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Relevance. Community-acquired pneumonia and chronic obstructive pulmonary disease (COPD) remain a serious public health problem in all respects today.Aims. To summarize the studies of domestic authors on the study of the effect of pneumococcal polysaccharide vaccine on various parts of the immune system and their relationship with the clinical course of the disease in patients with COPD and community-acquired pneumonia. We also consider it necessary to discuss the possible mechanisms of therapeutic effects after the introduction of a monovaccine against S. pneumoniae, as well as when it is combined with vaccines against Haemophilus influenzae type b infection, and the effectiveness of various vaccination regimens, including complex ones.Conclusions. Convincing arguments are presented proving that the introduction of vaccines against respiratory infections can have not only a reventive value, but also a therapeutic effect, accompanied by a transient restoration of the immune system parameters, as well as a reduction in the contamination or elimination of S. pneumoniae in patients with chronic pathology of the bronchopulmonary system.

The review examines the clinical and epidemiological links between COVID-19 and pneumonia. At the same time, both general patterns linking viral respiratory infections and bacterial infections of the lower respiratory tract are discussed, as well as recent data relating directly to COVID-19. The clinical aspects of secondary infections, the peculiarities of their etiology, course and outcomes are analyzed separately. The publication provides a short essay on the history of the development of vaccines against pneumococcal infection. The current vaccines against pneumococcal infection are described, their brief characteristics and individual characteristics are given, their clinical and immunological advantages and disadvantages are analyzed. The data on the effectiveness of vaccine prophylaxis using pneumococcal vaccine are presented. The specific and nonspecific effects of vaccine prophylaxis both at the population level and at the level of an individual organism as a whole and in particular when using vaccines against pneumococci are considered separately. Data on the putative biochemical and molecular mechanisms of these effects are presented. Based on the data presented, the need for the use of pneumococcal vaccines in the prevention of the spread of the SARS-Cov2 virus, the prevention of complications of COVID-19 and the rehabilitation of patients who have undergone this infection is substantiated. When considering the role of pneumococcal vaccines in the rehabilitation of patients who have undergone COVID-19, their potential is analyzed both in accelerating the restoration of the normal functioning of the immune system and in the prevention of superinfections. The ways of further research in this direction are outlined, which include the development of protocols for certain groups of patients with concomitant diseases and immuno-compromised contingents. In this direction, the role of a thorough and comprehensive study of the immunological and clinical indicators of this category of persons is emphasized.

Aim: to investigate the safety of acellular pertussis vaccines for adolescents.Materials and methods. The clinical tolerability of revaccination against pertussis (cell-free component), diphtheria and tetanus was analyzed in 107 children aged 13,5–14 years. Group 1 consisted of children revaccinated with DTacP-IPV combined vaccine (Tetraxim), group 2 – vaccinated with Td and group 3 – children who received Tdap vaccine (Adacel).Results. Statistically significant differences in the frequency of local reactions between the group that received Tdap and the other two (DTacP-IPV and Td) were detected (p = 0.001and p = 0.04, respectively). Analysis of the structure of local reactions revealed a difference only in the occurrence of the hyperemia at the site of injection, with the most frequent registration in the groups of children vaccinated with DTacPIPV (29,4%) and Td (14,7%), whereas in patients vaccinated with Tdap – only in 5,9% (χ2 = 6,8 p = 0,03). Systemic reactions occurred with the same frequency in all studied groups and did not require medical correction, as well as local reactions. Thus, revaccination against pertussis, diphtheria and tetanus of adolescents using Tdap, containing the acellular pertussis component, does not exceed the frequency of systemic reactions and the number of local reactions is significantly lower in comparison with the vaccine with a reduced content of diphtheria and tetanus toxoids (Td) that is used in practice for a long time.

A study was conducted to evaluate effectiveness of vitamin D and interferon α-2b preparations on cytokine profile in pregnant women with vaginal infections. It was shown that pregnant women with vs. without bacterial vaginosis were featured with low vitamin D level in 53.8–60.5% cases. Administration of vitamin D and interferon α-2b preparations in combination with antibacterial therapy in pregnant women with bacterial vaginosis conferred anti-inflammatory effect resulting in normalized IL-8 level corresponding to that one in healthy subjects. Use of vitamin D altered interferon status and augmented antimicrobial activity in pregnant women confirmed by reduced rate of ARI episodes.

