RESUMO
Introduction: The COVID-19 pandemic has greatly impacted the way that the world views vaccines. While safe and effective, COVID-19 vaccines were, and continue to be met with hesitancy and misinformation. We aimed to understand public perceptions and trust in COVID-19 vaccinations and how the pandemic has impacted perceptions of non-COVID-19 vaccines. Methods: Survey data were collected between August 7, 2023-August 16, 2023, from 7,000 respondents aged 18 years and older from the United States (n = 1,000); Nigeria (n = 1,000); United Kingdom (n = 1,000); France (n = 1,000); Canada (n = 1,000); Brazil (n = 1,000); and India (n = 1,000). Results: Trust in COVID-19 vaccines was highest in Brazil (84.6%) and India (80.4%) and lowest in the United States (63.5%) and France (55.0%). 47.5% of respondents agreed that they trust traditional protein-based vaccines more than mRNA vaccines, 13.5% disagree and 39.0% are neutral about their trust in protein-based versus mRNA vaccines. Overall, 53.9% of respondents reported that the COVID-19 pandemic impacted their perceptions of vaccines with half of these respondents (51.7%) reporting that the pandemic made them think that other vaccines are more important as they understand how critical vaccines can be at preventing serious illnesses. Discussion: These data can be used by health system decision makers, public health and researchers to understand how vaccine trust impacts perceptions of COVID-19 and influenza vaccines globally and develop tailored interventions that address local concerns.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Vacinas contra Influenza , Confiança , Humanos , Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Adulto , Masculino , Feminino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adolescente , Estados Unidos , Adulto Jovem , Influenza Humana/prevenção & controle , Hesitação Vacinal/estatística & dados numéricos , Hesitação Vacinal/psicologia , Idoso , SARS-CoV-2 , Canadá , Nigéria , Conhecimentos, Atitudes e Prática em Saúde , Índia , BrasilRESUMO
The objectives of this study were to evaluate the frequency of vaccine hesitancy against seasonal influenza and to analyze the associated factors among teachers in the municipal school system of Teresina, Piauí State, Brazil. An online questionnaire was applied, adapted from the Health Belief Model, and 449 teachers were included. Of the public interviewed, most live in the capital Teresina, (373, 83.26%), are women (360, 80.54%), aged between 23 and 50 years (306, 81.38%), born in the state of Piauí (382, 86.82%), brown (289, 64.65%), married (254, 56.70%) and with a lato sensu graduate degree (327, 72.99%). In total, 33.18% were considered hesitant, and hesitancy was defined as teachers who were not vaccinated against influenza in 2020. The variables associated with hesitancy in this group were: not being vaccinated against influenza in 2019, the flu vaccine is not convenient, there are many risks associated with it, and concern about reactions to the flu vaccine, the new coronavirus pandemic changed the relationship with the act of vaccinating and greater adherence to the vaccine after hearing information about its benefits in the media. However, in the regression analysis, only the variables "not being vaccinated against influenza in 2019" and "the change in behavior after the pandemic" were significant. Vaccines continue to be the main method of prevention and control of a series of diseases related to influenza viruses, requiring greater adherence by teachers, a priority population that is in constant contact with students from different backgrounds, representing an important source of virus dissemination.
Os objetivos deste estudo foram avaliar a frequência de hesitação à vacina contra influenza sazonal e analisar os fatores associados entre professores da rede municipal de ensino de Teresina, Piauí, Brasil. Foi aplicado um questionário online, adaptado do Modelo de Crenças em Saúde e foram incluídos 449 docentes. Do público entrevistado, a maioria reside na capital Teresina (373, 83,26%), são mulheres (360, 80,54%), com idade entre 23 e 50 anos (306, 81,38%), naturais do Estado do Piauí (382, 86,82%), de cor parda (289, 64,65%), casados (254, 56,7%) e com pós-graduação lato sensu (327, 72,99%). Um total de 33,18% foram considerados hesitantes à vacinação, sendo definidos como hesitantes aqueles professores que não se vacinaram contra influenza em 2020. As variáveis associadas à hesitação nesse grupo foram: não terem se vacinado contra a gripe (influenza) em 2019, acreditarem que a vacina contra a gripe não é conveniente, existem muitos riscos associados à vacina da gripe, e preocupação com reações à vacina da gripe, a pandemia do novo coronavírus mudou a relação com o ato de vacinar e uma maior adesão à vacina após ouvir informações sobre seus benefícios nos meios de comunicação. No entanto, na análise de regressão, somente as variáveis de não se vacinar contra influenza em 2019 e a modificação do comportamento após a pandemia foram significativas. As vacinas seguem sendo o principal método de prevenção e controle de uma série de doenças relacionadas aos vírus da influenza, sendo necessária uma maior adesão por parte dos professores, público prioritário que está em constante contato com alunos de diversas origens e representam uma importante fonte de disseminação do vírus.
