Vaccine Hesitancy, Knowledge, and COVID-19 Vaccination in a Sample of Italian and Albanian Healthcare Students Attending an University in Albania.

BACKGROUND: Vaccine hesitancy (VH) has increased over the past decade with large geographical variations between countries, posing a threat to global public health. This phenomenon is growing in the general population as well as among healthcare workers (HCWs), who are the most reliable source of vaccine-related information for patients. Special attention must therefore be paid to medical students, who are the future HCWs. METHODS: We conducted a cross-sectional study (November 2022-January 2023) on all the Albanian and Italian students attending medical science courses at the Catholic University "Our Lady of Good Counsel" (Tirane, Albania) to investigate VH and the factors contributing to it (using the Vaccination Attitude Examination Scale-VAX), including COVID-19 vaccination. Vaccine knowledge was assessed using the Zingg and Siegrist Scale. Students were asked to voluntarily answer an anonymous questionnaire. RESULTS: 689 questionnaires were collected (58.8% Albanians, 72.3% female; 70.4% aged 20-25 years; 70.4% attending the Medicine and Surgery course). Generally, students showed low VH, especially Italians (p < 0.001); however, some hesitancy was observed regarding the potential long-term effects of vaccines, especially among Albanians (p < 0.05). The results also showed a significant difference in vaccine knowledge scores between different course years (χ2 = 90.058; df = 40; p = < 0.001) and different degree courses (χ2 = 89.932; df = 40; p = < 0.001). With regard to COVID-19 vaccination, being of Albanian origin significantly increases the risk of not being vaccinated (OR = 7.215; 95%CI 3.816-13.640, p < 0.001), highlighting possible differences in vaccine coverage and policy between the two countries. CONCLUSION: Vaccine hesitancy should be addressed at early stages during medical sciences courses, in order to protect future healthcare workers, to preserve essential health services, and reduce the risk of further pandemics.

Pulmonary function assessment after COVID-19 in vaccinated healthcare workers.

COVID-19 typically presents with flu-like symptoms due to the viral infection itself. The most severe cases are characterised by lung damage, an important factor in fatal outcome due to alveolar damage. In some cases, patients develop a long COVID with persistent symptoms of chest pain and fatigue. Causes, including organ damage or inflammation, are being investigated. Clinical outcomes are variable and permanent lung damage is not fully understood, while vaccination is effective against severe infection but its effect on respiratory function in mild cases remains uncertain. This retrospective study aims to analyse changes in lung function in HCWs who had COVID-19 between 2020 and 2022, comparing their spirometric test results before and after the pandemic and taking into account their vaccination status. 321 HCWs were included in the study. The study examined spirometric parameters both before and after the pandemic, and all measured outcomes except the FEV1/FVC ratio showed a significant decrease during the study period. We then assessed the association between SARS-CoV-2 infection and changes in lung function parameters, analysing infections in 2020, 2021 and 2022 separately. We found a statistically significant difference in Forced vital capacity (FVC) between infected and non-infected subjects in 2020 and 2021, but not in 2022. To evaluate the protective effect of SARS-CoV-2 vaccination on respiratory function, a linear regression analysis was performed using changes in FVC, Forced expiratory volume in 1 s (FEV1), FVC/FEV1 ratio and Peak expiratory flow (PEF) as dependent variables. The analysis showed that the decline in FVC was significantly lower in subjects who had been vaccinated prior to infection. The study concludes that subclinical SARS-CoV-2 infections in 2020 and 2021 worsened respiratory parameters (FVC and FEV1), but vaccination protected against these effects. Even healthy individuals with previous infections showed respiratory changes, with vaccination providing protection, especially for FVC decline. This highlights the importance of vaccinating healthcare workers against COVID-19.

Rubella Vaccine Uptake among Women of Childbearing Age in Healthcare Settings.

