The human papillomavirus (HPV) infection is one of the risk factors for the development of a number of diseases in women and men. Vaccination of adolescents with the 4-valent HPV vaccine significantly reduces the prevalence of infection with vaccine strains of HPV.The aim of this study was to assess the cost-effectiveness of gender neutral vaccination with the 4-valent HPV vaccine in 12-year-old adolescents in the Russian Federation.Materials and methods. Markov modeling was used based on epidemiological data for the Russian Federation. In the base case, the analysis was carried out taking into account the social perspective. It was assumed that the effect of vaccination lasts throughout life. The analysis was carried out for the survival period of 12-year-old adolescents. Costs for the treatment of HPV-associated diseases corresponded to compulsory health insurance rates across St. Petersburg for 2023. Costs and life expectancy have been discounted for 3,5% a year.Results. Taking into account the accepted assumptions, vaccination of 12-year-old girls in the Russian Federation with the 4-valent HPV vaccine will prevent, per 100 thousand vaccinated people, 1448 cases of anogenital warts, 4106 cases of cervical intraepithelial neoplasia grade 2+, 1194 cases of invasive cervical cancer and 257 cases of other oncological HPV-associated diseases, and gender-neutral vaccination (100 thousand girls and 100 thousand boys) – an additional 1021 cases of anogenital warts and 162 cases of oncological HPV-associated diseases. Vaccination of girls will reduce the budgetary costs associated with HPV infection by 28.515 thousand rubles per 1 vaccinated girl with vaccination cost equal to 24.606 thousand rubles. Vaccination of adolescents of both sexes increases costs by 10.074 thousand rubles per 1 vaccinated person. The incremental cost-effectiveness ratio (ICER) is equal to 232.5 thousand rubles/QALY (quality adjusted life year), i.e. vaccination is highly cost-effective. Sensitivity analysis shows the high reliability of the results obtained.Conclusions. Gender neutral vaccination of adolescents before the onset of sexual activity with the 4-valent HPV vaccine can be considered as a highly effective health technology in the prevention of HPV associated diseases.

Complications after the introduction of the tuberculosis vaccine develop extremely rarely. They become accidentally vaccinated infants with undiagnosed severe immunodeficiency. The article considers a clinical case of the course of disseminated BCG infection with multiple organ damage in congenital immunodeficiency in a 9-month-old boy. The disease manifested itself acutely, the child’s condition worsened within a week, and its outcome was the death of the baby. Primary immunodeficiency was confirmed by the results of a pathoanatomic examination. The discussion provides a classification of complications after the introduction of BCG vaccine, the algorithm of the doctor’s actions in case of a suspected complication after vaccination, and also describes the main signs of immunodeficiency.

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.

The pandemic caused by the new coronavirus disease (COVID-19) was the largest in the last century since the Spanish Flu. One of the important strategies in the fight against COVID-19 has been vaccination. Although the end of the pandemic was declared in May 2023, the question of how the epidemic situation will spread (seasonal waves, new disease or gradual disappearance) remains unclear due to the high variability of the pathogen, which determines and changes recommendations in further immunization tactics.Purpose of the study: to compare the clinical effectiveness of the first vaccination, as well as 1–3 revaccinations against a new coronavirus infection in people of different ages and health conditions.Research methods: clinical observation of 1159 people aged 19 to 92 years (74,8% women), assessing the frequency and severity of confirmed coronavirus infection before vaccination and for 2 years after vaccination in comparison with health status and age of those vaccinated; laboratory examination – examination of a nasopharyngeal smear using realtime PCR (Real-time PCR) for SARS-CoV-2; statistical data processing.Results: out of 1159 people, 255 people (22.0%) fell ill before vaccinations, of which 154 people (22.5%) were among 684 healthy people, and 101 out of 475 (21.2%) were among people with chronic pathology. It was found that before the introduction of vaccinations, people 40–59 years old were significantly more likely to get sick compared to the group 60 years old and older (30,4% and 18,3%, respectively, p=0,015). Since December 11, 2020, 1106 out of 1159 people have been vaccinated against the new coronavirus infection, of which with adenovector vaccines (1056 people) and based on other technological platforms (50 people). Revaccinations were carried out only with adenovector vaccine: 1 revaccination – 780, 2 revaccination – 249 and 3 revaccination – 35 persons. After vaccination, a significant decrease in the number of sick people was revealed in all groups: after primary vaccination, 129 (11,7%) vaccinated people got sick, after 1 revaccination 44 out of 780 (5,6%), after repeated revaccination 5 out of 284 (1,7%). In the group of people with chronic pathology, a significant decrease in morbidity was also noted after the first revaccination: out of 366 revaccinated people, 24 people (6,5%) fell ill and after repeated revaccination: 3 out of 159 (1.8%), compared with the primary vaccination complex, 61 out of 467 vaccinated (13,0%), (p<0,001).Conclusion: In the absence of vaccination, middle-aged people are the highest risk group for developing coronavirus infection. A significant decrease in the incidence of diseases with an increase in the number of vaccinations has been established. Thus, among 1106 people who received the primary vaccine complex, 129 (11,7%) fell ill; after the complex vaccination and the first revaccination – 44 out of 780 (5,6%), in the group who received 2 and 3 revaccinations, 5 out of 284 vaccinated people fell ill (1,7%) (Px2<0,001).

