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1.
Artigo em Inglês | MEDLINE | ID: mdl-31738867

RESUMO

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


Assuntos
Programas de Imunização , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Cobertura Vacinal , Vacinação , Adolescente , Adulto , Feminino , Humanos , Influenza Humana/virologia , Pessoa de Meia-Idade , Mães , Northern Territory , Grupo com Ancestrais Oceânicos , Gravidez , Sistema de Registros , Estudos Retrospectivos , Adulto Jovem
2.
MMWR Morb Mortal Wkly Rep ; 68(40): 885-892, 2019 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-31600186

RESUMO

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


Assuntos
Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Coqueluche/epidemiologia , Coqueluche/prevenção & controle , Adolescente , Adulto , Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Feminino , Humanos , Lactente , Recém-Nascido , Vacinas contra Influenza/administração & dosagem , Pessoa de Meia-Idade , Gravidez , Estados Unidos/epidemiologia , Vacinação/estatística & dados numéricos , Adulto Jovem
3.
Praxis (Bern 1994) ; 108(13): 859-862, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31571544

RESUMO

Vaccination During Pregnancy Abstract. Vaccinations administered to women during pregnancy can provide protection against serious infectious diseases for the mother, for the newborn, or both. Two vaccines are routinely recommended during pregnancy: Influenza and Pertussis. While the influenza vaccine protects mainly the pregnant mother, who is at an increased risk for severe affection, the pertussis vaccine is an effective protection to infants who are at particularly high risk of pertussis complications and mortality in the first three months of life.


Assuntos
Vacinas contra Influenza , Vacina contra Coqueluche , Complicações Infecciosas na Gravidez , Coqueluche , Feminino , Humanos , Lactente , Recém-Nascido , Vacinas contra Influenza/administração & dosagem , Vacina contra Coqueluche/administração & dosagem , Gravidez , Complicações Infecciosas na Gravidez/prevenção & controle , Vacinação , Coqueluche/prevenção & controle
4.
Internist (Berl) ; 60(11): 1127-1135, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31478058

RESUMO

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


Assuntos
Antivirais/uso terapêutico , Vacinas contra Influenza/administração & dosagem , Influenza Humana/tratamento farmacológico , Influenza Humana/prevenção & controle , Neuraminidase/uso terapêutico , Europa (Continente)/epidemiologia , Humanos , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Morbidade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/tratamento farmacológico , Síndrome do Desconforto Respiratório do Adulto
5.
Artigo em Inglês | MEDLINE | ID: mdl-31522666

RESUMO

This tenth annual immunisation coverage report shows data for the calendar year 2016 derived from the Australian Immunisation Register (AIR) and the National Human Papillomavirus (HPV) Vaccination Program Register. After a decade of being largely stable at around 90%, 'fully immunised' coverage at the 12-month assessment age increased in 2016 to reach 93.7% for the age assessment quarterly data point in December 2016, similar to the 93.4% for the age assessment quarterly data point in December 2016 for 60 months of age. Implementation of the 'No Jab No Pay' policy may have contributed to these increases. While 'fully immunised' coverage at the 24-month age assessment milestone decreased marginally from 90.8%, in December 2015, to 89.6% for the age assessment quarterly data point in December 2016, this was likely due to the assessment algorithm being amended in December 2016 to include four doses of DTPa vaccine instead of three, following reintroduction of the 18-month booster dose. Among Indigenous children, the gap in coverage assessed at 12 months of age decreased fourfold, from 6.7 percentage points in March 2013 to only 1.7 percentage points lower than non-Indigenous children in December 2016. Since late 2012, 'fully immunised' coverage among Indigenous children at 60 months of age has been higher than for non-Indigenous children. Vaccine coverage for the nationally funded seasonal influenza vaccine program for Indigenous children aged 6 months to <5 years, which commenced in 2015, remained suboptimal nationally in 2016 at 11.6%. Changes in MMR coverage in adolescents were evaluated for the first time. Of the 411,157 ten- to nineteen-year-olds who were not recorded as receiving a second dose of MMR vaccine by 31 December 2015, 43,103 (10.5%) of them had received it by the end of 2016. Many of these catch-up doses are likely to have been administered as a result of the introduction on 1 January 2016 of the Australian Government's 'No Jab No Pay' policy. In 2016, 78.6% of girls aged 15 years had three documented doses of HPV vaccine (jurisdictional range 67.8-82.9%), whereas 72.9% of boys (up from 67.1 % in 2015) had received three doses.


