Fatores que influenciam na adesão de idosos a vacina contra covid-19: revisão de escopo / Factors that influence elderly people's adherence to the covid-19 vaccine: scoping review

Objetivo: Mapear as evidências científicas relacionadas aos fatores que influenciam na adesão de idosos a vacina COVID-19. Método: Revisão de escopo realizada em novembro de 2021, nas seguintes bases de dados: Medical Literature Analysis and Retrieval System Online (MEDLINE via PubMed®), Excerpta Medica Data Base (Embase) via Elsevier; Institute for Scientific Information (ISI) Web of Knwedge (Web of Science); Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Índice Bibliográfico Español em Ciencias de la Salud (IBECS). Resultados e Discussão: Houve 10 publicações atenderam aos critérios de inclusão. Dentre os fatores identificados para maior hesitação frente à vacina contra COVID-19 destacaram-se o desconhecimento, baixo nível educacional, preocupação com efeitos colaterais e a segurança das vacinas, subestimação do risco de infecção após o recebimento da primeira dose da vacina, situação econômica desfavorável, pouco acesso à internet e tecnologias, entre outros fatores. Conclusão: Conhecer os fatores que causam hesitação entre os idosos com relação à vacina contra COVID-19 e os adjuvantes na luta contra a doença, para que haja um melhor direcionamento das ações no intuito de melhorar a cobertura vacinal e enfrentamento da covid19.(AU)

Objective: To map the scientific evidence related to the factors that influence the adherence of older adults to the COVID-19 vaccine. Method: Scoping review carried out in November 2021, in the following databases: Medical Literature Analysis and Retrieval System Online (MEDLINE via PubMed®), Excerpta Medica Data Base (Embase) via Elsevier; Institute for Scientific Information (ISI) Web of Knwedge (Web of Science); Latin American and Caribbean Health Sciences Literature (LILACS) and Spanish Bibliographic Index in Health Sciences (IBECS). Results and Discussion: 10 publications met the inclusion criteria. Among the factors identified for greater hesitancy towards the COVID-19 vaccine were lack of knowledge, low educational level, concern about side effects and vaccine safety, underestimation of the risk of infection after receiving the first dose of the vaccine, unfavorable economic situation, little access to the internet and technologies, among other factors. Conclusion: Knowing the factors that cause hesitation among the elderly in relation to the COVID-19 vaccine and the adjuvants in the fight against the disease, so that there is a better targeting of actions in order to improve vaccination coverage and coping with covid19.(AU)

Objetivo: Mapear la evidencia científica relacionada con los factores que influyen en la adherencia de los adultos mayores a la vacuna COVID-19. Método: Revisión de alcance realizada en noviembre de 2021, en las siguientes bases de datos: Medical Literature Analysis and Retrieval System Online (MEDLINE vía PubMed®), Excerpta Medica Data Base (Embase) vía Elsevier; Institute for Scientific Information (ISI) Web of Knwedge (Web of Science); Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) e Índice Bibliográfico Español en Ciencias de la Salud (IBECS). Resultados y Discusión: 10 publicaciones cumplieron los criterios de inclusión. Entre los factores identificados para una mayor indecisión hacia la vacuna COVID-19 se encuentran el desconocimiento, el bajo nivel educativo, la preocupación por los efectos secundarios y la seguridad de la vacuna, la subestimación del riesgo de infección tras recibir la primera dosis de la vacuna, la situación económica desfavorable, el escaso acceso a internet y a las tecnologías, entre otros factores. Conclusión: Conocer los factores que causan dudas entre los ancianos en relación a la vacuna COVID-19 y los adyuvantes en la lucha contra la enfermedad, para que las acciones puedan ser mejor dirigidas para mejorar la cobertura vacunal y hacer frente a la COVID-19.(AU)

Evaluación de una intervención comunitaria para incrementar la cobertura vacunal de la gripe en mujeres embarazadas / Evaluation of a community-based intervention to increase influenza vaccination coverage in pregnant women

Objetivo: Conocer el impacto de la intervención educativa realizada sobre los profesionales de una zona básica de salud y su grupo de participación comunitaria, que conforman el grupo intervención (GI), y analizar su repercusión en la cobertura vacunal alcanzada para gripe en el grupo de riesgo (gestantes y puérperas) comparándola con su zona básica vecina, que conforma el grupo control (GC), durante la temporada vacunal 2019/20. Diseño: Estudio cuasiexperimental de intervención comunitaria. Emplazamiento: Dos zonas básicas de salud pertenecientes al departamento de salud Elche-Crevillente, España. Participantes: Gestantes y puérperas de 2 zonas básicas de salud y el grupo de participación comunitaria. Los profesionales de salud directamente relacionados con la campaña vacunal de gripe. Intervenciones: Sesión formativa al GI previa a la campaña de gripe 2019/20. Mediciones principales: Actitudes hacia la vacunación de gripe en profesionales sanitarios mediante el cuestionario validado CAPSVA y la cobertura vacunal de las gestantes y puérperas a través del Registro de Vacunas Nominal y su aceptación a la vacuna en la consulta de la matrona. Resultados: Los datos de cobertura vacunal en gripe registrados en el Registro de Vacunas Nominal para las mujeres gestantes y puérperas fue del 26,4% (n=207) en el GI y del 19,7% (n=144) en el GC (p=0,001), con una razón de incidencia del 1,34, lográndose así un 34% más de vacunación en el GI. La aceptación para la vacunación en las consultas de la matrona también fue elevada, inmunizándose en el GI el 96,5% vs. el 89,0% en el GC, con un RR=1,09 (IC 95% 1,01-1,62).Conclusiones: Estrategias de formación conjunta a profesionales y activos de la comunidad mejoran los resultados de cobertura vacunal.

