Premature newborns are most vulnerable to the severe infectious diseases. The timeliness of vaccination in this group of children is extremely important. Historically, however, vaccination coverage for premature newborns has been significantly reduced due to unjustified contraindications. This is due to the fear of developing post-vaccination complications and the opinion that the immune response to vaccines in preterm newborns is reduced. In addition, in our country, there are no approved federal clinical guidelines for the vaccination of premature newborns, which determines the lack of a unified approach among medical workers and raises doubts among parents.The article presents a review of Russian and foreign literature data, highlighting the state of the problem of timeliness and completeness of vaccination coverage of premature newborns. Features of the immunity of a child born prematurely and the possibility of an adequate response to vaccine antigens in various degrees of prematurity. According to the list of the National Immunization Schedule, scientific and practical data on the safety and efficacy of vaccines registered in Russia, the benefits of complying with approved schedule and the positive non-specific effects of individual vaccines are given. Data on the specific prevention of RS-virus infection are presented. It has been shown that conditions that can develop after vaccination and are characteristic of prematurity are not directly related to the vaccine and that premature newborns is able to develop a sufficient immune response. Accordingly, children born prematurely should be immunized in accordance with the passport age with the stabilization of the child’s condition and adequate weight gain.

Relevance. Growing distrust of vaccines around the world, a decrease in vaccination rates have led to an increase in the incidence of measles and a rise in the vulnerability of people with immunodeficiency status. The aim. To study the efficacy and safety of measles vaccination in children with oncohematological diseases. Materials & methods. The study involved 107 children: 74 of them with a history of acute lymphoblastic leukemia and 33 with solid tumors. All children had a history of receiving standardized polychemotherapy. In all the subjects, the vaccination history was studied, the titers of specific antibodies to measles were determined. Children with non-protective levels of antibodies (53 children) were subsequently vaccinated against measles. Results and discussions. Of the 107 children examined, before cancer, 99 (92.5%) were vaccinated against measles, of which 68 (68.7%) patients were only vaccinated, and 31 (31.3%) had vaccination and revaccination. Protective titers of antibodies against measles were preserved in 51 people (51.5%), and 48 (48.5%) were seronegative. When assessing immunogenicity on days 14, 45 after the introduction of the vaccine, it turned out that by day 14, 27 out of 53 children (50.9%) developed measles antibodies, and by day 45, 33 out of 53 children (62.3%), the rest of the children did not developed a protective level of antibodies, including 3 of 6 revaccinated. Conclusion. Thus, children with malignant diseases, regardless of the number of previous vaccinations and the duration of the end of therapy, become unprotected or have low titers of antibodies to measles in 83.8%, and immunization after treatment is effective in 62.3% of cases.

Background. During the ongoing COVID-19 pandemic and in the season of rising incidence of other respiratory infections, it is relevant to use preventive measures of non-specific prophylaxis. Synthetic peptides are widely considered as a tool. The representative of this group is the synthetic analogue of thymus regulatory peptides Thymogen, which has been used in Russia for more than 20 years in the treatment of acute and chronic infection diseases.The aim of the study. To evaluate the effect of Thymogen, a dosed nasal spray, on induced parameters of the immune system during prophylactic use in healthy volunteers.Materials and methods. Twenty healthy volunteers received Thymogen nasal dosed spray (JSC “Cytomed”, Russia) at a dose of 25 μg twice a day for 10 days. A comparative assessment of immunological parameters was carried out in dynamics: before the start of therapy, on days 6 and 11 of taking the drug and 14 days after the end of the course. Clinical observation was carried out from day 1 to day 11, registration of adverse events – the entire period of the study for 24 days. The first day was considered the day the drug was started.Results. In the course of the work, according to the data of immunological examination, a statistically significant increase in the virus-induced production of interferon alpha (INF-α) by a culture of peripheral blood cells was revealed. The growth rate was recorded on day 11 of taking Thymogen and persisted for 14 days after the end of the course. Significant differences in the dynamics of bactericidal and phagocytic activity of neutrophils, serum α- and γ-interferon were not obtained.Conclusion. The use of Thymogen spray at a dose of 25 μg for 10 days was safe and contributed to a significant induction of interferon-alpha in response to exposure to a viral pathogen, which allows us to recommend the drug for prophylactic use during the period of rising incidence of acute respiratory diseases.

