[Immunisation schedule of the Pediatric Spanish Association: 2021 recommendations]. / Calendario de vacunaciones de la Asociación Española de Pediatría: recomendaciones 2021.

The CAV-AEP annually publishes the immunisation schedule considered optimal for all children and adolescent resident in Spain, taking into account the available evidence. The 2+1 schedule is recommended (2, 4, and 11 months) with hexavalent vaccines (DTPa-VPI-Hib-HB) and with 13-valent pneumococcal conjugate.A 6-year booster is recommended, preferably with DTPa (if available), with a dose of polio for those who received 2+1 schemes, as well as vaccination with Tdpa in adolescents and in each pregnancy, preferably between 27 and 32 weeks. Rotavirus vaccine should be systematic for all infants. Meningococcal B vaccine, with a 2+1 schedule, should be included in routine calendar. In addition to the inclusion of the conjugated tetravalent meningococcal vaccine (MenACWY) at 12 years of age with catch up to 18 years, inclusive, the CAV recommends this vaccine to be also included at 12 months of age, replacing MenC. Likewise, it is recommended in those over 6 weeks of age with risk factors or who travel to countries with a high incidence of these serogroups. Two-dose schedules for triple viral (12 months and 3-4 years) and varicella (15 months and 3-4 years) will be used. The second dose could be applied as a tetraviral vaccine. Universal systematic vaccination against HPV is recommended, regardless of gender, preferably at 12 years, and greater effort should be made to improve coverage. The 9 genotype extends coverage for both genders.

Calendario de vacunaciones de la Asociación Española de Pediatría: recomendaciones 2021 / Immunisation schedule of the Pediatric Spanish Association: 2021 recommendations

El CAV-AEP publica anualmente el calendario de vacunaciones que estima idóneo para los niños y adolescentes residentes en España, teniendo en cuenta la evidencia científica disponible. Se mantiene el esquema 2 + 1 (2, 4 y 11 meses) con vacunas hexavalentes (DTPa-VPI-Hib-HB) y con antineumocócica conjugada 13-valente. Se aconseja un refuerzo a los 6 años, preferentemente con DTPa (si está disponible), junto a una dosis de polio para aquellos que recibieron esquemas 2 + 1, así como vacunación con Tdpa en adolescentes y en cada embarazo, preferentemente entre las 27 y 32 semanas. La vacuna del rotavirus debería ser sistemática para todos los lactantes. Se insiste en la incorporación en el calendario de la vacuna antimeningocócica B, con esquema 2 + 1 en lactantes. Además de la inclusión de la vacuna antimeningocócica conjugada tetravalente (MenACWY) a los 12 años con rescate hasta 18 años, inclusive, el CAV-AEP recomienda que esta vacuna sea introducida también a los 12 meses de edad, sustituyendo a MenC. Igualmente, se recomienda en los mayores de 6 semanas de edad con factores de riesgo o que viajen a países de elevada incidencia de estos serogrupos. Se emplearán esquemas de dos dosis para triple vírica (12 meses y 3-4 años) y varicela (15 meses y 3-4 años). La segunda dosis se podría aplicar como vacuna tetravírica. Se recomienda la vacunación sistemática universal frente al VPH, con independencia del género, preferentemente a los 12 años, insistiendo en un mayor esfuerzo para mejorar las coberturas. La de 9 genotipos amplía la cobertura para ambos sexos

The CAV-AEP annually publishes the immunisation schedule considered optimal for all children and adolescent resident in Spain, taking into account the available evidence. The 2 + 1 schedule is recommended (2, 4, and 11 months) with hexavalent vaccines (DTPa-VPI-Hib-HB) and with 13-valent pneumococcal conjugate.A 6-year booster is recommended, preferably with DTPa (if available), with a dose of polio for those who received 2 + 1 schemes, as well as vaccination with Tdpa in adolescents and in each pregnancy, preferably between 27 and 32 weeks. Rotavirus vaccine should be systematic for all infants. Meningococcal B vaccine, with a 2 + 1 schedule, should be included in routine calendar. In addition to the inclusion of the conjugated tetravalent meningococcal vaccine (MenACWY) at 12 years of age with catch up to 18 years, inclusive, the CAV recommends this vaccine to be also included at 12 months of age, replacing MenC. Likewise, it is recommended in those over 6 weeks of age with risk factors or who travel to countries with a high incidence of these serogroups. Two-dose schedules for triple viral (12 months and 3-4 years) and varicella (15 months and 3-4 years) will be used. The second dose could be applied as a tetraviral vaccine. Universal systematic vaccination against HPV is recommended, regardless of gender, preferably at 12 years, and greater effort should be made to improve coverage. The 9 genotype extends coverage for both genders

[Immunisation schedule of the Spanish Association of Paediatrics: 2020 recommendations]. / Calendario de vacunaciones de la Asociación Española de Pediatría: recomendaciones 2020.

