Conocimiento de los padres de familia sobre prevención de infecciones respiratorias agudas / Knowledge of parents about prevention of acute respiratory infections / Conhecimento dos pais sobre prevenção de infecções respiratórias agudas

Muchos países toman como estrategia la educación de salud, para incrementar los conocimientos de la población en la prevención de enfermedades, en caso de los niños menores de 5 años quienes son vulnerables a las infecciones respiratorias agudas (IRA), son sus padres a quienes se evalúa el conocimiento en medidas preventivas de las IRA. Objetivo: determinar el nivel de conocimiento de los padres de familia sobre prevención de IRA de un distrito del Perú. Materiales y métodos: Estudio de tipo básico, nivel descriptivo, transversal y prospectivo. Con una muestra de 210 padres de familia, los cuales fueron escogidos por conveniencia. La técnica de recolección de datos fue la encuesta y el instrumento un cuestionario con sus dos dimensiones, la primera dimensión el de medidas preventivas de CRED (Crecimiento y desarrollo) e inmunizaciones, la segunda dimensión sobre medidas preventivas de las condiciones ambientales, mencionado instrumento paso por el proceso de validez y confiabilidad, luego se entregó el consentimiento informado antes de aplicar el instrumento a la muestra en estudio. Resultados: Las edades de los padres de familia en un 71,43% lo conforman de 18 a 33 años, el nivel de conocimiento de los padres de familia sobre prevención de IRA fue considerado alto con 45,24%, en nivel regular con 31,90% y en nivel deficiente con 22,86%. Conclusión: El nivel de conocimiento de los padres de familia de niños menores de 5 años sobre prevención de IRA fue alto en menos del 50%, siendo mayor en la sumatoria de deficiente y regular

Many countries take health education as a strategy to increase the population's knowledge of disease prevention. In the case of children under 5 years of age who are vulnerable to acute respiratory infections (ARI), it is their parents who are evaluates knowledge of preventive measures for ARI. Objective: determine the level of knowledge of parents about ARI prevention in a district of Peru. Materials and methods: Basic type study, descriptive, transversal and prospective level. With a sample of 210 parents, who were chosen by convenience. The data collection technique was the survey and the instrument was a questionnaire with its two dimensions, the first dimension on preventive measures of CRED (Growth and Development) and immunizations, the second dimension on preventive measures of environmental conditions, mentioned instrument step through the validity and reliability process, then informed consent was given before applying the instrument to the study sample. Results: The ages of the parents in 71.43% are between 18 and 33 years old, the level of knowledge of the parents about ARI prevention was considered high with 45.24%, at a regular level with 31.90% and at a deficient level with 22.86%. Conclusion: The level of knowledge of parents of children under 5 years of age about ARI prevention was high at less than 50%, being higher in the sum of deficient and regular.

Spatial clusters and social inequities in COVID-19 vaccine coverage among children in Brazil / Aglomerados espaciais e desigualdades sociais na cobertura vacinal contra COVID-19 em crianças no Brasil

Abstract This study examined the spatial distribution and social inequalities in COVID-19 vaccine coverage among children aged 5-11 in Brazil. First and second dose vaccine coverage was calculated for all Brazilian municipalities and analyzed by geographic region and deciles based on human development index (HDI-M) and expected years of schooling at 18 years of age. Multilevel models were used to determine the variance partition coefficient, and bivariate local Moran's I statistic was used to assess spatial association. Results showed significant differences in vaccine coverage rates among Brazilian municipalities, with lower coverage in the North and Midwest regions. Municipalities with lower HDI and expected years of schooling had consistently lower vaccine coverage rates. Bivariate clustering analysis identified extensive concentrations of municipalities in the Northern and Northeastern regions with low vaccine coverage and low human development, while some clusters of municipalities in the Southeast and South regions with low coverage were located in areas with high HDI-M. These findings highlight the persistent municipal-level inequalities in vaccine coverage among children in Brazil and the need for targeted interventions to improve vaccine access and coverage in underserved areas.

Resumo O estudo analisou a distribuição espacial e as desigualdades sociais na cobertura vacinal para COVID-19 entre crianças de 5 a 11 anos no Brasil. As coberturas vacinais foram calculadas para os municípios brasileiros e analisadas por região geográfica e decis com base no Índice de Desenvolvimento Humano (IDH-M) e expectativa de escolaridade aos 18 anos. Modelos multiníveis foram usados ​​para determinar o coeficiente de partição da variância, e a estatística local bivariada de Moran I foi usada para avaliar a associação espacial. Os resultados mostraram diferenças significativas nas taxas de cobertura vacinal entre os municípios, com menor cobertura nas regiões Norte e Centro-Oeste. Municípios com menor IDH e anos de escolaridade esperados apresentaram menores taxas de cobertura vacinal. A análise de agrupamento bivariado identificou extensas concentrações de municípios nas regiões Norte e Nordeste com baixa cobertura vacinal e baixo desenvolvimento humano, enquanto alguns aglomerados de municípios nas regiões Sudeste e Sul com baixa cobertura localizavam-se em áreas com alto IDH-M. Essas descobertas destacam as desigualdades persistentes em nível municipal na cobertura vacinal entre crianças e a necessidade de intervenções para melhorar o acesso e a cobertura vacinal em áreas mais vulneráveis.

Conocimiento de los padres de familia sobre prevención de infecciones respiratorias agudas

Muchos países toman como estrategia la educación de salud, para incrementar los conocimientos de la población en la prevención de enfermedades, en caso de los niños menores de 5 años quienes son vulnerables a las infecciones respiratorias agudas (IRA), son sus padres a quienes se evalúa el conocimiento en medidas preventivas de las IRA. Objetivo: determinar el nivel de conocimiento de los padres de familia sobre prevención de IRA de un distrito del Perú. Materiales y métodos: Estudio de tipo básico, nivel descriptivo, transversal y prospectivo. Con una muestra de 210 padres de familia, los cuales fueron escogidos por conveniencia. La técnica de recolección de datos fue la encuesta y el instrumento un cuestionario con sus dos dimensiones, la primera dimensión el de medidas preventivas de CRED (Crecimiento y desarrollo) e inmunizaciones, la segunda dimensión sobre medidas preventivas de las condiciones ambientales, mencionado instrumento paso por el proceso de validez y confiabilidad, luego se entregó el consentimiento informado antes de aplicar el instrumento a la muestra en estudio. Resultados: Las edades de los padres de familia en un 71,43% lo conforman de 18 a 33 años, el nivel de conocimiento de los padres de familia sobre prevención de IRA fue considerado alto con 45,24%, en nivel regular con 31,90% y en nivel deficiente con 22,86%. Conclusión: El nivel de conocimiento de los padres de familia de niños menores de 5 años sobre prevención de IRA fue alto en menos del 50%, siendo mayor en la sumatoria de deficiente y regular.

Many countries take health education as a strategy to increase the population's knowledge of disease prevention. In the case of children under 5 years of age who are vulnerable to acute respiratory infections (ARI), it is their parents who are evaluates knowledge of preventive measures for ARI. Objective: determine the level of knowledge of parents about ARI prevention in a district of Peru. Materials and methods: Basic type study, descriptive, transversal and prospective level. With a sample of 210 parents, who were chosen by convenience. The data collection technique was the survey and the instrument was a questionnaire with its two dimensions, the first dimension on preventive measures of CRED (Growth and Development) and immunizations, the second dimension on preventive measures of environmental conditions, mentioned instrument step through the validity and reliability process, then informed consent was given before applying the instrument to the study sample. Results: The ages of the parents in 71.43% are between 18 and 33 years old, the level of knowledge of the parents about ARI prevention was considered high with 45.24%, at a regular level with 31.90% and at a deficient level with 22.86%. Conclusion: The level of knowledge of parents of children under 5 years of age about ARI prevention was high at less than 50%, being higher in the sum of deficient and regular.

