccination. Subjects affected by type 1 diabetes (T1D), contrary to non-diabetics, have a high prevalence of Hepatitis B. The objective of the study was to evaluate anti-HBs antigen (anti-HBsAg) antibody (Ab) in a group of 201 children (age range: 2-18 years), regularly vaccinated against HBV according to the national vaccination schedule. Patients with anti-HBs Ab≥10 mIU/mL have been defined "responders" and those with anti-HBs Ab<10mIU/mL have been defined "non-responders." The possible association between the T1D and a low immune response to the vaccine has been subsequently valued. Besides the presence of T1D, other possible influential variables have been studied: sex, age, presence of celiac disease and Hashimoto's thyroiditis, intervening years from the diagnosis of diabetes and presence/absence of diabetic ketoacidosis at time of diagnosis. Among the 201 subjects with T1D, 90 (44.8%) were responders, while 111 (55.2%) were non-responders; among the 145 subjects without T1D, 86 (59.3%) were responders and 59 (40.7%) non-responders. We invited "Subjects with T1D non-responders" to undergo a booster dose of the same vaccine. Of these, 21 refused the booster, reducing the sample to 90 patients. After 4 weeks from the booster dose 81 patients showed seroconversion ("false non-responders"), and 9 did not ("true non-responders"). After the booster dose, immune response in our cross-section has been similar to general population. Given the high frequency of "false non-responders" anti-HBsAg Ab should be tested in T1D patients and a booster dose should be administrated in non-responders.

A Decade of Experience in the use of 13-Valent Conjugated Polysaccharide Pneumococcal Vaccine in Russian Federation

Pneumococcal infection remains a significant global health problem, and vaccination is the main measure for its prevention. To date, the period of use of pneumococcal conjugated polysaccharide vaccines in Russia exceeds 14 years, and 13-valent conjugated polysaccharide pneumococcal vaccine (PCV13) - more than 10 years. During this time, extensive experience has been accumulated in the use of this type of vaccines, and many studies have been carried out to evaluate their effectiveness and safety.The purpose of this review is to summarize the experience of using PCV13 in Russian Federation with an assessment of its epidemiological and clinical effectiveness. A search was made for scientific publications devoted to the study of the epidemiological efficacy, the safety as well as cost-effectiveness of PCV13 use in Russian Federation. The review included original studies published in Russian journals. The results of the studies carried out indicate the efficacy and safety of PCV13 for both adults and children. The effectiveness of immunization of children at risk (premature, suffering from congenital pathology, having chronic diseases and often ill) was demonstrated, the need and safety of the timely start of vaccination (from 2 months of age) of newborns was shown, the possibility of its combination with immunization against other infections within the framework of the national vaccination schedule, the importance of following the recommended vaccination schedule in accordance with the age of the child. The effectiveness of vaccination of adults suffering from chronic diseases has been shown both in terms of preventing the aggravation of the course of the underlying pathology and reducing the risk of pneumonia. Positive experience has been gained in immunizing adults from occupational risk groups - medical workers, conscripts and persons exposed to a harmful production factor and having occupational lung diseases. The conducted studies have shown a high cost-effectiveness of PCV13 vaccination, however, with any changes in price and epidemiological parameters, it is necessary to clarify the economic feasibility of vaccination under the changed conditions. Taking into account the positive experience gained in immunization, it seems appropriate to further maintain a high level of vaccination coverage of the child population, expanding risk groups among the adult population subject to vaccination against pneumococcal infection within the framework of the National Immunization Schedule, taking into account its epidemiological, clinical and economic efficiency.

Impact of hepatitis B birth dose on immune response in Pakistani children: an open-label, non-inferiority randomized controlled trial, implications for achieving SDG target

