RESUMEN
BACKGROUND: With more than 7500 cases reported since April 2022, Spain has experienced the highest incidence of mpox in Europe. From 12 July onward, the modified vaccinia Ankara-Bavaria Nordic (MVA-BN) smallpox vaccine was offered as pre-exposure prophylaxis for those receiving pre-exposure prophylaxis for human immunodeficiency virus (HIV-PrEP). Our aim was to assess the effectiveness of 1 dose of MVA-BN vaccine as pre-exposure prophylaxis against mpox virus (MPXV) infection in persons on HIV-PrEP. METHODS: National retrospective cohort study between 12 July and 12 December 2022. Individuals aged ≥18 years receiving HIV-PrEP as of 12 July with no previous MPXV infection or vaccination were eligible. Each day, we matched individuals receiving a first dose of vaccine and unvaccinated controls of the same age and region. We used a Kaplan-Meier estimator, calculated risk ratios (RR) and vaccine effectiveness (VE = [1 - RR]x100). RESULTS: We included 5660 matched pairs, with a median follow-up of 62 days (interquartile range, 24-97). Mpox cumulative incidence was 5.6 per 1000 (25 cases) in unvaccinated and 3.5 per 1000 (18 cases) in vaccinated. No effect was found during days 0-6 post-vaccination (VE, -38.3; 95% confidence interval [CI], -332.7 to 46.4), but VE was 65% at ≥7 days (95% CI, 22.9 to 88.0) and 79% at ≥14 days (95% CI, 33.3 to 100.0) post-vaccination. CONCLUSIONS: One dose of MVA-BN vaccine offered protection against mpox in most-at-risk population shortly after the vaccination. Further studies need to assess the VE of a second dose and the duration of protection over time.
Asunto(s)
Infecciones por VIH , Mpox , Vacunas , Vaccinia , Humanos , Adolescente , Adulto , Vaccinia/prevención & control , Estudios de Cohortes , Estudios Retrospectivos , Virus Vaccinia , Vacunación , Monkeypox virus , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & controlRESUMEN
OBJECTIVE: Influenza vaccination rates among adults over 65 years have not reached the minimum levels recommended by the health authorities in Asturias during previous vaccination campaigns. The objective of this study is to describe the characteristics of an influenza vaccination strategy and its effectiveness. METHODS: Strategy developed during the 2019-2020 influenza vaccination campaign in the Área Sanitaria VII in the Servicio de Salud of the Principado de Asturias. The target population were people over 65 years. The strategy consisted of training sessions for professionals and the general population, information dissemination through the media, overt recommendations for the vaccination of hospital personnel and social recognition of the professionals involved. The vaccination rates were described and a two-tailed hypothesis test was used to determine the differences in the vaccination percentages. RESULTS: The percentage of vaccination in the Área Sanitaria VII went from 56.29% in the 2018-2019 campaign to 65.82% in the 2019-2020 campaign (+9.53; p<0.001). During the same campaign, the percentage of vaccination in Asturias was 57,38%, that is, 8,44% less than in the intervened Área Sanitaria. CONCLUSIONS: The strategy proved effective in increasing the rates of influenza vaccination among adults over 65 years in the Área Sanitaria VII of the Principado de Asturias.
OBJETIVO: La vacunación de la gripe en población mayor de 65 años en Asturias no ha alcanzado el mínimo recomendado por las autoridades sanitarias españolas en las últimas campañas de vacunación. El objetivo de este trabajo consistió en presentar las características de una estrategia de vacunación frente a la gripe y su efectividad. METODOS: Estrategia desarrollada en la campaña de vacunación 2019-2020, en el Área Sanitaria VII del Servicio de Salud del Principado de Asturias. Su población objeto fueron las personas mayores de 65 años. Incluyó sesiones formativas a profesionales y población, información a la población a través de medios de comunicación, recomendación activa de la vacunación en el ámbito hospitalario y reconocimiento social a los profesionales implicados. Se realizó la descripción de las tasas de vacunación y, para determinar las diferencias en los porcentajes de vacunación, se utilizó un contraste de hipótesis para proporciones de dos colas. RESULTADOS: El porcentaje de vacunación en el Área Sanitaria VII pasó de un 56,29% en la campaña 2018-2019 a un 65,82% en la 2019-2020 (+9,53; p<0,001). Esa misma campaña el porcentaje de vacunación en Asturias fue 57,38%, es decir un 8,44% menor que en Área Sanitaria intervenida. CONCLUSIONES: La estrategia ha mostrado ser efectiva para aumentar el porcentaje de vacunación frente a la gripe en población mayor de 65 años en el Área Sanitaria VII del Principado de Asturias.
