Sep 17, 2020
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Should I wait for an imported influenza vaccine or be vaccinated with a Russian one?

This year, the supply of foreign drugs is noticeably delayed: they will not arrive in private clinics until mid-October - early November. This means that supporters of imported vaccines can get vaccinated during the height of the flu season. Is it worth the risk and wait or is it better to deliver the domestic vaccine? Experts differ.

Ekaterina Evchenko

Background to the issue

The traditional vaccination campaign started in Russia on September 1. At the expense of the federal budget, it is planned to vaccinate at least 60% of Russians with coverage of up to 75% of people from risk groups. This year's influenza vaccination is of particular importance as seasonal infection and coronavirus are expected to circulate simultaneously. The flu shot does not protect against COVID-19, but it can reduce the risk of a severe illness as other infections can potentially worsen the disease. To minimize possible risks, this year the World Health Organization is recommending that quadrivalent vaccines containing four different strains of the virus be placed in the Northern Hemisphere.

As before, the Russian-made vaccine can be delivered free of charge at the nearest vaccination office, while the imported drug will be delivered to you in a private clinic and at your own expense. However, this year, even private medical institutions offer only two domestic vaccines: Grippol Plus and Sovigripp. In mid-September, the Russian Ultrix Quadri is expected to arrive. French "Vaxigripp" and Dutch "Influvac" will have to wait this year: deliveries are expected no earlier than mid-October - early November. Many private clinics already distribute vaccines by pre-order, which means that it will be difficult to get imported vaccines even when they are available.

Why are vaccines delayed?

As RBC found out, the delay in the delivery of imported vaccines is due to the fact that imported drugs are not involved in government purchases, and the commercial market for foreign manufacturers is too small. Note that it is not the first time that foreign vaccines arrive in Russia: for example, in 2018, Vaxigripp was delivered to private clinics and pharmacies only by the end of September, and Influvac was not available at all due to the heavy workload of production in the Netherlands. Last year, foreign vaccines also arrived in Russia with a noticeable delay. Obviously, against the backdrop of the coronavirus pandemic, this situation has become more visible and alarming for anyone interested in maximum protection from influenza.

Is there a difference?

The position of the state on this issue is more than unambiguous: put on the Russian vaccine and do not worry that it is less effective than imported analogues.

“There is no fundamental difference between Russian and foreign vaccines. All of them are produced according to the WHO recommendations, which are based on an analysis of the characteristics of the circulation of strains, "Tatiana Ruzhentsova, head of the clinical research department of the Central Research Institute of Epidemiology of Rospotrebnadzor, told MedPortal.

However, according to a number of experts, Russians are not just chasing imported vaccines for nothing:

“Imported drugs are better purified and the dosage of viruses in them is more accurate: for example, our vaunted Ultrix is ​​packed with 15 ± 2.2 μg of each virus strain, and in Influvac - exactly 15 μg. Naturally, production and statistics abroad are more transparent and an order of magnitude better controlled than in Russia. But by and large, a particular vaccine has no serious competitive advantages: none protects against all circulating strains. Therefore, now the number of strains that are included in the preparation comes to the fore. If there is an opportunity to vaccinate a 4-component vaccine, this strategy is better than getting any 3-component vaccine, including imported ones, ”wrote the author of the vaccination blog, science journalist Anna Remish.

“So what do we know about Russian vaccines? Roughly - we don't know anything. We know that Sovigripp and Grippol Plus contain 3 times less antigens than imported vaccines. This is a good saving. This pure greed is justified by the addition of immunomodulators (drugs with an unknown profile of effectiveness and safety, but more likely harmful than useful). Supposedly, they enhance the immune response, and a smaller amount of antigens should also be enough. This is an unfounded claim, because there is no evidence of this from extensive research. We do not know what the effectiveness of these vaccines is, but the worse is that we cannot be sure of their safety, ”wrote the leading specialist of GSM Clinic, pediatrician Fedor Katasonov on his Facebook page.

The doctor noted that the situation with "Ultrix" is not much better, since there is also not enough data on the effectiveness and safety of the drug, but doctors still recommend it based on "technical characteristics" - the antigen in this drug is the same as in imported vaccines.

“Therefore, by transferring their properties to Ultrix, we believe that it will be effective. And we are confident that immunization with such a vaccine is better than no immunization at all, ”the doctor concluded.

Wait or get vaccinated now?

There is no unequivocal answer to this question and everyone will have to make a decision independently. According to Anna Remish, on the one hand, the earlier you get vaccinated, the faster antibodies will develop before the start of the epidemic season.

“On the other hand, the adjuvant“ Sovidon ”does not inspire confidence in many, including me. In addition, the epidemic season in our country lasts at least until the end of March, so there is a small probability that the early vaccination will not "make it" until this time (however, this risk should not be greatly overestimated), the expert said. - As for Sovigripp itself, it cannot be said that it was somehow particularly ineffective or reactogenic. In general, all influenza vaccines have +/- similar efficacy. Therefore, if you have no complaints about Sovidon and the fact that because of it, the vaccine contains a reduced amount of each strain, I will not find a compelling reason why you should not vaccinate Sovigripp.

Fedor Katasonov believes that doctors who advocate evidence-based medicine cannot recommend Sovigripp and Grippol Plus due to lack of information. On the other hand, they have been massively used for several years without obvious problems.

“We understand that in general, vaccines are safe, and we have no reason to think that these vaccines can be particularly harmful in any way. And the number of immunomodulators in them is tiny, less than the standard doses prescribed in polyclinics. On the third hand, many of the currently illicit drugs have been and are being used for decades, and for many years no one realized that they hurt rather than help - until evidence-based medicine intervened. Therefore, you cannot trust personal feelings and experience here. On the fourth hand, the effectiveness of these vaccines, although not proven, is not at all excluded. There is a nonzero probability that some Grippol is actually more effective than Ultrix - we just don't know that, ”the expert said.

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