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1.
Artigo em Inglês | MEDLINE | ID: mdl-31738866

RESUMO

The Influenza Complications Alert Network (FluCAN) is a sentinel hospital-based surveillance program that operates at sites in all jurisdictions in Australia. This report summarises the epidemiology of hospitalisations with laboratory-confirmed influenza during the 2018 influenza season. In this observational surveillance system, cases were defined as patients admitted to any of the 17 sentinel hospitals with influenza confirmed by nucleic acid detection. Data were also collected on a frequency-matched control group of influenza-negative patients admitted with acute respiratory infection. During the period 3 April to 31 October 2018 (the 2018 influenza season), 769 patients were admitted with confirmed influenza to one of 17 FluCAN sentinel hospitals. Of these, 30% were elderly (≥65 years), 28% were children (<16 years), 6.4% were Aboriginal and Torres Strait Islander peoples, 2.2% were pregnant and 66% had chronic comorbidities. A small proportion of FluCAN admissions were due to influenza B (13%). Estimated vaccine coverage was 77% in the elderly (≥65 years), 45% in non-elderly adults with medical comorbidities and 26% in children (<16 years) with medical comorbidities. The estimated vaccine effectiveness (VE) in the target population was 52% (95% CI: 37%, 63%). There were a smaller number of hospital admissions detected with confirmed influenza in this national observational surveillance system in 2018 than in 2017, with the demographic profile reflecting the change in circulating subtype from A/H3N2 to A/H1N1.


Assuntos
Vírus da Influenza A Subtipo H1N1/imunologia , Vírus da Influenza A Subtipo H3N2/imunologia , Vacinas contra Influenza/imunologia , Influenza Humana/epidemiologia , Cobertura Vacinal , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Relatórios Anuais como Assunto , Austrália/epidemiologia , Estudos de Casos e Controles , Feminino , Hospitalização , Hospitais , Humanos , Influenza Humana/prevenção & controle , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Gravidez , Vigilância de Evento Sentinela , Adulto Jovem
2.
Artigo em Inglês | MEDLINE | ID: mdl-31738867

RESUMO

Introduction: Maternal influenza vaccination was introduced in 2010 due to the high morbidity and mortality associated with influenza in pregnancy. The aim of this study was to assess the maternal influenza vaccination uptake in Northern Territory public hospitals and identify gaps to improve uptake. Methods: Birth data from Northern Territory (NT) public hospitals obtained from the Perinatal Register for deliveries in 2016 were merged with vaccination records from the NT immunisation register. Results: There were 3,392 viable pregnancies in NT public hospitals in 2016 with 45.6% vaccination coverage against influenza. There was a statistically significant difference in coverage with 68.5% in Indigenous vs 31.7% in non-Indigenous deliveries (p < 0.001), yielding an odds ratio of 4.67 (95% CI 4.02, 5.42) for maternal influenza vaccination across Indigenous status. Influenza vaccination coverage for preterm births (< 37 weeks) was low especially in non-Indigenous mothers at 27.2% vs 65.05% in Indigenous mothers (p < 0.001). A distinct immunisation administration pattern was noted for 2016 with 58.9% of vaccinations occurring between April and June regardless of Indigenous status and maternal gestational age. This correlated with the annual influenza immunisation campaign by the NT and Commonwealth. Conclusion: A year-round maternal influenza vaccination campaign is crucial to avoid missed opportunities and increase vaccination protection for mother and baby. Antenatal influenza vaccination campaign with health care workers education and increasing patient awareness should continue throughout the year.


Assuntos
Programas de Imunização , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Cobertura Vacinal , Vacinação , Adolescente , Adulto , Feminino , Humanos , Influenza Humana/virologia , Pessoa de Meia-Idade , Mães , Northern Territory , Grupo com Ancestrais Oceânicos , Gravidez , Sistema de Registros , Estudos Retrospectivos , Adulto Jovem
3.
Medicine (Baltimore) ; 98(47): e18035, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31764822

RESUMO

Chronic obstructive pulmonary disease (COPD) patients are at a higher risk of development of lung cancer. Frequent exacerbations of COPD trigger the disease course to chronic inflammation which likely plays a role in the pathogenesis of lung cancer. Previous studies showed influenza virus infection is one of important causes for exacerbations of COPD. Therefore, the aim of this study was to know whether influenza vaccination could reduce the incidence of lung cancer in patients with COPD.This cohort study enrolled patients (≥55 years old) with a recorded diagnosis of COPD between January 1, 2000 and December 31, 2012 by using the Taiwan Health Insurance Database. A propensity score was calculated to reduce vaccine therapy selection bias. Cox proportional hazard regressions were used to investigate the association between the influenza vaccination and lung cancer incidence after adjusting for known confounding factors. Besides, we categorized the patients into 4 groups according to vaccination status (unvaccinated, total number of vaccinations: 1, 2-3, ≥4) to evaluate the dose-dependent effect on reducing lung cancer occurrence of lung cancer in COPD patients.Our study comprised of 28,752 eligible individuals from the COPD cohort database. Among them, 51% (14,630) received influenza vaccination; the rest (49%) of the COPD patients did not receive influenza vaccination. We observed that COPD patients receiving influenza vaccination had a lower risk of lung cancer (adjusted HR = 0.40, 95% CI (0.35-0.45), P < .001). We also founded comparable protective effect in both sexes and all age groups (55-64, 65-74, ≥75) regardless of influenza seasonality. Furthermore, dose-dependent protective effect could be seen after stratifying patients according to the total number vaccinations, the adjusted HRs for lung cancer risk were 0.48 (0.40-0.54) and 0.24 (0.20-0.29) for patients who received 2 to 3 and ≥4 vaccinations during the follow-up period.This population-based cohort study demonstrated that annual influenza vaccination administration could reduce incidence of lung cancer in COPD patients.


