Evaluation of the Usability of the Immunization Information System in Brazil: A Mixed-Method Study.

Introduction: Usability is a quality attribute that can evaluate the ease of use of user interfaces, based on standards called usability heuristics. Objective: To evaluate the usability components of the Brazilian Immunization Information System (IIS), focusing on the users and their interaction and agility with the interfaces. Materials and Methods: It was a concomitant and convergent mixed-method study that used a cross-sectional design for the quantitative approach and the indirect method of heuristic evaluation for the qualitative approach. Participants were 137 nursing professionals working in vaccination rooms, who completed a structured questionnaire on standards of usability quality, and 4 specialists in information technology, who used a semistructured form to carry out a software inspection. Descriptive and inferential statistics and the heuristic inspection were used for the analyses. Results: The evaluation resulted in 10 violated heuristics and identified 14 usability problems on the 68 screens of the IIS. The system presented simple usability problems (grade 2 severity), which can be repaired, with a low correction priority. The heuristics best evaluated were error prevention (3.03 ± 0.54) and help and documentation (3.00 ± 0.68); and the worst evaluated was visibility of system status, with a mean of 2.62 ± 0.55. Professionals with a technical education level presented a higher score on the scales for the recognition rather than recall heuristic when compared with the nurses (2.77 ± 0.49 vs. 3.67 ± 0.66, p = 0.003). Conclusion: The system provides easy access for users, however, has weaknesses in its ability to allow the users to easily achieve their goals of interaction with the interface.

Prevalence and underreporting of immunization errors in childhood vaccination: results of a household survey.

OBJECTIVE: To investigate underreporting of immunization errors based on vaccination records from children under five years of age. METHOD: An epidemiological, cross-sectional analytical study, carried out through a household survey with 453 children aged 6 months to 4 years in three municipalities in Minas Gerais in 2021. A descriptive analysis was carried out, and the prevalence of the error was calculated per 100 thousand doses applied between 2016 and 2021. The magnitude was estimated of the association between variables by prevalence and 95% Confidence Intervals (95%CI). To analyze underreporting, State reporting records were used. RESULTS: A prevalence of immunization errors was found to be 41.9/100,000 doses applied (95%CI:32.2 - 51.6). The highest prevalence occurred between 2020 (50.0/100,000 doses applied) and 2021 (78.6/100,000 doses applied). The most frequent error was an inadequate interval between vaccines (47.2%) associated with adsorbed diphtheria, tetanus and pertussis (DTP) vaccine (13.7/100,000) administration. Vaccination delay was related to immunization errors (7.55 95% CI:2.30 - 24.80), and the errors found were underreported. CONCLUSION: The high prevalence of underreported errors points to a worrying scenario, highlighting the importance of preventive measures.

Prevalence of errors causing events allegedly attributable to vaccination/immunization: systematic review and meta-analysis.

OBJECTIVE: To identify the prevalence of errors that caused events supposedly attributable to vaccination or immunization. METHOD: Systematic literature review with meta-analysis carried out on the Medline, Cochrane Library, Cinahl, Web of Science, Lilacs, Scopus; Embase; Open Grey; Google Scholar; and Grey Lit databases; with studies that presented the prevalence of immunization errors that caused events or that provided data that allowed this indicator to be calculated. RESULTS: We evaluated 11 articles published between 2010 and 2021, indicating a prevalence of 0.044 errors per 10,000 doses administered (n=762; CI95%: 0.026 - 0.075; I2 = 99%, p < 0.01). The prevalence was higher in children under 5 (0.334 / 10,000 doses; n=14). The predominant events were fever, local pain, edema and redness. CONCLUSION: A low prevalence of errors causing events was identified. However, events supposedly attributable to vaccination or immunization can contribute to vaccine hesitancy and, consequently, have an impact on vaccination coverage.

Spatial behavior of hepatitis A, MMR, and varicella vaccination coverage in the state of Minas Gerais, 2020.