Los objetivos de este estudio fueron evaluar la reticencia a la vacunación contra la influenza estacional y analizar los factores asociados entre los profesores de las escuelas municipales de Teresina, Piauí, Brasil. Se aplicó un cuestionario en línea adaptado del Modelo de Creencias en Salud y se incluyeron a 449 profesores. La mayoría de los participantes viven en la capital Teresina (373, 83,26%), son mujeres (360, 80,54%), de entre 23 y 50 años de edad (306, 81,38%), nacidos en el estado de Piauí (382, 86,82%), de color pardo (289, 64,65%), casados (254, 56,70%) y con título de posgrado (327, 72,99%). El 33,18% del total se consideró reticente a la vacunación, y se definió como reticentes a aquellos profesores que no se vacunaron contra la gripe en 2020. Las variables asociadas a la reticencia fueron: no haberse vacunado contra la gripe (influenza) en 2019; no considerar oportuna la vacuna contra la gripe; considerar muchos riesgos asociados a la vacuna contra la gripe y preocuparse por las reacciones a esta vacuna. La pandemia del nuevo coronavirus impactó la relación entre el acto de vacunarse y una mayor adherencia a la vacunación tras enterarse de sus posibles beneficios en los medios de comunicación. En el análisis de regresión, solo las variables no vacunarse contra la influenza en 2019 y el cambio del comportamiento después de la pandemia fueron significativas. La vacunación sigue siendo el principal método de prevención y control de enfermedades relacionadas con los virus de la gripe, lo que requiere una mayor adherencia por parte de los profesores, un público prioritario que está en constante contacto con los estudiantes de distintos orígenes y que representa una importante fuente de propagación del virus.
Assuntos
COVID-19 , Vacinas contra Influenza , Influenza Humana , Professores Escolares , Hesitação Vacinal , Humanos , Brasil/epidemiologia , Feminino , Masculino , Adulto , Professores Escolares/psicologia , Professores Escolares/estatística & dados numéricos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Pessoa de Meia-Idade , Influenza Humana/prevenção & controle , Vacinas contra Influenza/administração & dosagem , Adulto Jovem , Inquéritos e Questionários , Hesitação Vacinal/estatística & dados numéricos , Hesitação Vacinal/psicologia , SARS-CoV-2 , Pandemias/prevenção & controle , Estações do Ano , Estudos Transversais , Conhecimentos, Atitudes e Prática em SaúdeRESUMO
Del 14 al 16 del mayo se realizó en la Ciudad de México la reunión regional de la Red de Infecciones Respiratorias Agudas Severas (SARInet) y la Red de Evaluación de la Efectividad de las Vacunas en América Latina y el Caribe - influenza (REVELAC-i) para compartir experiencias sobre vigilancia, diagnóstico e inmunización de influenza y otros virus respiratorios. En esta reunión participaron más de 190 personas de 36 países, además de profesionales de la OPS/OMS, los Centros para el Control y la Prevención de Enfermedades (CDC) de Estados Unidos, la Agencia de Salud Pública de Canadá (PHAC), el Consejo de Ministros de Salud de Centroamérica (COMISCA) y la Agencia de Salud Pública del Caribe (CARPHA). En la reunión se debatieron los hitos alcanzados por la red SARInet en los últimos 10 años, los principales retos y los próximos pasos. En esta nota se presentan resúmenes de las presentaciones y sesiones impartidas por los ponentes. Antes del 2014, existía una red informal de laboratorios en la Región de las Américas, con alrededor de 30 países que realizaban vigilancia centinela de infecciones respiratorias agudas graves (IRAG), más de 900 centros centinela, 28 Centros Nacionales de Influenza (CNI) y 6 laboratorios nacionales. Sin embargo, faltaba un mecanismo para compartir información y buenas prácticas. La reunión inaugural de la red SARInet se celebró el 30 de mayo del 2014 en Panamá, integrando a laboratorios y epidemiólogos para mejorar la vigilancia. Con el tiempo, se fueron sumando más actores estratégicos, como redes de servicios de salud, clínicos, médicos generales y especialistas en investigación operativa, expandiendo un fenómeno que amplió la red para incluir componentes de acuerdo a las necesidades de los países. La red se operacionalizó y materializó a través de grupos de trabajo centrados en la carga de morbilidad, la vigilancia genómica, la gestión clínica y la eficacia de las vacunas, evolución que permitió su evolución desde 2006 y mejoró las directrices publicadas y los protocolos y directrices publicados.
