Informe especial: Coberturas de vacunación en residentes de la CABA en contexto Covid-19: 2 de octubre de 2020 / Special report: Vaccination coverage in CABA residents in context of Covid19

La vacunación es considerada una actividad esencial durante la pandemia de COVID-19 y se han desarrollado diferentes estrategias para el sostenimiento de la vacunación en el contexto actual, facilitar el acceso a través de la adaptación y reorganización de los servicios de salud, el no requerimiento de permisos de circulación para la vacunación, vacunación en instituciones fuera de salud, así como la elaboración de recomendaciones para realizar la vacunación de manera segura protegiendo tanto al vacunador como la persona a vacunar, entre otros. Con el objetivo de realizar la medición del impacto en las actividades de vacunación, se realiza el análisis comparativo de las vacunas aplicadas durante el primer semestre de los años 2018-2020, con la información recibida en el nivel central del Programa de Inmunizaciones. Se excluye del presente análisis la información referida a la vacuna antigripal ya que tiene una modalidad diferente de aplicación. (AU)

The influenza season 2016/17 in Bucharest, Romania - surveillance data and clinical characteristics of patients with influenza-like illness admitted to a tertiary infectious diseases hospital

ABSTRACT Background: Influenza continues to drive seasonal morbidity, particularly in settings with low vaccine coverage. Objectives: To describe the influenza cases and viral circulation among hospitalized patients. Methods: A prospective study based on active surveillance of inpatients with influenza-like illness from a tertiary hospital in Bucharest, Romania, in the season 2016/17. Results: A total of 446 patients were tested, with a balanced gender distribution. Overall, 192 (43%) patients tested positive for influenza, with the highest positivity rate in the age groups 3-13 years and >65 years. Peak activity occurred between weeks 1 and 16/2017, with biphasic distribution: A viruses were replaced by B viruses from week 9/2017; B viruses predominated (66.1%). Among the 133 (69.3%) subtyped samples, all influenza A were subtype H3 (n = 57) and all influenza B were B/Victoria (n = 76). Patients who tested positive for influenza presented fewer comorbidities (p = 0.012), except for the elderly, in whom influenza was more common in patients with comorbidities (p = 0.050). Disease evolution was generally favorable under antiviral treatment. The length of hospital stay was slightly longer in patients with influenza-like illness who tested patients negative for influenza (p = 0.031). Conclusions: Distinctive co-circulation of A/H3 and B/Victoria in Bucharest, Romania in the 2016/17 influenza season was found. While the A/H3 subtype was predominant throughout Europe that season, B/Victoria appears to have circulated specifically in Romania and the Eastern European region, predominantly affecting preschoolers and school children.

Fatores associados à vacinação contra influenza entre trabalhadores de saúde de um complexo hospitalar de Salvador / Factors associated with influenza vaccination among health care workers in a hospital complex in Salvador