Muitos países tomam a educação em saúde como estratégia para aumentar o conhecimento da população sobre a prevenção de doenças. No caso de crianças menores de 5 anos vulneráveis às infecções respiratórias agudas (IRA), são os pais que avaliam o conhecimento das medidas preventivas. IRA. Objetivo: determinar o nível de conhecimento dos pais sobre prevenção de IRA em um distrito do Peru. Materiais e métodos: Estudo do tipo básico, nível descritivo, transversal e prospectivo. Com uma amostra de 210 pais, escolhidos por conveniência. A técnica de coleta de dados foi a pesquisa e o instrumento foi um questionário com suas duas dimensões, a primeira dimensão sobre medidas preventivas de CRED (Crescimento e Desenvolvimento) e imunizações, a segunda dimensão sobre medidas preventivas de condições ambientais, mencionada etapa do instrumento através da validade e processo de confiabilidade, foi dado consentimento informado antes da aplicação do instrumento na amostra do estudo. Resultados: A idade dos pais em 71,43% está entre 18 e 33 anos, o nível de conhecimento dos pais sobre prevenção de IRA foi considerado alto com 45,24%, nível regular com 31,90% e nível deficiente com 22,86%. Conclusão: O nível de conhecimento dos pais de crianças menores de 5 anos sobre prevenção de IRA foi elevado, inferior a 50%, sendo maior na soma de deficiente e regular.

Encuesta nacional para pediatras de Argentina: vacunación en la práctica diaria, percepción de conocimientos y barreras / National survey for pediatricians in Argentina: Vaccination in daily practice, perception of knowledge and barriers

Introducción. El descenso de las coberturas de vacunación fue muy significativo en la última década. Los pediatras son una pieza fundamental para recuperar coberturas y aumentar la confianza en la vacunación. Objetivos. Describir la percepción de los pediatras acerca del conocimiento y prácticas sobre vacunas, e identificar barreras en el acceso. Métodos. Estudio analítico observacional, mediante encuesta en línea. Se incluyeron variables del perfil del profesional, capacitación y barreras en inmunizaciones. Resultados. Participaron 1696 pediatras (tasa de respuesta: 10,7 %), media de 50,4 años. El 78,7 % fueron mujeres. El 78,2 % contaba con ≥10 años de ejercicio profesional. El 78,4 % realizaba atención ambulatoria y el 56,0 % en el subsector privado. El 72,5 % realizó una capacitación en los últimos 2 años. Se manifestaron "capacitados" para transmitir a sus pacientes los beneficios de las vacunas: 97,2 %; objetivos de campañas: 87,7 %; contraindicaciones: 82,4 %; efectos adversos: 78,9 %; recupero de esquemas: 71,2 %; notificación de ESAVI: 59,5 %. La proporción fue estadísticamente superior, en todos los aspectos, en pediatras con ≥10 años de ejercicio y en aquellos con capacitación reciente (p ≤ 0,01). Barreras identificadas en el acceso a la vacunación: falsas contraindicaciones (62,3 %); falta temporaria de vacunas (46,4 %); motivos culturales (41,4 %); horario restringido del vacunatorio (40,6 %). Conclusiones. La percepción del grado de capacitación fue variable según el aspecto de la vacunación. Aquellos con mayor tiempo de ejercicio profesional y con actualización reciente se manifestaron con mayor grado de capacidad. Se identificaron múltiples barreras frecuentes asociadas al acceso en la vacunación.

Introduction. The decline in vaccination coverage has been very significant in the past decade. Pediatriciansplay a key role in catching-up coverage and increasing confidence in vaccination. Objectives. To describe pediatricians' perceptions of vaccine knowledge and practices and to identify barriers to access. Methods. Observational, analytical study using an online survey. Variables related to professional profile, training and barriers to vaccination were included. Results. A total of 1696 pediatricians participated (response rate: 10.7%). Their mean age was 50.4 years; 78.7% were women; 78.2% had ≥ 10 years of experience; 78.4% provided outpatient care and 56.0%, in the private subsector; and 72.5% received training in the past 2 years. Respondents described themselves as "trained" in convey the following aspects to their patients: benefits of vaccines: 97.2%; campaign objectives: 87.7%; contraindications: 82.4%; adverse effects: 78.9%; catchup vaccination: 71.2%; reporting of events supposedly attributable to vaccination or immunization: 59.5%. The proportion was statistically higher in all aspects, among pediatricians with ≥ 10 years of experience and those who received training recently (p ≤ 0.01). The barriers identified in access to vaccination were false contraindications (62.3%), temporary vaccine shortage (46.4%), cultural reasons (41.4%), and restricted vaccination center hours (40.6%). Conclusions. The perception of the level of training varied depending on the vaccination-related aspect. Pediatricians with more years of professional experience and those who received recent updates perceivedthemselves as more trained. Multiple barriers associated with access to vaccination were identified.

#VACINAPARATODOS: sentidos atribuídos por brasileiros à primeira dose da imunização contra a covid-19 no Instagram / #VACINAPARATODOS: meanings attributed by Brazilians to the first dose of immunization against covid-19 on Instagram / #VACINAPARATODOS: significados atribuidos por brasileños a la primera dosis de inmunización contra covid-19 en InstagramAutor

Este artigo se baseia em uma pesquisa que teve como objetivoapreender os sentidos atribuídos por brasileiros à primeira dose da imunização contra a covid-19. Trata-se de uma análise netnográfica. Os dados foram coletados em 2021 por meio da hashtag VACINAPARATODOS no Instagram. Os métodos utilizados para análise de dados foram: análise de similitude, com auxílio do software IRAMUTEQ e da análise do Discourse of the collective subject (discurso do sujeito coletivo), de Lefevre. Os resultados apontaram como ideias centrais: a emoção positiva e o sentimento de gratidão; a emoção negativa e o sentimento atribuído às vidas perdidas e ao negacionismo; o significado da primeira dose e o sentimento de esperança; a imunização e o exercício da cidadania: ato de consciência, responsabilidade e respeito. Os sentidos atrelados à oportunidade de acesso à vacina mostraram a dualidade de sentimentos que vão desde sensações positivas de reconhecimento e valorização até sentimentos negativos, de revolta e indignação, diante da hesitação vacinal e dos discursos antivacina.

This article bases on a research that aimed to understand the meanings attributed by Brazilians to the first dose of immunization against covid-19. A netnographic analysis was carried out. The data was collected in 2021 using the hashtag VACINAPARATODOS on Instagram. The methods used analyse the data were: similarity analysis, with the aid of the IRAMUTEQ software and of the analysis of Discourse of the collective subject, developed by Lefevre. The results pointed out the following central ideas: positive emotion and a feeling of gratitude; the negative emotion and a feeling attributed to lost lives and to denialism; the meaning of the first dose and the feeling of hope; the immunization and the exercise of citizenship: an act of conscience, responsibility and respect. The meanings linked to the opportunity to access the vaccine showed a duality of feelings ranging from positive feelings of recognition and appreciation to negative feelings of revolt and indignation, in the face of vaccine hesitancy and of the anti-vaccine discourses.

