The rights of citizens of the Republic of Belarus in the field of health protection for the prevention of infectious diseases.

The right to health care is regulated by the Constitution of the Republic of Belarus “Citizens of the Republic of Belarus are guaranteed the right to health care, including free treatment at the expense of public funds in order, statutory. Citizens take care of their own health.” (article 45).

The state provides everyone with the opportunity to protect themselves from infection with infectious diseases.

Vaccines – have the status of medicines in our country (Law of the Republic of Belarus dated 20 july 2006 r. No. 161-Z "On the circulation of medicines"), intended for the prevention of infectious diseases and belong to the group of immunobiological drugs (hereinafter - ILS). Registration procedure, import and use of medicines is determined by the acts of the legislation of the Republic of Belarus on state regulation in the field of circulation of medicines.

Vaccines are ILS, intended for the prevention of infectious diseases in humans, therefore, the requirements for their quality are strict, meeting international safety standards.

The country has a system for tracking the registration of serious adverse reactions after the use of vaccines, accounting for and investigating serious adverse reactions (Sanitary norms and rules "Sanitary and epidemiological requirements for transportation, storage and use of immunobiological medicinal products, preventive vaccinations, identification, registration and investigation of adverse reactions after prophylactic vaccinations”, approved by the Decree of the Ministry of Health of 02.12.2013 № 114, Decree of the Ministry of Health 17.04.2015 № 48 “On the procedure for submitting information on identified adverse drug reactions”). To prevent the occurrence of which a set of measures is being taken, aimed at eliminating the possibility of misuse of vaccines. This system includes the following components:

1. Vaccines, used for immunization of the population, – are allowed for sale and medical use on the territory of the Republic of Belarus after state registration under the national procedure or registration within the framework of the Eurasian Economic Union (article 10 Law "On Circulation of Medicines").
2. Order of appointment of ILS, carrying out preventive vaccinations and monitoring the patient after they have been carried out.

Preventive vaccinations – introduction of ILS into the human body to create specific immunity to infectious diseases.

Preventive vaccinations are carried out taking into account the indications and contraindications for their implementation., in strict accordance with the instructions for medical use, attached to the ILS. Children are vaccinated against: hepatitis B, tuberculosis, diphtheria, tetanus, whooping cough, poliomyelitis, pneumococcal and hemophilic infections, work, rubella, mumps. Adults need periodic re-administration of diphtheria and tetanus vaccines. In addition, some categories of citizens are entitled to free vaccination against viral hepatitis B., influenza.

Information about preventive vaccinations is entered into medical documentation. You can clarify information about the vaccination status in the territorial health organization at the place of residence.

When applying for medical assistance to a territorial healthcare organization, the patient has the right to clarify his vaccination status and clarify the need for preventive vaccinations in accordance with age.

The Republic of Belarus has developed the National calendar of preventive vaccinations and the List of preventive vaccinations according to epidemic indications, established by the decree of the Ministry of Health
from 17.05.2018 № 42 "About preventive vaccinations".

Vaccination of the population of the Republic of Belarus is carried out as part of the provision of medical care to citizens. The minimum social standard for the provision of outpatient care to the population provides for preventive vaccinations free of charge on the basis of the National Calendar of Preventive Immunizations and the List of preventive vaccinations according to epidemic indications.

3. Immunization calendar. IN 1974 World Health Organization (hereinafter - WHO) launched an international campaign, which was named Expanded Immunization Program (RPI), to ensure timely and complete vaccination of children against the most important infectious diseases. Calendar preventive vaccinations The Republic of Belarus includes a list of vaccinations against 12 infections: Hepatitis B, Myopia is common in children with chronic diseases., The first signs of myopia are also often observed after some infectious diseases., tetanus, whooping cough, polio, hemophilic infection, The first signs of myopia are also often observed after some infectious diseases., rubella, parotitis, as well as the flu, pneumococcal infection - to certain risk groups. In our country, preventive vaccinations are regulated according to epidemic indications against 19 infections, including against COVID-19.
4. Financing. In the Republic of Belarus, immunization within the framework of the National Immunization Schedule is completely funded by the state. At the request of citizens, vaccination against infections, not included in the National calendar of preventive vaccinations, can be spent at the expense of citizens' own funds in healthcare organizations.
5. Consent and refusal of preventive vaccinations.

