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Introduction: In Argentina, a pentavalent whole-cell pertussis vaccine (wP) is used in the National Immunization Program, however hexavalent acellular pertussis (aP) vaccines are available in the private market. Objective: To describe parent or guardians perceptions on reactogenicity, daily routine and satisfaction after a first or third dose of a wP-pentavalent plus IPV (wP-group) or the fully-liquid aP-hexavalent vaccine (aP-group) in infants. Material and methods: This was a prospective observational and analytical study. Parents or guardians of infants born at term attending a public or private vaccination center in Buenos Aires City were invited to participate. All parents or guardians had completed 12-year schooling and were asked to fill out an online 7-day post vaccination questionnaire. The questionnaire was validated as the first phase of the study. Descriptive analysis of study variables was carried out, REDCap was used for the online survey, and STATA 14 for data analysis. Results: 1071 parents or guardians answered the questionnaire (response rate 82%), 530 for wP-group and 541 for aP-group.Local and systemic adverse reactions, in groups wP and aP respectively, were: pain 83%, 28%; swelling 63%, 16%; redness 52%, 22%; irritability 72%, 52%; fever 37%, 8%; loss of appetite 36%, 19%; drowsiness 38%, 27%; and vomiting 15%, 11%.Impact on daily life: social activities 36%, 20%; routine 48%, 24%; mood 39%, 23%; vitality 47%, 24%; sleep 50%, 30%; and appetite 22%, 7%.Parents were satisfied with the vaccination process in 96% and 98% for wP-group and aP-group respectively. Parents reported willingness to bring infant for future vaccine doses in 97% and 99% for wP-group and aP-group respectively. Conclusions: Reported reactogenicity and impact on family daily routine was higher in infants receiving wP-pentavalent than aP-hexavalent vaccines. Parents in both groups conveyed vaccine acceptance and positive intentions for future immunizations.
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BACKGROUND: The WHO SAGE Working Group on Vaccine Hesitancy developed the Vaccine Hesitancy Scale (VHS) to identify and compare hesitancy in different global settings. The objectives of the study were to describe and analyze vaccine hesitancy and to validate the VHS in a group of parents in Buenos Aires city, Argentina. METHODS: A cross-sectional survey was conducted in parents of 1-3 and 12-15 year-old children at three health centres in Buenos Aires City, between June 2018 and May 2019. Sociodemographic data were collected together with history of refusal and/or delay in children's vaccination (defined as hesitancy). The 10-item VHS using 5-point Likert-scale (higher scores indicating lower hesitancy) was administered and children's immunization record cards were verified. Link between hesitancy and socio-demographic variables, and hesitancy and vaccination status was analyzed for five specific vaccines. Cronbach's α was used to determine internal consistency reliability and factor analysis to confirm survey subdomains. Simple and multiple regression analysis was used to examine associations between VHS scores and hesitancy, and VHS scores and vaccination status. RESULTS: Six hundred parents were surveyed and 469 immunization cards verified; 11.5% (n = 69) parents were hesitant. High maternal educational level showed significant association with hesitancy (OR 2.66 95% CI: 1.20-5.9) in the adjusted model. Hesitancy was significantly associated with incomplete MMR vaccination in children (OR 4.43 95% CI: 1.08-8.20) and HPV vaccination in adolescents (OR 3.75 95% CI: 1.54-9.12). Cronbach's α was 0.66 and factor analysis identified three underlying constructs: "Benefits", "Harms" and "Confidence in healthcare system". High scores in VHS were associated with lack of hesitancy (OR 1.2 95% CI: 1.13-1.27) and complete vaccination status (OR 1.07 95% CI: 1.02-1.12). CONCLUSIONS: Hesitancy was associated with high maternal educational level, and incomplete MMR and HPV immunization status in children and adolescents. VHS was a reliable and valid tool in this population.
Assuntos
Vacinas contra Papillomavirus , Recusa de Vacinação , Adolescente , Argentina , Criança , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pais , Aceitação pelo Paciente de Cuidados de Saúde , Reprodutibilidade dos Testes , Vacinação , Organização Mundial da SaúdeRESUMO
Introducción: La prevención de la hepatitis A en el personal de salud (PS) del Hospital Hospital de Niños "Ricardo Gutiérrez" (HNRG), se basa en la pesquisa de infección por virus de Hepatitis A en los mismos, y posterior vacunación únicamente de los trabajadores seronegativos. La endemia de infección por virus de Hepatitis A en Argentina se encuentra en un período de transición. Las estrategias de prevención son: a) vacunar a todo el PS sin pesquisa previa, y b) vacunar con pesquisa previa, que es la que se aplica en el Hospital. Objetivos: Comparar la eficiencia de la estrategia de prevención actual (pesquisa y vacunación del PS seronegativo) con la estrategia de prevención alternativa vacunación a todo el PS sin pesquisa previa. Establecer un punto teórico de equilibrio donde ambas estrategias resultan similares en términos de eficiencia. Material y Métodos: Se realizó serología a 1.117 trabajadores en el período de mayo 1999 a julio 2014. Se aplicó estudio de minimización de costos médicos directos para la estrategia de vacunación de hepatitis A en el PS. Resultados: El costo de la estrategia de prevención actual se estimó en AR$ 974,19 (U$S 54,88) por caso. El costo de prevención con vacunación a todo el PS sin pesquisa previa se estimó AR$ 1267,19 (U$S71,39) a pagar por caso. En el análisis univariado ambas estrategias son equivalentes en términos de eficiencia a un costo de la vacuna de $ 355 (US$ 20,28) la dosis o una seroprevalencia de 30%. Conclusión: La estrategia de vacunación posterior a la pesquisa resultó eficiente en nuestro medio. La vacunación directa presenta un costo incremental mayor. El punto teórico de equilibrio de ambas estrategias es una seroprevalencia de aproximadamente 30%
Introduction: The prevention of hepatitis A infection in healthcare workers (HCW) from Hospital de Niños Ricardo Gutiérrez (HNRG) is based on the previous detection of Hepatitis A infection and the subsequent vaccination of the seronegative workers only. The endemic hepatitis A infection in Argentina is in a period of transition. The prevention strategies are the following: a) immunizing all the HCWs without prior screening, and b) immunizing with prior screening, which is the strategy applied at the Hospital. Objectives: To compare the efficiency of the current prevention strategy (screening and vaccination of seronegative HCWs) with the strategy of alternative prevention with HAV vaccines to all HCWs without previous screening of Hepatitis A infection. To establish a theoretical point of equilibrium where both strategies are similar in terms of efficiency. Material and methods: Serology tests were performed in 1117 workers from May 1999 to July 2014. A minimization study of direct medical costs was done for the strategy of hepatitis A vaccination in HCWs. Results: The estimated cost of the current prevention strategy was AR$ 974,19 (USD 54.88) per case. The estimated cost of prevention with HAV vaccines to all HCWs without previous screening was AR$ 1267,19 (USD 71.39). In the univariate analysis both strategies are equivalent in terms of efficiency at a vaccine cost of AR$ 355 (USD 20) a dose or a seroprevalence of 30%. Conclusion: The post-screening strategy is efficient in our hospital. Direct vaccination without screening has a higher incremental cost. The theoretical point of equilibrium of both strategies is a seroprevalence of approximately 30%