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Pneumococcal infection remains a significant global health problem, and vaccination is the main measure for its prevention. To date, the period of use of pneumococcal conjugated polysaccharide vaccines in Russia exceeds 14 years, and 13-valent conjugated polysaccharide pneumococcal vaccine (PCV13) - more than 10 years. During this time, extensive experience has been accumulated in the use of this type of vaccines, and many studies have been carried out to evaluate their effectiveness and safety.The purpose of this review is to summarize the experience of using PCV13 in Russian Federation with an assessment of its epidemiological and clinical effectiveness. A search was made for scientific publications devoted to the study of the epidemiological efficacy, the safety as well as cost-effectiveness of PCV13 use in Russian Federation. The review included original studies published in Russian journals. The results of the studies carried out indicate the efficacy and safety of PCV13 for both adults and children. The effectiveness of immunization of children at risk (premature, suffering from congenital pathology, having chronic diseases and often ill) was demonstrated, the need and safety of the timely start of vaccination (from 2 months of age) of newborns was shown, the possibility of its combination with immunization against other infections within the framework of the national vaccination schedule, the importance of following the recommended vaccination schedule in accordance with the age of the child. The effectiveness of vaccination of adults suffering from chronic diseases has been shown both in terms of preventing the aggravation of the course of the underlying pathology and reducing the risk of pneumonia. Positive experience has been gained in immunizing adults from occupational risk groups - medical workers, conscripts and persons exposed to a harmful production factor and having occupational lung diseases. The conducted studies have shown a high cost-effectiveness of PCV13 vaccination, however, with any changes in price and epidemiological parameters, it is necessary to clarify the economic feasibility of vaccination under the changed conditions. Taking into account the positive experience gained in immunization, it seems appropriate to further maintain a high level of vaccination coverage of the child population, expanding risk groups among the adult population subject to vaccination against pneumococcal infection within the framework of the National Immunization Schedule, taking into account its epidemiological, clinical and economic efficiency.

Relevance. Vaccination of the child population against pneumococcal infection (PI) has been carried out in the Republic of Tatarstan according to the national calendar of preventive vaccinations since 2014. The vaccination scheme includes vaccination with PCV-13 conjugated pneumococcal vaccine.Aim. Study of the the frequency of bacterial transmission and the serotype landscape of S. pneumoniae isolated from healthy children- bacterial carriers of preschool age in the Republic of Tatarstan (RT).Materials and methods. During the period from 2016 to 2022, 1,426 children from Kazan and the districts of the Republic of Tatarstan were examined. Examination of nasopharyngeal smears was carried out by the classical bacteriological method. Serotyping was performed using molecular genetic methods (PCR).Results. The detection rate of S. pneumoniae among healthy preschool children varied in different years from 29.5 to 63%, averaging 38.5%. In urban children, the incidence of pneumococcal transmission was significantly higher than in rural children (p

Relevance. To date, there is ample evidence that diabetes mellitus (DM) and obesity are predictors of a severe course and adverse outcome of COVID-19. The SARS-CoV-2 virus is known to have deleterious effects on the pancreas, exacerbating insulin resistance The SARS-CoV-2 virus is known to have deleterious effects on the pancreas, exacerbating insulin resistance. Long-term data have been accumulated regarding pneumococcal infection and influenza, both of which are severe in patients with diabetes and obesity. The aim is to analyze scientific publications on the problems of vaccinating patients with diabetes and obesity against SARS-CoV-2, pneumococcal infection, and influenza. Conclusions. Vaccination against COVID-19 in patients with DM and obesity is an effective preventive measure. Experience with vaccination against COVID-19 using the following vaccines: Moderna mRNA-1273, Pfizer BioNTech, BNT162b2, AstraZeneca COVID-19 vaccine AZD1222, SII Covishield, SK Bioscience, Sputnik V showed similar safety and efficacy profiles among obese and DM patients and those at risk. Researchers in numerous publications have emphasized the importance of routine vaccination for people living with diabetes amid a pandemic of a new coronavirus infection. Researchers in numerous publications have emphasized the importance of routine vaccination for people living with diabetes in the face of a new coronavirus pandemic. Analysis of the literature reviewed in this review suggests that vaccination against SARS-CoV-2, especially for those at risk, will be an intensive area of research in the coming years and that vaccination against coronavirus infection is likely to be routine for people with diabetes and obesity.