Assuntos
Vacinas contra Influenza/uso terapêutico , Influenza Humana/complicações , Influenza Humana/prevenção & controle , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/prevenção & controle , Doença Pulmonar Obstrutiva Crônica/complicações , Idoso , Estudos de Coortes , Progressão da Doença , Feminino , Humanos , Esquemas de Imunização , Incidência , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade
4.
MMWR Morb Mortal Wkly Rep ; 68(40): 885-892, 2019 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-31600186

RESUMO

INTRODUCTION: Vaccinating pregnant women with influenza vaccine and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) can reduce influenza and pertussis risk for themselves and their infants. METHODS: Surveillance data were analyzed to ascertain influenza-associated hospitalization among pregnant women and infant hospitalization and death associated with influenza and pertussis. An Internet panel survey was conducted during March 27-April 8, 2019, among women aged 18-49 years who reported being pregnant any time since August 1, 2018. Influenza vaccination before or during pregnancy was assessed among respondents with known influenza vaccination status who were pregnant any time during October 2018-January 2019 (2,097). Tdap receipt during pregnancy was assessed among respondents with known Tdap status who reported a live birth by their survey date (817). RESULTS: From 2010-11 to 2017-18, pregnant women accounted for 24%-34% of influenza-associated hospitalizations per season among females aged 15-44 years. From 2010 to 2017, a total of 3,928 pertussis-related hospitalizations were reported among infants aged <2 months (annual range = 262-743). Maternal influenza and Tdap vaccination coverage rates reported as of April 2019 were 53.7% and 54.9%, respectively. Among women whose health care providers offered vaccination or provided referrals, 65.7% received influenza vaccine and 70.5% received Tdap. The most commonly reported reasons for nonvaccination were believing the vaccine is not effective (influenza; 17.6%) and not knowing that vaccination is needed during each pregnancy (Tdap; 37.9%), followed by safety concerns for the infant (influenza =15.9%; Tdap = 17.1%). CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: Many pregnant women do not receive the vaccines recommended to protect themselves and their infants, even when vaccination is offered. CDC and provider organizations' resources are available to help providers convey strong, specific recommendations for influenza and Tdap vaccination that are responsive to pregnant women's concerns.


Assuntos
Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Coqueluche/epidemiologia , Coqueluche/prevenção & controle , Adolescente , Adulto , Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Feminino , Humanos , Lactente , Recém-Nascido , Vacinas contra Influenza/administração & dosagem , Pessoa de Meia-Idade , Gravidez , Estados Unidos/epidemiologia , Vacinação/estatística & dados numéricos , Adulto Jovem
5.
Int J Nanomedicine ; 14: 7533-7548, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31571862

RESUMO

Background: The influenza A virus (IAV) is known for its high variability and poses a huge threat to the health of humans and animals. Pigs play a central role in the cross-species reassortment of IAV. Ectodomain of matrix protein 2 (M2e) is the most conserved protective antigen in IAV and can be used to develop nanovaccines through nanoparticles displaying to increase its immunogenicity. However, the high immunogenicity of nanoparticles can cause the risk of off-target immune response, and excess unwanted antibodies may interfere with the protective efficacy of M2e-specific antibodies. Therefore, it is necessary to select reasonable nanoparticles to make full use of antibodies against nanoparticles while increasing the level of M2e-specific antibodies. Porcine circovirus type 2 (PCV2) is the most susceptible virus in pigs and can promote IAV infection. It is meaningful to develop a vaccine that can simultaneously control swine influenza virus (SIV) and PCV2. Methods: In the present study, M2e of different copy numbers were inserted into the capsid (Cap) protein of PCV2 and expressed in Escherichia coli to form self-assembled chimeric virus-like particles (VLPs) nanovaccine. BALB/c mice and pigs were immunized with these nanovaccines to explore optimal anti-IAV and anti-PCV2 immunity. Results: Cap is capable of carrying at least 81 amino acid residues (three copies of M2e) at its C-terminal without impairing VLPs formation. Cap-3M2e VLPs induced the highest levels of M2e-specific immune responses, conferring protection against lethal challenge of IAVs from different species and induced specific immune responses consistent with PCV2 commercial vaccines in mice. In addition, Cap-3M2e VLPs induced high levels of M2e-specific antibodies and PCV2-specific neutralizing antibodies in pigs. Conclusion: Cap-3M2e VLP is an economical and promising bivalent nanovaccine, which provides dual protection against IAV and PCV2.


