During the COVID-19 pandemic, the problem of the population’s adherence to vaccination has become significantly aggravated around the world. This study is aimed at evaluating healthcare workers’ (HCWs) acceptance of COVID-19 vaccination in Russia. A cross-sectional multicenter study was carried out by interviewing HCWs in Russia using an electronic questionnaire and snowball sampling. The analysis included 85,216 questionnaires from 81 out of 85 regions of Russia. Statistical analysis was performed using SPSS v.22. The results indicated that 35.0% (CI 95%, 34.7–35.3) of HCWs were ready to get COVID-19 vaccination. The acceptance level was 42.4% (41.8–42.9) for all physicians and 31.3% (30.9–31.6) for nursing staff. A total of 29.4% (29.1–29.7) of HCWs were willing to recommend COVID-19 vaccination to patients: 38.5% (38.0–39.1) of physicians, and 24.7% (24.4–25.1) of nursing staff. Acceptance of COVID-19 vaccination is higher among HCWs dealing with infectious diseases and involved in vaccination. The low acceptance of HCWs toward vaccination against COVID-19 can be explained by the low level of awareness of HCWs in these issues. Additional educational programs are needed for HCWs, both for physicians and nurses, using all possible forms and methods of education.

Aim. Immunoprevention represents a well-established tool to prevent and eliminate life-threatening infectious diseases. However, low adherence in the population is a major obstacle to achieve the full coverage of preventive vaccinations. Here we studied the adherence of various population groups and healthcare workers to vaccination.Materials and Methods. We conducted an original survey among 1147 university students, 214 parents and 512 physicians.Results. Among the students of humanitarian and technical faculties, only 33% and 37% respectively showed a positive attitude to immunoprevention. This indicator, however, was higher in medical students and physicians (76% and 80%, respectively). Overall awareness of all population groups on immunization is insufficient to perform such measures efficiently. The reasons of low adherence include anti-vaccine propaganda, negative attitude and lack of awareness of healthcare workers on immunoprevention efficiency.Conclusion. Further large efforts are urgently needed to increase the adherence to immunization both in general population and healthcare professionals. The primary task is to eliminate the lack of information on the role and importance of immunization in maintaining population health.

Immunoprophylaxis is one of the most effective tools for reducing morbidity and mortality from infectious diseases. In the context of global epidemiological challenges and increased population mobility, the issues of managing immunization, proper patient selection, safety and effectiveness of vaccination are of particular importance. The document systematizes modern approaches to organizing and conducting vaccination of adults. It includes sections on planning and vaccination techniques, contraindications and "false contraindications", features of vaccination against specific infections (influenza, pneumococcal infection, hepatitis, diphtheria, tetanus, poliomyelitis, measles, rubella, etc.), as well as vaccination in pregnant women and military personnel. Particular attention is paid to the registration and treatment of post-vaccination reactions and complications, and the costeffectiveness of vaccination. The guidelines are intended for general practitioners, infectious disease specialists, epidemiologists, pediatricians, and public health specialists.

Over the last years, incidence of vaccine-preventable infections tended to increase both in Russia and multiple European countries due to diverse reasons, including loss of alertness in medical workers to ensure proper quality of immunization. Currently, vaccination is considered to be the most efficient means for preventing infectious diseases. However, vaccination efficacy is directly related to population coverage and proper timeframe for its application.Materials and methods. Diphtheria, tetanus, measles and hepatitis B vaccination coverage and timeframe were analyzed for population of Russia, Moscow as well as the three pediatric and adult out-patient hospitals.Results. It was found that compared to adults, pediatric subjects were vaccinated better. However, in case of 95% or higher coverage against all infections, shortcomings in vaccination timeframe were uncovered. In 2017, despite pediatric subjects should be vaccinated against diphtheria and tetanus at the age of 3-to-6 months, coverage was as low as 46.9% in Russia, 48.7% in Moscow that ranged in some polyclinics from 21.8% in 2012 down to 1.7% in 2017. Moreover, this situation was even more unfavorable in case of revaccination program. In particular, it was found that at the age of 18 months only 50, 54, and 49–55% underwent revaccination in the Russia, Moscow 54%, and some out-patient hospitals, whereas at the age of 7–14 years in Russia there were revaccinated up to 97% population. Likewise, at the age of 6 months there were covered with vaccination against hepatitis B as few as 49% population in Russia and Moscow, whereas more than 90% coverage was achieved only at the age of 1 year. Immunization coverage reaching more than 85% of adult population against hepatitis B is superior to diphtheria and tetanus. Immunization coverage against measles in Russia at all age groups was over 90% population. Thus, it is necessary to optimize activities on adhering to vaccination timeframe, as decline in quality of vaccination inevitably leads to elevated incidence rate of vaccine-preventable infections. This and vaccination coverage might be adjusted by introducing a Preventive Vaccination Surveillance and Reporting Automated System in the Russian Federation.