Relevance. Pneumococcal disease is a common cause of morbidity and mortality in adults and children worldwide. Vaccination against pneumococcal infection was included in the National Immunization Schedule in the Russian Federation in 2014. But despite the progress made, the proportion of children who received a completed course of vaccination remains insufficient. Coverage of the adult population remains low. A significant role in this is played by confidence of the population to vaccination against pneumococcal infection. In this regard, we conducted a study to assess the effectiveness of the educational programs in the improving of confidence in vaccination against pneumococcal infection among various target groups of population. Materials and methods. The results of the developed and conducted educational campaigns, consisting of two stages, were used as material: a series of face-to-face events for young people (students of non-medical universities in Moscow) and a series of webinars for medical professionals of various specialties. In the first stage of the educational component, the total coverage of the target audience («future parents») amounted to 650 people. Face-to-face events were held with the participation of students from Sechenov University using the peer-to-peer approach. The total audience of the second phase of the educational component (a series of 5 webinars for health professionals) was more than 3,000 people (2,902 connections, some of them group). Online events for medical workers were held by leading experts in the field of epidemiology and vaccine prevention, psychology. Evaluation of the effectiveness of the campaign was carried out through measurements (surveys before and after the event). To assess the statistical significance of differences, Pearson's Chi2 test was used at the accepted level of statistical significance p < 0.05. Qualitative variables are presented as proportion and 95% confidence interval of the proportion. Statistical processing was performed using IBM SPSS Statistics v.20.0, data visualization – Microsoft Excel 2016. Results. The proportion of students who have a positive attitude towards vaccination increased by 16% – from 41.0±5.6% to 57.0±6.0%, p

Relevance Antimicrobial resistance (AMR) is a growing acute global health issue. Uncontrolled combined use of antibiotics determines changes in the microbial agents' properties, leading to a decrease of susceptibility to antimicrobial substances and increasing the probability of severe invasive bacterial infections with limited possibilities to treat them. Vaccination against pneumococcal infection as well as improvement of the health care providers awareness can be considered as part of AMR management strategies. A number of epidemiological observations have been published indicating a change in antimicrobial resistance to Streptococcus pneumoniae following the implementation of the national infant immunization program against pneumococcal infection. Aim. To analyze the literature data on the pneumococcal vaccination contribution to the reduction of the number of pneumococcal diseases and the need for antibacterial therapy and to assess the burden of invasive pneumococcal diseases globally and in the Republic of Belarus (RB) and to identify gaps in the awareness of practicing physicians on pneumococcal infection immunoprophylaxis, its' effectiveness and impact on AMR. Conclusions. WHO considers and promote vaccination as an AMR containment measure. There are a lot of publications with the examples of countries with pneumococcal infection pediatric national immunization programs (NIP) and epidemiological data on changes in the S.pneumoniae sensitivity to antibacterial drugs after the start of the NIP. During the period of the mass PCV immunization and the subsequent drift of strains the sensitivity to antimicrobials may return. In Israel 88% and 93% reduction of otitis media cases caused by resistant to penicillin and macrolides vaccine types of S.pneumoniae after the phased introduction of PCV7 and PCV13 to the infant NIP, comparing to the period before vaccination introduction. A decrease in the frequency of bacteremia in combination with a sharp decrease in the proportion of penicillin-resistant pneumococcal isolates (from 50.9% to 5.3%) is also described. In France the proportion of S.pneumoniae strains with reduced susceptibility or resistance to penicillin declined from 47.1% to 39% after the start of PCV13 NIP; researchers also noted a decrease in antibiotic-resistant isolates of S.pneumoniae in children with otitis media: by 26, 31, 55, 29 and 57%, respectively, to penicillin, amoxicillin, cefotaxime, erythromycin and co-trimoxazole to in 2011. A study in Germany revealed a decrease in macrolide-resistant IPD strains after the start of PCV13 use of (in children 8.2%; in adults 8.8%) compared with the period after the introduction of PCV7 (17.3% and 13.0%) and especially in the cohort of children compared with the period before the use of PCV7 (24.8% and 13.3%). In Scotland, there was a decrease in the number of penicillin-resistant strains isolated from the blood of patients with IPD after the introduction of PCV13 into the NIP. The publication of the results of three parallel studies in Finland evaluated the effectiveness of PCV10 in reducing the number of IPD caused by vaccine-specific serotypes of PCV10 by 93%, 98% and 100%, respectively. At the same time, the effectiveness against «related» PCV10 serotypes was equal to 46%, 51% and 78%, respectively, and the estimated effectiveness against unrelated PCV10 serotypes was negative. Composition and resistance profile of the lower respiratory tract microflora isolated from sputum pneumococcal strains in children in 2016–2018, demonstrated up to 72.4% resistance to macrolides, 31.3% resistance to cefotaxime and 8.3% – to ceftriaxone. Spn serotypes structure in under 5 years of age children with meningitis was characterized by relatively high uniformity. Majority (92%) of multiresistant meningeal strains are covered by current PCVs. An anonymous questionnaire showed pediatricians' insufficient awareness about current approaches to pneumococcal infection prevention, underestimation of IPD risks and complications, and the impact of vaccination on reducing AMR. Additional education is required to increase the level of knowledge and understanding of the PCVs role in AMR reduction. PCV NIP introduction will provide additional opportunities to reduce AMR in the Republic of Belarus.