Assuntos
Circovirus/imunologia , Vírus da Influenza A/imunologia , Nanopartículas/uso terapêutico , Infecções por Orthomyxoviridae/imunologia , Infecções por Orthomyxoviridae/prevenção & controle , Vacinas Virais/imunologia , Animais , Anticorpos Antivirais/imunologia , Formação de Anticorpos/imunologia , Especificidade de Anticorpos/imunologia , Aves/virologia , Proteínas do Capsídeo/química , Proliferação de Células , Citocinas/metabolismo , Cães , Feminino , Humanos , Imunidade Humoral , Influenza Aviária/imunologia , Influenza Aviária/prevenção & controle , Influenza Aviária/virologia , Influenza Humana/imunologia , Influenza Humana/prevenção & controle , Influenza Humana/virologia , Linfócitos/citologia , Células Madin Darby de Rim Canino , Camundongos Endogâmicos BALB C , Testes de Neutralização , Proteínas Recombinantes/isolamento & purificação , Suínos , Vírion/imunologia , Vírion/ultraestrutura
6.
Internist (Berl) ; 60(11): 1127-1135, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31478058

RESUMO

BACKGROUND: The influenza virus (IV)-associated mortality and morbidity remains high in Europe. OBJECTIVE: This article gives an overview of the pathogenesis, diagnostics and treatment optimization strategies according to the currently existing guidelines and clinical trials. MATERIAL AND METHODS: Literature search and analysis of national and international guidelines for the epidemiology, diagnostics, treatment and prevention of IV infections. RESULTS AND CONCLUSION: Although the incidence of IV infections remains underrecognized, it is the leading infectious disease-associated cause of mortality and morbidity in Europe. Viruses are mainly transmitted by aerosol inhalation and can cause a wide spectrum of symptoms, ranging from mild signs of a cold to severe respiratory failure requiring mechanical ventilation. The clinical diagnosis should be verified through a PCR-based test in patients with indications for treatment. Neuraminidase inhibitors are currently the treatment of choice for IV infections. Seasonal influenza vaccination is an efficient preventive method. It is therefore imperative to improve vaccination rates in Germany, which have been continuously declining since the pandemic of 2009/2010.


Assuntos
Antivirais/uso terapêutico , Vacinas contra Influenza/administração & dosagem , Influenza Humana/tratamento farmacológico , Influenza Humana/prevenção & controle , Neuraminidase/uso terapêutico , Europa (Continente)/epidemiologia , Humanos , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Morbidade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/tratamento farmacológico , Síndrome do Desconforto Respiratório do Adulto
7.
JAMA ; 322(9): 824-833, 2019 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-31479137

RESUMO

Importance: Clinical studies have been inconclusive about the effectiveness of N95 respirators and medical masks in preventing health care personnel (HCP) from acquiring workplace viral respiratory infections. Objective: To compare the effect of N95 respirators vs medical masks for prevention of influenza and other viral respiratory infections among HCP. Design, Setting, and Participants: A cluster randomized pragmatic effectiveness study conducted at 137 outpatient study sites at 7 US medical centers between September 2011 and May 2015, with final follow-up in June 2016. Each year for 4 years, during the 12-week period of peak viral respiratory illness, pairs of outpatient sites (clusters) within each center were matched and randomly assigned to the N95 respirator or medical mask groups. Interventions: Overall, 1993 participants in 189 clusters were randomly assigned to wear N95 respirators (2512 HCP-seasons of observation) and 2058 in 191 clusters were randomly assigned to wear medical masks (2668 HCP-seasons) when near patients with respiratory illness. Main Outcomes and Measures: The primary outcome was the incidence of laboratory-confirmed influenza. Secondary outcomes included incidence of acute respiratory illness, laboratory-detected respiratory infections, laboratory-confirmed respiratory illness, and influenzalike illness. Adherence to interventions was assessed. Results: Among 2862 randomized participants (mean [SD] age, 43 [11.5] years; 2369 [82.8%]) women), 2371 completed the study and accounted for 5180 HCP-seasons. There were 207 laboratory-confirmed influenza infection events (8.2% of HCP-seasons) in the N95 respirator group and 193 (7.2% of HCP-seasons) in the medical mask group (difference, 1.0%, [95% CI, -0.5% to 2.5%]; P = .18) (adjusted odds ratio [OR], 1.18 [95% CI, 0.95-1.45]). There were 1556 acute respiratory illness events in the respirator group vs 1711 in the mask group (difference, -21.9 per 1000 HCP-seasons [95% CI, -48.2 to 4.4]; P = .10); 679 laboratory-detected respiratory infections in the respirator group vs 745 in the mask group (difference, -8.9 per 1000 HCP-seasons, [95% CI, -33.3 to 15.4]; P = .47); 371 laboratory-confirmed respiratory illness events in the respirator group vs 417 in the mask group (difference, -8.6 per 1000 HCP-seasons [95% CI, -28.2 to 10.9]; P = .39); and 128 influenzalike illness events in the respirator group vs 166 in the mask group (difference, -11.3 per 1000 HCP-seasons [95% CI, -23.8 to 1.3]; P = .08). In the respirator group, 89.4% of participants reported "always" or "sometimes" wearing their assigned devices vs 90.2% in the mask group. Conclusions and Relevance: Among outpatient health care personnel, N95 respirators vs medical masks as worn by participants in this trial resulted in no significant difference in the incidence of laboratory-confirmed influenza. Trial Registration: ClinicalTrials.gov Identifier: NCT01249625.


