Eficacia y seguridad de la vacunación antigripal pediátrica: una revisión sistemática / Efficacy and safety of pediatric flu vaccination: a systematic review

Introducción. Los a corren un mayor riesgo de infección por influenza en comparación con la población general. La Organización Mundial la Salud y las recomendaciones del Comité Asesor de Vacunas de la Asociación Española de Pediatría contemplan la vacunación anual como la forma más eficaz de prevenir la enfermedad. Por lo tanto, el propósito de esta revisión fue actualizar la información sobre eficacia y seguridad en la vacuna antigripal en niños y adolescentes. Material y métodos. Una búsqueda en cuatro bases de datos electrónicas (Scopus, Cumulative Index to Nursing and Allied Health Literature, MedLine / PubMed, Google Scholar y Cochrane), así como una búsqueda manual para identificar investigaciones originales publicadas entre 2012 y 2022. Se adoptaron las directrices de análisis (PRISMAcR) como elemento de informe preferido para revisiones sistemáticas. Resultados. Se incluyeron siete artículos de investigación originales donde se identificaron dos temas de la vacunación antigripal en niños/adolescentes sanos y con patologías. La eficacia (entre un 30% y un 80% aproximadamente) varió en función de la vacuna utilizada y los subtipos circulantes. La mayoría de las reacciones adversas fueron de intensidad leve y el evento adverso local más común informado fue dolor en el sitio de la inyección. Conclusiones. Destacamos positivamente la seguridad de la vacunación antigripal pediátrica en los estudios analizados, por el contrario, con respecto a la eficacia de la vacunación antigripal, observamos una amplia variabilidad de resultados. Existe una clara necesidad de seguir realizando estudios de eficacia y seguridad en el niño. (AU)

Introduction. Children are at a higher risk of influenza infection compared to the general population. The World Organization Health and recommendations of the Vaccine Advisory Committee of the Spanish Association of Pediatrics contemplate annual vaccination as the most effective way to prevent the disease. Therefore, the purpose of this review was to update information on efficacy and safety in the anti -shed vaccine in children and adolescents. Material and methods. A search in four electronic databases (Scopus, Cumulative Index to Nursing and Allied Health Literature, Medline / Pubmed, Google Scholar and Cochrane), as well as a manual search to identify original research published between 2012 and 2022. The guidelines of ANALYSIS (PRISMACR) as a preferred report element for systematic reviews. Results. Seven original research articles were included where two issues of antigripal vaccination were identified in healthy children/adolescents and with pathologies. The efficacy (between approximately 30% and 80%) varied depending on the vaccine used and circulating subtypes. Most adverse reactions were mild intensity, and the most common local adverse event was pain in the injection site. Conclusions. We positively highlight the safety of pediatric flu vaccination in analyzed studies, on the contrary, with respect to the efficacy of flu vaccination, we observe a wide variability of results. There is a clear need to continue conducting efficacy and safety studies in the child. (AU)

337º Reunião Ordinária - 14 dez. 2022

Influencia de la pandemia COVID-19 en la tasa de vacunación antigripal / Impact of the COVID-19 pandemic on the flu vaccination

Introducción: En la temporada 2020-2021 se realizaron campañas mayores de vacunación antigripal, primordialmente en pacientes inmunocomprometidos y sus convivientes. Objetivos: Principal: determinar el impacto de la pandemia COVID-19 en la tasa de vacunación antigripal en la temporada 2020-2021 en pacientes con patologías con carácter inmunosupresor, pacientes pertenecientes a grupos de riesgo y las personas convivientes. Secundarios: porcentaje de vacunas administradas, incidencia de infección del virus de la gripe y la influencia del Servicio de Farmacia sobre la decisión de los pacientes a vacunarse. Metodología: Estudio observacional, prospectivo, de ocho meses de duración, realizado en un hospital comarcal de 125 camas, en pacientes con patologías con carácter inmunosupresor y pacientes que solicitaban la vacunación y estaban incluidos en los grupos de riesgo. Resultados: En la campaña de vacunación 2020-2021 hubo un aumento de pacientes vacunados en un 44,1% (89) con respecto a la vacunación 2019-2020. En el 2019-2020 el 5,3% (6/113) presentaron cuadro de gripe y de los que no recibieron la vacuna el 7,9% (7/89). En la campaña 2020-2021 ningún paciente presentó cuadro de gripe, el 56,4% (114/202) de los pacientes refirieron que fueron influenciados por el servicio de farmacia para vacunarse. Conclusiones: La pandemia por COVID-19 aumentó las tasas de vacunación antigripal en la temporada 2020-2021 ayudando a disminuir la mortalidad en pacientes que sufrieron la enfermedad por la COVID-19. El Servicio de Farmacia influyó positivamente en la tasa de vacunación. (AU)

