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1.
MMWR Morb Mortal Wkly Rep ; 70(18): 674-679, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33956782

RESUMO

Adults aged ≥65 years are at increased risk for severe outcomes from COVID-19 and were identified as a priority group to receive the first COVID-19 vaccines approved for use under an Emergency Use Authorization (EUA) in the United States (1-3). In an evaluation at 24 hospitals in 14 states,* the effectiveness of partial or full vaccination† with Pfizer-BioNTech or Moderna vaccines against COVID-19-associated hospitalization was assessed among adults aged ≥65 years. Among 417 hospitalized adults aged ≥65 years (including 187 case-patients and 230 controls), the median age was 73 years, 48% were female, 73% were non-Hispanic White, 17% were non-Hispanic Black, 6% were Hispanic, and 4% lived in a long-term care facility. Adjusted vaccine effectiveness (VE) against COVID-19-associated hospitalization among adults aged ≥65 years was estimated to be 94% (95% confidence interval [CI] = 49%-99%) for full vaccination and 64% (95% CI = 28%-82%) for partial vaccination. These findings are consistent with efficacy determined from clinical trials in the subgroup of adults aged ≥65 years (4,5). This multisite U.S. evaluation under real-world conditions suggests that vaccination provided protection against COVID-19-associated hospitalization among adults aged ≥65 years. Vaccination is a critical tool for reducing severe COVID-19 in groups at high risk.


Assuntos
/administração & dosagem , Hospitalização/estatística & dados numéricos , Idoso , Feminino , Humanos , Masculino , Medição de Risco , Resultado do Tratamento , Estados Unidos/epidemiologia , Cobertura Vacinal/estatística & dados numéricos , Vacinas Sintéticas
4.
Vaccine ; 39(20): 2731-2735, 2021 05 12.
Artigo em Inglês | MEDLINE | ID: mdl-33875269

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has significantly affected utilization of preventative health care, including vaccines. We aimed to assess HPV vaccination rates during the pandemic, and conduct a simulation model-based analysis to estimate the impact of current coverage and future pandemic recovery scenarios on disease outcomes. The model population included females and males of all ages in the US. The model compares pre-COVID vaccine uptake to 3 reduced coverage scenarios with varying recovery speed. Vaccine coverage was obtained from Truven Marketscan™. Substantially reduced coverage between March-August 2020 was observed compared to 2018-2019. The model predicted that 130,853 to 213,926 additional cases of genital warts; 22,503 to 48,157 cases of CIN1; 48,682 to 110,192 cases of CIN2/3; and 2,882 to 6,487 cases of cervical cancer will occur over the next 100 years, compared to status quo. Providers should plan efforts to recover HPV vaccination and minimize potential long-term consequences.


Assuntos
Alphapapillomavirus , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Feminino , Humanos , Masculino , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Estados Unidos/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Vacinação , Cobertura Vacinal
8.
JAMA Netw Open ; 4(4): e217097, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33890990

RESUMO

Importance: A significant proportion of COVID-19 transmission occurs silently during the presymptomatic and asymptomatic stages of infection. Children, although important drivers of silent transmission, are not included in the current COVID-19 vaccination campaigns. Objective: To estimate the benefits of identifying silent infections among children as a proxy for their vaccination. Design, Setting, and Participants: This study used an age-structured disease transmission model, parameterized with census data and estimates from published literature, to simulate the estimated synergistic effect of interventions in reducing attack rates during the course of 1 year among a synthetic population representative of the US demographic composition. The population included 6 age groups of 0 to 4, 5 to 10, 11 to 18, 19 to 49, 50 to 64, and 65 years or older based on US census data. Data were analyzed from December 12, 2020, to February 26, 2021. Exposures: In addition to the isolation of symptomatic cases within 24 hours of symptom onset, vaccination of adults was implemented to reach a 40% to 60% coverage during 1 year with an efficacy of 95% against symptomatic and severe COVID-19. Main Outcomes and Measures: The combinations of proportion and speed for detecting silent infections among children that would suppress future attack rates to less than 5%. Results: In the base-case scenarios with an effective reproduction number Re = 1.2, a targeted approach that identifies 11% of silent infections among children within 2 days and 14% within 3 days after infection would bring attack rates to less than 5% with 40% vaccination coverage of adults. If silent infections among children remained undetected, achieving the same attack rates would require an unrealistically high vaccination coverage (≥81%) of this age group, in addition to 40% vaccination coverage of adults. The estimated effect of identifying silent infections was robust in sensitivity analyses with respect to vaccine efficacy against infection and reduced susceptibility of children to infection. Conclusions and Relevance: In this simulation modeling study of a synthetic US population, in the absence of vaccine availability for children, a targeted approach to rapidly identify silent COVID-19 infections in this age group was estimated to significantly mitigate disease burden. These findings suggest that without measures to interrupt transmission chains from silent infections, vaccination of adults is unlikely to contain the outbreaks in the near term.


