This paper reviews concept issues of vaccination in Russian Federation. There are three periods of vaccination history. The provisions of the concept were formulated on the basis of the results of multi-year researches and analysis of data from domestic and foreign studies. Main provisions aim at: reconstruction of domestic vaccine production; improvement of the national immunization schedule and public policy for country biosafety; promotion of the WHO strategy for full immunization throughout life in Russia; development of the national immunization schedule for adults and monitoring system for adverse events following immunization; implementation of vaccination risk management and epidemiological surveillance for disease prevention, improvement of vaccination compliance among people, health care workers, mass media, legislative and executive authorities. Implementation of the provisions of the modern vaccination concept in Russia would contribute to solving demographic problems, to reduce morbidity and mortality, to promote active aging, and would have a significant economic effect. 

Relevance. In accordance with Federal Law of November 24, 1995 No. 181-ФЗ “On the Social Protection of Persons with Disabilities in the Russian Federation”,  the activities of the rehabilitation service for people with disabilities are the most important indicator of public health and the effectiveness of the healthcare system. The official reporting data is one of the most important sources of information, however, the totality of the data presented in them is limited to the information entered in the corresponding reporting forms and, therefore, does not contain all the information that would make it possible to fully judge the problems arising from disability. For this reason, the need for special studies is obvious. Aims. Analysis of the epidemiology of adult disability in the Russian Federation. Materials and methods.  The volume of the study was 34,840,933 people aged 18 years and older, recognized as disabled, including 12,971,062 elderly people with disabilities. The object of the study was the data on primary and secondary disability in the form of state statistical observation No. 7-sobes  approved by the Federal State Statistics Service of Russia, statistical compilations of the Federal State Budget Institution of the Federal Security Service of the Ministry of Labor of the Ministry of Labor of Russia for 2005–2016. The study is continuous. Study Period 2009–2016  Research methods: documentary, data copying, statistical and graphic. Research bases: Federal State Budgetary Institution of the Federal Security Bureau of the Ministry of Labor of the Ministry of Labor of Russia and branches of the main bureau of medical and social expertise in Moscow (19 branches in the administrative districts of Moscow). Results. The leading age cohort in the structure of adult disability in the Russian Federation is the elderly, the proportion of which exceeded the VPI among other age groups of the adult population. In 2005–2016 6.6 million elderly people (56.8% of the total number of people with disabilities) were recognized as primarily disabled; on average, 552.2 thousand people a year (56.8%). On average, 156.2 thousand people (16.1% of the total number of people with disabilities) became disabled people at a young age, and 263.1 thousand people (27.1%) became middle-aged people with disabilities. The contingent, both for the first time and repeatedly recognized by people with disabilities, is formed by people with disabilities due to the classes of diseases of the circulatory system, malignant neoplasms, diseases of the musculoskeletal system and connective tissue. The dynamics of the severity of primary and secondary disability in the Russian Federation is multidirectional. There is a regional differentiation in the prevalence of disability among adults in the territories of federal districts and constituent entities of the Russian Federation. Older people (about 80%) suffer from multiple chronic pathologies. In one elderly patient older than 60 years, on average, four to five different chronic diseases are detected. The accumulation of impaired functions of organs and systems helps to reduce the adaptive capacity of the body and is associated with limited life, which entails an increase in the risks of disability in the elderly and the need for medical and social rehabilitation. Conclusions. Currently, the low level of rehabilitation and habilitation of persons with disabilities in the Russian Federation remains. In order to increase the effectiveness of rehabilitation of people with disabilities, it is necessary to develop a unified system for monitoring the implementation of rehabilitation treatment and socialization technologies as part of a single continuous process of medical and social rehabilitation at all levels of its implementation on an interdepartmental basis.