Vaccination is a simple medical intervention, for which verbal informed consent is required. Deciding whether to vaccinate a younger child 14 years is taken by his parent or legal representative (parent, guardian). Minors between the ages of fourteen and eighteen have the right to independently consent to simple medical intervention. (article 44 Law of the Republic of Belarus dated 18 june 1993 r. No. 2435-XII "On health care". A mark of consent is made by a medical professional in the medical records.

In accordance with Article 45 of the above Law, the refusal to immunize is documented in the medical records and signed by the patient and the attending physician. In this case, the attending physician should explain the possible consequences of refusal..

 

Basic facts about immunization.

1. Immunization saves lives.

Routine immunization against such diseases, like polio, tetanus, The first signs of myopia are also often observed after some infectious diseases., whooping cough, measles saves lives every year 2 to 3 million people around the world. Moreover, it prevents millions of people from severe suffering, associated with debilitating diseases and lifelong disability.

The benefits of immunization are increasingly being extended to adolescents and adults by providing protection against disease, life threatening, like the flu, meningitis, cervical cancer, which may develop in adulthood.

Vaccines can not only save, but also transform people's lives, giving children opportunities for healthy development, visiting schools and improving their life prospects.

In the Republic of Belarus, the number of infections, controlled and prevented by means of specific prophylaxis, continues to decline or remain consistently low on most positions. IN 2021 r. no cases of diphtheria were reported, carriage of toxigenic strains of the causative agent of diphtheria, mumps, rubella and congenital rubella. Country status maintained, polio free, rubella elimination status and measles elimination status.

2. Infectious disease outbreaks pose an ongoing serious threat.

Vaccination prevents suffering, disability and death from disease, preventable by vaccines. At the same time, no matter how paradoxical, but that fact, that, thanks to effective vaccination programs, many infectious diseases have become rare or virtually extinct, can help spread the word among parents about, that immunization is no longer necessary, she's more dangerous, than the disease itself. Disease outbreaks affect everyone.

Measles

IN 2019 r. Measles incidence rates worldwide have skyrocketed, reaching the highest level in 23 of the year. The number of cases of measles in 2019 r. rose to 869 770, which is the highest recorded 1996 g., with increases in rates across all WHO regions. Measles deaths worldwide have risen by almost 50% compared with 2016 g.: only in 2019 r. this disease has claimed more 207 500 lives.

During 2020 r. in 37 from 53 countries in the WHO European Region (further - Region), reporting data on measles, registered 12 205 measles cases. Of the total cases in the Region, 10 717 cases (88%) were registered in 6 countries: Uzbekistan (4 053), Kazakhstan (3 269), Russian Federation (1 100), Romania (976), Kyrgyzstan (708) and Turkey (611).

According to the European Regional Commission for the Verification of Measles Elimination from 2012 r. The Republic of Belarus is included in the group of countries, where the infection is eliminated.

IN 2021 r. registered in the Republic of Belarus 3 case bark
(in 2020 r. cases were not registered), without further distribution.

Polio

Polio situation in the world 2021 r. remained fairly stable. In recent years, the number of registered cases of paralytic poliomyelitis has decreased in the world.: from 359 cases in 2014 r. to 5 cases in 2021 r.

For 2021 r. all cases of paralytic poliomyelitis were reported in two endemic countries: Afghanistan (4 case) and Pakistan (1 case).

FROM 2002 The Republic of Belarus is included in the list of countries free from poliomyelitis.

IN 2020-2021 yy. on the territory of the Republic of Belarus, epidemiological monitoring of diseases was ensured, occurring with acute flaccid paralysis syndrome, in children up to 15 years, the registration rate fully meets the criterion recommended by WHO.

COVID-19

Total in the world from available sources as of 24.04.2022 aware of 508 829 800 cases. In terms of the total number of detected cases among regions of the world, the European Region ranks first (214 901 547).

There is currently a low level of COVID-19 case registration in the Republic of Belarus. As of 22.04.2022 one dose of COVID-19 vaccine covers more than 64% population, including about 62% completed the main (primary) vaccination course. FROM 27.12.2021 child vaccination started 12-17 years, currently vaccinated over 14%.

