Vídeos sobre vacinas: quais fatores influenciam em maior visualização no YouTube? / Videos about vaccines: what factors influence on having higher views on YouTube? / Videos sobre vacunas: ¿qué factores influyen en una mayor visualización en YouTube?

Considerando-se a crescente importância do YouTube como fonte para busca de informações em saúde, o objetivo deste trabalho é analisar os fatores associados a um maior número de visualizações de vídeos sobre vacinas contra a covid-19. Para isso, usaram-se técnicas de Processamento de Linguagem Natural e modelagem estatística com base em 13.619 vídeos, abrangendo três tipos de variáveis: métricas gerais, conteúdo textual dos títulos e informações sobre os participantes dos vídeos. Entre os resultados, destacam-se os vídeos de duração média ou longa, postados durante a madrugada e nos fins de semana, com tags, descrição e títulos curtos, além de elementos controversos e presença de figuras masculinas e brancas em miniaturas. Os achados contribuem para uma melhor compreensão dos possíveis fatores a serem considerados na produção de conteúdo de comunicação em saúde sobre vacinas no YouTube.

Considering the growing importance of YouTube as a source for health information search, the aim of this study was to analyze the factors associated with a higher number of views in videos about covid-19 vaccines. For this purpose, Natural Language Processing techniques and statistical modeling were employed based on 13,619 videos, encompassing three types of variables: general metrics, textual content of titles, and information about the participants in the videos. Among the results, videos of medium or long duration, posted during late hours and on weekends, with tags, descriptions, and short titles, along with controversial elements and the presence of male and white figures in thumbnails stand out. These findings contribute to a better understanding of the potential factors to be considered in the production of health communication content about vaccines on YouTube.

Teniendo en cuenta la creciente importancia de YouTube como fuente de búsqueda de información en salud, el objetivo de este artículo es analizar los factores asociados a un mayor número de visualizaciones en videos sobre vacunas contra el covid-19. Para eso, se emplearon técnicas de Procesamiento del Lenguaje Natural y modelado estadístico basadas en 13,619 videos, que abarcan tres tipos de variables: métricas generales, contenido textual de títulos y información sobre los participantes en los videos. Entre los resultados, destacan los videos de duración media o larga, publicados durante altas horas de la noche y los fines de semana, con tags, descripciones y títulos cortos, junto con elementos controvertidos y la presencia de figuras masculinas y blancas en las miniaturas. Estos hallazgos contribuyen a una mejor comprensión de los posibles factores a tener en cuenta en la producción de contenido de comunicación de salud sobre vacunas en YouTube.

Establecimiento del esquema de purificación de los antígenos de SOBERANA®02, SOBERANA®Plus y SOBERANA 01 / Establishment of the purification scheme for SOBERANA®02, SOBERANA®Plus and SOBERANA 01 antigens

La urgente necesidad de desarrollar y producir vacunas seguras y efectivas para garantizar la reducción de la propagación del coronavirus de tipo 2 causante del síndrome respiratorio agudo severo, hizo que el Centro de Inmunología Molecular y el Instituto Finlay de Vacunas, desarrollaran dos vacunas y un candidato vacunal contra la COVID-19, que tienen como componente la molécula del dominio de unión al receptor (aa 319-541) del virus. Para establecer el proceso productivo, se realizaron experimentos en los posibles pasos del proceso de purificación de la molécula del dominio de unión al receptor (aa 319-541), con vistas a su posterior transferencia tecnológica a escala industrial. Dicha molécula está fusionada con una etiqueta de hexahistidina en su extremo C-terminal y presenta nueve residuos de cisteína en su secuencia que forman cuatro enlaces disulfuros intramoleculares, quedando una cisteína libre que permite obtener dos moléculas: dimérica y monomérica, antígenos que forman parte de las vacunas SOBERANA®02 y SOBERANA®Plus y el candidato vacunal SOBERANA 01. Se determinaron las mejores condiciones de adsorción de las matrices cromatográficas de afinidad por quelatos metálicos, intercambio catiónico y exclusión molecular. Se evaluó el desempeño del proceso a escala piloto y se caracterizó la molécula de acuerdo a sus propiedades físico-químicas y biológicas. Los resultados obtenidos mostraron un 60,02 ± 5,15por ciento de recuperación total de la proteína de interés, con más del 98% de pureza en ambas moléculas, una eficiente remoción de contaminantes y una antigenicidad mayor del 90por ciento referido al monómero control del dominio de unión al receptor con 99 por ciento de pureza, lo que demuestra que el proceso establecido es eficiente en la obtención de un producto con la calidad requerida(AU)

The urgent need to develop and produce safe and effective vaccines to guarantee the reduction of the spread of the type 2 coronavirus that causes severe acute respiratory syndrome, led the Center for Molecular Immunology and the Finlay Vaccine Institute to develop two vaccines and one candidate vaccine to combat the 2019 coronavirus pandemic. As part of the establishment of the production process, experiments were carried out on the possible steps of the purification process of the receptor binding domain molecule (aa 319-541) with a view to its subsequent technological transfer on an industrial scale. This molecule is fused with a hexahistidine tag at its C-terminal end and has nine cysteine residues in its sequence that form four intramolecular disulfide bonds; leaving a free cysteine that allows two molecules to be obtained: dimeric and monomeric, which constitute the antigens of the SOBERANA®02 and SOBERANA®Plus vaccines and the SOBERANA 01 vaccine candidate. The best adsorption conditions of the chromatographic matrices of affinity for metal chelates, cationic exchange and molecular exclusion were determined. The performance of the process was evaluated on a pilot scale and the molecule was characterized according to its physical-chemical and biological properties. The results obtained showed a 60.02 ± 5.15percent total recovery of the protein of interest with more than 98% purity in both molecules, an efficient removal of contaminants and an antigenicity greater than 90percent referred to the control monomer of the domain receptor binding with 99% purity; which demonstrates that the established process is efficient in obtaining a product with the required quality(AU)