Whooping cough remains a life-threatening infection, especially for unvaccinated young children. The article describes a case of severe and non-smooth course of whooping cough in an unvaccinated girl of 4 months of life from the family hearth of whooping cough and COVID-19. There were cases of COVID-19 and whooping cough in adults in the family, occurring under the mask of a mild respiratory infection, not verified before they were detected in a child and did not require hospitalization. The combined course of two infectious diseases COVID-19 and whooping cough in a 4-monthold unvaccinated girl contributed to the prolongation of the duration of whooping cough, prolonged release of SARS-COV-2 RNA, the late appearance of hematological changes typical of whooping cough, the development of respiratory delays and re-hospitalization of a patient with prolonged respiratory support. In the context of the COVID-19 pandemic, the coverage of routine vaccination has significantly decreased, as a result of which children of the first years of life have become more vulnerable to vaccine-controlled infections, which causes the risk of combined infections.

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.

The World Health Organization announced on May 4, 2023 that coronavirus infection is no longer a global emergency, but despite this, it proposed a strategy for 2023-2025 that includes the definition of immunization principles by each country, the need for case registrations and surveillance behind the virus. The review article presents data on high-risk groups for a severe course of a SARS-CoV-2 and new approaches to vaccination and revaccination recommended by WHO on depending on risk factors in patients and circulating new strains of the virus.

One of the main causes of acute gastroenteritis in children under 5 years of age is rotavirus infection (RVI). Vaccines against RVI significantly reduce the incidence. Aim. To evaluate the cost-effectiveness of mass vaccination of children with a 5-valent RVI vaccine in the Russian Federation. Materials and methods. The assessment was carried out using modeling based on published data on the effectiveness of the vaccine and epidemiological indicators in the Russian Federation. The analysis was carried out from the perspective of the health care system and society as a whole with a 5-year horizon. The cost of RVI therapy corresponded to the compulsory health insurance tariffs for St. Petersburg for 2022, the price of 1 dose of the vaccine was the registered price, including VAT. Costs and life expectancy, taking into account quality, were discounted at 3.5 % per year. Results. Given the assumptions made, routine vaccination will prevent an average of 468,637 cases of RVI over 5 years. Avoided direct medical costs, i. e. RVI treatment costs will amount to 53,4 %, and lost income due to temporary disability – 46,6 % of the total avoided costs. At the same time, the volume of avoided costs is 61,4 % due to a decrease in morbidity in the vaccinated population, and 38.6 % due to the development of a indirect effect. The predicted avoided costs per 1 vaccinated person is 2,975 thousand rubles. From a societal perspective, the cost-effectiveness of the Rota-V-Aid vaccine will be 364,813 thousand rubles / QALY (quality-adjusted life year), and from a healthcare perspective – 1726,399 thousand rubles / QALY. Thus, in both cases, the cost-effectiveness of RVI vaccination will not exceed the generally accepted threshold of willingness to pay, equal to three times the gross domestic product per capita in the Russian Federation (according to data for 2021 – ~2,7 million rubles). The predicted cost-effectiveness of selective vaccination is significantly lower than that of mass vaccination. Conclusions. Mass vaccination of children with a 5-valent vaccine against RVI will not only reduce the incidence in the Russian Federation, but, taking into account the assumptions made, can also be considered as a cost-effective intervention.