The CAV-AEP annually publishes the immunisation schedule considered optimal for all children resident in Spain, taking into account the available evidence. The 2+1 schedule is recommended (2, 4, and 11 months) with hexavalent vaccines (DTPa-VPI-Hib-HB) and with 13-valent pneumococcal conjugate. A 6-year booster is recommended, preferably with DTPa (if available), with a dose of polio for those who received 2+1 schemes, as well as vaccination with Tdpa in adolescents and in each pregnancy, preferably between 27 and 32 weeks. Rotavirus vaccine should be systematic for all infants. Meningococcal B vaccine, with a 2+1 schedule, should be included in routine calendar. In addition to the inclusion of the conjugated tetravalent meningococcal vaccine (MenACWY) at 12 years of age with catch up to 18 years, inclusive, the CAV recommends this vaccine to be also included at 12 months of age, replacing MenC. Likewise, it is recommended in those over 6 weeks of age with risk factors or who travel to countries with a high incidence of these serogroups. Two-dose schedules for MMR (12 months and 3-4 years) and varicella (15 months and 3-4 years) will be used. The second dose could be applied as a tetraviral vaccine. Universal systematic vaccination against HPV is recommended, both for girls and boys, preferably at 12 years, and greater effort should be made to improve coverage. The 9 genotype extends coverage for both genders.

Calendario de vacunaciones de la Asociación Española de Pediatría: recomendaciones 2020 / Immunisation schedule of the Spanish Association of Paediatrics: 2020 recommendations

El CAV-AEP publica anualmente el calendario de vacunaciones que estima idóneo para los niños residentes en España, teniendo en cuenta la evidencia científica disponible. Se mantiene el esquema 2 + 1 (2, 4 y 11 meses) con vacunas hexavalentes (DTPa-VPI-Hib-HB) y con antineumocócica conjugada 13-valente. Se aconseja un refuerzo a los 6 años, preferentemente con DTPa (si está disponible), junto a una dosis de polio para aquellos que recibieron esquemas 2 + 1, así como vacunación con Tdpa en adolescentes y en cada embarazo, preferentemente entre las 27 y las 32 semanas. La vacuna del rotavirus debería ser sistemática para todos los lactantes. Se sigue proponiendo la incorporación en el calendario de la vacuna antimeningocócica B, con esquema 2 + 1 en lactantes. Además de la inclusión de la vacuna antimeningocócica conjugada tetravalente (MenACWY) a los 12 años con rescate hasta los 18 años, inclusive, el CAV recomienda que esta vacuna sea introducida también a los 12 meses de edad, sustituyendo a MenC. Igualmente, se recomienda en los mayores de 6 semanas de edad con factores de riesgo o que viajen a países de elevada incidencia de estos serogrupos. Se emplearán esquemas de 2 dosis para triple vírica (12 meses y 3-4 años) y varicela (15 meses y 3-4 años). La segunda dosis se podría aplicar como vacuna tetravírica. Se recomienda la vacunación sistemática universal frente al VPH, tanto a chicas como a chicos, preferentemente a los 12 años, debiendo realizar un mayor esfuerzo para mejorar las coberturas. La de 9 genotipos amplía la cobertura para ambos sexos

The CAV-AEP annually publishes the immunisation schedule considered optimal for all children resident in Spain, taking into account the available evidence. The 2 + 1 schedule is recommended (2, 4, and 11 months) with hexavalent vaccines (DTPa-VPI-Hib-HB) and with 13-valent pneumococcal conjugate. A 6-year booster is recommended, preferably with DTPa (if available), with a dose of polio for those who received 2 + 1 schemes, as well as vaccination with Tdpa in adolescents and in each pregnancy, preferably between 27 and 32 weeks. Rotavirus vaccine should be systematic for all infants. Meningococcal B vaccine, with a 2+1 schedule, should be included in routine calendar. In addition to the inclusion of the conjugated tetravalent meningococcal vaccine (MenACWY) at 12 years of age with catch up to 18 years, inclusive, the CAV recommends this vaccine to be also included at 12 months of age, replacing MenC. Likewise, it is recommended in those over 6 weeks of age with risk factors or who travel to countries with a high incidence of these serogroups. Two-dose schedules for MMR (12 months and 3-4 years) and varicella (15 months and 3-4 years) will be used. The second dose could be applied as a tetraviral vaccine. Universal systematic vaccination against HPV is recommended, both for girls and boys, preferably at 12 years, and greater effort should be made to improve coverage. The 9 genotype extends coverage for both genders

Eosinofilia, elevación de proteína C-reactiva y fiebre inducidos por clozapina / Clozapine-induced eosinophilia, elevated C-reactive protein and fever

No disponible

[Immunisation schedule of the Spanish Association of Paediatrics: 2019 recommendations]. / Calendario de vacunaciones de la Asociación Española de Pediatría: recomendaciones 2019.

