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1.
BMC Public Health ; 21(1): 1629, 2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488705

RESUMO

BACKGROUND: Human papillomavirus (HPV) infection can cause various cancers and can be prevented through vaccination. The American Cancer Society (ACS) has set an HPV vaccination completion target in 13-year-old children to 80% by 2026. While HPV vaccine coverage (proportion ever vaccinated) estimates are available, annual uptakes (proportion initiating vaccine in a year) in the United States (U.S.) are not well-known. METHODS: We analyzed MarketScan® claims database to assess HPV vaccination uptakes in the U.S. among the 9- to 26-year-olds in 2006-2016. The annual uptake was the ratio of the number of enrollees who had a first record of an HPV vaccine during the year, and the number of enrollees of similar age and sex that year. RESULTS: Uptake was below 1% among children turning 9 and 10 years old during the year. Since 2009 among female and since 2013 among males, the annual uptake has been the highest in those turning 13 years old (19.7% among females and 17.6% among males in 2016). Catch-up vaccination among older adolescents and young adults increased after Advisory Committee for Immunization Practices (ACIP) recommendations, but eventually slowed down as more younger persons were vaccinated. Most young adolescents were vaccinated by pediatricians, whereas young adult women were predominantly vaccinated by obstetricians/gynecologists and young adult males by family physicians. While only about half of the adolescents had well-check visits, the majority of those who initiated HPV vaccination had one the same year. CONCLUSION: Continued increase in uptake is needed to reach the ACS 2026 goals.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Adolescente , Comitês Consultivos , Criança , Feminino , Humanos , Masculino , Infecções por Papillomavirus/prevenção & controle , Pediatras , Estados Unidos , Vacinação , Adulto Jovem
3.
MMWR Morb Mortal Wkly Rep ; 70(35): 1183-1190, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34473682

RESUMO

The Advisory Committee on Immunization Practices (ACIP) recommends that adolescents aged 11-12 years routinely receive tetanus, diphtheria, and acellular pertussis (Tdap); meningococcal conjugate (MenACWY); and human papillomavirus (HPV) vaccines. Catch-up vaccination is recommended for hepatitis B (HepB); hepatitis A (HepA); measles, mumps, and rubella (MMR); and varicella (VAR) vaccines for adolescents whose childhood vaccinations are not current. Adolescents are also recommended to receive a booster dose of MenACWY vaccine at age 16 years, and shared clinical decision-making is recommended for the serogroup B meningococcal vaccine (MenB) for persons aged 16-23 years (1). To estimate coverage with recommended vaccines, CDC analyzed data from the 2020 National Immunization Survey-Teen (NIS-Teen) for 20,163 adolescents aged 13-17 years.* Coverage with ≥1 dose of HPV vaccine increased from 71.5% in 2019 to 75.1% in 2020. The percentage of adolescents who were up to date† with HPV vaccination (HPV UTD) increased from 54.2% in 2019 to 58.6% in 2020. Coverage with ≥1 dose of Tdap, ≥1 dose (and among adolescents aged 17 years, ≥2 doses) of MenACWY remained similar to coverage in 2019 (90.1%, 89.3%, and 54.4% respectively). Coverage increased for ≥2 doses of HepA among adolescents aged 13-17 years and ≥1 dose of MenB among adolescents aged 17 years. Adolescents living below the federal poverty level§ had higher HPV vaccination coverage than adolescents living at or above the poverty level. Adolescents living outside a metropolitan statistical area (MSA)¶ had lower coverage with ≥1 MenACWY and ≥1 HPV dose, and a lower proportion being HPV UTD than adolescents in MSA principal cities. In 2020, the COVID-19 pandemic disrupted routine immunization services. Results from the 2020 NIS-Teen reflect adolescent vaccination coverage before the COVID-19 pandemic. The 2020 NIS-Teen data could be used to assess the impact of the COVID-19 pandemic on catch-up vaccination but not on routine adolescent vaccination because adolescents included in the survey were aged ≥13 years, past the age when most routine adolescent vaccines are recommended, and most vaccinations occurred before March 2020. Continued efforts to reach adolescents whose routine medical care has been affected by the COVID-19 pandemic are necessary to protect persons and communities from vaccine-preventable diseases and outbreaks.


