Impact of age on the transmission of SARS-CoV-2 in healthcare workers : Influence of nonoccupational risk factors.

BACKGROUND: The incidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV­2) infection was highest among older adults early in the COVID-19 pandemic; however, this pattern was later reversed with young adults showing the highest incidence. The aim of this study was to identify risk factors in healthcare workers (HCWs) associated with this evolution. METHODS: We conducted a survey nested within a prospective cohort study of 680 HCWs from a tertiary referral public hospital who received 2 doses of SARS-CoV­2 vaccine in January and February 2021 (VACCICO-VAO cohort). In October 2022 all participants were invited to participate in a survey. Risk factors were tested for association with COVID-19 ever, the number of COVID-19 episodes, and the time to the first episode. RESULTS: Among 350 respondents (51% response rate, 90% female, mean age 48.1 years), 323 COVID-19 episodes were diagnosed during the study period. Multivariable analysis revealed that age < 35 years vs. > 50 years (odds ratio, OR 2.12, 95% confidence interval, CI 1.27-3.51; P = 0.004) and not maintaining social distance at social events (OR: 1.82, 95% CI: 1.16-3.19; P = 0.011) were associated with a higher risk of COVID-19. Age < 35 years (hazard ratio, HR 1.70, 95% CI 1.14-2.54; P = 0.010), and not maintaining social distance (HR 1.34, 95% CI 1.05-1.72; P = 0.020) were also associated with the time to the first episode. CONCLUSIONS: The youngest HCWs had the highest incidence rate of COVID-19, which was not explained by occupational risk factors or health conditions. The increase in nonoccupational exposure since the end of the lockdowns in summer 2020 could by a key factor.

Incremento de infecciones respiratorias agudas graves en niños durante la última etapa de la pandemia COVID-19 / Increase in severe acute respiratory infections in children during the last phase of the COVID-19 pandemic

Objetivo. La pandemia COVID-19 ha causado una variación en la circulación de otros patógenos respiratorios. Nuestro objetivo fue analizar la epidemiología de las infecciones respiratorias agudas graves (IRAG) en niños durante 3 años de pandemia COVID-19, en comparación con un período previo de la misma dimensión temporal. Pacientes y métodos. Estudio observacional, realizado en un hospital terciario de España, que analizó la frecuencia y características de pacientes ingresados por IRAG en la Unidad de Cuidados Intensivos Pediátricos (UCIP) durante la pandemia COVID-19 (1 marzo-2020 a 28 de febrero-2023), en relación a un período pre-pandemia (1 marzo-2017 a 29 febrero-2020). Resultados. Se incluyeron 268 pacientes (59,6% varones). La mediana de edad fue 9,6 meses (RIQ 1,7 – 37). En el período pre-pandemia hubo 126 ingresos con una media de 42 admisiones/año. Durante la pandemia se produjeron 142 ingresos, observándose una reducción significativa de admisiones en el primer año (12 ingresos/año), en contraste con 82 ingresos durante el tercer año, que representó un incremento del 95% respecto a la media de admisiones/año en pre-pandemia. Además, en el último año se evidenció un incremento de coinfecciones virales en relación al período prepandemia (54,9% vs 39,7%; p=0,032). No hubo diferencias en días de hospitalización, ni estancia en UCIP. Conclusiones. Durante el último año, coincidiendo con bajas tasas de hospitalización por COVID en España, observamos un notable incremento de ingresos en la UCIP por IRAG por otras causas. Probablemente, el período prolongado de baja exposición a patógenos por las medidas adoptadas durante la pandemia, ha provocado una disminución de la inmunidad poblacional con un repunte de infecciones respiratorias. (AU)