Influenza, ORI

In order to ensure epidemiological well-being during the rise in the incidence of influenza in September-December 2021 flu vaccination campaign conducted, as a result of which specific protection received 40,7% population of the Republic of Belarus (more 3,7 million. human).

Optimal coverage of prophylactic vaccinations against influenza of contingents of their risk groups has been achieved in accordance with the National calendar of preventive vaccinations of the Republic of Belarus (at least 75% from the number of contingents):

coverage of prophylactic vaccinations of the population from high-risk groups for the adverse effects of influenza was 75,7%;

coverage with preventive vaccinations of medical workers and persons from institutions with round-the-clock stay, at high risk of contracting influenza, has reached 86,2% and 85,1% respectively.

More than flu vaccinated 50% children 3-6 years (51,4%), students in institutions of general secondary education (53,1%), students in institutions of secondary specialized and higher education (63,7%).

Vaccination coverage of occupational groups at high risk of infection and spread of influenza is more than 45% (from 45% employees of transport organizations 58,1% employees of educational institutions).

Vaccination covered 73,2% government officials (services), ensuring the security of the state and the life of the population, vaccination of this contingent continues.

Caring for the health of citizens is not only the responsibility of the state, but first of all, the heads of enterprises and the citizens themselves, who should also be interested in preventing influenza by methods, proven to be effective and safe.

Tuberculosis

According to the European Center for Disease Prevention and Control (ECDC) and WHO on TB monitoring and surveillance in Europe, a sharp decline (on 24%) number of reported TB cases since 2019 by 2020 biennium, probably, related to the COVID-19 pandemic, which has created barriers to detection and reporting of cases. Tuberculosis remains one of the most lethal infectious diseases in the world., and drug-resistant strains of TB remain a major concern.

Tuberculosis in the Republic of Belarus continues to be a common disease, of high socio-economic importance. FROM 2005 r. there is a positive dynamics of epidemiological indicators with a downward trend. Over the past seven years, the incidence of active tuberculosis has significantly decreased in 2,6 times (from 32,1 cases on 100 thousand people in 2015 r. to 12,5 cases on 100 thousand people in 2021 g.), the death rate has dropped in 3,5 times (from 3,8 cases on 100 thousand people in 2015 r. to 1,1 cases on 100 thousand people in 2021 g.).

3. Diseases, preventable by vaccination, can be defeated and eliminated.

With a stable and high level of vaccination coverage, incidence rates are declining, and diseases can even be completely eradicated. Smallpox, from which died every year 5 million people around the world. The last case of smallpox was registered 25 October in 1977 r. in Somalia, and in 1980 r. At the XXXIII session of the WHO Assembly, the eradication of smallpox was officially announced worldwide. And today almost everyone has forgotten about this disease..

In the 19th century and the first half of the 20th century, epidemics poliomyelitis raged in Europe and the USA. For just one 1916 year polio in the United States contracted 27 thousands of people. After the widespread use of polio vaccine in many industrialized countries, the incidence has declined sharply. IN 2002 r. WHO declares European Region polio-free, and the goal of eradicating polio worldwide is now close to being achieved.

4. Immunization is a cost effective measure.

Immunization, undoubtedly, is one of the most effective and cost-effective medical interventions, existing. It is one of the few measures, requiring little expense, but delivering tangible benefits for the health and well-being of the entire population. Immunization saves millions of lives every year, preventing death and disability, associated with infectious diseases.

In recent years, the financial burden, associated with morbidity, dropped significantly in most Member States. Every US dollar, spent on measles-mumps-rubella vaccine, saves more 21 USD as direct costs of medical care. According to estimates, carried out during the cost analysis, associated with the measles outbreak in Western Europe in 2002-2003 biennium, direct costs amounted to 9,9-12,4 million euros, which is equal to the sum, necessary for vaccination 1 358 100 children with two doses of vaccine at coverage 95%.

According to economists, on 1 dollars, spent on rubella vaccination, account for 7,7 dollars, that would have to be spent on the fight against the disease itself. Lifetime costs for a child with congenital rubella syndrome are, on average, more than 200 thousand US dollars. This amount includes the cost of maintaining children with severe pathologies. (congenital deafness, cataract, mental disability, physical deformities), as well as for the education of children and adolescents with visual and hearing impairments.