Background. Acute respiratory viral infections (ARVI) and pneumococcal infections (PI) annually cause great damage to the health and working capacity of the population, and lead to economic losses for employers and the state. Aim. To study the impact of influenza and PI vaccination coverage on morbidity of ARVI and community-acquired pneumonia (CAP) of the morbidity of population in Central administrative district (CAD) of Moscow. Material and methods. The analysis of official data on monitoring of morbidity from ARVI and CAP was carried out, and information on vaccination of the population against influenza and PI for 2012–2018 was used. Results. In 2018 ARVI accounted for 95.2% of infectious morbidity and the incidence rate was 29853.5 per 100 ths population. Over the period from 2012–2018, the incidence of ARVI and influenza gradually decreased by 2016, but in 2017 the incidence of ARVI was increased to the level of 2012 (+25.3%) however influenza was decreased (-40.9%). In 2018, the incidence of ARVI in adults remained at the level of 2017, and in children there was a decrease (-16.9%). The incidence of influenza in 2018 decreased in both adults (-65.4%) and children (-63.9%). During 2012–2018 the incidence of CAP had a persistent tendency to increase. The coverage of influenza vaccination in CAD population of Moscow has increased annually since 2012 and in 2018 reached 85.5% of children 0–17 years old and 65.5% of adults 18 years and older, and against PI – 46.3% of children and 2.6% of adults. Conclusion. The epidemic circulation of ARVI and influenza had a significant impact on the morbidity of CAD population of Moscow in 2012–2018. Annual vaccination of the population lead to decreasing of influenza incidence but the incidence of pneumonia tended to increase and need to improve prevention.

Relevance. Among the groups at high risk of developing invasive pneumococcal infections, patients with multiple myeloma (MM) stand out among the highest rates of morbidity and mortality due to the presence of profound immunosuppression. Aims: to outline the current state of the problem of vaccine prevention of pneumococcal infection in patients receiving treatment for multiple myeloma, to present the evidence base for vaccination with conjugated pneumococcal vaccine. A continuous data review method was used to evaluate the studies on vaccination approaches against pneumococcal infection in patients with multiple myeloma. Conclusions. The article presents modern epidemiological data, as well as the results of original studies of clinical and immunological aspects of pneumococcal vaccination in patients with MM receiving new targeted agents and immunotherapy. The effectiveness of the use of the conjugated pneumococcal vaccine in patients treated with MM with bortezomib, lenalidomide, and ixazomib was indicated. An independent protective effect of pneumococcal vaccination has been shown as a preventive measure in a cohort of patients with MM, against the background of treatment with new targeted drugs.

