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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.

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.

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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.


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