Objective: To know the impact of the educational intervention carried out on the professionals of a basic health area and their community participation group, which make up the intervention group (IG), and to analyze its repercussion on the vaccination coverage achieved for influenza in the risk group (pregnant and puerperal women) comparing it with its neighboring basic zone, which makes up the control group (CG), during the 2019/20 vaccination season. Design: Quasi-experimental study of community intervention. SiteTwo basic health zones belonging to the Elche-Crevillente health department, Spain. Participants: Pregnant and postpartum women from 2 basic health areas and the community participation group. Health professionals directly related to the flu vaccination campaign. Interventions: Training session for the IG prior to the 2019/20 flu campaign. Main measurements: Attitudes towards influenza vaccination in health professionals through the validated CAPSVA questionnaire and the vaccination coverage of pregnant and postpartum women through the Nominal Vaccine Registry and their acceptance of the vaccine in the midwife's office. Results: The influenza vaccination coverage data recorded in Nominal Vaccine Registry for pregnant and puerperal women was 26.4% (n=207) in the IG and 19.7% (n=144) in the CG (p=0.001), with an incidence ratio of 1.34, thus achieving 34% more vaccination in the IG. Acceptance for vaccination in the midwife's office was also high, with 96.5% immunization in IG vs. 89.0% in CG, with a RR=1.09 (95% CI 1.01-1.62). Conclusions: Joint training strategies for professionals and community assets improve the results of vaccination coverage.(AU)

Estrategia de vacunación frente a COVID-19 del ISPLN / Vaccination strategy against COVID-19 of the ISPLN

La Estrategia de vacunación frente a la COVID ha sido el primer programa de vacunación queha implicado prácticamente a toda la población, por ello ha supuesto un esfuerzo muy impor-tante para el Ministerio de Sanidad en coordinación con las CCAA. También en Navarra ha sidonecesario coordinar todas las fases tanto de planificación como de operativización.En este artículo se introduce la gobernanza del programa de vacunación, se describe el pro-ceso de recepción de la vacuna en el Instituto de Salud Pública y Laboral de Navarra (ISPLN),el mantenimiento de la cadena del frío y la preparación para la distribución a los puntos deadministración y las coberturas de vacunación alcanzadas. A 30 de octubre de 2022, se habían recibido 1.406.169 dosis de vacunas. El 86,5% de la pobla-ción había recibido una dosis de vacuna, el 85,8% la pauta completa de primovacunación yel 56,6% una dosis de refuerzo (>95% de los mayores de 60 años). A 22 de febrero de 2023, enNavarra han recibido la segunda dosis de recuerdo de la vacuna el 86,3% de las personas de 80y más años, el 75,8% de las de 70 a 79 años y el 57,7% de las de 60 a 69 años, frente al 76,1%, el66,2% y el 46,8%, respectivamente, en el conjunto del estado. El éxito de este programa de vacunación se debe a la implicación de la organización y delpersonal que ha participado en cada eslabón del proceso, a haber mantenido una estrategiacomún y unos criterios similares en todas las CCAA, a haber monitorizado continuamente lascoberturas alcanzadas en los distintos grupos de población y a la adherencia de la poblaciónnavarra, que tiene impregnada la cultura de la prevención mediante la vacunación.(AU)

[Evaluation of a community-based intervention to increase influenza vaccination coverage in pregnant women]. / Evaluación de una intervención comunitaria para incrementar la cobertura vacunal de la gripe en mujeres embarazadas.

OBJECTIVE: To know the impact of the educational intervention carried out on the professionals of a basic health area and their community participation group, which make up the intervention group (IG), and to analyze its repercussion on the vaccination coverage achieved for influenza in the risk group (pregnant and puerperal women) comparing it with its neighboring basic zone, which makes up the control group (CG), during the 2019/20 vaccination season. DESIGN: Quasi-experimental study of community intervention. SITE: Two basic health zones belonging to the Elche-Crevillente health department, Spain. PARTICIPANTS: Pregnant and postpartum women from 2 basic health areas and the community participation group. Health professionals directly related to the flu vaccination campaign. INTERVENTIONS: Training session for the IG prior to the 2019/20 flu campaign. MAIN MEASUREMENTS: Attitudes towards influenza vaccination in health professionals through the validated CAPSVA questionnaire and the vaccination coverage of pregnant and postpartum women through the Nominal Vaccine Registry and their acceptance of the vaccine in the midwife's office. RESULTS: The influenza vaccination coverage data recorded in Nominal Vaccine Registry for pregnant and puerperal women was 26.4% (n=207) in the IG and 19.7% (n=144) in the CG (p=0.001), with an incidence ratio of 1.34, thus achieving 34% more vaccination in the IG. Acceptance for vaccination in the midwife's office was also high, with 96.5% immunization in IG vs. 89.0% in CG, with a RR=1.09 (95% CI 1.01-1.62). CONCLUSIONS: Joint training strategies for professionals and community assets improve the results of vaccination coverage.

Cobertura vacinal contra covid-19 em instituições de longa permanência para idosos / Cobertura vacunal contra covid-19 en instituciones de larga estancia para personas mayores / Covid-19 vaccination coverage in long-term institutions for the elderly

Objetivo: analisar a cobertura vacinal contra COVID-19 em Instituições de Longa Permanência para idosos. Método: estudo transversal com dados agregados fornecidos pela Comissão Intersetorial de Acompanhamento das Instituições de Longa Permanência da Bahia. Foram incluídas as instituições identificadas em Salvador, Bahia, Brasil, com pelo menos um residente idoso (60 ou mais anos) que responderam ao inquérito de vacinação realizado entre maio a julho de 2021. Resultados: a amostra foi composta por 83 estabelecimentos, com predomínio de instituições privadas (50,1%) e filantrópicas (32,5%). A cobertura vacinal da COVID-19 atingiu 94,7% dos idosos residentes e 75,2% dos trabalhadores. Conclusão: o estudo mostra alta cobertura vacinal em idosos residentes nestas instituições, porém, menor cobertura entre os trabalhadores. A maximização da cobertura vacinal entre os cuidadores e residentes é fundamental, devido à extrema vulnerabilidade da população idosa institucionalizada à COVID-19.

