Risk factors of the labor process and vaccination of the adult working population

According to the Federal Service of Rospotrebnadzor, working conditions are becoming one of the main risk factors for the formation of occupational and professionally caused pathology. The problem of reducing the level of occupational diseases was also considered at the Government Commission on the Protection of Citizens' Health, where proposals from Rospotrebnadzor on the need to transition to a system for assessing and managing occupational risks were adopted.

To the greatest extent, the problems of the influence of working conditions factors on health are typical for 35 constituent entities of the Russian Federation, mainly in the Northwestern, Central, Volga, Ural, Siberian and Far Eastern federal districts with a high proportion of the population working in the industrial sector of the economy. Employees of a number of enterprises in mining, metallurgy, mechanical engineering and shipbuilding, the production of building materials, the construction industry, agriculture, and transport, where the most unfavorable working conditions are registered, are at greatest risk of loss of ability to work. .

To preserve the health of millions of people and save labor resources, it is necessary to minimize the impact of labor process factors on workers. And the main role here is played by vaccination, which can protect against severe and often fatal infectious diseases.

The state program “Development of healthcare in the Russian Federation for the period until 2020” was developed to reduce morbidity and mortality of the population. This is planned to be achieved through prevention and promotion of a healthy lifestyle, development of a system of high-quality and affordable medical care, increasing the efficiency of primary health care and reducing the load on the hospital.

The organization of immunoprophylaxis for children and adults in the Russian Federation is regulated by Federal Law No. 157-FZ of September 17, 1998 “On Immunoprophylaxis of Infectious Diseases”, the National Calendar of Preventive Vaccinations and Preventive Vaccinations for Epidemic Indications, sanitary and epidemiological rules and methodological recommendations.

Childhood vaccination programs have made great strides in reducing infectious diseases. The high coverage of infants and older children with routine vaccinations allows us to state that today the majority of childhood diseases preventable by vaccination occur rarely or are not recorded at all. However, similar success has not been achieved in adult immunization. Of course, it is extremely important to protect children from disease, and adults (including some doctors), while often well aware of the vaccinations that their children need, are completely unaware that this is important for them, too.

• age (due to age, a person becomes susceptible to developing severe infections, for example, influenza and pneumococcal infections);
• professional activity (due to the work performed, a person becomes susceptible to developing a severe infection or can become a source of infection for many people. For example, if he is a health worker, teacher, water utility worker, food production or catering worker, etc.);
• health conditions;
• vaccination history (have you been vaccinated previously or not);
• epidemic situation in the region or country.

When planning vaccination for adults, the medical professional also takes into account the vaccination received by the person in childhood (according to the childhood vaccination schedule, Table 1) and the completion of the started course of vaccination in childhood or adolescence. Part of the adult population may not have been vaccinated at all in childhood, since vaccination against some infections was not carried out at that time. In addition, post-vaccination immunity may decline over time.

Table 1

National calendar of preventive vaccinations of the Russian Federation for children 0-18 years old [adapted from 3]

	At birth	First year of life	Second year of life	6-7 years	14-18 years old
Tuberculosis	+
Hepatitis B	+	+
Pneumococcal infection		+	+
Hib infection		+	+
Diphtheria, tetanus		+	+	+	+
Whooping cough		+	+
Polio		+	+		+
Measles, rubella, mumps			+	+
Flu		+ annually from 6 months of age

table 2

Vaccination of adults > 18 years of age [adapted from 3.4]:

NATIONAL CALENDAR PREVENTIVE VACCINATIONS
Against the flu		Annually without age limit
Against diphtheria and tetanus		Every 10 years without age limit
Against rubella		Girls and women under 25 years of age (inclusive), if they have not been previously ill, have not been vaccinated or do not have information about vaccinations
Against measles		Planned up to 35 years (inclusive), if you have not been sick before, have not been vaccinated or do not have information about vaccinations
Against hepatitis B		Planned up to 55 years
CALENDAR OF PREVENTIVE VACCINATIONS ACCORDING TO EPIDEMIC INDICATIONS
Against viral hepatitis A	Those living in regions unfavorable for the incidence of hepatitis A, as well as persons at occupational risk of infection (medical workers, public service workers employed in food industry enterprises, servicing water supply and sewerage facilities, equipment and networks). Traveling to disadvantaged countries (regions) where outbreaks of hepatitis A are registered. Contact persons in hepatitis A outbreaks.
Against tick-borne viral encephalitis	Living in areas where tick-borne viral encephalitis is endemic; persons traveling to areas endemic for tick-borne viral encephalitis, as well as persons arriving in these territories performing the following work: agricultural, drainage, construction, excavation and movement of soil, procurement, fishing, geological, survey, expedition, deratization and disinfestation; for logging, clearing and landscaping of forests, health and recreation areas for the population.
Against meningococcal infection	In areas of meningococcal infection caused by meningococci of serogroups A or C. Vaccination is carried out in endemic regions, as well as in the event of an epidemic caused by meningococci serogroups A or C. Persons subject to conscription for military service.
Against pneumococcal infection	Adults from risk groups, including those subject to military service.
Against chicken pox	Adults at risk, including those subject to military service, who have not previously been vaccinated and have not had chickenpox.

The national calendar of preventive vaccinations has been developed for the entire country and is financed by the state budget of the Russian Federation.

The national calendar of preventive vaccinations has been developed for the entire country and is financed by the state budget of the Russian Federation. In addition to this, in a number of regions of the Russian Federation local vaccination programs have been adopted, where, at the expense of regional budgets, certain groups of children and adults can be immunized for epidemic indications. For example, against tick-borne encephalitis, hepatitis A, pneumococcal infection with a 23-valent polysaccharide vaccine, against chickenpox, rotavirus infection, papilloma virus (HPV), acellular pertussis vaccine.

Immunization according to the National Calendar of Preventive Vaccinations of the Russian Federation is carried out as prescribed by a doctor with immunobiological drugs registered in Russia, according to the instructions for use.

If the timing of vaccination is violated, medical workers carry it out according to the schedules provided for by the National Preventive Vaccination Calendar, in accordance with the instructions for the use of drugs. In this case, it is allowed to administer vaccines (except for vaccines for the prevention of tuberculosis) on the same day with different syringes in different parts of the body.

Vaccinal prevention for adults

Flu vaccination

Influenza has a negative impact not only on the health of each individual and the entire nation, but also on the country's economy, especially when it comes to epidemics. According to the Federal Service of Rospotrebnadzor, in 2014, about 20% of the population of the Russian Federation suffered from ARVI.

Table 3.

Economic significance of infectious diseases registered in the Russian Federation in 2014

Every year in Russia more than 25 million cases of acute respiratory infections and influenza are registered, which, of course, affect the ability to work of workers, leading to an average of 3-7 days of absence. Flu also reduces productivity for those who continue to work while sick or come to work sick. The employees themselves, while on sick leave, lose part of their wages and are forced to buy medicine. That is why vaccination not only becomes an extremely important way to protect health, but also allows you to save on treatment.