Background Despite presence of hyperendemic areas, the national immunisation schedule in Pakistan does not include a hepatitis B birth dose, placing newborns at an additional risk of acquiring hepatitis B. This study aimed to assess the impact of adding hepatitis B birth dose in existing national vaccination schedule. Methods An open label, randomised controlled non-inferiority trial enrolled 296 healthy near-term mothers to intervention and control groups. Newborns in the intervention group received a hepatitis B birth dose along with routine immunisation vaccines, while control group newborns received vaccinations under the national schedule. Seroprotection was measured and compared at birth and 8 weeks after administering the third dose of pentavalent vaccine. The risk ratio of seroprotection was computed and compared with the delta value set at 5%. Results The study found that 95.8% of infants in the intervention group achieved seroprotection, which was significantly higher than the control group’s 58.7%. The difference in risk ratio of seroprotection was 1.62 (CI95: 1.37–1.93), with the upper limit of the CI below the delta margin, confirming non-inferiority. The time interval between birth and the first hepatitis B immunisation shot was a predictor of seroprotection, with an odds ratio of 1.79 (CI95: 1.01–2.9). Conclusion Our study indicates that adding a hepatitis B birth dose to the immunisation schedule in Pakistan is non-inferior to the existing one. This can also contribute towards Pakistan’s achievement of the SDG target of reducing hepatitis B surface antigen seroprevalence in children under 5 years of age. Trial Registration Number NCT04870021

Vaccine schedule recommendations and updates for patients with hematologic malignancy post-hematopoietic cell transplant or CAR T-cell therapy.

Revaccination after receipt of a hematopoietic cell transplant (HCT) or cellular therapies is a pillar of patient supportive care, with the potential to reduce morbidity and mortality linked to vaccine-preventable infections. This review synthesizes national, international, and expert consensus vaccination schedules post-HCT and presents evidence regarding the efficacy of newer vaccine formulations for pneumococcus, recombinant zoster vaccine, and coronavirus disease 2019 in patients with hematological malignancy. Revaccination post-cellular therapies are less well defined. This review highlights important considerations around poor vaccine response, seroprevalence preservation after cellular therapies, and the optimal timing of revaccination. Future research should assess the immunogenicity and real-world effectiveness of new vaccine formulations and/or vaccine schedules in patients post-HCT and cellular therapy, including analysis of vaccine response that relates to the target of cellular therapies.

“She vaccinated my baby and that’s all…” Immunisation decision-making and experiences among refugee mothers resettled in Aotearoa New Zealand

BackgroundTo prevent disease outbreaks, refugee children must be age-appropriately immunised. This qualitative study gained an in-depth understanding of refugee mothers’ vaccine decision-making and experiences accessing immunisation services for their children post-resettlement in Aotearoa New Zealand.MethodsAn interpretive description methodology involving focus groups with refugee mothers (N = 45) was conducted in Auckland, one of the resettlement locations. Mothers were asked about their perceptions of vaccine-preventable diseases and vaccines, their experiences of attending immunisation events, and their suggestions for improvements to immunisation services. Data were analysed following the phases of reflexive thematic analysis.ResultsFour themes were constructed. Do I have a choice? Mothers displayed pro-vaccination sentiments and parental obligation to vaccinate their children to protect their health, which underpinned their compliance with the national vaccine schedule. Transnational vaccine perceptions and behaviours It was evident that comparing their health experiences in their origin countries reinforced their positive perceptions of and trust in vaccines, health providers and their recommendations, the health system and government in New Zealand. Information sharing with their transnational networks had the potential to influence vaccine perceptions and behaviours in home and host countries. Unanswered questions and concerns Mothers discussed how many of their questions and concerns about immunisations and post-vaccine management went unanswered. Relationships and experiences matter Mothers stressed the importance of who vaccinated their child and how it was administered, highlighting that health providers’ demeanour and competence influence their immunisation experiences.ConclusionsHealth providers are encouraged to focus on creating a positive immunisation experience for refugee background families. Qualified interpreters and provision of culturally and linguistically appropriate information are required. Transnationalism at the individual level appears to influence vaccine perceptions and behaviours among refugee-background mothers. Future research focusing on caregivers with child(ren) who are not fully vaccinated would be beneficial.

Biologics in Rheumatoid Arthritis: When &amp; Why?