Assuntos
Programas de Imunização , Vacinas contra Influenza/administração & dosagem , Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem , Vacinas contra Papillomavirus/administração & dosagem , Cobertura Vacinal , Adolescente , Adulto , Idoso , Austrália , Criança , Pré-Escolar , Feminino , Humanos , Esquemas de Imunização , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Adulto Jovem
6.
Br J Nurs ; 28(15): 1032-1034, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31393758

RESUMO

The Flu Bee Game earned Joan Pons Laplana a runner-up place in the innovation category, as Andy Yeoman of Focus Games Ltd explains.


Assuntos
Distinções e Prêmios , Difusão de Inovações , Jogos Experimentais , Humanos , Vacinas contra Influenza/administração & dosagem , Corpo Clínico/psicologia , Medicina Estatal , Reino Unido , Vacinação/psicologia , Vacinação/estatística & dados numéricos
7.
Rev Esp Salud Publica ; 932019 Aug 08.
Artigo em Espanhol | MEDLINE | ID: mdl-31391453

RESUMO

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


Assuntos
Atitude do Pessoal de Saúde , Pessoal de Saúde/estatística & dados numéricos , Programas de Imunização , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Vacinação/estatística & dados numéricos , Local de Trabalho , Adulto , Estudos Transversais , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Espanha , Inquéritos e Questionários , Centros de Atenção Terciária , Organização Mundial da Saúde
8.
Pan Afr Med J ; 33: 42, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384357

RESUMO

Introduction: We investigated an outbreak of influenza-like illness (ILI) at a boarding school in Eastern Cape Province, South Africa. We aimed to confirm the etiological agent, estimate attack rates and identify risk factors for illness. Methods: We conducted a retrospective cohort study including senior school boarders (n=308). Students with ILI (cough and fever) were identified through school medical records. We also conducted a questionnaire-based cross-sectional study among senior students including boarders (n=107) and day students (n=45). We collected respiratory specimens for respiratory pathogen testing by real-time polymerase chain reaction from a subset of symptomatic students. We calculated attack rates of medically attended ILI (medILI) and identified factors associated with medILI using logistic regression. We calculated seasonal influenza vaccine effectiveness (VE) against medILI. Results: Influenza A (H3N2) virus was detected in 61% (23/38) of specimens. Attack rate for medILI was 13% among boarders (39/308) in the cohort study and 20% in both day students (9/45) and boarders (21/107) in the cross-sectional study. Playing squash was associated with medILI (aOR 5.35, 95% confidence interval [95% CI]: 1.68-17.07). Of the boarders, 19% (57/308) were vaccinated before the outbreak. The adjusted VE against medILI was 18% (aOR 0.82, 95% CI 0.38-1.78). The outbreak led to cancellation of several events and the need for academic remedial sessions. Conclusion: We confirmed an influenza A (H3N2) virus outbreak with a high attack rate. The outbreak affected academic and sports activities. Participation in sports and social gatherings while experiencing ILI should be discouraged to reduce viral transmission and impact on school activities.


Assuntos
Surtos de Doenças , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Vacinas contra Influenza/administração & dosagem , Influenza Humana/epidemiologia , Adolescente , Criança , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Influenza Humana/virologia , Masculino , Estudos Retrospectivos , Fatores de Risco , Instituições Acadêmicas , África do Sul/epidemiologia , Estudantes , Adulto Jovem
9.
S D Med ; 72(4): 164-167, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31436929

RESUMO

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


Assuntos
Programas de Imunização/organização & administração , Vacinas contra Influenza , Influenza Humana/prevenção & controle , Pneumonia/prevenção & controle , Idoso , Medicina de Família e Comunidade , Humanos , Vacinas contra Influenza/administração & dosagem , South Dakota , Vacinação
11.
BMC Public Health ; 19(1): 890, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31277611

RESUMO

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


Assuntos
Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Gestantes/psicologia , Cobertura Vacinal/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Hospitais Públicos , Humanos , Pessoa de Meia-Idade , Gravidez , Medição de Risco , Singapura , Inquéritos e Questionários , Adulto Jovem
12.
Metas enferm ; 22(6): 5-11, jul. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184042

