4 квартал 2024

Рекомендации по вакцинации против гриппа групп риска (беременные, дети, лица с хроническими заболеваниями и др.)

Вакцинация является наиболее простым, безопасным, эффективным и единственным способом специфической защиты от инфекции. Главная задача вакцинации против гриппа – сформировать индивидуальную защиту у привитого человека, предупредить возникновение заболевания и его тяжелое течение, в случае если человек заболеет.
Как и в предыдущие годы, помимо бесплатной вакцинации, доступна вакцинация за счет личных средств граждан и иных средств. Сделать прививку от гриппа в текущем году можно одной из следующих вакцин:
трехкомпонентная вакцина «Гриппол Плюс» (производства Российской Федерации), для бесплатной и платной вакцинации;
четырехкомпонентные вакцины: «ВаксигрипТетра» (производства Франции), «Инфлювак Тетра» (производства Нидерландов), для платной вакцинации.
Для бесплатной вакцинации лиц, относящихся к группам высокого риска тяжелого течения, неблагоприятных последствий гриппа и высокого риска заражения гриппом, доступна вакцина «Гриппол Плюс».
Все вакцины зарегистрированы и разрешены к применению на территории Республики Беларусь, содержат актуальные штаммы вируса, рекомендованные Всемирной организацией здравоохранения для включения в состав сезонных вакцин против гриппа для использования в сезоне 2024-2025 гг. в Северном полушарии:
• вирус, подобный A/Victoria/4897/2022 (H1N1)pdm09;
• вирус, подобный A/ Thailand/8/2022 (H3N2);
• вирус, подобный B/Austria/1359417/2021 (линия B/Victoria);
• вирус, подобный B/Phuket/3073/2013 (линия B/Yamagata) (только для четырехвалентных вакцин).
В сезоне 2024/2025 в составе вакцин проведена замена штамма вируса A/Darwin/9/2021 (H3N2) на A/ Thailand/8/2022 (H3N2).
Министерство здравоохранения Республики Беларусь напоминает, что в первую очередь, защита от гриппа важна для групп риска – детей в возрасте от 6 месяцев до 3-х лет, детей от 3-х лет и взрослых с хроническими заболеваниями и иммунодефицитными состояниями, лиц в возрасте старше 65 лет, беременных женщин, медицинских и фармацевтических работников, детей и взрослых, находящихся в учреждениях с круглосуточным режимом пребывания, работников государственных органов, обеспечивающих безопасность государства и жизнедеятельность населения. Также вакцинация важна для работников образования, торговли, общественного питания, коммунальной, транспортной сферы и других.
Учитывая то, что беременные женщины подвергаются повышенному риску развития осложнений после перенесенного гриппа, Всемирная организация здравоохранения рекомендует осуществлять вакцинацию данной категории населения на любом сроке беременности. В отношении вакцин, применяемых в Республике Беларусь, вакцинами «Инфлювак Тетра» и «ВаксигрипТетра» можно прививаться в течение всей беременности, вакцинами «Гриппол Плюс», «Совигрипп», «Ультрикс Квадри» – во втором и третьем триместрах беременности.
Что же касается детей, то для них доступны для иммунизации все три вакцины. Тактика и режим дозирования вакцин имеют различия в зависимости от конкретного препарата:
при использовании вакцины «Гриппол плюс» детям от 6 до 35 месяцев вводится 0,25 мл вакцины двукратно с интервалом 3-4 календарные недели; детям старше 35 месяцев вводится 0,5 мл вакцины однократно (возможна двукратная вакцинация с интервалом 3-4 календарные недели детей, ранее не болевших гриппом и не вакцинированных);
при использовании вакцины «ВаксигрипТетра» детям от 6 месяцев до 8 лет включительно вводится 0,5 мл вакцины однократно или двукратно с интервалом не менее 4-х календарных недель (ранее не вакцинированным против гриппа); детям от 9 лет и старше вводится 0,5 мл вакцины однократно;
при использовании вакцины «Инфлювак Тетра» детям от 6 месяцев до 17 лет включительно вводится 0,5 мл вакцины однократно, при этом детям от 6 месяцев до 9 лет, которые ранее не вакцинированы против гриппа, вводится 0,5 мл вакцины двукратно с интервалом не менее 4-х календарных недель.
Наличие хронического заболевания является не противопоказанием, а показанием к проведению прививки против гриппа. Пациенты с хроническими заболеваниями хорошо переносят вакцинацию и у них развивается достаточная защита от заболевания. Также необходимо понимать, что прививка не приводит к обострению хронического заболевания, в то время как перенесенный гриппа с большой долей вероятности может повлечь обострение хронического заболевания и утяжелить его дальнейшее течение. В период обострения хронического заболевания врач предложит пациенту отложить вакцинацию до стабилизации состояния и затем сделать прививку.