Among the autoimmune rheumatic diseases RA is common. Not only articular extra-articular manifestations are common including involvement of skin, ocular, haematological, pulmonary and renal systems. A heightened cardiovascular risk also exists which closely follows disease activity stresses to obtain remission or low disease activity. Therapeutic landscape of RA treatment most significantly shiftedwith the introduction of biological disease modifying anti-rheumatic drugs (bDMARDs). There are five classes of bDMARDs currently available, each with a different molecular target and subtle differences in their efficacy and safety profile. Patient with poor prognostic factors and failed to csDMARDs are the candidate of anti-TNF agents and or other biologics. Clinicians should screen for latent infections with hepatitis B and C serology, chest radiograph plus interferon gamma release assay or tuberculin skin test. In the indicated cases, HIV serology should be requested as well. To reduce infection risk, guidelines specify that patients on bDMARDs should continue with national vaccination schedules including influenza and pneumococcal immunisations as well as the HPV vaccine for cervical cancer. Live attenuated vaccines (like, live herpes zoster vaccine, yellow fever, measles, mumps, rubella), are contraindicated in patients taking a bDMARD. The contraindications of anti-TNF agent’s initiations are serious or untreated infections including TB, current malignancy, multiple sclerosis, severe heart failure and hypersensitivity. In case of tocilizumab contraindications are serious or untreated infections, hypersensitivity and diverticulitisand for rituximab reactivation of hepatitis B.Coadministration of one class of bDMARD with another from a different class is not recommended due to an increased risk of infection. A DAS28 reduction of &lt;1.2 should be considered as improvement at 3 and 6 monthvisits. A close monitoring is advocated for the adverse effects of biologic agents. TNF inhibitors may be continued during pregnancy. Rituximab, abatacept and IL-6 inhibitors are not safe in first trimester. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 193-194

Humoral immunity against pertussis among healthcare workers

Background. Vaccination is the most effective way to prevent infectious diseases. Inadequate vaccination coverage among healthcare workers is a major concern for healthcare organizations. The lack of specific immunity against pertussis represents the risk for acquiring a healthcare associated infection by medical staff but also of being a source of infection to patients. More than 70% of all healthcare associated infections are vaccine-preventable. Pertussis remains one of the most important vaccine-preventable infections and continues to be a public health concern even in countries with high vaccination coverage among children. Revaccination of adults against pertussis is not included in the National vaccination schedule of the Russian Federation.&#x0D; Aim. To assess the humoral immunity against pertussis among healthcare workers of the infectious disease hospitals.&#x0D; Materials and methods. We conducted a cross-sectional study that included 252 healthcare workers. All study participants were surveyed and tested for antibodies (immunoglobulins G) against Bordetella pertussis by enzyme immunoassay.&#x0D; Results. The proportion of healthcare workers seronegative for pertussis was 46.8%. The healthcare workers with unknown vaccination status amounted to 40.5%. More than half (55.6%) of the participants have been vaccinated and 3.9% of them have had pertussis in childhood. A recent infection was confirmed in 8.0% of participants who had the level of antibodies to Bordetella pertussis greater than 50 U/ml. The largest proportion of participants seronegative to Bordetella pertussis (55.2%) was observed among those under 30 years. The median level of antibodies against pertussis in seropositive health workers was 28.3 U/ml.&#x0D; Conclusion. The significant proportion of seronegative participants (46.8%) and those who had the recent infection underline the necessity of the improvement of pertussis prevention by implementation of vaccination in the risk groups, including healthcare workers to reduce the risk of healthcare associated infections.

Surveillance of acute flaccidparalysis and poliomyelitison some territories of Russia and South Vietnam. Part 1. Polioviruses and paralysis

The epidemiological and etiological aspects of poliomyelitis and acute flaccid paralysis (AFP) in Russia and Vietnam were analysed and compared. The polio-free status is maintained on 14 territories of Russia and 29 provinces of South Vietnam. The quality of epidemiological and virological surveillance for acute flaccid paralysis is in accordance with the requirements of the national and international polio surveillance systems. All AFP cases were revealed, registered, reported and investigated in both countries. The percentage of poliovirus isolation from 2492 samples collected from patients with acute flaccid paralysis and contact persons in different years in Russia ranged from 1.30.89 to 9.80.79. In South Vietnam, 2143 samples from patients with acute flaccid paralysis were investigated. In Russia and Vietnam, we isolated vaccine polioviruses of all three types with predominance of type 3 polioviruses (63% and 50%, respectively) in both countries. From AFP patients in Russia and Vietnam, polioviruses were isolated in 4.9% and 1.0% studied samples, respectively. Some VDPV strains were revealed on the territories of Russia and South Vietnam. Here, we describe five cases of vaccine-associated paralytic poliomyelitis registered in Russia and two cases of AFP caused by VDPV type 2 reported in Vietnam. To prevent the risk of developing vaccine-associated paralytic poliomyelitis, it is indispensable to ensure high-quality surveillance for acute flaccid paralysis, maintain 95% polio vaccine pediatric coverage and strictly comply with sanitary legislation, including the National Vaccination Schedule when vaccinating children, to improve virological surveillance of polioviruses using classical and new virological and molecular methods and to continue research on poliomyelitis, including development of new safe and effective poliovirus vaccines able to induce both humoral and mucosal immunity. The systematic control of adequate polio vaccination is indispensable in order to prevent transmission of imported wild polioviruses into polio free countries as well as circulation of vaccine-derived polioviruses worldwide.