Objetivo: analizar la cobertura vacunal contra COVID-19 en Instituciones de Larga Permanencia para ancianos. Método: estudio transversal con datos agregados proporcionados por la Comisión Intersectorial de Seguimiento de las Instituciones de Larga Permanencia de Bahía. Se incluyeron las instituciones identificadas en Salvador, Bahía, Brasil, con al menos un residente de edad avanzada (60 o más años) que respondieron a la encuesta de vacunación realizada entre mayo y julio de 2021. Resultados: la muestra fue compuesta por 83 establecimientos, con predominio de instituciones privadas (50,1%) y filantrópicas (32,5%). La cobertura vacunal de COVID-19 alcanzó el 94,7% de los ancianos residentes y el 75,2% de los trabajadores. Conclusión: el estudio muestra alta cobertura vacunal en ancianos residentes en estas instituciones, sin embargo, menor cobertura entre los trabajadores. La maximización de la cobertura vacunal entre cuidadores y residentes es fundamental debido a la extrema vulnerabilidad de la población de edad avanzada institucionalizada a COVID-19.

Objective to analyze vaccination coverage against COVID-19 in long-term care institutions for the elderly. Method: cross-sectional study with aggregated data provided by the Intersectoral Monitoring Commission of Long-Term Institutions of Bahia. We included the institutions identified in Salvador, Bahia, Brazil, with at least one elderly resident (60 years or older) who responded to the vaccination survey conducted between May and July 2021. Results: the sample consisted of 83 establishments, with a predominance of private (50.1%) and philanthropic (32.5%) institutions. Vaccination coverage for COVID-19 reached 94.7% of elderly residents and 75.2% of workers. Conclusion: the study shows high vaccination coverage in elderly residents of these institutions, but lower coverage among workers. Maximizing vaccination coverage among caregivers and residents is essential, due to the extreme vulnerability of the elderly population institutionalized to COVID-19.

Adherencia a la campaña de vacunación de la gripe 2020/21 en el contexto de la pandemia de SARS-CoV-2. Análisis de los cambios en la gestión: un estudio piloto / Adherence to influenza vaccination campaign 2020/21 in the pandemic SARS-CoV-2. Context analysis in management changes: A pilot study

Introducción Las campañas de vacunación contra la gripe alcanzan coberturas por debajo de lo deseado y recomendado. Lo que en el contexto actual de pandemia por SARS-CoV-2 cobra mayor relevancia. Nuestro objetivo consiste en evaluar el impacto en la cobertura vacunal alcanzada de una serie de estrategias de implementación vacunal llevadas a cabo. Material y métodos Se introdujo una serie de estrategias de implementación de la vacunación en nuestra zona básica de salud como la captación activa y la ampliación horaria entre otras, se evaluó y comparó la cobertura vacunal alcanzada en la campaña actual con las previas, tanto a las 8 semanas como al final de la campaña. Además, se llevó a cabo un estudio transversal mediante una encuesta para valorar el impacto que habían tenido las medidas. Resultados En la semana 8 de la campaña detectamos diferencias significativas en cuanto al incremento de la cobertura vacunal alcanzada respecto a años previos, resultado que se confirmó al finalizar la campaña alcanzándose diferencias significativas (p<0,05) de cobertura vacunal en todos los centros estudiados, datos que fueron a favor de la efectividad de las estrategias empleadas. Conclusiones Las estrategias de implementación vacunal empleadas se han mostrado efectivas, logrando un incremento de hasta un 74% en las dosis totales administradas respecto a campañas previas y de hasta un 15% en la cobertura vacunal alcanzada en mayores de 64 años; pese al contexto de pandemia y al aumento de los movimientos antivacunas (AU)

Introduction Vaccination campaigns against influenza virus achieve coverages under recommended and desired values. In current context of SARS-CoV-2 pandemic it becomes more relevant. Our objective is to evaluate the impact on vaccination coverage of a set of implementation strategies carried out. Material and method Vaccine implementation strategies were introduced in our basic health zone as active caption of patients and schedule extension. Then the vaccination coverage achieved in the current campaign was evaluated and compared with previous in the 8th week and at the end of the campaign. Besides, a transversal study through a survey was carried out to measure the impact of the applied strategies. Result In the 8th week of the campaign significant differences were detected in the increase of vaccination coverage compared with previous years. These results were confirmed at the end of the campaign, getting a significant difference (<.05) of vaccination coverage in all the studied centers, these data support the effectivity of the applied strategies. Conclusions The vaccine implementation strategies applied have shown effectivity, achieving an increase of until 74% in the total administered doses compared to previous campaigns and even a 15% of vaccination coverage increased in the group of patients older than 64 years; even in a pandemic context and the increasing of anti-vaccine movements (AU)

Declaración SLIPE: Aumento de la cobertura antipoliomielítica con vacunas más seguras: una urgencia inaplazable en Latinoamérica

Ante el riesgo real de ocurrencia de brotes de parálisis fláccida aguda en la región debidos a poliovirus derivado de la vacuna Sabin o a la importación de poliovirus salvaje, la Sociedad Latinoamericana de Infectología Pediátrica comisionó a un grupo ad hoc de expertos integrantes del Comité de Vacunas y Biológicos de la institución, para redactar un documento oficial de posición sobre la necesidad imperiosa de incrementar los niveles de inmunización contra la enfermedad en la región e incorporar definitivamente en forma exclusiva la vacuna de polio inactivada en todos los esquemas nacionales de vacunación. La presente publicación discute las principales conclusiones y recomendaciones generadas como resultado de esta actividad.

Given the actual risk of poliomyelitis outbreaks in the region due to poliovirus derived from the Sabin vaccine or the importation of wild poliovirus, the Latin American Society of Pediatric Infectious Diseases commissioned an ad hoc group of experts from the institution's Vaccines and Biologicals Committee, to draft an official position paper on the urgent need to increase immunization levels against the disease in the region and incorporate inactivated polio vaccine exclusive schedules in all national immunization programs. This publication discusses the main conclusions and recommendations generated as a result of such activity.

Increasing polio coverage with safer vaccines: a pressing need in Latin America

Given the actual risk of poliomyelitis outbreaks in the region due to poliovirus derived from the Sabin vaccine or the importation of wild poliovirus, the Latin American Society of Pediatric Infectious Diseases commissioned an ad hoc group of experts from the institution's Vaccines and Biologicals Committee, to draft an official position paper on the urgent need to increase immunization levels against the disease in the region and incorporate inactivated polio vaccine exclusive schedules in all national immunization programs. This publication discusses the main conclusions and recommendations generated as a result of such activity.