Assuntos
Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Vacinas Meningocócicas/administração & dosagem , Vacinas contra Papillomavirus/administração & dosagem , Cobertura Vacinal/estatística & dados numéricos , Adolescente , Comitês Consultivos , COVID-19/epidemiologia , Centers for Disease Control and Prevention, U.S. , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Esquemas de Imunização , Masculino , Guias de Prática Clínica como Assunto , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Vacinas Conjugadas/administração & dosagem
4.
Washington, D.C.; PAHO; 2021-09-14. (PAHO/FPL/IM/COVID-19/21-0038).
em Inglês | PAHO-IRIS | ID: phr-54833

RESUMO

Originally established in 1985 to discuss strategies for polio eradication, PAHO’s Technical Advisory Group (TAG) on Vaccine-Preventable Diseases convened its 26th meeting on 14-16 July 2021 to provide technical recommendations for the Region of the Americas and identify research needs to strengthen immunization programs. PAHO’s Assistant Director, Dr. Jarbas Barbosa da Silva, provided the opening remarks. In the two years since the last TAG meeting, the Region of the Americas has faced numerous public health emergencies. First, the Expanded Program on Immunization (EPI) in the Americas reported additional setbacks in routine vaccination and surveillance performance, reaching a 10% decline in DTP3 coverage over the last 10 years. The Region is at high risk of new and re-emerging outbreaks of vaccine-preventable diseases (VPDs). Second, the ongoing COVID-19 pandemic has put an additional strain on the national EPI and healthcare systems, while deflecting considerable resources to emergency response operations. The combination of public health and social measures and the administration of COVID-19 vaccines are the main tools to mitigate the pandemic and can prevent serious illness and death. PAHO’s priority is to ensure equitable access to COVID-19 vaccines for all people in the Region. The Organization remains committed to providing technical assistance to Member States while they implement national COVID-19 vaccination operations. PAHO intends to use this introduction process to further strengthen national routine immunization programs. The TAG Chair, Dr. Peter Figueroa, opened the meeting by welcoming all participants: TAG members; representatives of national immunization programs; National Immunization Technical Advisory Group (NITAG) presidents; Dr. Alejandro Cravioto, chair of WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization; and all representatives from partner agencies. Dr. Figueroa also took the opportunity to recognize the contributions of health workers and public health officials whose efforts during the pandemic saved lives while maintaining all operations of the national immunization programs. He concluded by issuing a strong call to Member States to act against the spread of VPDs in the time of COVID-19.


Assuntos
COVID-19 , Vacinas contra COVID-19 , Programas de Imunização , Comitês Consultivos , Organização Pan-Americana da Saúde , América
5.
MMWR Recomm Rep ; 70(5): 1-28, 2021 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-34448800