Assuntos
Pessoal de Saúde , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Influenza Humana/prevenção & controle , Influenza Humana/transmissão , Máscaras , Dispositivos de Proteção Respiratória , Adulto , Assistência Ambulatorial , Feminino , Humanos , Incidência , Controle de Infecções/métodos , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional , Infecções Respiratórias/prevenção & controle , Infecções Respiratórias/transmissão
8.
Artigo em Inglês | MEDLINE | ID: mdl-31426733

RESUMO

Remote-living Aboriginal and Torres Strait Islander women experience a higher burden of influenza infection during pregnancy than any other Australian women. Despite recommendations of inactivated influenza vaccination (IIV) in pregnancy, uptake and safety data are scarce for this population. We examined uptake of IIV in pregnancy and report adverse birth outcomes amongst a predominantly unvaccinated group of remote-living Aboriginal and Torres Strait Islander women from the Northern Territory (NT), using data from the 1+1 Healthy Start to Life study. Data were deterministically linked with the NT Immunisation Register to ascertain IIV exposure in pregnant women during 2003-2006 and 2009-2011 inclusive. Overall, IIV uptake in pregnancy was 3% (n=20/697 pregnancies); 0% (0/414) pre-influenza A(H1N1)pdm09 and 7% (20/293) post-influenza A(H1N1)pdm09 (2009-2011). Vaccine uptake was poor in this cohort and it is unclear at what stage this policy failure occurred. Women with known comorbidities and/or high risk factors were not targeted for vaccination. Much larger study participant numbers are required to validate between group comparisons but there was no clinically nor statistically significant difference in median gestational ages (38 weeks for both groups), mean infant birthweights (3,001 g unvaccinated vs 3,175 g IIV vaccinated), nor birth outcomes between the few women who received IIV in pregnancy and those who did not. There were no stillbirths in women who received an IIV in pregnancy.


Assuntos
Imunização , Influenza Humana/prevenção & controle , Mães , Vacinação , Adolescente , Adulto , Austrália/epidemiologia , Estudos de Coortes , Comorbidade , Feminino , Humanos , Lactente , Vírus da Influenza A Subtipo H1N1 , Vacinas contra Influenza , Influenza Humana/epidemiologia , Grupo com Ancestrais Oceânicos , Gravidez , Fatores de Risco , Adulto Jovem
9.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(8): 840-842, 2019 Aug 06.
Artigo em Chinês | MEDLINE | ID: mdl-31378046

RESUMO

In this study, the swabs were collected among patients with an influenza-like illness (ILI) admitted to 2 sentinel surveillance hospitals of Yantai from April 2014 to August 2017. All specimen were cultured and identified by hemagglutination inhibition assay. Complete sequences of Hemagglutinin (HA) of influenza A were amplified, sequenced and analyzed using molecular and phylogenetic methods. The potential vaccine efficacy were calculated using Pepitope model. The results showed that the antigenicity of A (H3N2) had changed greatly. 8 strains of influenza A (H1N1) pdm09 belonged to subclade 6B.1 and 14 strains clustered in 6B.2. 12 strains of influenza A (H3N2) fell into subgroup 3C.3a and 33 strains clustered in 3C.2a. Several residues at antigen sites and potential glycosylation sites had changed in influenza A strains. Vaccine efficacy of influenza A (H1N1) pdm09 in 2015/2016 and 2016/2017 seasons were 77.29% and 79.11% of that of a perfect match with vaccine strain, meanwhile vaccine efficacy of influenza A (H3N2) in 2014/2015, 2015/2016 and 2016/2017 were-5.18%, 16.97% and 42.05% separately. In conclusion, the influenza A virus circulated in Yantai from 2014 to 2017 presented continual genetic variation. The recommended vaccine strains still afforded protection against influenza A (H1N1) pdm09 strains and provided suboptimal protection against influenza A (H3N2) strains.