Measles clinical presentation, hospitalization and vaccination status among children in a community-wide outbreak.

In 2018-2019, a measles outbreak emerged in Israel (4158 notified cases). We aimed to evaluate the measles characteristics and the vaccination status among children during the outbreak. We performed a cross-sectional study of measles cases in children under 18years, residing in the Jerusalem district (2254 notified measles cases, June 2018-May 2019). The variables included: clinical symptoms (fever, rash, cough, coryza, conjunctivitis), hospitalizations and child's vaccination status. The national measles vaccination schedule includes two vaccine doses (at ages 12months and 6years). Children, under 18years, comprised 79% (1782/2254) of the notified measles cases. The hospitalization rate was 6.6%. There was one fatality. The measles vaccination status was analyzed by age groups. Infants under 12months (n=425) were excluded. Children aged 1-5years (n=785) and 6-17years (n=572) were expected to receive 1 and 2 measles vaccine doses, respectively. Most (88%) children (1-17years) were unvaccinated, 138 received 1 measles vaccine dose and 24 received 2 doses. Of children aged 1-5years 106 (13.5%) received 1 vaccine dose and were compared to unvaccinated children. Vaccinated children showed lower rates of clinical symptoms and lower risk for hospitalization compared to unvaccinated children (Odds ratio: OR=4.8, 95%CI 1.12-20.2). Vaccine effectiveness of 79% was estimated for one measles vaccine dose against hospitalization. Data on vaccine effectiveness reflect how well vaccines protect children against infection and morbidity. We evaluated the real-world effectiveness of measles vaccine, in an outbreak setting, and showed reduced morbidity in once-vaccinated children.

Проблемні питання стану здоров’я дітей зі spina bifida в Україні

Spina bifida is one of the most common congenital neural tube defects, which leads to dysfunction of many organs and systems and to disability. Purpose - to conduct a comprehensive analysis of the health status of children with spina bifida and hydrocephalus in Ukraine based on questionnaires of parents and their children, study of medical documentation and online counseling to improve the multidisciplinary support to children of this group. Materials and methods. A program of multidisciplinary online support for children with spina bifida in Ukraine was launched in June 2022 at the initiative of the patient organization «Association of parents of children with spina bifida and hydrocephalus «Lights of Spirit» and with the support of the international organization «Child Help». At the first stage, parents of children with spina bifida filled out a questionnaire to participate in the project, where demographic data and data on the child’s health were indicated. A total of 149 children with spina participated in the project. Girls predominated among the children (63.1%). The age of the patients ranged from 1 month to 24 years. At the next stages, online counseling was conducted with the participation of doctors of the multidisciplinary team and the head of the «Light of Spirit» NGO. Results. Impaired motor function was observed in 87.2% of children with spina bifida. Only 32.9% of children could walk independently, 14.1% needed outside help or aids, and 42.3% used a wheelchair or wheelchair to get around. Orthopaedic pathology was observed in 75.2% of patients, and hydrocephalus in 65.8% of children. A neurogenic bladder was noted in 79.9% of patients at the time of the questionnaire, and urinary tract infections (UTIs) in 77.9%. Clean intermittent catheterization was regularly performed in only 51.7% of patients. The study showed that early initiation of catheterisation was associated with a lower incidence of UTIs. Constipation was observed in 81.9% of children, faecal micturition and/or faecal incontinence in 58.4% of children. Bowel cleansing was performed in 49.7% of patients, and only 26.8% regularly. Skin damage (wounds and bedsores) was observed in 12.8% of children, and allergic manifestations in 21.8% of patients. Only 15% of children were immunized in accordance with the national vaccination schedule, and 70% of children were not vaccinated at all. Body weight disorders were observed in 43% of children, most often overweight/obesity (32.2%). Conclusions. A comprehensive analysis of the health status of children with spina bifida and hydrocephalus in Ukraine made it possible to outline a number of problems of children with this pathology, which affect quality of life and require a multidisciplinary approach to treatment and rehabilitation. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

