Prevalencia de anticuerpos neutralizantes frente al SARS-CoV-2 inducidos tras 2 dosis de vacuna BNT162b2 (Pfizer–BioNTech) en trabajadores sanitarios / Prevalence of neutralizing antibodies against SARS-CoV-2 using a rapid serological test in health workers of a Spanish Department of Health in Alicante (Spain) before the booster dose of the vaccine

Fundamento: Estudiar la prevalencia de anticuerpos neutralizantes en el personal sanitario y de apoyo tras la administración de la segunda dosis de vacuna BNT162b2 (Pfizer–BioNTech). Material y métodos: En diciembre 2021 llevamos a cabo un estudio en el Departamento de Salud de Orihuela, Alicante (España), formado por 1.500 trabajadores. En los participantes del estudio, recogimos variables demográficas y realizamos un test «point-of-care» (POC) de inmunocromatografía para medir la presencia de anticuerpos neutralizantes (OJABIO® SARS-CoV-2 Neutralizing Antibody Detection Kit, fabricado por Wenzhou OJA Biotechnology Co., Ltd.- Wenzhou, Zhejiang, China) antes de la administración de la tercera dosis de vacuna. Resultados: Obtuvimos información completa de 964 (64%) trabajadores, siendo 290 varones y 674 mujeres. La edad media fue de 45,8 años (mín: 18, máx: 68) y el tiempo desde la última dosis (TUD) de vacuna fue 40,5 semanas (mín: 1,71; máx: 47,71). Un total de 131 (13,5%) habían padecido infección por SARS-CoV-2 confirmada mediante RT-PCR. La proporción de sujetos con presencia de anticuerpos neutralizantes fue de 38,5%. En el análisis multivariable el TUD de vacuna (razón de probabilidades ajustada [ORa] semana: 1,07; IC 95%: 1,04; 1,09) y la infección previa por SARS-CoV-2 (ORa: 3,7; IC 95%: 2,39; 5,63) mostraron asociación estadísticamente significativa con la presencia de anticuerpos neutralizantes. Conclusiones: El TUD de vacuna y la infección previa por SARS-CoV-2 determinaron la presencia de anticuerpos neutralizantes en 38,5% del personal sanitario y personal de apoyo.(AU)

Aim: To study the prevalence of neutralizing antibodies in healthcare workers and healthcare support personnel after the administration of the second dose of the BNT162b2 vaccine (Pfizer-BioNTech). Materials and methods: In December 2021, we undertook a study in the Health Department in Orihuela, Alicante (Spain), which consists of 1500 workers. We collected demographic variables about the study participants, and we performed a «point-of-care» immunochromatography test to measure the presence of neutralizing antibodies (OJABIO® SARS-CoV-2 Neutralizing Antibody Detection Kit, manufactured by Wenzhou OJA Biotechnology Co., Ltd. Wenzhou, Zhejiang, China) before the administration of the third dose of the vaccine. Results: We obtained complete information about 964 (64%) workers, which consisted of 290 men and 674 women. The average age was 45,8 years (min. 18, max. 68) and the average time since the last dose of the vaccine was 40,5 weeks (min. 1,71, max. 47,71). A total of 131 participants (13,5%) had suffered infection by SARS-CoV-2 confirmed using RT-PCR. The proportion of participants who showed presence of neutralizing antibodies was 38,5%. In the multivariable analysis, the time since the last dose of the vaccine (aOR week: 1,07; 95%CI: 1,04; 1,09) and previous infection by SARS-CoV-2 (aOR: 3,7; 95CI: 2,39; 5,63) showed a statistically significant association with the presence of neutralizing antibodies. Conclusions: The time since the administration of the last dose of the vaccine and the previous infection by SARS-CoV-2 determined the presence of neutralizing antibodies in 38,5% of the healthcare workers and support workers.(AU)

Post-Ureteroscopic Lesion Scale: limitaciones en su aplicabilidad clínica / Post-Ureteroscopic Lesion Scale to determine ureteral wall damage, not so easy to employ