OBJECTIVE: To analyze the spatial behavior of hepatitis A, measles, mumps, and rubella (MMR), and varicella vaccination coverage in children and its relationship with socioeconomic determinants in the state of Minas Gerais. METHODS: This ecological study investigated records of doses administered to children, extracted from the Immunization Information System of 853 municipalities in Minas Gerais, in 2020. We analyzed the vaccination coverage and socioeconomic factors. Spatial scan statistics were used to identify spatial clusters and measure the relative risk based on the vaccination coverage indicator and the Bivariate Moran Index, and thus detect socioeconomic factors correlated with the spatial distribution of vaccination. We used the cartographic base of the state and its municipalities and the ArcGIS and SPSS software programs. RESULTS: Hepatitis A (89.0%), MMR (75.7%), and varicella (89.0%) showed low vaccination coverage. All vaccines analyzed had significant clusters. The clusters most likely to vaccinate their population were mainly located in the Central, Midwest, South Central, and Northwest regions, while the least likely were in the North, Northeast, and Triângulo do Sul regions. The municipal human development index, urbanization rate, and gross domestic product were spatially dependent on vaccination coverage. CONCLUSIONS: The spatial behavior of hepatitis A, MMR, and varicella vaccination coverage is heterogeneous and associated with socioeconomic factors. We emphasize that vaccination records require attention and should be continuously monitored to improve the quality of information used in services and research.

Vaccination coverage in children under one year of age and associated socioeconomic factors: maps of spatial heterogeneity.

OBJECTIVE: to analyze vaccination coverage spatial distribution in children under one year old and the socioeconomic factors associated with meeting the recommended goals in Minas Gerais. METHODS: an ecological study, carried out in 853 municipalities in the state. Pentavalent, poliomyelitis, meningococcal conjugate, yellow fever, rotavirus, and 10-valent pneumococcal conjugate vaccination coverage were analyzed. Scan statistics and multiple logistic regression were performed to identify spatial clusters and factors associated with meeting coverage goals. RESULTS: spatial analysis revealed clusters with risk of low coverage for all vaccines. Number of families with per capita income of up to 1/2 wage, Minas Gerais Social Responsibility Index and percentage of the poor or extremely poor population were associated with meeting the established goals. CONCLUSIONS: the results are useful for designing interventions regarding the structuring of vaccination services and the implementation of actions to increase vaccination coverage in clusters with less propensity to vaccinate.

Construction and validity of an educational video to prevent immunization errors.

OBJECTIVE: to construct and validate an orientation video, based on a low-fidelity clinical simulation scenario, to prevent immunization errors. METHODS: a methodological study with video construction, validated in two stages by different audiences. Content was selected based on a realistic simulation scenario of the vaccine administration process to a patient-actor. Items with concordance greater than 0.8 and 0.6 were considered valid, verified using the Content Validity Index (CVI) and the Content Validity Ratio (CVR), respectively. RESULTS: judges' CVI had an average of 97.5%, and CVR, 0.9, and health professionals' CVI, 95.4%, and CVR, 0.8. Successes in administering vaccines were addressed, such as careful reading of labels, double-checking the vaccine, distractions/interruptions and error reporting. CONCLUSIONS: the video was constructed and validated in terms of content, and can be used in training professionals working in vaccination.

The COVID-19 pandemic and vaccination abandonment in children: spatial heterogeneity maps.

OBJECTIVE: to identify spatial clusters corresponding to abandonment of routine vaccines in children. METHOD: an ecological study, according to data from the 853 municipalities of a Brazilian state. The records analyzed were those of the multidose pentavalent, pneumococcal 10-valent, inactivated poliomyelitis and oral human rotavirus vaccines of 781,489 children aged less than one year old. The spatial scan statistics was used to identify spatial clusters and assess the relative risk based on the vaccination abandonment indicator. RESULTS: the spatial scan statistics detected the presence of statistically significant clusters for abandonment regarding the four vaccines in all the years analyzed. However, the highest number of clusters with high relative risk estimates was identified in 2020. The Vale do Aço and West, North and West, and Southwest regions stand out for the pentavalent, poliomyelitis and rotavirus vaccines, respectively. CONCLUSION: in an attempt to mitigate the devastating impact of the COVID-19 pandemic, the immunization program experienced setbacks. The presence of clusters points to the need to implement integrated strategies that may involve different sectors for an active search for children and prevent outbreaks of vaccine-preventable diseases in the near future.