Introduction: In the 2020-2021 season larger vaccination campaigns were carried out, primarily in immunocompromised patients and their partners. Objectives: Primary end point: determine the impact of the COVID-19 pandemic on the influenza vaccination rate in the 2020-2021 season, in patients with immunosuppressive pathologies, people living with risk groups and patients who requested it and belonged to risk groups. Secondary end point: percentage of vaccines administered, incidence of influenza virus infection and the influence of the Pharmacy Service on the decision of patients to be vaccinated. Methodology: An eight-month prospective, observational study conducted in a 125-bed regional hospital in patients with immunosuppressive pathologies and patients who requested vaccination and were included in risk groups. Results: In the 2020-2021 vaccination campaign, there was an increase in vaccinated patients by 44.1% (89 patients) compared to the 2019-2020 vaccination. In 2019-2020 5.3% (6/113) presented flu symptoms and of those who did not receive the vaccine 7.9% (7/89). In the 2020-2021 campaign, no patient had flu symptoms, 56.4% (114/202) of the patients reported that their decision to get vaccinated was because it was offered at the hospital pharmacy. Conclusions: The COVID-19 pandemic increased flu vaccination rates in the 2020-2021 season, causing lower mortality in patients who suffered from the COVID-19 disease. The Pharmacy Service positively influenced the vaccination rate. (AU)

Seasonal Influenza Prevention and Control Progress in Latin America and the Caribbean in the Context of the Global Influenza Strategy and the COVID-19 Pandemic.

Each year in Latin America and the Caribbean, seasonal influenza is associated with an estimated 36,500 respiratory deaths and 400,000 hospitalizations. Since the 2009 influenza A(H1N1) pandemic, the Region has made significant advances in the prevention and control of seasonal influenza, including improved surveillance systems, burden estimates, and vaccination of at-risk groups. The Global Influenza Strategy 2019-2030 provides a framework to strengthen these advances. Against the backdrop of this new framework, the University of Colorado convened in October 2020 its Immunization Advisory Group of Experts to review and discuss current surveillance, prevention, and control strategies for seasonal influenza in Latin America and the Caribbean, also in the context of the COVID-19 pandemic. This review identified five areas for action and made recommendations specific to each area. The Region should continue its efforts to strengthen surveillance and impact evaluations. Existing data on disease burden, seasonality patterns, and vaccination effectiveness should be used to inform decision-making at the country level as well as advocacy efforts for programmatic resources. Regional and country strategic plans should be prepared and include specific targets for 2030. Existing investments in influenza prevention and control, including for immunization programs, should be optimized. Finally, regional partnerships, such as the regional networks for syndromic surveillance and vaccine effectiveness evaluation (SARInet and REVELAC-i), should continue to play a critical role in continuous learning and standardization by sharing experiences and best practices among countries.

Quantas doses da vacina contra a gripe o Butantan já entregou?

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Investigating the procurement system for understanding seasonal influenza vaccine brand availability in Europe.