Este artículo se basa en una investigación que tuvo como objetivo comprender los significados atribuidos por los brasileños a la primera dosis de inmunización contra la covid-19. Se realizó un análisis netnográfico. Los datos fueron recogidos en 2021 a través del hashtag VACINAPARATODOS en Instagram. Los métodos utilizados para el análisis de los datos fueron: análisis de similitud, con ayuda del softwareIRAMUTEQ y del análisis del Discourse of collective subject (Discurso del sujeto colectivo), de Lefevre. Los resultados evidenciaron como ideas centrales: la emoción positiva y el sentimiento de gratitud; la emoción negativa y el sentimiento atribuido a las vidas perdidas y al negacionismo; el significado de la primera dosis y el sentimiento de esperanza; la inmunización y el ejercicio de la ciudadanía: un acto de conciencia, responsabilidad y respeto. Los significados vinculados a la oportunidad de acceder a la vacuna mostraron la dualidad de sentimientos que van desde sentimientos positivos de reconocimiento y aprecio hasta sentimientos negativos de revuelta y indignación, frente a las dudas sobre las vacunas y los discursos antivacunas.

Reacciones adversas de las vacunas contra el SARS COV 2 en personales de salud, primer semestre del año 2021

El Ministerio de Salud Pública y Bienestar Social inició con el plan de vacunación contra el SARS COV 2, priorizando en la primera etapa a los grupos de mayor vulnerabilidad, quienes correspondían entre otros al personal de salud; en ese sentido el Programa Ampliado de Inmunizaciones (PAI) ha iniciado con el proceso de selección y capacitación de los personales de enfermería en los lineamientos técnicos y operativos del plan de vacunación, sistema de información y de vigilancia de eventos supuestamente atribuidos a la vacunación e inmunización. Objetivo: Determinar la incidencia de reacciones adversas de las vacunas contra el COVID 19 (CoronaVac®, Astrazeneca® y Covaxin®) en personal de salud de los sectores públicos y privados de la XIV Región Sanitaria Canindeyú. Metodología: Estudio cuantitativo, descriptivo de corte transversal. Resultados: Entre los efectos leves de mayor frecuencia fueron el dolor en el sitio de aplicación, siendo para la vacuna Covaxin® en un 63.6% y para la vacuna Astrazeneca® 62.8%. Con relación a los efectos generales la dispepsia fue la reacción más observada (86.6% para la vacuna Covaxin® y 83.3% para vacuna CoronaVac®), y falta de energía y motivación (vacuna Astrazeneca® con un 34.9%). Discusión: el estudio muestra claramente que existen diferencias en la observación de efectos leves provocados por diferentes vacunas. En esta oportunidad se han observado tres vacunas, resaltando que estos efectos leves son comunes, frecuentes y generalmente temporales en las vacunas.

The Ministry of Public Health and Social Welfare began the vaccination plan against SARS COV 2, prioritizing in the first stage the most vulnerable groups, which corresponded, among others, to health personnel; In this sense, the Expanded Immunization Program (PAI) has begun the process of selection and training of nursing personnel in the technical and operational guidelines of the vaccination plan, information system and surveillance of events supposedly attributed to vaccination and immunization. Objective: Determine the incidence of adverse reactions to COVID 19 vaccines (CoronaVac®, Astrazeneca® and Covaxin®) in health personnel from the public and private sectors of the XIV Canindeyú Health Region. Methodology: Quantitative, descriptive cross-sectional study. Results: Among the most frequent mild effects were pain at the application site, being 63.6% for the Covaxin® vaccine and 62.8% for the Astrazeneca® vaccine. In relation to the general effects, dyspepsia was the most observed reaction (86.6% for the Covaxin® vaccine and 83.3% for the CoronaVac® vaccine), and lack of energy and motivation (Astrazeneca® vaccine with 34.9%). Discussion: The study clearly shows that there are differences in the observation of mild effects caused by different vaccines. On this occasion, three vaccines have been observed, highlighting that these mild effects are common, frequent and generally temporary in vaccines.

Imunização: planejamento e estrutura organizacional na atenção primária à saúde / Immunization: planning and organizational structure in primary health care / Inmunización: planificación y estructura organizativa en la atención primaria de salud

Objetivo: Identificar como acontece o planejamento das ações de enfermagem e a estrutura física nos serviços de vacinação. Métodos: Pesquisa de método misto. Foram aplicadas 18 entrevistas e 203 questionários aos enfermeiros responsáveis pelas salas de vacinas, em 14 municípios do estado do Ceará. Os dados foram coletados de julho a setembro de 2018, e organizados em categorias: planejamento das ações de imunização na atenção primária à saúde; e estrutura física, recursos humanos e materiais das salas de vacinas. Resultados: Evidenciou-se a responsabilidade do enfermeiro no planejamento das ações e envolvimento da equipe em todo o processo de vacinação, apesar dos enfermeiros desses municípios não serem exclusivos nos serviços de vacinação; os agentes comunitários de saúde são componentes da equipe atuantes neste serviço; e a estrutura física das salas de vacinas não condizem com as normas preconizadas pelo Programa Nacional de Imunizações. Conclusão: Evidenciou-se a responsabilidade do enfermeiro no planejamento das ações e envolvimento da equipe no processo de vacinação; e a importância de uma boa estrutura organizacional, recursos humanos e materiais para o desenvolvimento das ações. (AU)

Objective: To identify how the planning of nursing actions and the physical structure in vaccination services take place. Methods: Mixed method research. Eighteen interviews and 203 questionnaires were applied to nurses responsible for vaccine rooms in 14 municipalities in the state of Ceará. Data were collected from July to September 2018, and organized into categories: planning of immunization actions in primary health care; and physical structure, human and material resources of vaccine rooms. Results: The responsibility of the nurse in planning the actions and involvement of the team in the entire vaccination process was evidenced, although nurses in these cities are not exclusive in the vaccination services; community health agents are members of the team working in this service; and the physical structure of the vaccine rooms does not comply with the standards recommended by the National Immunization Program. Conclusion: The responsibility of the nurse in planning actions and involvement of the team in the vaccination process was evidenced; and the importance of a good organizational structure, human and material resources for the development of actions. (AU)

Objetivo: Identificar cómo se realiza la planificación de las acciones de enfermería y la estructura física en los servicios de vacunación. Métodos: Investigación de método mixto. Se aplicaron 18 entrevistas y 203 cuestionarios a enfermeras responsables de salas de vacunación en 14 municipios del estado de Ceará. Los datos se recopilaron de julio a septiembre de 2018 y se organizaron en categorías: planificación de acciones de inmunización en la atención primaria de salud; y estructura física, recursos humanos y materiales de las salas de vacunas. Resultados: Se evidenció la responsabilidad de la enfermera en la planificación de las acciones y la participación del equipo en todo el proceso de vacunación, aunque las enfermeras de estas ciudades no son exclusivas en los servicios de vacunación; los agentes comunitarios de salud son miembros del equipo que trabaja en este servicio; y la estructura física de las salas de vacunas no cumple con los estándares recomendados por el Programa Nacional de Inmunizaciones. Conclusión: Se evidenció la responsabilidad de la enfermera en la planificación de acciones y la participación del equipo en el proceso de vacunación; y la importancia de una buena estructura organizativa, recursos humanos y materiales para el desarrollo de las acciones. (AU)

Estratégias utilizadas para a gestão de imunobiológicos na saúde do trabalhador / Occupational health vaccines management strategies / Estrategias utilizadas para la gestión de inmunobiológicos en la salud del trabajador