BACKGROUND: Rubella is a contagious viral infection that occurs most often in children and young adults. Rubella is the leading vaccine-preventable cause of birth defects. Rubella infection in pregnant women may cause fetal death or congenital defects known as congenital rubella syndrome. There is no specific treatment for rubella, but the disease is preventable by vaccination with an efficacy of over 95%. Vaccination coverage is still below the recommended levels and many cases have occurred worldwide. The COVID-19 pandemic has had a negative impact on the immunization programs and the quality of disease surveillance worldwide. Operators of the healthcare setting are at increased risk of infection due to their work duties and should receive preventive vaccination or serologic protection to work in a healthcare setting. AIMS: To evaluate the serological evidence of rubella IgG antibodies in female healthcare operators of childbearing age, to assess the risk of a breakthrough infection and the need for an additional dose of vaccine. METHODS: We collected age and antibody titers from 449 young female operators aged <50 years who underwent the periodic surveillance at the Occupational Medicine Unit of the Policlinico Tor Vergata, Rome, from January to July 2022. Subjects were considered immune if the anti-rubella IgG titer was >11.00 IU/mL. RESULTS: The rate of serologically unprotected subjects was 9.13% (41/449). The mean age of protected subjects was 26.93 years, while the mean age of unprotected subjects was 28.24 years. Age did not correlate with mean titer on statistical analysis (p = 0.10). The acceptance rate among unprotected operators was 31.7%. A positive attitude towards vaccination was found in 11/28 (39.3%) of the unvaccinated subjects, while a negative tendency was found in 2/28 (7.1%) of these subjects; most of the unvaccinated operators 15/28 (53.6%) prefer to postpone the administration of the vaccine. When compared with a similar population from the pre-pandemic period, the actual proportion of immune female subjects was not significantly different from that found in 2019 (90.87% vs. 90.3%). CONCLUSIONS: Protection against rubella was suboptimal among female healthcare workers of childbearing age. Acceptance of the rubella vaccine among these operators was low. Most of those who were hesitant intended to postpone the vaccination, while a minority had negative attitudes toward vaccination. A policy of mandatory vaccination policy should overcome the reluctance of operators.

Protective Anti-HBs Antibodies and Response to a Booster Dose in Medical Students Vaccinated at Childhood.

The immune system in humans is regulated by the circadian rhythm. Published studies have reported that the time of vaccination is associated with the immune response to vaccine for some pathogens. Our study aimed to evaluate the association between time of dose administration of challenge HBV vaccine and seroconversion for anti-HBs in medical students vaccinated at birth who were found to be unprotected at pre-training screening. Humoral protection for HBV was assessed in 885 medical students vaccinated during childhood. In total, 359 (41.0%) of them showed anti-HBs titer < 10 UI/mL and received a challenge dose of HBV vaccine followed by post-vaccination screening 30-60 days later. The challenge dose elicited a protective immune response (anti-HBs IgG titer > 10 UI/mL) in 295 (83.8%) individuals. Seroconversion was significantly associated with female gender and time of vaccination after controlling for age group and nationality at logistic regression analysis. Students who received the booster dose in the morning had a higher response rate than those who received the vaccine in the afternoon (OR 1.93; 95% C.I. 1.047-3.56: p < 0.05). This finding suggests that morning administration of the HBV booster may result in a better immune response in susceptible individuals.

Measles vaccine uptake among Italian medical students compared to the pre-COVID-19 era.