Справочно:
Анализ данных о заболеваемости гриппом среди привитого и непривитого населения в эпидемический период активности респираторных вирусов 2023-2024 гг. показал высокую эффективность проведенной иммунизации (индекс эффективности составил 10,4, т.е. заболеваемость гриппом привитых лиц в 10,4 раза ниже заболеваемости непривитых).
Результаты проводимого дозорного и рутинного слежения за гриппом в период ноябрь 2023 – март 2024 гг. показали, что 90,4% заболевших с лабораторно подтвержденным диагнозом гриппа не были вакцинированы в 2023 г.

Оптимальным временем для проведения вакцинации против гриппа в северном полушарии является период с сентября по ноябрь до наступления сезонного пика заболеваемости, который традиционно приходится на конец января – начало февраля. Концентрация противогриппозных антител достигает защитного уровня через 1,5-3 недели после введения вакцины и сохраняется на оптимальном уровне в течение около 6 месяцев.
В связи с приближением периода подъема заболеваемости острыми респираторными инфекциями специалисты рекомендуют соблюдать также иные меры, направленные на минимизацию риска распространения респираторных инфекций:
избегать или сократить до минимума время пребывания в местах массового скопления людей;
использовать средства защиты органов дыхания (маски) при невозможности соблюдения социальной дистанции 1-1,5 м, если у вас имеются респираторные симптомы (насморк, кашель, чихание) или вы находитесь в местах массового скопления людей;
избегать тесных контактов с людьми, которые имеют респираторные симптомы;
регулярно и тщательно мыть руки с мылом, обязательно после улицы и общественного транспорта. Использовать при необходимости антисептические средства;
проводить регулярное проветривание и влажную уборку помещения, в котором находитесь, чаще гулять на свежем воздухе.
При появлении симптомов респираторного заболевания (повышение температуры тела, кашель, насморк, головная боль, боль в горле и т.д.) необходимо оставаться дома и вызвать врача.

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42 thoughts on “Рекомендации по вакцинации против гриппа групп риска (беременные, дети, лица с хроническими заболеваниями и др.)

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  38. Our patients have described Superdrol as the oral equal of trenbolone, causing speedy changes in body composition and dry muscle positive aspects.
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    potent, hardcore anabolics and bodybuilding supplements
    for bulking, cutting, strength and efficiency. (17) Malhotra, A., Poon, E., Tse,
    W. Y., Pringle, P. J., Hindmarsh, P. C., & Brook, C.
    G.
    Testosterone just isn't suitable for ladies to take as a end result of its sturdy
    androgenic score. We have also seen testosterone speed up male sample baldness in men, as properly as
    oily pores and skin and acne vulgaris. This is as a end result of
    it's among the many best AAS for muscular endurance; thus, cardiovascular performance will vastly enhance due to
    a notable increase in purple blood cell manufacturing.