Objetivo Analizar el nivel de concordancia de la Post-Ureteroscopic Lesion Scale (PULS), y examinar las consecuencias de su aplicación en la práctica clínica con datos estadísticos más fiables que los utilizados en el trabajo original. Métodos Se realizaron 14 ureteroscopias (URS) y 14 micro-ureteroscopias (micro-URS) en 14 cerdos hembra. Todos los procedimientos se grabaron en vídeo y se realizó un análisis anatomopatológico en cada uréter. Dieciséis urólogos (9 endourólogos y 7 urólogos generales) y 4 médicos internos residentes evaluaron las lesiones ureterales según la escala PULS, con grados 0, 1 y ≥2. La concordancia se calculó mediante porcentajes, el Coeficiente W de Kendall, el índice kappa de Fleiss y el alfa de Krippendorff. La concordancia entre evaluadores se calculó con la Correlación de Spearman y el Coeficiente kappa de Cohen. Resultados El porcentaje de concordancia fue del 11,1%. Los coeficientes se clasificaron como bajos o muy bajos, y encontramos una mayor concordancia entre los evaluadores más inexpertos. Por otro lado, no hubo acuerdo entre el 50% de los evaluadores. Conclusiones La baja concordancia entre evaluadores, la especificidad de la PULS y la correlación clínico/patológica sugieren dificultades del uso de esta escala y una curva de aprendizaje probablemente larga. (AU)

Objective To analyze the level of agreement of the Post-Ureteroscopic Lesion Scale (PULS) and the consequences on its application in clinical practice with more reliable statistical data than the one used in the original work. Methods 14 URS and 14 micro-URS were performed in 14 female porcine model. All the procedures were video recorded and an anatomopathological analysis was performed in each ureter. Sixteen urologists (9 endourologists and 7 general urologists) and 4 residents evaluated the ureteral lesions according to the PULS, with degrees 0, 1 and ≥2. The agreement was calculated with percentages, Kendall's W coefficient and the indicators Fleiss’ Kappa and Krippendorff's Alpha, while the inter-rater agreement was calculated with Spearman's correlation and Cohen's Kappa. Results The percent of agreement was 11.1%. The coefficients were likewise classified as low or very low, with the greatest agreement found among the inexperienced. Also, 50% of the raters did not agree with the rest. Conclusions The low inter-rater agreement, the specificity of the PULS and the clinical-pathological correlation suggests that this scale is not simple, and probably has a long learning curve. (AU)

Prevalence of neutralizing antibodies against SARS-CoV-2 using a rapid serological test in health workers of a Spanish Department of Health in Alicante (Spain) before the booster dose of the vaccine.

AIM: To study the prevalence of neutralizing antibodies in healthcare workers and healthcare support personnel after the administration of the second dose of the BNT162b2 vaccine (Pfizer-BioNTech). MATERIALS AND METHODS: In December 2021, we undertook a study in the Health Department in Orihuela, Alicante (Spain), which consists of 1500 workers. We collected demographic variables about the study participants, and we performed a "point-of-care" immunochromatography test to measure the presence of neutralizing antibodies (OJABIO® SARS-CoV-2 Neutralizing Antibody Detection Kit, manufactured by Wenzhou OJA Biotechnology Co., Ltd. Wenzhou, Zhejiang, China) before the administration of the third dose of the vaccine. RESULTS: We obtained complete information about 964 (64%) workers, which consisted of 290 men and 674 women. The average age was 45,8 years (min. 18, max. 68) and the average time since the last dose of the vaccine was 40,5 weeks (min. 1,71, max. 47,71). A total of 131 participants (13,5%) had suffered infection by SARS-CoV-2 confirmed using RT-PCR. The proportion of participants who showed presence of neutralizing antibodies was 38,5%. In the multivariable analysis, the time since the last dose of the vaccine (aOR week: 1,07; 95%CI: 1,04; 1,09) and previous infection by SARS-CoV-2 (aOR: 3,7; 95CI: 2,39; 5,63) showed a statistically significant association with the presence of neutralizing antibodies. CONCLUSIONS: The time since the administration of the last dose of the vaccine and the previous infection by SARS-CoV-2 determined the presence of neutralizing antibodies in 38,5% of the healthcare workers and support workers.

