Order of the Ministry of Health of the Russian Federation of June 27, 2001 N 229
"About the national calendar preventive vaccinations and the calendar of preventive vaccinations according to epidemic indications"
(as amended January 17, 2006)
Cm. Guidelines MU 3.3.2.1172-02 "The procedure for providing state municipal health care organizations with medical immunobiological preparations within the framework of the national calendar of preventive vaccinations and the calendar of preventive vaccinations according to epidemic indications", approved by the Chief State Sanitary Doctor of the Russian Federation on November 14, 2002.
In accordance with the letter of the Ministry of Justice of the Russian Federation of July 31, 2001 N 07/7800-YUD, this order does not need state registration (information published in the Bulletin of the Ministry of Justice of the Russian Federation, 2001, N 9)
For the implementation of the provisions of this order, see the letter of the Department of State Sanitary and Epidemiological Surveillance of the Ministry of Health of the Russian Federation dated December 10, 2001 N 2510 / 12419-01-32
In order to implement the Federal Law "On Immunoprophylaxis of Infectious Diseases" dated September 17, 1998 N 157-FZ and ensure the epidemiological well-being of the population Russian Federation For infections controlled by means of specific prophylaxis, I order:
1. The heads of the health authorities of the constituent entities of the Russian Federation, the chief physicians of the centers of state sanitary and epidemiological supervision in the constituent entities of the Russian Federation to ensure the organization of preventive vaccinations from 01.01.2002 in accordance with the national calendar of preventive vaccinations
and a calendar of preventive vaccinations according to epidemic indications .
See Guidelines MU 3.3.1.1095-02 "Medical contraindications for preventive vaccinations with preparations of the national vaccination schedule", approved by the Chief State Sanitary Doctor of the Russian Federation on January 9, 2002.
2. State Research Institute for Standardization and Control of Medical Immunobiological Preparations. L.A. Tarasevich of the Ministry of Health of Russia until 01.11.2001 to submit for approval to the Ministry of Health of the Russian Federation the texts of instructions for the use of domestic and foreign vaccines in accordance with the national calendar of preventive vaccinations and the calendar of preventive vaccinations according to epidemic indications.
3. Consider the order of the Ministry of Health of Russia and the State Committee for Sanitary and Epidemiological Supervision of Russia of 03.06.96 / 21.05.96 N 226/79 "On the introduction of preventive vaccinations against hepatitis B" and the Ministry of Health of Russia of 12.18.97 N 375 "On the calendar of preventive vaccinations" from 01.01.2002 invalidated.
4. To impose control over the implementation of this order on the First Deputy Minister of Health of the Russian Federation G.G. Onishchenko.
Minister Yu.L. Shevchenko
By order of the Ministry of Health and Social Development of the Russian Federation dated January 17, 2006 N 27, this appendix has been amended
Order of the Ministry of Health of the Russian Federation No. 125 dated March 21, 2014 approved a new national calendar of mandatory preventive vaccinations and a calendar of preventive vaccinations according to epidemiological indications.
On a note
1. Vaccination against hemophilic and pneumococcal infections has been introduced into the new calendar of mandatory preventive vaccinations of the Russian Federation.
2. The preventive vaccinations indicated in the calendar are mandatory. All other preventive vaccinations are used according to epidemiological indications. That is, they are carried out, if necessary, against certain infections and certain categories of citizens, as well as depending on the place of residence (for example, against tularemia, anthrax, tick-borne encephalitis and others).
Let's talk about everything in more detail ...
How did the concept of "Calendar of preventive vaccinations" appear?
It was introduced in the 40s of the last century due to the fact that the number of vaccines increased.
Now each country has its own national vaccination calendar.
Available differences in the national calendar of mandatory preventive vaccinations in Russia from the calendars of other developed countries. The difference is that our calendar does not include mandatory preventive vaccinations against meningococcal and rotavirus infections, viral hepatitis A and chicken pox.
Why is tuberculosis vaccination important?
Basic principles of vaccination
The first vaccination is carried out in the maternity hospital on the 3rd-7th day of life with the BCG or BCG-M vaccine.
