Evaluation of Adverse Effects in Nursing Mothers and Their Infants After COVID-19 mRNA Vaccination.

Background and Objectives: Breastfeeding women are generally excluded from clinical trials with new vaccines. The objective of the study was to explore whether the BNT162b2 mRNA and mRNA-1273 COVID-19 vaccines are safe for breastfeeding mothers and their breastfed infants. Methods: A convenience sample prospective cohort single institution study was performed on breastfeeding health care professionals, who were exposed to second dose of SARS-CoV2 vaccine at the beginning of the study period. They and their breastfed children's symptoms were followed up through online questionnaires for 14 days. Results: Of the 95 finally included participants, only 1 was lost to follow-up on day 7. Mean age of the mothers was 35.9 ± 3.9 years and that of their infants was 14.6 ± 12.1 months. At least one adverse event was reported by 85% (95% confidence interval [CI]: 76-91.5%) of the mothers. The most frequent was injection site pain in 81% of cases. Moreover, 31% (95% CI: 22-41%) observed some event in their breastfed children. Most frequently, 19% (95% CI: 13-30%) of the children were irritable. During the 14 days of follow-up, 36% of the children (95% CI: 27-46%) were diagnosed with respiratory infection. Conclusions: Most mothers' reactions were mild and transitory, generally limited to the first 3 days after vaccination. Many children's events were associated with concomitant infectious processes and we did not detect a notable peak on any particular day of follow-up. Neither mothers nor their infants developed serious adverse events nor were they diagnosed with COVID-19 within the study period.

SARS-CoV-2 Antibodies in Breast Milk After Vaccination.

BACKGROUND AND OBJECTIVES: Passive and active immunity transfer through human milk (HM) constitutes a key element in the infant's developing immunity. Certain infectious diseases and vaccines have been described to induce changes in the immune components of HM. METHODS: We conducted a prospective cohort single-institution study from February 2 to April 4, 2021. Women who reported to be breastfeeding at the time of their coronavirus disease 2019 (COVID-19) vaccination were invited to participate. Blood and milk samples were collected on day 14 after their second dose of the vaccine. Immunoglobulin G (IgG) antibodies against nucleocapsid protein as well as IgG, immunoglobulin M and immunoglobulin A (IgA) antibodies against the spike 1 protein receptor-binding domain against severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2 RBD-S1) were analyzed in both serum and HM samples. RESULTS: Most of the participants (ie, 94%) received the BNT162b2 messenger RNA COVID-19 vaccine. The mean serum concentration of anti-SARS-CoV-2 RBD-S-IgG antibodies in vaccinated individuals was 3379.6 ± 1639.5 binding antibody units per mL. All vaccinated study participants had anti-SARS-CoV-2 RBD-S1-IgG, and 89% of them had anti-SARS-CoV-2 RBD-S-IgA in their milk. The antibody concentrations in the milk of mothers who were breastfeeding 24 months were significantly higher than in mothers with breastfeeding periods <24 months (P < .001). CONCLUSIONS: We found a clear association between COVID-19 vaccination and specific immunoglobulin concentrations in HM. This effect was more pronounced when lactation periods exceeded 23 months. The influence of the lactation period on immunoglobulins was specific and independent of other variables.

Temperatura corporal: ¿termómetro de mercurio o de infrarrojos? / Body temperature: mercury or infrared thermometer?

Objetivo: determinar, entre el termómetro timpánicoy axilar de mercurio, cuál era el más adecuadopara la medición de la temperatura corporal,bajo el criterio de beneficio para el pacientepor su ventaja en la detección de fiebre.Material y método: se conformó una muestrade la población de pacientes del Servicio deUrgencias del Hospital Universitario NuestraSeñora de Candelaria (Tenerife). El tamaño prefijadofue de 115 pacientes (potencia del 90%;detectar diferencias de al menos el 5%; parapruebas bilaterales con un nivel de significaciónestadística α de 0,05); seleccionados al azar.Se probó la dependencia lineal de las diferenciasde lecturas entre ambos métodos a la temperaturamedida y se obtuvieron las discordancias(tomando como referencia los 38º C). Se ajustóun modelo de regresión logística para identificarfactores con influencia sobre esas discordancias.Resultados: muestra de 126 pacientes deurgencias, 51% hombres, edad mediana 53años (rango: 5-88 años). Existía dependenciade las diferencias entre lecturas a la temperaturamedida (D=4,1ºC–0,1T, p<0,01). En un54% la temperatura infrarroja fue mayor y en un40% menor a la de mercurio. Discordancia: 12%(IC95%: 6%-18%). κ=0,65 (p<0,01). En un7% se actuaría con el termómetro ótico y no conel axilar y viceversa en un 5%. No influía sobrelas discordancias el sexo, la edad, la sueroterapia,ni el cerumen.Conclusiones: a mayor temperatura las lecturasconvergen. Se sugiere utilizar el termómetroótico

Objective: to determine which of the two -thetympanic or axillary mercury thermometer- isthe most appropriate for the measurement ofbody temperature under the criteria that bestbenefits the patient to detect fever.Material and method: a sample composed bya patient population from the EmergencyDepartment of the Nuestra Señora de CandelariaUniversity Hospital was used. The predeterminedsize was 115 patients (90% power todetected differences of at least a 5% for bilateraltesting with a level of ? statistical significanceof 0,05), selected at random. The lineal dependenceof the different readings between bothmethods to the average temperature waschecked and discordances obtained (taking 38degrees C as reference). A logistic regressionmodel was adjusted for identifying the factorsthat had an influence on those discordances.Results: the sample consisted of 126 emergencypatients, 51% men, mean age 53 years(range: 5-88 years). There was dependence ofthe differences between readings to the meantemperature (D=4, 1ºC-0,1T, p<0,01). In 54%the infrared temperature was greater and in40% it was less than that of mercury. Discordance:12% (CI95%: 6%-18%).?=0.65(p<0.01). In a 7% the thermometer usedwould be the ear thermometer and not the axillarythermometer and vice versa in 5%. Gender,age, serum therapy, or earwax did not have aninfluence on the discordances.Conclusions: the readings converge at greatertemperatures. An ear thermometer is recommended