Ante el riesgo real de ocurrencia de brotes de parálisis fláccida aguda en la región debidos a poliovirus derivado de la vacuna Sabin o a la importación de poliovirus salvaje, la Sociedad Latinoamericana de Infectología Pediátrica comisionó a un grupo ad hoc de expertos integrantes del Comité de Vacunas y Biológicos de la institución, para redactar un documento oficial de posición sobre la necesidad imperiosa de incrementar los niveles de inmunización contra la enfermedad en la región e incorporar definitivamente en forma exclusiva la vacuna de polio inactivada en todos los esquemas nacionales de vacunación. La presente publicación discute las principales conclusiones y recomendaciones generadas como resultado de esta actividad.

[Adherence to influenza vaccination campaign 2020/21 in the pandemic SARS-CoV-2. Context analysis in management changes: A pilot study]. / Adherencia a la campaña de vacunación de la gripe 2020/21 en el contexto de la pandemia de SARS-CoV-2. Análisis de los cambios en la gestión: un estudio piloto.

INTRODUCTION: Vaccination campaigns against influenza virus achieve coverages under recommended and desired values. In current context of SARS-CoV-2 pandemic it becomes more relevant. Our objective is to evaluate the impact on vaccination coverage of a set of implementation strategies carried out. MATERIAL AND METHODS: Vaccine implementation strategies were introduced in our basic health zone as active caption of patients and schedule extension. Then the vaccination coverage achieved in the current campaign was evaluated and compared with previous in the 8th week and at the end of the campaign. Besides, a transversal study through a survey was carried out to measure the impact of the applied strategies. RESULTS: In the 8th week of the campaign significant differences were detected in the increase of vaccination coverage compared with previous years. These results were confirmed at the end of the campaign, getting a significant difference (<.05) of vaccination coverage in all the studied centers, these data support the effectivity of the applied strategies. CONCLUSIONS: The vaccine implementation strategies applied have shown effectivity, achieving an increase of until 74% in the total administered doses compared to previous campaigns and even a 15% of vaccination coverage increased in the group of patients older than 64 years; even in a pandemic context and the increasing of anti-vaccine movements.

Facilitating access to pneumococcal vaccine for people living with HIV: an experience report / Como facilitar el acceso a la vacuna neumocócica a las personas que viven con el VIH: informe de una experiencia / Facilitando o acesso à vacina pneumocócica para pessoas vivendo com HIV: relato de experiência

ABSTRACT The article describes a strategy to facilitate access to pneumococcal conjugate vaccine 13 (PCV-13) for people living with HIV/AIDS (PLHIV) during the COVID-19 pandemic. Method: report on the experience regarding the organization of a care service for PLHIV in the city of São Paulo to facilitate access to PCV-13 in the framework of the 2020 influenza vaccination campaign during the COVID-19 pandemic. Results: through the integration between a PLHIV care service and an Immunization Center (CRIE in Portuguese), it was possible to offer PCV-13 to PLHIV at the point of care, reducing physical barriers to access to immunization. Thus, of the 1,906 PLHIV who passed through the service during the period March 23-July 31, 2020, 84.4% (1,609) received the influenza vaccine, PCV-13 or both. Of the 1609 vaccinated, 50.6% (814) were eligible and received PCV-13. Conclusion: offering the vaccine at the point of care and orienting PLHIV on the importance of vaccination as a disease prevention strategy, identifying those eligible to receive it, was an important action carried out by the institution together with the nursing team, as a strategy to facilitate access to vaccination.

RESUMEN El artículo describe una estrategia para facilitar el acceso a la vacuna neumocócica conjugada 13 (PCV-13) a las personas que viven con VIH/SIDA (PVVS) durante la pandemia de COVID-19. Método: relato de experiencia sobre la organización de un servicio de atención a las PVVS en la ciudad de São Paulo, para facilitar el acceso a la PCV-13 en el marco de la campaña de vacunación contra la gripe de 2020, durante la pandemia de COVID-19. Resultados: a través de la integración entre un servicio de atención a las PVVS y un Centro de Inmunización (CRIE), fue posible ofrecer la PCV-13 a las PVVS en su punto de atención, reduciendo las barreras físicas para el acceso a la inmunización. Así, de las 1.906 PVVS que pasaron por el servicio durante el periodo comprendido entre el 23 de marzo y el 31 de julio de 2020, el 84,4% (1.609) recibieron la vacuna de la gripe, la PCV-13 o ambas. De los 1609 vacunados, el 50,6% (814) eran elegibles y recibieron la PCV-13. Conclusión: ofrecer la vacuna en el lugar de atención y orientar a las PVVS sobre la importancia de la vacunación como estrategia de prevención de enfermedades, identificando a las personas elegibles para recibirlas, fue una acción importante realizada por la institución junto con el equipo de enfermería, como estrategia para facilitar el acceso a la vacunación.

RESUMO Descrever uma estratégia para facilitar o acesso à vacina conjugada pneumocócica 13-valente (PCV-13) para pessoas vivendo com HIV (PVHIV), durante a pandemia de COVID-19. Método: relato de experiência sobre a organização de um serviço de atendimento para PVHIV na cidade de São Paulo, para facilitar o acesso à PCV-13 no decorrer da campanha de vacinação de influenza de 2020, durante a pandemia de COVID-19. Resultados: por meio da integração entre um serviço de atendimento para PVHIV e um Centro de Imunizações (CRIE) foi possível oferecer a PCV-13 para as PVHIV em seu local de atendimento, diminuindo barreiras físicas de acesso à imunização. Dessa forma, das 1906 PVHIV que passaram pelo serviço durante o período de 23 de março a 31 de julho de 2020, 84,4% (1609) receberam a vacina influenza, PCV-13 ou ambas. Dos 1609 vacinados, 50,6% (814) foram elegíveis e receberam a PCV-13. Conclusão: oferecer a vacina em seu local de tratamento e orientar as PVHIV sobre a importância da vacinação como estratégia de prevenção de doenças, identificando os elegíveis a recebê-las, foi uma importante ação realizada pela instituição em conjunto com a equipe de enfermagem, como estratégia de facilitar o acesso à vacinação.