Assuntos
Infecções Assintomáticas/epidemiologia , Número Básico de Reprodução/estatística & dados numéricos , Transmissão de Doença Infecciosa , Cobertura Vacinal/estatística & dados numéricos , Vacinação , Adulto , Idoso , /prevenção & controle , /provisão & distribução , Criança , Simulação por Computador , Transmissão de Doença Infecciosa/prevenção & controle , Transmissão de Doença Infecciosa/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido , Masculino , Estados Unidos/epidemiologia , Vacinação/métodos , Vacinação/normas
9.
Artigo em Inglês | MEDLINE | ID: mdl-33808446

RESUMO

Vaccination is one of the most useful preventive interventions in healthcare. The purpose of our study was to gain overview of the opinions, knowledge, and engagement in vaccination practices among medical students (MS) and junior doctors (JD) in Europe. The survey was distributed from March 2016 until August 2016 via the e-mail and social media of the European Medical Students' Association. In total, 1821 responses from MS and JD from 34 countries in the European region were analysed. The majority of respondents agreed that vaccines are useful (98.7%) and effective (97.2%). Although the necessity of revaccination was supported by 99.2%, only 68.0% of the respondents went through with it. Even though the potential benefit of the flu vaccination seems to be acknowledged by our participants, only 22.1% of MS and JD declared getting the flu shot every or every other season. MS and JD were in favour of specific mandatory vaccination for medical staff (86.0%) and medical students (82.7%). Furthermore, we analysed the self-reported vaccination coverage of our participants regarding 19 vaccines. Of the respondents, 89.5% claimed to provide advice about vaccination to their friends and family. In conclusion, European MS and JD have a very positive attitude towards vaccination. However, their behaviour and knowledge demonstrate certain gaps which should be further addressed in medical education.


Assuntos
Vacinas contra Influenza , Influenza Humana , Estudantes de Medicina , Estudos Transversais , Europa (Continente) , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Autorrelato , Inquéritos e Questionários , Vacinação , Cobertura Vacinal
11.
Artigo em Inglês | PAHO-IRIS | ID: phr2-53586

RESUMO

Pathways to Health is a bulletin prepared by the office of the Pan American Health Organization/World Health Organization (PAHO/WHO) in Cuba. Its main aim is to share the most important aspects of the Representation's technical cooperation with the country's Ministry of Public Health (MINSAP) and other institutions. At the one-year anniversary of the pandemic in Cuba, this issue is dedicated to systematically review key aspects of the national response over the last months. In particular, it includes an interview with the Minister of Public Health, Dr. José Angel Portal Miranda, who reflects on the range of work and milestones achieved in confronting the novel coronavirus in the island nation. It also carries articles related to the epidemiological situation, treatment protocol, Cuban vaccine development, work carried out under the National Maternal–Child Health Program, and contributions by the country's PAHO/WHO Collaborating Centers, among others. As an exception, we publish this special issue in English. The bulletin is usually published in Spanish.


