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J Glob Health ; 12: 05041, 2022 Sep 17.
Article in English | MEDLINE | ID: mdl-36112520


Background: Several laboratory data have been identified as predictors of disease severity or mortality in COVID-19 patients. However, the relative strength of laboratory data for the prediction of health outcomes in COVID-19 patients has not been fully explored. This meta-analytical study aimed to evaluate the prediction capabilities of laboratory data on the prognosis of COVID-19 patients during 2020 while mass vaccination has not started yet. Methods: Two electronic databases, MEDLINE and EMBASE, from inception to October 10, 2020 were searched. Observational studies of laboratory-confirmed COVID-19 patients with well-defined severity or survival status, and with the desired laboratory data at initial hospital administrations, were selected. Meta-regression analysis with the generalized estimating equations (GEE) method for clustered data was performed sequentially. Primary outcome measures were to compare the level of laboratory data and their impact on different health outcomes (severe vs non-severe, critically severe vs non-critically severe, and dead vs alive). Results: Meta-data of 13 clinical laboratory items at initial hospital presentations were extracted from 76 selected studies with a total of 26 627 COVID-19 patients in 16 countries. After adjusting for the effect of age, 1.03 0.87 (OR = 0.0576; 95% CI = 0.0043-0.4726; P = 0.0079) had a much lower risk of severity, critical severity, and mortality from COVID-19, respectively. Conclusions: Lymphocyte count was the most powerful predictor among the 13 common laboratory variables explored from COVID-19 patients to differentiate disease severity and to predict mortality. Lymphocyte count should be monitored for the prognoses of COVID-19 patients in clinical settings in particular for patients not fully vaccinated.

COVID-19 , Mass Vaccination , Humans , Infant , Lymphocyte Count , Outcome Assessment, Health Care , Severity of Illness Index
PLoS Negl Trop Dis ; 16(9): e0010318, 2022 Sep.
Article in English | MEDLINE | ID: mdl-36067231


OBJECTIVES: Dog vaccination can eliminate rabies in dogs, but annual delivery strategies do not sustain vaccination coverage between campaigns. We describe the development of a community-based continuous mass dog vaccination (CBC-MDV) approach designed to improve and maintain vaccination coverage in Tanzania and examine the feasibility of delivering this approach as well as lessons for its optimization. METHODS: We developed three delivery strategies of CBC-MDV and tested them against the current annual vaccination strategy following the UK Medical Research Council's guidance: i) developing an evidence-based theoretical framework of intervention pathways and ii) piloting to test feasibility and inform optimization. For our process evaluation of CBC-MDV we collected data using non-participant observations, meeting reports and implementation audits and in-depth interviews, as well as household surveys of vaccination coverage to assess potential effectiveness. We analyzed qualitative data thematically and quantitative data descriptively. RESULTS: The final design included delivery by veterinary teams supported by village-level one health champions. In terms of feasibility, we found that less than half of CBC-MDV's components were implemented as planned. Fidelity of delivery was influenced by the strategy design, implementer availability and appreciation of value intervention components, and local environmental and socioeconomic events (e.g. elections, funerals, school cycles). CBC-MDV activities decreased sharply after initial campaigns, partly due to lack of supervision. Community engagement and involvement was not strong. Nonetheless, the CBC-MDV approaches achieved vaccination coverage above the critical threshold (40%) all-year-round. CBC-MDV components such as identifying vaccinated dogs, which village members work as one health champions and how provision of continuous vaccination is implemented need further optimization prior to scale up. INTERPRETATION: CBC-MDV is feasible to deliver and can achieve good vaccination coverage. Community involvement in the development of CBC-MDV, to better tailor components to contextual situations, and improved supervision of activities are likely to improve vaccination coverage in future.

Dog Diseases , Rabies Vaccines , Rabies , Animals , Dog Diseases/prevention & control , Dogs , Feasibility Studies , Mass Vaccination/veterinary , Rabies/prevention & control , Rabies/veterinary , Vaccination/veterinary
Salud Publica Mex ; 64(5, sept-oct): 443-444, 2022 Aug 26.
Article in Spanish | MEDLINE | ID: mdl-36130343


No disponible.

