Today we will learn what a medical exemption from vaccinations is, how to get it and why it is needed. This document may be extremely important. Therefore, you should not under any circumstances avoid registering it if the prerequisites exist for the process to take place. Vaccination may not go as smoothly as you would like if you neglect the medical procedure. So what kind of document is this?
What it is
A medical exemption is a document that provides a deferment for vaccination. Most often it is given to children. It confirms that the patient has contraindications for vaccination. Has a temporary effect.
Do not confuse medical withdrawal from vaccinations with refusing them. In the first case, this is an official medical document, in the second, it is the decision of the parents. Typically, this certificate is issued at the discretion of doctors. After this, the pediatrician draws up an individual vaccination schedule. And subsequent vaccinations will be done taking into account the availability of a medical outlet.
What is a medical outlet
The most active time for vaccination is the first year and a half of life. At this time, the baby still has little contact with other people, which means he has a low risk of infection and illness. After scheduled injections, the child’s body has enough time and energy to develop its own immune reactions to pathogens.
Of course, it is difficult to develop immunity if the child is already struggling with some disease. Therefore, during a period of deterioration in health, it is better to postpone the planned procedure until recovery. The doctor, together with the parents, decides to postpone or cancel planned medical procedures.
A contraindication for vaccination prescribed by a doctor for three or more months will be considered a medical exemption. Such a document is issued on the basis of the official list of medical contraindications approved in a particular country.
Contraindications vary depending on the duration:
- temporary: after the end of the medical withdrawal period, vaccinations are given according to an individual scheme;
- permanent: in this case, the withdrawal period is constantly extended, and parents need to be especially careful about maintaining the health of the baby.
Did you know? A medical exemption is not given forever. The document is issued for a period of three months to six months. Then two options are possible: a medical opinion that preventive vaccination is possible or an extension of the medical exemption for the next 6 months.
Who issues
Who should be responsible for issuing this document? It is not difficult to guess that this is done by medical institutions where this or that citizen is observed on an ongoing basis. It doesn’t have to be a public clinic, it can also be a private one. The main rule is regular monitoring of a person with contraindications to vaccination.
Most often, children are given a medical exemption from vaccinations after reviewing the tests and examination before the procedure. If the doctor suspects the presence of contraindications, he must give a medical advice. The certificate is issued absolutely free of charge and is issued very quickly. As practice shows, after the inspection is completed, you will have to produce a document - the basis.
When vaccination is prohibited: video
A well-known pediatrician answers a question that worries many parents: what diseases are a contraindication to vaccinations.
Of course, for general medical statistics, vaccination is a huge achievement of civilization. Thanks to her, such a deadly disease as smallpox completely disappeared, and child mortality from other diseases decreased hundreds of times. But when it comes to a specific child, only after a medical examination and tests can one have sufficient information about whether to give an injection or not. And although parents have the right and opportunity to avoid vaccinations, they should only do so if the risk from the vaccine outweighs the consequences of possible infection. What do you think? Share your thoughts in the comments.
Content
What is usually contained in the vaccine dispenser? Usually there is no special information here. Only information about the patient, the date the certificate was issued and the reason for the prohibition of vaccination. It is also worth paying attention to the fact that the doctor must write down the duration of the document’s validity. It is established in accordance with legal standards in Russia. The minimum term is a month, the maximum is lifelong medical withdrawal. By the way, the last option is extremely rare.
In some cases, children and adults are given a medical exemption from vaccinations for 2 weeks. For example, after a cold. But in practice, routine vaccination is most often postponed for 30 days.
The doctor fills out the appropriate form-certificate, puts his personal signature and the seal of the medical institution there - it’s done, you don’t have to be afraid of the next vaccination for some time. In some cases, it is necessary to assemble a consultation or an entire commission. In such circumstances, you will have to wait some time until a group of doctors decides what to do with vaccination.
How to obtain a medical exemption from vaccinations for an adult and a child
A medical exemption from vaccinations can only be issued in a medical institution by a doctor at the patient’s place of residence.
