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1.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 21-36, 2020 Jan 06.
Artigo em Chinês | MEDLINE | ID: mdl-31914565

RESUMO

Influenza virus infection is a respiratory infectious disease. The World Health Organization (WHO) estimated that seasonal influenza epidemics have caused an annual 3 to 5 million severe cases, and 290 000 to 650 000 deaths globally. Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from infection. Currently, China has licensed trivalent inactivated influenza vaccine (IIV3) and quadrivalent inactivated influenza vaccine (IIV4). In 2018, the Chinese Center for Disease Control and Prevention issued the "Technical Guidelines for Seasonal Influenza Vaccination in China (2018-2019)" ( "Guide 2018" for short). To strengthen the technical guidance for prevention and control of influenza and operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC) Influenza Vaccination Technical Working Group (TWG), updated the 2018 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2019-2020)" . The main updates in this version include the following: First, new research evidences especially studies of China, including disease burden, effectiveness, Vaccine-avoidable disease burden, vaccine safety monitoring, and cost-effectiveness and cost-benefit. Second, policies and measures for influenza prevention and control issued by National Health Commission (PRC) in the past year. Thirdly, new type seasonal influenza vaccine licensed and issued in 2019-2020 in China. Fourth, northern hemisphere influenza vaccination composition for the 2019-2020 season which included trivalent and quadrivalent influenza vaccine. The recommendations described in this report include the following: Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended, and appropriate product is available. To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups, the recommendations prioritize seasonal influenza vaccination for children aged 6-59 months, adults ≥60 years of age, persons with specific chronic diseases, healthcare workers, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to become pregnant during the influenza season. Children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. If they were vaccinated in 2018-2019 influenza season or a prior season, 1 dose is recommended. People more than 8 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. For the people unable to be vaccinated before the end of October, influenza vaccination will continue to be offered for the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for use by staff members of the Centers for Disease Control and Prevention at all levels who work on influenza control and prevention, PoVs staff members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and staff members of maternity and child care institutions at all levels. These guidelines will be updated periodically as new evidence becomes available.


Assuntos
Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Vacinação/normas , Adolescente , Adulto , Criança , Pré-Escolar , China , Feminino , Humanos , Esquemas de Imunização , Lactente , Pessoa de Meia-Idade , Gravidez , Estações do Ano , Adulto Jovem
3.
Vet Microbiol ; 238: 108429, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31648721

RESUMO

Viral haemorrhagic disease (VHD) and colibacillosis are common diseases in rabbits that cause economic losses worldwide. The effect of colibacillosis on the immune response of vaccinated rabbits against rabbit haemorrhagic disease virus (RHDV) was studied. Four groups (G1-G4) were included. G1 was the negative control group; G2 was the RHDV vaccine group; G3 was the E. coli-infected group; and G4 was the E. coli-infected + RHDV vaccine group. The E. coli infection and RHDV vaccination were simultaneously performed, with another previous infection, 3 days before vaccination. At 28 days post-vaccination (PV), the rabbits (G2-G4) were challenged intramuscularly with 0.5 ml of RHDV at a dose of 103 50% median lethal dose (LD50)/rabbit. The rabbits were observed for clinical signs, body weight gain and mortality rates. Tissue, blood, serum, and faecal samples and rectal swabs were collected at 3, 5, 7, 14, 21 and 28 days PV. Significant clinical signs and mortality and a decrease in BW were observed in the infected + RHDV vaccine group. On the 3rd day post-infection (PI), compared with all the other groups, the vaccinated group (G2) had significantly upregulated hepatic tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels; however, the infected + RHDV vaccine group had significantly higher intestinal levels of TNF-α and IL-6 than the other groups. Furthermore, E. coli infection in vaccinated rabbits led to immunosuppression, as shown by significant decreases (P < 0.05) in heterophil phagocytic activity, the CD4+/CD8+ ratio, and HI antibody responses to RHDV and a significant increase in the heterophil to lymphocyte (H/L) ratio. In conclusion, colibacillosis leads to immunosuppression involving a shift in the equilibrium of cytokines and reduced weight gain and mortality in vaccinated rabbits and could be a contributing factor in RHDV vaccination failure in rabbit farming.