The COVID-19 pandemic has severely affected health systems worldwide and raised the issue of vaccine hesitancy. In 2022, the World Health Organization reported an outbreak of measles infection among people over 20 years of age in the European Region. Previous studies found low rates of measles immunization among Italian healthcare workers (HCWs) and medical students. Vaccine hesitancy is a relevant cause of low immunization rate among HCWs and the general population. We aim to evaluate the measles vaccine uptake among medical students of a large teaching hospital, compared to the pre-pandemic period. This is a retrospective observational study, that evaluated the immune status and the vaccine acceptance rate for measles in medical students at the University of Tor Vergata, Rome, who underwent occupational health surveillance from 1 January to 1 December 2022. We also compared the data with the results of a pre-pandemic survey conducted in 2018. Vaccine uptake among unprotected medical students was 59.5%. The data showed no significant difference in vaccine uptake compared with the pre-COVID-19 period. Conversely, the rate of serologically immune subjects to measles increased from 89.66% in 2018 to 97.45% in 2022 as a result of the recent mandatory vaccination policy. Despite efforts to tackle vaccine hesitancy during the COVID-19 pandemic, measles vaccine uptake is still low among young adults starting their medical training, and their compliance with free workplace vaccination offers is suboptimal. Occupational health services should raise awareness among workers and work together to implement strategies to achieve comprehensive measles vaccination coverage among occupational health workers.

Serological Evaluation for Measles among Italian and Foreign Medical Students in a University Hospital in Rome.

BACKGROUND: Measles infection in the hospital setting is a major issue. Despite the availability of an effective vaccine, measles outbreaks continue to occur in some European countries. We aimed to evaluate the immunological status of medical students attending the Tor Vergata Polyclinic (PTV). METHODS: Measles antibodies titers were assessed by venipuncture on a sample of 2717 medical students who underwent annual health surveillance visits from January 2021 to March 2023. Subjects showing serum IgG values above 1.0 S/CO were considered serologically protected. Personal data, country of origin, and main demographic characteristic were also collected. RESULTS: 66.7% (1467 Italian and 346 foreign) of medical students showed protective IgG antibodies levels. Female students were serologically immune more frequently than males (68.6% vs. 63.3%; p < 0.01 at Chi2). The mean antibody titer was 1.72 S/CO, significantly higher in females than males (1.67 vs. 1.75, respectively; p < 0.05), and significantly related to age (p < 0.01). Albanian students, who were the largest foreign population in our study, showed a low serological protection rate (40/90: 44.4%). CONCLUSIONS: The proportion of serologically non-immune students is high, raising concerns about the possible risk of hospital transmission. Substantial differences in the rate of immunity have been found between subjects coming from different parts of Europe and the world. Pre-training assessment of all medical students and vaccination of susceptible individuals is highly recommended, particularly for those from low immunization rate countries.

Global Policy to Reduce the Incidence of Infection Spreading in Non-Vaccinated Healthcare Workers: A Literature Review.

Healthcare workers (HCWs) are at increased risk of SARS-CoV-2 infection because of their occupational exposure. Moreover, they can be a vehicle for the virus transmission among patients. The vaccination of healthcare personnel against COVID-19 is crucial in fighting the spread of SARS-CoV-2 infection, together with strict sanitary procedures that aim to limit the risk of contagion. Unfortunately, even if COVID-19 vaccination has been proved one of the most effective tools for protecting against COVID-19, many healthcare professionals are not yet vaccinated. The aim of the current review is to contribute to identifying an effective strategy for COVID-19 prevention especially among non-vaccinated HCWs. In this review, we collected the most recent and relevant findings from literature on the protection of unvaccinated HCWs, identifying three types of measures as principal actions to protect those operators: addressing vaccine hesitancy, improving non-pharmaceutical interventions and promoting actions at personal level (respiratory hygiene, hand hygiene and use of PPE). All these interventions are very effective in preventing contagion, if well respected and conducted; nevertheless, it is essential to promote vaccination, as it is the most effective measure.

Main Predictors of COVID-19 Vaccination Uptake among Italian Healthcare Workers in Relation to Variable Degrees of Hesitancy: Result from a Cross-Sectional Online Survey.