Assuntos
Infecções Respiratórias , Influenza Humana , Vacinas contra Influenza , Doenças Preveníveis por Vacina , Vacinação , Acesso a Medicamentos Essenciais e Tecnologias em SaúdeRESUMO
To reduce influenza-associated morbidity and mortality, countries in South America recommend annual influenza vaccination for persons at high risk for severe influenza illness, including young children, persons with preexisting health conditions, and older adults. Interim estimates of influenza vaccine effectiveness (VE) from Southern Hemisphere countries can provide early information about the protective effects of vaccination and help guide Northern Hemisphere countries in advance of their season. Using data from a multicountry network, investigators estimated interim VE against influenza-associated severe acute respiratory illness (SARI) hospitalization using a test-negative case-control design. During March 13-July 19, 2024, Argentina, Brazil, Chile, Paraguay, and Uruguay identified 11,751 influenza-associated SARI cases; on average, 21.3% of patients were vaccinated against influenza, and the adjusted VE against hospitalization was 34.5%. The adjusted VE against the predominating subtype A(H3N2) was 36.5% and against A(H1N1)pdm09 was 37.1%. These interim VE estimates suggest that although the proportion of hospitalized patients who were vaccinated was modest, vaccination with the Southern Hemisphere influenza vaccine significantly lowered the risk for hospitalization. Northern Hemisphere countries should, therefore, anticipate the need for robust influenza vaccination campaigns and early antiviral treatment to achieve optimal protection against influenza-associated complications.
Assuntos
Hospitalização , Vírus da Influenza A Subtipo H1N1 , Vacinas contra Influenza , Influenza Humana , Eficácia de Vacinas , Humanos , Influenza Humana/prevenção & controle , Influenza Humana/epidemiologia , Vacinas contra Influenza/administração & dosagem , Hospitalização/estatística & dados numéricos , Idoso , Pessoa de Meia-Idade , Adulto , Adolescente , Adulto Jovem , Pré-Escolar , Criança , Eficácia de Vacinas/estatística & dados numéricos , Lactente , América do Sul/epidemiologia , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Vírus da Influenza A Subtipo H1N1/imunologia , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Vírus da Influenza A Subtipo H3N2/imunologia , Feminino , Masculino , Estudos de Casos e ControlesRESUMO
Infections, particularly those involving the respiratory tract, are associated with an increased incidence of cardiovascular events, both de novo and as exacerbations of pre-existing cardiovascular diseases. Influenza vaccination has consistently been shown to reduce the incidence of cardiovascular events. Nonetheless, vaccination rates among adults remain suboptimal, both in the general population and among high-risk individuals. Multiple barriers hinder achieving adequate vaccination rates, with physicians' beliefs and attitudes towards these interventions being crucial. The FLUence project was developed within the framework of the World Heart Federation's Emerging Leaders program, to address this issue. This project has two phases: a global quantitative survey to assess the perceptions, opinions, and attitudes and challenges of physicians worldwide regarding the safety and efficacy of the influenza vaccination use, and a qualitative survey to further investigate the barriers and facilitators of recommending and using this vaccination. The quantitative survey was created and disseminated in five languages (English, Spanish, French, Italian, and Portuguese) to physicians of all specialties who care for adults, with a particular focus on patients with cardiovascular disease. The survey included eight domains with a total of 36 questions with closed options; a Likert scale with five possible answers was used to gauge participants' opinions. To gain deeper insights into the complexities behind the low vaccination rates in adults, the second part of the project comprises a qualitative survey, conducted in the two lower-middle- and upper-middle-income countries: India and Argentina, respectively. These countries were selected because patients with cardiovascular diseases have access to free influenza vaccination in Argentina, whereas patients must pay for the vaccine out of pocket in India. Thus, the FLUence study will provide valuable information to better understand the perceptions and barriers to improving influenza vaccination rates from the perspective of physicians. It is imperative to actively engage all healthcare providers to improve influenza vaccination rates.
Assuntos
Atitude do Pessoal de Saúde , Doenças Cardiovasculares , Vacinas contra Influenza , Influenza Humana , Vacinação , Humanos , Doenças Cardiovasculares/prevenção & controle , Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Influenza Humana/epidemiologia , Vacinação/psicologia , Médicos/psicologia , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em Saúde , Masculino , Padrões de Prática Médica , FemininoRESUMO
BACKGROUND: We examined the added value of serologic testing for estimating influenza virus infection incidence based on illness surveillance with molecular testing versus periodic serologic testing. METHODS: Pregnant persons unvaccinated against influenza at <28 weeks gestation were enrolled before the 2017 and 2018 influenza seasons in Peru and Thailand. Blood specimens were collected at enrollment and ≤14 days postpartum for testing by hemagglutination inhibition assay for antibodies against influenza reference viruses. Seroconversion was defined as a ≥4-fold rise in antibody titers from enrollment to postpartum with the second specimen's titer of ≥40. Throughout pregnancy, participants responded to twice weekly surveillance contacts asking about influenza vaccination and influenza-like symptoms (ILS). A mid-turbinate swab was collected with each ILS episode for influenza real-time reverse transcription polymerase chain reaction (rRT-PCR). RESULTS: Of 1,466 participants without evidence of influenza vaccination during pregnancy, 296 (20.2%) had evidence of influenza virus infections. Fifteen (5.1%) were detected by rRT-PCR only, 250 (84.4%) by serologic testing only, and 31 (10.5%) by both methods. CONCLUSIONS: Influenza virus infections during pregnancy occurred in 20% of cohort participants; >80% were not detected by a broad illness case definition coupled with rRT-PCR.