Relevance.  The circulatory  system  diseases  (CSD) are the leading cause of peoples’  death globally.  Therefore  the assessment of radiation risk of mortality for CSD is the most important task for radiation epidemiology, especially in low dose range (below 1 Gy). Aim: to establish the relationship between circulatory diseases incidence among the Chernobyl emergency accident workers (liquidators) and radiation dose they got. Materials and methods.  The object under study is the cohort of liquidators with known individual doses of external gamma exposure of whole body. The group of potential risk is identified by values of excess relative risk (ERR) and relative risk (RR) estimated in the cohort of 134 thousand people, the average radiation dose is 0.11 Gy, maximum individual dose is about 1 Gy. For the period of follow up from 1986 through 2012 12400 deaths were caused by CSD. Results. The group of potential radiation risk comprises of the liquidators with accumulated doses 0.15 Gy and above, they arrived in the Chernobyl exclusion zone in the first year after the accident and stayed there less than 6 weeks. The total size of the identified group was 9.5 thousand people (7% of the cohort members). In the group of potential radiation risk the statistically significant value of RR is 1.44 (95% CI: 1.25; 1.66), averageaccumulated dose is 0.23 Gy. In this risk group 31% of deaths from CSD should be considered as associated with radiation. In the beginning of 2013 the size of the group of potential radiation risk was 6155 liquidators. Conclusions. For remained life about 950 radiation induced deaths from CSD are expected. Adherence of liquidators of the risk group to prevention and control of circulatory system diseases would significantly decrease years of life lost due to radiation exposure in this cohort.

Relevance.  Annual elevation of enterovirus infection (EVI) incidence in the Russian Federation  as well as in the Sakhalin region determine  a necessity  of continuous  surveillance  involving molecular-genetic  methods  and  phylogenetic  analysis.  Objective:  to highlight epidemiological and molecular-genetic  peculiarities of EVI in the Sakhalin region during 2016-2018 years. Materials and methods.  Analysis of enterovirus incidence were based on official statistical reporting forms. The structure of enterovirus types was evaluated by means of molecular methods and followed by phylogenetic analysis. Results and discussion. A deterioration of epidemic situation concerning EVI that began in 2016 in the Sakhalin region included elevation of incidence and registration of enterovirus outbreaks in childcare facilities triggered by introduction of new enterovirus types or those that were not circulating for a long time suchas Coxsackievirus A-6, Coxsackievirus A-10, Coxsackievirus A-16, ECHO-9. The phylogenetic analysis of Coxsackievirus A-16 detected in the Sakhalin region revealed their similarities with two genovariants of B genogroup (В1а и В1b) that were continuously circulating in Russia and China. In addition, enterovirus ECHO-9 that was also circulating in other constituent entities of the Russian Federation was isolated in Sakhalin region from patients suffering from viral meningitis including two children from two different infection cites of EVI group incidence. Conclusion. An unfavorable epidemic situation concerning EVI was revealed in the Sakhalin region during the last three years of surveillance. It was caused by introduction and further spread among population of Coxsackieviruses A-6, 10, 16 and ECHO-9 that presumably have Russian or foreign origin.

Relevance.  According  to  official  statistics  prenatal  infections  outweigh  neonatal  purulent-septic  infections.  The  clinical  picture of prenatal infections is not the specifics. Doctors put a newborn diagnosed based on the mother's medical history, additional studies are not carried out. This leads to incorrect treatment of newborns and incorrect assessment of the epidemiological situation in the matenityhospital. We need to study prenatal infections as a marker epidemic in the matenity hospital. Materials and methods.  The study used data from official statistics and special form developed by researchers.  Follow-up  was 26 years (1991 to 2016). Total 26601 analyzed the case of newborn infections, including 6330 – prenatal infections. Results. Increasing the number of diagnoses prennatalnyh infections coincides with increasing neonatal sepsis diseases, respiratory tract infections, skin infections and intestinal infections. Growth for the prenatal  infections correlates  with lack midwife and their high production load, the increasing number of complications during childbirth. Conclusion. Prenatal neonatal infection is a mask of infections associated with medical care. The medical organization requires constant monitoring of the number of prenatal infections. Growth prenatal infections should be regarded as a marker to the complications of the epidemiological situation in the hospital.

