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2.
Vaccine ; 39(3): 512-520, 2021 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-33341308

RESUMO

Vaccines will be an important element in mitigating the impact of an influenza pandemic. While research towards developing universal influenza vaccines is ongoing, the current strategy for vaccine supply in a pandemic relies on seasonal influenza vaccine production to be switched over to pandemic vaccines. Understanding how much vaccine could be produced, in which regions of the world and in what timeframe is critical to informing influenza pandemic preparedness. Through the Global Action Plan for Influenza Vaccines, 2006-2016, WHO promoted an increase in vaccine production capacity and monitors the landscape through periodically surveying influenza vaccine manufacturers. This study compares global capacity for production of influenza vaccines in 2019 with estimates from previous surveys; provides an overview of countries with established production facilities; presents vaccine production by type and manufacturing process; and discusses limitations to these estimates. Results of the current survey show that estimated annual seasonal influenza vaccine production capacity changed little since 2015 increasing from 1.47 billion to 1.48 billion doses with potential maximum annual influenza pandemic vaccine production capacity increasing from 6.37 billion to 8.31 billion doses. However, this figure should be interpreted with caution as it presents a best-case scenario with several assumptions which may impact supply. Further, pandemic vaccines would not be immediately available and could take four to six months for first supplies with several more months needed to reach maximum capacity. A moderate-case scenario is also presented of 4.15 billion doses of pandemic vaccine in 12 months. It is important to note that two doses of pandemic vaccine are likely to be required to elicit an adequate immune response. Continued efforts are needed to ensure the sustainability of this production and to conduct research for vaccines that are faster to produce and more broadly protective taking into account lessons learned from COVID-19 vaccine development.


Assuntos
Saúde Global , Vacinas contra Influenza/provisão & distribução , Influenza Humana/prevenção & controle , Pandemias/prevenção & controle , Indústria Farmacêutica , Humanos , Organização Mundial da Saúde
3.
Vaccine ; 39(3): 495-504, 2021 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-33342632

RESUMO

The addition of other respiratory illnesses such as flu could cripple the healthcare system during the coronavirus disease 2019 (COVID-19) pandemic. An annual seasonal influenza vaccine is the best way to help protect against flu. Fears of coronavirus have intensified the shortage of influenza shots in developing countries that hope to vaccinate many populations to reduce stress on their health services. We present an inventory-location mixed-integer linear programming model for equitable influenza vaccine distribution in developing countries during the pandemic. The proposed model utilizes an equitable objective function to distribute vaccines to critical healthcare providers and first responders, elderly, pregnant women, and those with underlying health conditions. We present a case study in a developing country to exhibit efficacy and demonstrate the optimization model's applicability.


Assuntos
/epidemiologia , Países em Desenvolvimento/estatística & dados numéricos , Equipamentos e Provisões , Vacinas contra Influenza/provisão & distribução , Saúde Pública/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Pessoal de Saúde , Humanos , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Gravidez , Vacinação
4.
Vaccine ; 39(2): 255-262, 2021 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-33317870

RESUMO

BACKGROUND: Pandemic planning has historically been oriented to respond to an influenza virus, with vaccination strategy being a key focus. As the current COVID-19 pandemic plays out, the Australian government is closely monitoring progress towards development of SARS-CoV2 vaccines as a definitive intervention. However, as in any pandemic, initial supply will likely be exceeded by demand due to limited manufacturing output. METHODS: We convened community juries in three Australian locations in 2019 to assess public acceptability and perceived legitimacy of influenza pandemic vaccination distribution strategies. Preparatory work included literature reviews on pandemic vaccine allocation strategies and on vaccine allocation ethics, and simulation modelling studies. We assumed vaccine would be provided to predefined priority groups. Jurors were then asked to recommend one of two strategies for distributing remaining early doses of vaccine: directly vaccinate people at higher risk of adverse outcomes from influenza; or indirectly protect the general population by vaccinating primary school students, who are most likely to spread infection. RESULTS: Thirty-four participants of diverse backgrounds and ages were recruited through random digit dialling and topic-blinded social media advertising. Juries heard evidence and arguments supporting different vaccine distribution strategies, and questioned expert presenters. All three community juries supported prioritising school children for influenza vaccination (aiming for indirect protection), one by 10-2 majority and two by consensus. Justifications included that indirect protection benefits more people and is likely to be more publicly acceptable. CONCLUSIONS: In the context of an influenza pandemic, informed citizens were not opposed to prioritising groups at higher risks of adverse outcomes, but if resources and epidemiological conditions allow, achieving population benefits should be a strategic priority. These insights may inform future SARS-CoV-2 vaccination strategies.