Assuntos
Anticorpos Antivirais , Influenza Humana , Complicações Infecciosas na Gravidez , Testes Sorológicos , Humanos , Feminino , Gravidez , Influenza Humana/epidemiologia , Influenza Humana/diagnóstico , Influenza Humana/virologia , Adulto , Incidência , Tailândia/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/diagnóstico , Anticorpos Antivirais/sangue , Peru/epidemiologia , Adulto Jovem , Testes Sorológicos/métodos , Testes de Inibição da Hemaglutinação , Vacinas contra Influenza/imunologia , AdolescenteRESUMO
La Organización Panamericana de la Salud / Organización Mundial de la Salud (OPS/OMS) hace un llamado a los Estados Miembros para trabajar de forma colaborativa e intersectorial con el fin de preservar la sanidad animal y proteger la salud pública. La OPS/OMS insta a los Estados Miembros a reforzar los esfuerzos para la implementación de protocolos que permitan la detección oportuna, notificación y respuesta rápida ante brotes en animales, así como también para la detección de casos humanos de influenza aviar A(H5N1). Además, se insta a compartir los virus con los Centros Colaboradores de la OMS de ambos sectores para fortalecer los análisis de riesgo y contar con virus candidatos vacunales.
Assuntos
Humanos , Vacinas contra Influenza/uso terapêutico , Virus da Influenza A Subtipo H5N1/imunologia , Influenza Aviária/epidemiologia , América Latina/epidemiologiaRESUMO
Introducción: Las infecciones respiratorias son las enfermedades respiratorias con mayor mortalidad en el mundo. Las causadas por Streptococcus pneumoniae, virus de influenza, Bordetella pertussis, SARS-CoV-2 y el Virus Sincitial Respiratorio, cuentan hoy día con vacunas seguras y efectivas. Este documento representa una guía de práctica clínica (GPC) de la Asociación Latinoamericana de Tórax (ALAT), elaborada por iniciativa de los departamentos de enfermedades infecciosas y pediatría, con el objetivo de establecer recomendaciones sobre vacunas respiratorias, utilizando la evidencia disponible. Método: Se estableció un grupo de desarrollo de las guías conformado por cinco médicos responsables globales del proyecto, se crearon cinco subgrupos de trabajo, uno por cada vacuna, con expertos neumólogos de adulto, pediatras e infectólogos invitados, que generaron preguntas clínicas. Se trabajó con un grupo de expertos metodólogos que transformaron preguntas clínicas en preguntas PICO, seleccionándose nueve preguntas por método DELPHI. Luego, se utilizó el sistema GRADE (Grading of Recommendations Assessment, Development and Evaluation) para evaluar la evidencia disponible. Resultados: Se obtuvieron recomendaciones para población adulta y pediátrica de las vacunas de neumococo, influenza, tos ferina, COVID-19 y Virus Respiratorio Sincitial basadas en preguntas PICO. También se agregaron recomendaciones basadas en preguntas narrativas relacionadas al uso de vacunas respiratorias en población con enfermedades respiratorias crónicas como asma, EPOC y fibrosis pulmonar.
Introduction: Respiratory infections are the leading cause of respiratory disease-related mortality worldwide. Infections caused by Streptococcus pneumoniae, influenza virus, Bordetella pertussis, SARS-CoV-2 and Respiratory Syncytial Virus (RSV) now have safe and effective vaccines available.This document represents a Clinical Practice Guideline (CPG) by the Latin American Thoracic Association (ALAT), developed through the initiative of the departments of in-fectious diseases and pediatrics, with the goal of establishing recommendations on respiratory vaccines using the available evidence. Method: A guideline development group was established, composed of five lead physicians responsible for the overall project. Five working subgroups were created, one for each vaccine, involving invited experts in adult pulmonology, pediatrics, and infectious diseases, who formulated clinical questions. A group of expert methodologists then transformed these clinical questions into PICO questions, with nine questions selected using the DELPHI method. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) system was then used to assess the available evidence. Results: Recommendations were obtained for the adult and pediatric populations for pneumococcal, influenza, pertussis, COVID-19 and Respiratory Syncytial Virus vaccines based on PICO questions. Additionally, recommendations based on narrative questions related to the use of respiratory vaccines in populations with chronic respiratory diseases such as asthma, COPD, and pulmonary fibrosis were included.
