National Vaccine Coverage Survey 2020: methods and operational aspects.

OBJECTIVE: The national vaccination coverage survey on full vaccination at 12 and 24 months of age was carried out to investigate drops in coverage as of 2016. METHODS: A sample of 37,836 live births from the 2017 or 2018 cohorts living in capital cities, the Federal District, and 12 inner cities with 100 thousand inhabitants were followed for the first 24 months through vaccine record cards. Census tracts stratified according to socioeconomic levels had the same number of children included in each stratum. Coverage for each vaccine, full vaccination at 12 and 24 months and number of doses administered, valid and timely, were calculated. Family, maternal and child factors associated with coverage were surveyed. The reasons for not vaccinating analyzed were: medical contraindications, access difficulties, problems with the program, and vaccine hesitancy. RESULTS: Preliminary results showed that less than 1% of children were not vaccinated, full coverage was less than 75% at all capitals and the Federal District, vaccines requiring more than one dose progressively lost coverage, and there were inequalities among socioeconomic strata, favorable to the highest level in some cities and to the lowest in others. CONCLUSION: There was an actual reduction in full vaccination in all capitals and the Federal District for children born in 2017 and 2018, showing a deteriorating implementation of the National Immunization Program from 2017 to 2019. The survey did not measure the impacts of the COVID-19 pandemic, which may have further reduced vaccination coverage.

Zika Brazilian Cohorts (ZBC) Consortium: Protocol for an Individual Participant Data Meta-Analysis of Congenital Zika Syndrome after Maternal Exposure during Pregnancy.

Despite great advances in our knowledge of the consequences of Zika virus to human health, many questions remain unanswered, and results are often inconsistent. The small sample size of individual studies has limited inference about the spectrum of congenital Zika manifestations and the prognosis of affected children. The Brazilian Zika Cohorts Consortium addresses these limitations by bringing together and harmonizing epidemiological data from a series of prospective cohort studies of pregnant women with rash and of children with microcephaly and/or other manifestations of congenital Zika. The objective is to estimate the absolute risk of congenital Zika manifestations and to characterize the full spectrum and natural history of the manifestations of congenital Zika in children with and without microcephaly. This protocol describes the assembly of the Consortium and protocol for the Individual Participant Data Meta-analyses (IPD Meta-analyses). The findings will address knowledge gaps and inform public policies related to Zika virus. The large harmonized dataset and joint analyses will facilitate more precise estimates of the absolute risk of congenital Zika manifestations among Zika virus-infected pregnancies and more complete descriptions of its full spectrum, including rare manifestations. It will enable sensitivity analyses using different definitions of exposure and outcomes, and the investigation of the sources of heterogeneity between studies and regions.

Mononucleose infecciosa em crianças e adolescentes de Belém, Pará, Brasil: abordagem clínica e soroepidemiológica / Infection mononucleosis among children and adolescent living in Belem-PA Brasil

Um total de 234 crianças e adolescentes, menores de 16 anos (média de idade = ñ 5,8 anos), com suspeita clínica de mononucleose infecciosa, foi atendido no "Serviço de Virologia Geral" do "Instituto Evandro Chagas (IEC)", no período de junho a dezembro de 1995. As amostras de soro foram testadas quanto à presença de anticorpos das classes IgG e IgM anti-Epstein Barr (EBV), através do procedimento imunoenzimático (ELISA), especificamente contra o antígeno do capsídeo viral (anti-VCA). Para tanto se utilizou o Kit da Clark Laboratories(tm) (Jamestown - NY - EUA). O objetivo deste trabalho foi de estabelecer a frequência de infecçäo primária pelo EBV, avaliando as características clínicas em crianças e adolescentes. Dentre as 234 amostras analisadas a soropositividade em termos de IgG foi de 56 por cento (131/234), sendo que 55 por cento (72/131) e 45 por cento (59/131) eram do sexo masculino e feminino, respectivamente. Em 10,6 por cento (25/234) das crianças e adolescentes com mononucleose infecciosa ativa (presença de anticorpos IgM-EBV), registramos os seguintes achados clínicos: linfadonopatias (76 por cento), febre (68 por cento), erupçäo cutânea (12 por cento) e hepatomegalia (12 por cento). Os resultados indicam que, já aos seis anos de idade, metade das crianças já foram infectadas pelo EBV