Assuntos
/epidemiologia , Alocação de Recursos para a Atenção à Saúde/organização & administração , Programas de Imunização/organização & administração , Vacinas contra Influenza/provisão & distribução , Influenza Humana/prevenção & controle , Pandemias/prevenção & controle , Vacinação/ética , Adolescente , Adulto , Austrália/epidemiologia , Criança , Feminino , Humanos , Esquemas de Imunização , Vacinas contra Influenza/administração & dosagem , Vacinas contra Influenza/economia , Influenza Humana/epidemiologia , Influenza Humana/imunologia , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Orthomyxoviridae/imunologia , Saúde Pública/economia , Saúde Pública/métodos , Vacinação/economia , Cobertura Vacinal/estatística & dados numéricos
7.
J Pediatr ; 228: 87-93.e2, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32771480

RESUMO

OBJECTIVES: To determine factors associated with parents who plan to vaccinate their children against influenza next year, especially those who did not vaccinate against influenza last year using a global survey. STUDY DESIGN: A survey of caregivers accompanying their children aged 1-19 years old in 17 pediatric emergency departments in 6 countries at the peak of the coronavirus disease 2019 (COVID-19) pandemic. Anonymous online survey included caregiver and child demographic information, vaccination history and future intentions, and concern about the child and caregiver having COVID-19 at the time of emergency department visit. RESULTS: Of 2422 surveys, 1314 (54.2%) caregivers stated they plan to vaccinate their child against influenza next year, an increase of 15.8% from the previous year. Of 1459 caregivers who did not vaccinate their children last year, 418 (28.6%) plan to do so next year. Factors predicting willingness to change and vaccinate included child's up-to-date vaccination status (aOR 2.03, 95% CI 1.29-3.32, P = .003); caregivers' influenza vaccine history (aOR 3.26, 95% CI 2.41-4.40, P < .010), and level of concern their child had COVID-19 (aOR 1.09, 95% CI 1.01-1.17, P = .022). CONCLUSIONS: Changes in risk perception due to COVID-19, and previous vaccination, may serve to influence decision-making among caregivers regarding influenza vaccination in the coming season. To promote influenza vaccination among children, public health programs can leverage this information.


Assuntos
/epidemiologia , Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Vacinação , Adolescente , Cuidadores , Criança , Pré-Escolar , Tomada de Decisões , Serviço Hospitalar de Emergência , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Programas de Imunização , Lactente , Recém-Nascido , Cooperação Internacional , Masculino , Pais , Saúde Pública , Risco , Inquéritos e Questionários , Adulto Jovem
8.
Washington, D.C.; PAHO; 2020-12-28.
em Inglês | PAHO-IRIS | ID: phr-53167

RESUMO

Vaccines save between 2 million and 3 million lives each year and protect the entire population from more than a dozen life-threatening diseases. Thanks to vaccination, smallpox was eradicated in 1980, and we are on track to eradicate polio. However, despite great strides in the control of measles, one of the most contagious diseases known, the last few years have unfortunately seen an increase in cases. This is why high vaccination coverage—95% or more—is needed, posing a major technical and communication challenge for health workers. Studies show that telling people about the quality, safety, effectiveness and availability of vaccines is not enough to influence behavior change related to immunization, and in general, doesn´t increase coverage. For this reason, it´s necessary to understand the reasons why people choose not to get vaccinated or not get their children vaccinated, in order to begin a two-way respectful dialogue using the best, most effective messages. Given this context, the main objective of these guidelines is to provide tools for staff working in the field of immunization to support effective communication between health personnel and the general population, with the aim of strengthening, maintaining or recovering trust in vaccines and the immunization programs in the Region of the Americas.