Relevance.  HIV infection has a negative impact on the demographic and economic situation. Despite the slowdown in prevalence, incidence and prevalence rates remain. Aim. Analysis of the development of the HIV epidemic process in the risk group of prisoners ofthe Tyumen region over a period of many years. Materials and methods.  The work used statistical data from the Center for the Fight against AIDS of the Tyumen Oblast State Budgetary Health Institution, the Office of the Federal Service for Supervision of Human Welfare in the Tyumen Region. The work uses analytical, epidemiological methods, research methods, statistical evaluation methods, average errors, average errors, estimated significance, differences between comparison factors. Results. In the region, HIV-infection affects more than 1% of the population. The group of prisoners occupies a leading position Prisoners in prisons are at increased risk of infection  in the structure of HIV-infected  region with an average multiyear share of 16.3%. The maximum rate of increase in HIV among prisoners was + 44.0%, the minimum – -27.0%. The average long-term  share of nonresident prisoners was 40.6 ± 0.65%, and among those registered in the region – 59.4 ± 0.65%. Places of deprivation of liberty must be considered as one of the main places with a high degree of probability of contracting HIV due to the contact of a healthy population with HIV infected, like in no other location. Conclusions. In 2001, the share of prisoners of all identified HIV – positive in the region amounted to 30.3%. The nature of the generalized course of HIV infection has acquired in prisons since 2005. The intensity of the HIV epidemic process in the region is supported, among other things, by the continuity of the formed connection between the special contingent and the law-abiding population, which requires targeted attention from the sanitary and preventive services.

Relevance.  Socioeconomic and climatic conditions determine the nature of the epidemic situation in the Republic of Guinea, which requires further study and objective assessment. Materials and Methods. The research materials were the official statistics, the data from scientific publications, as well as the results of own researches. A complex of epidemiological, bacteriological, immunological, serological, molecular genetic and statistical research methods was applied. Conclusions. The structure and levels of morbidity and mortality in the Republic of Guinea were presented. New data were obtained on the etiology of acute suppurative otitis media, on the prevalence and epidemiological manifestations of intestinal helminthiases, typhoid fever, enteric and parenteral hepatitis, as well as sexually transmitted infections. The current situation of HIV and tuberculosis was assessed. A complex of epidemiological risk factors for a number of infectious and parasitic diseases contributing to complicated situations was revealed.

Relevance. Influenza vaccination is considered as the most effective way to prevent this infection. In the past epidemic season in Russia, the main share of influenza vaccines comprised domestically produced vaccines. Aims was to assess the vaccine effectiveness (VE) in preventing  severe forms of influenza that require hospitalization. Materials  & Methods.  To collect clinical and epidemiologicaldata for the epidemic season 2018–2019.  an active prospective surveillance approach was used. The study included 6 departments of three infectious diseases hospitals in St. Petersburg. Results It was established that early VE, estimated during the epidemic, was 66.4% for children and 64.7% for adults. Evaluation of VE for the entire study period from week 52 of 2018 to week 13 of 2019, showed that it decreased, the total VE for this period was 48.4%. Conclusions The data obtained in the course of the study indicate a pronounced protective role of vaccination in preventing the development of severe forms of influenza with subsequent hospitalization. 