Vaccination against pneumococcal infections by 13-valent conjugate vaccine (PCV13) can significantly reduce morbidity and mortality.The study has been aimed to evaluate the social and pharmacoeconomic aspects of PCV13 vaccination of 65-year-old patients with various risks of pneumococcal infection.Material and methods. Markov model with 5 and 15 years time horizon was used for the analysis from the position of the health care system.The analysis was carried out for 65-year-old citizens with low (absence of immunocompromized conditions and chronic diseases), moderate (patients with chronic diseases without immunodeficiency) and high (immunocompromized conditions) risk of pneumococcal infection as well as for the entire population of 65-year-old citizens, regardless of the risk level.In base-case assumption has been made that 1 dose of PCV13 should be administered for the patients from low and moderate risk groups and in the high-risk group 1 dose of PCV13 and in 8 weeks a dose of polysaccharide pneumococcal vaccine (PPV23) should be given.The treatment and physician visit costs have been calculated using CHI rates for St. Petersburg in 2018. Vaccination cost was calculated using the auction price to purchase PCV13 and PPV23 in 2018.Results.Vaccination of 1 cohort of 65-year-old citizens in Russian Federation within 5 years will result in prevention of 2200 deaths, 3900 cases of invasive pneumococcal diseases (IPD) and 48700 cases of community-acquired pneumonia. In 15 years prevention of about 4,3 thousand deaths, 6,6 thousand IPD and 101,1 thousand cases of CAP will be provided.Within 15-year horizon the cost-effectiveness ratio will be RUR 30,3, 82,4 and 410,0 thousand per QALY in high, moderate and low risk groups, respectively. Even if the time horizon is reduced to 5 years the PCV13 vaccination can be considered as an economically high-efficient intervention in moderate and high risk groups (cost-effectiveness ratio - RUR 279,2 and 221,7 thousand / QALY, respectively).In the 15-year-horizon noting the distribution of 65-yearolds by risk levels the cost-effectiveness ratio of PCV13 in population as a whole will be RUR 216,4 thousand / QALY. If moderate and high risk groups only are vaccinated, the average cost-effectiveness ratio will drop to RUR 67,6 thousand /QALY. At universal PCV13 vaccination of 65 years old in 5 year time horizon return of investment to the health care system budget will be 33.2% and at vaccination of persons with moderate and high risk return of investment will be 44.0%. With the assumption of vaccination during the planned physician visit (without additional visit) the return to the budget will be 46.8% and 60.9% for vaccination of all 65-year-olds and patients from the moderate and high risk groups, respectively.Conclusions.Vaccination of the 65-year-old persons against PCV13 pneumococcal infection in Russian Federation can be considered as a highly socially and economically effective intervention resulting in significant reduction of pneumococcal infection incidence and related mortality. The cost-effectiveness of vaccination is increasing along with the level of the risk. PCV13 vaccination of patients with moderate and high risk only provides a significant reduction in the burden for the health care budget in comparison with the vaccination of the entire population of 65-year-olds.

The aim of the study was to identify current epidemiological patterns of pertussis and to assess the need to improve immunization against this infection. Methods. A comparative retrospective epidemiological analysis of pertussis incidence in Russian population, in several European countries and in certain social and age groups has been performed considering vaccination coverage, immunization strategy, and diagnostic tests. A comparative analysis of gen eral and agerelated morbidity of and mortality from infectious and respiratory diseases in Russian population and in some European countries has also been performed. Data on morbidity, mortality and vaccination were obtained from databases of WHO and the Federal State Statistic Service of Russian Federation. Results. The epidemiological situation evolving pertussis is not good in Russia. The morbidity growth including high morbidity in infants and growing morbidity in children of 7–14 years old reflects active pathogen circulation in population. There is higher mortality from infectious and respiratory diseases in general population and in infants in Russia compared to European countries. Conclusion. The current approach to epidemiological surveillance on pertussis in Russia needs to be improved. Implementation of molecular and other new laboratory methods for pertussis diagnosis could improve identi fication of the infection sources, etiological diagnosis and treatment efficacy. The morbidity of pertussis could be decreased by a wide use of acellular vac cine and additional revaccinations.