Assuntos
Vacinas , Vacinação , Imunização , Família , Cuidadores , Infecções por Coronavirus , Coronavirus , Infecções por Coronavirus , Vacina Quadrivalente Recombinante contra HPV tipos 6, 11, 16, 18 , Papiloma , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Sarampo , Vacinas contra Influenza , Vacina contra Sarampo , Vírus da Influenza A , Vírus da Influenza B , Influenzavirus C , Vacina contra Sarampo-Caxumba-Rubéola
9.
Med Lav ; 111(6): 445-448, 2020 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-33311419

RESUMO

OBJECTIVES: We aimed at describing the attitudes towards influenza vaccination and a potential COVID-19 vaccine in Italy. METHODS: A nationally representative survey based on 1055 Italians aged 15-85 years was conducted in September 16-28, 2020. RESULTS: We found that 40.8% of the population reported the intention to be vaccinated against influenza next winter and 53.7% would accept to receive a potential COVID-19 vaccine. The percentages were higher among individuals aged 55 and over (58.8% for influenza vaccine and 58.2% for a potential COVID-19 vaccine) and among professionals, managers and teachers as compared to manual workers and farmers (36.1% vs. 27.6% for influenza vaccine and 51.6% vs. 44.8% for a potential COVID-19 vaccine). DISCUSSION: These data confirm a certain degree of vaccine mistrust in Italy, especially among less qualified workers.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Vacinas contra Influenza , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Humanos , Itália , Pessoa de Meia-Idade , Ocupações , Pandemias , Inquéritos e Questionários , Vacinação , Adulto Jovem
10.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(10): 1555-1576, 2020 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-33297613

RESUMO

Influenza virus infection is a respiratory infectious disease that can seriously affect human health. Influenza viruses can have frequent antigenic variation and changes, which can result in rapid and widespread transmission resulting in annual epidemics and outbreaks in places of public gathering such as schools, kindergartens and nursing homes. According to WHO estimation, seasonal influenza epidemics have caused an annually 3 to 5 million severe cases and 290 000 to 650 000 deaths globally. Pregnant women, young children, the elderly, and persons with chronic illnesses are at high risk for severe illness and death associated with influenza virus infection. Especially, COVID-19 pandemic might co-circulate with other respiratory infectious diseases such as influenza in the coming winter-spring season. 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) which includes split-virus influenza vaccine and subunit vaccine, quadrivalent inactivated influenza vaccine (IIV4) which is split, and trivalent live attenuated influenza vaccine (LAIV3) which was newly licensed. Except for a few major cities, influenza vaccine is a category Ⅱ vaccine, which means influenza vaccination is voluntary, and recipients must pay for it. In 2018 and 2019, the China CDC issued the "Technical Guidelines for Seasonal Influenza Vaccination in China" . In the past year, new research evidences home and abroad have been published, and new seasonal influenza vaccine has been licensed in China. 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 2019-2020 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2020-2021)" . 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 2020-2021 in China. Fourth, northern hemisphere influenza vaccination composition for the 2020-2021 season which included trivalent and quadrivalent influenza vaccine. Fifth, Influenza vaccination recommendations for 2020-2021 influenza season. 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. Considering the situation of globally pandemic of COVID-19, to decrease the risk of influenza virus infection and minimize the impact on COVID-19 prevention and control, we recommend the following priority for seasonal influenza vaccination: healthcare workers, including clinical doctors and nurses, public health professionals, quarantine professionals; vulnerable groups living in nursing homes or welfare homes and staffs who take care those vulnerable groups; people work or stay in high population density places, such as teachers and students in kindergartens, primary and secondary school, prisoners and staffs of prisons; other high risk group of influenza, including adults ≥60 years of age, children aged 6-59 months, persons with specific chronic diseases, 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. People whoever get IIV or LAIV all apply to the principle. If they were vaccinated in 2019-2020 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 CDCs 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 , Adulto , Idoso , Criança , Pré-Escolar , China/epidemiologia , Cidades , Feminino , Humanos , Lactente , Influenza Humana/epidemiologia , Pandemias , Gravidez
11.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(12): 1364-1377, 2020 Dec 06.
Artigo em Chinês | MEDLINE | ID: mdl-33333653