The effect of preventive vaccination on chickenpox incidence in Russia

Introduction. The significance of the chickenpox (CP) problem for public health and economy of Russia necessitated inclusion of CP vaccination in the regional immunization programs of some regions of the Russian Federation and in the vaccination schedule as an epidemic-response measure.&#x0D; The purpose of the study was to assess the effectiveness of CP vaccination to provide the rationale for recommendations on expansion of the national preventive vaccination schedule.&#x0D; Materials and methods. The vaccination effectiveness was assessed by comparison of the vaccination rates and CP incidence rates in 20062021 with the reference to the data collected from forms No. 2 and No. 5 of the National Statistical Monitoring in Russia and in its regions.&#x0D; Results and discussion. Before 2019, in some regions of Russia, CP vaccination of children within regional immunization programs and vaccination of risk groups within the vaccination schedule following the epidemic-response measures had hardly any effect on the epidemiological situation. The remote-work and stay-at-home policies during the COVID-19 pandemic in 2020 resulted in a decrease in the incidence and an increased number of individuals who did not have immunity against Varicella zoster, thus subsequently leading to the increased CP incidence in the country. However, the Central, Volga, and Siberian Federal Districts were able to avoid an increase in the CP incidence due to the significantly increased vaccination coverage among children in 20202021. At the same time, in most of the regions, less than 2% of children aged 16 years were vaccinated annually. The insufficient CP vaccination coverage in the regions having extensive experience of planned immunization of children led to the shift of the incidence towards older age groups and increased risk of development of congenital infection.&#x0D; Conclusion. To increase the effectiveness of CP preventive vaccination, it is recommended that the national vaccination schedule should include two-dose vaccination with the coverage of at least 90% of one-year-old children, while continuing immunization of older age individuals from the groups that are at risk of infection.

Чaстота носительства S. pneumoniae у организованных детей г. Ханты-Мансийска

Aim: to assess the landscape of pneumococcus serotypes among children organized in kindergarten groups in Khanty-Mansiysk city. Patients and Methods: the study included 510 children (2-6 years old) attending kindergartens in Khanty-Mansiysk city. The children were divided into 2 groups: vaccinated (n=50) and non-vaccinated against pneumococcal infection (n=460). The data on vaccination status were received from the prophylactic immunization records (Form 063/u) and child's medical records (Form 112/u). In addition, the following data were analysed: age, gender, gestation age at birth, attitudes of child's legal representatives towards vaccinations, and the presence of chronic health problems. Pneumococcal polysaccharide conjugate adsorbed 13-valent vaccine (PCV-13) was used for the prevention of pneumococcal disease. Nasopharyngeal swabs were collected from children as a source of biological material. The pneumococcus was detected using a culture-based method and PCR assay. Results: the average age of organized children examined in Khanty-Mansiysk for Streptococcus pneumoniae (S. pneumoniae, pneumococcus) was 54.31 [53.46–55.16] months. In 56% of the examined children, pneumococcal DNA was found in nasopharyngeal swabs by polymerase chain reaction assay. The identified serotypes in 71.1% of cases were the same as in the PCV13 vaccine formulation. The most common serotypes detected were 4 (27%), 19 F (13.3%), 23 F (3.6%) and serogroup 6 (11.6%). In children immunized against S. рneumoniae, the pneumococcal strain DNAs, same as the vaccine strain DNAs, were found in 53.7% of cases, while in non-immunized children — in 73% of cases (OR 0.54, 95% CI 0.29–0.97). Conclusion: the increasing prevalence of S. рneumoniae carriage in children as they get older and attend organized children's groups for a longer time, along with the predominance within the population of the same pneumococcus strains as those in the vaccine formulation, dictate the need for timely immunization against pneumococcal infection in compliance with the National Vaccination Schedule (vaccination at 2 and 4.5 months of age, revaccination at 15 months of age). KEYWORDS: children, pneumococcal infection, S. pneumoniae, vaccination, pneumococcal conjugate vaccine, children in organized groups, carriage. FOR CITATION: Girina A.A., Petrovsky F.I., Petrovskaya Yu.A., Zaplatnikov A.L. Prevalence of S. pneumoniae carriage among children organized in kindergarten groups in Khanty-Mansiysk city. Russian Journal of Woman and Child Health. 2023;6(2):164–168 (in Russ.). DOI: 10.32364/2618-8430-2023-6-2-164-168.