RESUMO

Objetivo: determinar la evolución de la tasa de vacunación antigripal y antineumocócica (23 valencias) entre los años 2010 y 2014 en pacientes reumáticos en tratamiento con inmunosupresores y evaluar la magnitud de infecciones respiratorias documentadas en el año posterior a la vacunación. Método: estudio descriptivo longitudinal retrospectivo. Se reclutaron por conveniencia 200 pacientes con artritis reumatoide o espondiloartropatías en tratamiento con fármacos antirreumáticos modificadores de la enfermedad (FAME) sintético, FAME biológico o corticoides. Se conformaron dos grupos de 100 pacientes (2010 y 2014) en los que se revisaron historias clínicas para recoger variables demográficas, comorbilidades, hábitos tóxicos, diagnóstico reumatológico y años de evolución de este, tratamiento, administración de la vacuna antigripal y antineumocócica 23v y número de infecciones respiratorias en el año posterior. Resultados: en la muestra un 66% fue mujer, la edad media fue de 66 años y 12 de evolución de la enfermedad. El 43,5% había recibido vacunación antigripal y el 30% vacunación neumocócica 23v. El 21,5% presentó infección respiratoria en el tiempo de seguimiento. Hubo una mayor tasa de vacunación antigripal y antineumocócica en 2014 frente a 2010 (49 y 29% vs. 38% y 21%, respectivamente), siendo solo estadísticamente significativo el aumento en la cobertura antineumocócica. Los pacientes mayores de 65 años y alguna comorbilidad o hábito tóxico son más vacunados (p< 0,05). No hubo diferencias en las vacunaciones ni en el número de infecciones respiratorias, ni en función del diagnóstico reumatológico, ni del tratamiento recibido por el paciente. Conclusiones: la tasa de vacunación mejoró en 2014 respecto a 2010. No obstante, el profesional enfermero ha de intervenir en mejorar la tasa de vacunación en estos pacientes


Objective: to determine the evolution in the rate of influenza and pneumococcal (23-valent) vaccination between the years 2010 and 2014 in rheumatic patients on treatment with immunosuppressants, and to evaluate the extent of documented respiratory infections within the year after vaccination. Method: a retrospective cross-sectional descriptive study. Two hundred (200) patients were recruited by convenience sampling, with rheumatoid arthritis or spondyloarthropathy, on treatment with synthetic disease modifying antirheumatic drugs (DMARDs), biologic DMARDs or corticosteroids. Two arms of 100 patients were formed (2010 and 2014), and clinical records were reviewed in order to collect demographical variables, comorbidities, toxic habits, rheumatology diagnosis and years of disease evolution, treatment, administration of the influenza and the pneumococcal 23 vaccine, and number of respiratory infections during the following year. Results: in the sample, 66% were women, their mean age was 66 years, with 12 years of disease evolution; 43.5% had received influenza vaccination, and 30% pneumococcal 23v vaccination; 21.5% presented respiratory infection within the time of follow-up. There was a higher rate of influenza and pneumococcal vaccination in 2014 vs. 2010 (49 and 29% vs. 38% and 21%, respectively); only the increase in pneumococcal coverage was statistically significant. Patients >65-year-old and with some comorbidity or toxic habit were more vaccinated (p< 0.05). There were no differences in vaccinations or in the number of respiratory infections based on the rheumatology diagnosis or the treatment received by the patient. Conclusions: the vaccination rate improved in 2014 vs. 2010. However, the nursing professional must be involved in the improvement of the vaccination rate for these patients


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Vacinas contra Influenza/administração & dosagem , Vacinas Pneumocócicas/administração & dosagem , Doenças Reumáticas/tratamento farmacológico , Doenças Reumáticas/imunologia , Imunossupressores/administração & dosagem , Cobertura Vacinal , Estudos Transversais , Estudos Longitudinais , Estudos Retrospectivos , Prednisona
13.
Artigo em Inglês | MEDLINE | ID: mdl-31315314

RESUMO

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


Assuntos
Infecções Comunitárias Adquiridas/epidemiologia , Influenza Humana/epidemiologia , Sistemas On-Line , Vigilância da População , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Criança , Pré-Escolar , Tosse/epidemiologia , Notificação de Doenças , Feminino , Febre/epidemiologia , Humanos , Incidência , Lactente , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Masculino , Pessoa de Meia-Idade , Faringite/epidemiologia , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
14.
BMC Public Health ; 19(1): 918, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288768

