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В настоящее время риск усиления циркуляции вакцинородственных полиовирусов и связанных с ними вспышек при низком уровне охвата прививками на фоне применения оральной вакцины осложняется еще и военными действиями в стране, приводящими к разрушению инфраструктур городов и населенных пунктов, интенсивной миграции и эвакуации населения. Украины, так и в регионы, где отсутствуют активные боевые действия (Черновицкая, Закарпатская, Львовская, Волынская обл.). Именно в этих областях отмечались самые низкие уровни вакцинации против полиомиелита в 2021 году.

Treatment with corticosteroids (especially prednisolone ≥20 mg/day or equivalent) is associated with an increased risk of infection. However, it is unclear whether corticosteroid therapy is associated with an increased risk of developing COVID-19 or its complications. Data on budesonide, a topical corticosteroid with low systemic bioavailability, show that these drugs are associated with significantly fewer side effects compared to systemic corticosteroids and their side effects are close to placebo. If possible, corticosteroids should be avoided and a rapid dose reduction considered, and a switch to budesonide is recommended. This must be taken into account, taking into account the risk of exacerbation of CKD. If a patient with COPD is in contact with a person with COVID-19 or develops COVID-19, it is recommended to gradually reduce the dose of corticosteroids, the use of budesonide is preferred, but taking into account the severity of COPD and the risk of exacerbation.

In 2021, in Ukraine, vaccination coverage rates for children under 1 year of age against such infections as tuberculosis, measles, whooping cough, diphtheria, poliomyelitis, hepatitis B, etc. ranged from 78% to 80.1% (with the required level >90 %), which is undoubtedly not enough to recognize the epidemic situation under control. In particular, this figure for 3 vaccinations against polio at the age of up to 1 year was 80.1%, 5 vaccinations at the age of 6 years received only 78.4% of children. At the same time, vaccination coverage rates varied widely across regions. In 12 regions, among children under 1 year old, they were <80% and ranged from 68.5% to 73.9%, and among children under 18 months. (4 vaccinations) - 66% to 73%. That is, almost 20-30% of children did not receive routine vaccination against poliomyelitis due to age in the above target groups, subject to vaccination according to the Immunization Schedule.

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Experts refer to the third category of skin manifestations as pink lichen and papulosquamous rashes, which are infectious-allergic skin lesions associated with COVID-19 infection. The clinical feature of pink lichen in this case is the absence of maternal plaque. The fourth category includes a measles rash. To the fifth - toxicodermia. This rash is associated with individual intolerance of patients of certain groups of drugs. The sixth category of skin manifestations of coronavirus infection, scientists include urticaria, which in some cases may be a harbinger of the onset of COVID-19.


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