Vaccination against influenza: Coverage and adherence in children under 15 years with high-risk medical conditions in the Community of Madrid.

INTRODUCTION: Vaccination against influenza is indicated in children at risk of complications or severe disease. The objective of this study was to describe the percentage of children aged less than 15 years with risk conditions vaccinated against influenza in the Community of Madrid, and to analyze the factors associated with adherence to vaccination throughout 3 vaccination campaigns. MATERIALS AND METHODS: Population-based cross-sectional observational study of children aged 6 months to 14 years with conditions that indicated influenza vaccination at the beginning of the 2018-2019 campaign. Electronic population registers were used. We described the percentage of children vaccinated in 3 consecutive campaigns, and assessed the association of adherence to vaccination with demographic and socioeconomic variables and risk conditions using bivariate and multivariate analysis. RESULTS: The vaccination coverage was 15.6% in the 2018-2019 campaign. The adherence to vaccination was 65.9%. The variables associated with greater adherence were age greater than 2 years, especially in the 6-10 years group (aOR = 1.63; 95% CI, 1.43-1.85) and presenting more than one risk condition, especially 3 or more diseases (aOR = 1.80; 95% CI, 1.00-3.26). Diabetes mellitus was the disease associated most strongly with adherence (aOR = 2.15; 95% CI, 1.74-2.65). Adherence was lower in the immigrant population (aOR = 0.43; 95% CI, 0.36-0.51). We found no association between vaccination adherence and sex or socioeconomic status. CONCLUSIONS: Vaccination coverage and adherence were suboptimal. Adherence to vaccination against influenza is associated with demographic and clinical conditions. Strategies need to be established to increase vaccination in children, with greater involvement of professionals and education of parents.

Quantitative assessment of macular and circumpapillary retinal vessel density across all stages of Leber hereditary optic neuropathy using swept source optical coherence tomography angiography.

PURPOSE: To investigate the macular and circumpapillary retinal microvasculature across all stages of Leber hereditary optic neuropathy (LHON) using swept source optical coherence tomography angiography (OCTA). METHODS: This prospective, multicentre, cross-sectional, observational study analysed a total of 119 eyes of 60 patients with molecularly confirmed LHON across all stages and 120 eyes of 60 control subjects. Optical coherence tomography angiography maps centred on the fovea and optic disc were obtained to measure vessel densities (VDs) in the macular superficial (SCP) and deep (DCP) capillary plexuses, and the radial peripapillary capillary plexus (RPCP) respectively. RESULTS: In asymptomatic eyes, only the SCP showed significant changes on average (B coefficient = -0.72, 95% CI = -1.34 to -0.10, p = 0.022) or in sectors representing the papillomacular bundle (PMB) (B coefficient = -1.17, 95% CI = -2.23 to -0.11, p = 0.031). However, in chronic eyes, the greatest magnitude of change was found in the temporal sector of the RPCP (B coefficient = -12.36, 95% CI = -14.49 to -10.23, p < 0.001). The RPCP showed the strongest correlations with visual acuity (VA, logarithm of the minimum angle of resolution; R = -0.677, p < 0.001) and structural parameters (R = 0.747, p < 0.001). CONCLUSIONS: Retinal VD changes in the circumpapillary region of the PMB appear later than in the macula but end up being more profound and correlate better with VA and structural parameters. Further studies are needed to assess the clinical utility of retinal VDs as potential LHON biomarkers.

Cobertura y adherencia a la vacunación frente a la gripe en menores de 15 años con condiciones de riesgo en la Comunidad de Madrid / Vaccination against influenza: Coverage and adherence in children under 15 years with high-risk medical conditions in the Community of Madrid

Introducción: La vacunación antigripal está especialmente indicada en población infantil con riesgo de complicaciones o enfermedad grave. El objetivo de este estudio es describir el porcentaje de vacunación frente a la gripe en menores de 15 años con condiciones de riesgo en la Comunidad de Madrid, así como analizar los factores asociados a la adherencia vacunal a lo largo de tres campañas de vacunación. Material y métodos: Estudio observacional, transversal, de base poblacional de niños/as de seis meses a 14 años y con condiciones de riesgo que tuvieran indicación de vacunación antigripal al inicio de la campaña 2018-2019. Se emplearon registros poblacionales electrónicos. Se describió el porcentaje de vacunados durante tres campañas consecutivas. Se analizó mediante análisis bivariado y multivariado la asociación de la adherencia vacunal con variables demográficas, socioeconómicas y condiciones de riesgo. Resultados: La cobertura vacunal fue del 15,6% en la campaña 2018-2019. La adherencia a la vacunación fue del 65,9%. Se asociaron a una mayor adherencia edad ≥ 3 años, fundamentalmente de 6-10 años (ORa=1,63; IC 95% [1,43-1,85]) y presentar más de una condición de riesgo, especialmente ≥ 3 (ORa=1,80; IC 95% [1,00-3,26]). La enfermedad más asociada fue diabetes mellitus (ORa=2,15; IC 95% [1,74-2,65]). Las personas extranjeras presentaron menor adherencia (ORa=0,43; IC 95% [0,36-0,51]). No se encontraron diferencias en la adherencia según sexo ni nivel socioeconómico. Conclusiones: La adherencia y cobertura vacunal se encuentran en niveles subóptimos. La adherencia a la vacunación antigripal se asocia a características demográficas y clínicas. Es necesario establecer estrategias para incrementar la vacunación en población infantil, con mayor implicación de profesionales y formación de progenitores. (AU)

Introduction: Vaccination against influenza is indicated in children at risk of complications or severe disease. The objective of this study was to describe the percentage of children aged less than 15 years with risk conditions vaccinated against influenza in the Community of Madrid, and to analyze the factors associated with adherence to vaccination throughout 3 vaccination campaigns. Materials and methods: Population-based cross-sectional observational study of children aged 6 months to 14 years with conditions that indicated influenza vaccination at the beginning of the 2018–2019 campaign. Electronic population registers were used. We described the percentage of children vaccinated in 3 consecutive campaigns, and assessed the association of adherence to vaccination with demographic and socioeconomic variables and risk conditions using bivariate and multivariate analysis. Results: The vaccination coverage was 15.6% in the 2018–2019 campaign. The adherence to vaccination was 65.9%. The variables associated with greater adherence were age greater than 2 years, especially in the 6–10 years group (aOR=1.63; 95% CI: 1.43–1.85) and presenting more than one risk condition, especially 3 or more diseases (aOR=1.80; 95% CI: 1.00–3.26). Diabetes mellitus was the disease associated most strongly with adherence (aOR=2.15; 95% CI: 1.74–2.65). Adherence was lower in the immigrant population (aOR=0.43; 95% CI: 0.36–0.51). We found no association between vaccination adherence and sex or socioeconomic status. Conclusions: Vaccination coverage and adherence were suboptimal. Adherence to vaccination against influenza is associated with demographic and clinical conditions. Strategies need to be established to increase vaccination in children, with greater involvement of professionals and education of parents. (AU)