RESUMO

BACKGROUND: Annual seasonal influenza vaccination (SIV) is recommended for people with diabetes, but their SIV rates remain far below public health targets. We aimed to identify temporal trajectories of SIV uptake over a 10-year period among French people with diabetes and describe their clinical characteristics. METHODS: We identified patients with diabetes in 2006 among a permanent, representative sample of beneficiaries of the French National Health Insurance Fund. We followed them up over 10 seasons (2005/06-2015/16), using SIV reimbursement claims and group-based trajectory modelling to identify SIV trajectories and to study sociodemographic, clinical, and healthcare utilization characteristics associated with the trajectories. RESULTS: We identified six trajectories. Of the 15,766 patients included in the model, 4344 (28%) belonged to the "continuously vaccinated" trajectory and 4728 (30%) to the "never vaccinated" one. Two other trajectories showed a "progressive decrease" (2832, 18%) or sharp "postpandemic decrease" (1627, 10%) in uptake. The last two trajectories (totalling 2235 patients, 14%) showed an early or delayed "increase" in uptake. Compared to "continuously vaccinated" patients, those in the "progressively decreasing" trajectory were older and those in all other trajectories were younger with fewer comorbidities at inclusion. Worsening diabetes and comorbidities during follow-up were associated with the "increasing" trajectories. CONCLUSIONS: Most patients with diabetes had been continuously vaccinated or never vaccinated and thus had stable SIV behaviours. Others adopted or abandoned SIV. These behaviour shifts might be due to increasing age, health events, or contextual factors (e.g., controversies about vaccine safety or efficacy). Healthcare professionals and stakeholders should develop tailored strategies that take each group's specificities into account.


Assuntos
Diabetes Mellitus/epidemiologia , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Vacinação/tendências , Idoso , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estações do Ano
15.
Hu Li Za Zhi ; 66(4): 79-86, 2019 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-31342504

RESUMO

Influenza vaccinations may decrease the risk of contracting influenza and its complications significantly in pregnant women and effectively help infants less than six months of age avoid hospitalization. Based on scientific evidence supporting the safety and benefits of the influenza vaccination for pregnant women and fetuses, the epidemic prevention policy of both the World Health Organization and Taiwan's Ministry of Health and Welfare recommend that pregnant women receive the influenza vaccination. However, low acceptance of the influenza vaccine among pregnant women is an ongoing concern in Taiwan. Nursing staffs play a key role in implementing the influenza vaccination program for pregnant women. Therefore, strengthening the professional competency and service effectiveness of nursing staffs may be expected to significantly improve the vaccination coverage rate. This article offers practical methods for achieving this, including promoting nursing staffs' professional knowledge and positive attitudes regarding influenza vaccinations for pregnant women, improving nursing staffs' related education and skills in communication with pregnant women and their families, and improving the implementation of the notification mechanism for disseminating accurate information regarding the vaccine and vaccine adverse events. Our ultimate goal is to enhance the confidence and willingness of pregnant women with regard to receiving influenza vaccinations in order to promote the health of mothers and their fetuses.


Assuntos
Adaptação Psicológica , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Recursos Humanos de Enfermagem/psicologia , Complicações Infecciosas na Gravidez/prevenção & controle , Gestantes/psicologia , Feminino , Humanos , Lactente , Pesquisa em Avaliação de Enfermagem , Gravidez , Taiwan
16.
Orv Hetil ; 160(30): 1193-1199, 2019 Jul.
Artigo em Húngaro | MEDLINE | ID: mdl-31327246

RESUMO

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


Assuntos
Infecção Hospitalar/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Estudantes de Medicina , Cobertura Vacinal , Vacinologia , Adulto , Feminino , Humanos , Masculino , Inquéritos e Questionários , Vacinação
17.
Nat Commun ; 10(1): 2981, 2019 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-31278315

RESUMO

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


Assuntos
Portador Sadio/imunologia , Vacinas contra Influenza/imunologia , Microbiota/imunologia , Mucosa Nasal/microbiologia , Streptococcus pneumoniae/imunologia , Adolescente , Adulto , Coinfecção/imunologia , Coinfecção/microbiologia , Coinfecção/prevenção & controle , Feminino , Voluntários Saudáveis , Humanos , Vacinas contra Influenza/administração & dosagem , Influenza Humana/imunologia , Influenza Humana/prevenção & controle , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Mucosa Nasal/imunologia , Infecções Pneumocócicas/imunologia , Infecções Pneumocócicas/microbiologia , Infecções Pneumocócicas/prevenção & controle , Streptococcus pneumoniae/patogenicidade , Vacinas Atenuadas/administração & dosagem , Vacinas Atenuadas/imunologia , Adulto Jovem
18.
Arch Virol ; 164(9): 2355-2358, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31227892

RESUMO

Equine influenza virus is an important pathogen for the horse industry because of its economic impact, and vaccination is a key control measure. Our previous work suggested that a mutation at position 144 in the hemagglutinin of Florida sublineage clade 2 viruses reduces the cross-neutralizing activity of antiserum against a former vaccine strain. To confirm this suggestion, here, we generated viruses by reverse genetics. Antibody titers against the mutated viruses were one-tenth to one-sixteenth of those against the former vaccine strain. Our findings confirm that this single amino acid substitution reduces the cross-reactivity of antiserum against this former Japanese vaccine.