Post-Ureteroscopic Lesion Scale to determine ureteral wall damage, not so easy to employ.

OBJECTIVE: To analyze the level of agreement of the Post-Ureteroscopy Lesion Scale (PULS) and the consequences on its application in clinical practice with more reliable statistical data than the one used in the original work. METHODS: 14 URS and 14 micro-URS were performed in 14 female porcine model. All the procedures were video recorded and an anatomopathological analysis was performed in each ureter. Sixteen urologists (9 endourologists and 7 general urologists) and 4 residents evaluated the ureteral lesions according to the PULS, with degrees 0, 1 and ≥2. The agreement was calculated with percentages, Kendall's W coefficient and the indicators Fleiss' Kappa and Krippendorff's Alpha, while the inter-rater agreement was calculated with Spearman's correlation and Cohen's Kappa. RESULTS: The percent of agreement was 11.1%. The coefficients were likewise classified as low or very low, with the greatest agreement found among the inexperienced. Also, 50% of the raters did not agree with the rest. CONCLUSIONS: The low inter-rater agreement, the specificity of the PULS and the clinical-pathological correlation suggests that this scale is not simple, and probably has a long learning curve.

[Scoping review of coronavirus case series (SARS-CoV, MERS-CoV and SARS-CoV-2) and their obstetric and neonatal results]. / Revisión exploratoria sobre series de casos de coronavirus (SARS-CoV, MERS-CoV y SARS-CoV-2) y sus resultados obstétricos y neonatales.

OBJECTIVE: The appearance of new infectious diseases, such as COVID-19, poses a challenge in monitoring pregnancy and preventing obstetric and neonatal complications. A scoping review has the objective to review the information available in pregnant women infected with the MERS-CoV, SARSCoV, SARS-CoV-2 coronaviruses to assess the similarities in terms of and differences in the clinical characteristics of the mothers and neonatal outcomes. METHODS: We carried out a bibliographic search (scoping review) according to the PRISMA guidelines between March and April 2020 in the MEDLINE, SciELO, and CUIDEN databases and the Elsevier COVID-19 Information Center. RESULTS: We analyzed 20 articles with a total of 102 cases. 9 of MERS-CoV, 14 of SARS-CoV and 79 of SARS-CoV-2. Fever (75.5%) and pneumonia (73.5%) were the most frequent symptoms in infected pregnant women. The most frequent obstetric complications were the threat of premature delivery (23.5%) and caesarean section (74.5%). No vertical transmission was documented in any of the infants. CONCLUSIONS: All three coronaviruses produce pneumonia with very similar symptoms, being milder in the case of SARSCoV2. Despite documented obstetric complications, neonatal outcomes are mostly favorable. Increased knowledge is needed to improve and prevent obstetric and neonatal complications from these infections in pregnant women.

Vaccination of pregnant women in the Valencian Community during the 2014-15 influenza season: a multicentre study.