Assuntos
Vírus da Influenza A Subtipo H1N1/genética , Vírus da Influenza A Subtipo H3N2/genética , Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Potência de Vacina , China , Glicoproteínas de Hemaglutininação de Vírus da Influenza , Humanos , Filogenia , RNA Viral
10.
Pol Merkur Lekarski ; 47(277): 5-13, 2019 Jul 29.
Artigo em Polonês | MEDLINE | ID: mdl-31385940

RESUMO

Medical personnel, including nursing staff, can become a source of influenza virus infections for their patients and co-workers. However, patients can infect the personnel, too. Therefore, influenza vaccinations are recommended for medical staff as an effective and safe form of preventing influenza and its complications. AIM: The aim of the study was to evaluate the current influenza vaccine coverage rate in nursing personnel and identify of incentives and disincentives for the performance of influenza vaccinations in nursing staff. MATERIALS AND METHODS: The cross sectional study was carried out a group of 770 nurses, using the research questionnaire, previously validated. RESULTS: The influenza vaccine coverage rate in the study group was 15%. The probability of having a vaccination this season and in the previous seasons was higher in medical staff working in out-patient health care (p <0.05, OR 5.15, 95% CI 3.33-7.96), with work experience >40 years (p <0 , 05, OR 6.93, 95% CI 2.04-23.78), dealing with chronic diseases (p <0.05, OR 1.57, 95% CI 1.00-2.46). The most important encouraging factor for influenza vaccination was that the employer paid for the vaccine available in the workplace, the desire to protect oneself from the disease, the belief in the safety and efficacy of the vaccine. The most important factor discouraging vaccination against influenza was the lack of reimbursement of the vaccine and the inconvenience of its implementation in the workplace, as well as doubts related to the safety and effectiveness of the vaccine. CONCLUSIONS: The influenza vaccine coverage rate is very low and certain activities should be undertaken to increase it. Measures taken to increase the influenza vaccine coverage rate for nursing staff should be targeted and include identified disincentives and incentives for vaccination.


Assuntos
Vacinas contra Influenza , Influenza Humana , Enfermeiras e Enfermeiros , Estudos Transversais , Humanos , Influenza Humana/prevenção & controle , Polônia , Vacinação
11.
Rev Esp Salud Publica ; 932019 Aug 08.
Artigo em Espanhol | MEDLINE | ID: mdl-31391453

RESUMO

OBJECTIVE: Healthcare professionals is one of the risk groups to which influenza vaccination is recommended. The main objective was to know the attitudes of healthcare professionals about influenza vaccination in the Principality of Asturias' reference centre during the campaign 2017-2018. METHODS: We carried out a cross-sectional study between September 2017 and May 2018, using a questionnaire. Sociodemographic variables and reasons for accepting or refuse the influenza vaccination were studied. For descriptive analysis we used the mean, mode, standard deviation, range, frequencies and percentages. The comparison between vaccinated and unvaccinated was made by the Chi square test, Saphiro-Wilk test and U Mann-Whitney test. RESULTS: The sample was formed by 518 participants, finally resulted a 29.53% vaccination rate. The principal reason for accepting the vaccine was its efficacy (average on the Likert scale of 4.11 out of 5), while the main reason for not vaccination was the lack of interest (mean=3.41 out of 5). It confirmed relationship between the type of contract and the professional category, the lower vaccination was in the temporary staff (p=0.003) and the nursing profession (p<0.001). We also found association between professionals that used to receive the vaccine in all the campaigns (p<0.001) and those who received the immunization in their workplace (p=0.002). Finally, the profession (p=0.014) and the family (p<0.001) also were influential in the decision of the immunized. CONCLUSIONS: The vaccination rate of the professionals who work in the Asturias´ reference hospital is similar to that of other health centres in Spain, but it is below the objective set by the World Health Organization. The previous contact with the influenza immunization, a positive working environment respecting the vaccine and the promotion of information, could be favourable factors in the vaccinal decision of the health workers.


Assuntos
Atitude do Pessoal de Saúde , Pessoal de Saúde/estatística & dados numéricos , Programas de Imunização , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Vacinação/estatística & dados numéricos , Local de Trabalho , Adulto , Estudos Transversais , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Espanha , Inquéritos e Questionários , Centros de Atenção Terciária , Organização Mundial da Saúde
12.
Drugs ; 79(12): 1337-1348, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31372959