The article presents the analysis of numerous scientific studies carried out in Russia with the use of pneumococcal polysaccharide vaccine in immunocompetent and immunocompromised patients. New data are available to assess the impact of vaccines on clinical and immunological aspects in a particular pathology in children, which allows to reveal the mechanisms associated with the effectiveness of vaccination.

The article presents the results of vaccination against diphtheria, tetanus and hepatitis B virus with the use of combined vaccine Bubo-M or a monovalent vaccine Hepatitis B in 120 patients with severe and medium chronic obstructive pulmonary disease (COPD) and 77 healthy people at the age 35 - 60 years. The lack of protective antibodies to diphtheria in patients with COPD was noted. The safety of immunization and the delayed production of post-vaccination antibodies to these infections were shown. The level of post-vaccination antibodies was the same as in healthy group after the administration of 3-rd dose both of the monovaccine and the combined one. During the year a clinical effect in reducing the number of exacerbations of the disease after a triple injection of the combined Bubo-M vaccine in patients with COPD was observed, comparable to that in patients with the combined use of the immunomodulator and hepatitis B vaccine. Moreover combined vaccination with immunomodulator led to normalization of level of the inflammatory mediators. Conclusion: Vaccination of patients with COPD with the use of the combined vaccine Bubo-M has both an advantages in clinical effect and the spectrum of anti-infection protection in comparison with the monovaccine against hepatitis

Background.In the absence of a vaccine against SARS-CoV-2, seasonal influenza vaccination during the pandemic contributed to lowered COVID-19 susceptibility and severity. The study was aimed to assess the state of post-influenza vaccination immunity, pneumonia frequency and severity in medical workers after using various flu vaccination regimens, between the 1st and 2nd peaks of COVID-19 epidemic rise.Materials and methods.Comparatively analyzed data on the levels of antibodies against influenza virus strains and pneumonia incidence in 487 medical workers was carried out: 1st group — unvaccinated in 2020–2021 (n = 281), 2nd group — vaccinated against influenza (Sovigripp), (n = 98), 3rd group — received combined vaccination against influenza and pneumococcus (Prevenar 13), (n = 108).Results.6 months after vaccination, the highest rates of influenza virus were detected in the A(H3N2), the level of seroprotection (≥ 1:40) ranged from 49.0% in unvaccinated (1st group) to 53.4–53.2% in those who received combined vaccination (group III), as well as influenza alone (2nd group), p 0.05; for strain A(H1N1) the level of seroprotection in 1st group is 24.5%, lower (p 0.04) than in 2nd group — 32.7%, but does not differ from the levels of 40.4% in group III; for strain B the level of seroprotection is the lowest ranging from 19.4% in the group of unvaccinated subjects up to 22.4% in 2nd group and 23.4% in 3rd group. The pneumonia incidence in 1st group (3.9%), 2nd group (3.1%), 3rd group (4.6%) did not differ, however, among all vaccinated subjects severity of pneumonia clinical course was mild, whereas in unvaccinated employees, except for mild course (45.4%, 5 out of 11 people) pneumonia in 36.4% (4 out of 11 people) cases was assessed as moderate and in 18.2% (2 out of 11 people) cases — severe with fatal outcomes.Conclusion.The study showed that 6 months after seasonal influenza immunization between the 1st and 2nd peaks of COVID-19 epidemic rise, the immunogenicity of the vaccine meets the CPMP criterion for the A(H3N2) strain. In vaccinated patients, the proportion of pneumonia with COVID-19 clinical picture was mild in 100% of cases, and in unvaccinated patients in 36.4% of cases — of moderate severity and in 18.2% — severe with fatal outcome.

