On the Road to Individualization of Vaccination: the Significance of Age and Sex

Relevance. The high variability of protection against vaccine-controlled infections, including COVID-19, is one of the actual problem of infectology. Aim. Based on the results of scientific publications and reports, the role of age and sex factors, their interactions and the main mechanisms in the immune response to vaccines, in the improvement of vaccines and vaccination regimens, has been analyzed. Conclusion. It has been shown that vaccine prophylaxis has always developed in the direction of individualization, going through the stages of defining target groups and developing immunization schemes for various groups. The important data obtained in recent decades on the importance of genetic and external factors, in particular, age and sex, in the variability of response to vaccines are analyzed. Analysis of the role of such factors has also been performed for coronavirus vaccines. The necessity and possibilities of next steps that can provide optimal responses of different people to vaccination were discussed.

World Experience in the Use Serogroup B Meningococcal Vaccines (literature review)

Relevance. The success of vaccine prophylaxis of meningococcal infection depends on the composition and properties of vaccine preparations and the strict implementation of recommendations on vaccine prophylaxis tactics by the territorial epidemiological characteristics of meningococcal infection. Despite the high burden of B-meningococcal infection, especially among young children, the design of B-meningococcal vaccines has faced serious difficulties. Aim. The literature review presents the history of the development of B-meningococcal vaccines and provides characteristics of two immunologically effective and safe new generation B-meningococcal vaccine preparations. Conclusion. The licensing of the two new B-meningococcal vaccines presented in the review (Bexsero and Trumenba) was based on immunogenicity and safety. The inclusion of vaccines in national vaccination programs requires careful analysis, including analysis of the antigenic characteristics of circulating strains.

Current aspects of COVID-19 vaccine prophylaxis: big steps from laboratory to clinical practice

For more than a year and a half, the entire world has been experiencing the COVID-19 pandemic. Only the development of safe and effective vaccines may make the most significant changes in the fight against this infection. The World Health Organization (WHO) and its partners are contributing to accelerated development of vaccines because it is the vaccination along with social distancing and the use of personal protective equipment that is an effective way to prevent the coronavirus disease. This review covers general characteristics of vaccines registered or approved by at least one national regulator, the risks and side effects of the vaccines, as well as approaches to assess the effectiveness of COVID-19 vaccination.

Socio-economic substantiation of expediency of seasonal influenza vaccine prophylaxis among medical workers

The purpose of this study is to determine the socio-economic effectiveness of seasonal influenza vaccine prophylaxis among health professionals based on the analysis of the morbidity with temporal disability (MTD) and the financial benefits of this preventive measure. The study included the collection and analysis of information on MTD and direct and indirect costs of influenza treatment compared to vaccine prophylaxis in “Dnipropetrovsk Regional Perinatal Center with Hospital” Dnipropetrovsk Regional Council” (ME “DRPC with Hospital” DRC”) during 2017-2020 (3 epidemic seasons). To assess the consequences of vaccine prophylaxis, the analysis of MTD indicators was performed, and the index and coefficient of anti-epidemic effectiveness were used. The economic effect was determined on the basis of the cost-benefit method using the analysis algorithm in the form of a “decision tree”. The information base for the analysis was the accounting and reporting and financial and economic documentation of the health care institution (HCI). The analysis of influenza MTD during the observation period revealed that all studied morbidity rates (number of cases per 100 employees; number of days per 100 employees; average case duration) were statistically significantly lower in vaccinated compared to unvaccinated (p<0.001). Precautionary number of cases of MTD for influenza in the last year of observation (2019-2020) was 11.07 (95% CI 6.68-15.46) per 100 employees; days – 96.23 (95% CI 81.86-110.60) per 100 employees. The index of anti-epidemic efficiency during the study increased by 2.37 (95% CI 1.95-2.79), the coefficient of anti-epidemic effectiveness – by 15.16% (95% CI 11.17-18.01). The economic efficiency of vaccination of 69.44% of employees for one epidemic season (2019-2020) amounted to a total of UAH 248,976 or UAH 494 (56%) benefits per employee. The study proved the high medical, social and economic effectiveness of vaccine prophylaxis in HCI. Medical efficiency consists in a significant reduction in the morbidity with temporary disability, high levels and a tendency to increase the indicators of anti-epidemic efficiency. The economic effect is defined as the available monetary benefit from the vaccine prophylaxis. The resulting savings are the basis for optimizing the use of resources of the medical institution, including labor.