RESUMO

Manufacturing influenza virus vaccines using a mammalian cell line rather than embryonated chicken eggs may carry certain advantages. A quadrivalent inactivated influenza virus vaccine produced using the Madin Darby canine kidney cell line has been approved in the EU (Flucelvax® Tetra) and USA (Flucelvax Quadrivalent®; QIVc hereafter) for the prevention of influenza in adults and children. The clinical development of QIVc has built upon that of a cell-based trivalent influenza virus vaccine (TIVc) manufactured using the same processes; the additional influenza B strain contained in QIVc reduces the risk of the strain in the vaccine not matching that in circulation. Pivotal phase III clinical trials in adult and paediatric participants have demonstrated the immunogenicity of QIVc to be noninferior to that of TIVc formulations against shared strains and superior against the influenza B strain absent from each TIVc formulation. Protective efficacy data for TIVc is considered foundational for QIVc and, in a phase III clinical trial, TIVc was effective in protecting adults against antigenically matched influenza strains. Large real-world studies from the 2017/2018 US influenza season further support the prophylactic effectiveness of QIVc, with possible benefits over egg-based vaccines. QIVc was generally well tolerated in clinical trials. In adult and paediatric QIVc recipients, the most common solicited adverse reactions were injection site pain and headache. Reactogenicity was comparable to that of TIVc; no safety signals unique to QIVc emerged. Through circumventing concerns around egg adaptation, QIVc has the potential to be more effective than currently available egg-based quadrivalent vaccines.


Assuntos
Vacinas contra Influenza/imunologia , Influenza Humana/prevenção & controle , Adulto , Animais , Criança , Ensaios Clínicos como Assunto , Ensaios Clínicos Fase III como Assunto , Cães , Aprovação de Drogas , Europa (Continente) , Humanos , Vacinas contra Influenza/efeitos adversos , Células Madin Darby de Rim Canino , Estados Unidos , Vacinas de Produtos Inativados/efeitos adversos , Vacinas de Produtos Inativados/imunologia
13.
S D Med ; 72(4): 164-167, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31436929

RESUMO

BACKGROUND: The Sioux Falls Family Medicine Residency serves a large non-English speaking and low socioeconomic status population. We designed a quality initiative to increase influenza and pneumonia vaccination rates in our elderly patients. METHODS: The main components of the project included improved clinic workflow, physician and staff education, and heightened patient awareness of vaccination importance. For the latter, we employed posters with key points about why patients should receive the vaccines, and personalized handouts with a photo of their provider discussing the importance of receiving these vaccines. The handouts were translated into the four most common non-English languages served by our clinics. RESULTS: Following implementation of the initiative, influenza vaccination rates increased from 35 to 53 percent, PPSV23 vaccination rates increased from 62.5 to 64 percent, and most impressively, PCV13 vaccination rates increased from 40 to 60 percent. CONCLUSION: This quality improvement project demonstrated meaningful change with minimal financial and logistical investment and should be sustainable in the long-term.


Assuntos
Programas de Imunização/organização & administração , Vacinas contra Influenza , Influenza Humana/prevenção & controle , Pneumonia/prevenção & controle , Idoso , Medicina de Família e Comunidade , Humanos , Vacinas contra Influenza/administração & dosagem , South Dakota , Vacinação
15.
BMC Infect Dis ; 19(1): 586, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31277580

RESUMO

BACKGROUND: Influenza vaccination is recognized as a primary public health intervention which prevents the illness of patients and relieves the societal burdens of influenza for medical community as well as the economy. To date, no effectiveness study of influenza vaccination has been conducted including a large population with a wide age span, in Japan. Here, we evaluated the clinical effectiveness of influenza vaccination in a large Japanese population. METHODS: We conducted a cohort study using a large-scale claims database for employee health care insurance plans. Vaccination status was identified using plan records for influenza vaccination subsidies. We excluded people aged 65 years or more because of the unavailability of vaccination records. Effectiveness of vaccination in preventing influenza and its complication was evaluated with doubly robust methods using inversed probability treatment weighting to adjust health conscious behaviours and other confounders. RESULTS: During the 2013/2014 influenza season, 369,425 subjects with age range from 1 to 64 years were eligible. Vaccination rate was 39.5% and an estimated odds ratio (OR) for influenza onset was 0.775 after doubly robust adjustment. Age-stratified ORs were significantly reduced in all age groups; lowest in subjects aged 1 to 4 years (0.600) and highest in those aged 13 to 19 (0.938). ORs for all the influenza complication outcomes were also statistically significant (0.403-0.709). CONCLUSIONS: We confirmed the clinical effectiveness of influenza vaccination in people aged 1 to 64 years. Influenza vaccination significantly prevented influenza onset and was more effective in reducing secondary risks of influenza complications.


Assuntos
Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Influenza Humana/epidemiologia , Formulário de Reclamação de Seguro/estatística & dados numéricos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estações do Ano , Resultado do Tratamento , Cobertura Vacinal/estatística & dados numéricos , Adulto Jovem
16.
BMC Public Health ; 19(1): 890, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31277611