Objetivo: Identificar estratégias utilizadas para a gestão de imunobiológicos e as limitações para a adesão às vacinas pelos trabalhadores da área da saúde. Métodos: Revisão integrativa que selecionou publicações em cinco bases de dados, utilizando a estratégia PICo, no período de 2016 a 2020. Utilizou-se os softwares Endnote X5 e Rayyan para identificação de documentos duplicados e cegamento dos avaliadores. Resultados: Totalizaram 15 artigos, dos quais um foi classificado com grau de recomendação alto e 10 artigos com nível de evidência 4, em relação ao delineamento, foram encontrados sete estudos transversais. Constatou-se que 14 (93,3%) abordaram o imunobiológico contra o vírus Influenza. Os estudos foram agrupados em duas categorias para melhor organização das estratégias de gestão e das limitações na adesão às vacinas pelos trabalhadores da saúde. Conclusão: Observou-se como um fator concordante nos diversos estudos para superar as barreiras da hesitação vacinal é importante intensificar as campanhas de comunicação e divulgação, focadas em ações de educação em saúde. Tais estratégias podem ser difundidas e replicadas em diferentes contextos dos serviços de saúde ocupacional. Este estudo contribui para avançar e fortalecer a utilização de estratégias para o gerenciamento de vacinação na saúde do trabalhador. (AU)

Objective: The aim of the study was to identify vaccine management strategies and barriers of adherence to vaccination among healthcare workers. Methods: An Integrative Review was conducted using five databases. The selection of the studies that had been published from the years 2016 to 2020 was based on the PICo strategy. To allow blinded evaluation and exclude duplicate references, the softwares Endnote and Rayyan were used. Results: 15 articles were selected. One was classified as having a high degree of recommendation and 10 other studies received level of evidence 4. Regarding design, seven studies were cross-sectional. 14 of the total (93.3%) addressed Influenza vaccines. The studies were split in two categories: management strategies and barriers of adherence to vaccination among healthcare workers. Conclusion: Several studies agreed that, in order to overcome barriers of adherence to vaccination among healthcare workers, it is important to intensify strategies and campaigns focused on communicating and disseminating health education. Those strategies can be disseminated and replicated in different contexts of occupational health services. This study contributes to advancing and strengthening the use of occupational vaccination management strategies. (AU)

Objetivo: Identificar las estrategias utilizadas para la gestión de inmunobiológicos y las limitaciones para la adherencia a las vacunas por trabajadores de la salud. Métodos: Revisión integradora que seleccionó publicaciones en cinco bases de datos, utilizando la estrategia PICo, en el período de 2016 a 2020. Se utilizó el software Endnote X5 y Rayyan para identificar documentos duplicados y cegar a los evaluadores. Resultados: Un total de 15 artículos, uno de los cuales fue clasificado como de alto grado de recomendación y 10 artículos con nivel de evidencia 4, en relación al diseño, se encontraron siete estudios transversales. Se encontró que 14 (93,3%) abordaron la inmunobiología frente al virus Influenza. Los estudios se agruparon en dos categorías para una mejor organización de las estrategias de gestión y las limitaciones en la adherencia a las vacunas por parte de los trabajadores de la salud. Conclusión: Se observó como factor de concordancia en varios estudios para superar las barreras de la vacilación vacunal, es importante intensificar las campañas de comunicación y difusión, enfocadas en acciones de educación en salud. Estas estrategias pueden difundirse y replicarse en diferentes contextos de los servicios de salud ocupacional. Este estudio contribuye a avanzar y fortalecer el uso de estrategias de gestión de la vacunación en la salud del trabajador. (AU)

Cobertura de vacunación contra COVID-19 e influenza en personal de salud y administrativo en Paraguay

Introducción: A nivel mundial, la cobertura de vacunación contra el COVID-19, así como contra la influenza es baja tanto en la población general como en los profesionales de la salud a pesar de que la vacuna es gratuita y obligatoria en el personal sanitario. Objetivo: Describir la cobertura de vacunación contra el COVID -19, y la influenza en personal de salud y administrativo de un hospital de referencia del Ministerio de Salud Pública y Bienestar Social en el periodo 2021-2022. Metodología: Estudio observacional descriptivo de corte trasverso. Se hizo la revisión de los registros del personal sanitario y administrativo del centro vacunatorio del Hospital Nacional de Itauguá de la campaña vacunal contra el COVID-19 y de anti-influenza en el periodo 2021- 2022. Resultados: De los 3.586 funcionarios, 999 (27,9 %) eran médicos, 1494 (41,7 %) personal de enfermería, 366 (10,2 %) otra categoría de personal sanitario, y 727 (20,3 %) personal administrativo. En forma global, el 86,5 % de los funcionarios recibió por lo menos las dos dosis que constituyen el esquema primario y el 73 % la dosis de refuerzo. El 2,1 % del personal no recibió ninguna dosis de vacuna anti covid-19, la cifra fue mayor en el personal administrativo (4,8 %). La cobertura de vacunación contra la influenza fue de 20 % en el 2021 y 25 % en el 2022. Discusión: Si bien cobertura de vacunación anti-COVID-19 fue comparable a otros países, la vacunación contra la influenza fue muy baja. Es urgente implementar estrategias dirigidas a aumentar la percepción de riesgo y aceptabilidad de las vacunas obligatorias para el personal sanitario.

Introduction: Worldwide, vaccination coverage against COVID-19, as well as against influenza, is low both in the general population and in health professionals, despite the fact that the vaccine is free and mandatory for health personnel. Objective: To describe the COVID -19 and influenza vaccination coverage in health and administrative personnel of a reference hospital of the Ministry of Public Health and Social Welfare in the period 2021-2022. Methods: Cross-sectional descriptive observational study. Charts of the health and administrative personnel of the vaccination center of the Itauguá National Hospital of the COVID-19 and influenza vaccination campaign in the period 2021-2022 were reviewed. Results: Of the 3,586 personnel, 999 (27.9%) were medical personnel, 1,494 (41.7%) nursing personnel, 366 (10.2%) other category of health personnel, and 727 (20.3%) administrative personnel. Overall, 86.5% of the employees received at least the two doses that constitute the primary schedule and 73% the booster dose; 2.1% of the staff did not receive any dose of the anti COVID-19 vaccine, which was higher in the administrative staff (4.8%). Influenza vaccination coverage was 20% in 2021 and 25% in 2022. Discussion: Even though the vaccination coverage of anti-COVID-19 was comparable to other countries, vaccination anti-influenza was very low. It is urgent to implement strategies aimed at increasing the perception of risk and acceptability of mandatory vaccines for health personnel.

Cobertura vacinal da BCG, VIP e Tríplice Viral no Brasil, 2010 a 2020: um estudo epidemiológico / BCG, VIP, and Triple Viral vaccine coverage in Brazil, 2010 to 2020: an epidemiological study / Cobertura de vacunación de BCG, VIP y Triple Viral en Brasil, de 2010 a 2020: un estudio epidemiológico

O objetivo deste estudo foi descrever a cobertura vacinal da BCG, da VIP e da tríplice viral no Brasil, entre os anos de 2010 e 2020. Trata-se de um estudo epidemiológico, descritivo e retrospectivo, com utilização de dados epidemiológicos disponíveis publicamente no Departamento de Informática do Sistema Único de Saúde. Os dados coletados durante o período selecionado foram analisados descritivamente. No Brasil, entre 2010 e 2020, a cobertura vacinal apresentou sua maior taxa anual no ano de 2015 e sua menor taxa em 2016. No que se refere à cobertura vacinal por região do Brasil, a Centro-Oeste obteve a maior taxa geral nos anos estudados. Quanto aos imunobiológicos enfatizados no estudo, é possível observar que as regiões Centro-Oeste e Sul apresentam as maiores taxas. Os valores encontrados nesta pesquisa expressam que houve uma queda da cobertura vacinal a partir de 2016 em todo o território brasileiro, e a maior taxa entre os estados foi a da região Centro-Oeste. Entre os imunobiológicos mencionados nesta pesquisa, observou-se que apenas a BCG e a VIP alcançaram valores acima de 90% no período em estudo, contudo, ambas vem apresentando queda da cobertura nos últimos anos, principalmente no ano de 2020, demonstrando que o atual cenário brasileiro está fora do preconizado.