Background: Hesitancy remains one of the major hurdles to vaccination, regardless of the fact that vaccines are indisputable preventive measures against many infectious diseases. Nevertheless, vaccine hesitancy or refusal is a growing phenomenon in the general population as well as among healthcare workers (HCWs). Many different factors can contribute to hesitancy to COVID-19 vaccination in the HCWs population, including socio-demographic characteristics (female gender, low socio-economical status, lower age), individual beliefs regarding vaccine efficacy and safety, as well as other factors (occupation, knowledge about COVID-19, etc.). Understanding the determinants of accepting or refusing the COVID-19 vaccination is crucial to plan specific interventions in order to increase the rate of vaccine coverage among health care workers. Methods: We conducted a cross-sectional online survey on HCWs in seventeen Italian regions, between 30 June and 4 July 2021, in order to collect information about potential factors related to vaccine acceptance and hesitancy. Results: We found an overall vaccine uptake rate of 96.4% in our sample. Acceptance was significantly related to job task, with physicians showing the highest rate of uptake compared to other occupations. At univariate analysis, the HCWs population's vaccine hesitancy was significantly positively associated with fear of vaccination side effects (p < 0.01), and negatively related to confidence in the safety and efficacy of the vaccine (p < 0.01). Through multivariate analysis, we found that only the fear of possible vaccination side effects (OR: 4.631, p < 0.01) and the confidence in vaccine safety and effectiveness (OR: 0.35 p < 0.05) remained significantly associated with hesitancy. Conclusion: Action to improve operator confidence in the efficacy and safety of the vaccine should improve the acceptance rate among operators.

Night Shift Work Is Associated with Reduced Rate of Humoral Response Following Vaccination for HBV.

Night shift work has been associated with cardiovascular and metabolic disease, endocrine and immunological disorders. Published studies have reported that a reduced total sleep time with sleep-wake cycle alterations were associated with a reduced rate of humoral response following vaccination. Our study aimed to evaluate the association between night shift work and serological status for HBV among workers employed in a university hospital in Rome. We evaluated medical records of 986 HCWs working at Tor Vergata Policlinic of Rome. We screened all study subjects for anti-HBs IgG, anti-HBc IgG and HBsAg. Serological protection for HBV was evaluated in relation to sex, age group, job task, risk setting and night shift work status. Protective titer was found in 856 (86.8%) study participants and the mean titer was significantly high in females, in subjects aged less than 40 years, in night shift workers and in high-risk setting workers. After adjustment for study covariates, night shift work was no longer associated with an HBV-protective titer. This finding suggests that a vaccination strategy for dampening HBV transmission should be carefully addressed in health care workers (HCWs) doing night shift.

Reduced Titers of Circulating Anti-SARS-CoV-2 Antibodies and Risk of COVID-19 Infection in Healthcare Workers during the Nine Months after Immunization with the BNT162b2 mRNA Vaccine.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has had a tremendous impact on health services; hundreds of thousands of healthcare workers (HCWs) have died from coronavirus disease 2019 (COVID-19). The introduction of the BNT162b2 mRNA vaccine in Italy provided recipients with significant protection against COVID-19 within one to two weeks after the administration of the second of the two recommended doses. While the vaccine induces a robust T cell response, the protective role of factors and pathways other than those related to memory B cell responses to specific SARS-CoV-2 antigens remains unclear. This retrospective study aimed to evaluate the determinants of serological protection in a group of vaccinated HCWs (n = 793) by evaluating circulating levels of antiviral spike receptor-binding domain (S-RBD) antibodies during the nine-month period following vaccination. We found that 99.5% of the HCWs who received the two doses of the BNT162b2 vaccine developed protective antibodies that were maintained at detectable levels for as long as 250 days after the second dose of the vaccine. Multivariate analysis was performed on anti-S-RBD titers in a subgroup of participants (n = 173) that were evaluated twice during this period. The results of this analysis reveal that the antibody titer observed at the second time point was significantly related to the magnitude of the primary response, the time that had elapsed between the first and the second evaluation, and a previous history of SARS-CoV-2 infection. Of importance is the finding that despite waning antibody titers following vaccination, none of the study participants contracted severe COVID-19 during the observational period.