COVID-19 , Mass Vaccination , Argentina , Humans
Internet resource in Portuguese | LIS -Health Information Locator | ID: lis-49127


O Ministério da Saúde segue em tratativas junto a entidades internacionais e a Organização Pan-Americana da Saúde (OPAS/OMS) para compra de vacinas e antivirais para o tratamento da varíola dos macacos, também conhecida como monkeypox

Mass Vaccination , Monkeypox
Math Biosci Eng ; 19(9): 9457-9480, 2022 06 28.
Article in English | MEDLINE | ID: mdl-35942768


The standard way of incorporating mass vaccination into a compartment model for an infectious disease is as a spontaneous transition process that applies to the entire susceptible class. The large degree of COVID-19 vaccine refusal, hesitancy, and ineligibility, and initial limitations of supply and distribution require reconsideration of this standard treatment. In this paper, we address these issues for models on endemic and epidemic time scales. On an endemic time scale, we partition the susceptible class into prevaccinated and unprotected subclasses and show that vaccine refusal/hesitancy/ineligibility has a significant impact on endemic behavior, particularly for diseases where immunity is short-lived. On an epidemic time scale, we develop a supply-limited Holling type 3 vaccination model and show that it is an excellent fit to vaccination data. We then extend the Holling model to a COVID-19 scenario in which the population is divided into two risk classes, with the high-risk class being prioritized for vaccination. In both cases, with and without risk stratification, we see significant differences in epidemiological outcomes between the Holling vaccination model and naive models. Finally, we use the new model to explore implications for public health policies in future pandemics.

COVID-19 , Communicable Diseases , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Communicable Diseases/epidemiology , Humans , Mass Vaccination , Pandemics/prevention & control , Vaccination
An. pediatr. (2003. Ed. impr.) ; 97(2): 129.e1-129.e8, ago, 2022.
Article in English, Spanish | IBECS | ID: ibc-207563


Presentamos el resumen de las principales modificaciones surgidas en la guía de práctica clínica «COVID-19 en Pediatría» entre su versión inicial publicada en el año 2021 y la publicada en el año 2022. El documento se ha elaborado siguiendo los pasos estructurados de la medicina basada en la evidencia e incorporando el sistema GRADE para realizar síntesis de la evidencia, con valoración de su calidad y, cuando se consideró apropiado, emitir recomendaciones jerarquizadas (en función de la calidad de la evidencia, los valores y preferencias, el balance entre beneficios, riesgos y costes, la equidad y la factibilidad). En esta actualización se incluyen también los cambios recomendados por los revisores externos. Se sintetizan las principales modificaciones en los siguientes apartados: epidemiología, clínica, diagnóstico, prevención, tratamiento y vacunas. En el conjunto del conocimiento alcanzado a lo largo del primer año de pandemia, las publicaciones durante el segundo año añaden nuevos datos, sin que en muchas de las áreas se produzcan modificaciones sustanciales. Los principales cambios acaecen en el campo de investigación de las vacunas. Esta actualización finaliza en diciembre de 2021, coincidiendo con el aumento de la infección por ómicron, por lo que será necesario una futura actualización del documento.(AU)

We present a summary of the main modifications to the «COVID-19 in Paediatrics» clinical practice guideline made from its initial version, published in 2021, and the version published in 2022. The document was developed following the structured steps of evidence-based medicine and applying the GRADE system to synthesize the evidence, assess its quality and, when appropriate, issue graded recommendations (based on the quality of the evidence, values and preferences, the balance between benefits, risks and costs, equity and feasibility). This update also includes the modifications proposed by external reviewers.We summarised the main modifications in the following sections: epidemiology, clinical features, diagnosis, prevention, treatment and vaccines. In relation to the body of knowledge achieved in the first year of the pandemic, the literature published in the second year contributed additional data, but without substantial modifications in many of the areas. The main changes took place in the field of vaccine research. This update was completed in December 2021, coinciding with the emergence of infections by the omicron variant, so the document will need to be updated in the future. (AU)

Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Pandemics , Coronavirus Infections/epidemiology , SARS Virus , Pediatrics , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Mass Vaccination
Rev. esp. quimioter ; 35(4): 333-343, ag. - sept. 2022.
Article in English | IBECS | ID: ibc-205379


The incidence of COVID in pediatrics was underestimated during the first months of the pandemic due to the oligosymptomatic nature of the infection in many children and thescarcity of diagnostic tests applied to this population. It is nowaccepted that children are infected and transmit the diseasein the same way as adults. On the contrary, children have lesssevere and less lethal COVID, probably due to a lower maturityof the child’s immune system, a lower number of ACE2 receptors and the lower presence of comorbidities in this populationgroup.The development of a multisystemic inflammatory syndrome after SARS-CoV-2 infection in children, despite its rarity, is a very serious condition that frequently requires intensivecare. Other less severe post-COVID manifestations have beendescribed in children but are not yet well defined.COVID has had and continues to have a significant psychological impact on the children themselves, on their caregiversand on the exacerbation of pre-existing psychiatric conditions.We apply adult therapeutic principles to children but withvery low levels of evidence. Information on the tolerability of the available medications in this population group is stillscarce. The mortality of COVID in children is very low and generally affects children with significant comorbidities.There are, at present, three vaccines licensed for pediatricuse which are compatible with all other vaccines applicable tochildren.In these circumstances, there has been much speculationabout the indication for vaccination in the pediatric age group,but given its good tolerance, there are clinical and ethical reasons that, in our opinion, justify it. (AU)

La incidencia de COVID en pediatría ha estado infraestimada durante los primeros meses de la pandemia por el carácter oligosintomático de la infección en muchos niños y porla escasez de pruebas diagnósticas aplicadas a esta población.Hoy se admite que los niños se infectan y transmiten la enfermedad igual que los adultos. Por el contrario, los niños tienencuadros clínicos menos graves y letales lo cuál parece relacionado con una menor madurez del sistema inmune del niño,una menor cantidad de receptores ACE2 y la menor presenciade comorbilidades en este grupo de población.El desarrollo de un síndrome inflamatorio multisistémicotras la infección por SARS-CoV-2 en niños, pese a su rareza, esun cuadro muy grave que frecuentemente requiere cuidadosintensivos. Se han descrito otros cuadros post-COVID en niños,menos graves, pero todavía no muy bien definidos.La COVID-19 ha tenido y tiene un importante impacto psicológico en los propios niños, en sus cuidadores y en la exacerbación de cuadros psiquiátricos pre-existentes.Aplicamos a los niños los principios terapéuticos de losadultos pero con niveles muy bajos de evidencia y la toleranciade los medicamentos disponibles en este grupo de poblaciónes todavía mal conocida. La mortalidad de la COVID en niñoses muy baja e incide generalmente en niños con importantescomorbilidades.Hay, en el momento presente, tres vacunas autorizadaspara el uso pediátrico y las vacunas frente a SARS-CoV-2 soncompatibles con el resto de las vacunas aplicables a niños.En estas circunstancias se ha especulado mucho sobre laindicación de vacunación en la edad pediátrica pero dada subuena tolerancia, existen, en nuestra opinión, razones clínicasy éticas que la justifican. (AU)

Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Pandemics , Coronavirus Infections/epidemiology , Pediatrics , Mass Vaccination , Coronavirus Infections/drug therapy , Spain
BMC Health Serv Res ; 22(1): 1059, 2022 Aug 19.
Article in English | MEDLINE | ID: mdl-35986322