Assuntos
Infecções por Caliciviridae/veterinária , Infecções por Escherichia coli/veterinária , Coelhos/imunologia , Vacinação/veterinária , Vacinas Virais/imunologia , Animais , Infecções por Caliciviridae/imunologia , Infecções por Caliciviridae/mortalidade , Citocinas/genética , Infecções por Escherichia coli/imunologia , Infecções por Escherichia coli/mortalidade , Infecções por Escherichia coli/fisiopatologia , Regulação da Expressão Gênica/imunologia , Vírus da Doença Hemorrágica de Coelhos/imunologia , Coelhos/microbiologia , Coelhos/virologia , Vacinação/normas
5.
Nervenarzt ; 90(12): 1254-1260, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31531686

RESUMO

In patients with multiple sclerosis (MS) primary varicella zoster virus (VZV) infections (chickenpox) or reactivation (shingles, herpes zoster) pose a particular challenge for neurologists and physicians in everyday clinical practice. On the one hand the various immunotherapeutic agents for treatment of MS have differently expressed risks for VZV-associated infections and on the other hand the currently available vaccination strategies (dead vs. live vaccines, single vs. combination vaccines) require an individualized approach. Moreover, in addition to the optimal timing of vaccination during the course of MS, the appropriate vaccine and, where indicated, the use of antiviral drugs should be determined.


Assuntos
Varicela , Herpes Zoster , Esclerose Múltipla , Vacinação , Varicela/prevenção & controle , Herpes Zoster/prevenção & controle , Humanos , Vacinação/normas
6.
BMC Med ; 17(1): 175, 2019 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-31530275

RESUMO

BACKGROUND: The introduction of highly effective direct-acting antiviral (DAA) therapy for hepatitis C has led to calls to eliminate it as a public health threat through treatment-as-prevention. Recent studies suggest it is possible to develop a vaccine to prevent hepatitis C. Using a mathematical model, we examined the potential impact of a hepatitis C vaccine on the feasibility and cost of achieving the global WHO elimination target of an 80% reduction in incidence by 2030 in the era of DAA treatment. METHODS: The model was calibrated to 167 countries and included two population groups (people who inject drugs (PWID) and the general community), features of the care cascade, and the coverage of health systems to deliver services. Projections were made for 2018-2030. RESULTS: The optimal incidence reduction strategy was to implement test and treat programmes among PWID, and in settings with high levels of community transmission undertake screening and treatment of the general population. With a vaccine available, the optimal strategy was to include vaccination within test and treat programmes, in addition to vaccinating adolescents in settings with high levels of community transmission. Of the 167 countries modelled, between 0 and 48 could achieve an 80% reduction in incidence without a vaccine. This increased to 15-113 countries if a 75% efficacious vaccine with a 10-year duration of protection were available. If a vaccination course cost US$200, vaccine use reduced the cost of elimination for 66 countries (40%) by an aggregate of US$7.4 (US$6.6-8.2) billion. For a US$50 per course vaccine, this increased to a US$9.8 (US$8.7-10.8) billion cost reduction across 78 countries (47%). CONCLUSIONS: These findings strongly support the case for hepatitis C vaccine development as an urgent public health need, to ensure hepatitis C elimination is achievable and at substantially reduced costs for a majority of countries.


Assuntos
Erradicação de Doenças , Hepacivirus/imunologia , Hepatite C/prevenção & controle , Modelos Teóricos , Vacinação , Vacinas contra Hepatite Viral/uso terapêutico , Antivirais/economia , Antivirais/uso terapêutico , Erradicação de Doenças/economia , Erradicação de Doenças/organização & administração , Erradicação de Doenças/normas , Erradicação de Doenças/estatística & dados numéricos , Hepatite C/economia , Hepatite C/epidemiologia , Hepatite C Crônica/economia , Hepatite C Crônica/epidemiologia , Hepatite C Crônica/prevenção & controle , Humanos , Incidência , Saúde Pública/economia , Saúde Pública/métodos , Abuso de Substâncias por Via Intravenosa/economia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Abuso de Substâncias por Via Intravenosa/virologia , Vacinação/normas , Cobertura Vacinal/economia , Cobertura Vacinal/organização & administração , Vacinas contra Hepatite Viral/economia
8.
Rev Med Suisse ; 15(660): 1521-1525, 2019 Aug 28.
Artigo em Francês | MEDLINE | ID: mdl-31496178

RESUMO

The Swiss 2019 immunization schedule published includes 7 news clauses: 1) DTPa-IPV-Hib-HBV vaccination in newborns with the simplified dosing schedule "2+1"; 2) recommendation for vaccination against measles, mumps and rubella administered at 9 and 12 months of age; 3) pneumococcal immunization in children under 5 years of age as a basic recommendation; 4) replacement of the monovalent capsular group C meningococcal conjugate vaccine by the quadrivalent ACWY conjugate vaccine (Menveo); 5) extension of vaccination against tick-borne encephalitis virus to the entire Swiss territory - with the exception of the cantons of Geneva and Tessin - in people with risk factors for contagion; 6) replacement of Gardasil® with Gardasil 9® since January 2019; 7) recommendation for vaccination against hepatitis B in newborns.