Relevance. Bronchial asthma is widespread in the world, according to WHO estimates, 235 million people suffer from it. In Russia, according to official figures, 1.3 million cases of bronchial asthma have been reported. Domestic experts reasonably believe that these data are underestimated at least 4 times. Considering that patients with bronchial asthma undergo significant changes in the immune system and are especially difficult to tolerate respiratory and other infectious diseases, determining the effect of vaccination on the clinical course of bronchial asthma is very important. The purpose of the review is to show how vaccinations against pneumococcal infection and influenza affect the condition of patients with bronchial asthma. Conclusion. Features of formation of protective immunity at various schemes of immunization against pneumococcal infection are analyzed. In patients with bronchial asthma, the justification of the vaccination scheme with the advantage of the priority administration of conjugated polysaccharide vaccine with the subsequent introduction of a polysaccharide pneumococcal vaccine after 8 weeks is given. Vaccination against pneumococcal infections has led to the elimination of sputum S. рneumoniae. In vaccination against pneumococcal infection, there was an improvement in the level of disease control, which was confirmed by the ACQ-5 test-a decrease in the indicator from 2 [1,5;1,8;3] points (lack of asthma control) to 0,6 [0;1] points (asthma control) during the year of observation, p < 0,001. Vaccination against influenza in patients with bronchial asthma leads to a decrease in the frequency and duration of exacerbations, there is a decrease in the level of markers of systemic inflammation. Combined vaccination against influenza and pneumococcal infection is not accompanied by a reliable difference in tolerability in comparison with monovaccination only against pneumococcal infection or influenza.

Background. Vaccination is considered by the world community as the main measure of the fight against pneumococcal infection [1–3]. Immunization of children has been carried out since the end of 2014. Goals. To study the compliance of the vaccination scheme against pneumococcal infection in young children and its influence on vaccination efficacy.Methodology. Evaluation of the compliance of the vaccination schedule against pneumococcal infection and the impact on morbidity in young children was carried out under the conditions of epidemiological observational descriptive and analytical («cohort») researches. Expert assessment is made of medical records of 52 patients, and 200 electronic medical cards and 200 cards of prophylactic vaccination in children were born in of 2015 and 2016.Results. The high importance of adherence to the vaccination scheme against pneumococcal infection was established not only in the prevention of disease and also in reducing carriage of S. pneumoniae. The greatest effect of pneumococcal immunization was observed in children who received the first vaccination before the age of 6 months and with a completed course of vaccination.Conclusion. Timeliness of immunization of young children against pneumococcal infection is a significant factor in ensuring preventive efficacy of immunization.

The pneumococcal infection is an important issue due to its prevalence, numerous severe complications, high mortality rate and disability. However modern vaccination allows preventing of the pneumococcal infection and reduces the severity of clinical complications. This article presents the analysis of the morbidity and mortality indicators from community-acquired pneumonia and the effect of pneumococcal vaccination on its dynamic in the at-risk groups within the adult population of the Aldan area and the city of Aldan of the Sakha Republic (Yakutia). In the Aldan area pneumonia morbidity persistently exceeds the national Russian average: in 2015 – 1.5 times (499.3 per 100,000 population) and in 2016 – 1.2 times (500.8 per 100,000 population). The morbidity indicators in Aldan are comparable to the national values. The community-acquired pneumonia mortality rates in the Aldan area were 20.55 per 100,000 population in 2015, and 18.5 per 100,000 population in 2016; these values are, respectively, 4.3 and 3.8 times higher than the national average. In the city of Aldan the community-acquired pneumonia mortality rates were 9.87 per 100,000 population in 2015 and 15.8 per 100,000 population in 2016, which is more than double the national average in the Russian Federation. Pneumococcal vaccinations of the adult population using the conjugate vaccine Prevenar 13 have been observed to lower the pneumonia morbidity and respiratory infections; the vaccinations also reduced the number of hospitalizations due to condition exacerbations or decompensations among adult patients with chronic lung disorders, cardiac insufficiency, and diabetes.