RESUMO

The overall coverage rate of influenza vaccination in China has been only about 2% in recent years. At present, free influenza vaccination programs, also named the "Publicly-funded Influenza Vaccination Project", have been carried out for the specific groups (the elderly, school-age children, healthcare workers, etc.) through livelihood projects or policies to benefit the people in some areas of China, which has significantly increased the vaccine coverage in the target population. In order to promote the project to be launched in a scientific and orderly manner in more and more regions of China, we organized and compiled this consensus on implementation of publicly-funded influenza vaccination project, including the project's purpose, establishment, implementation, organization and management, which was based on the research of influenza vaccine application strategies in some European countries and the United States and combined with the relevant policies, technical guidelines and past experiences in China. Meanwhile, the evaluation indicators, such as vaccination rates, effectiveness, safety and cost-effectiveness, and relevant assessment methods were also comprehensively expounded, aiming to provide reference for regions that are willing to implement or have launched the project.


Assuntos
Vacinas contra Influenza , Influenza Humana , Idoso , Criança , China , Consenso , Humanos , Programas de Imunização , Influenza Humana/prevenção & controle , Estados Unidos , Vacinação
12.
PLoS One ; 15(12): e0239112, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33382708

RESUMO

Influenza virus A is a significant agent involved in the outbreak of worldwide epidemics, causing millions of fatalities around the world by respiratory diseases and seasonal illness. Many projects had been conducting to investigate recovered infected patients for therapeutic vaccines that have broad-spectrum activity. With the aid of the computational approach in biology, the designation for a vaccine model is more accessible. We developed an in silico protocol called iBRAB to design a broad-reactive Fab on a wide range of influenza A virus. The Fab model was constructed based on sequences and structures of available broad-spectrum Abs or Fabs against a wide range of H1N1 influenza A virus. As a result, the proposed Fab model followed iBRAB has good binding affinity over 27 selected HA of different strains of H1 influenza A virus, including wild-type and mutated ones. The examination also took by computational tools to fasten the procedure. This protocol could be applied for a fast-designed therapeutic vaccine against different types of threats.


Assuntos
Anticorpos Antivirais/química , Antígenos Virais/química , Desenho de Fármacos , Glicoproteínas de Hemaglutininação de Vírus da Influenza/química , Fragmentos Fab das Imunoglobulinas/química , Vírus da Influenza A Subtipo H1N1/imunologia , Influenza Humana/prevenção & controle , Sequência de Aminoácidos , Anticorpos Antivirais/genética , Antígenos Virais/genética , Antígenos Virais/imunologia , Sítios de Ligação , Simulação por Computador , Glicoproteínas de Hemaglutininação de Vírus da Influenza/genética , Glicoproteínas de Hemaglutininação de Vírus da Influenza/imunologia , Humanos , Fragmentos Fab das Imunoglobulinas/genética , Vacinas contra Influenza/administração & dosagem , Vacinas contra Influenza/biossíntese , Influenza Humana/imunologia , Influenza Humana/virologia , Simulação de Acoplamento Molecular , Ligação Proteica , Conformação Proteica em alfa-Hélice , Conformação Proteica em Folha beta , Domínios e Motivos de Interação entre Proteínas , Alinhamento de Sequência , Homologia de Sequência de Aminoácidos , Termodinâmica
13.
Rev. esp. quimioter ; 33(6): 444-447, dic. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-FGT-6027

RESUMO

INTRODUCCIÓN: La cocirculación de los dos linajes de gripe B dificulta la predicción de la cepa a incluir en la vacuna trivalente. Comunidades autónomas (CCAA) como Cantabria continúan sin suministrar la vacuna tetravalente. El objetivo de este estudio fue analizar las características epidemiológicas de la gripe B en Cantabria (temporada 2019-2020), y determinar el linaje predominante y su relación con la vacuna recomendada. MÉTODOS: Estudio retrospectivo en el que el diagnóstico de gripe y los linajes de gripe B se determinaron mediante RTPCR. RESULTADOS: Todas las muestras pertenecieron al linaje Victoria. La coinfección vírica más frecuente fue por SARSCoV-2. La población afectada por gripe B fue fundamentalmente pediátrica y los pacientes no vacunados requirieron más frecuentemente ingreso hospitalario. CONCLUSIÓN: La gripe B presenta una mayor incidencia sobre población pediátrica, y la gripe A afecta más a población adulta. Sólo el 28,8% de los pacientes con gripe B que presentaban algún factor de riesgo estaban vacunados, existiendo la necesidad de aumentar la cobertura con vacunas tetravalentes para reducir la carga de enfermedad asociada al virus gripal B


