How to Prepare for the Flu Vaccination During a Pandemic. What is important to know

In the fall, influenza vaccination is traditionally carried out. But this year it will go hand in hand with large-scale vaccination against COVID-19.. How this can be organized, what manufacturers and doctors say - in the material of RBC

When will the flu vaccination start?

Every year, the Ministry of Health announces the start of a flu vaccination campaign by a separate order. Last year it began on September 1, a year earlier - on September 4. According to RBC's source in the pharmaceutical market, this year the timing of the campaign may be adjusted in order to "distribute the load on the healthcare system as efficiently as possible, since now all capacities are working as a priority to combat COVID-19." But so far there is no information that the campaign will be postponed, RBC sources close to the capital's mayor's office told RBC. This means that, most likely, it will fall on the beginning of September, as always.

RBC sent inquiries to the Ministry of Health and the Moscow Department of Health.

How many vaccines will be available this year

The turnover on the Russian market is mainly domestic vaccines: Fort, NPO Microgen (both part of the National Immunobiological Company), Petrovax and the St. Petersburg Research Institute of Vaccines and Serums (SPbNIIVS) account for about 90% of the volume of vaccines in Russia, follows from DSM Group data.

This year, the vaccine from the French Sanofi will not go into circulation: the manufacturer Vaxigripp has stopped supplying this trivalent vaccine due to the complete transfer of the production of anti-flu vaccines in syringes to quadrivalent. And it is currently only undergoing the procedure of state registration.

The epidemiological situation with the spread of coronavirus provoked an increase in demand for influenza vaccination last year. According to Petrovax (which produces vaccines under the Grippol brand), in 2020 the demand for influenza vaccine in the commercial and budget segments of the market increased by 25% compared to 2019. Growth in demand is also noted in SPbNIIVS (produced by Flu-M). The upward trend continues into 2021.

“In the current epidemiological situation, the demand for influenza vaccines is steadily growing. People are becoming socially responsible, confidence in vaccination is growing as an effective way of immunoprophylaxis and health protection,” the SPbNIIVS noted, without naming the exact dynamics of demand.

Due to the demand for influenza vaccines, Petrovax plans to more than double the production of Grippol Plus in 2021 - this is more than 18 million doses (but this volume also provides for about 80% of the vaccine for export). Subjects will allocate 80% of this volume to state contracts within the framework of regional procurement.

Manufacturers do not expect interruptions in the production of vaccines. The SPbNIIV noted that the annual application for the volume of purchases of vaccines for the prevention of influenza has not yet been fully communicated to manufacturers, but the volume of purchases is forecast not lower than 2020 - 24-25 million doses. For the manufacturer, priority is given to deliveries to the public sector, to ensure the campaign within the framework of the National Immunization Calendar. As a rule, it is 90% or more of the total volume of the order.

“The production capacity of SPbNIIVS allows to produce up to 35 million doses per year, and taking into account the epidemiological situation in the country, we are ready to produce the necessary volume to cover the population of the country,” they said, adding that production is operating at full capacity.

The press service of Nacimbio (Rostec) told RBC that in 2020 the holding provided the supply of more than 80 million doses of vaccine for the needs of the Ministry of Health and other customers. In 2021, the holding's enterprises continue to increase production capacity. “As of the end of June, Nacimbio has already signed the first contracts for the supply of influenza vaccines in the 2021-2022 epidemic season. Like last year, the first deliveries of vaccines are scheduled for August.”

What insurance companies say

Last fall, at the height of the vaccination campaign, insurance companies faced a problem - Ultrix, one of the most popular vaccines, disappeared from the commercial sector and pharmacies. The capacities of its manufacturer were loaded under the state order.

According to Igor Lappi, general director of Sovcombank Insurance, this year's flu vaccination campaign will follow the 2020 scenario, "because the flu shot is quite popular" and "it is not mutually exclusive during a pandemic, since it is likely , allows you to form cross-immunity. “We don’t expect a fall (in demand for a vaccine - because everyone understands the importance of vaccination, especially those who have been ill with coronavirus and they already have quite serious delayed effects on the body.” The company plans to apply for the same number of vaccines as in the past year (taking into account the proportional growth of the insurer's portfolio), as well as to lay a reserve - 5-10% - for an increase in demand.

Ingosstrakh admits that due to the mass vaccination against COVID-19, the demand for influenza vaccination may shift to a later date. At the same time, both the representative of Inogostrakh and Sergey Korochkin, director of the business development department of the VMI AlfaStrakhovanie, believe that this year the flu vaccination will remain at the level of 2020.

It is too early to talk about potential difficulties with the campaign, says Nina Mikhailova, Head of the Department for Interaction with VHI Providers at RESO-Garantiya: “Problems usually arise much later: at the stages of accreditation of actually incoming batches of vaccines, shipment of vaccines, which begin to be missed due to disruptions delivery times. And it is often impossible to resolve and prevent these problems. Now we can assume the absence of imported vaccines on the market, which will cause dissatisfaction among customers.”

Is it possible to combine the vaccine against COVID-19 and the flu

The difference between flu shots and COVID-19 shots (as well as between a coronavirus shot and any other vaccination) must be at least 30 days. This recommendation, given last year by the Moscow authorities, is still relevant, according to RBC's source in the capital's depzdrav.

The coronavirus vaccine does not cancel the flu shot, explains Irina Dobretsova, head of the Healthy Lifestyle Development Center. “When the time is now for a coronavirus infection, any other infection can aggravate the course of this disease, there can be severe complications. If this is a mix of coronavirus infection and influenza, then it turns out that it can exacerbate the unfavorable course at times, ”she said. It is necessary to plan a personal vaccination calendar in such a way that a stable immunity has already developed by the seasonal surge of influenza in December-January. “It is necessary to first develop immunity to coronavirus infection, and then calmly, in the fall, vaccinate yourself against influenza and pneumococcus in advance,” the expert added.

Doctor of Biological Sciences, Professor of Virology Alexander Shestopalov said that at least two to three weeks should pass between injections so that the body "accepts both vaccines." According to the immunologist, Doctor of Medical Sciences Vladislav Zhemchugov, you should not get vaccinated against the flu between the first and second components of the COVID-19 vaccine.

Therapist, clinical pharmacologist Andrei Kondrakhin says that a pause between vaccinations is also needed in order to more clearly determine the effect of vaccines. “A person can write off the action, the manifestation of one vaccine for another, this can distort the information,” he said.

RBC turned for comment to the Center. N. F. Gamalei, the developer of the Sputnik V vaccine.

How it is planned to avoid mass infection with coronavirus during the flu vaccination

The Russian and Moscow authorities have not yet given an answer to this question. However, last year the World Health Association developed recommendations in this regard. Thus, it was proposed to create more vaccination points in the open air, to vaccinate at home or in pharmacies, during calls to the hospital for other reasons, as well as through quick service points without getting out of the car. In addition, patients should be assigned a clear time for vaccination, before which it is not recommended to enter the point. This will help avoid crowds, the organization said.