You can get vaccinated against influenza from the age of six months, in the absence of contraindications. The vaccination schedule and the presence of contraindications in each specific case are determined by the doctor.

The World Health Organization (WHO) recommends priority influenza vaccination for adults at risk of exposure to the influenza virus and those at particular risk of developing severe disease, i.e. illness leading to hospitalization or death.

In accordance with the National Preventive Vaccination Calendar, the influenza vaccine is supplied at the expense of the federal budget for vaccination of the following risk groups:

• children from 6 months, students in grades 1–11;
• students studying in professional educational organizations and educational organizations of higher education;
• adults working in certain professions and positions (employees of medical and educational organizations, transport, public utilities);
• pregnant women;
• persons over 60 years of age;
• persons subject to conscription for military service;
• persons with chronic diseases, including lung disease, cardiovascular disease, metabolic disorders and obesity.

For annual vaccination of adults against influenza, inactivated vaccines are most often used and, less commonly, live attenuated vaccines are used.

Both types of vaccines contain three strains of the virus that are relevant in a given season (two A and one B). In the USA and Western Europe, quadrivalent inactivated influenza vaccines containing antigens of two influenza A viruses and two influenza B viruses are already used.

Inactivated vaccines cannot cause influenza even theoretically, since they do not contain the influenza virus, but only immunogenic particles of the killed virus. According to the instructions for use, a common expected reaction to the administration of inactivated influenza vaccine is pain at the injection site, and less commonly, a slight rise in temperature or malaise. Inactivated split (split) and subunit vaccines have similar side effects, as shown by a meta-analysis of the immunogenicity and safety of various types of influenza vaccines published in 2011.

Health care workers can begin immunizing against influenza as soon as the vaccine becomes available in the fall. A doctor may consider vaccinating throughout the flu season if a person has not been vaccinated previously.

In addition, it is important to consider that influenza outbreaks from April to September are recorded in many countries of the world, except Russia, so the vaccine can be used in travelers who missed vaccination in the fall and winter. In this case, the doctor may consider vaccination against influenza at the same time as vaccination against other diseases, for example, vaccination against pneumococcal infections, if there is an indication for it.

The results of influenza vaccination programs in foreign countries among the working population showed a decrease in the incidence of influenza-like infections in vaccinated people compared to unvaccinated influenza-like infections, loss of working time and the number of visits to the doctor. Workplace immunization is the third most common location for influenza vaccination in the United States.

Vaccination against pneumococcal infection

Respiratory tract infections are also closely related to occupational activities. At risk of contracting respiratory infections are workers who come into contact with metal vapors, mineral or other dust, and gaseous substances. Smoking is also a risk factor, which, along with unfavorable working conditions, can cause chronic respiratory diseases, as well as acute respiratory infections.

Contamination of the work area with aerosol particles makes a significant contribution to the spread and development of, for example, pneumococcal pneumonia, both individual cases and outbreaks. A significant increase in the incidence of pneumonia was first described in welders, and then in workers of other professions exposed to metal fumes - furnace workers, foundry workers, molders, core workers, and rolling millers.

The first vaccine against pneumococcus to protect industrial workers was used in 1911. The monovalent polysaccharide pneumococcal vaccine was introduced during an outbreak of pneumonia in gold miners in South Africa. The drug was then upgraded and went from a 6-valent vaccine in the 1940s to a 23-valent vaccine licensed in 1983. The 23-valent polysaccharide pneumococcal vaccine (23-PPV) contains antigens from purified capsular polysaccharides 23, the most common pneumococcal serotypes.

The polysaccharide polyvalent pneumococcal vaccine can be recommended by a doctor, primarily for specific immunoprophylaxis for risk groups and reducing mortality from pneumococcal infections.

To prevent community-acquired pneumonia, the Federal Service of Rospotrebnadzor of the Russian Federation recommends that medical workers carry out routine immunization of the population against influenza, as well as pneumococcal infection for epidemic indications and in risk groups.

Medical experts note that among adults 19-64 years old, the following categories (risk groups) are most susceptible to developing severe PI:

• Patients with chronic diseases of the lungs (COPD, emphysema, etc.) and the cardiovascular system (coronary heart disease, heart failure, cardiomyopathy, etc.), especially those who are often hospitalized;
• patients with diabetes;
• patients with bronchial asthma;
• persons with chronic liver diseases (including cirrhosis);
• persons in special conditions or special social institutions, or organized groups;
• patients with cerebrospinal fluid leak;
• people with functional or anatomical asplenia (including sickle cell disease and those who have had a splenectomy);
• immunocompromised patients (including persons with hematological and oncohematological diseases, nephrotic syndrome, chronic renal failure, HIV-infected).

A 2013 Cochrane meta-analysis* (18 randomized controlled trials, including 64,852 participants; 7 non-randomized observational studies, including 62,294 participants) confirmed the effectiveness of the 23-valent pneumococcal polysaccharide vaccine (23-PPV) against invasive pneumococcal infections** in adults, including young people, which was 74% (95% CI 56-86%)

For example, since 2012, the UK immunization schedule has included a recommendation to vaccinate welders with a high occupational risk of developing pneumococcal infections, especially lobar pneumonia, with 23-PPV. It was stated that "...one dose of 23-PPV should be offered to people who have frequent or prolonged occupational exposure to metal fumes (eg, welders) and have not previously received 23-PPV." The Merck International Medical and Diagnostic Manual Textbook includes recommendations for influenza and pneumococcal vaccinations in interventions to prevent coal mining-associated pneumoconiosis, silicosis, and asbestosis.

Pneumococcal vaccines are inactivated (killed).

Health care providers may consider pneumococcal immunization throughout the year. If you are planning a vaccination program for influenza and pneumococcal disease, it is possible to administer these vaccines simultaneously before the start of the influenza season.

In accordance with the instructions for use, healthcare workers can administer the 23-valent pneumococcal vaccine simultaneously (on the same day) with other vaccines (except for vaccines to prevent tuberculosis) in different parts of the body using different syringes.

Vaccination against diphtheria and tetanus

The primary set of vaccinations against diphtheria and tetanus is carried out in early childhood.

To maintain a protective antibody titer, adults should receive booster vaccination against diphtheria and tetanus every 10 years.

Persons aged 25 years and older who have not received revaccination within the last 10 years are subject to routine immunization. Repeated booster vaccinations against diphtheria are carried out every 10 years.

If adults have not previously been vaccinated against diphtheria, have not had diphtheria, then in accordance with the methodological documents, the doctor considers carrying out a full course of these vaccinations (2 vaccinations with an interval of 45 days and after 6 - 9 months - revaccination). Subsequent revaccinations are also carried out every 10 years.