This study aimed to describe BCG, VIP, and MMR vaccination coverage in Brazil from 2010 to 2020. This epidemiological, descriptive, and retrospective study used epidemiological data publicly available in the Department of Informatics of the Unified Health System. Data collected for the selected period were descriptively analyzed. In Brazil, from 2010 to 2020, national vaccination coverage showed its highest annual rate in 2015 and the lowest rate in 2016. Regarding vaccination coverage by region of Brazil, the Midwest obtained the highest higher overall rate in the studied years. The immunobiologicals emphasized in studies showed that the Midwest and South have the highest rates. The values in this study express a drop in vaccination coverage from 2016 onward throughout the country, with the highest rate among states referring to the Midwest. Among the immunobiological products emphasized in this research, only BCG and VIP reached values above 90% in the studied period, but both have shown a drop in coverage in recent years, especially in the year 2020, evincing that the current Brazilian scenario remains outside recommendations.

El objetivo de este estudio fue describir la cobertura de vacunación de BCG, VIP y triple viral en Brasil, en el período de 2010 a 2020. Este es un estudio epidemiológico, descriptivo y retrospectivo, que utilizó datos epidemiológicos disponibles públicamente en el Departamento de Informática del Sistema Único de Salud. Se analizaron descriptivamente los datos recopilados durante el período seleccionado. En Brasil, entre 2010 y 2020, la cobertura de vacunación presentó la tasa anual más alta en 2015 y la más baja en 2016. En cuanto a la cobertura de vacunación por regiones de Brasil, la región Centro-Oeste obtuvo la tasa general más alta en los años de estudio. Respecto a los inmunobiológicos enfatizados en los estudios, se puede observar que las regiones Centro-Oeste y Sur presentan las tasas más altas. Los valores encontrados en esta investigación muestran un descenso en la cobertura de vacunación a partir de 2016 en todo el país, y la tasa más alta entre los estados se registró en la región Centro-Oeste. Entre los inmunobiológicos destacados en esta investigación, se observó que solo BCG y VIP alcanzaron valores superiores al 90% en el período de estudio, sin embargo, ambos han mostrado un descenso en la cobertura en los últimos años, especialmente el año 2020, lo que demuestra que el escenario brasileño actual está lejos de lo recomendado.

Frecuencia y factores asociados a problemas de salud mental en trabajadores vacunados contra el Covid-19 de un hospital público peruano / Frequency and associated factors of mental health problems in Covid-19 vaccinated workers at a peruvian public hospital

RESUMEN Introducción: La pandemia aumentó el estrés y los problemas de salud mental subdiagnosticados en el trabajo. Objetivo: Determinar la frecuencia de problemas de salud mental y sus factores asociados en trabajadores vacunados del Hospital Nacional Dos de Mayo (HNDM). Métodos: Se realizó un estudio transversal-analítico utilizando datos secundarios de una encuesta de salud mental llevada a cabo por el Servicio de Salud Mental del HNDM en octubre de 2021. Se administró el Self-Reporting Questionnaire (SRQ) a todos los trabajadores del HNDM que habían recibido el esquema completo de vacunación. El análisis estadístico incluyó pruebas de chi-cuadrado y regresión logística para identificar factores asociados. Resultados: De 2109, el 2,7% de los trabajadores presentaron problemas de salud mental. 3,4% en mujeres y 1,5% en hombres y fue más frecuente en los grupos de edad de 18-29 años (4,8%) y 50-59 años (4%); así como en las personas divorciadas/separadas (7%) que las solteras (2,8%) o casadas (2%). El análisis multivariado indicó asociación positiva con mujeres (ORa: 2,30; IC 95%: 1,22-4,84) y personas divorciadas/separadas (ORa: 3,00; IC 95%: 1,12-7,25) frente a casados/convivientes. Hubo una asociación negativa en los grupos de 30-39 años (ORa: 0.43, IC 95%: 0.19-0.96) y 40-49 años (ORa: 0.30, IC 95%: 0.11-0.81) frente a 18-29 años. No se encontraron asociaciones significativas para otras variables. Conclusión: Uno de cada cuarenta trabajadores del HNDM presentó problemas de salud mental, con mayores riesgos observados entre mujeres, grupos etarios más jóvenes y mayores, y personas divorciadas/separadas. Se recomienda mejorar tamizaje y apoyo para intervención temprana.

ABSTRACT Introduction: The pandemic increased stress and underdiagnosed mental health issues in the workplace. Objetive: To determine the frequency of mental health problems and their associated factors among vaccinated workers at the Dos de Mayo National Hospital (HNDM). Methods: A cross-sectional analytical study was conducted using secondary data from a mental health survey carried out by the HNDM Mental Health Service in October 2021. The Self-Reporting Questionnaire (SRQ) was administered to all HNDM workers who had received the full vaccination scheme. Statistical analysis included chi-square tests and logistic regression to identify associated factors. Results: Of 2109 workers, 2.7% presented mental health problems, with a higher prevalence in women (3.4%) compared to men (1.5%), and more frequent in the age groups 18-29 years (4.8%) and 50-59 years (4%). Divorced/separated individuals (7%) had a higher prevalence compared to single (2.8%) or married (2%) individuals. Multivariate analysis indicated a positive association with women (ORa: 2.30; 95% CI: 1.22-4.84) and divorced/separated individuals (ORa: 3.00; 95% CI: 1.12-7.25) compared to married/cohabiting individuals. There was a negative association in the 30-39 years (ORa: 0.43, 95% CI: 0.19-0.96) and 40-49 years (ORa: 0.30, 95% CI: 0.11-0.81) age groups compared to 18-29 years. No significant associations were found for other variables. Conclusion: One in forty HNDM workers presented mental health problems, with higher risks observed among women, younger and older age groups, and divorced/separated individuals. Improved screening and support for early intervention are recommended.