Assuntos
Humanos , Infecções Respiratórias/prevenção & controle , Vacinas contra Influenza , Vacina contra Coqueluche , Vacinas Pneumocócicas , Vacinas contra Vírus Sincicial Respiratório , Vacinas contra COVID-19 , Comorbidade , Morbidade , Mortalidade , Técnica Delphi , Imunização/métodos , Abordagem GRADE/métodosRESUMO
OBJECTIVE: To identify risk factors for death from influenza A(H1N1), including the effectiveness of the vaccine against influenza A(H1N1) concerning mortality. METHODS: A case-control of incident cases of influenza A(H1N1) reported in the epidemiological information systems of the states of São Paulo, Paraná, Pará, Amazonas, and Rio Grande do Sul was conducted. RESULTS: 305 participants were included, 70 of them cases and 235 controls, distributed as follows: Amazonas, 9 cases/10 controls; Pará, 22 cases/77 controls, São Paulo, 19 cases/49 controls; Paraná, 10 cases/54 controls; Rio Grande do Sul, 10 cases/45 controls. These participants had a mean age of 30 years, with 33 years among cases and 25 years among controls. There was a predominance of females both among the cases and controls. Biological (age), pre-existing diseases (congestive heart failure, respiratory disease, and diabetes mellitus), and care factors (ICU admission) associated with death from influenza A(H1N1) were identified. CONCLUSION: The risk factors identified in this investigation not only allowed subsidizing the elaboration of clinical conducts but also indicate important aspects for facing "new" influenza epidemics that are likely to occur in our country.
Assuntos
Vírus da Influenza A Subtipo H1N1 , Influenza Humana , Humanos , Brasil/epidemiologia , Influenza Humana/mortalidade , Influenza Humana/epidemiologia , Feminino , Adulto , Masculino , Estudos de Casos e Controles , Fatores de Risco , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Fatores Socioeconômicos , Epidemias , Criança , Vacinas contra Influenza/administração & dosagemRESUMO
Las presentes recomendaciones se emiten en funcioÌn de la mejor evidencia disponible, con un enfoque individual de prevencioÌn de la influenza y sus complicaciones, en comparacioÌn con las recomendaciones que se efectuÌan desde el punto de vista de la salud puÌblica (que toman en consideracioÌn variables adicionales como prioridades en salud, asignacioÌn de presupues- tos, logiÌstica, entre otros) que no forman parte del enfoque de este documento
Assuntos
Vacinas contra Influenza , Programas de Imunização , Prevenção de Doenças , Grupos EtáriosRESUMO
BACKGROUND: Influenza virus remains a threat to human health, but gaps remain in our knowledge of the humoral correlates of protection against influenza virus A/H3N2, limiting our ability to generate effective, broadly protective vaccines. The role of antibodies against the hemagglutinin (HA) stalk, a highly conserved but immunologically subdominant region, has not been established for influenza virus A/H3N2. METHODS: Household transmission studies were conducted in Managua, Nicaragua, across 3 influenza seasons. Household contacts were tested for influenza virus infection using reverse-transcription polymerase chain reaction. We compared preexisting antibody levels against full-length HA, HA stalk, and neuraminidase (NA) measured by enzyme-linked immunosorbent assay, along with hemagglutination inhibition assay titers, between infected and uninfected participants. RESULTS: A total of 899 individuals participated in household activation, with 329 infections occurring. A 4-fold increase in initial HA stalk titers was independently associated with an 18% decrease in the risk of infection (adjusted odds ratio [aOR], 0.82 [95% confidence interval {CI}, .68-.98]; P = .04). In adults, anti-HA stalk antibodies were independently associated with protection (aOR, 0.72 [95% CI, .54-.95]; P = .02). However, in 0- to 14-year-olds, anti-NA antibodies (aOR, 0.67 [95% CI, .53-.85]; P < .01) were associated with protection against infection, but anti-HA stalk antibodies were not. CONCLUSIONS: The HA stalk is an independent correlate of protection against A/H3N2 infection, though this association is age dependent. Our results support the continued exploration of the HA stalk as a target for broadly protective influenza vaccines but suggest that the relative benefits may depend on age and influenza virus exposure history.
Assuntos
Anticorpos Antivirais , Testes de Inibição da Hemaglutinação , Glicoproteínas de Hemaglutininação de Vírus da Influenza , Vírus da Influenza A Subtipo H3N2 , Influenza Humana , Humanos , Influenza Humana/prevenção & controle , Influenza Humana/imunologia , Vírus da Influenza A Subtipo H3N2/imunologia , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Adulto , Masculino , Adolescente , Feminino , Criança , Adulto Jovem , Pessoa de Meia-Idade , Pré-Escolar , Nicarágua , Glicoproteínas de Hemaglutininação de Vírus da Influenza/imunologia , Lactente , Neuraminidase/imunologia , Idoso , Características da Família , Ensaio de Imunoadsorção Enzimática , Imunidade Humoral , Vacinas contra Influenza/imunologia , Vacinas contra Influenza/administração & dosagemRESUMO
Inactivated influenza A virus (IAV) vaccines help reduce clinical disease in suckling piglets, although endemic infections still exist. The objective of this study was to evaluate the detection of IAV in suckling and nursery piglets from IAV-vaccinated sows from farms with endemic IAV infections. Eight nasal swab collections were obtained from 135 two-week-old suckling piglets from four farms every other week from March to September 2013. Oral fluid samples were collected from the same group of nursery piglets. IAV RNA was detected in 1.64% and 31.01% of individual nasal swabs and oral fluids, respectively. H1N2 was detected most often, with sporadic detection of H1N1 and H3N2. Whole-genome sequences of IAV isolated from suckling piglets revealed an H1 hemagglutinin (HA) from the 1B.2.2.2 clade and N2 neuraminidase (NA) from the 2002A clade. The internal gene constellation of the endemic H1N2 was TTTTPT with a pandemic lineage matrix. The HA gene had 97.59% and 97.52% nucleotide and amino acid identities, respectively, to the H1 1B.2.2.2 used in the farm-specific vaccine. A similar H1 1B.2.2.2 was detected in the downstream nursery. These data demonstrate the low frequency of IAV detection in suckling piglets and downstream nurseries from farms with endemic infections in spite of using farm-specific IAV vaccines in sows.