Immunization against covid-19 and mortality in hospitalized patients: a retrospective cohort / Imunização contra covid-19 e mortalidade em pacientes hospitalizados: coorte retrospectiva

ABSTRACT OBJECTIVE To evaluate the effectiveness of vaccines developed against covid-19 in reducing mortality in people hospitalized with severe acute respiratory syndrome (SARS) caused by SARS-CoV-2. METHODS This is a retrospective cohort that evaluated risk factors and the effectiveness of the two-dose vaccination schedule in reducing the mortality of people hospitalized for covid-19 in the state of Paraíba from February to November 2021. The explanatory variables were vaccination status, presence of comorbidities, socioeconomic and demographic characteristics. Descriptive analyses and bivariate and multivariable logistic regression were performed. RESULTS Most hospitalizations and deaths occurred until May 2021. The percentage of patients with a complete vaccination schedule was similar across patients admitted to public and private hospitals and higher in residents of less developed municipalities. Multivariable analysis demonstrated that women (OR = 0.896; 95%CI 0.830-0.967) and people admitted to private hospitals (OR = 0.756; 95%CI 0.679-0.842) were less likely to die. Presence of any comorbidity (OR = 1.627; 95%CI 1.500-1.765) and age ≥ 80 years (OR = 7.426; 95%CI 6.309-8.741) were risk factors for death. Patients with complete vaccination schedule at the time of admission were 41.7% less likely to die (OR = 0.583; 95% CI 0.501-0.679) from covid-19 in the adjusted analysis, as compared to unvaccinated patients. CONCLUSIONS The study reveals that immunization was effective in reducing the likelihood of death from covid-19. The results suggest that greater vaccination coverage in the first half of 2021 would prevent thousands of deaths in the country.

RESUMO OBJETIVO Avaliar a efetividade das vacinas desenvolvidas contra a covid-19 na redução da mortalidade em pessoas internadas com síndrome respiratória aguda grave (SRAG) causada pelo SARS-CoV-2. MÉTODOS Trata-se de uma coorte retrospectiva que avaliou fatores de riscos e a efetividade do esquema vacinal com duas doses na redução da mortalidade de pessoas internadas por covid-19 no estado da Paraíba entre fevereiro e novembro de 2021. As variáveis explicativas foram situação vacinal, presença de comorbidades, características socioeconômicas e demográficas. Foram realizadas análises descritivas e regressão logística bivariada e multivariável. RESULTADOS A maior parte das internações e óbitos ocorreram até maio de 2021. O percentual de pacientes com esquema vacinal completo foi similar entre pacientes internados em hospitais públicos e privados e superior em residentes de municípios com menor desenvolvimento. A análise multivariável demonstrou que mulheres (OR = 0,896; IC95% 0,830-0,967) e pessoas internadas em hospitais privados (OR = 0,756; IC95% 0,679-0,842) apresentaram menor chance de morte. A presença de alguma comorbidade (OR = 1,627; IC95% 1,500-1,765) e idade ≥ 80 anos (OR = 7,426; IC95% 6,309-8,741) foram fatores de risco de óbito. Pacientes com esquema vacinal completo no momento da internação apresentaram uma chance 41,7% menor de morte (OR = 0,583; IC95% 0,501-0,679) por covid-19 na análise ajustada, quando comparados com pacientes não vacinados. CONCLUSÕES O estudo revela que a imunização foi efetiva na redução da chance de óbito por covid-19. Os resultados sugerem que uma maior cobertura vacinal no primeiro semestre de 2021 evitaria milhares de mortes no país.

COVID-19 vaccine acceptance among pregnant women: a multicentre cross-sectional survey in Port Harcourt, Nigeria

Introduction: effective COVID-19 vaccines for the prevention of severe illness have been available for more than one year now. This study was carried out to ascertain vaccine hesitancy and its associations among pregnant women receiving antenatal care in Port Harcourt, a large cosmopolitan town in Nigeria. Methods: we conducted a cross-sectional online survey over 2 months among consenting pregnant women receiving antenatal care in the 3 largest obstetric service centers in Port Harcourt to evaluate COVID-19 vaccine hesitancy and its associations. Results: the prevalence of vaccine hesitancy was 669 (72.2%). Of the respondents, 27 (2.9%) had been infected or had a close family member infected with SARS-CoV-2, and 897 (96.8%) of them had heard of the COVID-19 vaccine; however, only 133 (14.4%) had been vaccinated against COVID-19. The safety of the mother in 260 (32.8%) and the safety of the unborn baby in 114 (14.4%) of the respondents were the reasons for vaccine hesitancy. A small proportion of women 7(0.9%) were hesitant on religious grounds. Tertiary education, use of childhood immunization for previous infants delivered, and availability of COVID-19 vaccine in the antenatal clinic at no cost to the women, were statistically significant predictors of vaccine uptake among the respondents. Conclusion: the prevalence of vaccine hesitancy among pregnant women in Port Harcourt was 72.2%. Higher academic achievement and availability of the COVID-19 vaccine in the antenatal clinic were predictors of vaccine uptake, while reasons for hesitancy were mostly due to safety concerns for the mother and unborn baby.