The Advisory Committee on Vaccines of the Spanish Association of Paediatrics annually publishes the immunisation schedule considered optimal for children resident in Spain, according to available evidence on current vaccines. As regards funded immunisations, the 2+1 strategy (2, 4, 11 months) with hexavalent (DTPa-IPV-Hib-HB) and 13-valent pneumococcal vaccines are recommended. Administration of the 6-year booster dose with DTPa is recommended, with a poliomyelitis dose for children who had received the 2+1 scheme, as well as Tdap vaccine for adolescents and pregnant women in every pregnancy between 27 and 32 weeks gestation. The 2-dose scheme should be used for MMR (12 months and 3-4 years) and varicella (15 months and 3-4 years). MMRV vaccine could be applied as the second dose. Vaccination against HPV is recommended in both genders, preferably at 12 years of age. A stronger effort should be made to improve vaccination coverage. The new 9-valent vaccine is now available, expanding the coverage for both genders. Tetravalent meningococcal vaccine (MenACWY) is recommended at 12 months and 12-14 years, with a catch-up up at 19 years of age. It is also recommended in infants older than 6 weeks of age with risk factors, or travellers to countries with high incidence of ACWY meningococcal serogroups. As regards non-funded immunisations, it is recommended meningococcal B vaccination, with a 2+1 schedule, and requests that it be included in the National Immunisation Program. Vaccination against rotavirus is recommended in all infants.

Calendario de vacunaciones de la Asociación Española de Pediatría: recomendaciones 2019 / Immunisation schedule of the Spanish Association of Paediatrics: 2019 recommendations

El Comité Asesor de Vacunas de la Asociación Española de Pediatría publica anualmente el calendario de vacunaciones que estima idóneo para los niños residentes en España, teniendo en cuenta la evidencia disponible. En cuanto a las vacunas financiadas, se recomienda emplear el esquema 2 + 1 (2, 4 y 11 meses) con vacunas hexavalentes (DTPa-VPI-Hib-HB) y con antineumocócica conjugada 13-valente. Se aconseja un refuerzo a los 6 años, preferentemente con DTPa, junto con una dosis de polio para aquellos que recibieron esquemas 2 + 1, así como vacunación con Tdpa en adolescentes y en cada embarazo, entre la semana 27 y la 32. Se emplearán esquemas de 2 dosis para triple vírica (12 meses y 3-4 años) y varicela (15 meses y 3-4 años). La segunda dosis se podría aplicar como vacuna tetravírica. Se recomienda vacunación sistemática universal frente al VPH, tanto a chicas como a chicos, preferentemente a los 12 años, debiéndose realizar un mayor esfuerzo para mejorar las coberturas. La nueva vacuna de 9 genotipos amplía la cobertura para ambos sexos. Se recomienda que la vacuna antimeningocócica conjugada tetravalente (MenACWY) se introduzca en el calendario financiado a los 12 meses y a los 12-14 años, aconsejándose un rescate hasta los 19 años. Igualmente, se recomienda en los mayores de 6 semanas de edad con factores de riesgo o que viajen a países de elevada incidencia de estos serogrupos. Respecto a las vacunas no financiadas, se recomienda la antimeningocócica B, con esquema 2 + 1, solicitando su entrada en el calendario. Es recomendable vacunar a todos los lactantes frente al rotavirus

The Advisory Committee on Vaccines of the Spanish Association of Paediatrics annually publishes the immunisation schedule considered optimal for children resident in Spain, according to available evidence on current vaccines. As regards funded immunisations, the 2 + 1 strategy (2, 4, 11 months) with hexavalent (DTPa-IPV-Hib-HB) and 13-valent pneumococcal vaccines are recommended. Administration of the 6-year booster dose with DTPa is recommended, with a poliomyelitis dose for children who had received the 2 + 1 scheme, as well as Tdap vaccine for adolescents and pregnant women in every pregnancy between 27 and 32 weeks gestation. The 2-dose scheme should be used for MMR (12 months and 3-4 years) and varicella (15 months and 3-4 years). MMRV vaccine could be applied as the second dose. Vaccination against HPV is recommended in both genders, preferably at 12 years of age. A stronger effort should be made to improve vaccination coverage. The new 9-valent vaccine is now available, expanding the coverage for both genders. Tetravalent meningococcal vaccine (MenACWY) is recommended at 12 months and 12-14 years, with a catch-up up at 19 years of age. It is also recommended in infants older than 6 weeks of age with risk factors, or travellers to countries with high incidence of ACWY meningococcal serogroups. As regards non-funded immunisations, it is recommended meningococcal B vaccination, with a 2 + 1 schedule, and requests that it be included in the National Immunisation Program. Vaccination against rotavirus is recommended in all infants

Adherencia a las recomendaciones de introducción de la alimentación complementaria en un área de salud urbana multicultural / Adherence to recommendations for the introduction of complementary feeding in a multicultural urban health district