    Winstrol is not female-friendly, not like Anavar, with the
    previous being the culprit for so much of instances of virilization at our clinic.
    If you wish to avoid masculinization, Anavar is a higher choice for girls.
    The solely exception could be if females took very
    small doses of Winstrol and utilized short cycles, in which case ladies are
    likely to retain their femininity.
    As there's an elevated risk of duodenal ulcers and abdomen ulcers, medical recommendation should be
    sought if indigestion, acid reflux disorder or tummy (abdominal) pains happen. For folks at danger of these
    circumstances, medication could also be prescribed to
    reduce the signs and the risk of growing an ulcer.
    You can talk about anabolic steroid use with your doctor, even when you
    have been utilizing and not using a prescription.
    It can even assist to have a chat with a counsellor about
    the potential reasons you would possibly be
    using anabolic steroids.
    They decrease irritation in the body and may work as immunosuppressants and
    vasoconstrictors. Speak together with your physician about another medications, dietary supplements, and natural remedies you currently
    take to prevent attainable interactions with steroids.
    Thanks to high-profile circumstances of illicit misuse in sports activities,
    steroids have become synonymous with cheating.
    Nonetheless, steroids are additionally pharmaceuticals that can be used to treat a variety of widespread situations.
    The scientific neighborhood should intensify its
    efforts to assess the pathophysiology of habits and cognitive impairment due to long run AAS
    exposure.
    Until a physician prescribes anabolic steroids to you for a respectable medical purpose, there’s no safe approach
    to take these medications for other purposes.
    When girls take Anavar at 10 mg per day, we often see
    them experience muscle features inside the first 10
    days. A girl taking 10 mg of Anavar per day has a extra powerful impact than a person taking 20
    mg of Anavar per day.
    These compounds work by increasing nitrogen retention and protein synthesis within the muscle, resulting in sooner repair
    and progress after coaching. That’s why they’re so
    in style in energy sports, physique contests, and even amongst recreational lifters chasing the following level of increased muscle mass.

    SARMs and HGH are potentially the closest compounds to anabolic steroids we
    have seen in our clinic, with them mimicking the muscle-building and
    fat-burning properties (with some side effects). Generally, the optimistic results of anabolic steroids are unmatched by natural supplements.
    Anabolic-androgenic steroids (AAS) are lab-made testosterone supplements.
    They’re never a good selection for building muscle tissue or power because of their quite
    a few adverse unwanted aspect effects. For example,
    if somebody needs to build leaner muscle mass, they may have a peptide stack that
    incorporates some type of fat burner and a
    muscle development product.
    Some people in bodybuilding believe that roid rage is a fable; nonetheless, research shows that 60% of steroid users experience a rise
    in aggressive conduct (28). AIs have additionally been proven to be advantageous when combined with SERMs for restoring testosterone production. This is why we make the most of Nolvadex (tamoxifen), which reduces estrogen levels while concurrently having a positive effect
    on cholesterol levels (15). Severe gynecomastia
    from steroid use may be treated in a number of ways.

    The anabolic effect of creatine is significantly much less compared to Dianabol.
    If a beginner administers Dianabol in an inexpensive dose, being 10–20 mg per day (for men), they may
    experience notable will increase in muscle
    size and power. You can see that some of the old bodybuilders
    who’ve come off steroids can shrink dramatically.
    Nevertheless, a large proportion of this muscle loss could be attributed to them having stopped
    lifting weights. Elite feminine bodybuilders can take high doses of 10–20 mg; nonetheless, such customers can expect to experience masculinization effects.

    Anadrol pills are fat-soluble; therefore,
    consuming them with food may decrease their organic availability and hinder results.
    Furthermore, when Anadrol is taken in recreational settings, it's not
    guaranteed to be actual oxymetholone as a result of buy of
    this steroid on the black market. If you are predisposed
    to dropping your hair, steroids will accelerate this course of.

    Alternatively, if you have sturdy hair genetics, steroids
    may not cause you to go bald. This facet impact is commonly genetic; thus, if
    a person has skilled zits throughout puberty,
    they could be more in danger.
    Trenbolone is a really highly effective injectable illegal steroid harm reduction that produces massive will increase in lean muscle.
    Due to an absence of aromatization, it doesn't cause any noticeable water retention,
    making overall weight acquire less than on Dianabol or Anadrol.
    Although not probably the most powerful of steroids, Deca is usually utilized by bodybuilders to
    boost the gains from other bulking steroids. Selective Androgen Receptor Modulators, generally often identified as SARMS, exist in a legal gray space in the Usa.
    As of 2021, SARMS are not permitted by the Meals and Drug Administration (FDA) for medical use, but they are not explicitly unlawful.
    Moreover, the FDA has despatched warning letters to firms promoting SARMS as dietary
    dietary supplements, expressing concern about potential liver harm, cardiovascular dangers, and different side effects.

  41. In two double-blind randomized-controlled trials, hemodialysis
    sufferers acquired 100 mg oxymetholone daily for 24 weeks and none of these sufferers developed signs of liver harm (108, 109).
    The HAARLEM research also found no (sub)acute medical
    signs of liver harm despite 67% of subjects reporting using oral AAS (39).

