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Акушерские и перинатальные исходы после вакцинации против гриппа или перенесенной респираторной инфекции
Акушерские и перинатальные исходы после вакцинации против гриппа или перенесенной респираторной инфекции
Костинов М.П., Черданцев А.П., Семенова С.С. и др. Сравнительный анализ акушерских и перинатальных исходов после вакцинации беременных против гриппа и перенесенной респираторной инфекции. Гинекология. 2015; 17 (4): 43–46.
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Аннотация
Цель исследования. Проведение анализа течения беременности, перинатальных исходов у вакцинированных против гриппа беременных, перенесших острую респираторную инфекцию (ОРИ).
Материалы и методы. Проведено многоцентровое сравнительное исследование среди 2 групп беременных (108 женщин), вакцинированных против гриппа препаратами Гриппол плюс и Агриппал S1; 2 групп плацебо (93 беременных); 185 беременных с и без (135) ОРИ в сезон 2009–2010 гг.
Применяли клинические, инструментальные, иммунологические, статистические методы исследования.
Результаты. Доказано, что иммунизация с использованием субъединичных инактивированных вакцин на II и III триместрах беременности сопровождается развитием местных реакций в 8–9% случаев, не оказывает влияния на клиническое течение беременности, внутриутробное развитие плода. Респираторные инфекции приводят к увеличению частоты тяжелых акушерских патологий (плацентарная недостаточность субкомпенсированная – 49,6%, хроническая гипоксия плода – 49,6%, гестоз – 35,5% и др.), не отмеченные ни в одном случае среди групп вакцинированных. В раннем неонатальном периоде среди детей от привитых матерей период адаптации был сопоставим или даже выше в группе плацебо, 8–9 баллов по шкале Апгар отмечены в 87,5 и 82,8% случаев. В группе детей от беременных с ОРИ в отличие от привитых матерей нарушение периода адаптации, церебральная ишемия 1-й степени, неонатальная гипербилирубинемия регистрировались соответственно в 57,0; 47,0 и 21,5% случаев против 12,5–12,1; 6,9–6,3 и 0% случаев.
Заключение. Вакцинация беременных на II и III триместрах гестации с применением субъединичной иммуноадъювантной (Гриппол плюс) и безадъювантной (Агриппал S1) вакцины не оказывает влияния на течение беременности и раннего неонатального периода.
Ключевые слова: вакцина против гриппа, вакцинация беременных, исходы родов у вакцинированных, неонатальный период.
Material and methods. A comparative study of 108 pregnant women, vaccinated against influenza with vaccines Grippol® plus and Agrippal S1, and 93 unvaccinated; as well as study of 185 pregnant women (50 of whom had experienced ARI during pregnancy, 135 – not) during the 2009–2010 influenza pandemic. Were applied clinical, instrumental, immunological, statistical methods.
Results. It has been proven that immunization with inactivated subunit vaccines in the second and third trimester does not impact on the clinical course of pregnancy or the intrauterine growth of fetus. Respiratory infections result in increased frequency of obstetrics pathologies (subcompensated placental insufficiency 49.6%, chronic fetal hypoxia 49.6%, gestosis 35.5% and other). Adaptation in the early neonatal period among infants born to the vaccinated women is comparable to that of infants from the placebo group.
The infants born to the women having a history of ARI were 3 times or more frequent to have impaired adaptation, grade I cerebral ischemia, neonatal hyperbilirubinemia.
Conclusion. Vaccination of pregnant women in the II and III trimester of gestation with immunoadjuvant and unadjuvanted subunit influenza vaccine does not affect the course of pregnancy and the early neonatal period.
Key words: influenza vaccine, vaccination during pregnancy, birth outcomes in vaccinated, neonatal period.
Материалы и методы. Проведено многоцентровое сравнительное исследование среди 2 групп беременных (108 женщин), вакцинированных против гриппа препаратами Гриппол плюс и Агриппал S1; 2 групп плацебо (93 беременных); 185 беременных с и без (135) ОРИ в сезон 2009–2010 гг.