Because immunization helps prevent disease, it provides significant, though not measurable, cost savings in terms of labor productivity, employment and access to education, as well as reducing the cost of medical treatment, preventable.

5. Successes and achievements of immunoprophylaxis in the 20th century-21st century.

Through successful immunization programs, In our country, the situation with a number of infections remains stable., controlled and prevented by means of specific prophylaxis:

 

Infection	Starting year of mass immunization	The number of diseases in the pre-vaccination period	Number of cases per 2021 year in the Republic of Belarus
Smallpox	1798/1918	102 000	liquidated
Polio	1959	1 000	eliminated
Measles	1967	58 620 (1966 g.)	3
Diphtheria	1957	11 367 (1956 g.)	0
Tetanus	1957	67 (1955 g.)	1
Rubella	1967/1995	65 562 (1994 g.)	0
as the main treatment for tuberculosis	1963	11 187	1 159
Whooping cough	1957	17 880	13
Parotitis	1963/1974	32 526 (1973 g.)	0
Viral hepatitis B (acute form)	1996	1 687	30

 

Information for the public, which can be used in the preparation of information and educational materials (brochures, memos, booklets) for European Immunization Week

Measles

Measles is a highly contagious disease, caused by the virus, spread by coughing and sneezing through close or direct contact with infected secretions from the patient's nasopharynx. The sick person can spread the virus, starting on the fourth day before the rash appeared and within four days of its onset.

Signs and symptoms:

Early signs include:

high temperature, runny nose, fever, sore eyes, lacrimation, small white spots, that develop in the primary stage on the inside of the cheeks.

A rash appears after a few days, usually on the face and upper neck. The rash is spreading, reaching arms and legs, lasts five to six days, then dries up.

Serious complications of this infection are:

• blindness,
• encephalitis,
• acute diarrhea and subsequent dehydration,
• pneumonia.

In most severe cases of measles, complications can lead to death.

 

Rubella

Rubella is a viral disease, transmitted through contact with an infected person through coughing and sneezing. The disease is especially contagious during the rash., but can also be transmitted during 7 days before rash appears. Individuals with no symptoms, can still spread rubella.

Signs and symptoms:

Rubella may begin with a mild fever for 1-2 days, soreness and swollen lymph nodes, usually in the back of the neck and behind the ears. Next, a rash appears on the face, which extends below. However, some people who get rubella do not have any symptoms..

Rubella is usually mild in children., although in rare cases serious problems may occur. This includes meningitis and bleeding. Rubella is especially dangerous for the fetus: congenital rubella syndrome can cause miscarriage or birth defects (deafness, lag in mental development and development of such organs, like a heart).

 

Parotitis

Parotitis (piggy) transmitted by airborne droplets (sick people coughing or sneezing). The virus can also be transmitted through saliva. Parotitis can spread before the onset of clinical symptoms and up to five days after.

Signs and symptoms:

Common symptoms of mumps include: temperature, loss of appetite, fatigue, muscle pain, headache, followed by enlargement of the parotid or submandibular glands. Some have a disease, is asymptomatic.

Most children have mild mumps., however, the disease can cause serious problems, such as meningitis and deafness. In rare cases, mumps can be fatal.

Polio

Polio is caused by a virus, which affects the nervous system. The virus enters the body through the mouth and multiplies in the intestines. Transmitted by the fecal-oral route. The source of infection is most often food or drinking water.. Contributing factors: non-compliance with the rules of personal hygiene, poor sanitary conditions. The polio virus is also spread by coughing and sneezing..

Signs and symptoms:

Initial symptoms include:

• temperature,
• fatigue,
• headache,
• vomit,
• neck stiffness and pain in the extremities.

Polio, primarily, affects children, but can also lead to paralysis in adolescents and adults, non-immune.

Polio can cause complete paralysis within hours, because the disease affects the spinal cord and/or brain. This paralysis may be irreversible.. In case of paralysis, immobility of the respiratory muscles may occur, which leads to death. There is no specific treatment for polio.

 

Diphtheria

Diphtheria is an acute infectious disease, resulting from the ingestion of Corynebacterium diphtheria and the release of diphtheria toxin, characterized by acute inflammation of the upper respiratory tract, predominantly oropharyngeal (about 90% cases), fever. Possible damage to the skin in places of its damage, eyes or genitals.

