Cost effectiveness and budget impact of universal varicella vaccination in Russia.

This economic evaluation assesses the cost-effectiveness and budget impact of introducing a two-dose varicella vaccine in the Russian national immunization program. A static Markov model followed a simulated 2019 Russian cohort over its lifetime and compared outcomes and costs of three varicella vaccination strategies: strategy I (doses given at 12 and 15 months of age), strategy II (doses given at 1 year and 6 years of age), and a no vaccination scenario. Inputs on age-dependent clinical pathways, associated costs, and related health outcomes were collected from national sources and published literature.

A randomized trial assessing the efficacy, immunogenicity, and safety of vaccination with live attenuated varicella zoster virus-containing vaccines: ten-year follow-up in Russian children.

In Russia, a universal varicella vaccination (UVV) program has not been implemented, and varicella vaccination coverage is low. We assessed the efficacy, antibody persistence, and safety of one- and two-dose varicella vaccination schedules in Russian children with a ten-year follow-up period, as part of an international phase IIIB, observer-blind, randomized, controlled trial (NCT00226499). Children aged 12-22 months were randomized (3:3:1) to receive two doses of tetravalent measles-mumps-rubella-varicella vaccine (V2 group), one dose trivalent measles-mumps-rubella (MMR) vaccine and one dose of varicella vaccine (V1 group), or two doses of MMR vaccine (V0 [control] group), 42 days apart.

Issues in pediatric vaccine-preventable diseases in low- to middle-income countries.

The highest burden of pediatric vaccine-preventable disease is found in developing nations where resource constraints pose the greatest challenge, impacting disease diagnosis and surveillance as well as the implementation of large scale vaccination programmes. In November 2012, a Working Group Meeting convened in Casablanca to describe and discuss the status with respect to 8 vaccine-preventable diseases (pertussis, pneumococcal disease, measles-mumps-rubella-varicella (MMRV), rotavirus and meningococcal meningitis) to identify and consider ways of overcoming obstacles to pediatric vaccine implementation. Experts from Europe, Russia, the Commonwealth of Independent States, the Middle East, Africa and South East Asia participated in the meeting.

[Surgical treatment of rare combination of intestinal malrotation with secondary lymphangiectasia].

The rare combination of intestinal lymphangiectasia with malrotation of the duodenum in a child of three months of life is described. Basing on the literature review only 3 similar cases were described in the world practice. The boy with protein-losing enteropathy was examined at Moscow Scientific Centre of Children's Health.

Streptococcus pneumoniae serotype distribution in children in the Russian Federation before the introduction of pneumococcal conjugate vaccines into the National Immunization Program.

WHO recommends the inclusion of PCVs in childhood vaccination programs world-wide. Many countries including the Russian Federation are currently planning the inclusion of PCVs in their National Immunization Programs and, therefore, data on the pneumococcal serotype distribution is important to estimate the potential disease impact. Here we review eight recent epidemiological studies on the pneumococcal serotype distribution from Russia.

[Advances and challenges in immunoprophylaxis].

A significant progress in the management of controllable infections achieved by the early XXI century made it possible eliminate poliomyelitis across the nation, and practically eliminate measeles by vaccinating 96-99% of the children without raising the complication rate. The list of counterindications was shortened significantly, the Calendar of immunoprophylaxis was supplemented by inoculations against hepatitis B, rubella, flu, and type b Haemophilis influenzae infections. Morbidity of controllable infections in Russia decreased substantially compared with that in the 1990s.

[Perspectives of development of immunoprophylaxis in Russia].

Analytic materials on prevention of controlled infections in Russia and perspectives for extension of immunoprophylaxis field are presented. It was determined that immunization against pertussis should be expanded. Necessity to include vaccines against hepatitis A, Hib, pneumococcal infection, varicella as well as rotavirus and human papillomavirus infection in National immunization schedule is substantiated.

Epidemiology of respiratory syncytial virus in children ≤2 years of age hospitalized with lower respiratory tract infections in the Russian Federation: a prospective, multicenter study.

Background: Respiratory syncytial virus (RSV) is the leading cause of severe lower respiratory tract infections among infants and young children, and is responsible for an estimated four million deaths per year globally. A monthly injection of palivizumab has been used for prophylaxis of serious RSV infections among high-risk children in 71 countries since 1998 and approval for use in the Russian Federation was obtained in February 2010. A recommendation for RSV prophylaxis in the Russian Federation would require knowledge of the prevalence and seasonality of RSV in that country.

[Pneumococcal infection is a vaccine-preventable disease now].

Analysis of pneumococcal disease burden in Russia, which is a serious threat to children's and adults' health and which was underrecognized until last decade, is presented. Extrapolating data about etiologic structure of pneumonia and meningitis on published incidence figures, we can estimate the incidence of pneumococcal pneumonia in children in Russia: 490 per 100,000 for children aged 1 month - 15 years, and 1060 per 100,000 for children aged 1 month - 4 years. For complicated forms, these figures are 90 and 181 per 100,000 respectively.