If for some reason the child did not receive a vaccination against tuberculosis in the first days of life, then he is then vaccinated according to the scheme: up to two months of life - without setting the Mantoux reaction, older than two months of life - only after the Mantoux reaction.
Why is hepatitis B vaccination important?
The hepatitis B virus is 100 times more infectious than the AIDS virus. Therefore, if a woman is a carrier of the hepatitis B virus, then the risk of transmitting it to her child during childbirth is about 70-90%. During breastfeeding, as well as during close contact between the mother and the child, the risk of transmission of the virus also remains quite high.
Of course, all expectant mothers are examined for the presence of the Australian antigen in their bodies, but the method used does not detect it in 40% of cases.
Basic principles of vaccination
If the child is healthy then he is vaccinated according to the general scheme: 0-1-6 months. When using combined vaccines, a second vaccine can be given at two or three months. The third vaccination is carried out no earlier than six months after the first.
However, the pattern is changing if the baby is at risk: the mother is ill with acute or chronic hepatitis B or there are intravenous drug addicts in the family.
In this case, the baby is vaccinated at birth, then at the age of one, two and twelve months (0-1-2-12 months).
Why is vaccination against Haemophilus influenzae and pneumococcal infection important?
Most common in children under five years of age pneumococcal infection causes pneumonia (70-90% of all cases) and otitis media with perforation of the eardrum (50% of cases), pneumococcal meningitis (5-15% of all cases).
From hemophilic infection children under five years of age are also most often affected. It leads to the development of bronchitis, osteomyelitis ( inflammatory process, affecting the area of the bone marrow), epiglottitis (inflammation of the epiglottis), arthritis.
Moreover, the diseases are severe and difficult to treat, leading to the development of a large number of complications: respiratory and / or heart failure, cerebral edema, and others. Since these infections are resistant to almost all types of antibiotics, and the capsule of the pathogens themselves is too simple for the immune system to respond to them in full force.
Moreover, it is important to immunize the baby as early as possible. Because the maternal antibody cells that the baby receives with mother's milk protect against these two infections only until the third month of life.
Basic principles of vaccination
Vaccination dates correspond to those indicated in the national calendar. Particular attention is paid to children at risk (for example, often ill). If necessary, they are vaccinated according to an individual scheme.
Why is DPT and polio vaccination important?
Polio- a formidable disease, because it causes the development of paralysis, leading to the development of disability.
diphtheria and tetanus- deadly infections. Tetanus leads to the development of severe general convulsions and respiratory disorders, often to death. Diphtheria proceeds with a pronounced violation of the general condition (high body temperature, impaired consciousness, and others), spasm of the laryngeal muscles (causes suffocation). Unfortunately, often the outcome of the disease is the death of the patient.
Whooping cough- a severe infection that causes the development of a spasmodic paroxysmal cough, disturbances in the work of the heart and other complications.
The vaccine is quite serious and not all kids tolerate it easily. Therefore, the baby by this age should be examined by all specialists, and also undergo all examinations in accordance with the schedule of medical examinations.
Basic principles of vaccination
The vaccine is quite serious, not all kids tolerate it easily. Therefore, before her, it is necessary to examine the crumbs and make sure that he is absolutely healthy: a general blood test, a general urinalysis, an examination by a neurologist, an ultrasound of the brain.
After receiving the results and conclusions, the child is vaccinated. Then he receives revaccination in accordance with the terms indicated in the national vaccination calendar.
Why is measles, rubella and mumps vaccination important?
Measles, mumps and rubella are childhood infections. It would seem that there is nothing wrong with them. After all, our grandparents had been ill with them in childhood. However, this is not the case because infections can lead to the development of complications:
- Mumps. Sometimes deafness occurs, pancreatitis or type II diabetes mellitus develops, and infertility in boys.
- Rubella. If a girl is not immune to rubella, she can get the infection during pregnancy. Which can lead to the formation of congenital malformations in the fetus (defects of the heart, organs of vision and hearing, nervous system and others), miscarriage and some other consequences.
- Measles. Pneumonia, croup (inflammation and swelling of the mucous membrane of the larynx, leading to the development of suffocation), encephalitis (inflammation of the brain) and other complications develop.