INTRODUÇÃO: Embora a vacina influenza seja anualmente recomendada para todos trabalhadores de saúde, estudos revelam que a cobertura vacinal desse grupo frequentemente é baixa. Diferentes fatores podem influenciar a vacinação contra a influenza, sendo necessário utilizá-los a favor da ampliação da cobertura vacinal.OBJETIVO: Identificar fatores que influenciam a prática de vacinar-se contra influenza entre trabalhadores de saúde. MATERIAIS E MÉTODOS: estudo transversal, ocorrido num Complexo Hospitalar de Salvador, Bahia. Utilizou-se um questionário autoaplicável, e os modelos "Conhecimento, Atitudes e Práticas" (CAP) e "Health Belief Model" (HBM). A vacinação contra influenza em 2014 (autorreferida)representou a variável principal, e fatores sociodemográficos,histórico de outras vacinas,conhecimentos e atitudes constituíram variáveis independentes.Considerou-se haver "conhecimento adequado", quando 75,0% ou mais dos indivíduos julgaram determinada informação corretamente. As análises foram feitas por regressão logística no Stata, versão 13, utilizando-se o teste qui-quadrado ao nível de 5% de significância, odds ratio, e intervalos de confiança de 95%. O modelo multivariado foi ajustado por sexo, idade e profissão, sendo composto pelas variáveis com p valor igual ou inferior a 0,20 na análise bivariada. A verificação de modelos alternativos mais adequados foi feita por retirada retrógrada, utilizando-se como parâmetro o "Critério de Informação de Akaike" (AIC). RESULTADOS: A amostra foi de 755 indivíduos, destacando-se técnicos de enfermagem (41,4%),enfermeiros (15,2%) e médicos (14,7%).Predominaram trabalhadores do sexo feminino (82,5%), entre 19 e 39 anos (82,4%), com 5 anos ou menos de experiência (67,5%). A cobertura vacinal global foi de 61,5%, sendo a maior entre enfermeiros (69,0%) e a menor entre médicos (49,1%). Os principais motivadores da vacinação foram conhecer a recomendação da vacina para si (49,0%), confiar em vacinas no geral (41,6%) e na eficácia da vacina influenza (35,4%). Os principais desmotivadores foram esquecimento (37,3%), inconveniência de locais/horários (22,5%) e não saber da campanha (16,3%). A principal estratégia que facilitaria a vacinação foi vacinar os trabalhadores no seu próprio setor de trabalho (56,6%). O conhecimento foi adequado no julgamento de 9/16 das informações, com destaque para médicos (15/16) e enfermeiros (13/16). A maior adequação (94,6% de acerto)refere-se à indicação da vacina para todo trabalhador de saúde, e o conhecimento menos adequado foi sobre a incapacidade da vacina causar a influenza (32,0% de acerto). Os fatores associados à vacinação foram: conhecer que pessoas saudáveis também precisam se vacinar contra influenza (OR=3,15 ; IC95%: 1,74 - 5,71); saber que a vacina não protege por muitos anos (OR=2,08 ; IC95%: 1,30 - 3,33); e não ter medo dos efeitos adversos pós-vacinais (OR=1,93 ; IC95%: 1,26 - 2,95). CONCLUSÕES: a vacinação contra influenza é influenciada por onhecimentos,atitudes e questões organizacionais/operacionais.Medidas educativas e de desmistificação de questões relacionadas à influenza e à vacina, bem como ampliação de dias/horários e locais de vacinação de acordo com a conveniência dos trabalhadores de saúde, devem compor as estratégias voltadas à elevação da cobertura da vacina influenza neste grupo.

INTRODUCTION: Although the influenza vaccine is recommended annually for all health workers, studies show that vaccination coverage of this group is often low. Different factors can influence the vaccination against influenza, it is necessary to use them in favor of the expansion of vaccination coverage. GOAL: To identify factors that influence the practice of vaccination against influenza among health workers. MATERIALS AND METHODS: A cross-sectional study, which took place in a hospital complex in Salvador, Bahia. We used a self-administered questionnaire, and the models "Knowledge, Attitudes and Practices"(CAP) and "Health Belief Model"(HBM). Influenza vaccination in 2014 (self-reported) was the main variable, and sociodemographic factors, history of other vaccines, knowledge and attitudes were independent variables. Considered to be "appropriate knowledge" as 75.0% or more of subjects judged certain information correctly. Analyses were performed by logistic regression using Stata, version 13, using the chi-squared test at 5% significance, odds ratio, and 95% confidence intervals. The multivariate model was adjusted for sex, age and profession, being composed of the variables that had a pvalue less than or equal to 0.20 in the bivariate analysis. The verification of most suitable alternative models was performed by backward withdrawal, using as a parameter the "Akaike Information Criteria" (AIC). RESULTS: The sample consisted of 755 individuals, mainly nursing technicians (41.4%), nurses (15.2%) and physicians (14.7%). There was a predominance of female workers (82.5%), between 19 and 39 years (82.4%), with five years or less experience (67.5%). The global vaccination coverage was 61.5%, the highest among nurses (69.0%) and lowest among physicians (49.1%). The main motivators to get vaccinated were to know the recommendation of the vaccine for themselves (49.0%), trust in vaccines in general (41.6%) and in the effectiveness of influenza vaccine (35.4%). The main demotivating were forgetfulness (37.3%), inconvenience locations/times (22.5%) and not knowing the campaign (16.3%). The main strategy would facilitate the vaccination was to inoculate workers in their own work sector (56.6%)...