OBJECTIVE: To study influenza vaccination uptake in pregnant women from three Health Departments in the Valencian Community (Spain) during the 2014-15 flu season, to identify degree of knowledge, sources of information and attitudes toward immunization against influenza. METHODS: Multicentre cross-sectional descriptive study during the 2014-15 vaccination campaign. Vaccine coverage was determined using the Nominal Vaccination Registry (NVR). Subsequently, a telephone survey was carried out on a sample of vaccinated and unvaccinated postpartum women. RESULTS: The NVR had information on 934 (59.5%) out of 1,569 postpartum women; distribution per Health Departments was: 420 (44.9%), 161 (17.2%) and 353 (37.8%) in La Ribera, Torrevieja and Elx-Crevillent respectively. Vaccine uptake was 27.9% (n = 261). According to the "Country of Origin" variable, 77.5% (n = 724) of women were Spanish, with a vaccination rate of 26.7% (n = 193), compared to 22.5% (n = 210) who were non-Spanish, with a rate of 32.4% (n = 68). The main source of information was midwives for 83.7% (n = 159) of vaccinated pregnant women and for 44.6% (n = 127) of non-vaccinated women. The main reasons for vaccine refusal were lack of awareness (29.5%, n = 84) and not considering it necessary (25.6%, n = 73). CONCLUSIONS: Despite their high willingness to be vaccinated after receiving information about the flu vaccine, the vaccination coverage in pregnant women studied is still low and can be improved. Health professionals need new information strategies to extend vaccine uptake to a larger number of pregnant women in Spain. Midwife advice plays an essential role in transmitting information on influenza vaccination in pregnant women and has a significant impact on uptake.

Determinants of seasonal influenza vaccination in pregnant women in Valencia, Spain.

BACKGROUND: In most countries the coverage of seasonal influenza vaccination in pregnant women is low. We investigated the acceptance, reasons for rejection and professional involvement related to vaccine information in pregnant women in Valencia, Spain. METHODS: Observational retrospective study in 200 pregnant women, 100 vaccinated and 100 unvaccinated, were interviewed during the 2014/2015 vaccination campaign. Electronic medical records, immunization registry and telephone interviews were used to determine reasons for vaccination and immunization rejection. RESULTS: 40.5% of pregnant women in the health department were vaccinated. The midwife was identified as source of information for 89% of women. The vaccine was rejected due to low perceptions of risk of influenza infection (23%), lack of information (19%), considering the vaccine as superfluous (16%), close proximity of delivery date (13%) and fear of side effects (12%). CONCLUSION: Pregnant women in Spain declined to be vaccinated due to under-estimation of the risk of contracting or being harmed by influenza, and lack of information. Interventions aiming to optimize vaccination coverage should include information addressing the safety and effectiveness of the current vaccine together with improved professional training and motivation.

Aceptabilidad de la vacuna contra el virus del papiloma humano en madres de la provincia de Valencia (España) / Acceptability of human papillomavirus vaccine in mothers from Valencia (Spain)

Introducción: La Comunidad Valenciana inició en octubre del 2008 el programa de vacunación contra el virus del papiloma humano (VPH) en niñas de 14 años. El objetivo de este estudio es evaluar los conocimientos sobre la infección por VPH y su vacuna en madres de adolescentes e identificar los factores asociados a la predisposición de vacunar a sus hijas. Material y métodos: Estudio observacional transversal mediante cuestionario dirigido a madres de alumnas nacidas en 1995 matriculadas en centros de secundaria de la provincia de Valencia durante 2010-2011. Muestra aleatoria estratificada por conglomerados (n=1.279). Análisis estadístico: porcentajes, intervalos de confianza, OR, contrastes chi al cuadrado y regresión logística multivariante. Resultados: Ochocientos treinta y tres cuestionarios completados (65,1%). El 76,6% de las madres habían vacunado a sus hijas contra el VPH. El 93,8% conocía la vacuna, sobre todo a través de la televisión (71,5%). El 78,5% recibió consejo favorable de un profesional sanitario, lo que mejoró la vacunación de sus hijas (OR: 2,4). Los conocimientos globales sobre la infección por VPH y la vacuna fueron bajos. La confianza de las madres en las vacunas como método preventivo mejora la vacunación contra VPH (OR: 3,8). El miedo a los efectos adversos (45,6%) fue el primer motivo de rechazo. Conclusiones: No parece que los medios de comunicación influyan en la decisión de vacunar. Sería conveniente minimizar la percepción de riesgo ante esta vacuna. El consejo del profesional sanitario actúa a favor de la vacunación si este interviene activamente en sentido positivo. Existe una brecha entre nivel de conocimientos y toma de decisión para vacunar (AU)