BACKGROUND: Timely knowledge of which influenza vaccine brands are procured and where is of interest to inform site-selection for brand-specific influenza vaccine effectiveness (VE) studies. Vaccine procurement is a key determinant of brand availability. We therefore sought to understand how the procurement for seasonal influenza vaccine in Europe is organized, how this drives brand availability and how procurement data could enable to determine brand availability pre-season. METHODS: Structured telephone interviews were conducted with 15 experts in 16 European countries between 2017 and 2019 to collect information on the influenza vaccine procurement systems. Sources of (brand-specific) procurement data were identified and assessed on public accessibility. Vaccine type and brand availability and timelines were determined for the 2019-20 season to understand how procurement systems drive brand availability and diversity. RESULTS: Four main types of procurement systems for seasonal influenza vaccination campaigns were identified: national public tenders (Croatia, Denmark, Finland, Ireland, Lithuania, Netherlands, Norway, Scotland, Slovenia), regional public tenders (Italy, Spain, Sweden), direct purchase of vaccines by GPs (England, Wales) or pharmacies (Belgium, France, Germany, Greece) from manufacturers or wholesalers. National public tender outcomes are publicly available and timely; brand availability at clinic level can generally be deduced or narrowed down to two brands. Regional tender outcomes are more difficult to find, known very late or not available. In Italian and Spanish regions tenders may be awarded only a few weeks before the seasonal campaign. No public procurement information is available for countries with direct purchase. CONCLUSION: At the country-level, brand diversity is generally lower for countries with national public tenders than for countries with regional public tenders or direct purchase. In only a few countries, procurement data at the brand level is both publicly available and timely. Therefore the usefulness of procurement data for prospective site-selection for brand-specific VE studies is limited.

Coletiva de imprensa: anúncios do Governo - 24/03/2021

O Governador João Doria anunciou nesta quarta-feira (24) a antecipação, para esta sexta-feira (26), do início da vacinação contra COVID-19 para idosos com idade entre 69 e 71 anos. Dados do Plano Estadual de Imunização (PEI) indicam um total de novas 910 mil pessoas aptas a receberem a primeira dose no Estado de São Paulo. “O Governo do Estado de SP antecipou a vacinação das pessoas idosas de 69, 70 e 71 anos para esta sexta-feira, dia 26 de março. A otimização da entrega das vacinas do Butantan e a logística da Secretaria da Saúde estão permitindo a antecipação para o atendimento desta faixa etária. Protejam seus pais, protejam seus avós com a vacina”, disse Doria. A campanha ocorre com uma grande operação logística montada para a distribuição das vacinas disponíveis no país, com envio de remessas semanais pela Secretaria de Estado da Saúde para todas as regiões do Estado. Nesta quarta-feira (24), o Instituto Butantan liberou mais 2,2 milhões de doses de vacina, totalizando a distribuição de 27,8 milhões de doses da vacina contra o coronavírus, desde 17 de janeiro, ao PNI (Programa Nacional de Imunizações) do Ministério da Saúde. Somente em março, o Butantan entregou 14,3 milhões de doses, quantitativo maior do que o disponibilizado em janeiro e fevereiro juntos. O número representa quase 25 mil vacinas por hora. Até o final de abril, o número de vacinas garantidas por São Paulo ao país somará 46 milhões. O Butantan ainda trabalha para entregar outras 54 milhões de doses para vacinação dos brasileiros até 30 de agosto, totalizando 100 milhões de unidades. O pré-cadastro no site “Vacina Já” (vacinaja.sp.gov.br) economiza 90% no tempo de atendimento para imunização: leva cerca de 1 a 3 minutos para quem preencheu o formulário. Presencialmente, em média, a coleta de informações leva cerca de 10 minutos. A ferramenta ajuda a agilizar o atendimento e a evitar aglomerações. Não é um agendamento e o uso não é obrigatório para receber a vacina, mas utilizá-la contribui para melhorar a dinâmica dos serviços e a rotina do próprio cidadão. O pré-cadastro pode ser feito por familiares de idosos ou de qualquer pessoa que participe dos públicos previstos na campanha.

Global production capacity of seasonal and pandemic influenza vaccines in 2019.