Vaccination against hepatitis A

Viral hepatitis A (infectious jaundice) is widespread in the world. In most middle-income regions, including Eastern Europe, population-based sample surveys have demonstrated a mixture of medium and low levels of incidence. In these regions, where a significant proportion of adolescents and adults are susceptible to infection, hepatitis A virus can circulate, often occurring in outbreaks. Preliminary WHO estimates suggest an increase in the number of cases of acute hepatitis A globally. Increased numbers of cases were estimated to occur in age groups 2-14 years and over 30 years*

The fecal-oral mechanism of spread of this virus involves transmission through food and water, which carries the risk of infecting a large number of people. Therefore, vaccination against hepatitis A is considered the most important measure to protect the population from this infection.

The position of the World Health Organization provides for the need for routine vaccination of the child population in regions of medium endemicity for hepatitis A, together with additional vaccination of risk groups, and in regions of low endemicity - vaccination of risk groups (primarily those traveling to regions and countries of high and medium endemicity). For example, immunization against hepatitis A is recommended in the United States for all persons traveling to Russia.

The Russian Federation is a country with medium endemicity for hepatitis A. In 2014, the incidence rate of viral hepatitis A exceeded the Russian average from 1.5 to 8.6 times in 6 constituent entities of the Russian Federation: the Komi Republic, Krasnoyarsk Territory, the Republic of Khakassia, the Sverdlovsk Region, the Republic of Dagestan, the Nizhny Novgorod Region, mainly due to outbreak incidence .

According to the Federal Service of Rospotrebnadzor, the significance of outbreak incidence of GA remains significant throughout the country; 42 outbreaks were registered in 2014, and 31 outbreaks in 2013. In a number of regions, the leading role in shaping the level of long-term dynamics of seasonal incidence of HA belongs to the water factor. A problem for many constituent entities of the Russian Federation remains the operation of outdated and worn-out treatment facilities, which contributes to the active discharge of untreated wastewater into water bodies. .

• medical workers;
• teachers and staff of preschool organizations;
• public service workers engaged in public catering, maintenance of water supply and sewerage facilities, equipment and networks;
• those traveling to regions and countries unfavorable for hepatitis A;
• contacts in outbreaks for epidemic indications;

Guidelines of the Federal Service of Rospotrebnadzor

Guidelines of the Federal Service of Rospotrebnadzor also recommend that medical workers vaccinate against GA in the following groups:

• military personnel of units located or conducting combat operations in areas with unsatisfactory sanitary conditions or unguaranteed water supply;
• persons with chronic liver diseases or an increased risk of liver diseases (persons with chronic viral hepatitis; chronic carriers of hepatitis B, C and D viruses; with chronic hepatitis of alcoholic, autoimmune, toxic, drug and other origins; persons with Wilson-Konovalov disease, hepatosis and hepatopathy, etc.);
• patients with blood diseases and persons on hemodialysis;
• persons with a behavioral risk of becoming infected with HA (men who have sex with other men; persons who are promiscuous; persons who use injection drugs; patients at drug treatment clinics);
• HIV-infected people when they are identified.

The most important of the entire list are professional risk groups due to their contact with a large number of people.

The vaccine against GA is inactivated (killed) and cannot cause infection. If indicated, the doctor may consider vaccinating adults against hepatitis A without an age limit; the course consists of two vaccinations in the deltoid muscle of the shoulder with an interval of 6-18 months in accordance with the instructions for use of the specific drug.

Vaccination against hepatitis B

The adult population accounted for 98.6% of the total number of cases of acute hepatitis B (AHB). In order to further prevent the spread of hepatitis B on the territory of the Russian Federation and reduce the incidence of acute forms of the disease to a sporadic level, it is necessary to continue vaccination of children and adults within the framework of the national calendar of preventive vaccinations.

For people at risk, for example, those who have close household contact with a patient with hepatitis B, and above all, with patients with chronic forms of hepatitis B, including virus carriers, a doctor may recommend a vaccination complex consisting of 4 vaccinations according to the schedule of 0-1-2-12 months. , where 0 is the start day of vaccination.

The primary vaccination complex against hepatitis B (HB) for people not at risk consists of 3 vaccinations according to the 0-1-6 month schedule.

The vaccine does not contain the whole hepatitis B virus, but part of its outer shell, which cannot cause hepatitis even theoretically, but can only cause the formation of an immune response to them.

Vaccination against tick-borne encephalitis

The problem of tick-borne infections continues to be relevant for most regions of the Russian Federation. The expansion of the ranges of vectors, as well as the discovery of new pathogens that can exist together in one tick and cause a mixed infection, force us to pay close attention to this problem.

The main source of economic losses associated with the spread of these diseases is the retirement of the workforce due to disability and mortality, as a result of which a reduction in production is expected in the future, all other things being equal. The largest share of the burden falls on deferred non-medical costs, in the structure of economic losses – on tick-borne viral encephalitis (TBE). The cost of expenses per one patient with TBE, according to estimates, is about 400 thousand rubles. .

As before, deaths are associated with late seeking medical help, untimely diagnosis, lack of vaccination and specific immunoprophylaxis against TVE. .

Vaccination can be carried out by medical workers year-round if a person lives or travels to areas where TVE is endemic. Those who have received the full course of vaccination and one or more revaccinations are considered vaccinated against TVE. In case of violation of the vaccination course (absence of a documented full course), the doctor may recommend a serological blood test to determine the strength of post-vaccination immunity; if antibodies to the TBE virus (IgG) are detected in the patient’s blood serum in a protective titer (1:100 or more), the doctor decides to continue the course of vaccination; in the absence of a protective antibody titer in a previously vaccinated person or in the absence of the possibility of conducting these studies, the doctor considers the possibility of vaccination according to the primary course.

Vaccination against measles

According to the Federal Service of Rospotrebnadzor, the epidemic rise of measles continued in 2014. Compared to last year, the incidence has doubled. Due to the active migration processes operating on the territory of Russia, as well as insufficient immunization of certain epidemiologically significant groups of the population, a further complication of the measles situation is possible, accompanied by the emergence of group outbreaks. .

It is recommended to be vaccinated against measles in childhood, twice and without further revaccination. If an adult was not vaccinated against measles in childhood or received only one vaccination, the National Vaccination Calendar of the Russian Federation recommends routine vaccination for persons under 35 years of age. Due to the high incidence of measles in adults, according to the decision of the Rospotrebnadzor board of July 25, 2014 No. 6 “On measures to prevent the spread of measles in the constituent entities of the Russian Federation,” it is possible to increase the measles vaccination age to 55 years.

Measles vaccines are live attenuated and are administered by a healthcare professional in accordance with the instructions for use.