Objective. The COVID-19 pandemic has caused a variation in the circulation of respiratory pathogens. Our aim was to analyze the epidemiology of severe acute respiratory infections (SARI) in children during 3 years of the COVID-19 pandemic, in comparison with a previous period. Patients and Methods. An observational study was conducted in a tertiary hospital in Spain, which analyzed the frequency and characteristics of patients admitted for SARI in the Pediatric Intensive Care Unit (PICU) during the COVID-19 pandemic (1 March 2020 to 28 February 2023), compared to pre-pandemic period (1 March 2017 to 29 February 2020). Results. A total of 268 patients were included (59.6% males). The median age was 9.6 months (IQR 1.7 – 37). In the pre-pandemic period, there were 126 admissions with an average of 42 admissions/year. During the pandemic, there were 142 admissions, observing a significant reduction in admissions in the first year (12 admissions/year), in contrast to 82 admissions during the third year, which represented an increase of 95% compared to the average of admissions/year in pre-pandemic. In addition, in the last year there was evidence of an increase in viral coinfections in relation to pre-pandemic period (54.9% vs 39.7%; p=0.032). There were no differences in length of hospital stay or PICU stay. Conclusions. During the last year, coinciding with low rates of hospitalization for COVID in Spain, we observed a notable increase in admissions to the PICU for SARI. Probably, the prolonged period of low exposure to pathogens due to the measures adopted during the pandemic might have caused a decrease in population immunity with a rise in severe respiratory infections. (AU)

Eficacia, efectividad y seguridad de la vacuna antigripal adyuvada en población de 65 o más años de edad / Efficacy, effectiveness and safety of the adjuvanted influenza vaccine in the population aged 65 or over

La mayoría de las complicaciones y fallecimientos relacionados con la gripe estacional ocurren en población de 65 años o más y con enfermedades de base, y la vacuna frente a la gripe es la forma más efectiva de prevenirlas. La inmunización es menos eficaz en los adultos mayores debido a la inmunosenescencia. Las vacunas adyuvadas con MF59, diseñadas para mejorar la magnitud, persistencia y amplitud de la respuesta inmunitaria en personas de 65 años o más, se vienen utilizando en la práctica clínica desde 1997 en su formulación trivalente y, desde 2020, en formulación tetravalente. Los datos de diversos estudios muestran que estas vacunas son seguras para todos los grupos de edad, con un perfil de reactogenicidad similar al de la vacuna convencional, y que resultan especialmente efectivas para potenciar la respuesta inmunitaria en la población de 65 años o más, al aumentar los títulos de anticuerpos tras la vacunación y reducir significativamente el riesgo de ingreso hospitalario. Las vacunas adyuvadas han demostrado otorgar protección cruzada frente a cepas heterólogas y ser igual de efectivas que la vacuna de alta dosis en población de 65 años o más. En esta revisión se analiza la evidencia científica sobre la eficacia y la efectividad de la vacuna adyuvada con MF59 en la práctica clínica real en personas ≥65 años mediante una revisión narrativa y descriptiva de los datos publicados en ensayos clínicos, estudios observacionales y revisiones sistemáticas o metaanálisis (AU)

Most of the complications and deaths related to seasonal flu occur in the elderly population (≥65 years) with comorbidities, and the influenza vaccine is the most effective way to prevent them. Immunization is less effective in older adults due to immunosenescence. MF59-adjuvanted vaccines, designed to improve the magnitude, persistence and amplitude of the immune response in elderly people, have been used in clinical practice since 1997 in their trivalent formulation and, since 2020, in their tetravalent formulation. Data from various studies show that these vaccines are not only safe for all age groups, with a reactogenicity profile similar to that of the conventional vaccine, but also that they are especially effective in boosting the immune response in the population aged 65 or over by increasing antibody titers after vaccination and significantly reducing the risk of hospital admission. Adjuvanted vaccines have been shown to provide cross-protection against heterologous strains and to be as effective as the high-dose vaccine in the population aged 65 or over. In this review, the scientific evidence on the efficacy and effectiveness of the MF59-adjuvanted vaccine in real clinical practice in people ≥65 years of age is analyzed through a narrative and descriptive review of the literature with data from clinical trials, observational studies and systematic reviews or meta-analysis (AU)

[Analysis of the efficiency of hospitals in Castilla y León (Spain)]. / Análisis de la eficiencia de los hospitales de Castilla y León.