Assuntos
Coronavirus , Higiene das Mãos , Comunicação em Saúde , Promoção da Saúde , Cooperação Internacional , Liderança , Pandemias , Vacinação , Cobertura Vacinal
12.
Eur Rev Med Pharmacol Sci ; 25(7): 3132-3135, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33877682

RESUMO

OBJECTIVE: Vulnerable populations are being more severely impacted by the ongoing pandemic, and the recent release of vaccines for Coronavirus Disease 19 (COVID-19) may offer them protection. The aim of this study was to investigate the willingness of homeless persons to be vaccinated against COVID-19; secondary aims were to analyze the immunization coverage for other conditions. PATIENTS AND METHODS: The acceptance of COVID-19 vaccine and immunization coverage for other conditions were investigated through a form in 112 persons experiencing homelessness referring to the primary care medical services of the Eleemosynaria Apostolica, Holy See. RESULTS: Most subjects, with a male preponderance, were willing to be vaccinated against COVID-19 (64.3%), 3.6% were unsure and 32.1% preferred not to be vaccinated. When answering questions on the immunization coverage for tuberculosis and hepatitis A and B, most subjects reported not to be vaccinated (48.2%, 56.2% and 55.3%, respectively) or did not know (33%, 28.6% and 27.7%). CONCLUSIONS: A significant portion of our sample declared to be willing to be vaccinated against COVID-19. It would be auspicious that the recent statements from several countries on the importance to extend COVID-19 vaccination to fragile populations be followed by the distribution of the vaccine to these populations.


Assuntos
Atitude Frente a Saúde , /prevenção & controle , Pessoas em Situação de Rua , Cobertura Vacinal/estatística & dados numéricos , Adulto , Idoso , Feminino , Hepatite A/prevenção & controle , Vacinas contra Hepatite A/uso terapêutico , Hepatite B/prevenção & controle , Vacinas contra Hepatite B/uso terapêutico , Humanos , Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Roma , Tuberculose/prevenção & controle , Vacinas contra a Tuberculose/uso terapêutico , Adulto Jovem
14.
Medicine (Baltimore) ; 100(14): e24904, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832070

RESUMO

BACKGROUND: The role of the HLA-DRB1 and HLA-DQB1 genes in the antibody response to hepatitis B (HB) vaccine has been well established; however, the involvement of the HLA-DPB1 allele in the HB vaccine immune response remained to be clarified by a systematic review. METHODS: A meta-analysis was performed in which databases were searched for relevant studies published in English or Chinese up until June 1, 2020. Six studies were identified and a total of 10 alleles were processed into statistical processing in this meta-analysis. RESULTS: Three thousand one hundred forty four subjects (including 2477 responders and 667 non-responders) were included in this research. Alleles HLA-DPB1∗02:02, DPB1∗03:01, DPB1∗04:01, DPB1∗04:02, and DPB1∗14:01 were found to be associated with a significant increase in the antibody response to HB vaccine, and their pooled odds ratios (ORs) were 4.53, 1.57, 3.33, 4.20, and 1.79, respectively; whereas DPB1∗05:01 (OR = 0.73) showed the opposite correlation. CONCLUSIONS: These findings suggested that specific HLA-DPB1 alleles are associated with the antibody response to HB vaccine.


Assuntos
Cadeias HLA-DRB1/imunologia , Vacinas contra Hepatite B/imunologia , Cadeias HLA-DRB1/genética , Anticorpos Anti-Hepatite B/imunologia , Humanos , Cobertura Vacinal/estatística & dados numéricos
15.
J Prim Care Community Health ; 12: 21501327211005902, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33813919

RESUMO

OBJECTIVES: The purpose of this cohort study was to evaluate measles, mumps, rubella (MMR), and varicella immunity among a population of adult employees receiving primary care in an employer-sponsored health center. METHODS: Participants were eligible for MMR and varicella immunity screening if they were an employee receiving primary care in an employer-sponsored health center between January 1, 2019 and November 1, 2020 who could not provide proof of immunization and 1) had it recommended by their provider, 2) specifically requested immunity testing (often because they had heard of measles outbreaks in their country of origin), or 3) were seen for an immigration physical for their Green Card application. RESULTS: Overall, 3494 patients were screened for their MMR immunity. Of these, 3057 were also screened for varicella immunity. Among these patients, 13.9% lacked measles immunity, 0.83% lacked immunity to all 3 components of MMR, and 13.2% lacked varicella immunity. Among the 262 patients who presented specifically for immunity screening, the rates of lacking immunity were higher for all conditions: 22.7% lacked measles immunity and 9.2% lacked varicella immunity. CONCLUSION: Given declines in immunizations during the COVID-19 pandemic, there is reason to be concerned that measles and varicella-associated morbidity and mortality may rise. Employers, especially those with large foreign-born populations or who require international travel may want to educate their populations about common contagious illnesses and offer immunity validation or vaccinations at no or low cost.