It is recommended that those who are unvaccinated and have not had measles, as well as those who do not have documentation of vaccination, receive two vaccinations against measles; those who have been vaccinated once and have not had measles - one. The minimum interval between the first and second measles vaccination in the case of “catch-up vaccination” can be three months.

The sanitary and epidemiological rules for immunization against measles for epidemic indications contain instructions to medical workers about who should be vaccinated. These are persons who have had contact with a patient (if the disease is suspected), have not had measles before, have not been vaccinated, do not have information about vaccinations against measles, as well as persons vaccinated against measles once - without age restrictions. Immunization against measles according to epidemic indications is carried out by medical workers within the first 72 hours from the moment the patient is identified. If the boundaries of a measles outbreak expand (at a place of work, school, within a district, a settlement), the vaccination period can be extended by a doctor to seven days from the moment the first patient in the outbreak is identified.

Vaccination against rubella is carried out for girls and women under 25 years of age who were not vaccinated against rubella in childhood or received only one vaccination.

Vaccination against chickenpox is regulated for adults in the Russian Federation according to epidemic indications and consists of two vaccinations. In 2014, 6% of chickenpox cases were reported in adults. In the last decade, a trend of “maturation” of infection has been revealed, which is manifested in an increase in the proportion of adults among the sick, an increase in intensive morbidity rates in the adult population, as well as the registration of epidemic outbreaks of infection in groups of adults.

Contraindications to vaccination

Contraindications to vaccination (temporary and permanent) are regulated by the instructions of the Ministry of Health of the Russian Federation and the Federal Service of Rospotrebnadzor of the Russian Federation, as well as instructions for the use of immunodrugs; their presence is determined by a doctor (paramedic) when interviewing and examining a person before vaccination.

Table 4

List of medical contraindications for preventive vaccinations (adapted from 34)

	Vaccine	Contraindications
	All vaccines	Severe reaction or post-vaccination complication to a previous dose
	All live vaccines, including oral live polio vaccine (OPV)	Immunodeficiency state (primary) Immunosuppression Malignant neoplasms Pregnancy
	Live measles vaccine (LMV), live mumps vaccine (LMV), rubella, as well as combined di- and tri-vaccines (measles-mumps, measles-rubella-mumps)	Severe forms of allergic reactions to aminoglycosides Anaphylactic reactions to egg white (except rubella vaccine)
	Hepatitis B vaccine	Allergic reaction to baker's yeast
	Vaccines ADS-M, AD-M	Permanent contraindications, except mentioned in paragraph 1, do not have
	Note Acute infectious and non-infectious diseases, as well as exacerbation of chronic diseases are temporary contraindications for vaccination. Routine vaccinations are carried out 2-4 weeks after recovery or during the period of convalescence or remission. For mild ARVI, acute intestinal diseases, etc. Vaccinations are carried out immediately after the temperature normalizes.

Refusal to vaccinate

Citizens have the right to refuse vaccination in writing; this is enshrined in Article 5 of the Federal Law of September 17, 1998 N157-FZ “On Immunoprophylaxis of Infectious Diseases.” However, the lack of preventive vaccinations has many consequences:

• a ban on citizens entering countries whose stay in accordance with international health regulations or international treaties of the Russian Federation requires specific preventive vaccinations;
• temporary refusal to admit citizens to educational and health institutions in the event of widespread infectious diseases or the threat of epidemics;
• refusal to hire citizens for work or removal of citizens from work, the performance of which is associated with a high risk of contracting infectious diseases.

The list of works, the performance of which is associated with a high risk of infectious diseases and requires mandatory preventive vaccinations, is determined by Decree of the Government of the Russian Federation of July 15, 1999 No. 825:

1. Agricultural, drainage, construction and other work on excavation and movement of soil, procurement, fishing, geological, survey, expedition, deratization and disinfestation work in areas unfavorable for infections common to humans and animals.

2. Work on logging, clearing and improvement of forests, health and recreation areas for the population in areas unfavorable for infections common to humans and animals.

3. Work in organizations for the procurement, storage, processing of raw materials and livestock products obtained from farms affected by infections common to humans and animals.

4. Work on the procurement, storage and processing of agricultural products in areas unfavorable for infections common to humans and animals.

5. Work on the slaughter of livestock suffering from infections common to humans and animals, the procurement and processing of meat and meat products obtained from it.

6. Work related to the care of animals and maintenance of livestock facilities in livestock farms that are vulnerable to infections common to humans and animals.

7. Work on catching and keeping stray animals.

8. Maintenance work on sewerage structures, equipment and networks.

9. Work with patients with infectious diseases.

10. Work with live cultures of pathogens of infectious diseases.

11. Work with human blood and biological fluids.

12. Work in all types and types of educational institutions.

References

1. State report “On the state of sanitary and epidemiological well-being of the population in the Russian Federation in 2014”

2. A.G. Chuchalin, T.N. Bilichenko, M.P. Kostinov et al. Vaccinal prevention of respiratory diseases as part of primary health care for the population. Clinical recommendations. Pulmonology. 2015; 25(2). Application

3. Order of the Ministry of Health of the Russian Federation dated March 21. 2014 N 125n “On approval of the national calendar of preventive vaccinations and the calendar of preventive vaccinations for epidemic indications.”

4. T.N.Bilichenko, M.P.Kostinov, N.A.Roslaya. Vaccinal prevention of respiratory infections and other diseases in the working population. National calendar of preventive vaccinations 2014. Occupational medicine and industrial ecology. 2014; 10: pp. 1-7.

6. Keech M, Beardsworth P. The impact of influenza on lost working days: a review of the literature. Pharmacoeconomics. 2008; 6(11): 911-24.

7. Influenza activity: United States and worldwide. Centers for Disease Control and Prevention. MMWR. September 19, 2008; 57 (38): 1046-9.

8. Morales A, Martinez MM, Tasset-Tisseau A, et al. Costs and benefits of influenza vaccination and work productivity in a Colombian company from the employer’s perspective. Value Health. 2004; 7(4):433-41.

9. Keech M, Scott AJ, Ryan PJ. The impact of influenza and influenza-like illness on productivity and healthcare resource utilization in a working population. Occup Med (Lond). 1998; 48(2): 85-90.

10. Influenza vaccines: WHO position paper. Weekly epidemiological bulletin. 23.11. 2012; 47: 461-476.

11. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices - United States, 2013–2014. MMWR 2013; 62(RR07):1-43.

12. Beyer W. et al. Immunogenicity and safety of inactivated influenza vaccines in primed populations: A systematic literature review and meta-analysis. Vaccine. 2011; 29: 5785–5792

13. Lu PJ et al. National and state-specific estimates of place of influenza vaccination among adult populations - United States, 2011-12 influenza season. Vaccine. 2014;32(26):3198-204.