Severe COVID-19 in the context of a vaccinated population: Case-control study / COVID-19 grave no contexto de uma população vacinada: estudo caso-controle / COVID-19 grave en el contexto de una población vacunada: Estudio de casos y controles

Background and Objectives: Since its appearance in 2019, multiple risk factors have been identified for presenting a severe form of COVID-19 and different vaccines have also been developed to prevent severe manifestations. However, despite a vaccination history, some cases progress to complications or even death. The objective of this study was to determine the strength of the association between the severity of COVID-19 and the history of vaccination in patients treated at a public reference hospital in Mexico City. Methods: This was a non-experimental, retrospective, and analytical epidemiological study of cases and controls. The study population was people treated at a concentration hospital for COVID-19 care between July 1, 2021, and June 30, 2022, in Mexico City. Results: 132 participants (44 cases and 88 controls) were included in the study. The risk factors most strongly associated with COVID-19 severity were age greater than or equal to 60 years, presenting 22 breaths per minute at the first medical evaluation, systolic blood pressure greater than or equal to 140 millimeters of mercury, and a history of at least one chronic comorbidity. However, vaccination history was associated with 94% (OR 0.06) lower odds of developing severe COVID-19 compared to those without a history of vaccination, regardless of the presence of associated risk factors. Conclusion: Lacking a history of vaccination and presenting any of the identified risk factors confer higher odds of developing severe forms of the disease.(AU)

Justificativa e Objetivos: Desde o seu aparecimento em 2019, foram identificados múltiplos fatores de risco para a apresentação de uma forma grave de COVID-19 e foram desenvolvidas diferentes vacinas para prevenir o aparecimento de manifestações graves. No entanto, apesar de um histórico de vacinação, alguns casos podem evoluir para complicações ou mesmo para a morte. O objetivo deste estudo foi determinar a força de associação entre a gravidade da COVID-19 e o histórico de vacinação em pacientes atendidos em um hospital público de referência na Cidade do México. Métodos: Estudo epidemiológico não-experimental, retrospectivo e analítico, de casos e controles. A população do estudo foram indivíduos atendidos em um hospital de concentração para atendimento à COVID-19 entre 1 de julho de 2021 e 30 de junho de 2022, na Cidade do México. Resultados: 132 participantes (44 casos e 88 controles) foram incluídos no estudo. Os fatores de risco mais fortemente associados à gravidade da COVID-19 foram idade superior ou igual a 60 anos, apresentar 22 respirações por minuto na primeira avaliação médica, pressão arterial sistólica superior ou igual a 140 milímetros de mercúrio e histórico de pelo menos uma comorbidade crônica. No entanto, histórico de vacinação foi associado a uma probabilidade 94% (OR 0,06) menor de desenvolver COVID-19 grave em comparação com aqueles sem histórico de vacinação, independentemente da presença de fatores de risco associados. Conclusão: A ausência de histórico de vacinação e a presença de algum dos fatores de risco identificados conferem maiores probabilidades de desenvolver formas graves da doença.(AU)

Justificación y Objetivos: Desde su aparición en 2019, se han identificado múltiples factores de riesgo para presentar una forma grave de COVID-19 y también se han desarrollado distintas vacunas que previenen la aparición de manifestaciones de gravedad. Sin embargo, a pesar del antecedente de vacunación, algunos casos se complican o incluso fallecen. El objetivo del este estudio fue determinar la fuerza de asociación entre la gravedad de la COVID-19 con el antecedente de vacunación en pacientes atendidos en un hospital público de referencia de la Ciudad de México. Métodos: Estudio epidemiológico no experimental, retrospectivo y analítico, de casos y controles. La población de estudio fueron personas atendidas en un hospital de concentración para la atención de COVID-19 entre el 1 de julio de 2021 y el 30 de junio de 2022 en la Ciudad de México. Resultados: 132 participantes (44 casos y 88 controles) fueron incluidos en el estudio. Los factores de riesgo más fuertemente asociados con la gravedad de la COVID-19 fueron la edad mayor o igual a 60 años, presentar 22 respiraciones por minuto en la primera valoración médica, tensión arterial sistólica mayor o igual a 140 milímetros de mercurio y el antecedente de al menos una comorbilidad crónica. No obstante, el antecedente de vacunación se asoció con 94% (RM 0.06) menos posibilidades de desarrollar COVID-19 grave con respecto a aquellos sin antecedente vacunal, independientemente de la presencia de los factores de riesgo asociados. Conclusión: carecer del antecedente de vacunación y presentar alguno de los factores de riesgo identificados confieren las mayores posibilidades de presentar formas graves de la enfermedad.(AU)

Incidência de anafilaxia relacionada às vacinas do Programa Nacional de Imunizações / Incidence of vaccine-related anaphylaxis from Brazil's National Immunization Program

A incidência de anafilaxia pós-vacinal é um evento de saúde raro e carece de melhor detalhamento no Brasil. Neste estudo, objetivou-se descrever a incidência de anafilaxia como evento supostamente atribuído à vacinação e imunização (ESAVI) das vacinas do Programa Nacional de Imunizações (PNI).Foi realizado estudo retrospectivo com dados extraídos do sistema de notificação de ESAVI do PNI entre 01/2021 e 05/2023 com aceitação na Plataforma Brasil e aprovação ética. Foram identificados 84 casos encerrados com o descritor "anafilaxia" ou "choque anafilático" entre 290.101 eventos adversos notificados, concentrados principalmente nas regiões Sul e Sudeste. Crianças de 0 a 9 anos foram predominantemente afetadas, com maior incidência em mulheres e indivíduos brancos. A anafilaxia associou-se em números absolutos principalmente às vacinas COVID-19, destacando os fabricantes AstraZeneca/Fiocruz (vetor viral), Pfizer Comirnaty (RNAm) e CoronaVac (inativada), e a maior taxa de incidência foi com a vacina antirrábica (2,8 por milhão de doses aplicadas). A incidência global foi de 0,14/milhão de doses aplicadas. Entre os desfechos não foi relatado óbito. A subnotificação de casos é relevante e sublinha a importância de manter sistemas robustos de vigilância e manejo de reações alérgicas em programas de vacinação. Este estudo segue tendências mundiais da raridade da anafilaxia relacionada às vacinas. Os dados reforçam a segurança das vacinas COVID-19 e demais vacinas existentes no PNI, independente da demografia analisada.

Vaccine-related anaphylaxis is a rare health event, and its incidence requires further investigation in Brazil. The objective of this study was to describe the incidence of anaphylaxis as an event supposedly attributed to vaccination and immunization (ESAVI) associated with the Brazilian National Immunization Program (PNI). A retrospective study was conducted with data extracted from the PNI ESAVI notification system between January 2021 and May 2023, with ethical approval and registration in Plataforma Brasil. Among 290,101 adverse events reported, 84 cases closed with the descriptor "anaphylaxis" or "anaphylactic shock" were identified, mainly concentrated in the South and Southeast regions. Children aged 0 to 9 years were predominantly affected, with a higher incidence in women and white individuals. In absolute numbers, anaphylaxis was associated mainly with the AstraZeneca/Fiocruz (viral vector), Pfizer Comirnaty (mRNA), and CoronaVac (inactivated virus) COVID-19 vaccines, while the highest relative incidence was with the anti-rabies vaccine (2.8 cases per million doses administered). The overall incidence was 0.14 per million vaccine doses. No deaths were reported. Underreporting of vaccine-related anaphylaxis is relevant and highlights the importance of maintaining robust systems for surveillance and management of allergic reactions within vaccination programs. This study corroborates global trends in the rarity of vaccine-related anaphylaxis. The low incidence of this event, regardless of recipient demographics, provides further evidence of the safety of COVID-19 vaccines and other vaccines included in the PNI.