Current features of the epidemiology and prevention of hepatitis B in risk groups in Russian Federation

Hepatitis B is an infectious disease that leads to severe health problems, with the risk of chronicity and death. The World Health Organization (WHO) has shown that about 4.5 million premature deaths from the infection could be prevented by 2030 in low- and middle-income countries through vaccination, diagnostic tests, drugs, and education campaigns. The main goal of the WHO global hepatitis strategy is to reduce new infections by 90 % and deaths by 65 % between 2016 and 2030. The successes of hepatitis B vaccine prophylaxis are the basis for setting the ambitious goal of eliminating the disease in the future. However, to date, many questions about the organization and planning of regional vaccination programs remain unresolved and provoke discussions among specialists around the world, including in Russia. In order to systematize and summarize the scientific literature on prevention, as well as to evaluate its effectiveness, we performed a literature search using the electronic bibliographic resources https://pubmed.ncbi.nlm.nih.gov/ and https://elibrary.ru/ using the key words «hepatitis B» and «vaccine prophylaxis». Analysis of scientific papers allowed us to characterize some manifestations of hepatitis B epidemic process and reveal its modern features in the territory of Russia, including risk groups. Aspects of genetic heterogeneity of HBsAg pathogen circulating in Russian territory as well as in adjoining states are given in details. The organization of vaccine prophylaxis is considered; the used immunobiological preparations are characterized. The results of the work define the role of serological studies in the system of epidemic surveillance for hepatitis B, as well as their significance for formation of adequate tactics of vaccination of the population, including in risk groups.

Modeling of the Potential Effect of Revaccination against Whooping Cough in Children Aged 6–7 and 14 years within the Framework of the National of preventive vaccinations

Relevance. Currently, the national calendar of preventive vaccinations does not provide for revaccination against whooping cough in children over the age of 18 months. At the same time, the epidemiological and economic feasibility of revaccination against whooping cough in children aged 6–7 years, as well as adolescents, has been demonstrated in world practice. Aim. Based on a mathematical model, develop a forecast of pertussis morbidity dynamics and assess the potential socio-economic damage under the current and expanded vaccine prophylaxis algorithms.Methods. Mathematical modeling of the potential effect of revaccination against whooping cough in children aged 6–7 years (scenario 1) and at 6–7 years and 14 years (scenario 2) was carried out within the framework of the national calendar of preventive vaccinations. A simulation dynamic mathematical model is constructed that allows predicting the development of the epidemiological process of whooping cough on the basis of the dynamics of the main indicators of its prevalence in the population that developed in previous years. The model took into account dynamic changes in the preventive effectiveness of vaccinations and the potential level of underestimation of morbidity. The obtained arrays of indicators served as the basis for extrapolating trends in morbidity and mortality until 2034.The calculation of epidemiological benefits was carried out in the metrics of prevented loss of years of life under the two scenarios under consideration in comparison with the current vaccination algorithm. The calculation of the economic effect was carried out on the basis of the obtained indicators of epidemiological benefits in the metrics of the monetary equivalent of the average cost of a year of life, taking into account the projected inflation coefficients until 2034.Results. The projected decrease in the number of years of life lived in a state of illness, in comparison with the current situation, will total 44.5 thousand years for the period 2019–2034 under scenario 1 and 66.7 thousand years under scenario 2. The socio-economic damage from prevented cases of the disease, expressed in the monetary equivalent of the average cost of living, will decrease by 28.6% (scenario 1) or 42.0% (scenario 2).Conclusions. A comparison of the received public benefits with the costs of vaccination shows that the expansion of the NCPP with additional revaccinations against whooping cough (at 6–7 years or at 6–7 and at 14 years) is advisable both in epidemiological and economic aspects.