OBJECTIVE: The analysis of efficiency represents an area of growing interest in the field of public management. Hospital efficiency depends mainly on the use that the institution makes of its resources and their cost. The importance of hospital efficiency studies is justified by the fact that health spending is the second most important item of public spending. The objective of the present study focused on the analysis of the degree of efficiency with which the public hospitals of Castilla y León were managed. METHODS: The scope of the research was limited to the 14 hospitals of the Public Health Service of Castilla y León (Sacyl), taking the five-year period 2014-2018 as the study period. For the analysis, the non-parametric technique of Data Envelopment Analysis (DEA) was used. Both constant returns to scale (CRS) and variable returns to scale (VRS) have been used, calculating the global technical efficiency, pure technical efficiency and scale efficiency for each health institution. RESULTS: The grouped results showed that the global technical efficiency (GTE) had reached an average of 92.02%, the pure technical efficiency (PTE) 94.10% and the scale efficiency (EE) 97.74%. CONCLUSIONS: The DEA is presented as a valid technique for analyzing the efficiency of hospitals, with the efficiency of all groups of hospitals (groups I, III and IV) being very similar in terms of PTE, around 97%, with the exception of group II hospitals that are the least efficient.

OBJETIVO: El análisis de la eficiencia representa un área de creciente interés en el ámbito de la gestión pública, siendo además el gasto sanitario la segunda partida más importante del gasto público. La eficiencia hospitalaria depende principalmente del uso que la institución haga de sus recursos y del coste de los mismos. El objetivo del presente trabajo se centró en el análisis del grado de eficiencia con el que se gestionaban los hospitales públicos de Castilla y León. METODOS: El ámbito de la investigación se circunscribió a los catorce hospitales del Servicio Público de Salud de Castilla y León (Sacyl) durante el quinquenio 2014-2018. Se empleó la técnica no paramétrica del Análisis Envolvente de Datos (DEA), utilizándose tanto rendimientos constantes a escala (CRS) como rendimientos variables a escala (VRS), calculando la eficiencia técnica global, la eficiencia técnica pura y la eficiencia de escala para cada institución sanitaria. RESULTADOS: Los resultados agrupados mostraron que la eficiencia técnica global (ETG) alcanzó un promedio de un 92,02%, la eficiencia técnica pura (ETP) un 94,10% y la eficiencia de escala (EE) un 97,74%. CONCLUSIONES: El DEA se presenta como una técnica válida para el análisis de la eficiencia de los hospitales siendo, en términos de ETP, muy semejante la eficiencia de todos los grupos de hospitales (grupos I, III y IV), en torno al 97%, a excepción de los hospitales del grupo II que resultan los menos eficientes.

Análisis de la eficiencia delos hospitales de Castilla y León / Analysis of the efficiency of hospitals in Castilla y León (Spain)

FUNDAMENTOS: El análisis de la eficiencia representa un área de creciente interés en el ámbito de la gestión pública, siendoademás el gasto sanitario la segunda partida más importante del gasto público. La eficiencia hospitalaria depende principalmentedel uso que la institución haga de sus recursos y del coste de los mismos. El objetivo del presente trabajo se centró en el análisis delgrado de eficiencia con el que se gestionaban los hospitales públicos de Castilla y León. MÉTODOS: El ámbito de la investigación se circunscribió a los catorce hospitales del Servicio Público de Salud de Castilla y León (Sacyl) durante el quinquenio 2014-2018. Se empleó la técnica no paramétrica del Análisis Envolvente de Datos (DEA), utilizándose tanto rendimientos constantes a escala (CRS) como rendimientos variables a escala (VRS), calculando la eficiencia técnica global, la eficiencia técnica pura y la eficiencia de escala para cada institución sanitaria. RESULTADOS: Los resultados agrupados mostraron que la eficiencia técnica global (ETG) alcanzó un promedio de un 92,02%, la eficiencia técnica pura (ETP) un 94,10% y la eficiencia de escala (EE) un 97,74%. CONCLUSIONES: El DEA se presenta como una técnica válida para el análisis de la eficiencia de los hospitales siendo, en términos de ETP, muy semejante la eficiencia de todos los grupos de hospitales (grupos I, III y IV), en torno al 97%, a excepción de los hospitales del grupo II que resultan los menos eficientes.(AU)