RESUMO

This report updates the 2020-21 recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding the use of seasonal influenza vaccines in the United States (MMWR Recomm Rep 2020;69[No. RR-8]). Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. For each recipient, a licensed and age-appropriate vaccine should be used. ACIP makes no preferential recommendation for a specific vaccine when more than one licensed, recommended, and age-appropriate vaccine is available. During the 2021-22 influenza season, the following types of vaccines are expected to be available: inactivated influenza vaccines (IIV4s), recombinant influenza vaccine (RIV4), and live attenuated influenza vaccine (LAIV4).The 2021-22 influenza season is expected to coincide with continued circulation of SARS-CoV-2, the virus that causes COVID-19. Influenza vaccination of persons aged ≥6 months to reduce prevalence of illness caused by influenza will reduce symptoms that might be confused with those of COVID-19. Prevention of and reduction in the severity of influenza illness and reduction of outpatient visits, hospitalizations, and intensive care unit admissions through influenza vaccination also could alleviate stress on the U.S. health care system. Guidance for vaccine planning during the pandemic is available at https://www.cdc.gov/vaccines/pandemic-guidance/index.html. Recommendations for the use of COVID-19 vaccines are available at https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/covid-19.html, and additional clinical guidance is available at https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html.Updates described in this report reflect discussions during public meetings of ACIP that were held on October 28, 2020; February 25, 2021; and June 24, 2021. Primary updates to this report include the following six items. First, all seasonal influenza vaccines available in the United States for the 2021-22 season are expected to be quadrivalent. Second, the composition of 2021-22 U.S. influenza vaccines includes updates to the influenza A(H1N1)pdm09 and influenza A(H3N2) components. U.S.-licensed influenza vaccines will contain hemagglutinin derived from an influenza A/Victoria/2570/2019 (H1N1)pdm09-like virus (for egg-based vaccines) or an influenza A/Wisconsin/588/2019 (H1N1)pdm09-like virus (for cell culture-based and recombinant vaccines), an influenza A/Cambodia/e0826360/2020 (H3N2)-like virus, an influenza B/Washington/02/2019 (Victoria lineage)-like virus, and an influenza B/Phuket/3073/2013 (Yamagata lineage)-like virus. Third, the approved age indication for the cell culture-based inactivated influenza vaccine, Flucelvax Quadrivalent (ccIIV4), has been expanded from ages ≥4 years to ages ≥2 years. Fourth, discussion of administration of influenza vaccines with other vaccines includes considerations for coadministration of influenza vaccines and COVID-19 vaccines. Providers should also consult current ACIP COVID-19 vaccine recommendations and CDC guidance concerning coadministration of these vaccines with influenza vaccines. Vaccines that are given at the same time should be administered in separate anatomic sites. Fifth, guidance concerning timing of influenza vaccination now states that vaccination soon after vaccine becomes available can be considered for pregnant women in the third trimester. As previously recommended, children who need 2 doses (children aged 6 months through 8 years who have never received influenza vaccine or who have not previously received a lifetime total of ≥2 doses) should receive their first dose as soon as possible after vaccine becomes available to allow the second dose (which must be administered ≥4 weeks later) to be received by the end of October. For nonpregnant adults, vaccination in July and August should be avoided unless there is concern that later vaccination might not be possible. Sixth, contraindications and precautions to the use of ccIIV4 and RIV4 have been modified, specifically with regard to persons with a history of severe allergic reaction (e.g., anaphylaxis) to an influenza vaccine. A history of a severe allergic reaction to a previous dose of any egg-based IIV, LAIV, or RIV of any valency is a precaution to use of ccIIV4. A history of a severe allergic reaction to a previous dose of any egg-based IIV, ccIIV, or LAIV of any valency is a precaution to use of RIV4. Use of ccIIV4 and RIV4 in such instances should occur in an inpatient or outpatient medical setting under supervision of a provider who can recognize and manage a severe allergic reaction; providers can also consider consulting with an allergist to help identify the vaccine component responsible for the reaction. For ccIIV4, history of a severe allergic reaction (e.g., anaphylaxis) to any ccIIV of any valency or any component of ccIIV4 is a contraindication to future use of ccIIV4. For RIV4, history of a severe allergic reaction (e.g., anaphylaxis) to any RIV of any valency or any component of RIV4 is a contraindication to future use of RIV4. This report focuses on recommendations for the use of vaccines for the prevention and control of seasonal influenza during the 2021-22 influenza season in the United States. A brief summary of the recommendations and a link to the most recent Background Document containing additional information are available at https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/flu.html. These recommendations apply to U.S.-licensed influenza vaccines used according to Food and Drug Administration-licensed indications. Updates and other information are available from CDC's influenza website (https://www.cdc.gov/flu); vaccination and health care providers should check this site periodically for additional information.


Assuntos
Imunização/normas , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Guias de Prática Clínica como Assunto , Adolescente , Adulto , Comitês Consultivos , Idoso , COVID-19/epidemiologia , Centers for Disease Control and Prevention, U.S. , Criança , Pré-Escolar , Feminino , Humanos , Esquemas de Imunização , Lactente , Influenza Humana/epidemiologia , Masculino , Pessoa de Meia-Idade , Gravidez , Estações do Ano , Estados Unidos/epidemiologia , Adulto Jovem
6.
Ann Intern Med ; 174(8): JC86, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34339228

RESUMO

SOURCE CITATION: US Preventive Services Task Force; Krist AH, Davidson KW, et al. Screening for lung cancer: US Preventive Services Task Force recommendation statement. JAMA. 2021;325:962-70. 33687470.