RESUMO

BACKGROUND: Pregnant women are at increased risk of influenza-related complications. The World Health Organisation recommends influenza vaccination to this high-risk population as highest priority. However, achieving high influenza vaccine coverage among pregnant women remains challenging. We conducted a cross-sectional survey to estimate the coverage and determinants of influenza vaccination among pregnant women in Singapore. METHODS: Between September and November 2017, pregnant women aged ≥21 years were recruited at two public hospitals in Singapore. Participants completed an anonymous, self-administered online questionnaire assessing participants' influenza vaccination uptake, knowledge of and attitudes towards influenza and the influenza vaccine, vaccination history, willingness to pay for the influenza vaccine, and external cues to vaccination. We estimated vaccine coverage and used multivariable Poisson models to identify factors associated with vaccine uptake. RESULTS: Response rate was 61% (500/814). Only 49 women (9.8, 95% Confidence Interval (CI): 7.3-12.7%) reported receiving the vaccine during their current pregnancy. A few misconceptions were identified among participants, such as the belief that influenza can be treated with antibiotics. The most frequent reason for not being vaccinated was lack of recommendation. Women who were personally advised to get vaccinated against influenza during pregnancy were 7 times more likely to be vaccinated (prevalence ratio (PR) = 7.11; 95% CI: 3.92-12.90). However, only 12% of women were personally advised to get vaccinated. Other factors associated with vaccine uptake were vaccination during a previous pregnancy (PR = 2.51; 95% CI: 1.54-4.11), having insurance to cover the cost of the vaccine (PR = 2.32; 95% CI: 1.43-3.76), and higher vaccine confidence (PR = 1.62; 95% CI: 1.30-2.01). CONCLUSIONS: Influenza vaccination uptake among pregnant women in Singapore is low. There is considerable scope for improving vaccination coverage in this high-risk population through vaccination recommendations from healthcare professionals, and public communication targeting common misconceptions about influenza and influenza vaccines.


Assuntos
Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Gestantes/psicologia , Cobertura Vacinal/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Hospitais Públicos , Humanos , Pessoa de Meia-Idade , Gravidez , Medição de Risco , Singapura , Inquéritos e Questionários , Adulto Jovem
17.
Orv Hetil ; 160(30): 1193-1199, 2019 Jul.
Artigo em Húngaro | MEDLINE | ID: mdl-31327246

RESUMO

Introduction: The mistrust of vaccinations is already experienced among physicians. It is important for physicians to be well informed, able to convince their patients of the usefulness of vaccinations and set good example for them in this field. Aim: The aim of the study was to assess the vaccine knowledge and attitudes of the general medical students of Semmelweis University and their attitudes towards vaccinations before and after the education of 'Public Health and Preventive Medicine'. Emphasis was placed on the students' opinion on the vaccines against influenza, measles and hepatitis B virus and their effectiveness. Method: Data collection was done with volunteer participants, using anonymous self-administered questionnaires. The relationship between education and vaccination coverage was proved by calculating Pearson's correlation and one-way analysis of variance. Results: The knowledge of medical students is incomplete, with negative attitudes towards vaccination against influenza. Generally, respondents found the vaccines useful, but only two-thirds of them considered the influenza vaccine to be important. Students had 6.5% flu vaccination coverage before education, and 24% after education. Two-thirds (67.8%) of the students were aware that the flu vaccine could be given during an epidemic. Surprisingly, the importance of hand washing has been given a greater role in the primary prevention of influenza than flu vaccine. Conclusions: Education plays an important role in shaping the attitudes and responsible behaviour of future physicians. They need to acquire reliable knowledge to persuade their patients as practitioners to use the most effective means of primary prevention of infectious diseases. A change of attitude is needed to stop the route of infection through vaccination, to protect not only their own health but also that of their environment and thus of their patients. Orv Hetil. 2019; 160(30): 1193-1199.


Assuntos
Infecção Hospitalar/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Estudantes de Medicina , Cobertura Vacinal , Vacinologia , Adulto , Feminino , Humanos , Masculino , Inquéritos e Questionários , Vacinação
18.
Artigo em Inglês | MEDLINE | ID: mdl-31315167

RESUMO

Background: There is limited information on vaccination coverage and characteristics associated with vaccine uptake in Aboriginal and/or Torres Strait Islander adults. We aimed to provide more current estimates of influenza vaccination coverage in Aboriginal adults. Methods: Self-reported vaccination status (n=559 Aboriginal and/or Torres Strait Islander participants, n=80,655 non-Indigenous participants) from the 45 and Up Study, a large cohort of adults aged 45 years or older, was used to compare influenza vaccination coverage in Aboriginal and/or Torres Strait Islander adults with coverage in non-Indigenous adults. Results: Of Aboriginal and non-Indigenous respondents aged 49 to <65 years, age-standardised influenza coverage was respectively 45.2% (95% CI 39.5­50.9%) and 38.5%, (37.9­39.0%), p-value for heterogeneity=0.02. Coverage for Aboriginal and non-Indigenous respondents aged ≥65 years was respectively 67.3% (59.9­74.7%) and 72.6% (72.2­73.0%), p-heterogeneity=0.16. Among Aboriginal adults, coverage was higher in obese than in healthy weight participants (adjusted odds ratio (aOR)=2.38, 95%CI 1.44­3.94); in those aged <65 years with a medical risk factor than in those without medical risk factors (aOR=2.13, 1.37­3.30); and in those who rated their health as fair/poor compared to those who rated it excellent (aOR=2.57, 1.26­5.20). Similar associations were found among non-Indigenous adults. Conclusions: In this sample of adults ≥65 years, self-reported influenza vaccine coverage was not significantly different between Aboriginal and non-Indigenous adults whereas in those <65 years, coverage was higher among Aboriginal adults. Overall, coverage in the whole cohort was suboptimal. If these findings are replicated in other samples and in the Australian Immunisation Register, it suggests that measures to improve uptake, such as communication about the importance of influenza vaccine and more effective reminder systems, are needed among adults.