Vaccines will be an important element in mitigating the impact of an influenza pandemic. While research towards developing universal influenza vaccines is ongoing, the current strategy for vaccine supply in a pandemic relies on seasonal influenza vaccine production to be switched over to pandemic vaccines. Understanding how much vaccine could be produced, in which regions of the world and in what timeframe is critical to informing influenza pandemic preparedness. Through the Global Action Plan for Influenza Vaccines, 2006-2016, WHO promoted an increase in vaccine production capacity and monitors the landscape through periodically surveying influenza vaccine manufacturers. This study compares global capacity for production of influenza vaccines in 2019 with estimates from previous surveys; provides an overview of countries with established production facilities; presents vaccine production by type and manufacturing process; and discusses limitations to these estimates. Results of the current survey show that estimated annual seasonal influenza vaccine production capacity changed little since 2015 increasing from 1.47 billion to 1.48 billion doses with potential maximum annual influenza pandemic vaccine production capacity increasing from 6.37 billion to 8.31 billion doses. However, this figure should be interpreted with caution as it presents a best-case scenario with several assumptions which may impact supply. Further, pandemic vaccines would not be immediately available and could take four to six months for first supplies with several more months needed to reach maximum capacity. A moderate-case scenario is also presented of 4.15 billion doses of pandemic vaccine in 12 months. It is important to note that two doses of pandemic vaccine are likely to be required to elicit an adequate immune response. Continued efforts are needed to ensure the sustainability of this production and to conduct research for vaccines that are faster to produce and more broadly protective taking into account lessons learned from COVID-19 vaccine development.

Priority allocation of pandemic influenza vaccines in Australia - Recommendations of 3 community juries.

BACKGROUND: Pandemic planning has historically been oriented to respond to an influenza virus, with vaccination strategy being a key focus. As the current COVID-19 pandemic plays out, the Australian government is closely monitoring progress towards development of SARS-CoV2 vaccines as a definitive intervention. However, as in any pandemic, initial supply will likely be exceeded by demand due to limited manufacturing output. METHODS: We convened community juries in three Australian locations in 2019 to assess public acceptability and perceived legitimacy of influenza pandemic vaccination distribution strategies. Preparatory work included literature reviews on pandemic vaccine allocation strategies and on vaccine allocation ethics, and simulation modelling studies. We assumed vaccine would be provided to predefined priority groups. Jurors were then asked to recommend one of two strategies for distributing remaining early doses of vaccine: directly vaccinate people at higher risk of adverse outcomes from influenza; or indirectly protect the general population by vaccinating primary school students, who are most likely to spread infection. RESULTS: Thirty-four participants of diverse backgrounds and ages were recruited through random digit dialling and topic-blinded social media advertising. Juries heard evidence and arguments supporting different vaccine distribution strategies, and questioned expert presenters. All three community juries supported prioritising school children for influenza vaccination (aiming for indirect protection), one by 10-2 majority and two by consensus. Justifications included that indirect protection benefits more people and is likely to be more publicly acceptable. CONCLUSIONS: In the context of an influenza pandemic, informed citizens were not opposed to prioritising groups at higher risks of adverse outcomes, but if resources and epidemiological conditions allow, achieving population benefits should be a strategic priority. These insights may inform future SARS-CoV-2 vaccination strategies.

An inventory-location optimization model for equitable influenza vaccine distribution in developing countries during the COVID-19 pandemic.

The addition of other respiratory illnesses such as flu could cripple the healthcare system during the coronavirus disease 2019 (COVID-19) pandemic. An annual seasonal influenza vaccine is the best way to help protect against flu. Fears of coronavirus have intensified the shortage of influenza shots in developing countries that hope to vaccinate many populations to reduce stress on their health services. We present an inventory-location mixed-integer linear programming model for equitable influenza vaccine distribution in developing countries during the pandemic. The proposed model utilizes an equitable objective function to distribute vaccines to critical healthcare providers and first responders, elderly, pregnant women, and those with underlying health conditions. We present a case study in a developing country to exhibit efficacy and demonstrate the optimization model's applicability.

Webconferência: atualização do Calendário Nacional de Vacinação - Telessaúde ES 15/03/2016

WebPalestra: 21ª Campanha Nacional de vacinação contra a influenza

A vacinação contra influenza tem o propósito de reduzir complicações, internações e mortes na população alvo para a vacinação no Brasil. Em 2019, acontecerá a 21ª Campanha nacional de vacinação contra a influenza no período de 15 de abril a 31 de maio, sendo 4 de maio, o dia da mobilização nacional.