Assuntos
Varicela , Sarampo , Caxumba , Pandemias , Rubéola (Sarampo Alemão) , Cobertura Vacinal , Adulto , Anticorpos Antivirais , California , Varicela/imunologia , Varicela/prevenção & controle , Estudos de Coortes , Surtos de Doenças , Feminino , Humanos , Masculino , Programas de Rastreamento , Sarampo/imunologia , Sarampo/prevenção & controle , Caxumba/imunologia , Caxumba/prevenção & controle , Serviços de Saúde do Trabalhador , Atenção Primária à Saúde , Rubéola (Sarampo Alemão)/imunologia , Rubéola (Sarampo Alemão)/prevenção & controle , Vacinação
16.
Pan Afr Med J ; 38: 134, 2021.
Artigo em Francês | MEDLINE | ID: mdl-33912304

RESUMO

Introduction: no one can deny that vaccination against several serious diseases in the world, and particularly in Morocco, has given very satisfactory protective results. The extension of the COVID-19 pandemic in our country has led to a significant decline in childhood immunization, which could have severe repercussions increasing the risk of future outbreaks. Hence, the measures of the Ministry of Health to correct the situation. The purpose of this study was to highlight the extent of vaccine release during COVID-19 pandemic and to make recommendations to restore vaccination programmes. Methods: we conducted a cross-sectional study of the effect of containment measures during this pandemic on the monitoring of children´s vaccinations. We conducted a national survey of pediatricians using an electronic questionnaire administered via Google Forms. We collected, analyzed and interpreted the results. Results: one hundred and three Moroccan pediatricians answered the questionnaire. More than 2-thirds (78.6%) of pediatricians practiced in the private sector and delivered vaccines in the immunization schedule. The majority of pediatricians (95%) were asked about parental vaccine concerns. We noted that 82.5% of parents were reluctant to go to the local health department and 5.8% refused to take vaccination during COVID-19 pandemic. About 22% of pediatricians completely stopped immunization services and 72.8% delayed immunizations from 3 to 4 weeks. Vaccination stoppage involved older children in two thirds of cases. Conclusion: it is essential to maintain public confidence in vaccination. Ongoing and timely assessment of vaccine coverage as well as clear recommendations and broad public awareness are essential to respond to vaccine changes during the COVID-19 pandemic.


Assuntos
Esquemas de Imunização , Vacinação/estatística & dados numéricos , Vacinas/administração & dosagem , Adulto , Estudos Transversais , Feminino , Humanos , Programas de Imunização , Masculino , Pessoa de Meia-Idade , Marrocos , Pais , Pediatras/estatística & dados numéricos , Inquéritos e Questionários , Cobertura Vacinal
17.
Br J Hosp Med (Lond) ; 82(2): 1-4, 2021 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-33646036

RESUMO

The UK government recently decided to extend the interval between the first dose of the Pfizer BioNTech and AstraZeneca COVID-19 vaccines from 3 weeks to 12 weeks to maximise the number of people receiving the initial dose, despite the trials only providing vaccine efficacy data based on a schedule of 21 days between doses. This editorial discusses whether there is evidence to support this policy change.