Basic principles of vaccination
Mantoux reaction is given before vaccination. The goal is to test the ability of immunity to protect a child from tuberculosis after BCG in the maternity hospital, and also to make sure that the child has not contracted this dangerous infection.
72 hours after the manipulation, the result of the Mantoux test is evaluated. The child is then vaccinated against measles, rubella and mumps.
Is it better to use imported or domestic vaccines?
To answer this question, let's take a quick look at some of the vaccines that are used in healthcare facilities.
Tuberculosis vaccination in Russia it is carried out with the help of BCG and BCG-M vaccines. Each country uses its own vaccines (domestic) because they contain live attenuated vaccines and therefore cannot be transported.
BCG-M contains a reduced number of bacteria, so it is more weakened, but at the same time it develops sufficient immunity. In this regard, the BCG-M vaccine has recently been preferred.
For hepatitis B vaccination both domestic (for example, Combioteks) and imported (for example, Engerix B) vaccines are used. They are absolutely safe, but even if they cause side effects, they are about the same frequency.
For vaccination against diphtheria, tetanus, whooping cough and polio both domestic vaccines and imported combined vaccines are used.
Domestic vaccines are whole-cell, containing killed pertussis microorganisms, purified bacterial toxoids of tetanus and diphtheria (DTP), as well as the surface antigen of viral hepatitis B (“Bubo-Kok”).
Imported combination vaccines— acellular, containing only proteins of a pathogen and their toxoids (do not contain cells).
Therefore, domestic vaccines cause more side effects(mainly due to the whooping cough component): high fever, convulsions and others.
When using domestic vaccines, the child receives from 18 to 21 injections. Whereas when using imported combined vaccines, their number is reduced to 13 (Pentxim) and 11 (Infanrix Hexa) injections. Since the composition of imported vaccines includes several components: "Pentxim" - against whooping cough, diphtheria, tetanus, poliomyelitis, hemophilic infection, "Infanrix Hexa" - against whooping cough, diphtheria, tetanus, poliomyelitis, viral hepatitis B and hemophilic infection.
In medical treatment and preventive institutions, free domestic vaccines are used for healthy children, and imported vaccines are used for children with long-term medical exemptions or allergic reactions. The extent to which doctors adhere to this principle depends on the specific medical treatment and prevention facility and the availability of imported vaccines.
If you have the financial ability, you can only vaccinate your child with an imported vaccine, even if he is absolutely healthy.
The main absolute contraindications to vaccination
General contraindications for all vaccines
- Development of complications or severe reaction on the previous administration of the vaccine of this series: body temperature above 40C, convulsions, severe allergic reaction(anaphylactic shock, urticaria, angioedema).
- Convulsions at normal body temperature.
- Severe immunosuppression- for all vaccines containing live attenuated bacterial cells (for example, BCG).
Contraindications for BCG and BCG-M
- The weight of the child is 2000 grams or less.
- Children born to HIV-infected mothers until their HIV status is determined.
Contraindications for vaccination against measles, rubella and mumps
The presence of severe forms of allergic reactions (Quincke's edema, urticaria) to aminoglycoside antibiotics: gentamicin, kanamycin.
For vaccines that are produced in the chick embryo- an allergic reaction to the protein of a chicken or quail egg (for example, the Priorix vaccine is produced in a chicken embryo cell culture).
Contraindications for hepatitis B vaccination
- Allergic reactions to baker's yeast (for example, the Combiotex vaccine is made on baker's yeast).
- The weight of the child is less than 1400 grams.
Contraindications for DTP
- Progressive diseases of the nervous system: multiple sclerosis, syringomyelia and so on.
- Convulsions without fever.
Exist temporary contraindications to vaccinations: acute viral or bacterial infection, diseases of the nervous system (for example, the consequences of birth trauma) and other diseases. After recovery or the transition of the disease into remission (fading of symptoms), the child is vaccinated.
In order for the vaccine to fulfill its purpose (the production of antibodies by the immune system to the vaccine administered) and not lead to the development of undesirable consequences, the child must be absolutely healthy at the time of vaccination!
How to prepare a child for vaccination?
What is the interval between vaccinations?