COVID-19 y coberturas de vacunación del calendario regular del Paraguay, efecto de la pandemia

RESUMEN Introducción: La pandemia de COVID-19 produjo una crisis sanitaria afectando las coberturas de vacunación de los países. Objetivo : Describir la cobertura de vacunación de los biológicos trazadores durante el periodo prepandémico (2015- 2019) y pandémico (2020-2021) en Paraguay. Materiales y Métodos: Estudio descriptivo observacional de corte transverso, que comprendió a niños de 0 a 5 años de edad, de las 18 Regiones Sanitarias del País. Se analizaron las coberturas de vacunación del Programa Ampliado de Inmunización, periodo prepandémico (2015-2019) y pandémico (2020-201). Se incluyeron los biológicos trazadores: BCG, DPT1, DPT3, IPV1 y bOPV3, SPR1, SPR2 y vacuna antiamarílica (AA), el cálculo de cobertura de vacunación a nivel país se realizó por medio del análisis del reporte electrónico semanal de dosis de vacunas administradas por Región Sanitaria. Se estableció la comparación de las coberturas de vacunación por biológico trazador, por periodos y rango de edad. Resultados: Durante la pandemia se constató un descenso de cobertura de vacunación de los biológicos trazadores, para BCG: 4 % (2020), 15% (2021);DPT1: 5 % (2020), 13 % (2021); DPT3: 9 % (2020), 22 %(2021); IPV1: 5 % (2020),16 % (2021); bOPV3: 7% (2020),19 % (2021); SPR1: 9 %, SPR2: 13 % (2020),SPR1:17%, SPR2:16 % (2021) y AA: 7% (2020), 15% (2021). Conclusión: Durante la pandemia de Covid-19 disminuyeron las coberturas de vacunación de todos los biológicos trazadores, similar descenso se constató en otros países de América, existe el riesgo de aparición de brotes de enfermedades prevenibles por vacunación por el acúmulo de susceptibles.

ABSTRACT Introduction: The COVID-19 pandemic produced a health crisis affecting countries' vaccination coverage statistics. Objective: To describe the coverage of recommended vaccines during the pre-pandemic (2015-2019) and pandemic (2020-2021) periods in Paraguay. Materials and Methods: This was a descriptive, observational cross-sectional study, comprising children from 0 to 5 years of age, from the Country's 18 Health Regions. The vaccination coverage of the National Expanded Immunization Program, pre-pandemic (2015-2019) and pandemic (2020-201) periods were analyzed. The recommended vaccinations included were: BCG, DTP1, DTP3, IPV1 and bOPV3, MMR1, MMR2 and yellow fever vaccine (AA), the calculation of vaccination coverage at the country level was carried out through the analysis of the weekly electronic report of doses of vaccines administered by Health Region. The comparison of vaccination coverage by recommended vaccine was established, by periods and age range. Results: During the pandemic, a decrease in vaccination coverage of the recommended vaccines was observed, for BCG: 4% (2020), 15% (2021); DTP1: 5% (2020), 13% (2021); DTP3: 9% (2020), 22% (2021); IPV1: 5% (2020), 16% (2021); bOPV3: 7% (2020), 19% (2021); MMR1: 9%, MMR2: 13% (2020), MMR1: 17%, MMR2: 16% (2021) and AA: 7% (2020), 15% (2021). Conclusion: During the Covid-19 pandemic, vaccination coverage of all recommended vaccines decreased, a similar decrease was found in other countries in the Americas, there is a risk of outbreaks of vaccine-preventable diseases due to the accumulation of susceptible populations.

Análisis de las Campañas de Vacunación Antigripal destinadas al personal de salud del HIBA: período 2016-2018 / Analysis of Influenza Vaccination Campaigns for HIBA health personnel: 2016-2018 period

Introducción: la vacunación antigripal es la forma más eficaz para prevenir la enfermedad por virus Influenza y sus complicaciones. La cobertura en los profesionales sanitarios es un indicador de calidad hospitalaria. Material y métodos: estudio descriptivo de corte transversal. A partir de registros vacunales, se calculó la cobertura para las campañas 2013 a 2018. Se compararon las coberturas por trienios. Se describieron características generales de las campañas de 2016 a 2018. Resultados: en 2016 se alcanzó la mayor tasa del período (59,79%, IC 95%:58,75-60,81); en 2017, la menor (34,46%, IC 95%:33,48-35,46). La campaña 2018 obtuvo una cobertura de 54,90% (IC 95%: 53,88-55,92) y se inició más tempranamente que otras. Al comparar las tasas trienales del período se observó una diferencia de proporción de -1,3% (IC 95%: -2.84-0.24). Durante los tres últimos años, el personal vacunado correspondió mayormente al sexo femenino, a la Sede Central y tenía relación contractual directa. Las mayores coberturas específicas correspondieron a la sede de San Justo y a los profesionales de enfermería. El puesto ambulante fue el que aplicó más vacunas. Conclusión: si bien hubo variaciones en las coberturas alcanzadas a lo largo de los años, siendo la del año 2016 la más elevada y la del año 2017 la más baja, no se observaron diferencias estadísticamente significativas en las coberturas alcanzadas al comparar trienios. Resulta necesario continuar realizando intervenciones adaptadas al contexto local que permitan alcanzar los objetivos de cobertura esperados. Discusión: se reconocieron varios obstáculos para alcanzar las coberturas esperadas. La educación al personal de salud, la evaluación sistematizada de los ESAVI (Eventos supuestamente atribuibles a vacunación e inmunización) y la descripción de los elementos que facilitaron las coberturas específicas elevadas de algunas subpoblaciones podrían contribuir para mejorar los resultados. (AU)