Assuntos
Detecção Precoce de Câncer , Neoplasias Pulmonares , Adulto , Comitês Consultivos , Humanos , Neoplasias Pulmonares/diagnóstico , Programas de Rastreamento , Serviços Preventivos de Saúde
10.
MMWR Morb Mortal Wkly Rep ; 70(32): 1094-1099, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34383735

RESUMO

In December 2020, the Food and Drug Administration (FDA) issued Emergency Use Authorizations (EUAs) for Pfizer-BioNTech and Moderna COVID-19 vaccines, and in February 2021, FDA issued an EUA for the Janssen (Johnson & Johnson) COVID-19 vaccine. After each EUA, the Advisory Committee on Immunization Practices (ACIP) issued interim recommendations for vaccine use; currently Pfizer-BioNTech is authorized and recommended for persons aged ≥12 years and Moderna and Janssen for persons aged ≥18 years (1-3). Both Pfizer-BioNTech and Moderna vaccines, administered as 2-dose series, are mRNA-based COVID-19 vaccines, whereas the Janssen COVID-19 vaccine, administered as a single dose, is a recombinant replication-incompetent adenovirus-vector vaccine. As of July 22, 2021, 187 million persons in the United States had received at least 1 dose of COVID-19 vaccine (4); close monitoring of safety surveillance has demonstrated that serious adverse events after COVID-19 vaccination are rare (5,6). Three medical conditions have been reported in temporal association with receipt of COVID-19 vaccines. Two of these (thrombosis with thrombocytopenia syndrome [TTS], a rare syndrome characterized by venous or arterial thrombosis and thrombocytopenia, and Guillain-Barré syndrome [GBS], a rare autoimmune neurologic disorder characterized by ascending weakness and paralysis) have been reported after Janssen COVID-19 vaccination. One (myocarditis, cardiac inflammation) has been reported after Pfizer-BioNTech COVID-19 vaccination or Moderna COVID-19 vaccination, particularly after the second dose; these were reviewed together and will hereafter be referred to as mRNA COVID-19 vaccination. ACIP has met three times to review the data associated with these reports of serious adverse events and has comprehensively assessed the benefits and risks associated with receipt of these vaccines. During the most recent meeting in July 2021, ACIP determined that, overall, the benefits of COVID-19 vaccination in preventing COVID-19 morbidity and mortality outweigh the risks for these rare serious adverse events in adults aged ≥18 years; this balance of benefits and risks varied by age and sex. ACIP continues to recommend COVID-19 vaccination in all persons aged ≥12 years. CDC and FDA continue to closely monitor reports of serious adverse events and will present any additional data to ACIP for consideration. Information regarding risks and how they vary by age and sex and type of vaccine should be disseminated to providers, vaccine recipients, and the public.


Assuntos
Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/efeitos adversos , COVID-19/prevenção & controle , Imunização/normas , Guias de Prática Clínica como Assunto , Adulto , Sistemas de Notificação de Reações Adversas a Medicamentos , Comitês Consultivos , COVID-19/epidemiologia , Aprovação de Drogas , Humanos , Estados Unidos/epidemiologia , Vacinas Sintéticas
13.
Indian Pediatr ; 58(7): 647-649, 2021 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-34315833

RESUMO

JUSTIFICATION: In India, till recently, breastfeeding women have been excluded from the coronavirus disease (COVID-19) vaccination program, rendering a significant population of the country, including frontline workers, ineligible to derive the benefits of the COVID-19 vaccine rollout. OBJECTIVE: The objective of this recommendation is production of an evidence-based document to guide the pediatricians to give advice to breastfeeding mothers regarding the safety of COVID-19 vaccines in lactating women. PROCESS: Formulation of key question was done under the chairmanship of president of the IAP. It was followed by review of literature regarding efficacy and safety of COVID-19 vaccines in breastfeeding women. The recommendations of other international and national professional bodies were also deliberated in detail. The available data was discussed in the ACVIP focused WhatsApp group. Opinion of all members was taken and the final document was prepared after achieving consensus. RECOMMENDATIONS: The IAP/ACVIP recommends the administration of COVID-19 vaccines to all breastfeeding women. The IAP/ACVIP endorses the recent recommendation of the Government of India, to consider all breastfeeding women as eligible for COVID-19 vaccination.