    AAS are mostly administered by intramuscular (i.m.)
    injection or by oral ingestion.
    This stack combines the most effective protected and efficient alternatives to Anavar, Winstrol, and Clenbuterol.
    The name of the sport with this stack is a total give attention to fats
    burning and getting lean, maintaining muscle and revealing your abs, and critically, retaining and rising your
    energy and endurance while you’re weight-reduction plan. Another choice
    is to maintain that lower dosage vary of Primo while stacking
    it with Anavar (also at a low dosage) for combined effects.

    It also raises the risk of a situation that retains the mind from getting enough
    oxygen, referred to as a stroke. Biochemically, this expresses itself in relatively small elevations of blood aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate
    dehydrogenase (LDH) and gamma-glutamyl transpeptidase (GGT) (99) values.
    Not Often, AAS-induced hepatotoxicity might present itself in jaundice and pruritus (100, 101).

    With such medical shows, elevated bilirubin values are also to be
    anticipated. Different reports in literature have
    also documented peliosis hepatis (102, 103), hepatocellular carcinoma (104) and adenoma (105, 106) in association with AAS use.
    The incidence might be (very) low and a agency causal hyperlink has not been established.
    Inside the cell, it may possibly both bind on to
    the androgen receptor (AR) to affect gene expression or undergo bioactivation into
    dihydrotestosterone (DHT) by 5αR-reductase (5αR) family enzymes or
    estradiol (E2) by aromatase.
    For instance, the reality that using my weight loss technique doesn't
    contain utilizing a testosterone increase is an enormous cause it has not gained much recognition as a weight reduction method.
    In phrases of the changes to the fat cells, they were truly
    within the unfavorable, nevertheless it depends on what the particular weight reduction method is.
    Some reputable websites on-line promote legal anabolic steroids,
    that are basically steroid various supplements
    that replicate the positive results of steroids without the bad side effects.

    If you've any questions or would like more information about TRT, please click on the contact button above.
    Through normal skin, you possibly can expect round 10% absorption but via
    scrotal pores and skin, absorption could probably be near 50% in some men. The cream also produces more of the metabolite
    DHT or dihydrotestosterone which may be responsible for restoring libido in males
    who have been refractive to injectable testosterone therapy.

    But doping for sports is not one of the makes use
    of the drugs are permitted for. A few reports within the literature
    have linked AAS use to focal segmental glomerulosclerosis (FSGS) (169–171).
    FSGS is a histopathological discovering marked by glomerular lesions,
    mediated by diverse insults directed to, or inherent inside, the podocytes (172).
    Herlitz et al. had been the primary to current a
    case collection of nine sufferers who developed FSGS after prolonged AAS
    use (169).
    One study confirmed a bodybuilder who injected oil-based steroids intravenously
    suffered from acute respiratory distress36. This situation was not an meant
    IV injection; instead, it mistakenly hit a vein when injecting it into the buttock muscle.
    This exhibits us how cautious we must be when injecting, guaranteeing no veins or arteries
    are impacted. One Other sort of syringe many steroid users additionally purchase is the smaller 1ml insulin syringe.
    These syringes with needles hooked up are unsuitable for muscle injection but
    are used as a substitute for subcutaneous injections. Advanced
    users who use peptides, HCG, insulin, and other non-steroid compounds commonly use insulin syringes.

    To put trenbolone’s androgenicity into perspective, its androgen ranking is
    500, which is 5 instances larger than that of
    testosterone. Nevertheless, trenbolone doesn't induce aromatization, inflicting significant elevations in blood pressure, that are attributed to huge reductions in HDL
    cholesterol (medically referred to as hypoalphalipoproteinemia).
    Since trenbolone is an injectable steroid, it seldom
    compromises the liver like testosterone. According to our powerlifting patients,
    Dianabol is probably certainly one of the most potent steroids for increasing uncooked power
    and energy.
    Sure - you can plot your cycle with a number of compounds and visualize
    relative accumulation/decline over time as a steroid graph (for schooling only).
    I’ve by no means heard a single male say he doesn’t love Testosterone Cypionate.
    Testosterone Cypionate is just probably the greatest steroids you ought to use, and I will all the time suggest
    it to any male bodybuilder over age 25.

    References:

    PedsElite

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