Introduction: In October 2008, Valencian Community started its human papillomavirus (HPV) vaccination schedules for 14 year-old girls. The aim of this study is to assess knowledge about HPV infection and its vaccine among the mothers of these girls, and to identify factors associated with the willingness to vaccinate their daughters. Material and methods: Cross-sectional study by means of a questionnaire to mothers of girls born in 1995, and attending secondary schools in the province of Valencia during 2010-2011. Cluster stratified random sample (n=1279). Statistical analysis: percentages, confidence intervals, OR, Chi-squared and multivariate logistic regression contrasts. Results: A total of 833 (65.1%) questionnaires were completed. The results obtained showed that, 76.6% of mothers had vaccinated their daughters against HPV; 93.8% knew about the vaccine, particularly through television (71.5%); and 78.5% received positive advice from a health professional which increased the vaccination of their daughters (OR: 2.4). There was low overall knowledge about HPV infection and vaccination. Confidence of the mothers in vaccines as a preventative method increases the HPV vaccination (OR: 3.8). The first reason for refusal was the fear of adverse events (45.6%). Conclusions: Apparently, the media does not influence the willingness to vaccinate. It would be desirable to minimize the perception of risk of the vaccine. Positive health advice from a health professional can have a positive effect on vaccination. There is a gap between the level of knowledge and decision-making to vaccinate (AU)

Effectiveness of influenza vaccination programme in preventing hospital admissions, Valencia, 2014/15 early results.

Preliminary results for the 2014/15 season indicate low to null effect of vaccination against influenza A(H3N2)-related disease. As of week 5 2015, there have been 1,136 hospital admissions, 210 were due to influenza and 98% of subtype A strains were H3. Adjusted influenza vaccine effectiveness was 33% (range: 6-53%) overall and 40% (range: 13% to 59%) in those 65 years and older. Vaccination reduced by 44% (28-68%) the probability of admission with influenza.

[Acceptability of human papillomavirus vaccine in mothers from Valencia (Spain)]. / Aceptabilidad de la vacuna contra el virus del papiloma humano en madres de la provincia de Valencia (España).

INTRODUCTION: In October 2008, Valencian Community started its human papillomavirus (HPV) vaccination schedules for 14 year-old girls. The aim of this study is to assess knowledge about HPV infection and its vaccine among the mothers of these girls, and to identify factors associated with the willingness to vaccinate their daughters. MATERIAL AND METHODS: Cross-sectional study by means of a questionnaire to mothers of girls born in 1995, and attending secondary schools in the province of Valencia during 2010-2011. Cluster stratified random sample (n=1279). STATISTICAL ANALYSIS: percentages, confidence intervals, OR, Chi-squared and multivariate logistic regression contrasts. RESULTS: A total of 833 (65.1%) questionnaires were completed. The results obtained showed that, 76.6% of mothers had vaccinated their daughters against HPV; 93.8% knew about the vaccine, particularly through television (71.5%); and 78.5% received positive advice from a health professional which increased the vaccination of their daughters (OR: 2.4). There was low overall knowledge about HPV infection and vaccination. Confidence of the mothers in vaccines as a preventative method increases the HPV vaccination (OR: 3.8). The first reason for refusal was the fear of adverse events (45.6%). CONCLUSIONS: Apparently, the media does not influence the willingness to vaccinate. It would be desirable to minimize the perception of risk of the vaccine. Positive health advice from a health professional can have a positive effect on vaccination. There is a gap between the level of knowledge and decision-making to vaccinate.