BACKGROUND: COVID-19 mass vaccination programs place an additional burden on healthcare services. We aim to model the queueing process at vaccination sites to inform service delivery. METHODS: We use stochastic queue network models to simulate queue dynamics in larger mass vaccination hubs and smaller general practice (GP) clinics. We estimate waiting times and daily capacity based on a range of assumptions about appointment schedules, service times and staffing and stress-test these models to assess the impact of increased demand and staff shortages. We also provide an interactive applet, allowing users to explore vaccine administration under their own assumptions. RESULTS: Based on our assumed service times, the daily throughput for an eight-hour clinic at a mass vaccination hub ranged from 500 doses for a small hub to 1400 doses for a large hub. For GP clinics, the estimated daily throughput ranged from about 100 doses for a small practice to almost 300 doses for a large practice. What-if scenario analysis showed that sites with higher staff numbers were more robust to system pressures and mass vaccination sites were more robust than GP clinics. CONCLUSIONS: With the requirement for ongoing COVID-19 booster shots, mass vaccination is likely to be a continuing feature of healthcare delivery. Different vaccine sites are useful for reaching different populations and maximising coverage. Stochastic queue networks offer a flexible and computationally efficient approach to simulate vaccination queues and estimate waiting times and daily throughput to inform service delivery.

COVID-19 , General Practice , Ambulatory Care Facilities , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Mass Vaccination , Vaccination
Viruses ; 14(8)2022 07 27.
Article in English | MEDLINE | ID: mdl-36016265


In response to a large outbreak of the SARS-CoV-2 Beta (B.1.351) variant in the district Schwaz, Austria, a rapid mass vaccination campaign with BNT162b2 was carried out in spring 2021, immunizing more than 70% of the adult population within one week. Subsequent analysis revealed that the mass vaccination was associated with a significant reduction in new SARS-CoV-2 infections compared to control districts. Here, we aimed to evaluate both SARS-CoV-2-specific T- and B-cell responses at 35 ± 8 and 215 ± 7 days after the second dose in 600 study subjects who participated at both time points. Overall, a robust antibody and T-cell response was measured at day 35, which waned over time. Nevertheless, all persons preserved seropositivity and T cell response could still be detected in about half of the participants at day 215. Further, antibody response correlated negatively with age; however, in persons who experienced SARS-CoV-2 infection prior to study enrolment, the serum levels of both S- and N-specific antibodies surprisingly increased with age. In contrast, there was no correlation of T cell response with age. We could not detect any sex-related difference in the immune responses. SARS-CoV-2 infections prior to study enrolment or incident infections before day 215 resulted in higher antibody levels and T cell responses at day 215 compared to study participants with no history of infection. Collectively, our data support that vaccination with BNT162b2 against COVID-19 provides a durable immune response and emphasize the usefulness of vaccination even after a natural infection.

COVID-19 , SARS-CoV-2 , Adult , Antibodies, Viral , Antibody Formation , Austria , BNT162 Vaccine , COVID-19/prevention & control , Follow-Up Studies , Humans , Mass Vaccination , Vaccination
PLoS One ; 17(8): e0269944, 2022.
Article in English | MEDLINE | ID: mdl-35998135


BACKGROUND: COVID-19 vaccination acceptance is important, and combating hesitancy which is generally based on the individuals' beliefs and perceptions is essential in the present pandemic. This study assesses COVID-19 vaccine hesitancy and associated factors, beliefs and barriers associated with COVID-19 vaccination. METHODS: A cross-sectional study was carried out among 492 Bangladeshi residents (76% male; mean age = 24.21 ± 4.91 years; age range = 18-50 years) prior to the nationwide mass COVID-19 vaccination campaign (September 28, 2021). A semi-structured e-questionnaire included three sections (demographic variables, beliefs around the vaccination, and perceived barriers regarding COVID-19 vaccination). RESULTS: More than a quarter of participants (26.42%) were hesitant, 70.33% reported to accept the vaccine, and 3.25% refused to be vaccinated. While (54%) believed that mass vaccination would be the most effective method to combat the COVID-19 pandemic, concerns regarding the side effects of the vaccine (58%), inadequate vaccine trials before human administration (43%), commercial profiteering (42%), and mistrust of the benefits of the vaccine (20%) were also reported. In addition, other barriers including a short supply of vaccines, unknown future adverse effects (55%), low confidence in the health system (51%), doubts regarding its effectiveness (50%) and safety (45%), and insufficient information regarding potential adverse effects (44.7%) were reported. In bivariate analysis, variables such as current political affiliation, previous vaccination history, and health status were significantly associated with the COVID-19 vaccine uptake variable (acceptance, hesitancy, refusal). Regression analysis showed that participants who identified with the opposing current political parties, and not having been vaccinated since the age of 18 years were significantly more likely to report vaccine hesitancy. CONCLUSIONS: The current findings relating to COVID-19 vaccination demonstrate that government and policy makers need to take all necessary measures to ensure the effectiveness of the vaccination program among the Bangladeshi people.