Assuntos
Fazendas , Vírus da Influenza A , Vacinas contra Influenza , Infecções por Orthomyxoviridae , Filogenia , Doenças dos Suínos , Animais , Suínos , Doenças dos Suínos/virologia , Doenças dos Suínos/epidemiologia , Doenças dos Suínos/prevenção & controle , Infecções por Orthomyxoviridae/veterinária , Infecções por Orthomyxoviridae/virologia , Infecções por Orthomyxoviridae/epidemiologia , Vírus da Influenza A/genética , Vírus da Influenza A/imunologia , Vírus da Influenza A/isolamento & purificação , Vírus da Influenza A/classificação , Vacinas contra Influenza/imunologia , Vacinas contra Influenza/administração & dosagem , Animais Lactentes , Vacinação/veterinária , Doenças Endêmicas/veterinária , Vírus da Influenza A Subtipo H1N1/genética , Vírus da Influenza A Subtipo H1N1/imunologia , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , RNA Viral/genética , Vírus da Influenza A Subtipo H3N2/genética , Vírus da Influenza A Subtipo H3N2/imunologia , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Vírus da Influenza A Subtipo H1N2/genética , Vírus da Influenza A Subtipo H1N2/isolamento & purificação , Vírus da Influenza A Subtipo H1N2/imunologia , Genoma ViralRESUMO
BACKGROUND: Estimating the burden of disease averted by vaccination can assist policymakers to implement, adjust, and communicate the value of vaccination programs. Demonstrating the use of a newly available modeling tool, we estimated the burden of influenza illnesses averted by seasonal influenza vaccination in El Salvador, Panama, and Peru during 2011-2018 among two influenza vaccine target populations: children aged 6-23 months and pregnant women. METHODS: We derived model inputs, including incidence, vaccine coverage, vaccine effectiveness, and multipliers from publicly available country-level influenza surveillance data and cohort studies. We also estimated changes in illnesses averted when countries' vaccine coverage was achieved using four different vaccine deployment strategies. RESULTS: Among children aged 6-23 months, influenza vaccination averted an estimated cumulative 2,161 hospitalizations, 81,907 medically-attended illnesses, and 126,987 overall illnesses during the study period, with a prevented fraction ranging from 0.3 % to 12.5 %. Among pregnant women, influenza vaccination averted an estimated cumulative 173 hospitalizations, 6,122 medically attended illnesses, and 16,412 overall illnesses, with a prevented fraction ranging from 0.2 % to 10.9 %. Compared to an influenza vaccine campaign with equal vaccine distribution during March-June, scenarios in which total cumulative coverage was achieved in March and April consistently resulted in the greatest increase in averted illness (23 %-3,129 % increase among young children and 22 %-3,260 % increase among pregnant women). DISCUSSION: Influenza vaccination campaigns in El Salvador, Panama, and Peru conducted between 2011 and 2018 prevented hundreds to thousands of influenza-associated hospitalizations and illnesses in young children and pregnant women. Existing vaccination programs could prevent additional illnesses, using the same number of vaccines, by achieving the highest possible coverage within the first two months of an influenza vaccine campaign.
Assuntos
Vacinas contra Influenza , Influenza Humana , Vacinação , Humanos , Feminino , Peru/epidemiologia , Influenza Humana/prevenção & controle , Influenza Humana/epidemiologia , Panamá/epidemiologia , Gravidez , Vacinas contra Influenza/administração & dosagem , El Salvador/epidemiologia , Lactente , Vacinação/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Cobertura Vacinal/estatística & dados numéricos , Programas de Imunização/estatística & dados numéricos , Masculino , Adulto , IncidênciaRESUMO
Future pandemics caused by influenza or other respiratory viruses with epidemic and pandemic potential are highly likely. Given this threat, it is a priority for the Region of the Americas to define and strengthen a framework for the prevention and control of influenza, severe acute respiratory syndrome (SARS), coronavirus type 2, and other respiratory viruses in the context of the pandemic transition. This publication reflects the Pan American Health Organization’s permanent support to its Member States in the analysis of national response capacities for both seasonal influenza and other respiratory viruses with epidemic and pandemic potential. These capacities are achieved through the fulfillment of five objectives: 1) strengthen surveillance; 2) expand infection prevention and control policies; 3) strengthen epidemic and pandemic preparedness and response capacity; 4) promote operational research; and 5) improve risk communication and community engagement. It is essential to maintain the highest possible level of core national capacities for the early detection and control of diseases caused by respiratory viruses. This is crucial for managing future epidemics and pandemics since it directly contributes to the implementation of the core capacities of the International Health Regulations, as well as improvement of management, coordination, and planning, for the benefit of all the countries of the Region.