Применяли клинические, инструментальные, иммунологические, статистические методы исследования.
Результаты. Доказано, что иммунизация с использованием субъединичных инактивированных вакцин на II и III триместрах беременности сопровождается развитием местных реакций в 8–9% случаев, не оказывает влияния на клиническое течение беременности, внутриутробное развитие плода. Респираторные инфекции приводят к увеличению частоты тяжелых акушерских патологий (плацентарная недостаточность субкомпенсированная – 49,6%, хроническая гипоксия плода – 49,6%, гестоз – 35,5% и др.), не отмеченные ни в одном случае среди групп вакцинированных. В раннем неонатальном периоде среди детей от привитых матерей период адаптации был сопоставим или даже выше в группе плацебо, 8–9 баллов по шкале Апгар отмечены в 87,5 и 82,8% случаев. В группе детей от беременных с ОРИ в отличие от привитых матерей нарушение периода адаптации, церебральная ишемия 1-й степени, неонатальная гипербилирубинемия регистрировались соответственно в 57,0; 47,0 и 21,5% случаев против 12,5–12,1; 6,9–6,3 и 0% случаев.
Заключение. Вакцинация беременных на II и III триместрах гестации с применением субъединичной иммуноадъювантной (Гриппол плюс) и безадъювантной (Агриппал S1) вакцины не оказывает влияния на течение беременности и раннего неонатального периода.
Ключевые слова: вакцина против гриппа, вакцинация беременных, исходы родов у вакцинированных, неонатальный период.
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Material and methods. A comparative study of 108 pregnant women, vaccinated against influenza with vaccines Grippol® plus and Agrippal S1, and 93 unvaccinated; as well as study of 185 pregnant women (50 of whom had experienced ARI during pregnancy, 135 – not) during the 2009–2010 influenza pandemic. Were applied clinical, instrumental, immunological, statistical methods.
Results. It has been proven that immunization with inactivated subunit vaccines in the second and third trimester does not impact on the clinical course of pregnancy or the intrauterine growth of fetus. Respiratory infections result in increased frequency of obstetrics pathologies (subcompensated placental insufficiency 49.6%, chronic fetal hypoxia 49.6%, gestosis 35.5% and other). Adaptation in the early neonatal period among infants born to the vaccinated women is comparable to that of infants from the placebo group.
The infants born to the women having a history of ARI were 3 times or more frequent to have impaired adaptation, grade I cerebral ischemia, neonatal hyperbilirubinemia.
Conclusion. Vaccination of pregnant women in the II and III trimester of gestation with immunoadjuvant and unadjuvanted subunit influenza vaccine does not affect the course of pregnancy and the early neonatal period.
Key words: influenza vaccine, vaccination during pregnancy, birth outcomes in vaccinated, neonatal period.
Полный текст
Список литературы
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12. WHO SAGE Working Group. Background Paper on Influenza Vaccines and Immunization 2012: p. 9–13.
13. Englund JA, Mbawuike IN, Hammill H et al. Maternal Immunization with Influenza or Tetanus Toxoid Vaccine for Passive Antibody Protection in Young Infants. J Infect Dis1993; 168 (3): 647–56.
14. Deinard AS, Jr. Ogburn P. A/NJ/8/76 influenza vaccination program: effects on maternal health and pregnancy outcome. Am J Obstet Gynecol 1981; 140 (3): 240–5.
15. Murray DL, Imagava DT, Okada DM, Jr. St. Geme JW. Antibody response to monovalent A/New Jersey/8/76 influenza vaccine in pregnant women. J Clin Microbiol 1979; 10 (2): 184–7.
16. Sumaya CV, Gibbs RS. Immunization of pregnant women with influenza A/New Jersey/76 virus vaccine: reactogenicity and immunogenicity in mother and infant. J Infect Dis 1979; 140 (2): 141–6.