Introducción: el consumo exclusivo de lactancia materna se recomienda hasta los seis meses de edad, manteniéndola hasta los dos años con una alimentación complementaria adecuada. De requerirse, frutas, verduras y cereales sin gluten pueden introducirse entre los 4-6 meses. Se ha observado que una introducción inadecuada produce alteraciones en el desarrollo y favorece las intolerancias alimentarias. El propósito del presente trabajo es valorar la introducción de la alimentación complementaria en los niños menores de 24 meses de edad en un área de salud urbana con una importante diversidad cultural. Material y métodos: estudio observacional descriptivo mediante entrevistas durante nueve meses (de agosto de 2014 a abril de 2015). Se evaluaron variables sociodemográficas y económicas, tipo de parto, edad gestacional, cuidado o no del recién nacido por otros miembros del entorno, vacunación y el primer día de visita al centro de salud. En relación con la alimentación, se valoró el tipo de lactancia, la edad de inicio de lactancia diferente a la materna y el momento de introducción de la alimentación complementaria. Resultados: 51 niños fueron evaluados. Un 94% de los niños inicia la alimentación complementaria antes de los seis meses (frutas y cereales sin gluten). Estos datos son mayores si hay cuidado por otro miembro de la familia (abuela). No se apreciaron diferencias estadísticamente significativas en ninguna de las variables analizadas, excepto en la vacunación del neumococo (p <0,001). Conclusiones: en nuestro medio se realiza una correcta introducción de la alimentación complementaria. La aplicación de intervenciones en la comunidad puede mejorar la adherencia a las recomendaciones actuales

Introduction: exclusive breastfeeding is recommended for infants until age 6 months, followed by continuation of breastfeeding combined with appropriate complementary foods until age 2 years. If needed, fruits, vegetables and gluten-free cereals can be introduced between ages 4 and 6 months. There is evidence that inadequate introduction of foods may alter development and increase the risk of food allergies. The aim of our study was to assess the introduction of complementary foods in children aged less than 24 months in an urban health district with a very culturally diverse population. Materials and methods: we conducted an observational and descriptive study through interviews conducted over a 9-month period (August 2014 to April 2015). We collected data on sociodemographic and economic variables, type of delivery, gestational age at birth, care of the infant by individuals other than the parents, vaccination and time of first visit to the primary care centre. When it came to feeding, we collected data on the mode of feeding, age at which foods other than breastmilk were introduced and the timing of introduction of complementary foods. Results: We analysed 51 children. In 94%, complementary foods were introduced before age 6 months (fruit and gluten-free cereal). This proportion was greater in children cared for by a relative other than the parents (grandmother). We did not find statistically significant differences in any of the variables under study, except vaccination against pneumococcus (p < .001). Conclusions: in our area, complementary feeding was introduced correctly. The implementation of community-based interventions can improve adherence to current recommendations

Novedades en vacunas, ¿qué tenemos que saber para estar actualizados? / News on vaccines, what should we know to be updated?

Las vacunas son un área de interés para muchos profesionales sanitarios, pero en especial para los pediatras. Podríamos afirmar, independientemente del área de dedicación, que todos los pediatras investigan qué vacunas han recibido sus pacientes cuando realizan una historia clínica. En nuestro trabajo, en especial en el ámbito de la Atención Primaria, necesitamos saber mucho sobre vacunas, pero el mundo de la Vacunología es complicado, existen muchas publicaciones cada año, en 2017 por ejemplo se incluyeron 5095 trabajos en MEDLINE referentes a vacunas. En Trip Database con el descriptor vaccines aparecen 76 344 publicaciones. Parece imposible conocer las novedades de interés por parte de cada pediatra individualmente por estos medios. El comportamiento epidemiológico de algunas enfermedades infecciosas, la reaparición de enfermedades que parecían eliminadas, como la parotiditis o el sarampión, la disponibilidad de nuevas vacunas, el cambio en la práctica de la vacunación, etc., son algunos aspectos que debemos considerar. En este panorama tan cambiante, ¿hay algo que deba centrar nuestra atención en las novedades en vacunas? Se ha seleccionado cinco puntos de actualización que se expondrán como cinco flashes: 1. Calendario de vacunaciones de la Asociación Española de Pediatría: recomendaciones 2018. 2. Las vacunas frente a parotiditis y sarampión en la triple vírica ¿han dejado de funcionar? 3. Mejor abordaje del recelo a la vacunación. 4. Novedades puntuales: rotavirus, hepatitis A, rabia. Nuevas formas de administrar vacunas. 5. ¿Debemos seguir vacunándonos cada año?