Risk of latent tuberculosis infection among healthcare workers in Italy: a retrospective study with Quantiferon Test.

OBJECTIVE: The latent tuberculosis infection (LTBI) is a state of persistent immune response to stimulation by Mycobacterium Tuberculosis antigens without clinical manifestation: the healthcare workers (HCWs) have a higher exposure risk so prevention is an important challenge for occupational medicine. The aim of our study is to evaluate the prevalence of LTBI among HCWs of the Foundation Policlinic "Tor Vergata". METHODS: This is a retrospective study conducted by analyzing the clinical records of 825 HCWs of the PTV, from January 1st to December 31th 2016. To evaluate the TB infection we used the Quantiferon TB Gold interferon-gamma release assay. RESULTS: Our study underlines the low prevalence of LTBI in the Italian healthcare workers. CONCLUSION: Although the LTBI status is not contagious, the diagnosis and the safety strategies require specific clinical and preventive considerations.

Factors Associated with Pre-Vaccination SARS-CoV-2 Infection Risk among Hospital Nurses Facing COVID-19 Outbreak.

The objective of this work was to evaluate the magnitude of COVID-19 spread and the related risk factors among hospital nurses employed in a COVID hospital in Rome, before the beginning of the vaccination programmes commenced in 2021. Participants periodically underwent (every 15-30 days) nasopharyngeal swab and/or blood sample for SARS-CoV-2 IgG examination. From 1 March 2020 to 31 December 2020, we found 162 cases of COVID-19 infection (n = 143 nasopharyngeal swab and n = 19 IgG-positive) in a total of 918 hospital nurses (17.6%). Most SARS-CoV-2-infected hospital nurses were night shift workers (NSWs), smokers, with higher BMI and lower mean age than that of individuals who tested negative. After adjusting for covariates, age (OR = 0.923, 95% C.I. 0.895-0.952), night shift work (OR = 2.056, 95% C.I. 1.320-2.300), smoking status (OR = 1.603, 95% C.I. 1.080-2.378) and working in high-risk settings (OR = 1.607, 95% C.I. 1.036-2.593) were significantly associated with SARS-CoV-2 hospital infection, whereas BMI was not significantly related. In conclusion, we found a high prevalence of SARS-CoV-2 infection among hospital nurses at a Rome COVID hospital in the pre-vaccination period. Smoking, young age, night shift work and high-risk hospital settings are relevant risk factors for hospital SARS-CoV-2 infection; therefore, a close health surveillance should be necessary among hospital nurses exposed to SARS-CoV-2.

Persistence of Anti-S Titre among Healthcare Workers Vaccinated with BNT162b2 mRNA COVID-19.

The COVID-19 pandemic has led to health, social and economic consequences for public health systems. As a result, the development of safe and effective vaccines, in order to contain the infection quickly became a priority. The first vaccine approved by the Italian Agency for Drugs Authorization (AIFA) was the BNT162b2 mRNA vaccine, developed by BioNTech and Pfizer (Comirnaty). Comirnaty contains a molecule called messenger RNA (mRNA), which is a nucleoside-modified RNA that encodes the SARS-CoV-2 spike glycoprotein. Even if data from phase I suggest that vaccine induced antibodies can persist for up to six months following the second shot of BNT vaccine, data regarding the real duration of immunological protection are lacking. In this study, we aimed to evaluate the duration of serological protection by detecting the presence of anti-S-RBD (receptor-binding domain) antibodies for SARS-CoV-2 among a large group of healthcare workers (HCWs) three months after vaccination. 99% of HCWs had a detectable titre of anti-S SARS-CoV-2 antibodies 90 days after the second vaccine shot. Elderly operators showed significantly lower levels of protective antibodies when compared to the younger ones, thus they could become unprotected earlier than other operators.

Evaluation of Immunity for Mumps among Vaccinated Medical Students.