Fighting Hepatitis B in North Korea: Feasibility of a Bi-modal Prevention Strategy

In North Korea, the prevalence of hepatitis B is high due to natural factors, gaps in vaccination, and the lack of antiviral treatment. Aid projects are urgently needed, however impeded by North Korea's political and economical situation and isolation. The feasibility of a joint North Korean and German humanitarian hepatitis B prevention program was assessed. Part 1: Hepatitis B vaccination catch-up campaign. Part 2: Implementation of endoscopic ligation of esophageal varices (EVL) by trainings in Germany and North Korea. By vaccinating 7 million children between 2010 and 2012, the hepatitis B vaccination gap was closed. Coverage of 99.23% was reached. A total of 11 hepatitis B-induced liver cirrhosis patients (mean age 41.1 yr) with severe esophageal varices and previous bleedings were successfully treated by EVL without major complications. A clinical standard operating procedure, a feedback system and a follow-up plan were developed. The bi-modal preventive strategy was implemented successfully. Parts of the project can serve as an example for other low-income countries, however its general transferability is limited due to the special circumstances in North Korea.

Vacunación antigripal en personal de salud: cobertura, actitudes y barreras contra la vacunación en dos servicios de un hospital general / Influenza immunization in health care professionals: coverage, attitudes and barriers against immunization in two departments of a general hospital

Con el objetivo de conocer la cobertura y las barreras contra la vacunación antigripal, cuya aceptación estimábamos baja entre el personal de salud(PDS) se realizó un estudio transversal, descriptivo, con la metodología de encuesta, autoadministrada con opciones cerradas para su respuesta. Se utilizó una muestra de 142 PDS integrantes del Hospital Pasteur (MSP-ASSE), aleatorizada y adecuada para extraer conclusiones estadísticamente válidas. Los resultados mostraron que 87/142 (61,3%) de los encuestados conocía la campaña de vacunación antigripal en el Hospital, reconocieron tener indicación de vacunación antigripal 124/142 (87,3%) a pesar de lo cual se vacunaron en 2011 79/142 (55,6%) y en 2012 53/142 (37,3%). Los vacunados en 2012 respondieron como motivos principales de adherencia a la campaña protegerse a sí mismo de la enfermedad, pertenecer al PDS y proteger a su familia. De los no vacunados en 2012 respondieron como motivos principales: percepción de nunca haber contraído gripe, miedo a efectos adversos y descrédito al efecto inmunizador de las vacunas. Se confirmó la baja tasa de vacunación del PDS (37,3% en año 2012) a pesar de reconocer la indicación y tener accesibilidad a la misma; se identificaron como barreras las percepciones erróneas acerca de la vacunación...

Influenza Vaccination and Associated Factors among Korean Cancer Survivors : A Cross-Sectional Analysis of the Fourth & Fifth Korea National Health and Nutrition Examination Surveys