Complications following COVID-19 infection or vaccination in Libyan International Medical University students and their Families

Coronavirus disease 2019 (COVID-19) caused by a novel strain of coronavirus belonging to the genus Beta coronavirus named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged as a major pandemic worldwide. This contagious virus had spread in many different forms, and patients have demonstrated a wide range of symptoms, ranging from moderate to severe illness. This study aims to highlight the important associations between SARS-CoV-2 infection, vaccination, and possible complications at the Libyan International Medical University, Benghazi. This crosssectional survey was conducted among students and their families at Libyan International Medical University in Benghazi, Libya. Among the 100 participants, 72% were between the ages of 18 and 39. Up to (59%) of participants were men. As for the infection with COVID-19, 77% of participants were infected. Most of the participants had no chronic diseases (69%); however, the most common chronic disease was diabetes mellitus (13%). 82% of participants were vaccinated; the most common types of vaccines administered were Sinopharm and Sputnik V (24%). Following vaccination, 71% of participants had no COVID-19 infection, while 29% did get the infection. Regarding this study, after COVID-19 infection, 66% of participants had no complications; however, 17% had pulmonary complications, which was the most common complication among the participants. As for the complications following the vaccination, 81% of participants had none, while there were pulmonary and neurological complications in 7­6%. The results of the study showed that the most frequent complications noticed among the participants following the COVID-19 infection and vaccination were pulmonary and neurological complications.

Caminando hacia el final de la pandemia COVID-19: caso México / Moving towards the end of the COVID-19 pandemic: the case of Mexico

Introducción: se vive una crisis de confianza en la ciencia y una época de menosprecio a los conocimientos y evidencias. Las opiniones de los líderes políticos y otras figuras públicas ajenas a los problemas de salud tienen una mayor consideración y peso que los juicios emitidos por los expertos. Una evidencia que demuestra la debilidad de México en el campo de la salud son dos hechos en los cuales las autoridades del país son los culpables que son: la desaparición del Seguro Popular y la pobre respuesta a la pandemia de COVID-19. Conclusiones: la pandemia no termina por decreto, se logrará con cuidados y prevención realizada por el gobierno, instituciones y personal de salud y la sociedad (AU)

Introduction: we are living through a crisis of confidence in science and an era of disregard for knowledge and evidence. The opinions of political leaders and other public figures who are not involved in health problems are given greater consideration and weight than the judgments made by experts. Evidence that demonstrates Mexico's weakness in the field of health are two facts in which the country's authorities are to blame: the disappearance of Seguro Popular and the poor response to the COVID-19 pandemic. Conclusions: the pandemic does not end by decree, it will be achieved with care and prevention carried out by the government, health institutions and personnel and society (AU)

Vacuna contra la COVID-19 y menstruación, desde el desconocimiento a la información: revisión sistemática / Vaccine against COVID-19 and menstruation, from ignorance to information: a systematic review

La creación de una vacuna para enfrentar la pandemia de COVID-19 conllevó un vacío de información sobre las posibles alteraciones del ciclo menstrual. El objetivo fue verificar las posibles alteraciones que se pudiesen haber generado en el ciclo menstrual de las mujeres posterior a la inoculación de la vacuna contra la COVID-19. Se realizó una revisión sistemática en las bases bibliografías Medline, Medline Complete, LILACS, CINAHL y ScIELO, utilizando los descriptores “Women”, “Woman”, “Fertile period”, “Vaccination”, “Mass vaccination”, “Immunization”, “COVID-19 vaccines”, “SARS-CoV-2 infection”, “COVID-19”, “Menstrual cycle”, “Menstruation”, “Endometrial cycle”, “Dysmenorrhea” y “Menstruation disturbances”. Mediante la utilización del protocolo PRISMA, de los 319 artículos localizados, 17 fueron incluidos en el análisis. La mayoría de los estudios incluyeron, principalmente, las vacunas Pfizer, Moderna, AstraZeneca y Johnson&Johnson/Janssen con una a tres dosis administradas. El porcentaje de ciclos menstruales alterados fue del 8,0% al 77,8%, y la alteración con mayor frecuencia referida fue la duración del ciclo menstrual, que fue desde 0,3 hasta 12 días de retraso de la menstruación. Todos los estudios refieren cambios en el ciclo menstrual con diversas prevalencias, con y sin significación estadística; sin embargo, también concluyen que estas alteraciones son reversibles y en un corto periodo de tiempo.