Where to apply
To take a medical tap, the patient must contact his local doctor. He will refer the patient to a specialized specialist who will prescribe additional examinations and tests. Based on them, a conclusion will be issued, according to which the pediatrician or therapist will already issue a certificate.
What does the certificate look like and what information does it contain?
The form of a certificate with a medical exemption from vaccination is similar to the usual one. The registration rules require that you indicate the following information:
- last name and first name of the patient who received a medical exemption;
- patient's date of birth;
- diagnosis;
- date of issue.
The certificate is issued at the request of the patient or his parents, if we are talking about a child. If it is necessary to submit a document to any institution, for example, an educational institution, its name must be indicated in the certificate.
A medical exemption will be considered valid only if the document contains the seal of the medical institution, the signatures of the pediatrician and members of the medical advisory commission.
Consilium and commission
For some diseases, a pediatrician or therapist can issue a medical certificate immediately, but in some cases a meeting of a council of doctors is required. We are talking about those cases when it is not possible to accurately establish a diagnosis or fully assess the risks of vaccination. In particular, the commission meets when:
- identifying the patient’s tendency to have seizures;
- pregnancy;
- the formation of a colloidal scar during the previous administration of the vaccine.
A council may meet to decide on the need for vaccination in patients with chronic diseases or diseases that are grounds for issuing a permanent medical exemption. The potential risk of vaccination and its benefits, possible consequences, and so on are assessed. The commission’s conclusion is also necessary to obtain a lifelong medical exemption from vaccination.
Temporary illnesses
Medical advice from vaccinations for adults and children is issued under the responsibility of medical personnel. Therefore, it is important to have contraindications to vaccination. Otherwise, issuing a certificate may be regarded as a violation of the laws of the country. What are the reasons for issuing a document to defer vaccination?
Some believe that a child’s poor condition on a given day is an excellent reason to obtain a medical exemption. But as practice shows, this is not at all the case. If the child is healthy, but today he does not feel well, you should not hope for a delay in vaccination. You must have valid reasons for obtaining a certificate.
Yes, a temporary illness can be a sign of serious health problems. But if the doctor does not see them, there is no obstacle to routine vaccinations. Parents themselves can write a temporary waiver of this procedure for a certain period of time.
Relative contraindications
Most often, the population is faced with relative reasons for delays in vaccination. We can say this is a temporary phenomenon. There are a lot of relative reasons; the enumeration can last a long time. But most often they include some deviations in the analyzes.
Do you need a medical exemption from vaccinations? The reasons why this certificate is temporarily issued are varied. These include:
- chickenpox;
- allergic reactions;
- acclimatization of the child;
- recent contact with any sick person.
The possible list of relative reasons for receiving a medical exemption does not end there. Just some points require more detailed consideration. So what should you pay attention to?
Temperature deviations
The most common scenario in which a medical exemption from vaccinations is issued for some time is when a person’s temperature deviates from the norm. Ideally, in humans it should be no higher than 36.6 Celsius. But as practice shows, vaccination is carried out at a temperature of 36 to 37 degrees. This is how things really are.
If a child has low energy or has a fever, he should not be vaccinated. But they may not even give you a medical referral—the doctors simply tell you to come back the next day to check the child’s condition. Maybe he just has a temporary loss of strength. Then you will immediately receive a routine vaccination.
As practice shows, sometimes even an elevated temperature does not bother doctors, and they do not delay vaccination. Only irresponsible cadres behave this way. Unfortunately, this behavior is not so rare. After all, low/high temperature is often considered a temporary phenomenon.
Vaccination against COVID-19: answering basic questions
Free COVID-19 vaccinations began in December. In the capital, 70 vaccination points have been opened at urban adult clinics. They work daily and will be open even on New Year and Christmas holidays. We have collected answers to the most popular questions from residents about vaccination.
Can people who have been ill get vaccinated and when?
There is no ban on vaccination against coronavirus for those who have recovered from the disease. A resident can get vaccinated if he has no contraindications and more than two weeks have passed since any infectious disease. It is also necessary to have a compulsory medical insurance policy and fit into one of the categories for which vaccination is currently open.