If vaccinations of the same series, for example, against pneumococcal infection, then the interval between them should be at least one month, and for DPT - 45 days.
In all other cases, vaccination is possible even the next day after the last vaccination, but on condition that the baby is absolutely healthy.
What to do if the vaccination schedule has shifted?
In this case, the child is vaccinated according to an individual schedule.
If necessary the child receives a catch-up vaccine but from different series. That is, it is allowed to administer several vaccines on the same day, but in different parts of the body. Thus, the intervals between vaccinations are shortened. Because if they lengthen, then the quality of post-vaccination immunity is significantly lower.
For example, a child is vaccinated against pneumococcal infection and viral hepatitis B on the same day. Then the first vaccine is injected into the muscle of one thigh, and the second into the muscle of the other thigh.
To bathe or not to bathe the child on the day of vaccination?
It all depends on the vaccine administered:
- Vaccination against tuberculosis. On the first day of the child, you can not bathe, but you can only wash it. The next day, you can bathe the baby, but avoid rubbing the injection site.
- Vaccination against any other infection. The instructions state that bathing a child is allowed. However, it is better to refrain from this day. water procedures, as well as walks on the street in the autumn-spring period of the year. Because the immune system produces antibodies to the vaccine. And any hypothermia can lead to the acquisition of insufficient post-vaccination immunity, or to a disease.
Preventive vaccinations is a complex topic with many pitfalls.
Therefore, vaccination must be approached individually and carefully in each case. Indeed, often a child is vaccinated according to an individual vaccination schedule due to the fact that he had long-term medical withdrawals or had a pronounced reaction to the previous administration of the vaccine. Therefore, the most important assistant to the doctor is you. Because by telling in detail about your baby, you will help the doctor make the right decision.
After all, the main principle of medicine is "Do no harm". In relation to vaccinations, it means the following: to vaccinate the baby correctly and on time, minimizing the likelihood of developing undesirable consequences, and also to get good post-vaccination immunity that will protect the baby from dangerous infections.
If you decide not to vaccinate your child, you will benefit from the material on u-mom:
pediatric resident doctor
On the territory of Russia, as in other civilized countries of the world, there is a vaccination calendar approved by the Ministry of Health of the Russian Federation. According to it, routine vaccination against infectious diseases is carried out for all healthy children, starting from birth.
Within the framework of the national calendar, in the clinic at the place of residence, children are vaccinated free of charge, in accordance with Order No. 125N of the Ministry of Health dated March 21, 2011.
In accordance with this law, vaccination is carried out voluntarily, but at the same time, health workers are obliged to explain to parents the need and importance of the timely prevention of dangerous infectious diseases, to talk about a possible post-vaccination reaction and complication. If parents decide to refuse vaccination, the doctor must explain to them the possible negative consequences of such a refusal.
Federal Law 323-FZ of November 21, 2011 spells out the rights and obligations of citizens regarding medical interventions, including during vaccination. The law obliges before vaccination to sign a voluntary informed consent to the intervention or officially refuse to vaccinate.
Voluntary informed consent or refusal of medical intervention
Voluntary informed consent or refusal to be vaccinated must be in writing. Consent to the vaccination is signed by the parent or guardian of the child. The doctor should inform him about this procedure, tell him about the consequences of possible complications of the planned vaccination.
The duty to explain in an accessible form to an adult about the dangers of refusing vaccinations lies with the doctor. If the parents still refuse to be vaccinated, they write an official written refusal and one of them signs it with his personal signature. There are official forms approved by the Ministry of Health of Russia for voluntary consent or refusal of medical intervention (Order No. 1177n dated December 20, 2012)
In addition to vaccination, informed consent may be required for diagnostic tests, therapeutic procedures, and drug administration.