17. Steinhoff MC, Omer SB, Roy E et al. Influenza Immunization in Pregnancy – Antibody Responses in Mothers and Infants. N Engl J Med 2010; 362 (17): 1644–6.
18. Puleston RL, Bugg G, Hoschler K et al. Observational study to investigate vertically acquired passive immunity in babies of mothers vaccinated against H1N1v during pregnancy. Health Technol Assess 2010; 14 (55): 1–82.
19. Zaman K, Roy E, Arifeen SE et al. Effectiveness of Maternal Influenza Immunization in Mothers and Infants. N Engl J Med 2008; 359 (15): 1555–64.
20. Poehling KA, Szilagyi PG, Staat MA et al. Impact of maternal immunization on influenza hospitalizations in infants. Am J Obstet Gynecol 2012; 204 (Suppl. 6): S141–S148.
21. Тарбаева Д.А., Костинов М.П., Загородняя Э.Д. и др. Клиническое течение и исходы гриппа А (H1N1) 2009 у беременных. Акушерство и гинекология. 2012; 2: 67–71. / Tarbaeva D.A., Kostinov M.P., Zagorodniaia E.D. i dr. Klinicheskoe techenie i iskhody grippa A (H1N1) 2009 u beremennykh. Akusherstvo i ginekologiia. 2012; 2: 67–71. [in Russian]
22. Макаров О.В., Алешкина В.А., Савченко Т.Н. Инфекции в акушерстве и гинекологии. М.: МЕДпресс-информ, 2007. / Makarov O.V., Aleshkina V.A., Savchenko T.N. Infektsii v akusherstve i ginekologii. M.: MEDpress-inform, 2007. [in Russian]
2. Jamieson DJ, Honein MA, Rasmussen SA et al. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet 2009; 374 (9688): 451–8.
3. Ortiz JR, Englund JA, Neuzil KM. Influenza vaccine for pregnant women in resource-constrained countries: A review of the evidence to inform policy decisions. Vaccine 2011; 29 (27): 4439–52.
4. Fuhrman C, Bonmarin I, Paty AC et al. Severe hospitalised 2009 pandemic influenza A(H1N1) cases in France, 1 July – 15 November 2009. Euro Surveillance 2010; 15 (2): 133–8.
5. Glezen WP, Taber HL, Frank LA et al. Influenza virus infections in infants. Pediatr Infect Dis J 1997; 16 (11): 1065–8.
6. Pebody RG, McLean E, Zhao H et al. Pandemic Influenza A (H1N1) 2009 and mortality in the United Kingdom: risk factors for death, April 2009 to March 2010. Euro Surveillance 2010; 15 (20): 1333–40.
7. McNeil SA, Dodds LA, Fell DB et al. Effect of respiratory hospitalization during pregnancy on infant outcomes. Ame J Obstet Gynecol 2011; 204 (Suppl. 6): S54–S57.
8. Centers for Disease Control and Prevention (CDC). Guidelines for Vaccinating Pregnant Women from the Advisory Committee for Immunization Practices (ACIP), March 2012: p. 1–13.
9. Centers for Disease Control and Prevention (CDC). General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report 2011; 60 (2): 26–7.
10. Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report 2010; 59: 1–62.
11. Blanchard-Rohner G, Siegrist CA. Vaccination during pregnancy to protect infants against influenza: why and why not? Vaccine 2011; 29 (43): 7542–50.
12. WHO SAGE Working Group. Background Paper on Influenza Vaccines and Immunization 2012: p. 9–13.
13. Englund JA, Mbawuike IN, Hammill H et al. Maternal Immunization with Influenza or Tetanus Toxoid Vaccine for Passive Antibody Protection in Young Infants. J Infect Dis1993; 168 (3): 647–56.