Assuntos
Imunogenicidade da Vacina , Cobertura Vacinal , Vacinação , /epidemiologia , /prevenção & controle , /imunologia , Esquema de Medicação , Medicina Baseada em Evidências/métodos , Medicina Baseada em Evidências/normas , Regulamentação Governamental , Política de Saúde/legislação & jurisprudência , Humanos , Formulação de Políticas , Reino Unido/epidemiologia , Vacinação/métodos , Vacinação/normas , Vacinação/estatística & dados numéricos , Cobertura Vacinal/métodos , Cobertura Vacinal/normas
19.
Rheumatol Int ; 41(5): 895-902, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33661331

RESUMO

To assess non-compliance and potential changes in seasonal flu vaccination coverage before and during the Covid-19 pandemic in patients with autoimmune rheumatic diseases (ARDs). Consecutive patients with ARDs followed-up in 2 tertiary hospitals were telephone-interviewed (December 12-30, 2020) regarding seasonal flu vaccination during the 2019/20 and 2020/21 time periods. Self-reported disease flares that occurred after flu vaccination, as well as reasons for non-vaccination were recorded. One thousand fifteen patients were included. The rate of flu vaccination increased from 76% before to 83% during the COVID-19 pandemic (p = 0.0001). The rate of self-reported disease flares was < 1% among vaccinated patients. Reasons for not vaccination in both periods, respectively, included: 'was not recommended by their rheumatologists' (35.0vs.12.2%, p < 0.0001), 'did not feel that they would have any benefit' (36.9 vs. 32.6%), felt unsafe to do so (27.5 vs. 30.2%), or other reasons (18.9 vs. 23.8%). By multivariate analysis, age [OR = 1.03 (95% CI 1.02-1.04)] vs. [1.04 (95% CI 1.02-1.05)] and treatment with biologics [OR = 1.66 (95% CI 1.22-2.24) vs. [1.68 (95% CI 1.19-2.38)] were independent factors associated with vaccination in both periods. These findings, although are temporally encouraging, emphasize the need for continuous campaigns aiming at increasing patients' and physicians' awareness about the benefits of vaccination.


Assuntos
Doenças Autoimunes/psicologia , Vacinas contra Influenza/administração & dosagem , Doenças Reumáticas/psicologia , Cobertura Vacinal/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Autoimunes/epidemiologia , Estudos Transversais , Feminino , Humanos , Influenza Humana/prevenção & controle , Masculino , Pessoa de Meia-Idade , Pandemias , Cooperação do Paciente/estatística & dados numéricos , Doenças Reumáticas/epidemiologia , Adulto Jovem
20.
MMWR Morb Mortal Wkly Rep ; 70(12): 431-436, 2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33764963

RESUMO

The U.S. COVID-19 vaccination program began in December 2020, and ensuring equitable COVID-19 vaccine access remains a national priority.* COVID-19 has disproportionately affected racial/ethnic minority groups and those who are economically and socially disadvantaged (1,2). Thus, achieving not just vaccine equality (i.e., similar allocation of vaccine supply proportional to its population across jurisdictions) but equity (i.e., preferential access and administra-tion to those who have been most affected by COVID-19 disease) is an important goal. The CDC social vulnerability index (SVI) uses 15 indicators grouped into four themes that comprise an overall SVI measure, resulting in 20 metrics, each of which has national and state-specific county rankings. The 20 metric-specific rankings were each divided into lowest to highest tertiles to categorize counties as low, moderate, or high social vulnerability counties. These tertiles were combined with vaccine administration data for 49,264,338 U.S. residents in 49 states and the District of Columbia (DC) who received at least one COVID-19 vaccine dose during December 14, 2020-March 1, 2021. Nationally, for the overall SVI measure, vaccination coverage was higher (15.8%) in low social vulnerability counties than in high social vulnerability counties (13.9%), with the largest coverage disparity in the socioeconomic status theme (2.5 percentage points higher coverage in low than in high vulnerability counties). Wide state variations in equity across SVI metrics were found. Whereas in the majority of states, vaccination coverage was higher in low vulnerability counties, some states had equitable coverage at the county level. CDC, state, and local jurisdictions should continue to monitor vaccination coverage by SVI metrics to focus public health interventions to achieve equitable coverage with COVID-19 vaccine.


Assuntos
/administração & dosagem , Disparidades em Assistência à Saúde/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Cobertura Vacinal/estatística & dados numéricos , Populações Vulneráveis , /epidemiologia , Humanos , Programas de Imunização , Avaliação de Programas e Projetos de Saúde , Fatores Socioeconômicos , Estados Unidos/epidemiologia
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