The purpose of the study: to determine the development of vaccination against infections associated with contingents in an epidemic crisis. Materials and methods: the method of a sociological survey of future workers and those vaccinated in different epidemic status periods was used: 2019 – the pre-pandemic period and 2020 – the period of the COVID-19 pandemic. A sociological survey was conducted in 2019 among 212 medical workers (130 doctors and 82 nurses) and among 229 medical workers in 2020 (143 doctors and 86 nurses). Parents were also interviewed using a questionnaire. 100 and 50 respondents took part in the survey, respectively. Results: a large number of pregnant workers – 74.3-88.1% are positive about vaccination. However, 6.8% of therapists and 9.6% of nurses of adult health facilities express a wary attitude, there were no negative reactions, unlike in 2019, when the severity of 2.2% of general practitioners and 4.2% of nurses of adult health facilities was negative. The largest number of respondents of all groups among the reasons for refusing to vaccinate is called “information that vaccinations are dangerous” from 76.6% to 88.9% in 20219, from 74.1% to 93.2% in 2020. Among parents, only 34% had a positive attitude towards vaccination, 12% negatively. Conclusions: It is necessary to take prompt measures to increase adherence to vaccination of the main social groups that have a decisive influence on the attitude and effect of vaccination.

The review article discusses vaccines against SARS-CoV 2 based on adenovirus vectors currently used in the world. The concept of creating vector vaccines is described. The data of clinical studies on the efficacy and safety of registered adenovirus-vector vaccines for the prevention of new coronavirus infection are presented. The frequency of serious adverse events after their use is described in detail. In addition, the clinical efficacy of vector vaccines for changing genotypes of the Covid 19 virus has been determined.The review analyzes literature data on the safety and efficacy of vector vaccines against coronavirus infection.The vector vaccines currently used against the new coronavirus infection are quite safe and effective even in relation to the new genotypes of the SARS-CoV 2 virus.

Since March 2020, the World Health Organization has declared a coronavirus infection pandemic. Almost immediately, the development of vaccines began, according to the recommendations published by WHO. Currently, 137 vaccines in the world are undergoing clinical trials and 194 are at the stage of preclinical studies. Candidate vaccines have been developed using a variety of technology platforms. This article presents data on the safety and efficacy of mRNA vaccines against a new coronavirus infection in children and adolescents. A high population effect of these vaccines was noted before the spread of Delta and Omicron variants and a slight decrease in effectiveness against new coronavirus variants. The results of the use of these drugs in patients at risk are also described: cancer patients and people with autoimmune and autoinflammatory diseases.The review analyzed literature data on the safety and efficacy of mRNA vaccines against coronavirus infection. Currently used mRNA vaccines against novel coronavirus infection are safe and effective even among patients at risk (cancer patients and individuals with autoimmune or autoinflammatory diseases).The results of studies and post-registration monitoring of mRNA vaccines emphasize their safety and efficacy profile, which confirms the possibility and need for mass use.

A case of whooping cough in a moderate form in a child of the first month of life is described in the presented clinical observation. The moderate form was manifested by the duration of the preconvulsive period up to 5 days, the appearance of cyanosis of the face when coughing in the early stages of the disease (1 week), an increase in the number of coughing attacks. The difficulties of treating pertussis in young children are demonstrated by our observation of the course of the disease. There is no vaccination against pertussis in children in the family due to the refusal of parents and children with prolonged coughing were not examined at the outpatient stage. As a result, chemoprophylaxis was not performed on time and the newborn was discharged from the hospital to the center of pertussis infection. The solution to the problem of reducing the incidence in children in the first months of life should be vaccination of pregnant women in the last stages, and vaccination of the environment, including agerelated revaccinations.

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.