14. Esposito AL. Pulmonary infections acquired in the workplace. A review of occupation-associated pneumonia. Clin Chest Med. 1992; 13(2): 355-65.

15. Coggon D, Inskip H, Winter P, Pannett B. Lobar pneumonia: an occupational disease in welders. Lancet. 1994; 344:41–43.

16. Palmer KT et al. Mortality from infectious pneumonia in metal workers: a comparison with deaths from asthma in occupations exposed to respiratory sensitizers. Thorax. 2009; 64:983–986.

17. Fedson DS, Musher DM. Pneumococcal polysaccharide vaccines. In: Vaccines (6th Edition). Plotkin SA, Orenstein WA, Offit PA (Eds). Saunders, PA USA. 2013: 542–572.

18. Prevention of community-acquired pneumonia. Sanitary and epidemiological rules SP 3.1.2.3116-13.

19. WHO position on polysaccharide pneumococcal vaccine. Weekly epidemiological bulletin. 2008; 83 (42): 373–384.

20. Immunization with a polysaccharide polyvalent vaccine for the prevention of pneumococcal infection. Guidelines. Federal Service of Rospotrebnadzor No. 01/816-8-34 dated 02/08/08.

21. Updated Recommendations for Prevention of Invasive Pneumococcal Disease Among Adults Using the 23-Valent Pneumococcal Polysaccharide Vaccine (PPSV23). Recommendations of the Advisory Committee on Immunization Practices (ACIP). Morb. Mortal. Wkly Rep. 2010; 59(34):1102–1106.

22. Moberley SA et al. Vaccines for preventing pneumococcal infection in adult. Cochrane Database of Systematic Reviews. 2013 Jan 31;1:CD000422

23. Immunization against infectious disease. The Green Book. UK Department of Health; Chapter 25, Pneumococcal infection; p.306.

25. Chuchalin A. G., Sinopalnikov A. I., Kozlov R. S. et al. Russian Respiratory Society (RRO) Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy (IACMAC). Clinical guidelines for the diagnosis, treatment and prevention of severe community-acquired pneumonia in adults. Pulmonology. 2014; 4: 13-48.

26. Instructions for use of the medicinal product for medical use Pneumo 23 dated 02/18/14, Order No. 011092-180214.

27. Tactics of immunization of the adult population against diphtheria. Guidelines MU 3.3.1252-03. Approved Chief State Sanitary Doctor of the Russian Federation 03/30/2003

28. WHO position paper on hepatitis A vaccines. Weekly Epidemiological Bulletin. 2012; 87 (28-29): 261-276.

30. Jacobsen KH, Koopman JS. Declining hepatitis A seroprevalence: a global review and analysis. Epidemiol Infect. 2004 Dec;132(6):1005-22.

31. Epidemiological surveillance and prevention of viral hepatitis A. Guidelines MU 3.1.2837-11 (approved by the Federal Service for Surveillance on Consumer Rights Protection and Human Welfare on January 28, 2011).

32. Prevention of tick-borne encephalitis. Sanitary and epidemiological rules SP 3.1.3.2352-08 (as amended by Amendments No. 1, approved by Resolution of the Chief State Sanitary Doctor of the Russian Federation dated December 20, 2013 No. 69).

33. Prevention of measles, rubella and mumps. Sanitary and epidemiological rules SP 3.1.2952-11.

34. Medical contraindications to preventive vaccinations with drugs from the national vaccination calendar. Guidelines MU 3.3.1.1095-02 of Rospotrebnadzor of the Russian Federation.

* Critical assessment, analysis and synthesis of scientific research results using a special strict systematized methodology of international specialists of the Cochrane Collaboration.

** Invasive pneumococcal infections are a condition when the causative agent of the disease, the bacterium pneumococcus, is present in the blood, cerebrospinal fluid or other normally sterile tissues of the body (for example, pneumococcal sepsis, meningitis, pneumonia with bacteremia).

List of regulatory documents regulating vaccine prophylaxis in adults in the Russian Federation (status as of 01/01/2015)

1. Federal Law of March 30, 1999 N 52-FZ “On the sanitary and epidemiological welfare of the population.”

2. Federal Law of September 17, 1998 N 157-FZ “On Immunoprophylaxis of Infectious Diseases”.

3. Decree of the Government of the Russian Federation of August 2, 1999 N 885 “On approval of the list of post-vaccination complications caused by preventive vaccinations included in the national calendar of preventive vaccinations, and preventive vaccinations for epidemic indications, entitling citizens to receive state one-time benefits.”

4. Decree of the Government of the Russian Federation of July 15, 1999 N 825 “On approval of the list of works, the performance of which is associated with a high risk of infectious diseases and requires mandatory preventive vaccinations.”

5. Order of the Ministry of Health of the Russian Federation dated March 21, 2014 N 125n “On approval of the national calendar of preventive vaccinations and the calendar of preventive vaccinations for epidemic indications.”

6. Order of the Ministry of Health of the Russian Federation dated May 17, 1999 N 174 “On measures to further improve the prevention of tetanus.”

7. Order of the Ministry of Health of the Russian Federation dated September 17, 1993 N 220 “On measures to develop and improve the infectious diseases service in the Russian Federation.”

8. Order of the Federal Service of Rospotrebnadzor of December 27, 2012 N 1198 “On the Creation of a Scientific and Methodological Center for Immunoprophylaxis of the Federal Service for Surveillance in the Sphere of Protection of Consumer Rights and Human Welfare.”

9. Sanitary and epidemiological rules SP 3.1.2.3162-14 “Prevention of whooping cough.”

11. Sanitary and epidemiological rules SP 3.1.2.3117-13 “Prevention of influenza and other acute respiratory viral infections.”

12. Sanitary and epidemiological rules SP 3.1.2.3116-13 “Prevention of community-acquired pneumonia.”

13. Sanitary and epidemiological rules SP 3.1.2.3114-13 “Prevention of tuberculosis.”

14. Sanitary and epidemiological rules SP 3.1.2.3113-13 “Prevention of tetanus”.

15. Sanitary and epidemiological rules SP 3.1.2.3109-13 “Prevention of diphtheria”.

16. Sanitary and epidemiological rules SP 3.1.2952-11 “Prevention of measles, rubella and mumps.”

17. Sanitary and epidemiological rules SP 3.1.2951-11 “Prevention of polio.”

18. Sanitary and epidemiological rules and regulations SanPiN 2.1.7.2790-10 “Sanitary and epidemiological requirements for the management of medical waste.”