Influenza vaccination is important for cancer survivors, a population with impaired immunity. This study was designed to assess influenza vaccination patterns among Korean cancer survivors. In this cross-sectional analysis, data were obtained from standardized questionnaires from 943 cancer survivors and 41,233 non-cancer survivors who participated in the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (2007-2011). We identified the adjusted influenza vaccination rates and assessed factors associated with influenza vaccination using multivariate logistic regression. Cancer survivors tended to have a higher adjusted influenza vaccination rate than the general population. The rates for influenza vaccination in specific cancer types such as stomach, hepatic, colon, and lung cancers were significantly higher than non-cancer survivors. Among all cancer survivors, those with chronic diseases, elderly subjects, and rural dwellers were more likely to receive influenza vaccination; those with cervical cancer were less likely to receive influenza vaccination. Cancer survivors were more likely to receive influenza vaccinations than non-cancer survivors, but this was not true for particular groups, especially younger cancer survivors. Cancer survivors represent a sharply growing population; therefore, immunization against influenza among cancer survivors should be concerned as their significant preventative healthcare services.

Vacinação contra rubéola em mulheres em idade reprodutiva no Município de Campinas, São Paulo, Brasil / Rubella vaccination in women of childbearing age in Campinas, São Paulo State, Brazil / Vacunación contra la rubeola de mujeres en edad reproductiva en el municipio de Campinas, São Paulo, Brasil

As mulheres em idade reprodutiva são a população de maior interesse para a prevenção da síndrome da rubéola congênita. O objetivo do trabalho foi avaliar a prevalência de vacinação contra rubéola em mulheres e identificar fatores associados e motivos da não adesão. Trata-se de estudo transversal de base populacional, realizado em Campinas, São Paulo, Brasil, em 2008/2009, com amostra por conglomerados e em dois estágios. Das 778 mulheres de 10 a 49 anos, 83,8% (IC95%: 79,6-88,0) referiram vacinação em algum momento da vida. Faixa etária (30-39 anos), renda familiar per capita superior a três salários mínimos e a orientação de profissional de saúde estiveram positivamente associadas à vacinação contra a rubéola. Os principais motivos da não adesão foram a falta de orientação do profissional de saúde sobre sua importância (48,5%) e não considerá-la necessária (18,9%). A recomendação do profissional de saúde foi o fator mais fortemente associado à adesão das mulheres à vacinação. Nesse sentido, sua indicação pelas equipes de saúde pode ampliar o conhecimento sobre sua importância e seus benefícios.

Women of reproductive age are the population of greatest interest for the prevention of congenital rubella syndrome. The aim of this study was to evaluate the prevalence of rubella vaccination in women and to identify factors associated and motives for non-adherence. A cross-sectional population-based study, in Campinas, São Paulo State, Brazil, in 2008/2009, was carried out with stratified random, two-stage cluster sampling. Of the 778 women aged 10 to 49 years, 83.8% (95%CI: 79.6-88.0) reported vaccination in life. Age group (20-39 years), per capita household income greater than 3 times the minimum wage and orientation of health care professionals about the vaccine, were positively associated with rubella vaccination. The main motives for non-adherence were lack of orientation of professionals about their importance (48.5%) and not consider it necessary (18.9%). The recommendation of professionals was the factor most strongly associated with women's adherence to vaccination. In this sense, an indication of vaccination by health care teams can increase the knowledge about the importance their and benefits.

Las mujeres en edad reproductiva son la población de mayor interés para la prevención del síndrome de la rubeola congénita. El objetivo del trabajo fue evaluar la prevalencia de vacunación contra la rubeola en mujeres e identificar factores asociados y motivos de la no adhesión al programa de vacunación. Se trata de un estudio transversal de base poblacional, realizado en Campinas, São Paulo, Brasil, en 2008/2009, con una muestra por conglomerados y en dos fases. De las 778 mujeres, de 10 a 49 años, un 83,8% (IC95%: 79,6-88,0) informaron de vacunación en algún momento de la vida. La franja de edad (30-39 años), renta familiar per cápita superior a tres salarios mínimos y la orientación de un profesional de salud estuvieron positivamente asociadas a la vacunación contra la rubeola. Los principales motivos de la no adhesión fueron la falta de orientación del profesional de salud sobre su importancia (48,5%) y no considerarla necesaria (18,9%). La recomendación del profesional de salud fue el factor más fuertemente asociado a la adhesión de las mujeres a la vacunación. En este sentido, su indicación por los equipos de salud puede ampliar el conocimiento sobre su importancia y sus beneficios.