Instituto Butantan exporta vacina da gripe

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Coletiva de imprensa: anúncios do governo SP - 28/08/2020

O Governador João Doria anunciou nesta sexta-feira (28) que as internações por COVID-19 caíram pela quarta semana seguida no estado, pela primeira vez desde o início da pandemia. Entre domingo (23) e quinta-feira (27), foi registrada redução de 9% no número de pacientes internados no estado em comparação com os mesmos dias da semana anterior. São Paulo registrou o menor índice de ocupação de UTI desde o início do Plano São Paulo, com 54,3%. Houve queda também de 9% no número de óbitos entre domingo e quinta-feira em relação ao mesmo período da semana anterior, o que mostra que o estado segue para sua terceira semana seguida de redução de óbitos por COVID-19. Mais informações sobre os dados mais recentes do Plano São Paulo estão disponíveis neste link. “São indicadores que nos trazem otimismo, o pior está passando. Mas isso não deve inibir precaução, zelo, cuidado e atenção no combate à pandemia. Nenhum relaxamento deve ser adotado pelos bons resultados conquistados até aqui”, disse Doria. Em relação à semana epidemiológica anterior, o estado apresentou uma redução de 5% no número de casos, de 10% nas internações e de 11% nos óbitos. Na capital, a queda de casos foi de 2%, 11% de internações e de 6% nos óbitos. Interior e litoral também apresentaram redução: 6% no número de casos, 6% de internações e 18% no índice de óbitos. Nenhuma região foi rebaixada de fase na atualização desta sexta-feira do Plano São Paulo e os 645 municípios paulistas podem permitir a reabertura com restrições do atendimento presencial em comércios e serviços não essenciais. O estado permanece com 88% de sua população em regiões que estão na fase amarela. O Governo do Estado fez um ajuste no Plano São Paulo para aperfeiçoar os indicadores para manutenção na fase verde, evitando que regiões que reduziram sensivelmente os seus números sofram mudanças abruptas de fase, sem que de fato a pandemia tenha se agravado nestes locais. O Plano São Paulo foi concebido com três indicadores para monitoramento da transmissibilidade e da evolução da doença: de novos casos, de óbitos e de internação hospitalar. Estes indicadores foram concebidos para serem analisados de forma comparativa, sempre observando o resultado da semana com os índices da semana anterior. Para dar mais segurança ao plano, o Centro de Contingência do coronavírus implementou dois novos indicadores fixos que determinam que, para passar à fase verde, a região precisa ter no máximo 40 internações por 100 mil habitantes nos últimos 14 dias e 5 óbitos, no máximo, por 100 mil habitantes nos últimos 14 dias. Agora, com este aperfeiçoamento e para preservar a estabilidade das fases, sempre que a região estiver dentro dessa faixa de internações e óbitos, eles serão preponderantes com relação a possíveis alterações nos dados comparativos de internações e óbitos da semana. Caso a região ultrapasse 5 óbitos ou 40 internações por 100 mil habitantes nos últimos 14 dias, a classificação dos indicadores seguirá as regras gerais já vigentes. “Dentre as 22 regiões que são delimitadas pelo Plano SP, 11 destas têm uma taxa inferior a 40 internações por cem mil habitantes, índice este que mede a intensidade da pandemia naquele território”, afirma o Secretário de Desenvolvimento Regional, Marco Vinholi. A partir de agora os vestiários de academias estão liberados para uso dos frequentadores, seguindo os critérios sanitários previstos no Plano São Paulo. A recomendação de autoridades da Saúde é que as pessoas permaneçam em casa se puderem, principalmente idosos e portadores de doenças crônicas. O uso de máscaras em locais de acesso público e no transporte coletivo é obrigatório em todos os 645 municípios.

Seasonal influenza vaccination during a pandemic.

In the Northern Hemisphere, the persistence or reemergence of coronavirus circulation into the 2020-2021 influenza season threatens to overwhelm health-care resources and systems and increase mortality and morbidity. Data from Australia show that stay-at-home policies have reduced both influenza and coronavirus cases early in the season, thus "flattening the curve." However, influenza vaccination is critical to ensure the reduction in co-infection. Several policies, such as vaccination strategies to accommodate physical distancing measures, change population recommendations, and timing and location of vaccination have been implemented to increase influenza vaccine uptake during the pandemic. This commentary explores those policies.

Pessoas com sintomas gripais podem se vacinar?

Saiba mais em: www.saopaulo.sp.gov.br/coronavirus/planosp