19. Sanitary and epidemiological rules SP 3.1.2825-10 “Prevention of viral hepatitis A”.

20. Sanitary and epidemiological rules SP 3.1.7.2627 -10 “Prevention of rabies among people.”

21. Sanitary and epidemiological rules SP 3.3.2367-08 “Organization of immunoprophylaxis of infectious diseases.”

22. Sanitary and epidemiological rules SP 3.1.3.2352-08 “Prevention of tick-borne viral encephalitis.”

23. Sanitary and epidemiological rules SP 3.3.2342-08 “Ensuring the safety of immunization.”

24. Sanitary and epidemiological rules SP 3.1.1.2341-08 “Prevention of viral hepatitis B”.

25. Sanitary and epidemiological rules SP 3.3.2.1248-03 “Conditions for transportation and storage of medical immunobiological preparations.”

26. Sanitary and epidemiological rules SP 3.3.2.1120-02 “Sanitary and epidemiological requirements for the conditions of transportation, storage and dispensing to citizens of medical immunobiological preparations used for immunoprophylaxis by pharmacies and healthcare institutions” (as amended on February 18, 2008).

27. Guidelines MU 3.1.2.3047-13 “Epidemiological surveillance of community-acquired pneumonia.”

29. Guidelines MU 3.1.3018-12 “Epidemic surveillance of diphtheria.”

30. Guidelines MU 3.1.2943-11 “Organization and conduct of serological monitoring of the state of collective immunity to infections controlled by means of specific prevention (diphtheria, tetanus, whooping cough, measles, rubella, mumps, polio, hepatitis B).”

31. Guidelines MU 3.1.2837-11 “Epidemiological surveillance and prevention of viral hepatitis A.”

33. Guidelines MU 3.1.2792-10 “Epidemic surveillance of hepatitis B.”

34. Guidelines MU 3.3.2.2437-09 “Use of thermal indicators to control the temperature conditions of storage and transportation of medical immunobiological preparations in the Cold Chain system.”

35. Guidelines MU 3.1.2436-09 “Epidemiological surveillance of tetanus.”

36. Guidelines MU 3.3.2400-08 “Monitoring the work of health care organizations on the issues of immunoprophylaxis of infectious diseases.”

37. Guidelines MU 3.1.2313-08 “Requirements for the disinfection, destruction and disposal of single-use injection syringes.”

39. Methodological recommendations “Procedure for use, collection, storage, transportation, destruction, disposal (recycling) of self-locking (self-destroying) CP syringes and disposable injection needles” (approved by the Federal Service of Rospotrebnadzor on November 11, 2005 N 0100/9856-05 -34).

40. Guidelines MU 3.3.1889-04 “Procedure for preventive vaccinations.”

41. Guidelines MU 3.3.1879-04 “Investigation of post-vaccination complications.”

42. Guidelines MU 3.3.1878-04 “Economic effectiveness of vaccine prevention.”

43. Guidelines MU 3.3.2.1761-03 “On the procedure for destroying unusable vaccines and toxoids.”

44. Guidelines MU 3.3.1252-03 “Tactics of immunization of the adult population against diphtheria.”

45. Guidelines MU 3.3.2.1172-02 “Procedure for providing state municipal healthcare organizations with medical immunobiological preparations within the framework of national calendar of preventive vaccinations and calendar of vaccinations for epidemic indications.”

46. ​​Guidelines MU 3.3.1.1123-02 “Monitoring of post-vaccination complications and their prevention.”

47. Guidelines MU 3.3.1.1095-02 “Medical contraindications to preventive vaccinations with drugs from the national vaccination calendar.”

48. Letter of the Federal Service of Rospotrebnadzor “On the prevention of yellow fever” (information letter is issued annually).

49. Letter of the Federal Service of Rospotrebnadzor “On the list of endemic territories for tick-borne viral encephalitis in 2013” (information letter is issued annually).

*WHO position paper on hepatitis A vaccines - July 2012. Weekly Epidemiology Bulletin (WER), 2012;28-29(87): 261-276

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To ensure the health and life of education workers, the Russian Ministry of Health has issued a number of decrees on measures to prevent infectious diseases. The main important method of prevention is vaccination. Its timing is regulated by the national calendar of scheduled vaccinations. What mandatory vaccinations exist for employees of educational institutions, including kindergartens, and is it possible to refuse vaccination? Let's look at these questions.

Legal basis for mandatory vaccination of education workers. Vaccination of education workers is carried out on the basis of regulations of the Government of the Russian Federation and decrees of the Ministry of Health.

1. Order of the Russian Ministry of Health dated March 21, 2014 No. 125-H approves the national vaccination calendar. According to the order, all education workers must be vaccinated against infectious diseases, as they are at high risk of infection due to the large number of contacts.
2. Federal Law of September 17, 1998 No. 157 “On Immunoprophylaxis of Infectious Diseases.” According to this decree, all education workers must undergo mandatory vaccination against infections, unless they have contraindications.
3. Federal Law No. 323 of November 21, 2011 on protecting the health of the population of Russia. It states that every employee must consent to vaccination if he has no contraindications.
4. The Decree of the Government of the Russian Federation No. 825, issued on July 15, 1999, published a list of works associated with the risk of infection. The list includes work in all types of educational institutions. According to this resolution, education workers are subject to mandatory vaccination against a number of infections.
5. According to the resolution of Federal Law of the Russian Federation No. 257, every citizen has the right to vaccination. Immunization of workers in the education system is paid for and carried out by the employer as part of the Vaccination Calendar. Vaccination is carried out in state, municipal or private medical institutions.

Is it possible to refuse vaccination?

Based on the Federal Law issued on September 17, 1998 under Article 5, an educator may refuse vaccinations and medical intervention. However, the same law talks about the consequences of refusal.

1. Failure to vaccinate teachers may result in dismissal or refusal to hire.
2. Lack of vaccinations will be the reason for refusal of admission to an educational or health institution.
3. In the absence of calendar vaccinations, education specialists will not be able to travel to foreign countries. In addition to mandatory government vaccinations, some countries require additional ones for entry for epidemic reasons.

According to labor legislation, the head of the educational institution who provided the work bears administrative responsibility for the sanitary and epidemiological condition of the educational institution. If a teacher who has not been immunized gets sick with any infection and infects children and other employees with it, then he himself and the head of the institution may be brought to justice. And even if an education worker did not infect anyone, and did not get sick himself, the next check may reveal that he did not get vaccinated. In this case, the punishment of the employee and his employer will be qualified for violation of health protection orders, labor and sanitary-epidemiological legislation. But after vaccination, the education worker will be reinstated in his position.

Vaccination rights

Vaccinations are provided free of charge at the expense of the state or the employer of private organizations.

Before vaccination, education employees, if necessary, have the right to a medical examination, and on the day of vaccination, to a medical examination. Vaccination is not done if, upon examination, there is an exacerbation of chronic diseases.

If a teacher cannot vaccinate due to contraindications, he must write a written refusal justifying the medical withdrawal. The list of available contraindications is contained in the resolution of the Chief Sanitary Doctor dated July 10, 2008. The refusal is signed by the employee and the doctor, and provided to the head of the clinic or the head of the institution.