Who can get vaccinated?
You can sign up and get vaccinated against COVID-19 if you:
- over 18 years old;
— have a compulsory medical insurance policy;
- an employee in the field of healthcare, education, city social services, public service centers, cultural institutions or trade and services, transport, energy and industry, media, housing and communal services, public catering, construction industry, sports or law enforcement agencies (including police, prosecutors, courts and others), work with non-profit or religious organizations, or are a volunteer, student, have a chronic disease (but the vaccine is not contraindicated), or are over 60 years of age;
- you do not have ARVI at the time of vaccination and did not get sick in the last two weeks before it;
- have not been vaccinated in the last 30 days;
- not pregnant or breastfeeding (for women).
When will vaccination be opened to all Muscovites?
When new vaccine doses arrive, the list of people eligible for vaccination immediately expands, with preference given to those categories of citizens who are most at risk of the disease. As soon as the supply of vaccine is sufficient, vaccination will begin in Moscow for everyone.
Will those who received a placebo during clinical trials be able to get vaccinated?
Study participants cannot yet be vaccinated within the framework of civil circulation. A personalized record is kept for each volunteer, and the system will not allow him to get vaccinated. Vaccination is not available even if you receive only one component of the vaccine as part of the study and refuse further participation.
This rule is due to the fact that neither the volunteer nor the medical worker knows whether he received a placebo or a drug during the study. Without this understanding, getting the actual vaccine may not be safe.
The procedure and timing of information disclosure are determined by the institute that organizes the study. Once the clinical trial is completed and results are published, participants who received the placebo will be given priority for vaccination.
What vaccine will be injected?
At the moment, free vaccination against COVID-19 is carried out with the Sputnik V (Gam-Covid-Vac) vaccine, developed by the N.F. National Research Center. Gamaleya of the Russian Ministry of Health. It is safe because it does not contain coronavirus elements. As part of the post-registration study of the vaccine, which has already involved more than 20 thousand people, not a single case of serious complications was recorded.
What documents regulate the safety of the vaccine?
During registration, the Russian Ministry of Health sets requirements for the quality of the vaccine, and the Ministry of Industry and Trade monitors compliance with production requirements. Roszdravnadzor controls the quality of the vaccine in circulation, including conducting mandatory quality control of each batch of the vaccine.
Through which website can I sign up for vaccination?
You can sign up for vaccination in the “Services” section on the mos.ru website. To do this, you need to go to the “Service Catalog”, select the “Health” tab, then click “Make an appointment with a doctor” and “Make an appointment for vaccination against COVID-19”.
In the “Patient” section, indicate the compulsory medical insurance policy number and date of birth (if the data is entered in your personal account, select them in the drop-down list), and then select a convenient time for registration.
You can also sign up for vaccination:
— on the “Coronavirus: official information” page, which is located in the “Projects” section (at the bottom of the main page);
— on the website emias.info;
— through the Moscow State Services mobile application in the “Services” section (available in the App Store, Google Play);
— through the mobile application "EMIAS.INFO" (available in the App Store, Google Play);
— through the mobile application “My Moscow” mobile application (available in the App Store, Google Play);
- at information kiosks of city clinics.
How can the vaccine affect the health of people 65+?
The Sputnik V vaccine has passed two stages of clinical trials, received registration, and is undergoing post-registration trials. No serious side effects were identified. During registration, the Russian Ministry of Health sets requirements for the quality of the vaccine, and the Ministry of Industry and Trade monitors compliance with production requirements. Roszdravnadzor controls the quality of the vaccine in circulation, including conducting mandatory quality control of each batch of the vaccine. Thus, the quality of the vaccine is guaranteed by the state.
At the moment, registration for vaccination is available in Moscow for people over 60 years of age. According to the results of a post-registration study, vaccination for this generation is not dangerous, but on the contrary, it allows people over 60 years of age to protect themselves from infection. Can I get vaccinated if I have antibodies?
The presence of antibodies is not a contraindication for vaccination.