14. Deinard AS, Jr. Ogburn P. A/NJ/8/76 influenza vaccination program: effects on maternal health and pregnancy outcome. Am J Obstet Gynecol 1981; 140 (3): 240–5.
15. Murray DL, Imagava DT, Okada DM, Jr. St. Geme JW. Antibody response to monovalent A/New Jersey/8/76 influenza vaccine in pregnant women. J Clin Microbiol 1979; 10 (2): 184–7.
16. Sumaya CV, Gibbs RS. Immunization of pregnant women with influenza A/New Jersey/76 virus vaccine: reactogenicity and immunogenicity in mother and infant. J Infect Dis 1979; 140 (2): 141–6.
17. Steinhoff MC, Omer SB, Roy E et al. Influenza Immunization in Pregnancy – Antibody Responses in Mothers and Infants. N Engl J Med 2010; 362 (17): 1644–6.
18. Puleston RL, Bugg G, Hoschler K et al. Observational study to investigate vertically acquired passive immunity in babies of mothers vaccinated against H1N1v during pregnancy. Health Technol Assess 2010; 14 (55): 1–82.
19. Zaman K, Roy E, Arifeen SE et al. Effectiveness of Maternal Influenza Immunization in Mothers and Infants. N Engl J Med 2008; 359 (15): 1555–64.
20. Poehling KA, Szilagyi PG, Staat MA et al. Impact of maternal immunization on influenza hospitalizations in infants. Am J Obstet Gynecol 2012; 204 (Suppl. 6): S141–S148.
21. Tarbaeva D.A., Kostinov M.P., Zagorodniaia E.D. i dr. Klinicheskoe techenie i iskhody grippa A (H1N1) 2009 u beremennykh. Akusherstvo i ginekologiia. 2012; 2: 67–71. [in Russian]
22. Makarov O.V., Aleshkina V.A., Savchenko T.N. Infektsii v akusherstve i ginekologii. M.: MEDpress-inform, 2007. [in Russian]
2. Jamieson DJ, Honein MA, Rasmussen SA et al. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet 2009; 374 (9688): 451–8.
3. Ortiz JR, Englund JA, Neuzil KM. Influenza vaccine for pregnant women in resource-constrained countries: A review of the evidence to inform policy decisions. Vaccine 2011; 29 (27): 4439–52.
4. Fuhrman C, Bonmarin I, Paty AC et al. Severe hospitalised 2009 pandemic influenza A(H1N1) cases in France, 1 July – 15 November 2009. Euro Surveillance 2010; 15 (2): 133–8.
5. Glezen WP, Taber HL, Frank LA et al. Influenza virus infections in infants. Pediatr Infect Dis J 1997; 16 (11): 1065–8.
6. Pebody RG, McLean E, Zhao H et al. Pandemic Influenza A (H1N1) 2009 and mortality in the United Kingdom: risk factors for death, April 2009 to March 2010. Euro Surveillance 2010; 15 (20): 1333–40.
7. McNeil SA, Dodds LA, Fell DB et al. Effect of respiratory hospitalization during pregnancy on infant outcomes. Ame J Obstet Gynecol 2011; 204 (Suppl. 6): S54–S57.
8. Centers for Disease Control and Prevention (CDC). Guidelines for Vaccinating Pregnant Women from the Advisory Committee for Immunization Practices (ACIP), March 2012: p. 1–13.
9. Centers for Disease Control and Prevention (CDC). General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report 2011; 60 (2): 26–7.
10. Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report 2010; 59: 1–62.
11. Blanchard-Rohner G, Siegrist CA. Vaccination during pregnancy to protect infants against influenza: why and why not? Vaccine 2011; 29 (43): 7542–50.
12. WHO SAGE Working Group. Background Paper on Influenza Vaccines and Immunization 2012: p. 9–13.
13. Englund JA, Mbawuike IN, Hammill H et al. Maternal Immunization with Influenza or Tetanus Toxoid Vaccine for Passive Antibody Protection in Young Infants. J Infect Dis1993; 168 (3): 647–56.
