The goal of the study was the identification of epidemiological features of whooping cough and assessment of economic losses due to this disease in Moscow.Materials and methods. The retrospective descriptive epidemiological research is conducted. The statistical data on incidence of whooping cough in the Russian Federation and in Moscow from 2009 to June, 2018, the reports on registration of whooping cough cases as well as the results of laboratory testing on whooping cough in Moscow in 2017 have been studied. The general losses from whooping cough in Moscow in 2017 have been calculated.Results. The whooping cough incidence in Moscow considerably influences a situation on this infection in the country in general as more than 20% of all cases of whooping cough in Russia are registered in the capital, where the incidence exceed by 1.5–2.5 times the average country level. The incidence of whooping cough among children of 7–14 years and the share of this group of population in the structure of the whooping cough cases have increased in Moscow, and outbreaks of pertussis at schools are observed. In Moscow the general losses due to whooping cough in children of 7–14 years in 2017 were estimated as 19.72 million rubles. High performance of vaccinal prevention of whooping cough is confirmed: in Moscow in 2017 the coefficient of epidemiological efficiency of vaccination among children of 6-12 months was 97.7%, among children at the age of 1 year – 82.6%, 2 years -79.9%, 3 years – 74.9%. Weighted average of direct loss from a case of whooping cough was estimated as 31182.2 rubles. The general losses due to whooping cough in Moscow in 2017 were 67.88 million rubles.Conclusion. It is necessary to take additional measures for vaccinal prevention of whooping cough at children of school age and to support the high level of coverage by timely immunization of children of the first year of life. For assessment of economic feasibility of vaccinal prevention of whooping cough it is necessary to consider the size of economic losses due to this disease.

Фармакоэкономика в педиатрии Обоснование. Как свидетельствует российский и зарубежный опыт, применение в рамках национального календаря профилактических прививок (НКПП) комбинированных вакцин снижает количество инъекций, повышая таким образом приверженность вакцинации и, как следствие, способствуя достижению более высокого охвата прививками. Цель исследования-фармакоэкономический анализ проведения плановой иммунизации детей от 3 до 18 мес комбинированной пятивалентной вакциной для профилактики дифтерии, коклюша, столбняка, полиомиелита, гемофильной инфекции типа b (АаКДС-ИПВ/Hib) в рамках НКПП Российской Федерации. Методы. Моделирование; экономические методы оценки: анализ затрат, анализ «влияния на бюджет». Результаты. При учете исключительно затрат системы здравоохранения сценарий с 4 плановыми прививками пятивалентной вакциной потребует расходования 1 013 955 985 руб. С позиции государства и общества, переход на использование комбинированной вакцины позволит сэкономить 1 825 385 700 руб. из расчета на всю популяцию детей от 3 до 18 мес за весь временной горизонт. Выводы. С позиции анализа «влияния на бюджет», переход с текущей схемы вакцинации к схеме с комбинированной вакциной при учете лишь затрат системы здравоохранения потребует дополнительного расхода средств. С учетом позиции государства и общества, то есть социальных и других расходов, не входящих в бюджет системы здравоохранения, применение схемы с вакцинацией всей когорты 4 дозами комбинированной вакцины позволит снизить финансовую нагрузку, связанную с бременем инфекционных заболеваний. Настоящий анализ показал целесообразность использования пятикомпонентной вакцины для всех детей в рамках отечественного национального календаря профилактических прививок.

The goal of study was the epidemiological substantiationof optimization measures of a vaccinal prevention of whooping cough in the Russian Federation. Materials and methods. The retrospective descriptive epidemiological research has been conducted by analysis of the official statistical data on the whooping cough case rate (form No. 2) in 2005–2017 in the Russian Federation, as well as the data about preventive whooping cough inoculations (forms No. 5, No. 6) in 2005–2017 and about epidemic outbreakes in 2017 (form No. 23-17). The assessment of an economic damage from whooping cough in 2005-2017 has been carried out. Results. The following adverse characteristics of a modern epidemiological situation on whooping cough in Russia are shown: long-term recurrence of epidemic process, tendency of rising of a case rate of children of 0-2 years; high percentage of children of preschool and school age among whooping cough cases; prevalence among the patients with whooping cough of the children who have been vaccinated against this infection previously, epidemic outbreakes in children’s collectives, the stability of a case rate of teenagers and adults with prevalence of the mild and the erased clinical forms of this infection. The risks due to weaknesses of the whooping cough vaccinal prevention are noted: the insufficient immunization coverage owing to falce contraindications and refusals of parents of vaccinations of children, noncompliance with terms and intervals between inoculations, lack of domestic vaccine for revaccination of children at the age of 5 years and older. Conclusion. It is necessary to introduce in the national vaccination schedule a preschool booster dose for children at the age of 6 and adolescents at 14 years with the combined reduced antigen content tetanus–diphtheria and acellular pertussis vaccines as well as the inoculations of this vaccine according to epidemiological indications to health workers, employees of educational institutions. A revaccination against whooping cough is recommended as “cocoon” for the persons contacting to not vaccinated child under 1 year of age.

Представлен зарубежный опыт оценки экономической эффективности ревакцинации против коклюша детей дошкольного возраста, подростков и взрослых. Показана экономическая целесообразность второй ревакцинации против коклюша в дошкольном/раннем школьном возрасте для снижения как прямых, так и косвенных затрат, ассоциированных с заболеванием коклюшем не только в ревакцинируемых возрастных группах, но и среди детей первых месяцев жизни за счет повышения уровня популяционного иммунитета к коклюшу. Приведены международные рекомендации по внедрению ревакцинирующих прививок против коклюша путем замены АДС-М на АакдС при проведении ревакцинаций в рамках национального календаря профилактических прививок.

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