The creation of a vaccine to face the COVID-19 pandemic, led to an information gap on possible alterations of the menstrual cycle. The objective was to verify the possible alterations that could have been generated in the menstrual cycle of women, after the inoculation of the vaccine against COVID-19. A systematic review was carried out in the Medline, Medline Complete, LILACS, CINAHL and ScIELO bibliographic databases, using the descriptors “Women”, “Woman”, “Fertile period”, “Vaccination”, “Mass vaccination”, “Immunization”, “COVID-19 vaccines”, “SARS-CoV-2 infection”, “COVID-19”, “Menstrual cycle”, “Menstruation”, “Endometrial cycle”, “Dysmenorrhea” and “Menstruation disturbances”. Using the PRISMA protocol, of the 319 articles located, 17 were included in the analysis. Most of the studies mainly included the Pfizer, Moderna, AstraZeneca and Johnson&Johnson/Janssen vaccines with one to three doses administered. The percentage of altered menstrual cycles ranged from 8.0% to 77.8%, and the most frequently reported alteration was the length of the menstrual cycle, which occurred from 0.3 to 12 days late in menstruation. All the studies refer to changes in the menstrual cycle with different prevalences, with and without statistical significance; however, the same studies also conclude that these alterations are reversible and in a short period of time.

Impacto social de la ciencia y la tecnología cubana en el enfrentamiento a la COVID-19 / Social Impact of Cuban Science and Technology the Fight Against COVID-19

Introducción: La ciencia mediante la innovación de los servicios y la tecnología brinda importantes beneficios en función de la sociedad. Objetivo: Proporcionar información sistematizada sobre el impacto social de la ciencia y la tecnología cubana en el enfrentamiento a la COVID-19. Métodos: Se realizó una búsqueda bibliográfica en las bases de datos Scopus, SciELO, ScienceDirect y MEDLINE/PubMed. Para ello, se utilizaron los descriptores o palabras relacionadas con la temática (ciencia, tecnología, COVID-19). Se consultaron artículos de revisión, de posición, y metaanálisis de los años 2020, 2021 y 2022, de la búsqueda solo 30 artículos cumplieron con los criterios de selección. Resultados: En la etapa pandémica, Cuba depositó toda la confianza en sus científicos y sacó provecho a la industria biotecnológica en la búsqueda de salvaguardar la población. Gracias a la satisfactoria gestión del gobierno se obtuvieron resultados positivos en las investigaciones, a partir de la inventiva de los productos como jusvinza, nasalferon, biomodulina T, entre otros. Se inventó un ventilador pulmonar asistido de alta gama para el tratamiento de los adultos, de este modo se fortaleció el trabajo interinstitucional e intersectorial. Conclusiones: La ciencia, la tecnología y las innovaciones han sido cruciales para el manejo de la crisis sanitaria generada por la COVID-19. En Cuba, se obtuvieron valiosos resultados en diferentes niveles para el beneficio de la sociedad; como las vacunas soberana y Abdala(AU)

Introduction: Both science and technology justify their existence through the innovation of services and technologies for the benefit of society. Objective: To provide systematized information on the social impact of Cuban science and technology in the fight against COVID-19. Methods: A bibliographic search was carried out in Scopus, SciELO, ScienceDirect and MEDLINE/PubMed databases. Descriptors or words related to the theme (science, technology, COVID-19) were used. Review articles, position articles, and meta-analyses from 2020, 2021, and 2022 were consulted. Only 30 articles met the selection criteria. Results: In the pandemic stage, Cuba placed all its trust in its scientists and took advantage of the biotechnology industry in the search for the safeguarding of the population. Thanks to the satisfactory management of the government, good results were obtained in the investigations with the inventiveness of products such as Jusvinza, nasalferon, biomodulin T, among others. A high-end assisted lung ventilator was invented for treating adults, in the same way that inter-institutional and intersectoral work was strengthened. Conclusions: Science, technology, and innovations have been crucial in managing the health crisis caused by COVID-19. In Cuba, relevant results have been obtained at different levels for the benefit of society, among which Soberana and Abdala vaccines stand out(AU)

Inmunización con vacunas ARN mensajero contra la COVID-19 en pacientes adolescentes con antecedente de síndrome inflamatorio multisistémico: serie de casos / Immunization with messenger RNA vaccines against COVID-19 in adolescents with a history of multisystem inflammatory

Los niños cursan mayormente la infección por el virus SARS-CoV-2 en forma leve. Sin embargo, de forma muy infrecuente algunos pueden desarrollar una patología con marcada gravedad denominada síndrome inflamatorio multisistémico en niños relacionado temporalmente con COVID-19 (SIM-C). Dado su reciente surgimiento, aún hay aspectos de su fisiopatología que se desconocen. La posibilidad de recidiva en caso de reinfección o ante la vacunación contra SARS-CoV-2 son nuevos interrogantes a los que nos enfrentamos. Reportamos una serie de casos de 4 pacientes adolescentes que cursaron SIM-C y meses después han sido vacunados contra SARS-CoV-2 con plataformas ARN mensajero (ARNm) sin presentar recurrencia de la enfermedad ni efectos adversos cardiológicos

In most cases, children with SARS-CoV-2 have a mild infection. However, very rarely, some children may develop a severe disease called multisystem inflammatory syndrome in children temporally associated with COVID-19 (MIS-C). Given its recent emergence, some aspects of its pathophysiology are still unknown. The possibility of recurrence in case of reinfection or SARS-CoV-2 vaccination are new questions we are facing. Here we report a case series of 4 adolescent patients who developed MIS-C and, months later, received the SARS-CoV-2 vaccine with messenger RNA (mRNA) platforms without disease recurrence or cardiac adverse events.

COVID-19, ¿un conflicto ético? / COVID-19, an ethical conflict?