BACKGROUND: The analysis of efficiency represents an area of growing interest in the field of public management. Hospital efficiency depends mainly on the use that the institution makes of its resources and their cost. The importance of hospital efficiency studies is justified by the fact that health spending is the second most important item of public spending. The objective of the present study focused on the analysis of the degree of efficiency with which the public hospitals of Castilla y León were managed. METHODS: The scope of the research was limited to the 14 hospitals of the Public Health Service of Castilla y León (Sacyl), taking the five-year period 2014-2018 as the study period. For the analysis, the non-parametric technique of Data Envelopment Analysis (DEA) was used. Both constant returns to scale (CRS) and variable returns to scale (VRS) have been used, calculating the global technical efficiency,pure technical efficiency and scale efficiency for each health institution. RESULTS: The grouped results showed that the global technical efficiency (GTE) had reached an average of 92.02%, the pure technical efficiency (PTE) 94.10% and the scale efficiency (EE) 97.74%. CONCLUSIONS: The DEA is presented as a valid technique for analyzing the efficiency of hospitals, with the efficiency of all groups of hospitals (groups I, III and IV) being very similar in terms of PTE, around 97%, with the exception of group II hospitals that are the least efficient.(AU)

Direct Medical Costs of Four Vaccine-Preventable Infectious Diseases in Older Adults in Spain.

OBJECTIVE: Protection against vaccine-preventable diseases is especially relevant in older adults due to age-related decline in immunity (immunosenescence). However, adult vaccination remains a challenge with overall low coverage rates, which has an impact on both the patients who have these diseases and the health care system in terms of resource use and costs derived. This study aimed to estimate the direct economic impact of herpes zoster, pneumococcal disease, influenza and pertussis in Spanish adults 45 years and older. METHODS: Data from 2015 were extracted from two Spanish public databases: the Minimum Basic Data Set for Hospitalisations and the Clinical Database of Primary Care. Codes from the International Classification of Diseases and the International Classification of Primary Care were used to identify and classify the diseases analysed. The variables extracted and calculated were hospitalisation (cases, percentage, length of stay, costs, mortality), primary care (cases, percentage, costs) and referrals (cases, percentage, costs). Results were presented for the age groups 45-64 years, 65-74 years, > 74 years and all ages. RESULTS: In adults 45 years and older, total costs amounted to €134.1 million in 2015 (i.e. 63.9% of the total direct costs for all age groups): 44.4% due to pneumococcal disease, 39.5% due to influenza, 16.0% due to herpes zoster and 0.1% due to pertussis. Hospitalisations represented 58.1% (€77.9 million) of the total costs, with 15,910 admissions, 144,752 days of hospitalisation and 1170 deaths. Primary care registered 566,556 visits with a cost of €35.0 million, and 269,186 referrals with a cost of €21.1 million. CONCLUSION: The direct economic burden of herpes zoster, pneumococcal disease, influenza and pertussis in adults 45 years and older was high in Spain, and may be underestimated as it only considered medical assistance and not other applicable direct or indirect costs. Increasing vaccination rates in adults may potentially reduce the economic burden derived from these diseases, although future cost-effectiveness analysis including other disease-related costs, vaccination costs and vaccination effectiveness would be needed.