Assuntos
Esquemas de Imunização , Vacinas/administração & dosagem , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Vacinação/normas
9.
BMC Infect Dis ; 19(1): 771, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31481053

RESUMO

BACKGROUND: Although worldwide measles elimination achieved great progress for decades, outbreaks were still reported in certain countries. This study describes the epidemiologic features of a substantial measles outbreak in an office building in Beijing and explores control strategies in a crowded city. METHODS: We performed descriptive analyses of data on demographic characteristic, laboratory testing and epidemiological information. RESULTS: From February 25 to March 28, 2016, 43 outbreak-related measles cases occurred in an office building in Beijing. The total crude attack rate was 1.20% in the building. The age range of patients was 23 to 45 years old, of whom 30 (69.8%) were migrants and 5 (11.6%) were vaccinated but without documentation. The attack rate of the department and the company of the source case was 22.73 and 11.86%, respectively. The attack rate in the building was 1.78%, except for the commercial center on the lower floors, which was 0.34%. Of the 43 measles cases, only 19 cases (53.5%) were reported by hospitals through the National Notifiable Disease Reporting System (NNDRS), and the rest were found through active surveillance. Outbreak response immunization was conducted for 6216 persons. CONCLUSIONS: Office buildings in crowded metropolis are prone to large-scale measles outbreaks, and require a rapid outbreak response. Early Outbreak response immunization and active surveillance are important strategies to control outbreaks such as the one reported herein.


Assuntos
Aglomeração , Surtos de Doenças , Sarampo/epidemiologia , Adulto , Pequim/epidemiologia , China/epidemiologia , Surtos de Doenças/prevenção & controle , Feminino , Hospitais , Humanos , Incidência , Masculino , Sarampo/prevenção & controle , Pessoa de Meia-Idade , Urbanização , Vacinação/normas , Vacinação/estatística & dados numéricos , Adulto Jovem
11.
MMWR Morb Mortal Wkly Rep ; 68(32): 698-702, 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31415491

RESUMO

Vaccination against human papillomavirus (HPV) is recommended to prevent new HPV infections and HPV-associated diseases, including some cancers. The Advisory Committee on Immunization Practices (ACIP)* routinely recommends HPV vaccination at age 11 or 12 years; vaccination can be given starting at age 9 years. Catch-up vaccination has been recommended since 2006 for females through age 26 years, and since 2011 for males through age 21 years and certain special populations through age 26 years. This report updates ACIP catch-up HPV vaccination recommendations and guidance published in 2014, 2015, and 2016 (1-3). Routine recommendations for vaccination of adolescents have not changed. In June 2019, ACIP recommended catch-up HPV vaccination for all persons through age 26 years. ACIP did not recommend catch-up vaccination for all adults aged 27 through 45 years, but recognized that some persons who are not adequately vaccinated might be at risk for new HPV infection and might benefit from vaccination in this age range; therefore, ACIP recommended shared clinical decision-making regarding potential HPV vaccination for these persons.


Assuntos
Vacinas contra Papillomavirus/administração & dosagem , Vacinação/normas , Adulto , Comitês Consultivos , Feminino , Humanos , Esquemas de Imunização , Masculino , Infecções por Papillomavirus/prevenção & controle , Estados Unidos
12.
MMWR Morb Mortal Wkly Rep ; 68(33): 718-723, 2019 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-31437143

