The vaccination calendar does not turn over – Newspaper Kommersant No. 33 (7478) of 02/27/2023

The government has pushed back the deadlines for introducing new vaccinations into the national calendar. Now vaccines against rotavirus and human papillomavirus will only get into it in 2025, and the chickenpox vaccine in 2027. The Ministry of Health explains that this is necessary to synchronize with the timing of the entry into the market of localized or domestic vaccines. Meanwhile, the medical and patient communities have long been waiting for the expansion of the national calendar. Yan Vlasov, co-chairman of the All-Russian Union of Patients, believes that, first of all, dangerous infections – meningococcus and chicken pox – should be taken under control.

The Government of the Russian Federation has made adjustments to the action plan “Strategy for the development of immunoprophylaxis of infectious diseases until 2035”. The changes affected the National Immunization Schedule (NCV). It is assumed that the vaccine against rotavirus will enter the national calendar in 2025, although it was originally planned that this would happen in 2022. Also, the deadlines for replenishing the NCV with the chickenpox vaccine have been shifted – from 2023 to 2027, and for the human papillomavirus (HPV) – from September 2023 to September 2025. In addition, from November 2023 to November 2025, the date for submitting a report to the government on determining the contingent to be vaccinated and on financial support for purchases has been postponed.

Alexei Kuznetsov, Assistant Minister of Health of Russia, told Kommersant that the localization of the production of vaccine preparations and the creation of domestic vaccines are now continuing. “The proposed changes will synchronize the timing of the inclusion of new vaccinations with the timing of the entry into the market of localized or domestic vaccines. They were discussed with the main freelance specialists of the ministry, taking into account the epidemiological situation,” Mr. Kuznetsov told Kommersant. He noted that the “main principle” of the formation of the national calendar is to ensure sustainable access to vaccines, regardless of external factors. Aleksey Kuznetsov also reminded that already today, vaccination against rotavirus infection, chickenpox and human papillomavirus can be carried out outside the framework of the NCIP – by decision of the constituent entities of the Russian Federation.

Leyla Namazova-Baranova, chief freelance pediatric specialist in preventive medicine at the Ministry of Health, told Kommersant that although we have “traditionally high” coverage of routine vaccination, there are fewer positions on the preventive vaccination calendar in the Russian Federation today than in the United States, Australia or EU countries (there 17–19). She noted that doctors are waiting for all our children and adults to be effectively protected from meningococcus and chickenpox, rotavirus and papillomavirus, hepatitis A and tick-borne encephalitis.

“If the vaccine is included in the national calendar, it is provided free of charge and you can get it at the clinic. In the absence of a specific vaccination at the NKPP, this issue is left for adults, parents and their children, the pediatrician and the therapist, the epidemic situation to decide on their own, ”says Yulia Fokina, a therapist at the Doctor Nearby medical company. At the same time, according to her, the economic damage to the state from these three infections – rotavirus, HPV and chicken pox – reaches several tens of billions of rubles annually. Ms. Fokina points out that vaccines that prevent these diseases are not yet produced in the Russian Federation. Difficulties with the localization of foreign drugs are noted, specific vaccine drugs are also not included in the procurement budget: “Probably, this is the reason for the lack of vaccination against these diseases at the NCPP, since it will be impossible to provide the population with vaccines.”

RNC Pharma Development Director Nikolay Bespalov calls the situation with the rotavirus vaccine a “vicious circle”. He notes that there is a joint project with Indian partners to localize the drug in Russia. “But partners want guarantees that the drug will be purchased. And since it has not yet been included in the national calendar, there are no guarantees of public procurement,” says Mr. Bespalov. “Naturally, this slows down the start of the project. Because far from all development companies can invest in a product at an early stage, either partnership or state guarantees are required here. For the state, in his opinion, the problem lies in the fact that there is no understanding of the prices at which drugs can be purchased.

Neurologist Yan Vlasov, co-chairman of the All-Russian Union of Patients, believes that meningococcus and chickenpox should be taken under control first of all. He recalls that chickenpox has a high mortality rate. There is a risk of smallpox encephalitis – these are disorders of the central nervous system, when paralysis can occur. Epidemic meningitis comes with severe symptoms, and survivors may experience brain damage. “Money for vaccination campaigns needs to be found, it is impossible to postpone the inclusion of new vaccines in the NCIE all the time,” Mr. Vlasov insists. Moreover, at the end of 2022, outbreaks of meningococcal infection were recorded. In the Moscow region, the number of diseases has tripled, in the Krasnodar Territory – five times. Yan Vlasov suggests that outbreaks may recur against the backdrop of an increase in migration flows from Tajikistan, Uzbekistan and Ukraine: “For example, in Ukraine over the past 30 years there has never been a mandatory vaccination under the state program. The situation with the availability of vaccines in Uzbekistan and Tajikistan is no better.” Mr. Vlasov assumes that it is “quite realistic” to replenish the NKPP with domestic vaccines when organizing a state order.

It should be noted that the only nearest candidate vaccine, the dates for inclusion in the national calendar of which were not postponed, was a drug against meningococcal infection using a quadrivalent vaccine (against serogroups A, C, W, Y). It is planned that it will become available in Russia in 2025. On February 21, it became known that the Ministry of Health issued permission to conduct a clinical trial of the vaccine to the Indian company Serum Institute.

Natalia Kostarnova