Childhood vaccination coverage of hepatitis A, measles, mumps and rubella, and varicella: temporal trend analysis in Minas Gerais, Brazil. / Cobertura vacinal infantil de hepatite A, tríplice viral e varicela: análise de tendência temporal em Minas Gerais, Brasil.

OBJECTIVE: To analyze the temporal trend of vaccination coverage for hepatitis A, measles, mumps and rubella, and varicella in a Brazilian state from 2014 to 2020. METHODS: An ecological, time-series study that considered data from 853 municipalities in the state of Minas Gerais that compose the 14 regions of the state, these being the territorial units of analysis. Records of applied doses of hepatitis A, measles, mumps and rubella, and varicella vaccines registered in the Brazilian Immunization Information System were analyzed. Trends were estimated by Prais-Winsten regression and 95% confidence intervals of measures of variation were calculated. RESULTS: Low vaccine coverage of hepatitis A, measles, mumps and rubella, and varicella was identified. Coverages above 95% were observed only in 2015 for the vaccine against hepatitis A (98.8%) and, in 2016, for varicella (98.4%). The measles, mumps and rubella vaccine showed coverage of less than 95% in all analyzed years. Decreases of 13.6 and 4.3% between the years 2019 and 2020 were identified for the measles, mumps and rubella, and hepatitis A vaccines, respectively. There was a decreasing trend in hepatitis A vaccination coverage in the South (p=0.041), East (p=0.030), and North (p=0.045) regions; and for the measles, mumps and rubella in Jequitinhonha Valley (p=0.002), East (p=0.004), and North (p=0.024) regions. Increasing coverage was observed only for varicella in eight regions of the state. CONCLUSIONS: The data point to heterogeneity in the temporal behavior of vaccination coverage in Minas Gerais. The downward trend in some regions causes concern about the possibility of resurgence of diseases, such as measles, which until then had been controlled.

OBJETIVO: Analisar a tendência temporal da cobertura vacinal de hepatite A, tríplice viral e varicela em um estado brasileiro no período de 2014 a 2020. MÉTODOS: Estudo ecológico de séries temporais, que considerou dados dos 853 municípios de Minas Gerais que compõem as 14 regiões do estado, sendo estas as unidades territoriais de análise. Foram analisados registros de doses aplicadas das vacinas hepatite A, tríplice viral e varicela registrados no Sistema de Informação de Imunização do Brasil. As tendências foram estimadas pela regressão de Prais-Winsten e calculados os intervalos de confiança 95% das medidas de variação. RESULTADOS: Identificaram-se baixas coberturas vacinais de hepatite A, tríplice viral e varicela. Coberturas acima de 95% foram observadas somente no ano de 2015 para a vacina contra hepatite A (98,8%) e, em 2016, para a varicela (98,4%). A vacina tríplice viral apresentou cobertura inferior a 95% em todos os anos analisados. Uma queda de 13,6 e 4,3% entre os anos de 2019 e 2020 foi identificada para as vacinas tríplice viral e hepatite A, respectivamente. Observou-se tendência decrescente na cobertura vacinal da hepatite A nas regiões Sul (p=0,041), Leste (p=0,030) e Norte (p=0,045); para a tríplice viral, nas regiões Jequitinhonha (p=0,002), Leste (p=0,004) e Norte (p=0,024). A cobertura crescente foi observada somente para a varicela em oito regiões do estado. CONCLUSÕES: Os dados apontam heterogeneidade no comportamento temporal das coberturas vacinais em Minas Gerais. A tendência decrescente em algumas regiões desperta preocupação pela possibilidade do recrudescimento de doenças, como o sarampo, até então controladas.