RESUMO

The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of persons aged 11-12 years to protect against certain diseases, including human papillomavirus (HPV)-associated cancers, meningococcal disease, and pertussis (1). A booster dose of quadrivalent meningococcal conjugate vaccine (MenACWY) is recommended at age 16 years, and serogroup B meningococcal vaccine (MenB) may be administered to persons aged 16-23 years (1). To estimate vaccination coverage among adolescents in the United States, CDC analyzed data from the 2018 National Immunization Survey-Teen (NIS-Teen) which included 18,700 adolescents aged 13-17 years.* During 2017-2018, coverage with ≥1 dose of HPV vaccine increased from 65.5% to 68.1%, and the percentage of adolescents up-to-date† with the HPV vaccine series increased from 48.6% to 51.1%, although the increases were only observed among males. Vaccination coverage increases were also observed for ≥1 MenACWY dose (from 85.1% to 86.6%) and ≥2 MenACWY doses (from 44.3% to 50.8%). Coverage with tetanus and reduced diphtheria toxoids and acellular pertussis vaccine (Tdap) remained stable at 89%. Disparities in coverage by metropolitan statistical area (MSA)§ and health insurance status identified in previous years persisted (2). Coverage with ≥1 dose of HPV vaccine was higher among adolescents whose parents reported receiving a provider recommendation; however, prevalence of parents reporting receiving a recommendation for adolescent HPV vaccination varied by state (range = 60%-91%). Supporting providers to give strong recommendations and effectively address parental concerns remains a priority, especially in states and rural areas where provider recommendations were less commonly reported.


Assuntos
Cobertura Vacinal/estatística & dados numéricos , Vacinas/administração & dosagem , Adolescente , Comitês Consultivos , Vacina contra Varicela/administração & dosagem , District of Columbia , Feminino , Pesquisas sobre Serviços de Saúde , Vacinas contra Hepatite B/administração & dosagem , Humanos , Esquemas de Imunização , Masculino , Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem , Vacinas Meningocócicas/administração & dosagem , Vacinas contra Papillomavirus/administração & dosagem , Guias de Prática Clínica como Assunto , Estados Unidos , Vacinação/normas , Vacinas Conjugadas/administração & dosagem
14.
Artigo em Inglês | MEDLINE | ID: mdl-31315166

RESUMO

This report summarises Australian passive surveillance data for adverse events following immunisation (AEFI) for 2017 reported to the Therapeutic Goods Administration and describes reporting trends over the 18-year period 1 January 2000 to 31 December 2017. There were 3,878 AEFI records for vaccines administered in 2017; an annual AEFI reporting rate of 15.8 per 100,000 population. There was a 12% increase in the overall AEFI reporting rate in 2017 compared with 2016. This increase in reported adverse events in 2017 compared to the previous year was likely due to the introduction of the zoster vaccine (Zostavax®) provided free for people aged 70­79 years under the National Immunisation Program (NIP) and also the state- and territory-based meningococcal ACWY conjugate vaccination programs. AEFI reporting rates for most other individual vaccines in 2017 were similar to 2016. The most commonly reported reactions were injection site reaction (34%), pyrexia (17%), rash (15%), vomiting (8%) and pain (7%). The majority of AEFI reports (88%) described non-serious events. Two deaths were reported that were determined to have a causal relationship with vaccination; they occurred in immunocompromised people contraindicated to receive the vaccines.


Assuntos
Doenças do Sistema Imunitário/epidemiologia , Vacinação/efeitos adversos , Vacinas/efeitos adversos , Adolescente , Adulto , Sistemas de Notificação de Reações Adversas a Medicamentos , Idoso , Austrália/epidemiologia , Criança , Pré-Escolar , Exantema/induzido quimicamente , Exantema/epidemiologia , Feminino , Febre/induzido quimicamente , Febre/epidemiologia , Vacina contra Herpes Zoster , Humanos , Programas de Imunização , Lactente , Reação no Local da Injeção/epidemiologia , Masculino , Pessoa de Meia-Idade , Dor/induzido quimicamente , Dor/epidemiologia , Vigilância da População , Vacinação/normas , Vacinação/estatística & dados numéricos , Vacinas/administração & dosagem , Vômito/induzido quimicamente , Vômito/epidemiologia , Adulto Jovem
15.
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
16.
Future Microbiol ; 14: 15-19, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31274016

RESUMO

Protection of healthcare workers (HCWs) from biological hazards in the workplace has the added benefit of contributing to the quality of patient care and patient safety. Vaccinated HCWs act as a barrier against the spread of infections and maintain essential healthcare delivery during outbreaks. In Italy, specific recommendations for vaccination of HCWs are issued by the Ministry of Health within the framework of the National Immunization Prevention Plan. These recommendations provide advice regarding HCW vaccination for hepatitis B, influenza, pertussis, measles, mumps, rubella, varicella and tuberculosis. This paper summarizes the current literature on vaccine-preventable diseases and vaccination among Italian HCWs.