Notificación de reacciones adversas a la vacuna frente al virus del papiloma humano en la Comunidad Valenciana (2007-2011) / Adverse reactions to human papillomavirus vaccine in the Valencian Community (2007-2011)

INTRODUCCIÓN: En 2009, 2 casos de convulsiones en adolescentes tras la administración de la vacuna tetravalente frente al virus del papiloma humano (VPH) generaron impacto mediático y afectaron negativamente la confianza del público en esta vacuna. Nuestros objetivos fueron describir las sospechas de reacciones adversas (SRA) notificadas al Centro Autonómico de Farmacovigilancia de la Comunidad Valenciana (CAFCV) tras la administración de la vacuna frente al VPH y comparar la tasa de notificación de síncope y convulsiones de esta vacuna con la de otras vacunas administradas en adolescentes. MATERIAL Y MÉTODOS: Estudio descriptivo de las notificaciones de SRA relacionadas con esta vacuna recibidas por el CAFCV entre 2007 y 2011. RESULTADOS: Las manifestaciones clínicas más comunicadas fueron mareos, cefalea y síncope. Las tasas de notificación de síncope o pérdida de conciencia y convulsiones con la vacuna frente al VPH fueron de 17 y 3,2 por 100.000 dosis administradas, respectivamente, y de 15 y 1,6 para síncope o pérdida de conciencia y convulsiones sincopales ocurridas el día de la vacunación. Las tasas de notificación de síncope o pérdida de conciencia y convulsiones fueron de 6,4 y 0,4 para otras vacunas. CONCLUSIONES: Las tasas de notificación de síncope o pérdida de conciencia y convulsiones fueron mayores para la vacuna frente al VPH que para otras vacunas administradas en adolescentes; esto es consistente con la atención mediática originada por la vacuna y con hallazgos de estudios previos. No obstante, la información obtenida sobre las SRA a la vacuna sugiere un buen perfil de seguridad

INTRODUCTION: In 2009, two cases of seizures in adolescents following quadrivalent human papillomavirus vaccine (qHPV) administration, generated important media attention, and adversely affected public trust in this vaccine. Our objectives were to describe suspected adverse reactions (SARs) reported to the Pharmacovigilance Centre in the Valencian Community (PCVC) after administration of HPV vaccine, and to compare reporting rates of syncope and seizures following this vaccine with those of other vaccines administered to girls aged 13-15 years. MATERIAL AND METHODS: Descriptive study of SARs reported following this vaccine to the PCVC between 2007 and 2011. RESULTS: The clinical symptoms most frequently reported were dizziness, headache, and syncope. Reporting rates of syncope or loss of consciousness and seizures with qHPV vaccine were 17 and 3.2 per 100,000 doses administered, respectively, and 15 and 1.6 for syncope or loss of consciousness and syncopal seizures occurred on the day of vaccination. The reporting rates of syncope or loss of consciousness and seizures were 6.4 and 0.4, for the other vaccines. CONCLUSIONS: Consistent with the media attention generated, and with results from other studies, the reporting rates of syncope or loss of consciousness and seizures were higher for the HPV vaccine than for other vaccines given in adolescence. Nevertheless, the overall information obtained on SARs following the qHPV vaccine suggests a good safety profile

[Adverse reactions to human papillomavirus vaccine in the Valencian Community (2007-2011)]. / Notificación de reacciones adversas a la vacuna frente al virus del papiloma humano en la Comunidad Valenciana (2007-2011).

INTRODUCTION: In 2009, two cases of seizures in adolescents following quadrivalent human papillomavirus vaccine (qHPV) administration, generated important media attention, and adversely affected public trust in this vaccine. Our objectives were to describe suspected adverse reactions (SARs) reported to the Pharmacovigilance Centre in the Valencian Community (PCVC) after administration of HPV vaccine, and to compare reporting rates of syncope and seizures following this vaccine with those of other vaccines administered to girls aged 13-15 years. MATERIAL AND METHODS: Descriptive study of SARs reported following this vaccine to the PCVC between 2007 and 2011. RESULTS: The clinical symptoms most frequently reported were dizziness, headache, and syncope. Reporting rates of syncope or loss of consciousness and seizures with qHPV vaccine were 17 and 3.2 per 100,000 doses administered, respectively, and 15 and 1.6 for syncope or loss of consciousness and syncopal seizures occurred on the day of vaccination. The reporting rates of syncope or loss of consciousness and seizures were 6.4 and 0.4, for the other vaccines. CONCLUSIONS: Consistent with the media attention generated, and with results from other studies, the reporting rates of syncope or loss of consciousness and seizures were higher for the HPV vaccine than for other vaccines given in adolescence. Nevertheless, the overall information obtained on SARs following the qHPV vaccine suggests a good safety profile.