14. Deinard AS, Jr. Ogburn P. A/NJ/8/76 influenza vaccination program: effects on maternal health and pregnancy outcome. Am J Obstet Gynecol 1981; 140 (3): 240–5.
15. Murray DL, Imagava DT, Okada DM, Jr. St. Geme JW. Antibody response to monovalent A/New Jersey/8/76 influenza vaccine in pregnant women. J Clin Microbiol 1979; 10 (2): 184–7.
16. Sumaya CV, Gibbs RS. Immunization of pregnant women with influenza A/New Jersey/76 virus vaccine: reactogenicity and immunogenicity in mother and infant. J Infect Dis 1979; 140 (2): 141–6.
17. Steinhoff MC, Omer SB, Roy E et al. Influenza Immunization in Pregnancy – Antibody Responses in Mothers and Infants. N Engl J Med 2010; 362 (17): 1644–6.
18. Puleston RL, Bugg G, Hoschler K et al. Observational study to investigate vertically acquired passive immunity in babies of mothers vaccinated against H1N1v during pregnancy. Health Technol Assess 2010; 14 (55): 1–82.
19. Zaman K, Roy E, Arifeen SE et al. Effectiveness of Maternal Influenza Immunization in Mothers and Infants. N Engl J Med 2008; 359 (15): 1555–64.
20. Poehling KA, Szilagyi PG, Staat MA et al. Impact of maternal immunization on influenza hospitalizations in infants. Am J Obstet Gynecol 2012; 204 (Suppl. 6): S141–S148.
21. Тарбаева Д.А., Костинов М.П., Загородняя Э.Д. и др. Клиническое течение и исходы гриппа А (H1N1) 2009 у беременных. Акушерство и гинекология. 2012; 2: 67–71. / Tarbaeva D.A., Kostinov M.P., Zagorodniaia E.D. i dr. Klinicheskoe techenie i iskhody grippa A (H1N1) 2009 u beremennykh. Akusherstvo i ginekologiia. 2012; 2: 67–71. [in Russian]
22. Макаров О.В., Алешкина В.А., Савченко Т.Н. Инфекции в акушерстве и гинекологии. М.: МЕДпресс-информ, 2007. / Makarov O.V., Aleshkina V.A., Savchenko T.N. Infektsii v akusherstve i ginekologii. M.: MEDpress-inform, 2007. [in Russian]
________________________________________________
2. Jamieson DJ, Honein MA, Rasmussen SA et al. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet 2009; 374 (9688): 451–8.
3. Ortiz JR, Englund JA, Neuzil KM. Influenza vaccine for pregnant women in resource-constrained countries: A review of the evidence to inform policy decisions. Vaccine 2011; 29 (27): 4439–52.
4. Fuhrman C, Bonmarin I, Paty AC et al. Severe hospitalised 2009 pandemic influenza A(H1N1) cases in France, 1 July – 15 November 2009. Euro Surveillance 2010; 15 (2): 133–8.
5. Glezen WP, Taber HL, Frank LA et al. Influenza virus infections in infants. Pediatr Infect Dis J 1997; 16 (11): 1065–8.
6. Pebody RG, McLean E, Zhao H et al. Pandemic Influenza A (H1N1) 2009 and mortality in the United Kingdom: risk factors for death, April 2009 to March 2010. Euro Surveillance 2010; 15 (20): 1333–40.
7. McNeil SA, Dodds LA, Fell DB et al. Effect of respiratory hospitalization during pregnancy on infant outcomes. Ame J Obstet Gynecol 2011; 204 (Suppl. 6): S54–S57.
8. Centers for Disease Control and Prevention (CDC). Guidelines for Vaccinating Pregnant Women from the Advisory Committee for Immunization Practices (ACIP), March 2012: p. 1–13.
9. Centers for Disease Control and Prevention (CDC). General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report 2011; 60 (2): 26–7.
10. Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report 2010; 59: 1–62.
11. Blanchard-Rohner G, Siegrist CA. Vaccination during pregnancy to protect infants against influenza: why and why not? Vaccine 2011; 29 (43): 7542–50.
12. WHO SAGE Working Group. Background Paper on Influenza Vaccines and Immunization 2012: p. 9–13.
13. Englund JA, Mbawuike IN, Hammill H et al. Maternal Immunization with Influenza or Tetanus Toxoid Vaccine for Passive Antibody Protection in Young Infants. J Infect Dis1993; 168 (3): 647–56.
14. Deinard AS, Jr. Ogburn P. A/NJ/8/76 influenza vaccination program: effects on maternal health and pregnancy outcome. Am J Obstet Gynecol 1981; 140 (3): 240–5.
15. Murray DL, Imagava DT, Okada DM, Jr. St. Geme JW. Antibody response to monovalent A/New Jersey/8/76 influenza vaccine in pregnant women. J Clin Microbiol 1979; 10 (2): 184–7.
16. Sumaya CV, Gibbs RS. Immunization of pregnant women with influenza A/New Jersey/76 virus vaccine: reactogenicity and immunogenicity in mother and infant. J Infect Dis 1979; 140 (2): 141–6.
17. Steinhoff MC, Omer SB, Roy E et al. Influenza Immunization in Pregnancy – Antibody Responses in Mothers and Infants. N Engl J Med 2010; 362 (17): 1644–6.
18. Puleston RL, Bugg G, Hoschler K et al. Observational study to investigate vertically acquired passive immunity in babies of mothers vaccinated against H1N1v during pregnancy. Health Technol Assess 2010; 14 (55): 1–82.
19. Zaman K, Roy E, Arifeen SE et al. Effectiveness of Maternal Influenza Immunization in Mothers and Infants. N Engl J Med 2008; 359 (15): 1555–64.
20. Poehling KA, Szilagyi PG, Staat MA et al. Impact of maternal immunization on influenza hospitalizations in infants. Am J Obstet Gynecol 2012; 204 (Suppl. 6): S141–S148.
21. Tarbaeva D.A., Kostinov M.P., Zagorodniaia E.D. i dr. Klinicheskoe techenie i iskhody grippa A (H1N1) 2009 u beremennykh. Akusherstvo i ginekologiia. 2012; 2: 67–71. [in Russian]
22. Makarov O.V., Aleshkina V.A., Savchenko T.N. Infektsii v akusherstve i ginekologii. M.: MEDpress-inform, 2007. [in Russian]
Авторы
М.П.Костинов*1, А.П.Черданцев2, С.С.Семенова3, Д.А.Тарбаева4, А.А.Сависько5, О.Ф.Серова6,7, С.А.Иозефсон4, Н.К.Ахматова1, Т.А.Костинова1, Д.А.Праулова7
1. ФГБНУ НИИ вакцин и сывороток им. И.И.Мечникова. 105064, Россия, Москва, Малый Казенный пер., д. 5а;
2. ФГБОУ ВПО Ульяновский государственный университет. 432700, Россия, Ульяновск, пл. 100-летия со дня рождения В.И.Ленина, д. 4;
3. ГБУЗ Городская поликлиника №45 Департамента здравоохранения г. Москвы. 125171, Россия, Москва, ул. 1-я Радиаторская, д. 5;
4. ГБОУ ВПО Читинская государственная медицинская академия Минздрава России. 672090, Россия, Чита, ул. Новобульварная, д. 163;
5. ГБОУ ВПО Ростовский государственный медицинский университет Минздрава России. 344022, Россия, Ростов-на-Дону, Нахичеванский пер., д. 29;
6. ГБУЗ МО Московский областной перинатальный центр. 143900, Россия, Балашиха, ш. Энтузиастов, д. 12;
7. ФГБУ ГНЦ РФ Федеральный медицинский биофизический центр им. А.И.Бурназяна ФМБА России;
8. ФГБУ Федеральный научно-клинический центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева Минздрава России. 117997, Россия, Москва, ул. Саморы Машела, д. 1