COVID-19 , Drug-Related Side Effects and Adverse Reactions , Urogenital Abnormalities , Vaccines , Adolescent , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Mass Vaccination , Middle Aged , Pandemics , Patient Acceptance of Health Care , Vaccination , Young Adult
BMC Infect Dis ; 22(1): 671, 2022 Aug 04.
Article in English | MEDLINE | ID: mdl-35927711


BACKGROUND: Hand, foot, and mouth disease (HFMD) is a common child infectious disease caused by more than 20 enterovirus (EV) serotypes. In recent years, enterovirus A71 (EV-A71) has been replaced by Coxsackievirus A6 (CV-A6) to become the predominant serotype. Multiple EV serotypes co-circulate in HFMD epidemics, and this study aimed to investigate the etiological epidemic characteristics of an HFMD outbreak in Kunming, China in 2019. METHODS: The clinical samples of 459 EV-associated HFMD patients in 2019 were used to amplify the VP1 gene region by the three sets of primers and identify serotypes using the molecular biology method. Phylogenetic analyses were performed based on the VP1 gene. RESULTS: Three hundred and forty-eight cases out of 459 HFMD patients were confirmed as EV infection. Of these 191 (41.61%) were single EV infections and 34.20% had co-infections. The EVs were assigned to 18 EV serotypes, of which CV-A6 was predominant (11.33%), followed by CV-B1 (8.93%), CV-A4 (5.23%), CV-A9 (4.58%), CV-A 16 (3.49%) and CV-A10 and CVA5 both 1.96%. Co-infection of CV-A6 with other EVs was present in 15.25% of these cases, followed by co-infection with CV-A16 and other EVs. The VP1 sequences used in the phylogenetic analyses showed that the CV-A6, CV-B1 and CV-A4 sequences belonged to the sub-genogroup D3 and genogroups F and E, respectively. CONCLUSION: Co-circulation and co-infection of multiple serotypes were the etiological characteristic of the HFMD epidemic in Kunming China in 2019 with CV-A-6, CV-B1 and CV-A4 as the predominant serotypes. This is the first report of CV-B1 as a predominant serotype in China and may provide valuable information for the diagnosis, prevention and control of HFMD.

Coinfection , Enterovirus A, Human , Enterovirus Infections , Enterovirus , Hand, Foot and Mouth Disease , Child , China/epidemiology , Coinfection/epidemiology , Enterovirus/genetics , Enterovirus B, Human , Enterovirus Infections/epidemiology , Hand, Foot and Mouth Disease/epidemiology , Humans , Infant , Mass Vaccination , Phylogeny
Trop Anim Health Prod ; 54(5): 249, 2022 Aug 09.
Article in English | MEDLINE | ID: mdl-35941399


Pneumonia caused by Mycoplasma (M.) hyopneumoniae is one of the major respiratory diseases in swine production. Commercial vaccines for M. hyopneumoniae are widely used in weaned piglets to reduce lung lesions and clinical signs in the downstream flow; however, no information regarding the effect of mass immunization of the breeding herd is available. The aim of this work was to evaluate a mass vaccination protocol for M. hyopneumoniae on the humoral response of sows and their offspring 24 h post-partum (trial registration number 40156). A total of 52 sows from two different farms (13 primiparous and 13 multiparous sows on each farm), one with mass vaccination (MVF) and one without mass vaccination against M. hyopneumoniae (control farm (CF)) were enrolled in this study. Five piglets from each litter were selected, resulting in 260 piglets. Blood was collected from sows and piglets 24 h post-partum for M. hyopneumoniae antibody detection by ELISA. The results showed that primiparous sows from MVF had higher antibody titers compared to multiparous sows of the same farm, and multiparous and primiparous sows from the CF. Similar results were evidenced in their offspring. The findings of this study suggest that mass vaccination results in a more robust serologic response on primiparous sows, which could be the main target of vaccination strategies for the breeding herd.