Recommendations for rotavirus vaccination: A worldwide perspective.

Official guidelines are crucial for new vaccines to be accepted by physicians and policy makers, and for reimbursement decisions, particularly for vaccines against diseases with an under-appreciated burden, such as rotavirus gastroenteritis (RVGE). Evidence-based guidelines, which take into account the best available data, ensure that new vaccine introductions achieve the greatest sustainable impact. For rotavirus vaccination, guidelines are specific to the locality for which they are developed, reflecting, for example, potential differences in disease burden, prevalence of co-infections (e.

[Current problems of immunoprophylaxis of infectious and non-infectious diseases].

Progress in immunology greatly contributed to the understanding of mechanisms of infectious immunity and vaccine action. Moreover, it facilitated the development of new vaccines and vaccination not only of healthy children but also of subjects with health problems and chronic diseases including the use of several vaccines. The number of contraindications could be decreased without a rise in the frequency of post-vaccination complications.

[International clinical trials of vaccines].

Modern principles of organization and planning of international clinical trials of vaccines and stages of development of domestic vaccines are presented. Factors that determine the success of large-scale clinical trials are thoroughly described. Differences between domestic registration trials and international multicenter randomized clinical trials are discussed.

[Results of Russian multicenter trial of immunogenicity, reactogenicity and safety of new combination vaccine against hepatitis A and B (Twinrix)].

Results of registration trial of combination vaccine for prevention of hepatitis A and B are presented. The trial was conducted in 5 centers of Russia in 2004-2005 with full accordance to good clinical practice requirements and standards for multicenter open randomized trials. Immunogenicity of studied combination vaccine Twinrix was evaluated in comparison with two simultaneously administered monovalent vaccines against hepatitis A and B (Havrix and Engerix-B) in 200 healthy subjects aged 18-40, which were seronegative to hepatitis A and B.

Nosocomial rotavirus infection in European countries: a review of the epidemiology, severity and economic burden of hospital-acquired rotavirus disease.

The data currently available on the epidemiology, severity and economic burden of nosocomial rotavirus (RV) infections in children younger than 5 years of age in the major European countries are reviewed. In most studies, RV was found to be the major etiologic agent of pediatric nosocomial diarrhea (31-87%), although the number of diarrhea cases associated with other virus infections (eg, noroviruses, astroviruses, adenoviruses) is increasing quickly and almost equals that caused by RVs. Nosocomial RV (NRV) infections are mainly associated with infants 0-5 months of age, whereas community-acquired RV disease is more prevalent in children 6-23 months of age.

Contraindications to vaccination in the Russian Federation.

Failure to achieve high levels of immunity among children contributed to the epidemic of diphtheria that occurred in the Russian Federation during the 1990s. A major factor in this failure was the extensive list of contraindications to vaccination that was in use throughout the countries of the former Soviet Union. In 1980, the Ministry of Health (MOH) of the Soviet Union adopted an extensive list of contraindications for use of the diphtheria-tetanus toxoids-pertussis (DTP) vaccine.

[Antibiotics in bacterial acute respiratory tract infection in children].

The data on changes in the susceptibility of the most frequent respiratory tract pathogens i.e. Pneumococcus spp.

[Etiology and treatment of pneumonia in children].

The most widespread pathogens of pneumonia in children i.e. Streptococcus pneumoniae and Haemophilus influenzae and their antibiotic susceptibility are described.

[Use of oral macrolide and azalide antibiotics in children with bronchopulmonary diseases].

The therapeutic efficacy of oral macrolides (erythromycin base and midekamycin, macropen) and azalides (azithromycin, sumamed) in the treatment of children with acute and chronic (during the aggravation) bronchopulmonary diseases was studied. The main etiological factors of acute and chronic pneumonia were Streptococcus pneumoniae and Haemophilus influenzae. The proportion of Staphylococcus aureus was high in infants with acute pleuropulmonary inflammations.

[The periodic and regional characteristics of the pneumococcal serotype spectrum in children with respiratory diseases and in healthy carriers].

The aim of the work was the comparative study Streptococcus pneumoniae serotypes, isolated from healthy carriers and acute pneumonia patients in different regions of the CIS; in Moscow observations were carried out for 10 years. Specific antibodies to different S.pneumoniae capsular polysaccharide antigens were determined in blood serum samples by the method of heterogeneous enzyme immunoassay.

[Use of oral antibacterial drugs in the treatment of acute pneumonia in children].

The efficacy of oral antimicrobial agents was studied under conditions of monitored clinical trials. Overall 279 children with different clinical forms of acute pneumonia were entered into the study. It has been shown that the treatment of uncomplicated acute pneumonias may be started since the day of admission to the hospital.