Will entertainment centers be closed during the holidays?
Until January 17, additional education organizations subordinate to the Moscow Government are closed in Moscow. The operation of private entertainment centers remains at the discretion of the owners, however, according to the decree of the Moscow Mayor, they are also recommended to suspend work to minimize the spread of coronavirus infection.
Diseases
Very often a medical exemption from vaccinations is given after an acute respiratory viral infection. Exactly the same as after other diseases. Indeed, the relative reasons for receiving our certificate today include the presence of a particular disease. It doesn't matter which one. Even a common runny nose can cause a delay in vaccination of a child and an adult.
Perhaps no one undertakes to vaccinate a sick child. As practice shows, in this case, a medical certificate from vaccinations is issued for 2 weeks after the illness. Or in general for a month from the date of discovery of the disease.
Absolute liberation
In addition to the relative reasons for obtaining a medical deferment from vaccination, absolute exemption can be distinguished. In such circumstances, you will either be denied this or that vaccination for life, or for about a year. What is the absolute reason for which a medical exemption from vaccinations of up to a year can be obtained? These include:
- HIV and AIDS;
- oncological diseases;
- undergoing chemotherapy;
- systematic diseases in chronic form;
- anemia;
- decreased hemoglobin;
- allergic reactions to vaccine components;
- acute diseases accompanied by a malignant course.
Often, in such circumstances, patients are given a medical exemption from (specific) vaccinations for life. Typically, DPT is most often excluded from the standard vaccination list. This is quite normal, because this drug is considered heavy. It is not always well tolerated even by perfectly healthy children. By the way, vaccinations after medical withdrawal will be carried out exclusively on an individual schedule. Otherwise, there is a high risk of complications in a person at any age. Remember this.
If the child is sick
An acute cold with a high fever gives reason to reschedule a scheduled injection. If a child gets sick often, the pediatrician calculates an individual vaccination schedule for him.
Conditions under which it is worth postponing vaccination will be as follows:
- ARVI even with non-acute or residual symptoms. The injection is recommended for a completely healthy child;
- decreased hemoglobin level;
- weakened immunity, a sign of which is frequent illness. In this case, the baby must first strengthen the immune system, and then be given an additional load in the form of vaccines. Another option is to select a drug with a special composition; an immunologist can help with this.
Parents, like no one else, know the behavioral characteristics of their baby. Therefore, they should be alerted to any sudden changes in condition: drowsiness, lethargy, irritability, fatigue, loss of appetite. Such changes should be discussed with your pediatrician and, possibly, additional tests taken before deciding to vaccinate.
The injection is allowed a few days after the main symptoms of the disease have disappeared. After a severe infection, wait about a month.
Consilium and commission
It has already been said that under certain circumstances the doctor cannot independently decide to postpone vaccination. Instead, a medical commission is assembled to assess the situation of a particular patient. In the end, the most correct decision will be made. And if doctors consider the reasons for delaying vaccination to be really serious, they may cancel it altogether. Very dubious reasons for medical withdrawal include:
- negative reaction of the body to previous vaccines;
- any immunodeficiency;
- underweight;
- diseases of the nervous system;
- The patient has an allergy to egg white.
It's also worth noting that some vaccinations cannot be delayed for medical reasons. For example, everyone must undergo ADS and ADSM. The exception is a lifetime exemption from vaccination. It is also believed that the polio vaccine should also be given to everyone who is not exempt from such injections for life.
After the medical examination
What to do if you have been issued a medical exemption from vaccinations? It has already been said that this certificate requires the preparation of an individual vaccination schedule. This is usually performed by a pediatrician. But especially responsible parents prefer to contact an immunologist. Only he will be able to correctly draw up a schedule of vaccinations for you and your child, taking into account all the features.
If you are categorical about any vaccines and do not intend to give them to your child, there is no need to bother your head with medical advice. Just write a refusal to vaccinate. Parents themselves have the right to decide which vaccinations to give and not to give to their minor child. If you are afraid of negative consequences, you can refuse such injections for a certain period. For example, until the child turns 1 year old, by this time the immune system is already more stable. Many parents do just that. In any case, if you want to get the most accurate vaccination schedule, you need to contact an immunologist.