EVALUATION OF UKRAINIAN MEDICAL STUDENTS' KNOWLEDGE, ATTITUDE, AND PRACTICE REGARDING THE PREVENTION OF PAPILLOMAVIRUS INFECTION

The purpose of the study was to assess the level of Ukrainian medical students' knowledge regarding the human papillomavirus (HPV), as well as their attitude and practice regarding the prevention of HPV infection. Materials and methods. A cross-sectional epidemiological study was conducted among medical students in Kharkiv, Kyiv, and Vinnytsia in October–December 2022. A questionnaire was developed. Two hundred and fifty-two medical students took part in the survey. Descriptive statistics methods were used for data analysis. Pearson's χ2 test was used to determine if there was a significant relationship between two nominal variables. Results. The sample of respondents was represented by students aged 16–38 years, primarily female (87.3%, n = 220). Almost three-quarters (73.8%, n = 186) of all respondents indicated the need for additional information about HPV. Only 43.3% of respondents (n = 109) knew that the early onset of sexual life was a risk factor for HPV infection. Thirty-seven respondents (14.7%) correctly indicated that men who had sex with men were at increased risk of HPV infection compared to heterosexual men. Seventy-nine students (31.3%) reported that they didn't know about the existence of the HPV vaccine before taking the questionnaire. Seventy-five students (29.8%) didn't know whether vaccination against HPV infection was mandatory in Ukraine and whether it was included in the national vaccination schedule. Only 57.9% of respondents (n = 146) reported that they systematically (at least once a year) visited a gynecologist/urologist. The proportion of students who had sexual relations and visited a gynecologist/urologist was greater than the proportion of students who didn't have sexual relations and regularly visited a gynecologist/urologist (χ2 = 27.559; p &lt; 0.00001). One hundred and forty-eight respondents (58.7%) indicated that they had sexual relations. Of them, 52.0% (n = 77) of respondents had two or more sexual partners during their lifetime. Twenty-seven respondents of those who had sex life (18.2%) had never been tested for sexually transmitted infections (STIs). The majority of students with sexual relations (57.4%, n = 85) never demanded documentary confirmation of the absence of STIs from their sexual partners. The proportion of students vaccinated against HPV was 5.2% (n = 13 of 252). Forty-three respondents (n = 43) did not know their vaccination status and could not say with certainty whether they had been vaccinated against HPV. The other 77.8% of respondents (n = 196) indicated that they were not vaccinated against HPV infection. Among the unvaccinated students, 33.7% of respondents (n = 66) planned to get vaccinated against HPV; 21.9% of respondents (n = 43) didn't plan to be vaccinated against HPV. Conclusion. An insufficient level of knowledge of medical students regarding HPV was revealed. There is a lack of adherence of medical students to HPV vaccination. Factors of risky sexual behavior have been identified among persons who have sexual relations. It is necessary to increase the awareness of future doctors about HPV and HPV immunoprophylaxis by optimizing educational programs in medical universities and to intensify sanitary and educational work on safe sex.

Knowledge, attitudes and behaviors of family physicians about childhood vaccinations that are not in the routine vaccination schedule: a cross-sectional study.

In our country, there are childhood vaccinations that are not included in the routine vaccination schedule and that families have to buy and have for a fee. In addition to income level, family physicians' recommendations also play a major role in getting these vaccines.Our study was planned to determine the level of knowledge, attitudes and behaviors of family physicians about rotavirus, HPV and meningococcal vaccines, which are not included in the routine vaccination scheme of the Ministry of Health. Our cross-sectional and descriptive study was carried out between May and July 2019. The population of our study consists of approximately 30000 family physicians working as Family Physicians in Turkey. When the sample size is calculated with 5% margin of error and 95% confidence interval, it turns out to be 381. A 15-question questionnaire prepared by scanning the literature and including socio-demographic characteristics was presented to the participants. The Likert scale, which includes 12 questions about rotavirus, meningococcus, HPV and vaccines developed for these microorganisms, was administered to physicians either face-to-face or via the internet. In our study, the statistical significance level was accepted as P < 0.05, and the SPSS statistical package program was used in the calculations. 81 Research Assistants, 62 Family Medicine Specialists and 234 Family Physicians participated in our study, and the participants were determined by simple random sampling method. The mean age of the participating physicians was 37.96 ± 9.3 (min: 25 and max: 68). 50.9% of the physicians were women, 79.8% were married, 85.1% were in the city center, and 62.1% were practicing family medicine as general practitioners. 74.82% of the participating physicians recommend rotavirus and 56.2% HPV vaccines to their patients. 10.6% (40 people) of the physicians participating in our study did not recommend any of the rotavirus, HPV, meningococcal, influenza and adult pertussis vaccines to their patients. In the evaluation of the reason for this, 58.7% (27 people) of physicians who did not recommend special vaccines state that they did not recommend vaccines because they are not included in the routine vaccination schedule of the Ministry of Health. Another important reason was that the vaccines are paid (30.4%, 14 people). To the question of having sufficient information about special vaccines that are not included in the routine vaccination schedule, 26% of the participants stated that they have sufficient knowledge, and 56.5% stated that they have partial knowledge. The Likert knowledge questions total score of those who recommended at least one vaccine to their patients was significantly higher than those who did not recommend it at all. Likert knowledge questions total score of those who had at least one vaccination was significantly higher than those who never had it (P = 0.001). In general, as the level of knowledge about private vaccines decreases, the rates of self-vaccination, recommending it to their patients, and asking it to be included in the national vaccine schedule decrease. For this reason, increasing the knowledge of physicians about vaccines not included in the national vaccination schedule will contribute to the dissemination of vaccines, thus increasing immunity and reducing mortality and morbidity.