Relative Effectiveness of Cell-Cultured versus Egg-Based Seasonal Influenza Vaccines in Preventing Influenza-Related Outcomes in Subjects 18 Years Old or Older: A Systematic Review and Meta-Analysis.

Avian mutations in vaccine strains obtained from embryonated eggs could impair vaccine effectiveness. We performed a systematic review and meta-analysis of the adjusted relative vaccine effectiveness (arVE) of seed cell-cultured influenza vaccines (ccIV) compared to egg-based influenza vaccines (eIV) in preventing laboratory-confirmed influenza related outcomes (IRO) or IRO by clinical codes, in subjects 18 and over. We completed the literature search in January 2021; applied exclusion criteria, evaluated risk of bias of the evidence, and performed heterogeneity, publication bias, qualitative, quantitative and sensitivity analyses. All estimates were computed using a random approach. International Prospective Register of Systematic Reviews, CRD42021228290. We identified 12 publications that reported 26 adjusted arVE results. Five publications reported 13 laboratory confirmed arVE and seven reported 13 code-ascertained arVE. Nine publications with 22 results were at low risk of bias. Heterogeneity was explained by season. We found a significant 11% (8 to 14%) adjusted arVE favoring ccIV in preventing any IRO in the 2017-2018 influenza season. The arVE was 3% (-2% to 7%) in the 2018-2019 influenza season. We found moderate evidence of a significant advantage of the ccIV in preventing IRO, compared to eIV, in a well-matched A(H3N2) predominant season.

Social Distancing, Lockdown and the Wide Use of Mask; A Magic Solution or a Double-Edged Sword for Respiratory Viruses Epidemiology?

The use of non-pharmaceutical interventions (NPIs), such as social distancing, lockdowns and the massive use of masks, have not only largely prevented the spread of SARS-CoV-2, but also of other respiratory viruses such as influenza or respiratory syncytial virus (RSV). This decrease has been so high that, in most countries, the influenza and RSV epidemic has not occurred. Far from being a beneficial fact, this can be problematic, since the absence of circulation of certain pathogens can lead to a decrease in herd immunity against them. This can promote the rise of more serious, longer-lasting epidemics that start sooner. To alleviate the collateral effects that may occur due to the decrease in circulation of viruses such as influenza, it is necessary to increase the production of influenza vaccines, carry out mass vaccination campaigns and focus on vaccinating the main drivers of this virus, children.

Do Vaccines Need a Gender Perspective? Influenza Says Yes!

Background: Sex differences in immune responses are well known. However, the humoral response in males and females in the case of influenza vaccination is yet to be characterized since studies have shown uneven results. Methods: A retrospective study was conducted in 2,243 individuals (46.9% males) divided by age (15-64 and ≥65 years old). A serological analysis was performed by hemagglutination inhibition assay (HI) just before and 28 days after annual vaccination against seasonal influenza viruses in people vaccinated during the 2006-2018 seasons. A comparison of the humoral responses against influenza A and B viruses contained in the vaccine, between male and female individuals in young adults and elderly was conducted. Results: Significative higher humoral response against classical influenza A (H1N1), A(H1N1)pdm09 subtype and B/Victoria lineage in terms of seroconversion rate were found in elderly women. No significant differences were found in the case of A(H3N2) subtype. Conclusions: Elderly women seem to display a greater humoral response against classical A(H1N1), pandemic A(H1N1)pmd09 and B/Victoria lineage than elderly men. Sex dimorphism does not affect young adults.