Assuntos
COVID-19 , Pediatria , Comitês Consultivos , Aleitamento Materno , Vacinas contra COVID-19 , Criança , Feminino , Humanos , Imunização , Esquemas de Imunização , Lactação , SARS-CoV-2 , Vacinação
19.
MMWR Morb Mortal Wkly Rep ; 70(27): 977-982, 2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34237049

RESUMO

In December 2020, the Food and Drug Administration (FDA) issued Emergency Use Authorizations (EUAs) for the Pfizer-BioNTech COVID-19 (BNT162b2) vaccine and the Moderna COVID-19 (mRNA-1273) vaccine,† and the Advisory Committee on Immunization Practices (ACIP) issued interim recommendations for their use in persons aged ≥16 years and ≥18 years, respectively.§ In May 2021, FDA expanded the EUA for the Pfizer-BioNTech COVID-19 vaccine to include adolescents aged 12-15 years; ACIP recommends that all persons aged ≥12 years receive a COVID-19 vaccine. Both Pfizer-BioNTech and Moderna vaccines are mRNA vaccines encoding the stabilized prefusion spike glycoprotein of SARS-CoV-2, the virus that causes COVID-19. Both mRNA vaccines were authorized and recommended as a 2-dose schedule, with second doses administered 21 days (Pfizer-BioNTech) or 28 days (Moderna) after the first dose. After reports of myocarditis and pericarditis in mRNA vaccine recipients,¶ which predominantly occurred in young males after the second dose, an ACIP meeting was rapidly convened to review reported cases of myocarditis and pericarditis and discuss the benefits and risks of mRNA COVID-19 vaccination in the United States. Myocarditis is an inflammation of the heart muscle; if it is accompanied by pericarditis, an inflammation of the thin tissue surrounding the heart (the pericardium), it is referred to as myopericarditis. Hereafter, myocarditis is used to refer to myocarditis, pericarditis, or myopericarditis. On June 23, 2021, after reviewing available evidence including that for risks of myocarditis, ACIP determined that the benefits of using mRNA COVID-19 vaccines under the FDA's EUA clearly outweigh the risks in all populations, including adolescents and young adults. The EUA has been modified to include information on myocarditis after receipt of mRNA COVID-19 vaccines. The EUA fact sheets should be provided before vaccination; in addition, CDC has developed patient and provider education materials about the possibility of myocarditis and symptoms of concern, to ensure prompt recognition and management of myocarditis.


Assuntos
Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/efeitos adversos , Imunização/normas , Miocardite/epidemiologia , Guias de Prática Clínica como Assunto , Vacinas Sintéticas/administração & dosagem , Vacinas Sintéticas/efeitos adversos , Adolescente , Adulto , Sistemas de Notificação de Reações Adversas a Medicamentos , Comitês Consultivos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Centers for Disease Control and Prevention, U.S. , Criança , Feminino , Humanos , Masculino , Estados Unidos/epidemiologia , Adulto Jovem
20.
Acta Gastroenterol Belg ; 84(2): 347-359, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34217187

RESUMO

Liver transplantation (LT) remains the only curative option for patients suffering from end-stage liver disease, acute liver failure and selected hepatocellular carcinomas and access to the LT-waiting list is limited to certain strict indications. However, LT has shown survival advantages for patients in certain indications such as acute alcoholic hepatitis, hepatocellular carcinoma outside Milan criteria and colorectal cancer metastases. These newer indications increase the pressure in an already difficult context of organ shortage. Strategies to increase the transplantable organ pool are therefore needed. We will discuss here the use of HCV positive grafts as the use of normothermic isolated liver perfusion. Belgian Liver Intestine Advisory Committee (BeLIAC) from the Belgian Transplant Society (BTS) aims to guarantee the balance between the new indications and the available resources.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Transplante de Fígado , Comitês Consultivos , Bélgica , Humanos , Intestinos
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