[Visibility of the vaccine cold chain in Spain]. / Visibilidad de la cadena de frío vacunal en España.

Over the last fifty years, the implementation of the vaccine cold chain in Spain has gone through different stages. Related published articles, from the first polio vaccination campaigns until the mid-eighties, show a rudimentary and proactive organization with limited resources. 1990 brought a stage of awareness, when national and regional healthcare authorities started to pay greater attention to appropriate material resources. Finally, the last twenty years represent a third period that has brought the modernization of resources, adoption of protocols, training of clinical personnel involved in the vaccination program, application of logistics and knowledge dissemination. Various studies and publications that have enhanced the acceptable visibility of the vaccine cold chain have been reviewed. It is after all the backbone of the vaccination programmes and though often consigned to the technicians, the vaccine cold chain requires constant training of the clinical staff that administers vaccines.

Visibilidad de la cadena de frío vacunal en España / Visibility of the vaccine cold chain in Spain

La implementación de la cadena de frío vacunal en España ha pasado por distintas etapas durante los últimos cincuenta años. Los textos en que aparece citada desde las primeras campañas de vacunación contra la poliomielitis hasta mediados de los años ochenta muestran una organización rudimentaria, voluntarista y con pocos recursos. En 1990 se inicia una etapa de sensibilización por parte de las autoridades sanitarias centrales y autonómicas que comienzan a prestar mayor atención hacia los recursos materiales precisos. Finalmente, un tercer periodo que abarca los últimos veinte años supone la modernización de los recursos, la adopción de protocolos, la formación de los sanitarios implicados en el programa de inmunización, la aplicación de la logística y la difusión del conocimiento. Se ha efectuado una revisión de los diferentes estudios y publicaciones que han contribuido a dar una aceptable visibilidad a la cadena de frío, columna vertebral de los programas vacunales, relegada a menudo al campo de los técnicos y precisada de una continua puesta al día de los sanitarios que administran las vacunas (AU)

Over the last fifty years, the implementation of the vaccine cold chain in Spain has gone through different stages. Related published articles, from the first polio vaccination campaigns until the mid-eighties, show a rudimentary and proactive organization with limited resources. 1990 brought a stage of awareness, when national and regional healthcare authorities started to pay greater attention to appropriate material resources. Finally, the last twenty years represent a third period that has brought the modernization of resources, adoption of protocols, training of clinical personnel involved in the vaccination program, application of logistics and knowledge dissemination. Various studies and publications that have enhanced the acceptable visibility of the vaccine cold chain have been reviewed. It is after all the backbone of the vaccination programmes and though often consigned to the technicians, the vaccine cold chain requires constant training of the clinical staff that administers vaccines (AU)

[Factors associated with willingness to be vaccinated against pandemic flu A/H1N1 in the adult population of the Health Department of Elche (Spain)]. / Factores asociados a la predisposición a vacunarse contra la gripe pandémica A/H1N1 en población adulta del Departamento de Salud de Elche (España).

BACKGROUND: To assess, in the general population, the information sources, attitudes and willingness to be vaccinated against pandemic influenza A/H1N1 in 2009. METHODS: We carried out a cross sectional study between 25th November and 30th December 2009, through face to face interviews with a random sample (826) of adults resident in the Health Department of Elche (Spain). RESULTS: Respondents reported that television (57%) and the family doctor (47.9%) were their main sources of information about vaccinations. Eighty-two point two percent had a good opinion of vaccinations, 30.5% perceived A/H1N1 to be more severe than seasonal flu, with a higher rate among older and less educated people. Twenty-five point four percent of respondents were concerned about contracting it, especially among the less educated. Forty-two point one percent expressed their willingness to be vaccinated against seasonal flu. Eighteen point four percent intended to be vaccinated against A/H1N1. The bias towards vaccination increases with age and in the case of A/H1N1 decreases among more educated people. The family doctor was the main source of information when people wanted to be immunized against seasonal flu (OR = 1.43) and A/H1N1 (OR = 2.47). CONCLUSIONS: Low acceptance of the pandemic vaccination and low perceived severity of influenza A/H1N1. Previous vaccination experience with seasonal flu creates a predisposition to immunization against A/H1N1. Although the media were the leading source of information during this period, the family doctor's influence on their decision to be vaccinated was significant.