INTRODUCTION: Co-circulation of the two Influenza B lineages hinders forecast of strain to include in trivalent vaccine. Autonomous Communities such as Cantabria continue without supplying tetravalent vaccine. The aim of this study was to analyse epidemiological characteristics of influenza type B in Cantabria (2019-2020 season) as well as to establish the predominant lineage and its relation to the recommended vaccine. METHODS: Retrospective study whereby flu diagnosis and lineage analysis were determined by RT-PCR. RESULTS: All samples belonged to the Victoria lineage. Most prevalent viral co-infection was due to SARS-CoV-2. The population affected by influenza B was mainly paediatric and non-vaccinated patients more frequently required hospital admittance. CONCLUSIONS: Influenza type B has a higher incidence in the paediatric population and type A affects more the adult population. Only 28.8% of patients with Influenza B that presented with some underlying condition or risk factor were vaccinated. This shows the need to increase coverage with tetravalent vaccines in order to reduce the burden of disease associated with the Influenza B virus


Assuntos
Humanos , Masculino , Feminino , Criança , Adulto , Infecções por Coronavirus/epidemiologia , Vírus da Influenza B , Influenza Humana/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Distribuição de Qui-Quadrado , Coinfecção/epidemiologia , Hospitalização/estatística & dados numéricos , Vacinas contra Influenza/administração & dosagem , Estudos Retrospectivos , Estações do Ano , Espanha/epidemiologia
14.
J Natl Med Assoc ; 112(6): 681-687, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33276969

RESUMO

Influenza is a contagious respiratory virus that causes a significant annual health burden in the United States (US). In spite of effective yearly vaccinations to protect individuals against influenza-related health complications, especially with certain chronic co-morbid illnesses, persistent racial/ethnic disparities exist in influenza immunization. African Americans continue to experience low vaccination uptake, stemming, at least in part, from years of bias in and mistrust of orthodox medicine, safety concerns, and environmental barriers to vaccine access. The novel respiratory coronavirus, SARS-CoV2, causes COVID-19, leading to a pandemic that in the U.S. has exerted severe physical, psychological, and economic tolls on the African Americans and other disadvantaged communities. These two respiratory-borne virus' cause disparate effects in the black community, unmasking persistent disparities in healthcare. Unfortunately, suboptimal influenza immunization acceptance exacerbates flu-related adverse health outcomes, similar to difficulties from the effects of the COVID-19 pandemic. In consideration of the impending influenza-COVID-19 "twindemic", robust educational campaigns, policy initiatives, and novel approaches to influenza immunization must be considered for the African American community to build trust in the health benefits of the influenza vaccination and, ultimately, to trust in the health benefits of potential SARS-CoV2 vaccines, when available for the general public.


Assuntos
Afro-Americanos , Vacinas contra Influenza/uso terapêutico , Influenza Humana , Serviços Preventivos de Saúde , Melhoria de Qualidade/organização & administração , /epidemiologia , Disparidades em Assistência à Saúde , Humanos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Pandemias/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/normas , Estados Unidos/epidemiologia , Vacinação
15.
BMJ Open ; 10(12): e041577, 2020 12 10.
Artigo em Inglês | MEDLINE | ID: mdl-33303459