Perfil epidemiológico e fatores associados à covid-19 em um município do Espírito Santo / Epidemiological profile and factors associated with covid-19 in a municipality of Espírito Santo

Objetivo: avaliar o perfil e os fatores associados à covid-19 em residentes no município de Alegre, Espírito Santo. Métodos: foi realizado um estudo epidemiológico com delineamento transversal no município de Alegre, por meio de inquérito domiciliar, entre os meses de novembro e dezembro de 2021. A análise descritiva foi realizada por meio de distribuição de frequências para as variáveis categóricas e por mediana e intervalo interquartil para as variáveis contínuas. Os fatores associados foram analisados por regressão de Poisson com variância robusta. Resultados: foram entrevistadas 687 pessoas, das quais 18,8% reportaram ter contraído a covid-19. A infecção foi mais frequente entre mulheres e pessoas mais jovens, especialmente antes da vacinação. A vacina inicial mais usada foi a Coronavac (42,6%), enquanto a dose de reforço foi predominantemente da Pfizer (86,30%). Cerca de um terço das aplicações de vacina resultou em reações adversas, destacando-se febre (56%), dor no corpo (31%) e dor de cabeça (41%). A automedicação foi comum, com 76,9% dos entrevistados utilizando medicamentos para tratar a covid-19, sendo a Azitromicina (26,4%), Ivermectina (24,0%) e Dipirona (10,8%) as mais citadas. Fatores como consultas médicas recentes e automedicação foram associados à ocorrência de covid-19. Conclusão: os resultados deste estudo podem ajudar a conscientizar a população sobre fatores que podem agravar a doença, destacando a importância do reforço nas medidas de prevenção.

Objective: to evaluate the profile and factors associated with covid-19 in residents of the municipality of Alegre through a household survey between the months of November and December 2021. Methods: An epidemiological study with a cross-sectional design was carried out in the city of Alegre in 2021. The descriptive analysis was carried out using frequency distribution for categorical variables and the median and interquartile range for continuous variables. Associated factors were analyzed using Poisson regression with robust variance. Results: 687 people were interviewed, with 18.8% reporting having contracted covid-19. Infection was more common among women and younger people, especially before vaccination. The most used initial vaccine was Coronavac (42.6%), while the booster dose was predominantly from Pfizer (86.30%). Around a third of vaccine applications resulted in adverse reactions, including fever (56%), body pain (31%) and headache (41%). Self-medication was common, with 76.9% of respondents using medications to treat covid-19, with Azithromycin (26.4%), Ivermectin (24.0%), and Dipyrone (10.8%) being the most cited. Factors such as recent medical appointments and self-medication have been associated with the occurrence of covid-19. Conclusion: the results of this study can help raise awareness among the population about factors that can worsen the disease, highlighting the importance of reinforcing prevention measures.

Nivel de conocimiento sobre VPH en estudiantes de la Universidad del Pacífico

Introducción. El virus del papiloma humano (VPH) es una infección viral más habitual del aparato reproductor y causa diversos trastornos, tanto en hombres como en mujeres, y se considera como el principal agente para el desarrollo del cáncer cervicouterino. Objetivo. Determinar el nivel de conocimiento sobre el VPH de las alumnas del segundo año de las diferentes carreras de la Universidad del Pacífico Sede Asunción en el año 2023. Materiales y Métodos. Se realizó un estudio observacional, descriptivo de corte transversal en alumnas del segundo año de las diferentes carreras de la Universidad del Pacifico en el 2023, mediante una encuesta de conocimiento, influencia y métodos para evitar el contagio del VPH. Se aplicó la estadística descriptiva utilizando el programa EpiDat 4.2. Resultados. Participaron 95 alumnas, el 49,92% conoce que el VPH es una infección viral, el 87,37% que su síntoma más común son las verrugas genitales, el 91,58% sabe que la infección por VPH afecta a ambos sexos, el 90,53% que se puede transmitir por vía sexual, 71,58% sabe que puede producir cáncer de cuello uterino y el 86,32% conoce que la vacunación es la principal medida de prevención. El 48% de las estudiantes tuvieron un buen nivel de conocimiento global sobre el VPH. Conclusión. El nivel insuficiente de conocimiento sobre VHP refleja la necesidad de realizar fortalecer el programa educativo universitario y campañas educativas con respecto al VPH y el cáncer de cuello uterino.

Introduction. Human papillomavirus (HPV) is the most common viral infection of the reproductive tract, causes various disorders in both men and women, and it is considered to be the main agent for the development of cervical cancer. Objective. To determine the level of knowledge about HPV among students in the second year of the different careers of the Universidad del Pacífico, Asunción, 2023. Materials and Methods. A cross-sectional, observational, descriptive study was carried out with 2nd year students of the different careers of the Universidad del Pacifico in 2023, by means of a survey of knowledge about HPV, influence, and methods to prevent infection. Descriptive statistics using EpiDat 4.2 software were applied. Results. Of the 95 female students surveyed, 49.92% knew that HPV was a viral infection, 87.37% knew that the most common symptom was genital warts, 91.58% knew that HPV disease affects both sexes, 90.53% knew that it can be transmitted sexually, 71.58% knew that it could cause cervical cancer, and 86.32% knew that vaccination was the main prevention measure, 48% of the students have a good global knowledge about HPV. Conclusion. The insufficient level of knowledge about HPV reflects the need to strengthen the university educational program and educational campaigns regarding HPV and cervical cancer.

Cadena de frío del programa nacional de inmunizaciones peruano en el contexto de la pandemia covid-19 / Cold chain of the peruvian national immunization program in the context of the covid-19 pandemic

RESUMEN Objetivo: Identificar aspectos críticos de la Cadena de Frío en el Perú Metodología: Estudio descriptivo. Se analizaron datos del Ministerio de Economía y Finanzas (MEF) y del Ministerio de Salud (MINSA) de los años 2020-2021, así como los registros administrativos de las Estrategias Sanitarias Regionales de inmunizaciones del MINSA en 2020. Se consideraron aspectos técnicos de la Norma Técnica de Manejo de cadena de frío, como es obsolescencia, dotación, funcionalidad y capacidad de almacenamiento. Resultados: En el año 2020, en términos de obsolescencia el 61.8% de los equipos de cadena de frío a nivel nacional presentaban obsolescencia, siendo regiones claves como Lima Metropolitana (capital del país) la más afectada con un 88%. En cuanto a la dotación de equipos, el 9% de los establecimientos de salud del primer nivel carecen de equipos de refrigeración, siendo Loreto la región con mayor déficit 46%, seguida de Huancavelica con un 21% de brecha. En términos de funcionamiento, se registra que el 84% de los equipos a nivel nacional funcionan, y el 16% reportan fallas técnicas, lo cual representa alto riesgo en la seguridad y potencia inmunogénica de las vacunas a prever. En términos de capacidad, al considerar el almacenamiento trimestral o mensual para las vacunas contra la COVID-19 u otras emergencias sanitarias se identificaron brechas significativas. Conclusiones: Existen riesgos en la operatividad, suministro y capacidad de almacenamiento de las vacunas del esquema nacional de inmunizaciones de Perú incluso ante emergencias sanitarias.

ABSTRACT Objective: The aim of this study was to identify critical aspects of the Cold Chain in the immunization process in Peru. Methodology: A descriptive study was conducted, analyzing data from the Ministry of Economy and Finance (MEF) and the Ministry of Health (MINSA) for the years 2020-2021, as well as administrative records from the MINSA's Regional Health Strategies for immunizations in 2020. Technical aspects established in the Health Technical Standard for Cold Chain Management, such as obsolescence, allocation, functionality, and storage capacity were taken into account. Results: In the year 2020, at the national level, 61.8% of the cold chain equipment showed obsolescence, with some regions exceeding 75%, with Lima's metropolitan region being the most affected at 88%. Concerning equipment allocation, 9% of the first-level health facilities lacked refrigeration equipment, with Loreto having the highest deficit (46%), followed by Huancavelica with a 21% gap. The overall equipment functionality nationwide was 84%, meaning that 16% of health facilities experienced technical failures, affecting vaccine's storage capacity and posing risks to their safety and immunogenicity. Significant gaps were identified when considering quarterly or monthly storage for COVID-19 vaccines or other health emergencies. Conclusions: This study highlights potential risks in the operability and storage capacity of the national immunization program's vaccines in Peru during contingencies such as the COVID-19 pandemic or other health emergencies.