Introduction: influenza vaccination is the most effective way to prevent influenza virus disease and its complications. Coverage in health professionals measurement is an indicator of hospital quality. Material and methods: descriptive cross-sectional study. From vaccination records, the coverage was calculated for the 2013 to 2018 campaigns. The coverage for three years was compared. General characteristics of the campaigns from 2016 to 2018 were described. Results: in 2016, the highest was achieved during the period (59.79%, IC 95%: 58.75 -60.81). In 2017, the lowest (34.46%, IC 95%: 33.48-35,46). The 2018 campaign achieved a coverage of 54.90% (IC 95%: 53.88-55.92) and started earlier than others. When comparing the triennial rates of the period, a difference of proportion of -1.3% was observed (IC 95%: -2.84-0.24). During the last three years, the vaccinated staff corresponded mostly to the female sex, to the headquarters and had a direct contractual relationship. The largest specific coverage corresponded to the San Justo headquarters and to nursing professionals. The ambulatory position was the post that applied the most vaccines. Conclusion: although there were variations in the coverage achieved over the years, with 2016 being the highest and 2017 being the lowest, there were no statistically significant differences in the coverage achieved when comparing trienniums. It is necessary to continue carrying out interventions adapted to the local context to achieve the expected coverage objectives. Discussion: several obstacles were recognized to reach the expected coverage. The education of health personnel, the systematic evaluation of the ESAVIs and the description of the elements that facilitated the high specific coverage of some subpopulations could contribute to improve the results. (AU)

[Antipneumococcal vaccination in Catalonian adults: Vaccine coverages and adequacy to distinct guideline recommendations]. / Vacunación antineumocócica en adultos de Cataluña: coberturas y grado de adecuación a distintas guías de recomendaciones.

OBJECTIVES: To know antipneumococcal vaccination coverages among Catalonian adults and evaluate the adequacy of vaccine use according to 3 distinct current vaccination guidelines. DESIGN: Population-based cross-sectional study. SETTING: Primary Health Care. Catalonia, Spain. PARTICIPANTS: A total of 2,033,465 individuals≥50 years-old registered in the Catalonian Health Institute. MAIN MEASUREMENTS: Vaccination status for the 23-valent pneumococcal polysaccharide vaccine (PPV23) and/or the 13-valent pneumococcal conjugate vaccine (PCV13) was revised at 1/01/2015. Adequacy of vaccination status was determined according to 3 distinct vaccination recommendation guidelines: Spanish Ministry of Health (basically coinciding with Catalonian Health Institute's recommendations), Spanish Society of Family Physicians (semFYC) and Centers for Disease Control and Prevention (CDC). RESULTS: Overall, 789,098 (38.8%) persons had received PPV23 and 5,031 (0.2%) had received PCV13. PPV23 coverage largely increased with increasing age (4.8% in 50-59 years, 35.5% in 60-69 years, 71.9% in 70-79 years and 79.5% in≥80 years; P<.001), whereas PCV13 coverage was very small in all age groups. Considering the 3 analysed vaccine guidelines a 46.1% of the overall study population were adequacy vaccinated according to Spanish Ministry's recommendations, 19.3% according to semFYC's recommendations and 4.6% according to CDC's recommendations. CONCLUSION: PPV23 coverage among Catalonian adults may be considered as intermediate, but PCV13 coverage is very small. The institutional recommendations (Spanish Ministry) are more followed than corporative (semFYC) or less local (CDC) recommendations in clinical practice.

Vaccination coverage against pertussis in pregnant women of Catalonia in the first year of implementation of the immunisation program. / Cobertura vacunal frente a tos ferina en gestantes de Cataluña en el primer año de implantación del programa de inmunización.

INTRODUCTION: The re-emergence of pertussis and the severity of its complications in infants younger than 3 months, were determining factors for starting a vaccination program for pregnant women in the third trimester of gestation in Catalonia in February 2014. This was the first autonomous community to introduce it in Spain. The aim of the study was to estimate the coverage of the program in its first year of implementation. METHODS: A retrospective analysis was performed on the data from the Primary Care Centre computerised medical records of pregnant women attending Sexual and Reproductive Health Care centres of the Metropolitan Nord area of the province of Barcelona, part of the Catalan Institute of Health. The overall coverage was estimated, as well as the sociodemographic variables of Tdap vaccination of women who had registered a delivery of a live birth between August 2014 and August 2015. RESULTS: A total of 6,697 deliveries of live births were recorded, and 1,713 pregnant women were vaccinated, which represented an overall coverage of 25.6% (95% CI; 24.1-26.1). Vaccination coverage was higher in pregnant women under 18 years and Spanish women (P=.018 and P=.036, respectively). CONCLUSION: The estimation of vaccine coverage against pertussis in pregnant women in the third trimester of pregnancy, after the first year of implementation of the program in a health area of Catalonia was lower than the objective set. Strategies need to be designed in order to improve program coverage.

Situação sorológica e vacinal para Hepatite B em puérperas de uma maternidade pública / Hepatitis B serologic and vaccination status in postpartum women at a public maternity hospital / La situación serológica y vacunal contra la Hepatitis B en mujeres durante el posparto en una maternidad pública

A Hepatite B é uma infecção viral que se destaca pela alta morbimortalidade, cronicidade, cirrose e carcinoma hepatocelular. Esta pesquisa objetivou avaliar a situação sorológica e vacinal para Hepatite B em puérperas internadas em uma maternidade pública de Teresina. Trata-se de um estudo transversal, realizado por meio de entrevistas com 377 puérperas, entre janeiro a fevereiro de 2011. A baixa cobertura vacinal caracterizou-se pelas oportunidades perdidas de vacinação, pois 77,5% delas não receberam nenhuma dose da vacina, embora a maioria tenha realizado o pré-natal. Apenas 41,9% realizaram sorologia. Em relação às informações sobre a vacina, observa-se que 77,3% das puérperas foram informadas sobre as vacinas que deveriam receber durante o pré-natal. Dentre as fontes informantes, o enfermeiro foi o mais citado, com 55%, reforçando o seu papel de destaque como um educador em saúde na atenção pré-natal. Evidenciou-se a ocorrência de baixas coberturas sorológica e vacinal, denunciando a ineficiência do acompanhamento pré-natal.