Relevance. Bronchopulmonary dysplasia (BPD) is the most frequent chronic pathology of the lungs in children of the first year of life, especially among children born with extremely low and very low birth weight.Goal. The safety, immunogenicity and preventive efficacy of Prevenar 13 in preterm infants with bronchopulmonary dysplasia were assessedMaterials and methods. There were 29 children under observation, as well as 29 non-vaccinated children as a comparison group. Oxygen support was not needed by any child with BPD. Children in both groups had consequences of perinatal involvement of the central nervous system. Prevenar 13 vaccine was used for immunization.Results. The level vaccine adverse event following immunization in the group of vaccinated children was 16.7 ± 0.07%. One child had a high body temperature up to 39.5 °C, it was required to prescribe antipyretic drugs in the age-related dosage. All vaccine adverse event following immunization disappeared on 2 day. Local reactions were not recorded.Conclusions. The use of the Prevenar13 vaccine has established high preventive efficacy among preterm infants with BPD, a decrease in the incidence of otitis media by 3.5 times. Evaluation of the immunogenicity of the Prevenar 13 vaccine among children with BPD showed good immunological efficacy (a 4-fold increase in the mean geometric titer of antibodies at 28 days after vaccination).

Pneumococcal infections are among the most common infections are an important cause of morbidity and mortality worldwide, including Russia. At the end of 2014 in the national immunization schedule countries introduced vaccination against pneumococcal infection The aim of study. To assess the epidemiological effectiveness of vaccination against pneumococcal infection in young children selectively in different territories of the Russian Federation 2 years later from its beginning Materials and methods. In the course of epidemiological observational analytical research of type «case-control» data were obtained on the incidence in vaccinated and unvaccinated against pneumococcal infection in children from 2 months to 2 years We analyzed 1422 outpatients and 356 case histories of children in several cities (Moscow, Smolensk, Sevastopol, Perm, Tyumen, Barnaul). The results are subjected to statistical processing The results and discussion Established that there is a reliable causal connection between the lack of vaccination of children against pneumococcal infection and incidence of diseases. Shows high prophylactic efficacy of vaccination of children up to 2 years. Received in outpatient and inpatient facilities, evidence suggests that the incidence of invasive and non-invasive forms of pneumococcal infection was significantly lower in the vaccinated children It was revealed that the vaccination coverage against pneumococcal infection in children from 2 months to one year and the second year of life was 51 and 40% respectively. Vaccination in the first six months of life in 2016 received only 25% of children. A high proportion of the parent's refusal of vaccination of children (54.2%), and high frequency medical taps (9.7%) from vaccination.

Whereas the quality of the program depends on promptness, full coverage, vaccination schedule abidance. Taking new Moscow regions as an example there have been studied factors influencing vaccination against Pneumococcal infection (PI). Insufficient provision of the vaccine to reach the desired level of coverage has been detected: in 2014 only 67.57% of liable children could receive double vaccination; the available quantity of vaccine in 2015 was able to provide 33. 84% of children up to 12 months old with double vaccination.However, the actual number of children vaccinated turned to be much lower (0.23% in 2014 and 20.85% in 2015).The survey of the doctors with the purpose of defining the level of knowledge and commitment to the vaccination against PI has shown a modest level of epidemiology, clinical implications, PIimmunoprophylaxis method awareness. Parental attitude towards PI vaccination has been estimated as positive. Parental interest to opportunities of immunoprophylaxis against PI is worthwhile noting despite the insufficient level of knowledgeability of its effects. Hence 74.5% of parents whose children are not vaccinated against PI would like to start vaccination, however a part of them look into receiving more information (29.41% parents).

The paper presents evidence of the relevance of pneumococcal infection (PI) in children of Krasnoyarsk. The most severe form of PI is pneumococcal meningitis that characterizes by lesion of not only meninges but brain substance, extreme severity, long-term nonsmooth flow with the development of complications that threaten a patient's life. The inclusion of pneumococcal conjugate vaccine in the planned childhood immunization scheme will significantly reduce the severity of these diseases.