Generalized forms of invasive meningococcal desease (IMD) are very dangerous because they have a high mortality rate.The aim of the work was to assess the cost-effectiveness of meningococcal vaccination of infants with the 4-valent MenACWY-D conjugate vaccine in the Russian Federation.Material and methods. Cost-effectiveness analysis based on epidemiological data for the Russian Federation was carried out by a modeling method with a horizon of 80 years from the position of the healthcare system and taking into account the social perspective. Vaccination costs were calculated on the basis of the registered price of the vaccine, including VAT, the costs of GFMI therapy and patient rehabilitation – based on the compulsory medical insurance tariffs in St. Petersburg for 2021. Indirect costs due to temporary disability of patients’ parents, disability of patients and premature death were estimated by the lost GDP. In the base case, costs were discounted by 3,5% per year, life expectancy – by 1,5% per year.Results. Given the assumptions made, the average lifetime burden of a child’s illness is 17,556 million rubles. (no discounting). In the base case, the incremental cost per LYG from the payer perspective – 7,821 million rubles, and from the social perspective – 3,328 million rubles. Incremental cost per QALY – 5,350 million rubles and 2,277 million rubles, respectively. The most important factors that have a significant impact on the cost-effectiveness of vaccination are the incidence of IMD, the price of the vaccine, and the value of the discounting of costs and life expectancy.Conclusions. Given the assumptions made, meningococcal vaccination of infants with 4-valent meningococcal vaccine can be considered as a viable option.

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.

Background. Patients with juvenile idiopathic arthritis (JIA) may have incomplete vaccination againts different vaccines leads to lower protective levels of anti-vaccine antibodies.The aim of the study – to evaluate the rate and the main factors of incomplete vaccination against measels, parotitis, rubella (MMR), and diphtheria in JIA patients.Methods. In the present study were included data 170 JIA (55 boys and 115 girls) aged from 2 to 17 years, who received scheduled vaccination before the age of 2 years and before JIA onset against measles, parotitis, diphtheria and rubella. Incomplete vaccination means the reduced number of vaccine to age. In all patients the IgG anti-vaccine antibodies levels were detected with ELISA. Data presented with odds ratio ()OR) with 95 confidence interval (CI).Results. Incomplete vaccination against MMR was in 50 (32.5%) of children less than 6 years. Incomplete vaccination against diphtheria was in 6/16 (37.5%) of children less than 6 year, in 53/110 (48.2%) of children aged 6–14 years and in 26/44 (59.1%) of the JIA patients more than 14 years. The main predictors in logistic regression for incomplete vaccination for MMR were: onset age <4 years (OR=12.2 [95% CI: 5.0–28.9]; p=0.0000001), JIA duration >3.1 years (OR=4.4 [95% CI: 2.0–9.9]; p=0.0002), methotrexate duration >3 years (OR=5.7 [95% CI 2.7–12.0]; p=0.0000012); biologic treatment (OR=2.5 [95% CI: 1.3–4.9]; p=0.008) and treatment >1 biologic (OR=3.3 [95% CI: 1.1–10.4]; p=0.002); for diphtheria were: JIA duration >3.1 years (OR=3.4 [95% CI: 1.8–6.5]; p=0.0002), methotrexate duration >2.8 years (OR=4.1 [95% CI: 2.1–8.1]; p=0.00004), biologic treatment (OR=2.4 [95% CI: 1.3–4.4]; p=0.006). In the multiple regression only JIA onset age (p=0.00001) and duration of methotrexate (p=0.003) were predictors of incomplete vaccination against MMR. Methotrexate duration (p=0.005) and biologics treatment (p=0.05) were predictors of incomplete vaccination against diphtheria.Conclusion. The main predictor of incomplete vaccination was younger onset age of JIA. Children received more intensive immunosupression usually have scheduled vaccination rarely which leads to increased number of patients without protective antibody levels. These facts indicate the attitude of physicians parents to vaccination in immunocompromised children. Further investigations required for assessment of safety of vaccinations in children with rheumatic diseases may be a factor for changing this prejudice.

Varicella is a significant burden on society and the healthcare system.Objective: to analyze the cost effectiveness of universal vaccination of children against varicella.Material and methods. The analysis was carried out from the perspective of the healthcare system and societal perspective, based on epidemiological data for the Russian Federation. The effect was taken into account only in the vaccinated population. The time horizon of the study is 10 years. The amount of direct medical costs for treatment of varicella was calculated based on the rates of compulsory medical insurance in St. Petersburg in 2020. The cost of drug therapy in outpatient settings was calculated based on the weighted average retail price of prescribed drugs. The analysis of direct nonmedical and indirect costs was carried out taking into account statistical data on the Russian Federation and duration of temporary disability of family members of sick children. Costs and quality-adjusted life expectancy were discounted by 3.5% per year.Results. The average cost due to the disease in the Russian Federation is 43,139 rubles / patient, of which 8,5% is direct cost. Vaccination of 100,000 children will prevent 38,551 cases of varicella in 10 years. When analyzing from a social perspective, vaccination provides a reduction in costs compared to no vaccination, and the savings will amount to 10.1 thousand rubles per 1 vaccinated person.If vaccination coverage is 90%, taking into account the fact that the cohort of children in the Russian Federation at the age of 1 year is about 1.9 million people, the cost of vaccination will amount to about 8.1 billion rubles annually. At the same time, already 6 years after vaccination, the volume of averted budgetary costs will exceed the costs of vaccination.Conclusion. Universal varicella vaccination of children will reduce the incidence of the disease and reduce the budget costs associated with this disease.