Hepatitis B is a viral infection notable for high rates of morbidity, chronicity, cirrhosis and hepatocellular carcinoma (HCC). This transversal study to evaluate serologic and Hepatitis B vaccination status in women admitted to a public maternity hospital in Teresina was conducted in January and February, 2011, through interviews of a sample of 377 postpartum women. Poor vaccine coverage was characterized by missed opportunities for immunization: 77.5% of the sample received no dose of the vaccine, even though most had received antenatal care. Hepatitis serology testing had been performed on only 41.9%. However, 77.1% were informed of what vaccines they should receive during the antenatal period. Nurses were the information source most mentioned (by 55%), underlining their key role as health educators in antenatal care. The study found low vaccine and serological coverage, evidencing the inefficiency of antenatal monitoring.

La Hepatitis B es una infección viral que se caracteriza por la alta morbimortalidad, cronicidad, cirrosis y carcinoma hepatocelular. Esta investigación tuvo como objetivo evaluar la situación serológica y vacunal contra la Hepatitis B en mujeres en el periodo de posparto internadas en una maternidad pública de Teresina. Se trata de un estudio transversal, realizado a través de entrevistas junto a 377 mujeres en el posparto, entre enero y febrero de 2011. La baja cobertura vacunal se ha caracterizado por las oportunidades perdidas de vacunación, ya que el 77,5% no recibió ninguna dosis de vacuna, aunque la mayoría haya realizado el prenatal. Sólo el 41,9% realizó serología. En cuanto a las informaciones acerca de la vacuna, se observa que el 77,1 % de las mujeres en posparto fue informado acerca de las vacunas que se deben tomar en el período prenatal. Entre las fuentes informantes, el enfermero fue el que más se ha mencionado, en 55%, lo que refuerza su papel de destaque como un educador de salud en la atención prenatal. Reveló la existencia de bajas coberturas serológicas y vacunal, denunciando la ineficiencia de la atención prenatal.

[Influenza vaccination coverage in children with risk conditions in Catalonia]. / Cobertura de vacunación antigripal en niños con condiciones de riesgo en Cataluña.

INTRODUCTION: Influenza vaccination is recommended in Catalonia in children older than 6 months with risk conditions for developing flu-related complications. The aim of this study is to determine influenza vaccine coverage in children with risk conditions and their association with socio-demographic factors and medical variables. MATERIAL AND METHOD: Descriptive cross-sectional study of children with risk conditions for developing influenza complications (aged between 6months and 15years old) assigned to Primary Health Care centers in Catalonia at the beginning of the 2011-2012 influenza vaccination campaign. The information on vaccination status and study variables were obtained from data registered on electronic health records by primary care teams. The relationship between influenza vaccination and demographic and medical variables was analyzed using bivariate analysis and a multiple logistic regression model. RESULTS: Influenza vaccination coverage was 23.9%. Variables associated with influenza vaccination were: age 2years or older (aOR: 1.6 [1.4-1.7] in children 3-5years old; 1.8 [1.7-2.0] in those 6-10 years, and 2.2 [2.0 -2.4] in children ≥11years]); male sex (aOR: 1.1 [1.0-1.1]); foreign nationality (aOR: 1.2 [1.2-1.3]); age-appropriate immunization according to the systematic immunization schedule (aOR: 3.3 [2.8-3.8]); more than one visit to the primary care physician (5 or more visits) (aOR: 4.1 [3.8-4.4]), and more than one risk condition (3 or more conditions) (aOR: 2.5 [1.6-3.9]). DISCUSSION: Compared to other countries, influenza vaccination coverage among children with risk conditions is low in our study. Strategies to improve coverage should be implemented.

[Vaccination--General concepts. Systematic vaccination schedules for the child and adult in Spain. Impact of vaccination programs]. / Conceptos generales. Calendarios de vacunación sistemática del niño y del adulto en España. Impacto de los programas de vacunación.

One area of major importance in promoting health is the prevention of infectious diseases through vaccination. Vaccine is any preparation intended to generate immunity against a disease by stimulating the production of antibodies. There are two basic types: live attenuated and inactivated, with different characteristics that determine their use. The main properties of a vaccine are safety and protective efficacy. The vaccines can be administered based on individualized directions depending on various factors (personal, environmental…), or systematically as part of the immunization schedules. In Spain, the first childhood immunization schedule was implemented in 1975. The Autonomous Communities are currently responsible for establishing vaccine recommendations. The incidence of vaccine-preventable diseases and vaccination coverage are essential criteria for the evaluation of vaccination programs. In Spain the incidence of vaccine-preventable diseases is low. Vaccination coverage is high in childhood, but in adolescents, adults and groups at risk it is not always appropriate.

Socio-economic determinants and inequities in coverage and timeliness of early childhood immunisation in rural Ghana.

OBJECTIVES: To assess the extent of socio-economic inequity in coverage and timeliness of key childhood immunisations in Ghana. METHODS: Secondary analysis of vaccination card data collected from babies born between January 2008 and January 2010 who were registered in the surveillance system supporting the ObaapaVita and Newhints Trials was carried out. 20 251 babies had 6 weeks' follow-up, 16 652 had 26 weeks' follow-up, and 5568 had 1 year's follow-up. We performed a descriptive analysis of coverage and timeliness of vaccinations by indicators for urban/rural status, wealth and educational attainment. The association of coverage with socio-economic indicators was tested using a chi-square-test and the association with timeliness using Cox regression. RESULTS: Overall coverage at 1 year of age was high (>95%) for Bacillus Calmette-Guérin (BCG), all three pentavalent diphtheria-pertussis-tetanus-haemophilus influenzae B-hepatitis B (DPTHH) doses and all polio doses except polio at birth (63%). Coverage against measles and yellow fever was 85%. Median delay for BCG was 1.7 weeks. For polio at birth, the median delay was 5 days; all other vaccine doses had median delays of 2-4 weeks. We found substantial health inequity across all socio-economic indicators for all vaccines in terms of timeliness, but not coverage at 1 year. For example, for the last DPTHH dose, the proportion of children delayed more than 8 weeks were 27% for urban children and 31% for rural children (P < 0.001), 21% in the wealthiest quintile and 41% in the poorest quintile (P < 0.001), and 9% in the most educated group and 39% in the least educated group (P < 0.001). However, 1-year coverage of the same dose remained above 90% for all levels of all socio-economic indicators. CONCLUSIONS: Ghana has substantial health inequity across urban/rural, socio-economic and educational divides. While overall coverage was high, most vaccines suffered from poor timeliness. We suggest that countries achieving high coverage should include timeliness indicators in their surveillance systems.

