Doctors and teachers will no longer be required to get vaccinated against coronavirus

The Ministry of Health has again changed the requirements for vaccination of citizens against coronavirus: from September 1, it will remain mandatory only for vulnerable categories of the population. It is recommended to revaccinate one year after the last vaccination. Doctors with whom Kommersant spoke note that vaccination against coronavirus has long passed into a formal status and the time has come to enshrine it in law. However, there is also an opinion that the medical community “could not withstand the onslaught of anti-vaxxers and followed Western recommendations.”

The Ministry of Justice registered the order of the Ministry of Health with changes to the calendar of preventive vaccinations for epidemic indications. Changes are proposed to be made to the order of the Ministry of Health of the Russian Federation No. 1122n dated December 6, 2021. Then it was mandatory for medical workers, teachers, senior citizens and children aged 12 to 17 to be vaccinated against coronavirus. As noted by the Ministry of Health back in the summer of 2023, the motivation for revising these requirements was the formation of a high level of collective immunity against COVID-19 and the stabilization of the coronavirus epidemiological situation in the Russian Federation. Under these conditions, the Ministry of Health considers it advisable to move from mass vaccination to protecting the most vulnerable categories of citizens. These are people over 18 years of age who have not previously had COVID-19 and/or have not been vaccinated; people aged 60 years and older; patients with chronic diseases such as tuberculosis, diabetes mellitus and obesity, cardiovascular and bronchopulmonary diseases; people with primary or secondary immunodeficiencies, including HIV infection, autoimmune and oncological/hematological diseases.

Appendix No. 3 to Order No. 1122n is supplemented by clause 15, according to which repeated vaccination (re-vaccination) against coronavirus is carried out no earlier than a year after the previous vaccination. Until now, the Ministry of Health recommended revaccination once every six months. The document will come into force on September 1 this year and will be valid until March 1, 2030.

“Since the COVID-19 pandemic began to decline, the volume of vaccinations has decreased significantly,” says Tatyana Kogut, an infectious diseases specialist of the highest category at the Doctis telemedicine service. “Everyone who wants it has already received the necessary vaccinations, people from risk groups have received a recommendation for seasonal vaccination.” . But the activity of the coronavirus, severe cases with hospitalization and deaths will still persist, the doctor reminds, so the recommendations for risk groups, according to her, are correct and they will remain, just like the recommendations for flu vaccination.

“The requirement for vaccination has become a formality. In practice, few people get vaccinated against coronavirus on their own initiative. Mandatory vaccination requirements before travel and in other cases have been lifted. There have been relaxations in medical organizations,” continues the scientific director of the Grand Clinic network of immunorehabilitation and preventive medicine clinics, Olga Shuppo. “This was facilitated by many factors: a decrease in the mortality rate, modern research data, the accumulation of practical data, and weakening of the virus due to mutation. Accordingly, the time has come to enshrine the changes in legislation.”

On the other hand, Tatyana Kogut points out that the vaccines that were created to combat the then circulating strains of coronavirus are now “not entirely effective”: “Either we need to monitor the antigenic characteristics of new strains and make changes to the vaccine, as they do with the flu, or we should there must be an understanding that the effectiveness of vaccination will not be high.”

Leading general practitioner, chief physician of the Niardmedic clinic, Anna Rybakova, believes that the medical community “could not withstand the onslaught of anti-vaxxers and followed Western recommendations.” She admits that vaccination against coronavirus has virtually “come to a standstill”: “Firstly, the release of a vaccine with a new antigenic composition was significantly delayed. Director of the Gamaleya Center Alexander Gintsburg announced his readiness to create a new vaccine back in 2022, but, unfortunately, the release took place only at the end of last year. By this time, many had already recovered from coronavirus infection of the Omicron strain; the rest had no plans to get vaccinated. The severity of the disease in case of infection has indeed decreased significantly, but the fact of the high virulence of the virus remains and seasonal infections (influenza, rhinovirus) have been added, as a result of which the working population is in a constant state of ill health,” the doctor comments. “Secondly, vaccination against SARS- CoV-2 was never included in the national vaccination calendar, the decision fell on the shoulders of the population, and with the anti-advertising that was in the first wave of Covid, one cannot expect a rush.”

Anna Rybakova considers the decision to abandon mass vaccination in favor of vulnerable groups to be incorrect. She points out that the instructions for use of the Sputnik line of drugs indicate: vaccination of persons with diseases of the cardiovascular system, chronic diseases, and diseases of an autoimmune nature should be carried out with caution, with an assessment of benefits and risks. “In other words, responsibility for the decision falls on the attending physician,” says Ms. Rybakova. “In order to confirm the possibility of vaccinating citizens of vulnerable categories, additional research must be conducted. Doctors know very well what disorders of the immune system occur as a result of chronic diseases. The vaccine simply may not work on this category of people, and if the rate of general vaccination decreases, the immune layer will disappear, and we may again encounter a problem that is already known to us.” The doctor warns: the currently existing “loyal” Omicron strain may change to an aggressive and deadly one, and hesitation in making decisions about vaccination “can have irreversible consequences.”

Natalia Kostarnova