Pediatric hospital admissions from influenza A (H1N1) in Brazil: effects of the 2010 vaccination campaign

lIn 2009, the influenza A (H1N1) virus spread rapidly around the world, causing the first pandemic of the 21st Century. In 2010, there was a vaccination campaign against this new virus subtype to reduce the morbidity and mortality of the disease in some countries, including Brazil. Herein, we describe the clinical and epidemiological characteristics of patients under 19 years of age who were hospitalized with confirmed influenza A (H1N1) infection in 2009 and 2010. We retrospectively reviewed files from the pediatric patients who were admitted to a university hospital with real-time polymerase chain reaction (RT-PCR) confirmed influenza A (H1N1) infection in 2009 and 2010. There were 37 hospitalized patients with influenza A (H1N1) in 2009 and 2 in 2010. In 2009, many of the hospitalized children had an underlying chronic disease and a lower median age than those not hospitalized. Of the hospitalized patients, 78% had a chronic disease, primarily pneumopathy (48%). The main signs and symptoms of influenza were fever (97%), cough (76%), and dyspnea (59%). Complications occurred in 81% of the patients. The median length of hospitalization was five days; 27% of the patients required intensive care, and two died. In 2010, two patients were hospitalized with influenza A (H1N1): one infant with adenovirus co-infection who had received one previous H1N1 vaccine dose and presented with respiratory sequelae and a 2-month-old infant who had a hospital-acquired infection. An impressive reduction in hospital admissions was observed in 2010 when the vaccination campaign took place in Brazil.

Fatores relacionados à vacinação contra a gripe em idosos: estudo transversal, Cambé, Paraná, Brasil / Factors associated with influenza vaccination among the elderly: a cross-sectional study in Cambé, Paraná State, Brazil

Este trabalho teve como objetivo verificar a cobertura vacinal contra a gripe em idosos e a associação entre a vacinação e variáveis socioeconômicas, demográficas, de saúde e estilo de vida. Estudo de natureza epidemiológico-descritiva, transversal, realizado de abril de 2008 a setembro de 2009, com 990 idosos do Município de Cambé, Paraná, Brasil. A cobertura vacinal foi de 74,6%. A maior taxa de adesão foi entre os indivíduos com idades de 70-79 anos [razão de prevalência ajustada (RP) = 1,05] e 80 anos ou mais (RP = 1,03), hipertensos, e com renda mensal de até 3 salários mínimos (RP = 1,10) ou superior (RP = 1,17) comparados aos idosos sem renda. Idosos sedentários (RP = 0,96) aderiram menos à vacinação, e divorciados/separados (RP = 0,92) apresentaram menor adesão comparados aos casados. Os resultados sugerem a necessidade de estratégias de atenção à saúde, considerando os fatores que interferem na adesão voluntária à vacinação, contribuindo para aumentar as chances de sucesso dos programas de imunização.

The aim of this study was to assess influenza immunization coverage in the elderly and the association between vaccination and socioeconomic, demographic, health, and lifestyle variables, using a descriptive cross-sectional epidemiological approach from April 2008 to September 2009 with 990 elderly in Cambé, Paraná State, Brazil. Vaccination coverage was 74.6%. The highest vaccination rate was among individuals 70 to 79 years of age [adjusted prevalence ratio (PR) = 1.05] and 80 or older (PR = 1.03), with hypertension, and with monthly income up to 3 times the minimum wage (PR = 1.10) or higher (PR = 1.17) compared to elderly without income. Sedentary elderly (PR = 0.96) adhered less to vaccination, and divorced/separated individuals (PR = 0.92) had lower adherence compared to the married. The results suggest the need for healthcare strategies considering the factors that affect voluntary vaccination in order to help increase the odds of success for immunization programs.

