Analysis of immunization errors in pregnant women.

OBJECTIVE: To analyze immunization errors in pregnant women from Minas Gerais, according to the absence and presence of Adverse Events Following Immunization. METHODS: This is a cross-sectional study, carried out with data on immunization errors in pregnant women, between 2015 and 2019, registered in the Information System for the Surveillance of Adverse Events, in Minas Gerais. The trend of the incidence rate of immunization error per 100,000 doses applied was checked using Prais-Winsten models. RESULTS: Of all notifications, 3.72% were vaccination errors with adverse events following immunization. The highest proportion of immunization errors with no adverse events (32.40%) was in the macro-region Centro and, with adverse events (27.78%), in Triângulo do Sul, both with a stationary trend in the period. Regarding the incidence rate, the macro-region with the highest immunization errors with no adverse events was Vale do Aço and the macro-region with the highest incidence rate of immunization errors with adverse events was Triângulo do Sul. CONCLUSION: In this study, the notifications of Adverse Events Following Immunization resulting from vaccination errors with and without adverse events occurred with no significant trend within the years of the study.

CCL3, CCL5, IL-15, IL-1Ra and VEGF compose a reliable algorithm to discriminate classes of adverse events following 17DD-YF primary vaccination according to cause-specific definitions.

In the present study, a range of serum biomarkers were quantified in suspected cases of adverse events following YF immunization (YEL-AEFI) to propose a reliable laboratorial algorithm to discriminate confirmed YEL-AEFI ("A1" class) from cases with other illnesses ("C" class). Our findings demonstrated that increased levels of CXCL8, CCL2, CXCL10, IL-1ß, IL-6 and TNF-α were observed in YEL-AEFI ("A1" and "C" classes) as compared to primary vaccines without YEL-AEFI [PV(day 3-28)] and reference range (RR) controls. Notably, increased levels of CCL3, CCL4, CCL2, CCL5, IL-1ß, IL-15, IL-1Ra and G-CSF were found in "A1" as compared to "C" class. Venn diagrams analysis allowed the pre-selection of biomarkers for further analysis of performance indices. Data demonstrated that CCL3, CCL5, IL-15 and IL-1Ra presented high global accuracy (AUC = 1.00) to discriminate "A1" from "C". Decision tree was proposed with a reliable algorithm to discriminate YEL-AEFI cases according to cause-specific definitions with outstanding overall accuracy (91%). CCL3, CCL5, IL-15 and IL-1Ra appears as root attributes to identify "A1" followed by VEGF as branch nodes to discriminate Wild Type YFV infection ("C(WT-YFV)") from cases with other illnesses ("C*"). Together, these results demonstrated the applicability of serum biomarker measurements as putative parameters towards the establishment of accurate laboratorial tools for complementary differential diagnosis of YEL-AEFI cases.

Analysis of immunization errors in pregnant women / Análisis de los errores de inmunización en gestantes / Análise dos erros de imunização em gestantes

ABSTRACT Objective: To analyze immunization errors in pregnant women from Minas Gerais, according to the absence and presence of Adverse Events Following Immunization. Methods: This is a cross-sectional study, carried out with data on immunization errors in pregnant women, between 2015 and 2019, registered in the Information System for the Surveillance of Adverse Events, in Minas Gerais. The trend of the incidence rate of immunization error per 100,000 doses applied was checked using Prais-Winsten models. Results: Of all notifications, 3.72% were vaccination errors with adverse events following immunization. The highest proportion of immunization errors with no adverse events (32.40%) was in the macro-region Centro and, with adverse events (27.78%), in Triângulo do Sul, both with a stationary trend in the period. Regarding the incidence rate, the macro-region with the highest immunization errors with no adverse events was Vale do Aço and the macro-region with the highest incidence rate of immunization errors with adverse events was Triângulo do Sul. Conclusion: In this study, the notifications of Adverse Events Following Immunization resulting from vaccination errors with and without adverse events occurred with no significant trend within the years of the study.

RESUMEN Objetivo: Analizar los errores de inmunización en gestantes de Minas Gerais, Brasil, según ausencia y presencia de Evento Adverso Postvacunal. Métodos: Estudio transversal, realizado con datos de errores de inmunización en gestantes, entre los años 2015 y 2019, registrados en el Sistema de Información de Vigilancia de Eventos Adversos, en Minas Gerais. La tendencia de la tasa de incidencia de error de inmunización por 100 mil dosis utilizadas fue verificada por los modelos de Prais-Winsten. Resultados: 3,72% de todas las notificaciones fueron errores de inmunización con evento adverso postvacunal. La gran proporción de errores de inmunización sin evento adverso (32,40%) fue en la macrorregión Centro y, con evento adverso (27,78%), en la Triângulo do Sul, ambos con tendencia de estabilización en el período. En lo que se refiere a la tasa de incidencia, la macrorregión con mayores errores de inmunización sin evento adverso fue la región de Vale do Aço y la macrorregión con mayor tasa de incidencia de errores de inmunización con evento adverso fue la Triângulo do Sul. Conclusión: En este estudio, las notificaciones de Evento Adverso Post vacuna provenientes de errores de inmunización sin y con eventos adversos ocurrieron sin tendencia significativa entre los años de estudio.

RESUMO Objetivo: Analisar os erros de imunização em gestantes mineiras, segundo ausência e presença de Evento Adverso Pós-Vacinação. Métodos: Estudo transversal, realizado com dados de erros de imunização em gestantes, entre os anos 2015 e 2019, registrados no Sistema de Informação da Vigilância de Eventos Adversos, em Minas Gerais. A tendência da taxa de incidência de erro de imunização por 100 mil doses aplicadas foi verificada pelos modelos de Prais-Winsten. Resultados: De todas as notificações, 3,72% foram erros de imunização com evento adverso pós-vacinação. A maior proporção de erros de imunização sem evento adverso (32,40%) foi na macrorregião Centro e, com evento adverso (27,78%), na Triângulo do Sul, ambos com tendência estacionária no período. Em relação à taxa de incidência, a macrorregião com maiores erros de imunização sem evento adverso foi a Vale do Aço e a macrorregião com maior taxa de incidência de erros de imunização com evento adverso foi a Triângulo do Sul. Conclusão: Neste estudo, as notificações de Evento Adverso Pós-Vacinação decorrentes de erros de imunização sem e com eventos adversos ocorreram sem tendência significativa entre os anos do estudo.