Assuntos
Anticorpos Antivirais/imunologia , Glicoproteínas de Hemaglutininação de Vírus da Influenza/genética , Glicoproteínas de Hemaglutininação de Vírus da Influenza/imunologia , Doenças dos Cavalos/imunologia , Vírus da Influenza A/imunologia , Vacinas contra Influenza/genética , Vacinas contra Influenza/imunologia , Infecções por Orthomyxoviridae/veterinária , Substituição de Aminoácidos , Animais , Reações Cruzadas , Glicoproteínas de Hemaglutininação de Vírus da Influenza/administração & dosagem , Glicoproteínas de Hemaglutininação de Vírus da Influenza/química , Doenças dos Cavalos/virologia , Cavalos , Soros Imunes/imunologia , Vírus da Influenza A/genética , Vacinas contra Influenza/administração & dosagem , Vacinas contra Influenza/química , Infecções por Orthomyxoviridae/imunologia , Infecções por Orthomyxoviridae/virologia
19.
Cent Eur J Public Health ; 27(2): 127-130, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31241287

RESUMO

OBJECTIVE: In the Austrian population approximately 350,000-400,000 cases and 1,000-1,200 deaths are observed during an average epidemic, which puts influenza-related deaths on top of the list of vaccine-preventable cases of death. In face of extensive vaccination recommendations, the current vaccination rate of the general population of about 6% is one of the lowest worldwide. The objective of this study was to provide an update regarding the use of influenza vaccination in Austria over the period 1982-2015. METHODS: This paper presents data on influenza vaccine use in Austria displayed by the number of distributed doses per 1,000 population over a period of 33 years. Further data was collected from representative population-based telephone surveys. RESULTS: Austria has always been among the countries with a low number of distributed doses of influenza vaccine. The highest number ever was reached in 2006 with 142 doses/1,000. From 2007 onwards, a steady decrease happened to 62 doses/1,000 in the 2015/16 season, which corresponds to the level of the mid-nineties. CONCLUSION: Despite the fact that Austria is a country with comprehensive recommendations for influenza vaccination, this vaccination continues to be misjudged by the Austrian population and many areas of the medical system. From a public health point of view, this situation is not acceptable. Efforts must be increased to attain a much higher vaccination rate, e.g. the importance of the healthcare workers' influence must be recognized, the options of social marketing have to be utilized and studies on the main barriers in Austria are urgently needed.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Áustria/epidemiologia , Pessoal de Saúde , Política de Saúde , Humanos , Influenza Humana/epidemiologia
20.
MMWR Morb Mortal Wkly Rep ; 68(24): 544-551, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31220057

RESUMO

Influenza activity* in the United States during the 2018-19 season (September 30, 2018-May 18, 2019) was of moderate severity (1). Nationally, influenza-like illness (ILI)† activity began increasing in November, peaked during mid-February, and returned to below baseline in mid-April; the season lasted 21 weeks,§ making it the longest season in 10 years. Illness attributed to influenza A viruses predominated, with very little influenza B activity. Two waves of influenza A were notable during this extended season: influenza A(H1N1)pdm09 viruses from October 2018 to mid-February 2019 and influenza A(H3N2) viruses from February through May 2019. Compared with the 2017-18 influenza season, rates of hospitalization this season were lower for adults, but were similar for children. Although influenza activity is currently below surveillance baselines, testing for seasonal influenza viruses and monitoring for novel influenza A virus infections should continue year-round. Receiving a seasonal influenza vaccine each year remains the best way to protect against seasonal influenza and its potentially severe consequences.


Assuntos
Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Vírus da Influenza B/isolamento & purificação , Influenza Humana/epidemiologia , Vigilância da População , Adolescente , Adulto , Idoso , Antivirais/farmacologia , Criança , Mortalidade da Criança , Pré-Escolar , Efeitos Psicossociais da Doença , Farmacorresistência Viral , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Vírus da Influenza A Subtipo H1N1/efeitos dos fármacos , Vírus da Influenza A Subtipo H1N1/genética , Vírus da Influenza A Subtipo H3N2/efeitos dos fármacos , Vírus da Influenza A Subtipo H3N2/genética , Vírus da Influenza B/efeitos dos fármacos , Vírus da Influenza B/genética , Vacinas contra Influenza/administração & dosagem , Vacinas contra Influenza/química , Influenza Humana/mortalidade , Influenza Humana/prevenção & controle , Influenza Humana/virologia , Pessoa de Meia-Idade , Pacientes Ambulatoriais/estatística & dados numéricos , Pneumonia/mortalidade , Estações do Ano , Índice de Gravidade de Doença , Estados Unidos/epidemiologia , Adulto Jovem
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