Relevance.Upon the unquestionable utility of regular season vaccination influenza vaccine effectiveness varies depending on how vaccinal strains to be in accord with seasonal circulating influenza strains, i.e. the influenza vaccines are virtually strain-spesific and not able to elicit broad, protective immune responses. Aim is widening the scope of bioinformatics applications to show the possibility to construct  H1 and H3 hemagglutinin structures that contain long identical invariant (conservative) sequences from various strains and can accordingly be used as a universal influenza vaccine at the level of strain subtypes for the future seasons and also to discuss possibilities and limitations in the search for the universal influenza vaccine. Materials and methods.  For the computer analysis, the database of the hemagglutinin (HA) primary structures of the H1N1 and H3N2 strains isolated in the influenza epidemiological season 2009/2010–2018/2019 were used from the Internet. For every epidemical season dominant and invariant H1 sequences (presenting the generalized HA images of circulating strains) are constructed and used for the comparison of seasons. The dominant sequence of the seasonal dominant sequences and the invariant sequences of the seasonal dominant sequences are used as the HA characteristics for ten year period. Results.  The seasonal dominant HA sequences of the last ten year period contain a few changes, i.e. their structures are robust and each structure contains practically all identical conservative sequences of the HA of the following seasons. During the last ten years the bird and swine HA H1 and H3, in contrast to human HA H1 and H3, have requiredsignificant changes. Conclusion. The vacccines using the H1 and H3 dominant sequences for preceding epidemical seasons could be effective against the various strain subtypes in the future seasons.

Relevance Aims. Despite of widespread achievements and maintenance of appropriate levels of coverage of preventive vaccinations (>95%) the problem of delayed immunizations and vaccination on time is still existed in the Russian Federation over the last years. Materials and methods.  A selective analysis of the vaccination on time against diphtheria, tetanus, pertussis and hepatitis B, of children aged under 2 years in Russia, Moscow, from 2014 to 2018 was conducted. To assess the timeliness of vaccination, two independent sample studies were conducted: the vaccination history of 6003 whooping cough patients in Moscow was analyzed and vaccination was evaluated in 641 children, who were born 2016–2018  in Kirov, depending on the implementation of combination vaccines.  Results.  The current  95% coverage  of preventive  age-recommended vaccination  of decreed  age against  pertussis, diphtheria, tetanus, polio, hepatitis B is achieved only by 2–3 years of age. Conducted analysis showed, that the implementation of combination vaccines contributed  to increase in the proportion  of timely vaccinated children up to 1 year of age as well as propotion of children who started primary immunization series at recommended age of 3 months. Also as a result the vaccination coverage against Hib infection and proportion of timely vaccinated against pneumococcal infection was increased. Conclusions.The implementation of modern multicomponent combination vaccines allows to increase vaccination coverage in population and to control effectively infectious diseases and also to reduce number of injections and visits to clinics.

Hantaviruses are highly pathogenic causative agents of hantaviral fevers, including hemorrhagic fever with renal syndrome, registered among people in countries of the Eurasian continent and a disease  called «hantavirus  pulmonary  syndrome»  – in the countries of North and South America. More recently, the spread of hantaviral diseases has been detected in Africa. There are still no drugs for specific antiviral therapy. The most promising method of dealing with hantaviral fevers is specific prophylaxis, that is, vaccination of the population against hantaviruses, which determine the endemicity of different territories. This review summarizes current data on existing and developed vaccines against hantaviral fevers.

The history of influenza pandemics of the 20th century and the 2009 pandemic is analyzed, as well as the stages of parallel development of the influenza doctrine. Hypotheses and theoretical aspects explaining the mechanisms of formation of seasonal epidemics and pandemics are considered. Zooanthroponosis locates the Genesis of pandemic influenza type A and type anthropogenic   the essence of seasonal drift epidemics of influenza of all types. Taking into account the diversity of opinions of experts, it is proposed to return to the discussion of controversial epidemiological and virological issues officially recognized by WHO in 2009 of the pandemic to develop a unified concept of pandemic influenza on the basis of multi-level variability of the pathogens. We discuss the possibility of improving the prediction of epidemiological (epizoonotic) influenza situation by complex monitoring of the predictors of pandemics (epidemics, epizoonotics) in the hog production regions laboratories, epidemiological and veterinary profile. It is assumed that the probable causative agent of the next pandemic will be influenza virus of serasubtype A (Н2N2).