Impacto de la vacunación antigripal sobre la enfermedad cardiovascular / The impact of influenza vaccination on cardiovascular disease

La gripe se ha identificado como un factor desencadenante o agravante de los eventos cardiovasculares. Con el objetivo analizar el efecto de la vacunación antigripal en la enfermedad cardiovascular se realizó una búsqueda sistemática de estudios publicados entre 2009 y 2019. Se consideraron todos los trabajos que evaluaron el efecto de la vacunación frente a la gripe sobre eventos cardiovasculares y su evolución. Finalmente se incluyeron 30 de los 1.147 estudios identificados. Estos trabajos ponen de manifiesto el efecto protector de la vacuna antigripal tanto en el desarrollo de eventos cardiovasculares (infarto de miocardio, ictus, fibrilación auricular e insuficiencia cardíaca) como en el empeoramiento de estos procesos. Además, se demuestra que los pacientes vacunados presentan un menor riesgo de muerte por enfermedades cardiovasculares. La vacunación antigripal es, pues, una medida efectiva en la prevención de enfermedades cardiovasculares tanto en personas con enfermedad cardiovascular establecida como en aquellas sin patología previa. (AU)

Influenza infection has been identified as a triggering or exacerbating factor for cardiovascular events. To analyse the effect of influenza vaccination on cardiovascular disease, a systematic search of studies published between 2009-2019 was conducted. All the studies that evaluated the effect of vaccination against influenza on cardiovascular events and their outcome were considered. Finally, 30 of the 1147 identified studies were included. These studies show a protective effect of the influenza vaccine on the development of cardiovascular events (myocardial infarction, cerebrovascular accidents, atrial fibrillation, and heart failure) and on the worsening of these conditions. Furthermore, the data showed that vaccinated patients have a lower risk of death from cardiovascular pathologies. Influenza vaccination is therefore an effective measure in the prevention of cardiovascular diseases both in patients with established cardiovascular disease and in the population without previous coronary pathology. (AU)

The impact of influenza vaccination on cardiovascular disease. / Impacto de la vacunación antigripal sobre la enfermedad cardiovascular.

Influenza infection has been identified as a triggering or exacerbating factor for cardiovascular events. To analyse the effect of influenza vaccination on cardiovascular disease, a systematic search of studies published between 2009-2019 was conducted. All the studies that evaluated the effect of vaccination against influenza on cardiovascular events and their outcome were considered. Finally, 30 of the 1147 identified studies were included. These studies show a protective effect of the influenza vaccine on the development of cardiovascular events (myocardial infarction, cerebrovascular accidents, atrial fibrillation, and heart failure) and on the worsening of these conditions. Furthermore, the data showed that vaccinated patients have a lower risk of death from cardiovascular pathologies. Influenza vaccination is therefore an effective measure in the prevention of cardiovascular diseases both in patients with established cardiovascular disease and in the population without previous coronary pathology.

CRISPR/CasRx Proof-of-Concept for RNA Degradation: A Future Tool against RNA Viruses?

Influenza viruses provide a great threat for the human population, causing highly contagious respiratory infections that can lead to serious clinical complications. There are a limited variety of influenza antivirals, and these antivirals are subjected to the constant emergence of resistances. Therefore, the development of new antiviral strategies to combat influenza viruses and other RNA viruses must be promoted. In this work, we design a proof-of-concept of a recently described CRISPR/Cas tool that has been proposed as a possible future RNA virus antiviral, named CRISPR/CasRx. For this, we verified the efficiency of the CasRx endonuclease in the degradation of the eGFP mRNA reporter gene and we established the best conditions for, and the efficient performance of, the CRISPR/CasRx system. The results were measured by fluorescence microscopy, flow cytometry, and qRT-PCR. The analyses demonstrated a reduction in fluorescence, regardless of the amount of eGFP reporter plasmid transfected. The analyses showed an 86-90% reduction in fluorescence by flow cytometry and a 51-80% reduction in mRNA expression by qRT-PCR. Our results demonstrate that the CasRx endonuclease is an efficient tool for eGFP mRNA knockdown. Therefore, subsequent experiments could be useful for the development of a new antiviral tool.

Adjuvanted Influenza Vaccines Elicits Higher Antibody Responses against the A(H3N2) Subtype than Non-Adjuvanted Vaccines.