Assuntos
Vacinas contra Influenza , Influenza Humana/prevenção & controle , Cobertura Vacinal/normas , Vacinação/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Austrália , Estudos de Coortes , Feminino , Serviços de Saúde do Indígena , Humanos , Programas de Imunização/normas , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Autorrelato , Vacinação/normas
19.
Artigo em Inglês | MEDLINE | ID: mdl-31315314

RESUMO

Flutracking participation continued to grow, with a total of 33,947 participants in 2017 (a 9.5% increase from 2016). The majority of participants completed their survey within 24 hours of the email being sent (average 72.5% responses received in 24 hours). Overall, the rate of influenza-like illness (ILI) in 2017 was higher and remained elevated for a longer period compared to previous years except for the 2009 pandemic. Flutracking placed the severity and magnitude of the influenza season into historical context. Following the highest number of laboratory-notified influenza cases on record (2.8-fold increase from 2016), Flutracking data demonstrated a large increase in the percent of participants with fever and cough that were tested for influenza (2.9% to 5.0% for 2016 and 2017 respectively) and thus determined it was increased laboratory testing that contributed to the substantial increase in influenza notifications. Flutracking participants with fever and cough that were tested for influenza have increased each year from 2013 to 2017 at the national level, with a large increase from 2016 (2.9%) to 2017 (5.0%). The peak weekly fever and cough attack rate occurred in mid-August, with 4.1% ILI in the unvaccinated, compared to 3.1% in vaccinated Flutrackers. In the peak four weeks of ILI, 12.3% of participants experienced an episode of fever and cough. Divergence between the vaccinated and unvaccinated participants' ILI percentages was highest during the week ending 6 August 2017 (4.1% in the unvaccinated group and 2.7% in the vaccinated group). The timing of the ILI peak amongst Flutracking participants was consistent with peak notifications of laboratory-confirmed influenza.


Assuntos
Infecções Comunitárias Adquiridas/epidemiologia , Influenza Humana/epidemiologia , Sistemas On-Line , Vigilância da População , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Criança , Pré-Escolar , Tosse/epidemiologia , Notificação de Doenças , Feminino , Febre/epidemiologia , Humanos , Incidência , Lactente , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Masculino , Pessoa de Meia-Idade , Faringite/epidemiologia , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
20.
Nat Commun ; 10(1): 2981, 2019 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-31278315

RESUMO

Streptococcus pneumoniae is the main bacterial pathogen involved in pneumonia. Pneumococcal acquisition and colonization density is probably affected by viral co-infections, the local microbiome composition and mucosal immunity. Here, we report the interactions between live-attenuated influenza vaccine (LAIV), successive pneumococcal challenge, and the healthy adult nasal microbiota and mucosal immunity using an experimental human challenge model. Nasal microbiota profiles at baseline are associated with consecutive pneumococcal carriage outcome (non-carrier, low-dense and high-dense pneumococcal carriage), independent of LAIV co-administration. Corynebacterium/Dolosigranulum-dominated profiles are associated with low-density colonization. Lowest rates of natural viral co-infection at baseline and post-LAIV influenza replication are detected in the low-density carriers. Also, we detected the fewest microbiota perturbations and mucosal cytokine responses in the low-density carriers compared to non-carriers or high-density carriers. These results indicate that the complete respiratory ecosystem affects pneumococcal behaviour following challenge, with low-density carriage representing the most stable ecological state.


Assuntos
Portador Sadio/imunologia , Vacinas contra Influenza/imunologia , Microbiota/imunologia , Mucosa Nasal/microbiologia , Streptococcus pneumoniae/imunologia , Adolescente , Adulto , Coinfecção/imunologia , Coinfecção/microbiologia , Coinfecção/prevenção & controle , Feminino , Voluntários Saudáveis , Humanos , Vacinas contra Influenza/administração & dosagem , Influenza Humana/imunologia , Influenza Humana/prevenção & controle , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Mucosa Nasal/imunologia , Infecções Pneumocócicas/imunologia , Infecções Pneumocócicas/microbiologia , Infecções Pneumocócicas/prevenção & controle , Streptococcus pneumoniae/patogenicidade , Vacinas Atenuadas/administração & dosagem , Vacinas Atenuadas/imunologia , Adulto Jovem
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