Relevance. Cancer therapy forms a temporary immunosuppressive state, which determines an increase in the frequency and severity of infectious diseases. Vaccination is a highly effective and safe way to protect against infection, but people with immunodeficiency have risks of inefficiency and complications. To substantiate the need for immunoprophylaxis in cancer patients after therapy, it is important to understand the preservation of their specific response after previous vaccinations. The aim of the study was to assess the safety of antibodies to vaccine–controlled infections in children with oncological diseases after therapy Materials and methods. The safety of antibodies to vaccine-controlled infections was studied in 3 groups: 1 -in patients with oncological (n=62); 2-in the group (n=43) withoutoncological diseases, but who received immunosuppressive (IST) and/or polychemotherapy (PCT) and/or hematopoietic stem cell transplantation (HSCT), and 3– in healthy children (n=31 – comparison group). The concentration of antibodies was determined by the ELISA method. The minimum protective level was considered to be the amount for measles ³0.18 IU/ml, rubella - ³25 IU/ml; hepatitis B - ³10 IU/ml; diphtheria – 0.03 IU/ml and higher. The coefficient of positivity, estimated as protective against mumps, was ³1.0. Results. It was found that from 41.7% to 93.7% of children with cancer lose post-vaccination immunity to the studied vaccine antigens. The number of children who retained the protective level of antibodies in groups 1 and 2 was significantly less than in the comparison group. There were no significant differences in the level of those protected from diphtheria and rubella. The maximum effect on the loss of antibodies is provided by the performed HSCT. For diphtheria and rubella antibodies, the differences are not pronounced. The possible connection of genetic breakdowns in 35 examined children with oncological diseases and the safety of antibodies was analyzed. It turned out that in the presence of chromosomal deletions, antibodies to measles were lost in 100% of cases and to diphtheria in 75%, which was different from other chromosomal abnormalities. Conclusion. The safety of antibodies in patients with a history of cancer is influenced by the presence of HSCT in therapy, the type of genetic breakdown, as well as the peculiarity of the vaccine antigen. Children with oncological diseases, as well as with non-oncological ones, but who have received HSCT therapy, should be vaccinated again against vaccine-controlled infections, despite the indication of the presence of vaccinations before therapy.

Relevance. Vaccine prophylaxis is the most cost-effective and affordable means of controlling infectious diseases. At the same time, there is a great regional diversity in the number of people who refuse vaccination. In our country, according to several large studies, there is a relatively low adherence to vaccination compared to other European countries. It is common to have doubts and questions about immunization in adult patients or parents who vaccinate their children. A decrease in vaccination coverage of the population can lead to an increase in the incidence of infections preventable by immunization. At the same time, measures to promote vaccination used by preventive health care systems in various countries are insufficient. This increases the likelihood for doctors of various specialties to meet in their daily activities with patients' questions and concerns about vaccination.The purpose of this work was to highlight the practical aspects of building a dialogue with patients who have doubts about vaccination. Conclusions. Successful communication is based on the doctor's ability to build a confidential dialogue based on confidence in the decency and goodwill of all its participants. Based on the study, the following conclusions can be drawn. An alarming trend in recent years is the increasing number of patients who doubt the effectiveness of vaccination. For hesitant patients, the doctor is one of the most important sources of information about vaccines. The doctor's ability to clearly and confidently build a dialogue about vaccination helps to dispel the patient's doubts and is the most effective means of increasing adherence to immunization of the population.

The article describes the characteristics and classification of adverse events after immunization (AEFI) according to the latest WHO recommendations. The registration systems for AEFI in the USA and in Russia are described. Particular attention is paid to the interpretation of the convulsive syndrome that developed after vaccination. Four clinical cases of the development of convulsive syndrome in children hospitalized at the Pediatric Research and Clinical Center for Infectious Diseases of Russia (St. Petersburg) in the postvaccination period are presented. The criteria for differential diagnosis of the described diseases are indicated. Only a search for the etiology of the disease allows us to assess the relationship with vaccination, timely conduct adequate therapy and generate objective information on the safety of vaccines. There is a need to register all episodes of seizures after vaccination and introduce new methods for registering PPI, as well as creating a system of statistical accounting of background health conditions (convulsions, allergies) of the population of the Russian Federation of various age groups.