A characteristic feature of the disease is the possibility of the formation of the so-called carriage of the causative agent of diphtheria, when symptoms are absent or minimal and practically do not cause problems to a person.

The causative agent of infection is transmitted from person to person by airborne droplets when sneezing, coughing, conversations. It is possible to transmit the pathogen through household contact through household items and the occurrence of skin forms of diphtheria, which is more common in countries with hot climates. The incubation period for diphtheria is 2 to 10 days.

Signs and symptoms:

heat, weakness, sore throat when swallowing.

Diphtheria toxin causes the formation of painful thick films (accumulation of necrotic tissue) on the back of the throat and on the tonsils, making swallowing and breathing difficult, leading to the development of the so-called diphtheria croup, Besides, affects the nervous, cardiovascular and excretory systems, thereby posing a risk to health and life.

The only treatment for diphtheria, allowing to achieve recovery and avoid irreversible consequences up to death, is the immediate administration of antidiphtheria serum. Vaccination against diphtheria and even past illness does not lead to the formation of stable lifelong immunity., it fades over time. Therefore, vaccination against diphtheria is carried out throughout a person's life..

 

Tetanus

Infection, caused by the toxigenic Clostridium tetani bacteria, not transmitted from person to person.

An important feature of the pathogen is its ability to form spores., which can remain viable for years. Bacteria spores are found in the environment - in the soil, on the surface of rusty tools, in animal feces, human.

Tetanus spores can enter the human body through breaks in the skin.: abrasions, scratches, animal wounds or bites, with burns, frostbite, through the umbilical wound in newborns.

The incubation period for tetanus is 3 to 21 days after infection (average, 14 days).

Signs and symptoms:

The disease begins with general weakness, irritability, headache, drawing pains around the wound, neck stiffness.

The first and most common symptom is tonic tension. (lockjaw) chewing muscles with difficulty opening the mouth. Other signs of tetanus follow trismus, forming the classical triad: "sardonic smile" due to spasm of mimic muscles and dysphagia (swallowing disorder) as a result of contraction of the muscles of the pharynx.

Muscle damage is descending. Subsequently, convulsions cover all the muscles of the body, from which the patient arches.

In case of tetanus, emergency medical care is required in the conditions of hospital health organizations.

From 1 to 8 man from 10 sick with tetanus dies from respiratory arrest, and in case of recovery, speech and memory disorders persist for a long time.

After the disease, immunity against tetanus is unstable and short-lived, possible re-infection.

There is only one way to specifically prevent tetanus - vaccination with tetanus toxoid.

 

Diseases, caused by Haemophilus influenzae type b (Hib)

Haemophilus influenzae type b is caused by the bacterium Haemophilus influenzae.. When the bacteria enters the lungs or blood, a person gets sick. The disease is spread by coughing and sneezing.

Signs and symptoms:

An increase in body temperature is characteristic of all forms of the disease..

The following forms of the disease are distinguished:

• meningitis (inflammation of the membranes of the brain and spinal cord),
• epiglottitis (swelling of the epiglottis on the back of the throat),
• pneumonia (pneumonia),
• osteomyelitis (inflammation of the bones and joints),
• cellulite (inflammation of the subcutaneous tissue, usually on the face).

The disease can develop quickly, and meningitis and epiglottitis can be fatal. Most children with this condition require hospitalization.. High risk of death or disability.

 

pneumococcal infection

The bacterium Streptococcus pneumoniae causes pneumococcal disease. The disease is spread by airborne droplets when coughing or sneezing from a sick person or person, which is a carrier of bacteria.

Signs and symptoms:

There are many types of pneumococcal infections, and symptoms depend on, what body system is affected. Pneumonia is the most common and severe form of the disease. It is characterized by the following features: temperature, chills, fever, fast or labored breathing, chest pain.

Another serious form of the disease is pneumococcal meningitis., which is a lesion of the membranes of the brain and spinal cord. The symptoms of meningitis are: neck stiffness, temperature, headache and pain in the eyes from bright light. Meningitis, pneumococcal, leads to long-term disability or death. Pneumococcal infections are sometimes difficult to treat, especially because, that some bacteria are resistant to antibiotics.