Refusal of preventive vaccinationsI, _________ (full name), as the legal representative of my young child _________ (full name), ________________ year of birth, DECLARE that I refuse to vaccinate my child against ________________ (fill in as necessary: tuberculosis, hepatitis B, diphtheria, tetanus, whooping cough, polio, measles, rubella, mumps, influenza, etc.) based on:
1. Federal Law “On the fundamentals of protecting the health of citizens of the Russian Federation” dated November 21, 2011 N 323-FZ:
Article 20. Informed voluntary consent to medical intervention and refusal of medical intervention.
1) A necessary precondition for medical intervention is the giving of informed voluntary consent of a citizen or his legal representative to medical intervention on the basis of complete information provided by a medical worker in an accessible form about the goals, methods of providing medical care, the risks associated with them, possible options for medical intervention, about its consequences, as well as the expected results of medical care.
3) A citizen, one of the parents or other legal representative of the person specified in part 2 of this article has the right to refuse medical intervention or demand its termination, except for the cases provided for in part 9 of this article. The legal representative of a person recognized as incompetent in accordance with the procedure established by law exercises this right if such person, due to his condition, is unable to refuse medical intervention.”
2. Federal Law “On Immunoprophylaxis of Infectious Diseases” dated September 17, 1998 N 157-FZ :
Article 5. Rights and responsibilities of citizens when carrying out immunoprophylaxis.
1) When carrying out immunoprophylaxis, citizens have the right to:
- refusal of preventive vaccinations
2) Lack of preventive vaccinations entails:
— a ban on citizens traveling to countries where, in accordance with international health regulations or international treaties of the Russian Federation, their stay requires specific preventive vaccinations;
— temporary refusal to admit citizens to educational and health institutions in the event of mass infectious diseases or the threat of epidemics;
— refusal to hire citizens for work or removal of citizens from work, the performance of which is associated with a high risk of contracting infectious diseases.
3) When carrying out immunoprophylaxis, citizens are obliged to:
— follow the instructions of medical workers;
— confirm in writing the refusal of preventive vaccinations.
Article 11. Requirements for preventive vaccinations
2) Preventive vaccinations are carried out in the presence of informed voluntary consent to medical intervention of a citizen, one of the parents or another legal representative of a minor under the age of 15 years or a drug addicted minor under the age of 16 years, the legal representative of a person declared incompetent in the manner established by the legislation of the Russian Federation Federation.
3) Preventive vaccinations are carried out for citizens who do not have medical contraindications.
Article 19. State one-time benefits
1) If a post-vaccination complication occurs, a citizen has the right to receive a state one-time benefit in the amount of 10,000 rubles. The list of post-vaccination complications that entitle citizens to receive state one-time benefits is approved by the Government of the Russian Federation upon the proposal of the federal executive body in the field of healthcare.
2) In the event of the death of a citizen resulting from a post-vaccination complication, members of his family have the right to receive a state one-time benefit in the amount of 30,000 rubles.
I know the LIST of post-vaccination complications approved by Government Resolution No. 885 of August 2, 1999:
1. Anaphylactic shock.
2. Severe generalized allergic reactions (recurrent angioedema - Quincke's edema, Steven-Johnson syndrome, Lyell's syndrome, serum sickness syndrome, etc.).
3. Encephalitis.
4. Vaccine-associated polio.
5. Lesions of the central nervous system with generalized or focal residual manifestations leading to disability: encephalopathy, serous meningitis, neuritis, polyneuritis, as well as clinical manifestations of convulsive syndrome.
6. Generalized infection, osteitis, osteitis, osteomyelitis caused by the BCG vaccine.
7. Chronic arthritis caused by the rubella vaccine.
This DISCLAIMER is a deliberate and balanced decision made on the basis of a detailed and comprehensive study of issues related to vaccination, personal experience and is fully consistent with the norms of current legislation.
_____________ (signature), ______________ (date)