Assuntos
COVID-19 , Vacinas contra Influenza , Doenças Respiratórias , Epidemias , Pandemias , Planos de EmergênciaRESUMO
BACKGROUND AND PURPOSE: Some studies have shown that influenza vaccination is associated with a lower risk of SARS-CoV-2 infection; in patients with COVID-19 infection, admission to intensive care is reduced, with less need for mechanical ventilation, shorter hospital stays, and reduced mortality. This study aimed to determine if a history of annual influenza vaccination impacts the clinical course of SARS-CoV-2 infection during hospitalization. METHODS: This was an observational, prospective, cohort study of patients older than 65 admitted to the COVID-19 unit from January to June 2021. The history of influenza vaccination over the last 5 years was assessed in each patient during hospitalization. We measured the length of hospital stay, the need for admission to the intensive care unit (ICU), the patient's oxygen requirements, complications during hospitalization, and outcome (medical discharge or death). Patients with a history of vaccination against SARS-CoV-2 were not included. RESULTS: We analyzed 125 patients, 50.4% (n=63) with history of influenza vaccination and 49.6% (n=62) without a history of influenza vaccination. In-hospital mortality was 44.8%, higher in the unvaccinated (54.8%) population (p=0.008). ICU admission was 27% higher in vaccinated (35%) patients (p=0.05). Patients without a history of influenza vaccination had a higher prevalence of cardiac (8% vs. 5%, p=0.04) and renal complications (29% vs. 13%, p=0.02). Patients with a history of vaccination had a greater need for invasive mechanical ventilation (25.4%, p=0.02). CONCLUSION: In this study, a history of influenza vaccination in older adults with SARS-CoV-2 infection was related to lower in-hospital mortality.
Assuntos
COVID-19 , Mortalidade Hospitalar , Hospitalização , Vacinas contra Influenza , Influenza Humana , Humanos , Idoso , COVID-19/prevenção & controle , COVID-19/complicações , COVID-19/mortalidade , COVID-19/epidemiologia , Masculino , Feminino , Estudos Prospectivos , Hospitalização/estatística & dados numéricos , Idoso de 80 Anos ou mais , Influenza Humana/prevenção & controle , Influenza Humana/mortalidade , Influenza Humana/epidemiologia , Influenza Humana/complicações , Tempo de Internação/estatística & dados numéricos , Vacinação , Respiração Artificial/estatística & dados numéricos , Unidades de Terapia IntensivaRESUMO
BACKGROUND: The 2022-2023 period marked the largest global Mpox outbreak, with Latin America's situation notably underexplored. This study aims to estimate Mpox's instantaneous reproduction number (R(t)), analyze epidemiological trends, and map vaccination efforts in six Latin American countries. METHODS: Utilizing Pan American Health Organization Mpox surveillance data, we examined demographic characteristics, cumulative incidence rates, and epidemic curves, calculated R(t) with weekly sliding windows for each country, alongside a review of vaccination initiatives. RESULTS: From 2022 to 2023, 25,503 Mpox cases and 71 deaths were reported across Argentina, Brazil, Chile, Colombia, Mexico and Peru, with a significant majority (91.8%-98.5%) affecting men, with a mean age of 32-35 years. Maximum R(t) values varied across countries: Argentina (2.63; 0.85 to 5.39), Brazil (3.13; 2.61 to 3.69), Chile (2.91; 1.55 to 4.70), Colombia (3.15; 2.07 to 4.44), Mexico (2.28; 1.18 to 3.75), and Peru (2.84; 2.33 to 3.40). The epidemic's peak occurred between August and September 2022 with R(t) values subsequently dropping below 1. From November 2022, and as of February 2024, only Chile, Peru, and Brazil had initiated Mpox vaccination campaigns, with Colombia launching a Clinical Trial. CONCLUSION: The peak of the Mpox epidemic in the studied countries occurred before the commencement of vaccination programs. This trend may be then partly attributed to a combination of behavioral modifications in key affected communities and contact tracing local programs. Therefore, the proportion of the at-risk population that remains susceptible is still uncertain, highlighting the need for continued surveillance and evaluation of vaccination strategies.