Mycoplasma hyopneumoniae , Pneumonia of Swine, Mycoplasmal , Swine Diseases , Animals , Animals, Newborn , Female , Immunity, Humoral , Mass Vaccination/veterinary , Pneumonia of Swine, Mycoplasmal/prevention & control , Swine , Swine Diseases/prevention & control , Vaccination/veterinary
RECIIS (Online) ; 16(2): 221-226, abr.-jun. 2022. graf
Article in Portuguese | LILACS | ID: biblio-1378340


A dinâmica da pandemia de covid-19 vem evoluindo segundo fases marcadas por uma maior ou menor taxa de infecção, e diferentes impactos sobre o sistema de saúde e a mortalidade. Essas fases foram estudadas segundo quatro indicadores disponibilizados no sistema MonitoraCovid-19: positividade de testes de diagnóstico, número de casos, número de óbitos e o número de pessoas com ao menos duas doses de vacinas ­ padronizados numa série histórica para permitir sua comparação. São distinguidas cinco fases, marcadas pela circulação de diferentes variantes do vírus, estratégias de implementação ­ ou mesmo boicote ­ de medidas de controle e a vacinação gradativa da população. Esses indicadores podem ser usados no futuro para monitorar tendências e apontar políticas públicas adequadas.

The dynamics of the covid-19 pandemic has evolved according to phases marked by a higher or lower rate of infection, the different impacts on the health system and mortality. These phases were studied according to four indicators made available by the MonitoraCovid-19 system: positivity rates of diagnostic tests, number of cases, number of deaths and number of people who received at least two vaccine doses, standardized in a historical series to allow their comparison. Five phases are discerned, evidenced by the circulation of different virus variants, strategies employed to implement -or even undermine ­ disease control measures and the gradual vaccination of the population. These indicators can be used in the future to monitor trends and point out appropriate public policies.

La dinámica de la pandemia de covid-19 ha evolucionado según fases marcadas por una mayor o menor tasa de contagios, sus diferentes impactos en el sistema de salud y mortalidad. Estas fases se estudiaron según cuatro indicadores disponibles en el sistema MonitoraCovid-19: positividad de las pruebas diagnósticas, número de casos, número de defunciones y el número de personas vacunadas con al menos dos dosis, estandarizados en una serie histórica para permitir su comparación. Se distinguen cuatro fases, marcadas por la circulación de diferentes variantes del virus, las estrategias de implementación - o mismo el boicoteode medidas de control y la paulatina vacunación de la población. Estos indicadores pueden utilizarse en el futuro para monitorear tendencias y señalar políticas públicas apropiadas.

Humans , Pandemics , COVID-19 , Health Policy , Indicators and Reagents , Brazil , Mass Vaccination , Mortality , Diagnostic Techniques and Procedures
Rev. senol. patol. mamar. (Ed. impr.) ; 35(3)Julio - Septiembre 2022. ilus
Article in Spanish | IBECS | ID: ibc-207601


Las reacciones a la vacuna contra el virus causante de la actual pandemia del covid-19 están todavía en estudio. Presentamos el caso de una mujer de edad avanzada que, tras la administración de dicha vacuna en el brazo izquierdo, desarrolla 24 horas después una mastitis en la mama ipsilateral. Ningún caso previo ha sido descrito en la literatura. (AU)

Reactions to the vaccine against the virus causing the current pandemic are still under investigation. We present the case of an elderly woman who, after administration of the vaccine in the left arm, developed mastitis in the ipsilateral breast 24 h later. No previous case has been described in the literature. (AU)

Humans , Female , Mastitis/diagnostic imaging , Mastitis/diagnosis , Mastitis/prevention & control , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/diagnosis , Breast Neoplasms/prevention & control , Mass Vaccination , Coronavirus Infections/epidemiology , SARS Virus