Survey of rubella knowledge and acceptability of rubella vaccination among Brazilian adults prior to mass vaccination / Encuesta sobre el conocimiento de la rubéola y la aceptabilidad de la vacunación antirrubeólica en los adultos brasileños antes de una campaña de vacunación masiva

OBJECTIVE: Evaluate knowledge of rubella and acceptability of vaccination and identify sources of health information among brazilian adults to inform communication strategies for a national vaccination campaign to eliminate rubella and congenital rubella syndrome (CRS). METHODS: From 5-8 July 2008 a qualitative telephone survey was conducted among a nonprobabilistic sample of brazilian adults 18 to 65 years of age (n = 1 023) from all five geographic regions of Brazil to measure knowledge of rubella and willingness to receive the vaccine and to identify sources of health information. Frequencies of responses were stratified by respondents' sex, age, education, and income. RESULTS: Although 69.9 percent of respondents said they knew what rubella was, actual knowledge of the disease was limited, with only 29.9 percent answering affirmatively when asked if they would recognize symptoms of rubella infection. Self-reported knowledge increased with increasing age, education, and income, and was higher among women than men. A total of 94.5 percent of the respondents expressed willingness to be vaccinated for rubella elimination. The most frequently mentioned sources of health information were television and doctors. CONCLUSIONS: Despite limited knowledge of rubella, brazilian adults expressed willingness to be vaccinated for disease elimination.

OBJETIVO: Evaluar el conocimiento de la rubéola y la aceptabilidad de la vacunación antirrubeólica, y determinar las fuentes de información sanitaria en los adultos brasileños, con objeto de fundamentar las estrategias de comunicación de una campaña nacional de vacunación dirigida a eliminar la rubéola y el síndrome de rubéola congénita (SRC). MÉTODOS: Del 5 al 8 de julio del 2008 se llevó a cabo una encuesta telefónica cualitativa en una muestra no probabilística de adultos brasileños de 18 a 65 años de edad (n = 1 023) de las cinco regiones geográficas del Brasil, con objeto de evaluar el conocimiento de la rubéola y la disposición a recibir la vacuna antirrubeólica, y determinar las fuentes de información sanitaria. Las frecuencias de las respuestas se estratificaron según el sexo, la edad, el nivel educativo y los ingresos de los entrevistados RESULTADOS: Aunque 69,9 por ciento de los entrevistados dijeron que sabían lo que era la rubéola, el conocimiento real de la enfermedad era limitado, ya que solo 29,9 por ciento respondieron afirmativamente cuando se les preguntó si reconocerían los síntomas de esta infección. El grado de conocimiento notificado por los propios entrevistados aumentó con la edad, el nivel educativo y los ingresos, y fue mayor en las mujeres que en los hombres. El 94,5 por ciento de los entrevistados expresaron su disposición a vacunarse con objeto de eliminar la rubéola. Las fuentes de información sanitaria mencionadas con mayor frecuencia fueron la televisión y los médicos. CONCLUSIONES: A pesar de tener un conocimiento limitado de la rubéola, los adultos brasileños expresaron su disposición a vacunarse con objeto de eliminar la enfermedad.

Síntomas gripales asociados a la vacunación antigripal en personal de salud / Flu-like symptoms associated with influenza vaccination in health personnel