Vaccines are an area of great interest for health care workers, especially for Paediatricians. We could affirm that, independently of the clinical specialty, all paediatricians try to know what kind of vaccines have received their patients in their practice. In our work, especially in Primary Care Paediatrics, we need to be updated on vaccines, but the field of vaccines is complicated, every year a lot of articles dealing with this topic are published, in 2017 for instance 5095 issues of vaccines were included in MEDLINE. In Trip Database 76344 articles were found with the descriptor "vaccines". It seems impossible for every paediatrician dealing with this huge information individually, in this way. The epidemiology of certain infectious diseases, the arise of illnesses which seemed to be eliminated, like mumps or measles, new vaccines available, new ways to administer some immunogens that change the practice, etc. are some of the aspects that we have to be in mind. In this view so changeable ¿what news have we to focus on? Five points have been chosen as important to be updated, they will be show as flashes. 1. Children immunization schedule of the Spanish Association of Paediatricians. 2018 recommendations. 2. Mumps and measles vaccines, don’t they work anymore?. 3. How to best manage vaccine hesitancy?. 4. Breaking news: rotavirus, hepatitis A, rabies, and new ways to immunize. 5. Influenza. Should we get de shot every year?

[Immunisation schedule of the Spanish Association of Paediatrics: 2018 recommendations]. / Calendario de vacunaciones de la Asociación Española de Pediatría (CAV-AEP): recomendaciones 2018.

The Advisory Committee on Vaccines of the Spanish Association of Paediatrics annually publishes the immunisation schedule considered optimal for children resident in Spain, according to available evidence on current vaccines. Regarding funded immunisations, 2+1 strategy (2, 4, 11-12 months) with hexavalent (DTPa-IPV-Hib-HB) and 13-valent pneumococcal vaccines are recommended. Administration of the 6-year booster dose with DTPa is recommended, and a poliomyelitis dose for children who had received the 2+1 scheme, as well as Tdap vaccine for adolescents and pregnant women in every pregnancy between 27 and 32 weeks' gestation. The two-dose scheme should be used for MMR (12 months and 2-4 years) and varicella (15 months and 2-4 years). MMRV vaccine could be applied as the second dose if available. Coverage of human papillomavirus vaccination in girls aged 12 with a two dose scheme (0, 6 months) should be improved. Information and recommendation for male adolescents about potential beneficial effects of this immunisation should be provided as well. The new 9 genotypes vaccine is now available, expanding the coverage for both gender. Regarding non-funded immunisations, Committee on Vaccines of the Spanish Association of Paediatrics recommends meningococcal B vaccination, with a 3+1 schedule, and requests to be included in the National Immunisation Program. Tetravalent meningococcal vaccine (MenACWY) is recommended to adolescents (14-18 years) who are going to live in countries with systematic vaccination against ACWY serogroups, and people >6 weeks of age with risk factors or travellers to countries with very high incidence. Vaccination against rotavirus is recommended in all infants.

Calendario de vacunaciones de la Asociación Española de Pediatría (CAV-AEP): recomendaciones 2018 / Immunisation schedule of the Spanish Association of Paediatrics: 2018 recommendations

El Comité Asesor de Vacunas de la Asociación Española de Pediatría publica anualmente el calendario de vacunaciones que estima idóneo para los niños residentes en España, teniendo en cuenta la evidencia disponible. En cuanto a las vacunas financiadas, se recomienda emplear el esquema 2+1 (2, 4 y 11-12 meses) con vacunas hexavalentes (DTPa-VPI-Hib-VHB) y con antineumocócica conjugada 13-valente. Se aconseja un refuerzo a los 6 años, preferentemente con DTPa, junto a una dosis de polio para aquellos que recibieron esquemas 2+1, así como vacunación con Tdpa en adolescentes y en cada embarazo, entre la 27 y 32 semanas. Se emplearán esquemas de dos dosis para triple vírica (12 meses y 2-4 años) y varicela (15 meses y 2-4 años). De haber disponibilidad, la segunda dosis se podría aplicar como vacuna tetravírica. Se deben incrementar las coberturas frente al papilomavirus en niñas de 12 años con dos dosis (0, 6 meses), así como informar y recomendar la vacunación de los varones, dados los beneficios potenciales de la misma. La nueva vacuna de 9 genotipos ya está disponible, ampliando la cobertura para ambos sexos. Respecto a vacunas no financiadas, se recomienda la antimeningocócica B, con esquema 3+1, solicitando su entrada en calendario. Se recomienda individualmente la vacuna antimeningocócica conjugada tetravalente (MenACWY) en adolescentes (14-18 años) que vayan a residir en países con vacunación sistemática frente a los serogrupos ACWY. También en mayores de 6 semanas de vida con factores de riesgo o viajeros a países de elevada incidencia. Es recomendable vacunar a todos los lactantes frente al rotavirus (AU)

