Preventive vaccinations

Regulatory and legal framework

The organization of vaccination work in the Russian Federation is not arbitrary; it is strictly regulated at the highest level by federal legislation and detailed by orders of the relevant ministry.

The baseline document acting as the foundational legal act is Federal Law No. 157-FZ (dated September 17, 1998) "On Immunoprophylaxis of Infectious Diseases." It is this law that defines the global state policy in the field of protecting the population from infectious threats, establishing the legal foundations for all preventive measures.

Physician's working tools: vaccination schedules

For the practical implementation of the provisions of the federal law, Order of the Russian Ministry of Health No. 125n (dated March 21, 2014) is used. This document is of colossal importance for the physician's daily practice, as it directly approves the two main working tools of immunoprophylaxis:

1. National Schedule of Preventive Vaccinations. This document regulates the procedure for mass routine vaccination of the population.
2. Schedule of Preventive Vaccinations Based on Epidemiological Indications. This tool is used in non-standard situations: for vaccinating individuals located directly in infection foci, as well as for protecting vulnerable risk groups.

Clinical aspects and therapy review

From a clinical perspective, vaccination is performed to prevent the development of infectious diseases or minimize the risk of their severe, complicated course. According to clinical guidelines, immunization must be carried out in strict accordance with the national schedule.

However, the immunization process requires individual medical monitoring. When prescribing a vaccination, a medical worker is obliged to take into account the current period of the patient's existing disease, as well as the specifics of the therapy they are receiving.

Note: This approach has a recommendation strength grade of C (level of evidence certainty — 5).

Special patient groups and the impact of the pandemic

The significance and relevance of preventive vaccinations have sharply increased against the backdrop of the COVID-19 pandemic. It has been proven that timely vaccination not only prevents the incidence of target infections itself, but also critically reduces the total number of hospitalizations. Through this mechanism, the risk of nosocomial infection of patients with other dangerous infections, including COVID-19, is indirectly reduced.

Special emphasis is placed on the management of patients with comorbid pathologies, in particular, type 2 diabetes mellitus (T2DM). For this category of patients, it is strongly recommended to ensure standard vaccination.

Immunization of patients with T2DM is carried out in accordance with both documents:

• National Schedule of Preventive Vaccinations.
• Schedule of Vaccinations Based on Epidemiological Indications (this section includes, in particular, mandatory prevention of influenza).

Note: The recommendation strength grade for patients with T2DM is C, and the level of evidence certainty is 2.

Class and exam questions

What else to study on this topic

• Specifics of immunoprophylaxis in type 2 diabetes mellitus.
• Influenza prevention within the framework of the schedule based on epidemiological indications.
• Assessment of recommendation strength grades (RSG) and levels of evidence certainty (LEC) in vaccinology.
• The impact of the COVID-19 pandemic on approaches to routine vaccination.
• Criteria for choosing between routine vaccination and vaccinations based on epidemiological indications.

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.