Serological evaluation and antibody prediction model for inactivated COVID-19 vaccination in school children / 上海预防医学

ObjectiveTo determine the serum antibody level and risk factors in the adolescent population in a county in Zhejiang Province， following the immunization with inactivated COVID-19 vaccine， and to construct a prediction model for antibody concentration. MethodsWe conducted the study in a county in Zhejiang Province， employing a stratified cluster random sampling strategy in school children who had received the inactivated COVID-19 vaccine. Data on gender， age， type of vaccine， and time of vaccination was collected. Serum samples were also collected to test for anti-S and N IgG antibody against the SARS-CoV-2 by using chemiluminescent immunoassay （CLIA）. Risk factors were determined to construct a prediction model for antibody concentration. ResultsThe IgG antibody concentration was significantly higher in girls， those who received two doses， and those who had simply received the KX vaccine . It decreased with age and time interval between the sampling and last vaccination. The prediction model constructed by random forest regression in the study had a better model fit and predictive ability than that by the multivariable linear stepwise regression. ConclusionGender， age， vaccination dose， type of vaccine， and time of vaccination are associated with vaccination effectiveness of inactivated COVID-19 vaccines in adolescents. Prediction model could predict the antibody level in the vaccinated population， which can provide a new tool for better evaluation of vaccination effectiveness against emerging infectious diseases in future.

Systematic review of current research on vaccination of congenital heart disease children in China / 上海预防医学

ObjectiveCongenital heart disease （CHD） is a common birth defect in children， with its incidence increasing annually. Because of their special health status， the vaccination situation for children with CHD has become a focal point of attention. This paper systematically reviews the current status of vaccination among children with CHD in China to identify existing issues in vaccination efforts for children with CHD， provide guidance for increasing vaccination rates among children with CHD， reduce the incidence of vaccine-preventable diseases， and provide ideas for subsequent research. MethodsLiterature on the vaccination of children with CHD in China was searched in both Chinese and English databases， including CNKI， Wanfang Data Knowledge Service Platform， VIP， Chinese Biomedical and Web of Science， PubMed， EmBase， and the Cochrane Library. Relevant literature was identified based on inclusion and exclusion criteria， and data extraction was carried out to summarize the research results. ResultsA total of 15 studies were included. Three articles focusing on expert consensus （guideline recommendations） for vaccination of children with CHD in China all agreed that vaccination is both feasible and necessary for children with CHD. Systematic analysis found that the overall timely vaccination rate for children with CHD was between 34% and 50%， with a notable delay in vaccination. However， after professional outpatient assessment， the vast majority of children with CHD were advised to be vaccinated according to the national recommended schedule， with only about 2% of them being advised to delay vaccination. The proportion of children with CHD who reported suspected adverse events following immunization （AEFI） was low and not significantly different from that of healthy/control children. ConclusionThe safety of vaccinations for children with CHD in China is relatively high， but the total timely vaccination rate is currently low. In order to improve the coverage and timeliness of vaccination in children with CHD， it is recommended that relevant departments provide vaccination policy support. There is a lack of research on the effectiveness of vaccination in children with CHD， so further studies are urgently needed to further improve the vaccination strategy for children with CHD in China.

Analysis of influencing factors of post-vaccination serologic testing in children exposed to hepatitis B virus in Tongzhou District， Beijing from 2020 to 2022 / 上海预防医学

ObjectiveTo explore the importance of post-vaccination serological testing （PVST） for children exposed to hepatitis B virus （HBV）， and analyze the factors affecting the progress of PVST. MethodsThe study focused on hepatitis B surface antigen （HBsAg）-positive pregnant women and their newborns residing in Tongzhou District， Beijing， who delivered at various obstetric institutions from January 1， 2020 to March 31， 2022. The obstetric institutions and community health service centers conducted follow-up visits 1 to 2 months after the children had received three doses of the hepatitis B vaccine （HepB）. ResultsThe vaccination rate of hepatitis B immunoglobulin （HBIg） was 100.00% （800/800）， with a successful PVST follow-up rate of 85.88% （687/800） in Tongzhou District. The initial non-response rate to immunization was 0.29% （2/687）， but successful immunization was achieved after re-immunization. The mother-to-infant transmission rate of hepatitis B was 0. Children who did not undergo PVST accounted for 14.13% （113/800）， with the main reasons being delays due to the COVID-19 pandemic， parents’ reluctance to allow venous blood collection due to the young age of the children， and loss to follow-up because children moved back to their parents’ place of origin. Logistic regression analysis showed that the proportion of PVST was higher among high-risk children （OR=30.009，P=0.001）， children with family residing in Beijing （OR=2.218，P=0.002）， and children whose mothers were <35 years old （OR=1.687，P=0.020）. ConclusionPVST is necessary for assessing the status of HBV immune response in newborns after vaccination with HepB. The COVID-19 pandemic impacted the implementation of PVST for children exposed to HBV. Strengthening the management of non-high-risk children， those living outside Beijing， and children with mothers aged ≥ 35 years old may increase the rate of PVST in Tongzhou District.

Long-term safety and effectiveness of withdrawal of HBIG and/or nucleos(t)ide analogues in recipients undergoing hepatitis B immune reconstitution after liver transplantation / 器官移植

<b>Objective</b> To investigate the long-term safety and effectiveness of withdrawal of hepatitis B immuneglobulin (HBIG) and/or nucleos(t)ide analogues (NAs) to prevent hepatitis B virus (HBV) reinfection in liver transplant recipients with hepatitis B-related diseases after successful vaccination. <b>Methods</b> Baseline data of 76 liver transplant recipients undergoing hepatitis B immune reconstitution after receiving hepatitis B vaccines were retrospectively analyzed. The vaccination and response, the follow-up results of respondents with HBIG and/or NAs withdrawal, and the reinfection of HBV after withdrawal of HBIG and/or NAs were analyzed. <b>Results</b> The time interval from liver transplantation to hepatitis B vaccination was 26 (20, 40) months. The time interval from vaccination to response was 15 (8,27) months. Initially, 76 recipients withdrew HBIG, and 36 recipients withdrew HBIG and NAs. During the follow-up, 12 of 76 recipients who withdrew HBIG resumed use of HBIG, and 16 of 36 recipients who withdrew HBIG and NAs resumed use of NAs. The withdrawal time of HBIG and NAs was 135 (98,150) and 133 (34,149) months, respectively. Sixteen respondents did not receive booster, and 36 respondents received boosters on a regular basis. The time interval between the first booster and HBIG withdrawal was 44 (11,87) months. No significant differences were observed in baseline data between the respondents with and without boosters (all <i>P</i>>0.05). During the follow-up, 9 recipients were lost to follow-up, 5 were re-infected with HBV, 3 died, and 1 recipient developed graft loss and underwent secondary liver transplantation. Among 5 recipients re-infected with HBV, 4 cases had virus mutation. Significant differences were found between re-infected and uninfected patients regarding withdrawal of NAs and hepatitis B e antigen (HBeAg) positive before transplantation (both <i>P</i><0.05). <b>Conclusions</b> Long-term withdrawal of HBIG is feasible and safe for recipients with successful hepatitis B immune reconstitution after liver transplantation for hepatitis B-related diseases. Nevertheless, whether antiviral drugs can be simultaneously withdrawn remains to be validated.