Objective. To compare the reactogenicity and immunogenicity of inactivated influenza vaccines: Grippol Plus polymer subunit vaccine, Influvac subunit vaccine, and Vaxigrip split vaccine as part of influenza prevention in people aged 18 - 55 with no pre-existing conditions. Materials and methods. Comparative study of three groups of volunteers with no pre-existing conditions using coded serum samples. Randomisation: 1:1:1. Group 1:100 people vaccinated with Grippol® Plus, Group 2:100 people vaccinated with Influvac, Group 3: 100 people vaccinated with Vaxigrip. The study looked into the levels of specific hemagglutination-inhibition antibodies to influenza viruses in a standard hemagglutination inhibition assay (HAI), with the coding of sera obtained before the vaccination and 28 days post-vaccination. The seroconversion rate (share of patients with the antibody titer increase of more than 4x) and seroprotection rate (share of patients with antibody titer > 1:40) were measured. Reactogenicity was evaluated based on the intensity of systemic and local reactions during the first five days post-vaccination. Results. Reactogenicity: in general the number and intensity of systemic and local reactions in all the groups was insignificant, the reactions were mild and required no treatment with medications. Tolerability levels were high. There was a reliable decline in local reactions to subunit vaccines over time. Immunogenicity: the seroprotection rate for the A/H1N1 strain on day 28 post-vaccination was 95.0% for the Grippol Plus group, 95.0% for the Influvac group, and 96.0% for the Vaxigrip group. The seroprotection rate for the A/H3N2 strain on day 28 post-vaccination was 90.9% for the Grippol Plus group, 90.0% for the Influvac group, and 96.0% for the Vaxigrip group. The seroprotection rate for the B strain on day 28 post-vaccination was 99.0% for the Grippol Plus group, 100.0% for the Influvac group, and 100.0% for the Vaxigrip group. Conclusion: the study found that the Grippol Plus, Influvac, and Vaxigrip vaccines have similar efficacy in vaccination against the A/H1N1, A/H3N2, and В strains 28 days post-vaccination. All the vaccines tested were in line with the CPMP requirements to the immunogenicity of human influenza vaccines. All the vaccines had a similar safety profile, but the incidence of injection site pain, swelling and itching was reliably lower in those vaccinated with the Grippol Plus and Influvac vaccines as compared to the Vaxigrip vaccine.

In 2013 WHO re-evaluated its main goals of the polio eradication program. A modernization program was accepted with regard to the National vaccination calendars worldwide which includes a step-by-step refusal from the living polio vaccine (OPV) and a total transition to the inactivated polio vaccine (IPV) starting in 2019. Because of the total eradication of the polio type 2 virus, as an intermediate step the 3-valence OPV was substituted with the 2-valence OPV, which does not contain the type 2 polio virus, in April 2016. The aim of the article is to present the history of polio prevention and to state the reasons for the adoption of 3rd edition of the Global Polio Eradication Initiative. The new approaches were defined for eradication of wild polio virus type 1 and vaccine related strains. A new strategy for global switch to inactivated polio vaccine by 2019 was suggested.

Objective: Our aim was to study the clinical efficacy of pneumococcal conjugate 13-valent vaccine (PCV13) in children aged less than 3 years.Methods: retrospective comparative study of the incidence of acute respiratory infections (ARI), otitis and pneumonia during the first three years of life in 184 children vaccinated with PKV13 and 186 unvaccinated peers.Results: 91 of 184 children (49.4%) were vaccinated during the 1st year of life, 61 (33.2%) — during the 2nd year, and 32 (17.4%) — during the 3rd year. Number of ARI per 1 child among children vaccinated in the 1st year of life was 5.5 times less than among unvaccinated children (0.42 and 2.31 cases); frequency of otitis during the second year of life was 6.8 times less (7.6% and 52.1%, р < 0,01), and during the third — 34.7 times less (1.1% and 38.2%, р < 0,01). All children vaccinated before the age of 1 were 6.3 times less (1.1% and 6.9%) ill with pneumonias. Additionally it was noted that number of ARI per 1 person among children, vaccinated during the 1st year of life, during the third year of life was lower than among children vaccinated later (0.42; 1.02; 2.03 respectively). There also was a significant in otitis number between children vaccinated during the first and the third years of life (1.1 and 15.6% р < 0,01).Conclusion: to reduce the incidence of ARI, otitis and pneumonia in children, it is necessary to vaccinate children with PCV13 in the age under 1 year. «Catching up» immunization of the second and third years of life is effective, but to a lesser extent.

Проведено двойное слепое рандомизированное сравнительное исследование по оценке реактогенности и иммуногенности противогриппозных инактивированных вакцин: полимер-субъединичной Гриппол плюс, субъединичной Инфлювак и сплит-вакцины Ваксигрип. В исследовании приняло участие 300 здоровых добровольцев в возрасте 18–55 лет. Работа выполнена в эпидемический сезон 2014–2015 гг. С целью оценки безопасности проведено клиническое наблюдение за привитыми и регистрация поствакцинальных реакций в течение 5 дней, а также учет всех нежелательных явлений в течение 58–62 дней после иммунизации. С целью оценки эффективности проводилось серологическое исследование крови до, на 8-й и 28-й день после вакцинации для определения специфических антител к вирусу гриппа с помощью реакции торможения гемагглютинации по общепринятой методике. Было показано, что исследуемые вакцины имеют близкий профиль безопасности и схожую иммунологическую эффективность.

