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Еще в 2002 г. по обоснованию Института в Календарь прививок Украины была введена инактивированная полиомиелитная вакцина (ИПВ) для 1-й прививки против полиомиелита (остальные 5 доз по возрасту дети продолжали получать ОПВ). В 2006 г. – эту вакцину начали применять и для второй прививки. Это позволило сначала снизить, а затем практически прекратить случаи вакциноассоциированного паралитического полиомиелита в Украине. С тех пор неоднократно поднимался вопрос перехода в Украину на полную схему вакцинации ИПВ, как это практикуется уже много лет во всех странах Европы, США, Канаде, Австралии. В настоящее время эта проблема приобретает еще большую актуальность, учитывая как эпидемическую ситуацию, так и перспективы вступления Украины в ЕС.
5-ASA preparations have very weak immunosuppressive activity. There are no reports that these drugs are associated with an increased risk of infection, and studies evaluating the safety profile of 5-ASA do not show an increased risk of serious or opportunistic infections. Treatment with 5-ASA should be continued without concern for an increased risk of infection or severe COVID-19. If the patient is in contact with a patient with COVID-19 or develops COVID-19, treatment with 5-ASA should be continued.
At present, the risk of increased circulation of vaccine-related polioviruses and associated outbreaks with a low level of vaccination coverage against the background of the use of an oral vaccine is also complicated by military operations in the country, leading to the destruction of the infrastructure of cities and towns, intensive migration and evacuation of the population. Ukraine, and to regions where there are no active hostilities (Chernivtsi, Transcarpathian, Lvov, Volyn regions). These areas were the ones with the lowest polio vaccination rates in 2021.
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.
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