Healthcare workers are considered at higher risk for mumps infection than the general population. Since 2017, the national immunization plan recommended the administration of a dose of measles-mumps-rubella (MMR) vaccine to the healthcare operators who are unable to demonstrate a complete vaccination history or that are seronegative for at least one of the three agents. Regarding mumps infection, based on actual concerns regarding the loss of protection over the years after vaccination, the Advisory Committee on Immunization Practices (ACIP) recommended to administer a third dose of vaccine to operators previously vaccinated with two doses of MMR vaccine who belong to a group at increased risk of mumps infection in the event of an epidemic. This guideline, however, is not currently followed in Italy, resulting in a potential risk for vaccinated operators to become unprotected from mumps over the years. The aim of our study is to evaluate the persistence of a protective antibody level for mumps among medical students vaccinated during infancy or adolescence, at the start of their hospital internship. We retrospectively evaluated mumps-specific IgG levels in a group of medical students, in the period from 1 January to 31 December 2020. We evaluated the persistence of the detectable level of mumps-specific antibodies in relation to their vaccinal status, gender and time elapsed from vaccination. We found that 17.4% (65 subjects) of our sample were seronegative for mumps. The univariate analysis showed a significant difference in serological protection between male and female gender (77.0% vs. 86.2%; p < 0.05 with chi2 test) and between age classes (86.5% vs. 76.4%; p < 0.05 for subjects aged 18-23 years and over 23 years, respectively). Female gender was significantly related to higher serological protection even after adjusting for age classes and number of vaccine doses administered in a multivariate analysis model. Our study shows a substantial percentage of subjects lacking a protective mumps titer among medical students who were vaccinated in childhood. Given the higher risk of infection among those subjects, routine pre-employment screening should be performed among those operators regardless of their vaccination history and a third dose of MMR should be offered to unprotected students.

Intention to Be Vaccinated for COVID-19 among Italian Nurses during the Pandemic.

BACKGROUND: While the COVID-19 pandemic has spread globally, health systems are overwhelmed by both direct and indirect mortality from other treatable conditions. COVID-19 vaccination was crucial to preventing and eliminating the disease, so vaccine development for COVID-19 was fast-tracked worldwide. Despite the fact that vaccination is commonly recognized as the most effective approach, according to the World Health Organization (WHO), vaccine hesitancy is a global health issue. METHODS: We conducted a cross-sectional online survey of nurses in four different regions in Italy between 20 and 28 December 2020 to obtain data on the acceptance of the upcoming COVID-19 vaccination in order to plan specific interventions to increase the rate of vaccine coverage. RESULTS: A total of 531 out of the 5000 nurses invited completed the online questionnaire. Most of the nurses enrolled in the study (73.4%) were female. Among the nurses, 91.5% intended to accept vaccination, whereas 2.3% were opposed and 6.2% were undecided. Female sex and confidence in vaccine efficacy represent the main predictors of vaccine intention among the study population using a logistic regression model, while other factors including vaccine safety concerns (side effects) were non-significant. CONCLUSIONS: Despite the availability of a safe and effective vaccine, intention to be vaccinated was suboptimal among nurses in our sample. We also found a significant number of people undecided as to whether to accept the vaccine. Contrary to expectations, concerns about the safety of the vaccine were not found to affect the acceptance rate; nurses' perception of vaccine efficacy and female sex were the main influencing factors on attitudes toward vaccination in our sample. Since the success of the COVID-19 immunization plan depends on the uptake rate, these findings are of great interest for public health policies. Interventions aimed at increasing employee awareness of vaccination efficacy should be promoted among nurses in order to increase the number of vaccinated people.

Contact Screening for Healthcare Workers Exposed to Patients with COVID-19.