If complications arise after vaccination or disability occurs, then within the framework of the state guarantee program, free medical care will be provided, as well as state compensation in a minimum amount. In some cases, an increase in pension is provided.

Vaccinations required for education workers

Teachers and educators are part of the decreed population, which is particularly at risk of infection. The list of mandatory vaccinations for education workers is as follows.

1. An annual flu vaccination is mandatory for education workers.
2. Every 10 years, revaccination against diphtheria and tetanus is carried out.
3. The measles vaccination is given to education employees under the age of 35. But only if they have not had measles, were not previously vaccinated or do not have information about it.
4. Vaccination against rubella is given to women under 25 years of age, if they have not had rubella, have not been vaccinated against it, or do not have information about it.
5. Education workers aged 18 to 55 years are subject to immunization against hepatitis B, if they have not previously had hepatitis and have not been vaccinated against it.
6. Preschool workers are also vaccinated against hepatitis A and Sonne dysentery. The same vaccinations are given to employees of kindergartens and closed institutions (orphanages, boarding schools).
7. According to epidemic indications, vaccinations are carried out in the event of a threat or outbreak of polio and shigellosis infections.

What vaccines are used for education workers?

Immunization of education workers is carried out with vaccines provided for in the Russian Vaccination Calendar.

1. Russian vaccines “Grippol” and “Grippol plus” are used for vaccination against influenza. Alternative vaccines can also be used: Vaxigrip or Influvac.
2. For vaccination against measles, according to the Vaccination Calendar, the Russian LCV (live measles vaccine) is used. The vaccination is given once to employees who have not had measles and have not previously been vaccinated against it.
3. To prevent rubella, the “Live attenuated rubella vaccine” is used. In addition, the associated American MMR vaccine and the English Priorix vaccine are used against measles and rubella.
4. Education workers are vaccinated against diphtheria and tetanus with the ADS-M vaccine once every 10 years.
5. For immunization against hepatitis B, the Combitech, Engerix B and GEP-A+B-in-VAK vaccines are used.
6. For vaccination against hepatitis A, UK-made Havrix 1440 and Russian GEP-A-in-VAK are used.
7. To prevent Sonne dysentery, the Shigellvac vaccine is used.

To summarize, let us recall the main theses. For education workers, vaccinations are mandatory and necessary. Immunization is provided free of charge at the expense of the state or employer. It is possible to refuse vaccination, but this entails undesirable consequences. Vaccinations are done with vaccines with minimal side effects, but in case of complications, medical care is provided at the expense of the state.

Vaccinations for a health record are a prerequisite for any employment. Many businesses will only require a record sheet, but some establishments require a full medical examination.

Each employee must have a special medical record. It indicates when the medical examination took place and the absence of possible illnesses. A medical book is a document in which, when filled out, a stamp is placed indicating permission to work. For many enterprises and organizations, this is one of the main criteria when hiring.

When is a health certificate required?

This document is required for:

• Catering and food industry workers.
• Public transport drivers.
• For workers in the service sector (hotels, hotels).
• Masters in beauty salons (cosmetologists, hairdressers, manicurists).
• Medical workers.
• Education workers.

Every employer must ensure that its employees have mandatory vaccinations. This is the key to the health of employees and the people around them. Regardless of the field of activity. Very often people have a question about what vaccinations are needed for a health certificate, because every job requires additional and mandatory vaccinations.

Therefore, vaccinations are mandatory for those who work directly with people, as well as for food industry workers.
A permit for working with food must have two mandatory vaccination notes: measles and diphtheria. In addition to food industry workers, such vaccines should be available to:

• vehicle drivers, controllers, flight attendants;
• utility workers;
• medical staff;
• school teachers and kindergarten teachers;
• sanitary standards and maintaining a sanitary record are especially strict for people working with products. This is reasonable from the point of view that there is any threat of infecting a large number of people through food.

The same reason is the main one for medical workers. There is a high risk of infecting people in a medical facility, and to avoid this, you need to undergo a medical examination in a timely manner.
A health certificate is required to work in a kindergarten or school, because children are most susceptible to various diseases.

Basic vaccinations

Diphtheria is a disease that is transmitted directly through the air and is considered dangerous for workers in any field. For employees in the food industry, transportation and trade, diphtheria vaccinations are given once every 10 years. Measles disease is typical for people under 35 years of age, so vaccination is mandatory for workers in all fields who are younger than this age. This type of vaccination is mandatory for those who are in constant contact with children.

Therefore, this vaccination is given annually for educational and medical workers. If the vaccination was done on time and this is indicated in the book, the person does not need to be isolated during the epidemic. The measles vaccine may not be prescribed only in case of individual intolerance to the components, as well as in case of possible pregnancy in women under 35 years of age.

Important! In addition to workers in education and medicine, employees of beauty salons, pharmacies and various hotels and hotels are vaccinated against measles. Pharmacists definitely need vaccination against diphtheria and measles, because people with various diseases most often turn to them.

Tetanus- one of the most insidious diseases. A small wound that can easily become infected can lead to serious consequences. In these cases, hairdressers and beauty salon employees must have a health certificate and vaccinations.

Hepatitis B vaccine. Such vaccination is mandatory when working in the field of education and medicine. The vaccination is done once every six months. It must be carried out by everyone, without fail, except for people with heart failure and individual characteristics of the body. Vaccination against hepatitis A is a separate issue.

Vaccination against dysentery. Dysentery bacteria can severely affect the intestines and its mucous membranes. For people whose work involves frequent travel to countries with low sanitary levels, such vaccination is mandatory. This applies to: flight attendants, pilots, as well as people working in the media.

Each doctor, when vaccinating, must take into account the individual characteristics of the patient’s body, as well as the characteristics of the immune system. Therefore, it is very important to vaccinate in a medical facility where there are high-quality, certified vaccines (not to be confused with a certificate). Otherwise, this will lead to undesirable consequences. Modern medicine uses the highest quality vaccinations that are safe for everyone.

Where and how to apply for a health certificate

You can register a health record at the Sanitary and Epidemiological Center. Vaccinations can be carried out at the nearest medical facility or private clinic. The attending physician should advise on the necessary vaccinations, as well as the possible consequences of their implementation.
To register the document, you will need a passport, additional photographs, as well as an extract from work, with the help of which you will be assigned a list of mandatory vaccines. The following must be noted in the health book:

1. Intestinal infections (which can very often be transmitted by airborne droplets).
2. Tests for typhoid fever (if necessary, vaccination with Vianvac).
3. Examination by a dermatovenerologist (syphilis, Candida fungi).
4. Fluorography.
5. Examination by a therapist.
6. For food industry workers, they are also tested for the presence of staphylococcus.