Exposición sobre posibles dilemas éticos ante la pandemia Covid-19 desde los comité de ética en investigación, en relación a la validación de resultados y distribución de diferentes vacunas, y a los criterios objetivos en la toma de decisiones con respecto a las conductas médicas aprobadas y permitidas durante la pandemia; de modo tal de crear un protocolo especial para la utilización de las futuras generaciones en contextos similares.

Investigación en Pandemia: intervenciones del Comité Provincial de Bioética de Santa Fe / Pandemic research: Santa Fe Provincial Committee of Bioethics interventions

Se presenta brevemente la evaluación ética de los protocolos presentados durante la pandemia de Covid-19 al Comité Provincial de Bioética de Santa Fe, organismo que regula las investigaciones con seres humanos en esta provincia, articulando esta tarea con los 24 comités de ética acreditados a nivel provincial. Se describen especialmente dos protocolos que fueron observados y en uno de los casos rechazado por el Comité en base a aspectos éticos.

COVID-19 en pacientes con esclerosis múltiple: estudio observacional retrospectivo en un centro de referencia colombiano / COVID-19 in patients with multiple sclerosis: retrospective observational study in a reference center in Colombia

Introducción: En Colombia, la información sobre la frecuencia de presentación de la enfermedad por CO-VID-19 y sus desenlaces en personas con esclerosis múltiple (EM) es prácticamente inexistente. El objetivo de este estudio es describir la frecuencia, las características y los factores relacionados con la infección por COVID-19 en una muestra de pacientes con EM en Colombia. Materiales y métodos: Análisis descriptivo y retrospectivo de pacientes diagnosticados con criterios de esclerosis múltiple que acudieron a nuestro centro entre junio y octubre del año 2021. Los pacientes proporcionaron información sobre la infección por SARS-CoV-2 y su vacunación. Se analizaron los factores relacionados con la infección por COVID-19 mediante modelos de regresión logística binomial uni y multivariable. Resultados: Se analizaron 240 pacientes, de los cuales el 71 % eran mujeres, con una edad promedio de 34 años. La mayoría estaban en tratamiento con terapias modificadoras de la enfermedad y más del 80 % estaban vacunados. Sesenta y nueve pacientes declararon haber tenido COVID-19. En los modelos multivariables, la edad (OR 0,96; IC 95 % 0,93-0,99) fue el único factor asociado con una menor probabilidad de infección por COVID-19. Discusión: La infección por COVID-19 en pacientes con EM en Colombia parece ser independiente de las variables clínicas y de tratamiento y parece estar asociada con la menor edad. Conclusiones: Se requieren más estudios para evaluar el comportamiento del COVID-19 en pacientes con EM en el contexto colombiano.

Introduction: The information about the frequency of COVID-19 and its outcomes in people with Multiple Sclerosis (MS) in Colombia is practically non-existent. We aimed to describe the frequency characteristics and factors associated with of COVID-19 in a sample of patients with MS. Materials and methods: Descriptive and retrospective analysis of patients diagnosed with Multiple Sclerosis criteria who attended our center between June and October 2021. Patients provided information about SARS-CoV-2 infection and their vaccination. COVID-19 determinants were analyzed using uni-and multivariable binomial logistic regression models. Results: 240 patients were analyzed, of whom 71% were women, with a mean age of 34 years. The majority of patients were on disease-modifying therapies and over 80 % were vaccinated. 69 patients reported having had COVID-19. In multivariable models, age (OR 0.96; 95 % CI 0.93-0.99) was the only factor associated with a lower odds of COVID-19 infection. Discussion: COVID-19 infection in patients with MS in Colombia appears to be independent of clinical and treatment variables, and it appears to be associated with younger age. Conclusions: More studies are needed to assess the behavior of COVID-19 in MS patients from Colombia.

Reações de hipersensibilidade a vacinas / Hypersensitivity reactions to vaccines

O desenvolvimento e a ampliação do uso das vacinas durante décadas contribuíram para o controle e erradicação de doenças infecciosas, causando um grande impacto na saúde pública no mundo. A análise de segurança das vacinas percorre criteriosos processos e fases dos estudos clínicos, um dos pilares essenciais para aprovação regulatória e utilização do produto na população. O evento supostamente atribuído à vacinação e imunização (ESAVI), terminologia atual, é definido como qualquer ocorrência médica indesejada após a vacinação que possui, ou não, uma relação causal com o uso de uma vacina ou outro imunobiológico. Cabe ressaltar que eventos adversos mais raros ou inesperados, incluindo os eventos de hipersensibilidade, poderão ocorrer na fase pós-comercialização, quando as vacinas são aplicadas em milhões de pessoas. Neste artigo, serão discutidos os principais aspectos relacionados aos eventos adversos de hipersensibilidade pós-vacinais de interesse do especialista, e os desafios frente ao reconhecimento do agente causal e conduta a ser adotada. Além disso, serão revisados os potenciais alérgenos presentes nas vacinas de uso rotineiro para auxiliar o profissional de saúde na identificação de pacientes com potencial de risco de ESAVI por tais componentes. A atualização do conhecimento acerca da segurança e dos benefícios das vacinas pelos profissionais de saúde, sobretudo em populações especiais, contribui para condutas em imunização mais apropriadas, reduzindo o risco de exposição a um possível alérgeno em pessoas comprovadamente alérgicas às vacinas ou a alguns dos seus componentes, além de evitar contraindicações desnecessárias em eventos coincidentes ou não graves.