Introducción: En el Hospital Italiano de Buenos Aires se realizó una campaña de vacunación masiva destinada al personalde la institución durante mayo de 2009.Objetivo: Medir síntomas gripales asociados a la vacunación en personal de salud. Métodos: Estudio de cohorte. Se compararon, mediante riesgo relativo, las incidencias de los síntomas gripales informados para la semana epidemiológica 20, por 400 vacunados durante dicha semana y 400 no vacunados, apareados por edad, sexo y profesión. Los síntomas comunicados dentro de las 48 horas posteriores a la vacunación se consideraron secundarios a ella. Resultados: Fueron encuestados 583 (72.5%) de los cuales 281 vacunados y 302 no vacunados: edad media 36 (DS 11) vs. 35.2 (DS 10.5); mujeres 54% vs. 57% y médicos 21% vs. 18%. En la semana de vacunación presentaron fiebre 12.46% vs. 6.95% (RR 1.79, IC95% 1.07-3), coriza 24.2% vs. 17.22% (RR 1.41 IC95%1.02-1.94), odinofagia 11.74% vs. 0.33%(RR 35.47 IC 95% 4.88-257), dolor corporal 18.86% vs. 14.57% (RR 1.29 IC 95% 0.9-1.87) vacunados y no vacunados, respectivamente. Se atribuyen a la vacuna: dolor corporal 9.25% (IC95% 6.3-13.6), coriza 8.19% (IC95% 5.4-12.31); fiebre 6.78% (IC95% 4.31-10.6) y odinofagia 4.27% (IC 95% 2.42-7.5). Y dolor de brazo 65%. Los médicos no informaronmayor frecuencia de síntomas gripales.Discusión: En la literatura, la odinofagia y la coriza no están asociadas a la vacunación, la frecuencia de los otros síntomas a las 48 horas fue similar a la informada. Conclusión: El síndrome gripal fue descripto con mayor frecuencia entre los vacunados y puede ser resultado de un sesgo de reporte.

Introduction: In May 2009, prior to the beginning of winter in the Southern hemisphere, a massive vaccination campaign for the personnel was performed at the Hospital Italiano de Buenos Aires. Objective: To assess symptoms associated with influenza vaccination in health personnel. Methods: In a cohort study, the impact of flu symptoms reported for the epidemiological week number 20 were compared using the relative risk between 400 vaccinated vs. 400 unvaccinated individuals matched for age, sex and occupation. Symptoms reported within 48 hours after vaccination were considered secondary this event. Results: 583 people were respondents (72.5%) of whom 281 were vaccinated vs. 302 who were unvaccinated (mean age, 36 yr (SD 11 yr) vs. 35.2 yr (SD 10.5 yr); women, 54% vs. 57%; doctors 21% vs. 18%, respectively). During the vaccination week, 12.46% vaccinated vs. 6.95% unvaccinated individuals presented fever (RR 1.79, CI95% 1.07-3); a cold, 24.2% vs. 17.2% (RR 1.41, CI95% 1.02-1.94); sore throat, 11.74% vs. 0.33% (RR 35.47, CI 95% 4.88-257); body pain, 18.86% vs. 14.57% (RR 1.29, CI 95% 0.9-1.87), respectively. Symptoms attributed to the vaccine were: body pain, 9.25% (CI95% 6.3-13.6); cold, 8.19% (CI95% 5.4-12.31); fever, 6.78% (CI95% 4.31-10.6); sore throat, 4.27% (CI 95% 2.42-7.5); and arm pain, 65%. Doctors did not report a higher frequency of flu symptoms.Discussion: Sore throat and cold are not symptoms commonly reported in association with vaccination. The frequency of other symptoms following the first 48 hours of vaccination was similar to previous reports. Conclusion: The flu syndrome was reported more frequently in vaccinated people as compared with those unvaccinated.However, these results might be due to a reporting bias.

A cluster survey for determination of regular vaccination coverage among children.

One of the objectives of the Expanded Program of Immunization (EPI) is to achieve and sustain vaccination coverage to >90%. The coverage is not uniform within the districts, some of the areas showing more than 100% while others are far behind. The objective of the survey was to determine the coverage of immunization among children 12-23 months of age in Rautahat District of Nepal. A cross-sectional method was applied with the 30-cluster sampling method followed by taking a sample of 210 children. The structured questionnaire requesting information about socio-economic characteristics, vaccination, history of vaccination, doses of vaccines, and vaccination records were used for collecting data. The coverage responses according to history from mothers for BCG, DPTHb-3, Polio3 and Measles immunizations were 96.7%, 90.0%, 97.6% and 78.1% respectively. By analyzing the records of the sampled Village Development Committees (VDCs), the coverage for the same vaccines was 88.1%, 78.1%, 79.0, 73.8% respectively. The drop-out of BCG versus measles was also very high. The District Health Office (DHO) reports were remarkably higher than the coverage of immunizations obtained by the survey, showing additional number of the target children.