The Advisory Committee on Vaccines of the Spanish Association of Paediatrics annually publishes the immunisation schedule considered optimal for children resident in Spain, according to available evidence on current vaccines. Regarding funded immunisations, 2+1 strategy (2, 4, 11-12 months) with hexavalent (DTPa-IPV-Hib-HB) and 13-valent pneumococcal vaccines are recommended. Administration of the 6-year booster dose with DTPa is recommended, and a poliomyelitis dose for children who had received the 2+1 scheme, as well as Tdap vaccine for adolescents and pregnant women in every pregnancy between 27 and 32 weeks' gestation. The two-dose scheme should be used for MMR (12 months and 2-4 years) and varicella (15 months and 2-4 years). MMRV vaccine could be applied as the second dose if available. Coverage of human papillomavirus vaccination in girls aged 12 with a two dose scheme (0, 6 months) should be improved. Information and recommendation for male adolescents about potential beneficial effects of this immunisation should be provided as well. The new 9 genotypes vaccine is now available, expanding the coverage for both gender. Regarding non-funded immunisations, Committee on Vaccines of the Spanish Association of Paediatrics recommends meningococcal B vaccination, with a 3+1 schedule, and requests to be included in the National Immunisation Program. Tetravalent meningococcal vaccine (MenACWY) is recommended to adolescents (14-18 years) who are going to live in countries with systematic vaccination against ACWY serogroups, and people >6 weeks of age with risk factors or travellers to countries with very high incidence. Vaccination against rotavirus is recommended in all infants (AU)

[Immunisation schedule of the Spanish Association of Paediatrics: 2017 recommendations]. / Calendario de vacunaciones de la Asociación Española de Pediatría (CAV-AEP): recomendaciones 2017.

The Advisory Committee on Vaccines of the Spanish Association of Paediatrics (CAV- AEP) annually publishes the immunisation schedule which, in our opinion, is considered optimal for children resident in Spain, taking into account the evidence available on current vaccines. Pneumococcal and varicella immunisation in early childhood is already included in all funded vaccines present in the regional immunisation programmes. Furthermore, this committee establishes recommendations on vaccines not included in official calendars (non-funded immunisations), such as rotavirus, meningococcal B, and meningococcal ACWY. As regards funded immunisations, 2+1 strategy (2, 4, 11-12 months) with hexavalent (DTaP-IPV-Hib-HB) and 13-valent pneumococcal vaccines is recommended. Administration of the 6-year booster dose with DTaP is recommended, as well as a poliomyelitis dose for children who had received the 2+1 scheme, with the Tdap vaccine for adolescents and pregnant women between 27 and 32 weeks gestation. The two-dose scheme should be used for MMR (12 months and 2-4 years) and varicella (15 months and 2-4 years). Coverage of human papillomavirus vaccination in girls aged 12 with a two-dose scheme (0, 6 months) should be improved. Information and recommendations for male adolescents about potential beneficial effects of the tetravalent HPV vaccine should also be provided. ACWY meningococcal vaccine is the optimal choice in adolescents. For recommended unfunded immunisations, the CAV-AEP recommends the administration of meningococcal B vaccine, due to the current availability in Spanish community pharmacies, with a 3+1 scheme. CAV-AEP requests the incorporation of this vaccine in the funded unified schedule. Vaccination against rotavirus is recommended in all infants.

Consensus document on the approach to children with allergic reactions after vaccination or allergy to vaccine components

Vaccinations are one of the main public health tools for the control of vaccine-preventable diseases. If a child is identified as having had an allergic reaction to a vaccine, subsequent immunisations will probably be suspended - with the risks such a decision implies. The incidence of severe allergic reactions is very low, ranging between 0.5 and 1 cases/100,000 doses. Rather than the vaccine antigens as such, the causes of allergic reactions to vaccines are often residual protein components of the manufacturing process such as gelatine or egg, and less commonly yeasts or latex. Most vaccine reactions are mild and circumscribed to the injection site; although in some cases severe anaphylactic reactions can be observed. If an immediate-type allergic reaction is suspected at vaccination, or if a child with allergy to some of the vaccine components is scheduled for vaccination, a correct diagnosis of the possible allergic process must be made. The usual vaccine components must be known in order to determine whether vaccination can be safely performed

No disponible

Consensus document on the approach to children with allergic reactions after vaccination or allergy to vaccine components.

Vaccinations are one of the main public health tools for the control of vaccine-preventable diseases. If a child is identified as having had an allergic reaction to a vaccine, subsequent immunisations will probably be suspended - with the risks such a decision implies. The incidence of severe allergic reactions is very low, ranging between 0.5 and 1 cases/100,000 doses. Rather than the vaccine antigens as such, the causes of allergic reactions to vaccines are often residual protein components of the manufacturing process such as gelatine or egg, and less commonly yeasts or latex. Most vaccine reactions are mild and circumscribed to the injection site; although in some cases severe anaphylactic reactions can be observed. If an immediate-type allergic reaction is suspected at vaccination, or if a child with allergy to some of the vaccine components is scheduled for vaccination, a correct diagnosis of the possible allergic process must be made. The usual vaccine components must be known in order to determine whether vaccination can be safely performed.

Non-therapeutic male circumcision performed on immigrant children from Africa in Spain.