A Pilot Study to Develop an Assessment Tool for Dogs Undergoing Trap-Neuter-Release (TNR) in Italy. An Overview on the National Implementation of TNR Programmes

A descriptive analysis, inter-observer and test–retest reliability of the animal-based measures (ABMs) included in the protocol were performed. This study aimed at the development of a welfare assessment protocol for dogs recruited in the trap-neuter-release (TNR) programmes and the description of the implantation of these programmes in Italy. Nine Italian regions carried out TNR programmes. A varied scenario, along with some critical issues, emerged. Fifty dogs were recruited and assessed simultaneously by two assessors to determine the reliability of ABMs included in the protocol. A subsample of ten dogs were assessed three times to assess test–retest reliability. All females were neutered against 36% of males. Most dogs were adults (58%) and of a large size (68%). Vaccine prophylaxis and parasitic prevention were regular in 13% and 76% of dogs, respectively. Few dogs showed lameness, evidence of pain, other clinical problems, or thermal discomfort. Overall, 82% of dogs did not show fear or aggression to unfamiliar people. The level of agreement between the two assessors was quite high, ranging from substantial (0.61–0.80) to perfect (1) for the majority of measures. This study highlighted some critical issues in TNR implementation and the suitability of the protocol as a tool for animal welfare assessment.

Preventive vaccination compliance among medical students and pediatricians during the COVID-19 pandemic

The novel coronavirus disease (COVID-19) pandemic has become a strength test for the national healthcare systems and medical professional communities. The pandemic gave a revealing insight into the provision of resuscitation care, a shortage of personnel and protective equipment, and the lack of effective drugs to treat a novel, poorly studied infection. Objective. To identify the attitude towards immunoprophylaxis in general and against the coronavirus infection (COVID-19) in particular among medical students and pediatricians and to assess the dynamics of compliance to vaccination in these groups. Materials and methods. The survey was conducted among the 5-6-year students of the medical and pediatric faculties of the Ryazan State Medical University (RSMU) of the Ministry of Health of Russia in 2017 and 2021, the groups of students included 250 and 225 people, respectively. The children’s polyclinic pediatrician groups included 45 and 60 people in 2017 and 2021, respectively. The survey was conducted anonymously, face-to-face, and without compulsion. The identical questionnaires asked students 13 questions and pediatricians 10 questions with suggested response options. Results and discussion. The percentage of students who correctly named the number of vaccine preventable diseases in the National Immunisation Schedule has significantly decreased; the number of students who were not aware of the availability of the chickenpox vaccine has increased by 1.9 times. In 2021, the number of students giving priority to domestic vaccines decreased by 2.3 times, and the number of those choosing imported drugs as better and safer ones has increased by 1.5 times. In 2021, the number of senior students who were vaccinated against influenza doubled as compared to 2017. At the same time, the students agreed to recommend their patients to be vaccinated against influenza 1.4 times more often. During the 2021 pediatrician survey, the number of respondents, who preferred imported vaccines as better and safer ones, increased by 4 times, and the number of domestic vaccine advocates decreased by 1.8 times. In addition, the number of pediatricians who did not decide on this issue has increased by 9.8 times. Сonclusion. The results of the survey showed that there is still a lack of compliance to vaccine prophylaxis in certain groups of the professional medical community. The student cohort showed a decrease in knowledge and confidence in the vaccine prophylaxis. Among practitioners, there has been a positive trend towards an increase in the percentage of pediatricians, who considered it expedient to vaccinate children with chronic pathology.