The analysis of safety and efficiency of vaccination of the children born before the term (61 children of 1 – 4 degree of prematurity) and children born in time (21 children – group of comparison). For vaccination and revaccination was used: DTP (20 and 15 children respectively), DTaP (22 and 4 children), pentavalentny vaccine (DTaP/IPV/Hib – 9 and 2 children) and DT (10 children of the studied group with convulsion in the anamnesis). Against measles, mumps and a rubella was immunized 47 and 20 children respectively. After immunization all clinical symptoms was analyzed and after 2 months diphtheria measles and mumps antibodies was detected.Prematurely born children has the 1 vaccination for 3 – 4 months later, then infants, with born at time. After vaccination 75.4% and 74.5% infants in both groups hadn’t any clinical symptoms. Acute respiratory infection was registered with the same frequency (25,5 – 25.0% and 24.6 – 23.8%). The antibodies titer to diphtheria, measles, mumps didn't depend on degree of prematurity.

In 2011 - 2012 years in the Institute of childhood infections followed by an open comparative randomized study of tick-borne encephalitis vaccine EntseVir («Microgen») at a dose of 0.25 ml of the two schemes, planned and emergency in children aged 3 - 17 years. As a reference drug used vaccine FSME-Immun junior production (Baxter, AG, Austria). The results of clinical studies have shown that Entsevir at a dose of 0.25 ml has a good safety profile, low reactogenicity. Mostly recorded transient local reactions such as pain at the injection site weak degree. Severe reactions and post-vaccination complications were absent. EntseVir has no immunosuppressive, immunopathological action, highly immunogenic and can be recommended for mass prophylaxis tick-borne encephalitis in children 3 - 17 years on two schemes of vaccination (planned with an interval of 60 days and emergency with an interval of 14 days).

In 2011 - 2012 years in the Institute of childhood infections followed by an open comparative randomized study of tick-borne encephalitis vaccine EntseVir («Microgen») at a dose of 0.25 ml of the two schemes, planned and emergency in children aged 3 - 17 years. As a reference drug used vaccine FSME-Immun junior production (Baxter, AG, Austria). The results of clinical studies have shown that Entsevir at a dose of 0.25 ml has a good safety profile, low reactogenicity. Mostly recorded transient local reactions such as pain at the injection site weak degree. Severe reactions and post-vaccination complications were absent. EntseVir has no immunosuppressive, immunopathological action, highly immunogenic and can be recommended for mass prophylaxis tick-borne encephalitis in children 3 - 17 years on two schemes of vaccination (planned with an interval of 60 days and emergency with an interval of 14 days).

The levels of antibodies to the separate and combined administration of the vaccine plus Grippol® Plus and vaccines against measles, mumps and/or rubella, diphtheria and tetanus (DT) in children with chronic medical illnesses, including HIV and organic CNS. Revealed that at low reactogenicity and safety of the vaccine Grippol® Plus, concomitant vaccination does not affect the dynamics of the synthesis (seroprotection, seroconversion), diphtheria, mumps, and rubella antibodies, however, reduces the synthesis of measles antibodies. When combined administration of DT and mumps-measles vaccines + Grippol® Plus suppressed antibody response to a strain of influenza virus A/H3N2.

Aim : to study safety and immunological efficacy of vaccination against influenza in separate and associated immunization according to the National Calendar. Patients and methods : 100 children with various disorders as well as children with HIV subjected to revaccination against diphtheria, tetanus, measles, parotiditis and rubella, were included into the study. Children were divided into 5 groups of 20 persons each: groups of separate or associated vaccination. In order to assess safety of vaccination children were observed for 30 days after vaccination. In order to analyze immunologic efficacy participants were taken serum tests before and on the 30 th day after vaccination. Results : the study demonstrated high safety of the vaccine against influenza. Mild and moderate topical and general reactions were observed in isolated instances and did not differ in comparison groups. Simultaneous vaccination against influenza with immunization against diphtheria, parotiditis and rubella did not influence synthesis of antibodies, while synthesis of antibodies against measles was decreased; immunization against diphtheria and measles when associated with vaccination against influenza depressed synthesis of antibodies against A/H3N2 influenza . Conclusions : vaccine against influenza has low reactivity, high safety and can be used in association with immunization according to the National calendar in independence to somatic disorders of patients.