The World Immunization Week (24–30 April) is to highlight the importance of vaccination and demonstrate its contribution to prevention of dangerous diseases and decrease of healthcare system and budget burden.

Immunization has been and remains an emotional and hot-button issue. Preventive vaccination provokes a lot of discussion; therefore, it is key to consider a variety of opinions and build on scientific evidence when covering this subject.

According to the WHO, immunization annually prevents 2-3 million lethal cases in all age groups worldwide and is one of the most efficacious and economically feasible health buildup actions[1].

Due to many-year broad-scale vaccination campaigns, we have basically done away with natural smallpox, infantile paralysis, plague, tetanus, and some other severe infections. Importantly, vaccines are primarily developed to protect against most dangerous human diseases. Should the number of vaccinated individuals go down, dangerous diseases would recur bringing about deaths and disability.

To protect the citizens, both children and adults, against the most dangerous diseases, the National Immunization Schedule (NIS) has been developed. In Russia, the NIS includes vaccines against 12 infections. Regional immunization programs protect the most vulnerable children and adult groups against severe infections not covered by the mandatory NIS.

Vaccination within the framework of the National Immunization Schedule does yield the results. E.g., in 2014, the NIS was extended to include pneumococcal vaccine. According to Rosstat (Russian Federal Statistics Service), in 2016, the infantile mortality rate due to various pneumonia types decreased by 41% vs. the pre-vaccination period[2].

Studies conducted in Russia provide evidence that in the region with a 95% vaccination coverage of children and additional vaccination of risk-group adults, significant results in terms of reduction in morbidity have been achieved, i.e. the epidemiological efficacy factor of pneumococcal vaccination in children aged 0–2 years is 84.3% with regards to community-acquired pneumonia and 100% with regards to pneumococcal pneumonia.[3]

For vaccination to manifest its benefits in full, it must be timely and comprehensive both in children and adults. In Russia, the results of pneumococcal vaccination in adult patients with chronic obstructive pulmonary disease (COPD) indicate that 4 years after vaccination with a 13-valent pneumococcal vaccine, pneumonia incidence rate decreased 3.4-fold; the number of COPD aggravation cases decreased 4.1-fold; and hospital admissions associated with disease aggravation and pneumonia went down 4.5-fold. A study demonstrates that immunization with a 13-valent pneumococcal vaccine helped minimize healthcare expenditure; annual budget savings may amount to 78.5 % of the planned treatment costs for specific patient groups.[4]

Collaboration of Russian and international pharmaceutical companies provides for covering the Russian population with locally manufactured innovative vaccines. A joint project of Pfizer and Petrovax Pharm in Russia has resulted in setting up a unique production of innovative pneumococcal vaccine Prevenar® 13. A transfer to Russia of advanced global technologies provided for compliance of the local vaccine with the top world quality standards. Over the past 4 years, the vaccine supplies to Russia’s regions within the NIS framework totaled 15M shots.

Local vaccine production and technology transfer do not only make the vaccine readily available for the healthcare system but also boost the level of expertise of Russian experts, advance the innovative development of the Russian pharmaceutical industry and its export potential.

About pneumococcal infection

According to the WHO, pneumonia is among the TOP10 causes of death in the world[5]. Diseases of children under 5 caused by pneumococcal infection are the primary cause of death preventable through vaccination[6]. It is pneumonia that is the most widespread manifestation of pneumococcal infection in adults.[7],[8]

According to Rosstat, in 2016, 31,201 persons died of all pneumonia types in Russia[9], which equals to the population of a small town. The mean duration of a disease case is 25.6 days per 100,000 population annually. The estimated economic damage is about 15B RUB a year.[10]

Young children and the elderly are most susceptible to the infection. The risk group also includes subjects with immunodeficiency, diabetes, asthma, COPD, and chronic cardiovascular diseases. Smoking, alcohol abuse, and adverse environmental factor also increase the risk of disease.

On the other hand, the uncontrolled antibiotic use in human and animal health areas as well as in agriculture has resulted in widely spread antibiotic-resistant pneumonia agents; therefore, pneumonia is easier prevented than treated. As referred to in the Strategy of Antimicrobial Resistance Spread Prevention in the Russian Federation Until 2030, preventive vaccination provides for the formation of specific immunity, which decreases the demand for antibiotics[11].

[1] World Health Organization (WHO). 10 facts on immunization. http://www.who.int/features/factfiles/immunization/facts/en/. Updated March 2018.

[2] Federal State Statistics Service. http://www.gks.ru/free_doc/2016/demo/edn02-16.htm.

[3] Н.П. Андреева, Т.И. Петрова, В.А. Родионов, С.В. Леженина. «Первые результаты вакцинации против пневмококковой инфекции в Чувашской Республике».

[4] Игнатова Г.Л., Антонов В.Н. «Эпидемиологические особенности хронической респираторной патологии при вакцинации против пневмококковой инфекции», Пульмонология. 2017; 27 (3): 376–383.

[5] World Health Organization (WHO). Media centre: The top 10 causes of death. Fact sheet N°310. Updated May 2014. http://who.int/mediacentre/factsheets/fs310/en/. Checked on 10.04.2018

[6] World Health Organization (WHO). 23-valent pneumococcal polysaccharide vaccine. WHO Position Paper. Wkly Epidemiol Rec. 2008;83(42):373-384.

[7] World Health Organization (WHO). Immunization, vaccines and biologicals. Pneumococcal vaccines. April 2003. Wkly Epidemiol Rec. 2003;78(14):97-120

[8] Centers for Disease Control and Prevention. Pneumococcal disease: clinical features. Page last updated: June 6, 2013. Available at: http://www.cdc.gov/pneumococcal/clinicians/clinical-features.html.

[9] Росстат, «Сведения о смертности населения по причинам смерти по Российской Федерации в 2016 году» (Federal State Statistics Services, Russian population mortality data by causes of death, 2016). gks.ru/free_doc/2016/demo/t3_3.xls.

[10] Государственное санитарно-эпидемиологическое нормирование Российской Федерации. Эпидемиологический надзор за внебольничными пневмониями. Методические указания МУ (The state sanitary and epidemiological standardization in the Russian Federation. Community-acquired pneumonia surveillance. Guidelines MU

[11] «Стратегия предупреждения распространения антимикробной резистентности в РФ на период до 2030 года» . Утверждена Правительством РФ 25.09.2017 № 2045-р (The Strategy of Antimicrobial Resistance Spread Prevention in the Russian Federation Until 2030. Approved by the Russian Government on 25.09.2017, No. 2045-r).

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