RESUMO

OBJECTIVE: To investigate possible relationships between pre-existing medical conditions (including common comorbidities and chronic medications) and risk for suffering COVID-19 disease in middle-aged and older adults. DESIGN: Population-based retrospective cohort study. SETTING: Twelve primary care centres (PCCs) in Tarragona (Spain). PARTICIPANTS: 79 083 people (77 676 community-dwelling and 1407 nursing-home residents), who were all individuals aged >50 years affiliated to the 12 participating PCCs. OUTCOMES: Baseline cohort characteristics (age, sex, vaccinations, comorbidities and chronic medications) were established at study start (1st. March 2020) and primary outcome was time to COVID-19 confirmed by PCR among cohort members throughout the epidemic period (from 1st. March 2020 to 23rd. May 2020). Risk for suffering COVID-19 was evaluated by Cox regression, estimating multivariable HRs adjusted for age, sex, comorbidities and medications use. RESULTS: During the study period, 2324 cohort members were PCR-tested, with 1944 negative and 380 positive results, which means an incidence of 480.5 PCR-confirmed COVID-19 cases per 100 000 persons-period. Assessing the total study cohort, only age (HR 1.02; 95% CI 1.01 to 1.03; p=0.002), nursing-home residence (HR 21.83; 95% CI 16.66 to 28.61; p<0.001) and receiving diuretics (HR 1.35; 95% CI 1.04 to 1.76; p=0.026) appeared independently associated with increased risk. Smoking (HR 0.62; 95% CI 0.41 to 0.93; p=0.022), ACE inhibitors (HR 0.68; 95% CI 0.47 to 0.99; p=0.046) and antihistamine (HR 0.47; 95% CI 0.22 to 1.01; p=0.052) were associated with a lower risk. Among community-dwelling individuals, cancer (HR 1.52; 95% CI 1.03 to 2.24; p=0.035), chronic respiratory disease (HR 1.82; 95% CI 1.08 to 3.07; p=0.025) and cardiac disease (HR 1.53; 95% CI 1.06 to 2.19; p=0.021) emerged to be also associated with an increased risk. Receiving ACE inhibitors (HR 0.66; 95% CI 0.44 to 0.99; p=0.046) and influenza vaccination (HR 0.63; 95% CI 0.44 to 0.91; p=0.012) was associated with decreased risk. CONCLUSION: Age, nursing-home residence and multiple comorbidities appear predisposing for COVID-19. Conversely, receiving ACE inhibitors, antihistamine and influenza vaccination could be protective, which should be closely investigated in further studies specifically focused on these concerns.


Assuntos
/epidemiologia , Comorbidade , Preparações Farmacêuticas/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Feminino , Cardiopatias/epidemiologia , Humanos , Vacinas contra Influenza/uso terapêutico , Masculino , Pessoa de Meia-Idade , Casas de Saúde , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Espanha/epidemiologia
16.
Medicina (Kaunas) ; 56(12)2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33352889

RESUMO

Coinfection with both SARS-CoV-2 and influenza viruses seems to be a real and severe problem. However, coinfection is far from a simple matter, and cannot be considered having more unfavorable outcomes as a direct consequence. In reality, the aftermath is powerfully nuanced by the presence of risk factors and specific molecular mechanisms. Our objective was to raise awareness around the unpredictable association between COVID-19 pandemics and the upcoming flu season, and make arguments about the need to develop new routine testing protocols for both viruses, at least during the period with an expected high incidence. Our reasoning is built around the various impacts that the whole range of risk groups, common immunological mechanisms, and complex interactions, such as influenza vaccination, will have on patients' prognosis. We show that the more flawed clinical course is due to managing only one of the infections (and, subsequently, neglecting the other condition).


Assuntos
/epidemiologia , Vacinas contra Influenza/administração & dosagem , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Coinfecção/epidemiologia , Suscetibilidade a Doenças , Humanos , Pandemias , Prognóstico , Fatores de Risco , Romênia/epidemiologia , Estações do Ano
17.
Occup Med (Lond) ; 70(9): 665-671, 2020 12 30.
Artigo em Inglês | MEDLINE | ID: mdl-33300998