OBJECTIVES: To study the frequency, characteristics, and complications of non-therapeutic male circumcision on immigrant children from Africa in Spain. METHODS: This descriptive study focused on primary care consultations conducted at 21 Aragon health centres during 2010 and 2011. The data were gathered through interviewer-administered questionnaires to the parents of African children. Sociodemographic variables were studied, along with others related to the practice of circumcision. RESULTS: 283 questionnaires were obtained. 98.93 % of the children had undergone or were planning to undergo circumcision. 68.2 % were circumcised. Circumcisions were most frequently performed during a vacation to the country of origin (67.04 %), especially so for the Maghreb population. The remaining circumcisions had been performed in Spain. Half of the circumcisions practiced in Spain were performed at home, and 84 % of these were performed on Gambian children. CONCLUSIONS: The current study demonstrates that, in Aragon, Spain, almost all immigrant children from Africa have been or will be circumcised and that a considerable proportion has been circumcised at home by unqualified individuals. Gambians are particularly at risk of performing unsafe circumcision.

Conocimientos sobre violencia de género de la población que consulta en Atención Primaria / Knowledge of gender-based violence in the population seen in Primary Care

Objetivo: Determinar conocimientos y actitudes hacia la violencia de género de la población consultante en Atención Primaria y su relación con factores sociodemográficos y experiencias personales.DiseñoEstudio descriptivo transversal.EmplazamientoCentros de Salud urbanos.ParticipantesPacientes ≥ 18 años que acuden a consulta de Atención Primaria.Mediciones principalesSe utilizó un cuestionario que incluía preguntas relativas a conocimientos, actitudes y experiencias vividas en relación con la violencia de género y en el ámbito doméstico, y que también recogía edad, sexo, nivel de estudios, estado civil y detección de experiencias personales de violencia de género mediante la versión corta del Woman Abuse Screening Tool (WAST).ResultadosRespondieron 673 personas, de 18-86 años, con un 68% de mujeres. Solo un 18,2% tenía un adecuado conocimiento sobre quién se considera que ejerce la violencia de género. La mitad de los participantes consideraban que la violencia de género incluía lesiones físicas, psicológicas, cohibición de libertad y violación. A través de un análisis de regresión logística se encontró una asociación independiente con el conocimiento de la respuesta correcta sobre qué es la violencia de género del estado civil, siendo menos probable en los casados con respecto a los viudos (OR: 0,28; IC 95%: 0,11-0,72) considerar que la violencia de género implica lesión física (OR: 2,55; IC 95%: 1,28-5,08), pero no lesiones psicológicas (OR: 0,52; IC 95%: 0,28-0,96), y no dar la respuesta correcta sobre qué es la violencia doméstica (OR: 0,06; IC 95%: 0,03-0,12).ConclusionesExiste una gran dispersión en las respuestas con relación a qué consideran los pacientes que es la violencia de género y qué aspectos abarca(AU)

Objective: To determine the knowledge and attitudes towards gender-based violence in the Primary Care patient population and their relationship with sociodemographic factors and personal experience.DesignA descriptive, cross-sectional study.SettingUrban Health Centres.ParticipantsPatients ≥18 years-old who were seen in a Primary Care clinic.Materials and methodA questionnaire was used that included questions associated with knowledge, attitudes and experience of gender-based violence in the domestic environment. Variables such as, age, sex, education level, marital state were recorded, as well as the detection of personal experiences of Gender-Based Violence using the short Woman Abuse Screening Tool (WAST).ResultsA total of 673 people, from 18- 86 years, responded, of which 68% were women. Only 18.2% had sufficient knowledge on who is considered to exercise gender-based violence. Half of the participants believed that gender-based violence included physical and psychological injuries, inhibition of freedom and rape. In the logistic regression analysis an independent relationship was found with the knowledge of the correct response on what is gender-based violence by marital state, being less likely in married people as regards widowers (OR: 0.28; CI 95%: 0.11-0.72), to consider that gender-based violence involves physical injury (OR: 2.55; CI 95%: 1.28-5.08), but not psychological injury (OR: 0.52; CI 95%: 0.28-0.96), and not giving the correct response on what is domestic violence (OR:0.06; CI 95%: 0.03-0.12).ConclusionsThere is a wide variation in the results as regards what patients believe gender-based violence is and what aspects it covers(AU)

[Knowledge of gender-based violence in the population seen in primary care]. / Conocimientos sobre violencia de género de la población que consulta en Atención Primaria.