The expansion of vaccine use and development in recent decades has contributed to the control and eradication of infectious diseases, causing a major impact on public health worldwide. Vaccine safety analysis, which involves careful processes and clinical study, is one of the essential pillars of regulatory approval and use in the population. In current terminology, events supposedly attributable to vaccination and immunization (ESAVI) are defined as any unwanted medical occurrence after vaccination that may or may not have a causal relationship with vaccines or other immunobiologicals. It is noteworthy that rare or unexpected adverse events, including hypersensitivity, can occur during the post-marketing phase, when vaccines are administered to millions of people. In this article, we will discuss the main aspects of post-vaccine hypersensitivity events of interest to specialists and challenges to recognizing the causal agent and appropriate clinical practice. Potential allergens in routine vaccines will also be reviewed to help health professionals identify patients with a potential risk of ESAVI due to such components. Updating health professionals' knowledge about the safety and benefits of vaccines, particularly in special populations, can contribute to more appropriate clinical practice regarding immunization, reducing the risk of exposure to possible allergens in people with allergies to vaccines or their components, avoiding unnecessary contraindications in coincidental or non-serious events.

Anticuerpos anti-SARS-CoV-2 en personal de salud de un hospital pediátrico / SARS-CoV-2 antibodies among health care workers from a children's hospital

Introducción. En Argentina, el personal de salud ha sido el primero en vacunarse contra COVID-19, pero todavía existen pocos datos sobre la producción de anticuerpos IgG anti-S. Objetivos. Evaluar IgG específica contra glicoproteína spike del SARS-CoV-2 (IgG anti-S) posvacunación en personal de un hospital pediátrico. Explorar la asociación entre presencia de dichos anticuerpos, edad y antecedente de infección previa. Población y métodos. Estudio transversal que incluyó 193 trabajadores vacunados con los dos componentes de la vacuna Sputnik V. Se pesquisó el título de IgG anti-S y se registraron edad, antecedente de infección previa por SARS-CoV-2 y fecha de la vacunación. Resultados. El 98,6 % de los sujetos generó IgG anti-S. El título fue mayor en quienes habían cursado infección previamente (p <0,001), pero no hubo relación con la edad de los sujetos. Conclusión. Aportamos datos de generación de anticuerpos IgG anti-S posvacunación en personal de salud de un hospital pediátrico y exploramos algunos predictores.

Introduction. In Argentina, health care workers have been the first ones to receive the COVID-19 vaccine, but there are still few data on the production of anti-S IgG antibodies. Objectives. To assess specific IgG against the SARS-CoV-2 spike protein (anti-S IgG) after the vaccination of health care workers from a children's hospital. To explore the association between the presence of these antibodies, age, and history of prior infection. Population and methods. Cross-sectional study in 193 workers who received both doses of the two component Sputnik V vaccine. The anti-S IgG antibody titer was measured and age, history of prior SARS-CoV-2 infection, and date of vaccination were recorded. Results. Anti-S IgG antibodies were produced in 98.6% of the subjects. The titer was higher in those with prior infection (p < 0.001), but no relationship was established with subjects' age. Conclusion. We provide data on post-vaccination production of IgG anti-S antibodies among health care workers from a children's hospital and explore some predictors.

Variante mexicana de COVID-19: ómicron BW. 1 o Xibalbá / Mexican variant of COVID-19: omicron BW. 1 o Xibalbá

Introducción: desde la aparición del COVID-19 a principios de diciembre del año 2019, en la ciudad China de Wuhan, esta enfermedad respiratoria empezó a avanzar a nivel mundial. El 30 de enero de 2020, la Organización Mundial de la Salud declaró a esta enfermedad con carácter epidémico y como una situación de emergencia a nivel mundial. El propósito de este estudio es presentar información de la variante ómicron BW.1 o Xibalbá. Conclusión: México está en un proceso de transición de pandemia hacia endemia, pero no quiere decir que no seguirán apareciendo nuevas variantes como ocurrió en la quinta ola (ómicron BA.5) o con subvariantes que emergieron como BW.1 «Xibalbá¼, BQ.1 «perro del infierno¼ y XBB «pesadilla¼. La población y los gobiernos deberán continuar con las medidas preventivas establecidas desde el inicio de la pandemia como son el uso de cubrebocas, el correcto lavado de manos y de ropa, los hábitos de higiene, limpieza, desinfección personal y de nuestro entorno, el aislamiento precoz ante alguna sintomatología y la vacunación (ya sea la primera o sus refuerzos subsecuentes).(AU)

Introduction: since the appearance of COVID-19 in early December 2019 in the Chinese city of Wuhan, this respiratory disease began to spread worldwide. On the thirtieth of January of the year two thousand and twenty, the World Health Organization (WHO) declared this disease to be epidemic and with a worldwide emergency situation. The purpose of the study is to present information on the Omicron BW.1 or Xibalba variant. Conclusion: Mexico is in a process of transition from pandemic to endemic but this does not mean that new variants will not continue to appear as they did in the fifth wave (omicron BA.5) or subvariants that emerged such as: BW.1 or «Xibalbá¼, BQ.1 «hellhound¼ and XBB «nightmare¼. The population and governments should continue with the preventive measures established since the beginning of the pandemic, such as: use of masks, proper hand and clothing washing, hygiene habits, personal and environmental cleaning and disinfection, early isolation in case of any symptomatology, and vaccination, either first or subsequent boosters.(AU)