¿Dónde y cuánto colocar el termómetro de mercurio? Resultados de un sondeo / Where and when to place a mercury thermometer. Results of a survey

Objetivo. Conocer la opinión del personal sanitario y de los pacientes sobre el modo de empleo del termómetro y cómo se manipulan sus residuos. Material y método. Se realiza una encuesta sobre el modo de empleo del termómetro y de la manipulación que se debe hacer en caso de rotura del instrumento. Resultados. De 85 profesionales, el 67 por ciento considera que le es indiferente en qué axila colocar el termómetro, el 12 por ciento prefiere la derecha y el 6 por ciento, la izquierda; respecto al tiempo, el 27 por ciento considera suficientes 5 min y el 24 por ciento cree que con 3 min hay suficiente; se les ha roto un termómetro al 88 por ciento, y todos manipularon incorrectamente los residuos. De 151 pacientes, el 85 por ciento considera indiferente la axila donde se coloca el termómetro, el 11 por ciento prefiere la derecha, y el 1 por ciento, la izquierda, el 42 por ciento considera suficiente 5 min; se les ha roto un termómetro al 50 por ciento, y todos manipularon incorrectamente los residuos. Conclusiones. El personal sanitario y la población deben recibir información sobre el empleo del termómetro de mercurio y el correcto manejo de sus residuos (AU)

¿Dónde y cuándo colocar el termómetro demercurio? Resultados de una comparación / When and where should the mercury thermometer be used? Results of a comparison

Objetivo. Identificar la axila y el tiempo más adecuados para medir la temperatura con un termómetro de mercurio. Material y método. Se compara la temperatura entre axilas a 1, 3, 5, 8 y 10 min y la concordancia respecto a 38 ºC, considerando factores que puedan asociarse a esta discordancia. Se comparan las lecturas con la obtenida a los 10 min en la misma axila para hallar el momento de estabilidad. Resultados. En 147 pacientes se observa una discordancia de lecturas entre las axilas, con aumento en la derecha en el rango del 3-5 por ciento, y no se identifica ningún factor asociado a ella. La medición se estabiliza a los 8 min (discordancia del 3 por ciento; IC del 95 por ciento, 0-6 por ciento). Conclusión. La temperatura debe ser medida en la axila derecha y el termómetro debe permanecer 8 min (AU)

Termómetro timpánico. ¿Oído derecho o izquierdo? / Tympanic thermometer: right ear or left ear?

Un método alternativo al termómetro de mercurio para medir la temperatura corporal es la lectura de la temperatura timpánica con termómetros de rayos infrarrojos. Se valora la concordancia entre las temperaturas registradas con diferentes termómetros de infrarrojos en cada oído y en los dos oídos del mismo paciente. Se registra la temperatura timpánica a 147 pacientes, 76 hombres y 71 mujeres, entre 5 y 88 años, empleando dos termómetros Firstemp Genius®, modelo 3000A. A cada paciente se le mide la temperatura con los dos termómetros en cada oído. Se calcula la concordancia entre las temperaturas del mismo oído de cada paciente, según el método de Bland y Altman. Se compara la temperatura entre oídos de cada paciente, fijando la temperatura de 38 ºC como referencia para calcular el índice k de Cohen y el porcentaje de discordancia. Se emplea un modelo de regresión logística para identificar factores que se asocien a la discordancia. En el mismo oído, con diferente termómetro, se produce la misma discordancia, 8 por ciento, tanto en el oído derecho como en el izquierdo. Entre oídos, el índice k de Cohen es de 0,70 y la discordancia es del 11 por ciento. La discordancia que se produce entre lecturas en el mismo oído con aparatos iguales y entre oídos izquierdo y derecho excede los límites del azar. Recomendamos medir la temperatura timpánica en el oído derecho, o en ambos oídos y emplear la temperatura mayor (AU)

[Tympanic thermometer. The left or the right ear?]. / Termómetro timpánico. Oído derecho o izquierdo?

One alternative method to use of a mercury thermometer to measure body temperature is the reading of the tympanic temperature with an infrared ray thermometer. The authors evaluate the concordance among the temperatures registered with different infrared thermometers in each ear and in the both ears of the same patient. Tympanic temperature was registered in 147 patients, 76 men and 71 women, between the ages of 5 and 88, using two Firstemp Genius model 3000A thermometers. Each patient had their temperature recorded with both thermometers in each ear. The concordance among the temperatures recorded in the same ear of each patient was calculated according to the Bland and Altman method. The temperature between both ears in each patient was compared using a temperature of 38 degrees C as the reference point to use to calculate the Cohen kappa index and the percentage of disparity. The investigators employed a logistical regression to identify factors which are associated with this disparity. In the same ear, with a different thermometer, the same disparity was produced, 8%, in the right ear as well as in the left. When considering different ears, the Cohen kappa index was 0.70 and the disparity was 11%. The disparity which was produced among the recordings in the same ear using identical thermometers and between the right and left ear readings exceed the limits of chance. The authors recommend that tympanic temperature be registered in the right ear or in both ears in which case the highest reading should be recorded.