Analysis of a previous smallpox vaccination study: estimation of the time period required to acquire vaccine-induced immunity as assessed by revaccination.

The time interval required to develop immunity after vaccination, in the event of a bioterrorist attack using variola virus, is yet to be clarified. In this article, a historical vaccination study conducted in Japan in 1929 was re-examined. Forty-four previously vaccinated and 44 unvaccinated children were involved. After successful first round primary (or re-) vaccination, all children underwent revaccination at variable intervals. Absence of a major reaction (vaccine 'take') after revaccination was taken as a sign of immunity conferred by first round primary (or re-) vaccination. Univariate analysis was employed to examine the relationship between vaccine 'take' and the exposure variables. Maximum likelihood estimates of the time period required to develop immunity were obtained using a simple logit model. The interval between vaccinations was significantly associated with vaccine 'take' in both the previously unvaccinated (p < 0.01) and vaccinated (p < 0.01) groups, and the median interval required for immunity after vaccination was estimated to be 6.4 [95% Confidence Interval (CI): 5.8, 7.1] and 4.3 days (95 % CI: 4.1, 4.7), respectively. Obtained estimates were consistent with previous observations, and the logistic fits reasonably explained the discrepancy among previous suggestions. The findings suggest that it is necessary to vaccinate exposed susceptible individuals within 3 days after exposure to ensure disease protection, and within at least 5 days (for those previously unvaccinated) to provide a certain level of protection; the probability shows a dramatic decline hereafter.

Impacto de la Jornada Nacional de Vacunación contra la poliomielitis en Colombia, 2001: una aproximación ecológica / National immunization day evaluation in Colombia, 2001: an ecological approach

OBJETIVOS: Determinar el impacto de la Jornada Nacional de Vacunación realizada en el 2001 sobre las coberturas de esquemas completos (VPO3) y cumplimiento de la meta de refuerzos de vacuna antipoliomielítica, en diferentes regiones del país y su asociación con el índice de Necesidades Básicas Insatisfechas (NBI), desplazamiento forzoso y conflicto armado. MÉTODOS: Estudio ecológico de grupos múltiples y analítico, utilizando como unidades de observación la región, departamento, provincia y municipio. Se realizó análisis bivariado con diferencia de proporciones para muestras pareadas (prueba de McNemar), cálculo del OR, regresión lineal y determinación del riesgo relativo con la fórmula de Morgenstern. Además fueron comparadas las poblaciones protegidas y susceptibles entre unidades de observación. RESULTADOS: El incremento de la cobertura de VPO3 entre Octubre y Diciembre del 2001 de 15 a 19 por ciento (p<0,05) y la cobertura final de 78 a 84 por ciento. El análisis provincial evidenció un 25,8 por ciento de la población en sitios con coberturas útiles. Se registró un aumento de 4 a 7 departamentos y 281 a 328 municipios con coberturas mayores de 95 por ciento (p<0,05). Se encontró una disminución del riesgo de no completar esquemas en zonas de conflicto, se mantuvo en zonas con NBI alto y aumentó en zonas con alta proporción de familias desplazadas. El cumplimiento de la meta de refuerzos de VPO tuvo una mediana de 61 por ciento. CONCLUSIONES: La Jornada Nacional de Vacunación disminuyó las dificultades de acceso de la población menor de 5 años. El análisis de diferentes unidades geográficas controla el efecto del desconocimiento de los denominadores de población. Los estudios ecológicos enriquecen el análisis de los datos rutinarios.