Incidence of immunization errors in the state of Minas Gerais, Brazil: a cross-sectional study, 2015-2019. / Incidência de erros de imunização em Minas Gerais: estudo transversal, 2015-2019.

OBJECTIVE: To evaluate the incidence of immunization errors in the public health service of the state of Minas Gerais, Brazil. METHODS: This was a cross-sectional study, based on errors reported on the National Immunization Program Information System between 2015 and 2019. A descriptive analysis and calculation of the incidence for the state's health macro-regions were performed. RESULTS: A total of 3,829 notifications were analyzed. Children younger than 1 year old were the most affected (39.1%) and the intramuscular route accounted for 29.4% of the errors. The most frequently reported error was administration of vaccines outside minimum and maximum recommended ages (37.7%). There was a higher incidence of errors in Vale do Aço (26.5/100,000) and Triângulo do Norte (22.6/100,000) macro-regions. CONCLUSION: Immunization errors showed a heterogeneous incidence among the macro-regions of the state of Minas Gerais, between 2015-2019, and the administration of vaccines outside minimum and maximum recommended ages was the most frequently reported error.

Construction and validation of a matrix for normative evaluation of the integrated health system of the borders.

OBJECTIVE: to build and validate a matrix for normative evaluation of the Integrated Health System of Borders. METHOD: a methodological study, composed by the construction of an evaluation matrix elaborated in three stages: elaboration of the logical model, containing the triad of structure, process and result; definition of evaluative questions and appearance and content validation of the matrix. Appearance and content validation were performed simultaneously by seven judges. For data collection, an online questionnaire and the Delphi technique were used and, for analysis, the Content Validity Index and Content Validity Ratio. RESULTS: the evaluation matrix containing 24 questions was submitted to two evaluations for its appearance and content validation. In the first, the overall mean Content Validity Index was 99.40% and the Content Validity Ratio was 0.90. In the second, the Content Validity Index was 100% and the Content Validity Ratio, 1.0; there were no new proposals and the matrix was made up of 24 questions. The matrix was considered intelligible in terms of appearance validation. CONCLUSION: the evaluation matrix of the Integrated Health System of the Borders is validated in terms of appearance and content for analyzing the performance of public actions and policies in border regions.

[Primary Healthcare e-SUS: determinant attributes for the adoption and use of a technological innovation]. / e-SUS Atenção Primária: atributos determinantes para adoção e uso de uma inovação tecnológica.

The study aimed to analyze the adoption and use of the Primary Healthcare e-SUS (PHC e-SUS) as a technological innovation from the perspective of workers in primary healthcare (PHC). This was a sequential exploratory mixed-methods study (QUAN → qual) in municipalities in the interior of São Paulo state, Brazil, drawing on Diffusion of Innovation Theory. The quantitative component was analytical cross-sectional, applying a validated questionnaire to 114 PHC workers. The model was tested by applying partial least squares structural equation modeling (PLS-SEM) using SmartPLS 2.3.0. The qualitative study was descriptive-exploratory, using interviews (n = 10) with thematic content analysis, aimed at understanding the attributes that did not influence the adoption and use of PHC e-SUS. The attributes "experimentation", "ease of use", "relative advantage", and "compatibility" did not display statistical significance, indicating that they were not determinant attributes for the adoption and use of PHC e-SUS. Integration of the data evidenced failures in connectivity; lack of time to feed the system in real time and training; lack of prior experimentation; abrupt presentation of the system; and lack of skill with the technology. The results can assist other municipalities in Brazil with the implementation of the PHC e-SUS in relation to the importance of the organizational infrastructure, as well as training in the technology's use and handling. The study contributes to reflections and proposals for interventions in the problems faced in daily work with the adoption and use of a technological innovation such as the PHC e-SUS.