In China and Italy, many cases of coronavirus disease 2019 (COVID-19) have occurred among healthcare workers (HCWs). Prompt identification, isolation and contact tracing of COVID-19 cases are key elements in controlling the COVID-19 pandemic. The aim of this study was to evaluate the rate of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection among HCWs exposed to patients with COVID-19 in relation to the main determinants of exposure. To assess the risk of exposure, we performed active symptom monitoring in 1006 HCWs identified as contacts of COVID19 cases. The presence of symptoms was statistically associated with a positive nasopharyngeal swab result. Only one subject was asymptomatic at the time of positive test. These data suggest that clinical history may help in the selection of subjects to be investigated by means of reverse transcriptase-polymerase chain reaction (RT-PCR) in the case of a shortage of diagnostic resources. We found that close contact (within 2 m for 15 min or more) was not statistically related to contagion. Regarding the use of personal protective equipment (PPE), only the use of facial masks was inversely related to the chance of becoming infected (p < 0.01). In conclusion, our data show that unprotected contacts between HCWs should be considered a major route of HCW contagion, suggesting that the use of facial masks should be implemented even in settings where known patients with COVID-19 are not present.

Rubella Immunity among Italian Female Healthcare Workers: A Serological Study.

Rubella, also known as German measles or three-day measles, is an infectious disease caused by virus of the genus Rubivirus, which may be prevented by vaccination. The infection is potentially dangerous for non immune subjects, although 20-50% of infected subjects are asymptomatic. Healthcare workers (HCWs) have an increased potential exposure to rubella in comparison to the general population, putting them and their patients at risk of infection and its complications. In 2019, 20 cases of rubella have been reported in Italy. According to the Italian National Immunization and Prevention Plan, HCWs should provide a written certification of vaccination for rubella or serological evidence of protective antibodies. The aim of the study was to evaluate the rubella immunization status in female HCWs of the teaching hospital Policlinic Rome Tor Vergata (PTV) of childbearing age. For this purpose, we retrospectively checked the serologic values of rubella-specific IgG antibodies analyzing the clinical records of the HCWs of undergoing the occupational health surveillance program from January 1st to June1st 2020. Five hundred fourteen HCWs with a mean age of 23.19 (range 19-37, DS: 2.80) were included: 90.3% (464) showed a protective antibody titre. The mean value of the anti-rubella IgG was 49.59 IU/mL. Our study shows a non-protective anti rubella IgG titre in a substantial percentage of HCWs (9.7%). As vaccine protection decreases over the years and the risk of congenital rubella syndrome (CRS) in vaccinated subjects should not be underestimated, we suggest routine screening of the immunological status followed by the administration of a third dose of vaccine if the antibody titre becomes non-protective.

Procedimentos de emparelhamento com o modelo e possíveis aplicações na avaliação de habilidades de linguagem / Matching procedures with the model and possible applications in assessment of language skills

Procedimentos de emparelhamento com o modelo (ECM) são amplamente empregados na pesquisa experimental de processos comportamentais complexos. Sua utilização na avaliação clínica de habilidades de linguagem, todavia, tem sido pouco explorada. No presente estudo, ilustra-se a aplicação de tarefas de ECM na avaliação de habilidades de reconhecimento auditivo de palavras e nomeação de figuras em um menino com perda auditiva de grau severo. O participante foi submetido a diferentes testes informatizados de reconhecimento auditivo e nomeação, que eram repetidos até que desempenho acurado fosse observado. Em tentativas de reconhecimento apresentava-se como modelo uma palavra ditada e três figuras como alternativas de escolha, uma das quais era definida como correta em presença do modelo. Em tentativas de nomeação, o computador apresentava uma figura com instrução para nomeação...

Procedures of matching to sample (ECM) are widely use don experimental studies of complex behavioral processes. Its use in clinical evaluation of language skills, however, has not been explored. This study illustrates the application of ECM tasks in the assessment of skills of auditory recognition of words and naming fi gures in a child with severe hearing loss. The participant was submitted to different computerized tests for auditory recognition and naming, which were repeated until accurate performance was observed. In attempts of recognition it was presented as model a dictated word and three pictures as alternative choices, one of which was defined as correct in the presence of the model In attempts of naming, the computer showed a figure with instruction for naming...