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The use of thiopurine (azathioprine and mercaptopurine) reduces the immune response to viruses, which is associated with an increased risk of opportunistic infections. There is limited evidence that they increase the risk of respiratory infections. The risks and benefits should be considered, but most patients can continue on a stable dose. In patients in stable remission, elderly patients and in the presence of concomitant pathology, it is recommended to stop taking thiopurine. During a pandemic, it is recommended to avoid starting thiopurine or increasing the dose, which will allow patients to avoid potential side effects. If the patient is in contact with a COVID-19 person, temporary withdrawal of thiopurine for 2 weeks should be considered. If a patient tests positive for SARS-CoV-2 and/or develops COVID-19, temporary discontinuation of thiopurine may be recommended until the patient clears the infection.

Back in 2002, according to the justification of the Institute, inactivated polio vaccine (IPV) was introduced into the Immunization Calendar of Ukraine for the 1st vaccination against poliomyelitis (children continued to receive OPV for the remaining 5 doses by age). In 2006, this vaccine was also used for the second vaccination. This made it possible to first reduce and then practically stop the cases of vaccine-associated paralytic poliomyelitis in Ukraine. Since then, the issue of switching to a full IPV vaccination scheme in Ukraine has been repeatedly raised, as has been practiced for many years in all European countries, the USA, Canada, and Australia. Currently, this problem is becoming even more urgent, given both the epidemic situation and the prospects for Ukraine's accession to the EU.

Both patients and doctors should be well aware of the need for long-term therapy with periodic monitoring of key indicators and the obligatory achievement of the so-called target levels of blood pressure, that is, stable normalization of blood pressure. Only such an approach to the treatment of patients with hypertension can give a successful result. But at present, as mentioned above, only a very small number of patients with hypertension are treated effectively. In this regard, there is no decrease in the frequency of complications of this disease in Ukraine.

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В 2021 г. в Украине уровни охвата прививками детей в возрасте до 1 года против таких инфекций, как туберкулез, корь, коклюш, дифтерия, полиомиелит, гепатит В и др. составляли от 78% до 80,1% (при необходимом уровне >90 %), что бесспорно недостаточно, чтобы признать эпидемическую ситуацию контролируемой. В частности, этот показатель относительно 3 прививок против полиомиелита в возрасте до 1 года составил 80,1%, 5 прививок в возрасте 6 лет получило только 78,4% детей. При этом уровни охвата прививками очень отличались по регионам. В 12 регионах среди детей до 1 года они были <80% и составляли от 68,5% до 73,9%, а среди детей до 18 мес. (4 прививки) – 66% до 73%. То есть практически 20-30% детей не получили по возрасту плановую вакцинацию против полиомиелита в вышеперечисленных целевых группах, подлежащих вакцинации согласно Календарю прививок.


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