RESUMO

BACKGROUND: In next fall and winter, SARS-CoV-2 could circulate in parallel with seasonal influenza. The dual epidemics will result in considerable morbidity and mortality; therefore, influenza vaccination may be essential. Recent studies found increased risk of coronavirus in individuals receiving influenza vaccination. AIMS: Our aim is to analyse the association between influenza vaccination and COVID-19 in a population of healthcare workers (HCWs). METHODS: IgG antibodies against SARS-CoV-2 were detected in 3520 HCWs at a large hospital in Northern Italy. For each participant, we collected data on flu immunization status for the last five flu seasons. Logistic regression was used to test associations between seasonal flu vaccination status and a positive serology tests for COVID-19. RESULTS: During the last five flu seasons, 2492 vaccinations were administered. Serology tests were negative for 3196 (91%) HCWs and residents and only 21 (1%) people had an equivocal test (12.0-15.0 AU/mL). Only 128 (4%) people received a diagnosis of COVID-19, with a positive swab test. No flu vaccinations for the last five flu seasons were specifically associated with diagnosis of COVID-19 or with positive results of serology tests. CONCLUSIONS: Flu vaccinations did not appear to be associated with SARS-CoV-2 infection. Influenza vaccination should continue to be recommended for HCWs and for individuals at increased risk for severe illness from respiratory infection.


Assuntos
Anticorpos Antivirais/sangue , Pessoal de Saúde/estatística & dados numéricos , Imunoglobulina G/sangue , Vacinas contra Influenza/efeitos adversos , Influenza Humana/prevenção & controle , /isolamento & purificação , Adulto , Idoso , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Humanos , Vacinas contra Influenza/imunologia , Itália , Masculino , Pessoa de Meia-Idade
18.
PLoS One ; 15(12): e0243408, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33296417

RESUMO

We study a novel multi-strain SIR epidemic model with selective immunity by vaccination. A newer strain is made to emerge in the population when a preexisting strain has reached equilbrium. We assume that this newer strain does not exhibit cross-immunity with the original strain, hence those who are vaccinated and recovered from the original strain become susceptible to the newer strain. Recent events involving the COVID-19 virus shows that it is possible for a viral strain to emerge from a population at a time when the influenza virus, a well-known virus with a vaccine readily available, is active in a population. We solved for four different equilibrium points and investigated the conditions for existence and local stability. The reproduction number was also determined for the epidemiological model and found to be consistent with the local stability condition for the disease-free equilibrium.


Assuntos
/epidemiologia , Epidemias , Modelos Biológicos , /prevenção & controle , Humanos , Vacinas contra Influenza/uso terapêutico , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle
20.
J Glob Health ; 10(2): 021102, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33312512

RESUMO

Background: Influenza vaccination prevents people from influenza-related diseases and thereby mitigates the burden on national health systems when COVID-19 circulates and public health measures controlling respiratory viral infections are relaxed. However, it is challenging to maintain influenza vaccine services as the COVID-19 pandemic has the potential to disrupt vaccination programmes in many countries during the 2020/21 winter. We summarise available recommendations and strategies on influenza vaccination, specifically the changes in the context of the COVID-19 pandemic. Methods: We searched websites and databases of national and international public health agencies (focusing on Europe, North and South America, Australia, New Zealand, and South Africa). We also contacted key influenza immunization focal points and experts in respective countries and organizations including WHO and ECDC. Results: Available global and regional guidance emphasises the control of COVID-19 infection in immunisation settings by implementing multiple measures, such as physical distancing, hand hygiene practice, appropriate use of personal protective equipment by health care workers and establishing separate vaccination sessions for medically vulnerable people. The guidance also emphasises using alternative models or settings (eg, outdoor areas and pharmacies) for vaccine delivery, communication strategies and developing registry and catch-up programmes to achieve high coverage. Several novel national strategies have been adopted, such as combining influenza vaccination with other medical visits and setting up outdoor and drive through vaccination clinics. Several Southern Hemisphere countries have increased influenza vaccine coverage substantially for the 2020 influenza season. Most of the countries included in our review have planned a universal or near universal influenza vaccination for health care workers, or have made influenza vaccination for health care workers mandatory. Australia has requested that all workers and visitors in long term care facilities receive influenza vaccine. The UK has planned to expand the influenza programme to provide free influenza vaccine for the first time to all adults 50-64 years of age, people on the shielded patient list and their household members and children in the first year of secondary school. South Africa has additionally prioritised people with hypertension for influenza vaccination. Conclusions: This review of influenza vaccination guidance and strategies should support strategy development on influenza vaccination in the context of COVID-19.


Assuntos
/epidemiologia , Controle de Doenças Transmissíveis/organização & administração , Programas de Imunização/organização & administração , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , /prevenção & controle , Criança , Saúde Global , Humanos , Pandemias
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