Factores asociados a la predisposición a vacunarse contra la gripe pandémica A/H1N1 en población adulta del Departamento de Salud de Elche (España). Influencia de las fuentes de información / Factors associated with willingness to be vaccinated against pandemic flu A/H1N1 in the adult population of the Health Department of Elche (Spain). The influence of sources of information

Fundamento. Evaluar en población general las fuentes de información, actitudes y predisposición hacia la vacunación contra la gripe pandémica A/H1N1 de 2009.Métodos. Estudio descriptivo de carácter transversal realizado entre el 25 de noviembre y 30 de diciembre de 2009 mediante entrevista personal cara a cara a una muestra aleatoria (826) de adultos residentes en el Departamento de Salud de Elche (España). Resultados. Los encuestados manifestaron que la televisión (57%) y el médico de familia (47,9%) eran su fuente principal de información sobre vacunas. El 82,2% tenía una buena opinión sobre las vacunas, un 30,5% percibía la gripe A/H1N1 como más grave que la estacional, siendo esta percepción creciente entre los de mayor edad y con menos estudios. Un 25,4% de encuestados sentía preocupación por padecerla , sobre todo los de menor nivel educativo. Un 42,1% manifiesta su buena predisposición para vacunarse contra la gripe estacional, disminuyendo hasta un 18,4% la intención hacia la gripe A/H1N1. La predisposición hacia la vacunación crece con la edad y en el caso de la gripe A/H1N1 decrece a mayor nivel educativo. El médico de familia es la fuente de información más determinante para inmunizarse frente a gripe estacional (OR 1,43) y gripe A/H1N1 (OR 2,47). Conclusiones. Existe baja aceptabilidad de la vacuna pandémica y baja percepción de gravedad sobre la gripe A/H1N1. La experiencia previa de vacunación ante gripe estacional predispone hacia la inmunización contra gripe A/H1N1. Aunque los medios de comunicación encabezan la fuente de información más usual durante este episodio, la influencia del médico de familia en la decisión de vacunarse resulta significativa(AU)

Background. To assess, in the general population, the information sources, attitudes and willingness to be vaccinated against pandemic influenza A/H1N1 in 2009. Methods. We carried out a cross sectional study between 25th November and 30th December 2009, through face to face interviews with a random sample (826) of adults resident in the Health Department of Elche (Spain). Results. Respondents reported that television (57%) and the family doctor (47.9%) were their main sources of information about vaccinations. Eighty-two point two percent had a good opinion of vaccinations, 30.5% perceived A/H1N1 to be more severe than seasonal flu, with a higher rate among older and less educated people. Twenty-five point four percent of respondents were concerned about contracting it, especially among the less educated. Forty-two point one percent expressed their willingness to be vaccinated against seasonal flu. Eighteen point four percent intended to be vaccinated against A/H1N1. The bias towards vaccination increases with age and in the case of A/H1N1 decreases among more educated people. The family doctor was the main source of information when people wanted to be immunized against seasonal flu (OR = 1.43) and A/H1N1 (OR = 2.47). Conclusions. Low acceptance of the pandemic vaccination and low perceived severity of influenza A/H1N1. Previous vaccination experience with seasonal flu creates a predisposition to immunization against A/H1N1. Although the media were the leading source of information during this period, the family doctor’s influence on their decision to be vaccinated was significant(AU)