Download form:
National vaccination calendar for 2016-2017
| Who to vaccinate | Vaccination | Rules and procedure for vaccination |
| newborns | Vaccination against viral hepatitis B | Vaccination is carried out in strict accordance with the instructions for vaccination of newborns. |
| Child age 3-7 days | Tuberculosis vaccine (BCG) | The BCG vaccine is used to form primary immunity. |
| Baby age 1 month | Revaccination against hepatitis B | Conducted for children at risk |
| Age 2 months | Third hepatitis B vaccination | Made for children at risk |
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|
First pneumococcal vaccination | Children at risk |
| 3 months | First vaccination against diphtheria, whooping cough and tetanus | According to the indications, the DTP or ATP vaccine is used |
| Age 3 to 6 months | First vaccination against Haemophilus influenzae | Vaccination is carried out for children at risk |
| Child age 4.5 months | Second DTP vaccination | For children who received their first vaccination at 3 months |
|
|
Second pneumococcal vaccination | In accordance with the rules of vaccination |
|
|
First polio vaccination | used inactivated vaccine |
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|
Second vaccination against Haemophilus influenzae | For children who received their first vaccination at 3 months (for children at risk) |
| Age 6 months | Third DTP vaccination | Conducted to children who received the first two vaccinations at 3 and 4.5 months |
|
|
Third vaccination against Haemophilus influenzae | For children at risk who received the first two vaccinations at 3 and 4.5 months |
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Third polio vaccination | |
| Child age 1 year | First vaccination against measles, mumps and rubella | According to the vaccination schedule |
|
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Fourth hepatitis B vaccination | According to the vaccination schedule for children at risk |
| 15 months | Revaccination against pneumococcal infection | According to the vaccination schedule |
| Child age 18 months | First revaccination against whooping cough, diphtheria and tetanus | According to the vaccination schedule |
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|
According to the vaccination schedule | |
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|
Revaccination against Haemophilus influenzae | According to the vaccination schedule |
| Baby age 20 months | Second revaccination against polio | According to the vaccination schedule. used live vaccine |
| Age 6 years | Revaccination against measles, rubella and mumps | Conducted in accordance with the vaccination schedule |
| Child's age 6-7 years | Revaccination against tetanus and diphtheria | |
| Age 7 years | Revaccination against tuberculosis | The BCG vaccine is given if the Mantoux test is negative. |
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|
Third revaccination against polio | According to the vaccination schedule. A live vaccine is used. |
| 14 years | Third revaccination against diphtheria and tetanus | A toxoid with a reduced number of antigens is used for vaccination. |
| Adults over 18 years old | Revaccination against tetanus and diphtheria | Performed every 10 years since the last revaccination |
| All categories of the population up to 55 years | Hepatitis B vaccination | |
| Children from 1 to 18 years old, women under 25 years old | Rubella vaccination | For those who have not received vaccination and do not have information about vaccinations against this infection |
| All categories of the population up to 35 years | Measles vaccination | On an individual basis. For those who did not receive vaccinations according to the national schedule |
| For all age groups | Influenza vaccination | Children from 6 months; students in grades 1-11; representatives of certain professions; pregnant women; pensioners over 60; conscripts; patients with chronic somatic diseases. |
The concept of vaccination and revaccination
Vaccination can be both single and multiple. Doctors vaccinate as many times as necessary to form a stable immunity to infection.
Revaccination- re-vaccination, it is done after a certain period of time after the previous vaccination. Its purpose is to support the immunity already developed in the body.
Risk groups: who is included in them
The risk groups for viral hepatitis B include:
- children whose mothers had hepatitis B during pregnancy;
- whose parents use drugs;
- if the family has a carrier of the hepatitis B virus or a patient with this disease.
Risk groups for infection with poliomyelitis and hemophilic infection
- children with immunodeficiencies or HIV infection;
- with malignant diseases of the blood and blood-forming organs;
- if HIV infection is detected in the mother;
- All babies are in orphanages.
Vaccinations are not given to children with acute forms of illness (including colds), and within 2-4 weeks after recovery. Before vaccination, you need to take tests and make sure that there are no deviations.
Summary
Changes are made to the national vaccination calendar every year, new diseases and vaccines are added, and the timing of vaccinations is changed. These changes are due to the results of recent scientific developments, research and improvement of the composition of vaccines.
Adults have the right to decide for themselves whether they should vaccinate their child or not. This issue is especially acute for parents whose children are weakened or born ahead of schedule have chronic somatic diseases. But do not be afraid: the pediatrician is obliged to draw up a vaccination schedule individually or give a medical exemption from vaccination for your child.
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