*vaccinums@gmail.com
1. I.I.Mechnikov Research Institute of Vaccines and Sera. 105064, Russian Federation, Moscow, Malyi Kazennyi per., d. 5a;
2. Ulyanovsk State University. 432700, Russian Federation, Ulyanovsk, pl. 100-letiia so dnia rozhdeniia V.I.Lenina, d. 4;
3. Сity Clinical Hospital №45 of the Department of Health of the Russian Federation. 125171, Russian Federation, Moscow, 1-ia Radiatorskaia, d. 5;
4. Chita State Medical Academy 672090, Russian Federation, Chita, ul. Gor'kogo, d. 39a;
5. Rostov State Medical University. 344022, Russian Federation, Rostov-on-Don, per. Nakhichevanskii, d. 29;
6. Moscow Regional Perinatal Center. 143900, Russian Federation, Balashikha, sh. Entuziastov, d. 12;
7. A.I.Burnazyan Federal Medical Biophysical Center. 123098, Russian Federation, Moscow, ul. Marshala Novikova, d. 23;
8. Dmitrii Rogachev Federal Research Center of Pediatric Hematology, Oncology and Immunology of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Samory Mashela, d. 1
*vaccinums@gmail.com
1. ФГБНУ НИИ вакцин и сывороток им. И.И.Мечникова. 105064, Россия, Москва, Малый Казенный пер., д. 5а;
2. ФГБОУ ВПО Ульяновский государственный университет. 432700, Россия, Ульяновск, пл. 100-летия со дня рождения В.И.Ленина, д. 4;
3. ГБУЗ Городская поликлиника №45 Департамента здравоохранения г. Москвы. 125171, Россия, Москва, ул. 1-я Радиаторская, д. 5;
4. ГБОУ ВПО Читинская государственная медицинская академия Минздрава России. 672090, Россия, Чита, ул. Новобульварная, д. 163;
5. ГБОУ ВПО Ростовский государственный медицинский университет Минздрава России. 344022, Россия, Ростов-на-Дону, Нахичеванский пер., д. 29;
6. ГБУЗ МО Московский областной перинатальный центр. 143900, Россия, Балашиха, ш. Энтузиастов, д. 12;
7. ФГБУ ГНЦ РФ Федеральный медицинский биофизический центр им. А.И.Бурназяна ФМБА России;
8. ФГБУ Федеральный научно-клинический центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева Минздрава России. 117997, Россия, Москва, ул. Саморы Машела, д. 1
*vaccinums@gmail.com
________________________________________________
1. I.I.Mechnikov Research Institute of Vaccines and Sera. 105064, Russian Federation, Moscow, Malyi Kazennyi per., d. 5a;
2. Ulyanovsk State University. 432700, Russian Federation, Ulyanovsk, pl. 100-letiia so dnia rozhdeniia V.I.Lenina, d. 4;
3. Сity Clinical Hospital №45 of the Department of Health of the Russian Federation. 125171, Russian Federation, Moscow, 1-ia Radiatorskaia, d. 5;
4. Chita State Medical Academy 672090, Russian Federation, Chita, ul. Gor'kogo, d. 39a;
5. Rostov State Medical University. 344022, Russian Federation, Rostov-on-Don, per. Nakhichevanskii, d. 29;
6. Moscow Regional Perinatal Center. 143900, Russian Federation, Balashikha, sh. Entuziastov, d. 12;
7. A.I.Burnazyan Federal Medical Biophysical Center. 123098, Russian Federation, Moscow, ul. Marshala Novikova, d. 23;
8. Dmitrii Rogachev Federal Research Center of Pediatric Hematology, Oncology and Immunology of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Samory Mashela, d. 1
*vaccinums@gmail.com
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