BACKGROUND: vaccination is the best approach to prevent influenza infections so far. Serological studies on the effect of different vaccine types are important to address vaccination campaigns and protect our population. In our study, we compared the serological response against influenza A subtypes using the non-adjuvanted influenza vaccine (NAIV) in adults and the elderly and the adjuvanted influenza vaccine (AIV) in the elderly. METHODS: We performed a retrospective analysis by hemagglutination inhibition assay (HI) of serum samples right before and 28 days after seasonal influenza vaccination during the 1996-2017 seasons. CONCLUSIONS: The AIV presents better performance against the A(H3N2) subtype in the elderly whereas the NAIV induces a better response against A(H1N1)pdm09 in the same group.

Vacunación frente al neumococo en adultos mayores de 65 años / Pneumococcal vaccine for adults over 65

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The situation of infection in the elderly in Spain: a multidisciplinary opinion document / Situación de la infección en el anciano: un documento multidisciplinar de opinión

Infection in the elderly is a huge issue whose treatment usually has partial and specific approaches. It is, moreover, one of the areas where intervention can have the most success in improving the quality of life of older patients. In an attempt to give the widest possible focus to this issue, the Health Sciences Foundation has convened experts from different areas to produce this position paper on Infection in the Elderly, so as to compare the opinions of expert doctors and nurses, pharmacists, journalists, representatives of elderly associations and concluding with the ethical aspects raised by the issue. The format is that of discussion of a series of pre-formulated questions that were discussed by all those present. We begin by discussing the concept of the elderly, the reasons for their predisposition to infection, the most frequent infections and their causes, and the workload and economic burden they place on society. We also considered whether we had the data to estimate the proportion of these infections that could be reduced by specific programmes, including vaccination programmes. In this context, the limited presence of this issue in the media, the position of scientific societies and patient associations on the issue and the ethical aspects raised by all this were discussed

La infección en los ancianos es un tema enorme que suele recibir enfoques muy específicos pero parciales. Además, es una de las áreas en las que la intervención podría tener más éxito para mejorar la calidad de vida de los pacientes mayores. En un intento de dar el mayor enfoque posible a este tema, la Fundación de Ciencias de la Salud ha convocado a expertos de diferentes áreas para elaborar este documento de opinión sobre la situación de la infección en los ancianos, tratando de comparar las opiniones de médicos expertos, enfermeras, farmacéuticos, periodistas, representantes de asociaciones de ancianos y terminando con los aspectos éticos que plantea el problema. El formato es el de la discusión de una serie de preguntas preformuladas que fueron discutidas entre todos los presentes. Empezamos discutiendo el concepto de "anciano", las razones de la predisposición a la infección, las infecciones más frecuentes y sus causas, y la carga laboral y económica que suponen para la sociedad. También preguntamos si teníamos datos para estimar la proporción de estas infecciones que podrían ser reducidas por programas específicos, incluyendo programas de vacunación. En este contexto, se discutió la baja presencia de este problema en los medios de comunicación, la posición de las asociaciones científicas y de pacientes sobre el problema y los aspectos éticos que todo esto plantea

Quadrivalent cell culture influenza virus vaccine. Comparison to egg-derived vaccine.

Influenza virus infections pose a serious public health problem and vaccination is the most effective public health intervention against them. The current manufacture of influenza vaccines in embryonated chicken eggs entails significant limitations. These limitations have been overcome by producing vaccines in cell culture, which allow a faster and more flexible response to potential pandemic threats. Given the impact of influenza B virus on disease burden, the availability of quadrivalent vaccines is useful for increasing the rate of protection from disease. This paper analyzes the limitations of the current production of influenza vaccine in eggs and the advantages of vaccines developed in cell culture, as well as their safety, tolerability, efficacy and effectiveness. Additionally, we reflect on the contribution of new quadrivalent vaccines from cell culture as an alternative in seasonal vaccination campaigns against influenza.

Transmisión nosocomial comparada de los virus gripales / Comparative nosocomial transmission of influenza viruses

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