Background. Individuals who were vaccinated against seasonal influenza or had a history of pneumococcal vaccination were found to be less likely to become infected and tolerate COVID-19 more easily. However, it has not been sufficiently studied how vaccination against these infections, carried out during the pandemic period, can affect the incidence of COVID-19.Aims. The purpose of the investigation: to study the effect of vaccination against influenza and pneumococcal infection carried out during the pandemic of a new coronavirus infection on the susceptibility and course of COVID-19 in healthcare workers.Materials and methods. In August- Setempber 2020, after the first rise in the incidence of COVID-19, out of 547 employees (aged 18 to 70 years) of a medical organization (MO), 266 (49%) were vaccinated against influenza (group II, n = 98), pneumococcal infection (group III, n = 60) and combined vaccination (group IV, n = 108), while 281 (51%) remained unvaccinated (group 1). Follow-up period: from September 2020 to March 2021 with the registration of the incidence of acute respiratory infections (ARI) according to primary medical records and the use of PCR methods for SARS-CoV-2, epidemiological and statistical analysis.Results. Two months after the start of the study, the proportion of cases of COVID-19 in the 1st group (unvaccinated) was 5% versus 1% in the 4th group (persons vaccinated with two vaccines), after 4 months – 15% and 5%, respectively, and at the end of observation (166 days) – 16% and 8%, respectively. That is, among unvaccinated individuals, the risk of getting COVID-19 was higher by HR = 2.1 [95% CI: 1.0÷4.7] times. The time between the start of observation and a positive test for COVID-19 in study participants was significantly higher in the 4th group compared to the group I: 106 [60–136] days versus 47 [17–75] days. The distribution of patients with COVID-19 according to the severity of viral pneumonia showed that in unvaccinated patients in most (64%) cases, pneumonia had a moderate to severe course, while in the 4th group of patients with combined vaccination in 100% of cases, mild (p = 0.04 for the entire sample).Conclusions. During the COVID-19 epidemic rises, vaccination against respiratory infections remains relevant, reducing the number of cases, the severity of the coronavirus infection and preventing the occurrence of co-infections.

The aim of this study was to generate dendritic cells from the bone marrow of mice (DC) in vitro and to assess the effect of virulent and attenuated variants of influenza virus on the maturation of DCs. Granulocyte-macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4) were used in combination, to induce differentiation of mouse bone marrow (BM) mononucleocytes into DCs. On the 5th day, distinct variants of influenza virus were added to the cell culture, and the cells were additionally incubated for 2 days. The morphological characteristics of DCs, immunophenotype of DCs and expression of some Toll-like receptors were evaluated. On the 5th day of incubation. the DCs acquired typical morphological characteristics. DCs were large in size with an eccentrically located nucleous, often irregular in shape, with numerous processes. On the 7th day of incubation with influenza virus variants, their cytoplasm was somewhat denser. DCs acquired more processes, necessary for intercellular contacts. Expression levels of CD11c, a specific marker of BM-derived DCs, and of co-stimulatory molecules such as CD40, CD80, CD86, and MHC-II were elevated in mature DCs. Virulent versus attenuated strains of the influenza virus induced special variants of DCs differentiation, with respect to expression rates of differentiation markers, as well as expression of Toll-like receptors and costimulatory molecules. Conclusions. The in vitro cultured murine mononucleocytes derived from bone marrow can produce a large number of n-DCs, that can mature in the presence of different variants.During evolution of the DC immunophenotype treated with variant influenza viruses, we have found distinct signs of immunosuppression.The attenuated U-2 and M-26 influenza variants obtained by site-specific mutagenesis upon development of DCs immunophenotype, exhibited a decreased immunosuppressive activity and were not inferior to the cold-adapted (CA) reassortant for the most positions, but exceeded it in some instances. These studies can help to assess the criteria for evaluation the efficiency of in vitro developed influenza vaccines.

Within a framework of the state measles elimination program, in April, 2018 a level of measles herd immunity was assessed in 1899 Moscow hospital medical workers aged from 19 to 69 years and older. All subjects enrolled in the study were vaccinated against measles or recovered after measles infection. Serum samples were collected from subjects and examined by ELISA for measles IgG antibodies with the Vector-Best IgG-measle test system (Russia). It was found that 278 (14.6%) and 1621 (85.4%) subjects were seronegative (< 0.18 IU/mL) and seropositive (> 0.18 IU/ml), respectively. Age-related group distribution of 1855 serum samples revealed that percentage of seronegative subjects was in: aged 19—23 years was -38.5%; 24-28 and 29-33 years - 22.2%; 34-38 years - 27.5%; 39-43 years - 25.8%; 44-48 years - 16.8%; 49-53 and 54-58 years — 8.6% and 8.3%, respectively; 59-63 years old — 4.9%; 64-68 and over 69 years old — 0%. Moreover, mean level of measles IgG antibodies increased proportionally to age of medical workers from 0.58 IU/ml (19-23 years) to 2.94-2.72 IU/ml (64-68 and over 69 years). The data obtained indicate that a cohort of measles susceptible subjects (from 38.5% to 16.8%), respectively, is identified among young and middle age (from 19 to 48 years) individuals. It is assumed that two-dose measles vaccination in childhood does not contribute to the long-term preservation of protective levels of measles antibodies, thereby justifying a need to administer a three-dose measles vaccine.