Infección con SARS-CoV2, antes y después de la vacunación, en funcionarios de un hospital de mediana y alta complejidad / Sars-CoV2 infection, before and after vaccination, in health care workers of a medium and high complexity hospital

Introducción: La pandemia de COVID-19 evidenció la importancia de los trabajadores esen-ciales de la salud. Objetivo: Estimar la ocurrencia de la infección por el virus Sars_CoV2 en funcionarios de un hospital, antes y después de implementación del programa de vacunación institucional y la fracción preventiva atribuible a la vacunación. Material y métodos: Estudio de cohorte histórica, teniendo como punto de inicio la fecha del primer funcionario diagnosticado con la Covid19 en el Hospital. Alrededor de mil traba-jadores fueron examinados, durante el periodo de estudio comprendido entre junio de 2020 y octubre 2021. Se utilizó el estadístico de Kaplan-Meier, para comparar la velocidad de infección y la fracción preventiva atribuible al programa de vacunación. Resultados. Hubo diferencias estadísticamente significativas en la reducción de casos según tipo de trabajo, los trabajadores asistenciales experimentaron una reducción del 58,1%, de 124 a 52 y la diferencia en la mediana de la velocidad de infección, antes y después, Log Rank = 127,4 gl = 1 p = 0,000; los administrativos 51,7% de 29 a 14, mediana log Rank = 34,4 gl = 1 p = 0,000, y los operativos 45,5% de 11 a 6, mediana Log Rank = 13,5 gl = 1 p = 0,000. La fracción atribuible preventiva entre los asistenciales fue 47,5% (37,4­54,9); 85,2% (77,7­88,9) en administrativos y una reducción no significativa de 43,6% (-20,7, 63,2) en operativos. Conclusiones: Los trabajadores asistenciales tienen un riesgo alto de contraer la infección por Sars_CoV2. Fue una acertada decisión vacunar a todos los trabajadores del hospital, el impacto es demostrable.

Introduction: The COVID-19 pandemic highlighted the importance of essential health care workers.Objective: To estimate the occurrence of Sars_CoV2 virus infection in hospital staff before and after implementation of the institutional vaccination program and the preventive fraction attributable to vaccination. Material and methods: Historical cohort study, having as starting point the date of the first employee diagnosed with Covid19 in the Hospital. About one thousand workers were exa-mined, during the study period from June 2020 to October 2021. The Kaplan-Meier statistic was used to compare the infection, rate and the preventive fraction attributable to the vac-cination program. Results: There were statistically significant differences in the reduction of cases according to type of work, with the assistential workers experiencing a reduction of 58.1%, from 124 to 52 and the difference in median infection rate, before and after, Log Rank = 127.4 gl = 1 p = 0.000; the administrative 51.7% from 29 to 14, median Log Rank = 34.4 gl = 1 p = 0.000, and the operatives 45.5% from 11 to 6, median Log Rank = 13.5 gl = 1 p = 0.000. The preventive attributable fraction among assistants was 47.5% (37.4-54.9); 85.2% (77.7-88.9) in adminis-trative and a non-significant reduction of 43.6% (-20.7, 63.2) in operatives.Conclusions: Healthcare workers are at high risk of contracting Sars_CoV2 infection. It was a wise decision to vaccinate all hospital workers, the impact is demonstrable.

Hipertiroidismo por enfermedad de Graves posterior a vacuna contra SARS-CoV-2: reporte de 2 casos / Graves' disease hyperthyroidism following SARS-CoV-2 vaccination: a two cases report

Luego del inicio de las campañas de vacunación masiva contra la infección por COVID-19, se han publicado una serie de reportes que muestran la posible asociación entre la vacuna y alteraciones de la función tiroidea. Desde entonces, múltiples teorías han intentado explicar este hallazgo, en su mayoría de índole autoinmune. Dentro de estas destaca el síndrome autoinmune-autoinflamatorio secundario a adyuvantes (ASIA), que podría generar desórdenes tiroideos de novo o exacerbar los ya existentes. Presentamos dos casos de enfermedad de Graves Basedow posterior al uso de Coronavac. Ambas pacientes presentaron características similares a las descritas en la literatura y cumplen con los criterios de ASIA. No obstante, los beneficios de las vacunas superan los posibles riesgos asociados.

After the beginning of COVID-19 vaccination campaigns, a number of reports have shown the potential association between vaccines and thyroid disfunction. Since then several theories have tried to explain this finding, mostly autoinmmune. One of them is the autoimmune/inflammatory syndrome induced by adjuvants, that could trigger or exacerbate thyroid disease. We present two cases of Graves' disease post Coronavac vaccination. Both pacients share similar features than cases published previously and meet criteria for ASIA syndrome. Nevertheless, the benefts of vaccination largely outweigh any adverse events associated.