[Microbiological profile of acute viral gastroenteritis attended in a paediatric department of an area with high vaccine cover against rotavirus]. / Caracterización microbiológica de las gastroenteritis agudas virales atendidas en un servicio de pediatría en un área de alta cobertura vacunal frente a rotavirus.

INTRODUCTION: Vaccination against rotavirus has led to a significant decline of the disease. The aim of the present work is to evaluate the clinical and epidemiological features of the viral acute gastroenteritis (AGE) in an area with high immunization coverage against rotavirus. METHOD: A prospective microbiological evaluation was made of stool culture and Real Time Polymerase Chain Reaction (RT-PCR) to gastroenteric virus and genotyping of rotavirus strains in < 5 year-old with AGE episodes attended by or admitted to our hospital from November-March of 2009-2010 and 2010-2011. RESULTS: A total of 51 patients were included, with a mean age (standard deviation) of 19.1 (13.9) months. Stool culture was negative in 23 samples (45% of the samples analyzed), and it was identified a responsible microorganism in 70% by the RT-PCR (16 samples). Rotavirus was the most common isolated microorganism (53%), and G1[P8] the most frequent genotype. A co-infection was detected in 14% of samples (7 patients), and rotavirus and astrovirus were the most frequent etiological agents involved. CONCLUSIONS: Rotavirus, basically G1[P8], is the most common AGE responsible agent identified in our study. The use of RT-PCR enhances the AGE diagnostic sensitivity, and uncovers an important number of viral co-infections.

Pertussis booster vaccine for adolescents and young adults in São Paulo, Brazil / Avaliação de reforços vacinais contra a coqueluche para adolescentes e adultos na cidade de São Paulo / Evaluación de refuerzos vacunales contra la tosferina para adolescentes y adultos en la ciudad de Sao Paulo, Sureste de Brasil

OBJECTIVE: To develop a model to assess different strategies of pertussis booster vaccination in the city of São Paulo. METHODS: A dynamic stationary age-dependent compartmental model with waning immunity was developed. The "Who Acquires Infection from Whom" matrix was used to modeling age-dependent transmission rates. There were tested different strategies including vaccine boosters to the current vaccination schedule and three of them were reported: (i) 35 percent coverage at age 12, or (ii) 70 percent coverage at age 12, and (iii) 35 percent coverage at age 12 and 70 percent coverage at age 20 at the same time. RESULTS: The strategy (i) achieved a 59 percent reduction of pertussis occurrence and a 53 percent reduction in infants while strategy (ii) produced 76 percent and 63 percent reduction and strategy (iii) 62 percent and 54 percent, respectively. CONCLUSION: Pertussis booster vaccination at age 12 proved to be the best strategy among those tested in this study as it achieves the highest overall reduction and the greatest impact among infants who are more susceptible to pertussis complications.

OBJETIVO: Desenvolver um modelo capaz de acessar resultados de diferentes possíveis estratégias de reforço vacinal contra a coqueluche, na cidade de São Paulo. MÉTODOS: O modelo matemático dinâmico proposto é dependente da idade e considerou perda da imunidade vacinal com o avanço da idade. A matriz "who acquire infection from whom" foi utilizada para inserir as diferentes dinâmicas de contatos entre os grupos etários. Diferentes estratégias vacinais foram testadas, acrescentando reforços vacinais ao atual esquema utilizado, e três diferentes estratégias foram reportadas: (i) 35 por cento ou (ii) 70 por cento de cobertura vacinal na idade de 12 anos e (iii) coberturas vacinais de 35 por cento aos 12 anos e 70 por cento aos 20 anos ao mesmo tempo. RESULTADOS: A estratégia (i) produziu redução de 59 por cento nos casos de coqueluche e 53 por cento de redução entre os menores de um ano; a estratégia (ii) alcançou redução de 76 por cento nos casos e de 63 por cento entre os menores de um ano; a estratégia (iii) reduziu em 62 por cento o total de casos e 54 por cento entre os menores de um ano. DISCUSSÃO: Reforço vacinal contra a coqueluche aos 12 anos é a melhor estratégia dentre as testadas, pois gera maior redução de casos em todas as idades e alcança maior impacto entre os menores de um ano, os mais vulneráveis às complicações da coqueluche.

OBJETIVO: Desarrollar un modelo capaz de acceder resultados de diferentes posibles estrategias de refuerzo vacunal contra la tosferina, en la ciudad de Sao Paulo, Sureste de Brasil. MÉTODOS: El modelo matemático dinámico propuesto es dependiente de la edad y consideró pérdida de la inmunidad vacunal con el avance de la edad. La matriz "who acquire infection from whom" fue utilizada para insertar las diferentes dinámicas de contactos entre los grupos de edad. Diferentes estrategias vacunales fueron evaluadas, añadiendo refuerzos vacunales al actual esquema utilizado, e tres diferentes estrategias fueron reportadas: (i) 35 por ciento o (ii) 70 por ciento de cobertura vacunal en la edad de 12 años e (iii) coberturas vacunales de 35 por ciento a los 12 años y 70 por ciento a los 20 años al mismo tiempo. RESULTADOS: La estrategia (i) produjo reducción de 59 por ciento en los casos de tosferina y 53 por ciento de reducción entre los menores de un año; la estrategia (ii) alcanzó reducción de 76 por ciento en los casos y de 63 por ciento entre los menores de un año; la estrategia (iii) redujo en 62 por ciento el total de casos y 54 por ciento entre los menores de un año. DISCUSIÓN: Refuerzo vacunal contra la tosferina a los 12 años es la mejor estrategia entre las evaluadas, pues genera mayor reducción de casos en todas las edades y alcanza mayor impacto entre los menores de un año, los mas vulnerables a las complicaciones de la tosferina.