Assuntos
Controle de Doenças Transmissíveis/estatística & dados numéricos , Infecção Hospitalar/prevenção & controle , Pessoal de Saúde/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Controle de Doenças Transmissíveis/normas , Doenças Transmissíveis/epidemiologia , Infecção Hospitalar/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Itália/epidemiologia , Saúde do Trabalhador , Vacinação/psicologia , Vacinação/normas
17.
Future Microbiol ; 14: 21-25, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31210535

RESUMO

The assessment and management of biological risk has always been a primary goal toward which occupational medicine has focused its efforts, in particular in healthcare workplaces. Healthcare professionals represent a category of workers at high risk for infections, many of which are vaccine-preventable diseases. There are various reasons for vaccinating healthcare workers, including to prevent illness among them so as to reduce absenteeism, to ensure an effective health service to users and to reduce social costs. Recently, the issue of vaccinations has been the subject of many debates. Vaccination is not always appreciated by health operators, and the reasons for low vaccination coverage are several and heterogeneous. This paper focuses on current Italian law and vaccination policies, along with the international background, evaluating the effectiveness of current policies and the consequences on public health. Overall, preventing infectious diseases means reducing costs, cases and outbreaks, shows responsibility toward third parties, and improves general welfare.


Assuntos
Pessoal de Saúde , Política de Saúde , Vacinação/legislação & jurisprudência , Vacinação/normas , Política de Saúde/tendências , Humanos , Controle de Infecções/legislação & jurisprudência , Controle de Infecções/normas , Itália , Saúde do Trabalhador/legislação & jurisprudência , Saúde do Trabalhador/normas , Saúde Pública , Medição de Risco , Vacinação/estatística & dados numéricos , Vacinas/administração & dosagem
18.
Future Microbiol ; 14: 9-14, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31210537

RESUMO

The transmission of infectious agents within healthcare settings is a priority public health problem. Although the main burden of healthcare-associated infections is commonly caused by Gram-negative bacteria and fungi, vaccine-preventable diseases represent an additional infectious risk for patients attending healthcare facilities. Hepatitis B, rotavirus gastroenteritis, influenza, measles, pertussis and pneumococcal and meningococcal invasive bacterial infections still represent a threat, notwithstanding the presence of universal vaccination programs. For this reason, healthcare worker immunization is an important strategy to limit the risk of vaccine-preventable diseases in such a fragile population.


Assuntos
Controle de Doenças Transmissíveis , Doenças Transmissíveis/transmissão , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/transmissão , Doenças Transmissíveis/epidemiologia , Infecção Hospitalar/epidemiologia , Surtos de Doenças/prevenção & controle , Pessoal de Saúde/normas , Pessoal de Saúde/estatística & dados numéricos , Humanos , Programas de Imunização , Risco , Vacinação/normas , Vacinação/estatística & dados numéricos , Vacinas/normas
19.
Medicina (Kaunas) ; 55(6)2019 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-31208087

RESUMO

Background and Objective: Current evidence suggests that patients with chronic obstructive pulmonary disease (COPD) should receive influenza and pneumococcal vaccinations. Despite international guidelines recommending vaccination in patients with COPD, many patients remain unvaccinated. Reasons for vaccine non-acceptance are multifaceted and are likely to be influenced by multiple psychosocial factors and pre-existing health beliefs. The aim of this review was to identify interventions which have been shown to effectively increase vaccination rates in patients with COPD. Materials and Methods: A structured search of PubMed returned 491 titles. Following title and abstract screening, seven full-text articles reporting on 6 unique interventional studies were extracted for narrative synthesis. A variety of interventions were investigated which, for the purposes of this review, were grouped into patient-focussed, clinician-focussed and mixed interventions. Results: Three papers reported findings from clinical trials (2 unique studies) and 4 papers reported findings from before-after studies. Two studies were conducted in the primary care setting, the remaining studies were conducted in secondary and tertiary care. Most studies reported both influenza and pneumococcal vaccination rates. These studies suggest that multimodal interventions, which target multiple aspects of evidence-based care and use both patient-focussed and clinician-focussed techniques, may have the greatest impact on vaccination rates in patients with COPD. Conclusions: Further, adequately powered, high quality studies are needed. It is crucial for individual institutions to monitor their own vaccination rates to determine if there is scope for performance improvement.


Assuntos
Vacinas contra Influenza/uso terapêutico , Vacinas Pneumocócicas/uso terapêutico , Doença Pulmonar Obstrutiva Crônica/prevenção & controle , Vacinação/normas , Humanos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico
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