Ranking of immunization programs in Latin America, 2019Ranking dos programas de imunização na América Latina, 2019

To establish a ranking of national immunization programs in Latin America that compares the various realities, identifies challenges and unachieved goals, and encourages countries to search for strategies to overcome the obstacles they face. Ten countries with the most innovative national vaccination schedules (NVCs) were selected. Information published on official websites of ministries of health, the World Health Organization (WHO), the Pan American Health Organization (PAHO), and the United Nations Children's Fund (UNICEF) were used, as well as interviews with experts from each country. A ranking was constructed, based on domains linked to the 2019 NVC (vaccinations given at different life stages, influenza vaccination, and vaccination in special situations); vaccination coverage in 2018; and programmatic aspects. The general ranking is led by Chile and Panama, due to vaccination in the first and second year of life. They are followed by Argentina, Uruguay, and Costa Rica, which stand out for vaccination of other groups, influenza vaccination, and programmatic aspects. Brazil, Colombia, and Mexico have more delays in their NVCs, as well as programmatic gaps and lower vaccination coverages. Finally, Paraguay and Peru have similar deficiencies and bigger information gaps. However, when the domains are analyzed individually, the ranking changes and the same pattern is not repeated. This is the first ranking of national immunization programs in Latin America that highlights strengths and weaknesses in each country. The periodicity of this exercise will be key when comparing the evolution and positioning of these programs over time.

Improving Innovation and Access to Combination Vaccines for Childhood Immunization in China

combination vaccines can improve timely vaccination coverage and mitigate the social and economic burdens of both caregivers and health systems. Compared to other countries with high immunization performance, China remains behind the curve in promoting the inclusion of new combination vaccines into national vaccination schedules. The domestic research and development pipeline faces many technical obstacles, regulatory pressures, and competitive opposition. In addition to this, health disparities regarding combination vaccines exist in each dimension of access and their determinants, including availability, accessibility, acceptability, and quality. Our study aims to provide a cross-disciplinary analysis of China's combination vaccines (from innovation to access) and identify the main factors that affect the attitudes and behavior choices for combination vaccines. systematic reviews and secondary data analysis will be conducted to map the landscape of combination vaccines in China and the determinants influencing their innovation and access. A cross-sectional survey will be performed in seven provinces of China based on geo-economic representativeness among caregivers with children that are between 2 and 24 months old and are registered in the national immunization system. Questionnaires will be used to examine the relationship between each dimension of access and their determinants. These questionnaires will cover the caregivers' knowledge, attitude, and willingness to pay for combination vaccines, as well as their perceptions about vaccination services. Semi-structured interviews with the suppliers (public and private) and healthcare providers will help identify research gaps and the key challenges they face when developing and introducing combination vaccines in China. using a combined approach, with cross-country and multi-disciplinary support from experts, our research is designed to fill the information gaps in China's combination vaccine industry across the innovation-access spectrum. It will lead to evidence-based recommendations which will foster greater access to innovation-enhancing combination vaccines for childhood immunization in China. Moreover, the multi-dimensional approach could also be adapted beyond combination vaccines to assess innovation and other public goods for health among disadvantaged groups in the future.