Whooping cough is still an urgent health problem in Russia, despite the vaccination that has been carried out for many decades. The group at high risk of severe whooping cough and death from it is children under 1 year old who have not received routine vaccination or are not vaccinated by age (the first months of life). The world health organization recognizes vaccination of pregnant women as the most effective method of preventing whooping cough in children before they receive three routine vaccinations. World experience in immunization programs for pregnant women against pertussis shows that up to 91% of children under 3 months of life are protected from pertussis as a result of transplacental transmission of antibodies formed in the mother after her vaccination (which corresponds to the timing of vaccination of children against pertussis in Russia: the first vaccination at the age of 3 months). The maximum preventive effect for a child was observed when a pregnant woman was immunized at 28–32 weeks of gestation. The safety of vaccination for both mother and child is shown. No serious adverse events related to vaccination have been reported. Coverage of pregnant women with vaccination in different countries reaches 51-70%. In order to increase adherence to vaccination of pregnant women, medical personnel should be regularly trained in the basics of vaccination, as well as conduct active health education among the population.

Relevance. The growth of pertussis is observed in all countries of the world. The main reasons for this are: decreased level of vaccination, loss of antibodies after vaccination, new methods of examination, changes in the antigenic structure of the pathogen. Solution: vaccination of pregnant women, increasing the level of vaccination, age-related revaccinations. The prospect is to create new vaccines.Purpose. Determine the frequency of untimely vaccination against whooping cough in children of the first years of life, the duration of immunity preservation after the completed set of vaccinations, and the rationale for the catch-up immunization scheme.Results. The timeliness of vaccination was evaluated in 675 children according to vaccination certificates and form112/y. It turned out that 9,21% of children received the first vaccination after a first year old, the second – already 24,10%, the third more than 34%. 49,75% of children included in the analysis had revaccination by the 2 year old. Antibody titers were evaluated after vaccination and 1 revaccination in 114 children with informed parental consent. Through the year after whole cell vaccine did not have protective titers of 17 of the 58 children (29,3%), the grafted acellular – 15of 56 (26.8 percent). After 3 years was examined 39 children (25 – grafted acellular vaccine and the whole-cell 14). 44,0% (11 children) and 50,0% (7 children) did not have protective titers, respectively. The data coincided with the results of serological monitoring of Rospotrebnadzor in St. Petersburg. The need for catch-up immunization and the introduction of age-related revaccinations against pertussis was confirmed. Catch-up immunization schemes have been developed. Conclusions. Almost half of children are vaccinated with a violation of the calendar, the primary complex of vaccinations, both whole-cell and acellular vaccines, does not provide long-term protection. It is necessary to introduce catchup immunization and age-related revaccinations.

Vaccination is one of the most effective and cost-effective means of reducing infectious diseases. However, the effectiveness of vaccination is determined by a huge number of different factors: gender, age, genetic characteristics that determine the level of the immune response, the presence of comorbid conditions. In addition, a significant role in the effectiveness of vaccination belongs to the vaccine itself. In recent years, special attention has been paid to the detection of intrauterine or congenital infections in children, the frequency of which reaches 52.2%. The most common clinical manifestations of intrauterine infections are infections, damage to the central nervous system, liver, genitourinary system, and hematopoietic system. The appearance of signs of intrauterine infections often leads to the fact that children are not vaccinated in a timely manner. At the same time, it was shown that patients with intrauterine infections, including premature babies, children with malnutrition, immunodeficiency states, die from controlled infections significantly more often than their peers without comorbid conditions. In this article, vaccination opportunities for patients with intrauterine infection are formulated, which allow immunizing children with various health conditions in accordance with the vaccination calendar and additional vaccines for selective indications.