After the examination, the therapist prescribes mandatory vaccination. After which, the passage of the sanitary commission is considered completed. For each individual type of activity, passing the commission can vary from 3 months to 1 year. For food industry workers, vaccination should be carried out once a year, depending on the type of vaccination.

The medical book is kept by the employer, who monitors the timely completion of the commission by employees. For some workers, additional tests are required: HIV, hepatitis C, B, as well as visits to the dentist and otolaryngologist. You should not refuse vaccination, because it is the key to your health and the safety of others. Having this document and the necessary vaccinations will protect you from possible diseases.

Hello!

According to Art. 34 of the Federal Law of March 30, 1999 N 52-FZ “On the sanitary and epidemiological welfare of the population”:

1. In order to prevent the occurrence and spread of infectious diseases, mass non-infectious diseases (poisonings) and occupational diseases, employees of certain professions, industries and organizations, when performing their work duties, are required to undergo preliminary upon entry to work and periodic preventive medical examinations (hereinafter referred to as medical examinations) .

2. If necessary, based on proposals from bodies exercising federal state sanitary and epidemiological supervision, decisions of state authorities of constituent entities of the Russian Federation or local governments in individual organizations (shops, laboratories and other structural units) may introduce additional indications for medical examinations of workers .
(as amended by Federal Laws dated August 22, 2004 N 122-FZ, dated July 18, 2011 N 242-FZ)

3. Individual entrepreneurs and legal entities are obliged to provide the conditions necessary for timely medical examinations by employees.
4. Employees who refuse to undergo medical examinations are not allowed to work.

Similar to Art. 76 of the Labor Code of the Russian Federation, the Employer is obliged to remove from work (not allow to work) the employee:

who has not undergone a mandatory medical examination in accordance with the established procedure.

According to Art. 5 of the Federal Law of September 17, 1998 N 157-FZ “On Immunoprophylaxis of Infectious Diseases”, the absence of preventive vaccinations entails:

refusal to hire citizens for work or removal of citizens from work, the performance of which is associated with a high risk of contracting infectious diseases.

When carrying out immunization, citizens are obliged to:
follow the instructions of medical professionals;
confirm in writing the refusal of preventive vaccinations.

Decree of the Government of the Russian Federation dated July 15, 1999. No. 825 approved the List of works, the performance of which is associated with a high risk of infectious diseases and requires mandatory preventive vaccinations.

1. Agricultural, drainage, construction and other work on excavation and movement of soil, procurement, fishing, geological, survey, expedition, deratization and disinfestation work in areas unfavorable for infections common to humans and animals.

2. Work on logging, clearing and improvement of forests, health and recreation areas for the population in areas unfavorable for infections common to humans and animals.

3. Work in organizations for the procurement, storage, processing of raw materials and livestock products obtained from farms affected by infections common to humans and animals.

4. Work on the procurement, storage and processing of agricultural products in areas unfavorable for infections common to humans and animals.

5. Work on the slaughter of livestock suffering from infections common to humans and animals, the procurement and processing of meat and meat products obtained from it.

6. Work related to the care of animals and maintenance of livestock facilities in livestock farms that are vulnerable to infections common to humans and animals.

7. Work on catching and keeping stray animals.

8. Maintenance work on sewerage structures, equipment and networks.

9. Work with patients with infectious diseases.

10. Work with live cultures of pathogens of infectious diseases.

11. Work with human blood and biological fluids.

12. Work in organizations engaged in educational activities.

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Tests for a medical record - what vaccinations and tests are needed for a medical record?

When talking about what vaccinations are needed for a medical book, one cannot ignore the question of what this document represents. This is a small blue book on which the Rospotrebnadzor emblem is clearly visible. Actually, it is this federal organization that is responsible for recording and issuing these documents. Each booklet is distinguished from the others by its unique number, entered in the appropriate register. In order to undergo all vaccinations for a medical record, as well as other formalities and receive the document in hand, you need to be patient for 7-10 days.

Each profession has its own list in the “permit”

A medical book is a document that serves as a kind of access to the workplace for people of various professions. They have one thing in common: they are all employed in the service sector - be it

• train conductor;
• kindergartener,
• cook in the dining room kitchen;
• airline stewardess;
• medical worker;
• college teacher;
• minibus driver.

Each of these people, before receiving this “passport”, must undergo tests and vaccinations for a medical book in full. Moreover, for each profession their list may be different. That is why it is so important to know, for example, what vaccinations should be given in medical care. book.

Official document – ​​in a specialized institution

In order to get a 100% result, and with it the treasured document in your hands, you need to know: in addition to specialized state medical institutions, other organizations can offer services for issuing such documents. However, having found out, for example, the list of tests in the SES for a medical book, paid money and even received the required “crusts” in your hands, you can get into trouble. Because an official document is only one issued by an institution included in the relevant list of Rospotrebnadzor. It is in such an organization, by the way, that you can find out for sure, and the tests you need for your medical book in 2019, they will definitely be in the know!

Pros, cons and must-check boxes

When going for the coveted “permit”, you should take into account that private organizations do their work faster and with a higher level of service. However, government agencies also have their own advantage: as a rule, prices here are lower than those of a private owner.

Regardless of what tests you need to pass for a medical record and what form of ownership the company you contacted has, there are uniform rules for all holders of the required document. These rules, among others, explain what tests and vaccinations need to be taken for a health certificate, regardless of profession. In this list:

• therapeutic examination;
• passing a fluorography room;
• a statement about what vaccinations you have received (this certificate is also called a vaccination certificate).

In public catering - one, for drivers - another

Now let's figure out what tests are needed for a medical book in public catering, as well as for an employee employed in the food industry or a food seller. In addition to the above, for official admission you will need information about:

You will learn how to test for staphylococcus for your medical record when you visit the appropriate specialist. And in addition to the above information, your “crusts” must necessarily contain the results of examinations by doctors such as:

• psychiatrist;
• dermatologist;
• dentist.

Vaccinations required for chefs

Any list of tests for a medical record must be supplemented with information about vaccinations. After all, if a person is not vaccinated, for example, against diphtheria, then by contracting this disease and transmitting it through airborne droplets, he can infect others. Therefore, the appropriate vaccination is given to workers employed in catering, transport and trade - once every 10 years.

The following vaccination will protect a person from measles, but it is only relevant for workers under 35 years of age. Moreover, such vaccinations are required mainly for all those whose field of activity is working with children.

Those employed in the service sector, hotel business and pharmacy are vaccinated against measles and ADS-M. ADS-M is the name of the adsorbed diphtheria-tetanus vaccine, which is also given once every 10 years. Pharmacists must also be vaccinated against diphtheria.

In addition to those mentioned above, you should be vaccinated against tetanus; hairdressers and beauty salon workers undergo this procedure.

The total cost of all the costs that you will have to incur to get your hands on the treasured document is 1.5–2 thousand rubles.