The review presents data on the role of respiratory agents in the pathogenesis of exacerbations of bronchial asthma and the impact of vaccination on the clinical course of the disease. The features of the formation of protective immunity in various immunization schemes are analyzed. In patients with bronchial asthma, the substantiation of the vaccination scheme with the advantage of priority administration of conjugated polysaccharide vaccine followed by the introduction of polysaccharide pneumococcal vaccine after 8 weeks is given. It was shown that vaccination against pneumococcal infection resulted in elimination from sputum S. pneumoniae. Influenza vaccination in patients with bronchial asthma reduced the frequency and duration of exacerbations. Combined vaccination against influenza and pneumococcal infections did not reduce the clinical and immunological effect.

HIV-infection is a widespread and social importance disease. HIV-infection leads to secondary immunodeficiency and lower resistance to infectious diseases, such as influenza and pneumo coccal infection. In this regard, the relevant vaccination against pneumococcal infection and influenza in the risk group. According to research, 91% HIV-infected respond to the 23-valent pneumococcal polysaccharide vaccine (PKV23), and duration of immunity is 5 and more years. Vaccination against influenza had effect in 76% patients, it was lower, than in health control. This data suggests, that new vaccines and immunization scheme are needed.

Aim: to study the level of antibodies to strains of the influenza virus in trivalent vaccine, in pregnant women vaccinated in different trimester of the gestation. Materials and methods: according to CPMP criteria the level of postvaccinal antibodies to the strain of influenza A and B virus was determined by the hemagglutination inhibition reaction in sera of 48 women vaccinated in the second and third trimester of gestation. Results: in 1 month after vaccination against influenza in pregnant women the level of the seroprotection, seroconversion and the factor of the seroconversion increased in accordance with CPMP requirements. In six months after the birth, the protective titer of antibodies to different strains was registered in 30,4–70,2% of women wich was vaccinated in second trimester and 52,4–66,7% in the third trimester of gestation. Conclusion: the level of the postvaccination antibodies to influenza virus (except for the strain A / H3N2 / in vaccinated in the second trimester) in pregnant women met the criteria for CPMP irrespective of the trimester of gestation.

The review is devoted to the analysis of pertussis incidence of children in the age group of 5–7, as well as strategies of DTP immunization with the help of the drugs in foreign countries. Mass vaccination against pertussis began in the middle of the 20th century, which contributed to a reduction in incidence and mortality rate from this infection. However, in the last decade, there has been an opposite tendency of increasing incidence of patients among children under school age, school age and adults. Atypical forms of the disease and complications due to ARVI, respiratory mycoplasmosis and cytomegalovirus infections are described in the review. Various strategies for the use of whole-cell and acellular pertussis vaccines as part of DTP drugs are described, as well as the epidemiological effect of introducing an additional booster dose of vaccine to children under school age. The expediency of revaccination of children aged 6–7 in Russia is argued, which can help to reduce the overall incidence of pertussis. The research materials related to the study of the properties of acellular anti-pertussis vaccine, such as immunogenicity and safety in comparison with whole-cell vaccine, are analyzed. The main drugs and their composition, which are used to vaccinate children against pertussis, are described in the review. It is assumed, that the increase in the incidence among children and teenagers, with the appearance of atypical forms of pertussis, is associated with a number of factors, such as the spread of new genotypes of Bordetella pertussis bacterium, emerged from mutations, as well as short duration of immunity after vaccination with acellular drugs, in comparison with whole-cell, and the use of more modern methods of detecting the pathogen. The mechanisms of the immune response due to different types of pertussis vaccines are also reviewed. It is concluded, that revaccination of children aged 6–7 with an additional fifth dose of an acellular vaccine against pertussis, as part of the DTaP instead of the Td drug, which is regulated in the National Calendar of preventive vaccinations, will have a favorable effect on the epidemic situation with pertussis infection in Russia.