Assuntos
Surtos de Doenças , Humanos , Surtos de Doenças/prevenção & controle , América Latina/epidemiologia , Masculino , Adulto , Feminino , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Vacinação/estatística & dados numéricos , Pessoa de Meia-Idade , Adolescente , Adulto Jovem , Incidência , Criança , Vacinas contra Influenza/administração & dosagem , Pré-Escolar , LactenteRESUMO
Adult smokers, those with comorbidities, and the elderly, are at greater risk of contracting infections and their complications. Community acquired respiratory infections due to viruses, pneumococcus and other bacteria, affect both healthy and sick adults. There are vaccines that the pulmonologist must know and prescribe. The target strains of the influenza vaccine are defined by the WHO for the Southern hemisphere considering those involved in the previous influenza season in the Northern hemisphere. Its effectiveness depends on virulence, concordance between circulating and vaccine strains, and population coverage. The anti-pneumococcal polysaccharide vaccine available since 1983 is being replaced by more effective conjugate vaccines to prevent infections related to serotypes present in them. Immunization against SARS-CoV-2 reduced the contagion, severity, and lethality of COVID-19. The acellular vaccine against Bordetella pertussis for adults is present for specific situations in the adult calendar; vaccinating them strengthens the control of childhood contagion. The double (diphtheria + tetanus), and triple (double + pertussis) bacterial vaccines, and the vaccines against measles, chickenpox, rubella, human papillomavirus, Haemophilus influenzae, meningococcus, herpes zoster, Argentine hemorrhagic fever and yellow fever, are of a more limited use. Soon we will have new vaccines such as the one recently approved by the FDA against respiratory syncytial virus. Through a consensus of experts in respiratory infections, we review the new evidence regarding the immunization of adults who consult a pulmonologist, and thus update the recommendations on vaccination made eight years ago.
Los adultos fumadores con comorbilidades, y los ancianos, corren mayor riesgo de contraer infecciones y sus complicaciones. Las infecciones respiratorias comunitarias por virus, neumococo y otras bacterias afectan tanto a adultos sanos como enfermos. Existen vacunas que el neumonólogo debe conocer y prescribir. Las cepas blanco de la vacuna contra influenza son definidas por la OMS para el hemisferio sur considerando a las implicadas en la temporada precedente de influenza en el hemisferio norte. Su efectividad depende de la virulencia, la concordancia entre las cepas circulantes y las vacunales y la cobertura de la población. La vacuna anti-neumocócica polisacárida disponible desde 1983 está siendo reemplazada por vacunas conjugadas más eficaces para prevenir infecciones relacionadas a serotipos presentes en las mismas. La inmunización contra SARS-CoV-2 redujo el contagio, la gravedad y la letalidad de COVID-19. La vacuna acelular contra Bordetella pertussis para adultos está presente para situaciones puntuales en el calendario para adultos, vacunarlos fortalece el control del contagio infantil. Las vacunas doble bacteriana (difteria + tétanos), y triple (doble + pertussis), y contra sarampión, varicela, rubeola, virus del papiloma humano, Haemophylus influenzae, meningococo, herpes zóster, fiebre hemorrágica argentina y fiebre amarilla, son de uso más limitado. Pronto contaremos con nuevas vacunas, como la recientemente aprobada por la FDA contra el virus sincicial respiratorio. Revisamos a través de un consenso de expertos en infecciones respiratorias las nuevas evidencias acerca de la inmunización de adultos que consultan al neumonólogo, y actualizamos así las recomendaciones sobre vacunación realizadas ocho años atrás.
Assuntos
COVID-19 , Vacinas contra Influenza , Pneumologia , Adulto , Humanos , Lactente , Idoso , Vacinação , Vacinas Pneumocócicas , COVID-19/prevenção & controleRESUMO
BACKGROUND AND PURPOSE: Liver injury after Covid-19 vaccine has been described, although the incidence was not well established. We aimed to compare cumulative incidence of new onset liver test alteration after Covid-19 vaccination, and to compare with an historical control of influenza vaccination. METHODS: We conducted a retrospective cohort study which included adults who received at least one dose of Covid-19 vaccine from January 1 to May 30, 2021 and a control group who received a single dose of influenza vaccine during 2019, in a tertiary medical center from Argentina. RESULTS: We included 29 798 patients in Covid-19 vaccine group and 24 605 in influenza vaccine group. Liver function tests were performed in 7833 (26.9%) in Covid-19 vaccine group and 8459 (34.37%) in influenza vaccine group. Cumulative incidence at 90 days of new onset liver enzyme test alteration was 4.7 per 1000 (95% 4.0-5.5) for Covid-19 group, and 5.1 per 1000 (95% 4.3-6.1) for the influenza vaccine group (p value = 0.489). Two patients in the Covid-19 vaccine group developed immune mediated liver injury. CONCLUSIONS: We found no difference in liver test alteration between groups. These findings support the safety of Covid-19 vaccines. While we have identified two cases that are consistent with immune mediated liver injury following COVID-19 vaccination, we believe that the available data is insufficient to attribute them solely to the vaccination.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Testes de Função Hepática , Adulto , Humanos , Grupos Controle , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Vacinas contra Influenza/administração & dosagem , Estudos Retrospectivos , Vacinação/efeitos adversosRESUMO
Calendario de inmunización para población infantil.