OBJECTIVE: To determine the knowledge and attitudes towards gender-based violence in the Primary Care patient population and their relationship with sociodemographic factors and personal experience. DESIGN: A descriptive, cross-sectional study. SETTING: Urban Health Centres. PARTICIPANTS: Patients ≥18 years-old who were seen in a Primary Care clinic. MATERIALS AND METHOD: A questionnaire was used that included questions associated with knowledge, attitudes and experience of gender-based violence in the domestic environment. Variables such as, age, sex, education level, marital state were recorded, as well as the detection of personal experiences of Gender-Based Violence using the short Woman Abuse Screening Tool (WAST). RESULTS: A total of 673 people, from 18-86 years, responded, of which 68% were women. Only 18.2% had sufficient knowledge on who is considered to exercise gender-based violence. Half of the participants believed that gender-based violence included physical and psychological injuries, inhibition of freedom and rape. In the logistic regression analysis an independent relationship was found with the knowledge of the correct response on what is gender-based violence by marital state, being less likely in married people as regards widowers (OR: 0.28; CI 95%: 0.11-0.72), to consider that gender-based violence involves physical injury (OR: 2.55; CI 95%: 1.28-5.08), but not psychological injury (OR: 0.52; CI 95%: 0.28-0.96), and not giving the correct response on what is domestic violence (OR:0.06; CI 95%: 0.03-0.12). CONCLUSIONS: There is a wide variation in the results as regards what patients believe gender-based violence is and what aspects it covers.

Experiencias en relación con la Violencia de Género de la población que consulta en Atención Primaria / Experience in gender violence in the general population within the Primary Care setting

Objetivo. Conocer la prevalencia de violencia de género padecida por la población consultante en Atención Primaria y su relación con factores sociodemográficos y otras experiencias personales. Diseño. Estudio observacional, descriptivo, transversal. Emplazamiento. Centros de Salud urbanos. Participantes. Pacientes de 18 o más años que acuden a consulta de Atención Primaria. Mediciones principales. Se utilizó un cuestionario diseñado ad hoc, que incluía preguntas relativas a las experiencias vividas en relación con la violencia de género y en el ámbito doméstico, junto a la versión corta del Woman Abuse Screening Tool (WAST). También recogía edad, sexo, nivel de estudios y estado civil, así como conocimientos y actitudes con respecto a este tema. Resultados. Respondieron al cuestionario 673 personas. De las 662 personas que respondieron a la pregunta sobre si ha sufrido algún tipo de violencia en sus relaciones sentimentales, 76 dieron una respuesta afirmativa (11,48%; IC 95%: 8,98-13,98%). Esta respuesta era más probable encontrarla en viudos y separados (p<0,00001), mientras que entre los más jóvenes predominaba el no haber sufrido violencia (p=0,01), sin diferencias para otras variables sociodemográficas. Mediante regresión logística, la edad fue la única variable asociada independiente con haber sufrido violencia de género (OR: 1,02; IC95%: 1,005-1,036). Para el test WAST se obtuvieron 560 respuestas, de las que un 12,0 % (IC95%: 9,2-14,7%) fueron positivas. La concordancia entre la respuesta a la pregunta sobre si ha sufrido algún tipo de violencia en sus relaciones sentimentales y el resultado del WAST fue muy baja (Kappa: 0,153; IC 95%: 0,038-0,243). A la pregunta “¿qué ha hecho?” (en caso de violencia en alguna relación sentimental), la respuesta más frecuente es alejarse del agresor. Hasta un 42,1% de los participantes decía conocer a alguna persona que hubiera padecido violencia de género. Conclusiones. Existe un contacto frecuente de las personas que acuden a consulta de atención primaria con la violencia de género, siendo considerable el número de personas que afirman haber sufrido maltrato (AU)

Objectives. To determine the prevalence of gender violence in the general population in the primary care setting and its association with sociodemographic factors and other personal experience. Design. Cross-sectional, observational, descriptive study. Setting. Urban primary care centres. Participants. Patients aged 18 years or over who attended the Primary Care centre. Main measurements. An ad hoc designed questionnaire that included questions on experience of domestic violence and the short version of the Woman Abuse Screening Tool (WAST), were used. Sociodemographic variables and knowledge and attitudes towards gender violence were also collected. Results: A total of 673 persons responded to the questionnaires. Of the 662 subjects who answered the question on whether they had suffered any type of abuse by their partner, 75 answered affirmatively (11.48%; 95% CI: 8.98-13.98%). This response was more probable in widowed or separated subjects (p<0.00001). Amongst young people there was a predominance of not having suffered abuse (p=0.01). There were no differences regarding the other sociodemographic variables. Logistic regression analysis revealed that age was the only variable that demonstrated an independent association with having suffered gender violence (OR: 1.02; 95% CI: 1.005 – 1.036). A total of 560 responses were obtained in the WAST questionnaire and 12.0% were positive (95% CI; 9.2 – 14.7%). Its concordance with the question on history of domestic violence was very low (Kappa: 0.153; 95% CI: 0.038-0.243). In the case of previous abuse, in answer to the question “What did you do? the most frequent response was to get away from the aggressor. Up to 42.1% said they knew someone who was a victim of gender violence. Conclusions. In the primary care setting there is frequent contact with persons suffering gender violence. There are a considerable number of persons who admit to being abused (AU)