Contraindications to Vaccination in the Russian Federation

Abstract

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. In 1994, the MOH of the Russian Federation revised the list of contraindications to vaccination to be largely in accord with World Health Organization recommendations. Since then, age-appropriate vaccination coverage has increased markedly: In 1996, DTP3 coverage among children 12 months of age had increased to 87% from 60% in 1990.

Successful Control of Epidemic Diphtheria in the States of the Former Union of Soviet Socialist Republics: Lessons Learned

“…Beginning in 1980, Soviet immunization recommendations allowed the use of an alternative primary immunization schedule against diphtheria ( physicians of the risk of pertussis vaccine complications. Physicians' fears of other adverse events from vaccination led to delays in initiating immunization beyond the first year of life due to an extensive list of contraindications to immunization that was expanded in 1980 far beyond internationally accepted conditions [7]. In the 1986 immunization schedule, the schoolentry booster dose was dropped, resulting in an increase in the interval between booster doses.…”

“…To raise childhood coverage, a shortened list of contraindications was adopted, and full-strength vaccine preparations became the vaccine of choice for the primary series [7]. In October 1994, the school-entry booster dose was reinstituted.…”

Diphtheria Epidemic in the Republic of Uzbekistan, 1993–1996

“…Achieving immunization coverage goals was also affected by the acceptance of false contraindications to vaccination, which had become institutionalized during the Soviet period [3]. Analysis of data from 1990-1993 showed that pertussis vaccination coverage among infants was 4%-8% lower than diphtheria coverage during this time period.…”

Quo vadis SANEPID? A cross-country analysis of public health reforms in 10 post-Soviet states

“…While operation had already been weakened in the years prior to the break-up of the Soviet Union [7,8], the situation substantially worsened in the years following independence. The new states faced severe economic, social and political problems.…”

“…Many of these diseases can be cured if detected at an early stage, but the countries do not have the same experience in screening and early detection as they do in immunization programmes. In Armenia, Azerbaijan, Kazakhstan and various other countries [8,10,18], screening programmes and other secondary prevention measures for noncommunicable diseases are underdeveloped or non-existent. While Belarus and the Russian Federation have implemented a broad range of screening programmes-including screenings for cervical, breast, rectum, and skin cancer in Belarus and ovarian and prostate cancer in the Russian Federation-some of the programmes are not based on sound evidence or lack qualified staff [37,38].…”