Causes and consequences of delayed vaccination against pertussis infection in the Russian Federation

Abstract

Introduction . One of the reasons for the increase of pertussis in the Russian Federation on the background of the widespread coverage of prophylactic vaccinations of more than 95% is a large number of unreasonable medical recusals and parental refusals and, as a result, untimely prophylactic vaccinations against pertussis infection. Materials and methods . We analyzed 5101 emergency notifications for pertussis in children under 17 years of age in Moscow in 2012-2017 and 300 child development histories for children under 14 years of age in two clinics in Moscow. A сase-сontrol study was conducted to assess the relationship between pertussis and the presence of deviations in the immunization schedule. Results . It was found that the level of timely immunization against pertussis did not exceed 5%. Medical (20%) and parental refusals (45%) prevail among the reasons for delayed vaccination. In the structure of medical exemption, the main causes are perinatal encephalopathy, congenital heart defects, intestinal dysbiosis, allergic diseases, anemia and some chronic diseases. Discussion. The main principle for the formation of a full protective immunity from pertussis infection is the mandatory administration of a full primary course of vaccination against pertussis, with the completion of three vaccinations at the age of 10-12 months and mandatory control over the timely receipt of a booster dose no later than the child reaches two years of age. In addition, it is necessary to introduce additional booster doses of pertussis vaccine at the age of 6-7 years, 12-14 years, vaccination of adults every 10 years, as well as consider the introduction of vaccination of expectant mothers in each pregnancy at 27-36 weeks, vaccination for medical personnel and employees who provide child care services.