New-onset thyroid eye disease after COVID-19 vaccination in a radioactive iodine-treated graves’ disease patient: A case report and literature review / Journal of the ASEAN Federation of Endocrine Societies

@#Autoimmunity associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been well-described as the mechanism of development of thyroid dysfunction following Coronavirus Disease 19 (COVID-19) infection and SARS-CoV-2 vaccination. However, the occurrence of thyroid eye disease (TED) after SARS-CoV-2 vaccination is scarcely described. The postulated mechanisms include immune reactivation, molecular mimicry and the autoimmune/inflammatory syndrome induced by adjuvants (ASIA). We report a case of new-onset TED after receiving the SARSCoV- 2 vaccine.

Detection of neutralizing antibodies among health care workers and staff fully-vaccinated against COVID-19 in a Baguio City tertiary hospital: A cross-sectional study

Background@#Coronavirus disease 2019, otherwise known as COVID-19 is caused by the novel coronavirus. The WHO stated that as of April 24, 2020, no study has evaluated if the antibodies against COVID-19 confer immunity. The aim therefore of this research is to determine the presence of neutralizing antibodies among fully vaccinated Health Care workers and staff of Notre Dame de Chartres Hospital.@*Methods@#This study is a single-center, cross-sectional study conducted at Notre Dame de Chartres Hospital in Baguio City. This study was designed to determine the presence of neutralizing antibodies 6 months after the 2nd dose of COVID-19 vaccine, either with Sinovac (CoronaVac®), an inactivated virus, or Oxford AstraZeneca, a non-replicating viral vector. The study was approved by the Ethics Review Board of the Baguio General Hospital Medical Center. A total of 206 participants enrolled voluntarily in the study. Descriptive statistics such as frequency and percentage were used to determine the baseline characteristics of the research participants. The mean amounts of antibodies after vaccination against COVID-19 were determined. Independent-sample t-test was utilized to determine if there was a significant difference in antibody production when comparing the two brands of vaccine, according to sex, employee status, presence of at least one comorbidity, and history of COVID-19 vaccination. One-way analysis of variance (ANOVA) was used for the variable age. All statistical tests were conducted at p<0.05 level of significance. Computations were done using SPSS version 22.0.@*Results@#A total of 236 healthcare workers and staff of Notre Dame de Chartres Hospital were included in the study. Among the study participants given either Sinovac or AstraZeneca, 52.97% belong to the 20-30 years old age group. Most of them were females (69.92%). For employment status, healthcare workers comprised the majority of the study population at 71.61% while the rest (28.36%) were hospital staff. Most did not have any comorbidities, while 26.27% reported having comorbidities, with hypertension and asthma identified as the predominant diseases at 9.75% and 9.32%, respectively; followed by allergic rhinitis (5.32%) and diabetes mellitus (2.97%). Among the participants, 74.6% were never diagnosed with COVID-19, while 25.4% reported to have been infected, with 16.5% having only mild symptoms. Most of the study participants (67.4%) were inoculated with Sinovac® while the rest (32.6%) received AstraZeneca.@*Conclusion@#There was no significant difference in the mean amount of antibodies when grouped according to each of the following variables: age, sex, employee status, and comorbidities. These results apply to both SINOVAC and AstraZeneca groups. There was a significantly higher mean amount of antibodies in those who had previously contracted COVID-19 than in those who never had a previous infection. On the other hand, comparing the mean amount of antibodies between the two brands of vaccines, SinovacTM and AstraZenecaTM, those who were vaccinated with AstraZenecaTM developed higher amounts of antibodies than those who were vaccinated with SinovacTM.

Perceived knowledge, attitude and readiness to accept towards COVID-19 vaccine among health care staffs in a tertiary government hospital

Introduction@#Fear and concern over vaccine safety are the most common reasons for vaccine hesitancy. During the COVID-19 pandemic, healthcare staff are among those at high risk of contracting the virus. They are also the public’s vital source of information and in providing trust regarding COVID-19 vaccines. This study was conducted to assess perception, attitude, and vaccination acceptance towards COVID-19 vaccines among healthcare staff at Eastern Visayas Regional Medical (EVMC).@*Objective@#To assess the perceived knowledge, attitude, and readiness to accept COVID-19 Vaccines among Eastern Visayas Regional Medical Center (EVMC) healthcare staff.@*Methods@#This analytic cross-sectional study included all medical and allied personnel employed at EVMC. Data were collected with signed consent through self-administration of a researcher-developed validated questionnaire, subsequently analyzed using descriptive and inferential statistics.@*Results@#About 634 participated, many belonged to the age group 30-39 years old (47.8%), mostly female (66.3%), single (50 %), and Roman Catholic (89.4%). Data showed no significant relationship between age, sex, marital status, religion, and the presence of chronic illness of the healthcare staff towards perceived knowledge, attitude, and readiness towards the COVID-19 vaccine. However, their clinical role was noted as significant towards their perceived knowledge and attitude (p-value = <.001). Overall, the healthcare staff response showed a moderate to high perceived knowledge and attitude about COVID-19 vaccine acceptance (p-value= <.001).@*Conclusions@#Notably, the clinical role of healthcare staff is significantly related to their perceived knowledge and attitude towards the COVID-19 vaccine. Moreover, they manifested moderate to high levels of perceived knowledge, attitude, and COVID-19 vaccine acceptance. These results may help address COVID-19 vaccine hesitancy, thus strengthen vaccine confidence among the general population. Furthermore, it provides inputs to create strategies that will enhance vaccine literacy and acceptance, directly addressing the community’s concerns and misconceptions, particularly those vulnerable groups that may easily contract severe infection.