O estudo objetivou analisar a adoção e o uso do e-SUS Atenção Primária (e-SUS APS) como inovação tecnológica na perspectiva dos profissionais da atenção primária à saúde (APS). Trata-se de um estudo de método misto explanatório sequencial (QUAN → qual) realizado em municípios do interior de São Paulo, Brasil, utilizando a Teoria da Difusão de Inovação. O estudo quantitativo foi do tipo transversal analítico, aplicando-se um questionário validado a 114 profissionais da APS. Para testar o modelo do estudo, aplicou-se a modelagem de equações estruturais de mínimos quadrados parciais (PLS-SEM) por meio do software SmartPLS 2.3.0. O estudo qualitativo teve caráter descritivo-exploratório, por meio de entrevistas (n = 10) analisadas por análise temática de conteúdo, visando entender os atributos que não influenciaram a adoção e o uso do e-SUS APS. Os atributos "experimentação", "facilidade de uso", "vantagem relativa" e "compatibilidade" não apresentaram significância estatística, indicando não serem atributos determinantes para adoção e uso do e-SUS APS. Na integração dos dados, evidenciaram-se: falhas de conectividade; ausência de tempo para alimentação do sistema em tempo real e de capacitação; não experimentação prévia; apresentação abrupta do sistema e ausência de habilidade com a tecnologia. Os resultados podem auxiliar os demais municípios do Brasil na implantação e/ou efetivação do e-SUS APS, no que tange à importância da infraestrutura organizacional, bem como na capacitação para utilização e manuseio da tecnologia. Este estudo contribui para reflexões e propostas de intervenções aos problemas enfrentados no cotidiano do trabalho quanto à adoção e ao uso de uma inovação tecnológica, como o e-SUS APS.

El objetivo del estudio fue analizar la adopción y uso del e-SUS Atención Primaria (e-SUS APS), como innovación tecnológica, desde la perspectiva de los profesionales de la atención primaria en salud (APS). Se trata de un estudio de método mixto secuencial explicativo (CUAN → Cual) realizado en municipios del interior de São Paulo, utilizando la Teoría de la Difusión de Innovación. El estudio cuantitativo fue de tipo transversal analítico, aplicándose un cuestionario validado a 114 profesionales de la APS. Para probar el modelo del estudio se aplicó el modelado de ecuaciones estructurales de mínimos cuadrados parciales (PLS-SEM), a través del software SmartPLS 2.3.0. El estudio cualitativo tuvo carácter descriptivo-exploratorio, mediante entrevistas (n = 10), analizadas por análisis de contenido temático, con el objetivo de entender los atributos que no influenciaron en la adopción y uso de la e-SUS APS. Los atributos "probar", "facilidad de uso", "ventaja relativa" y "compatibilidad" no presentaron significación estadística, indicando no ser atributos determinantes para la adopción y uso de la e-SUS APS. En la integración de los datos se evidenciaron: fallos de conectividad; ausencia de tiempo para alimentación del sistema en tiempo real y de capacitación; no pruebas previas; presentación abrupta del sistema y ausencia de habilidad con la tecnología. Los resultados pueden ayudar a los demás municipios de Brasil en la implantación y/o efectuación de la e-SUS APS, en lo que atañe a la importancia de la infraestructura organizativa, así como la capacitación para la utilización y manejo de la tecnología. Este estudio contribuye a las reflexiones y propuestas de intervenciones, respecto a los problemas enfrentados en el día a día del trabajo, en cuanto a la adopción y uso de una innovación tecnológica, como la e-SUS APS.

Adequacy assessment of immunobiological agent conservation in the Western Health macro-region of Minas Gerais State, Brazil: a descriptive study, 2017. / Avaliação da adequação da conservação de imunobiológicos na macrorregião de saúde Oeste de Minas Gerais: estudo descritivo, 2017.

OBJECTIVE: To describe the adequacy of immunobiological agent conservation in vaccination rooms in the municipalities of the Western health macro-region of the state of Minas Gerais, Brazil. METHODS: This was a descriptive study, based on a validated scale, with a maximum score of 15 points. A descriptive analysis and an association test between the scores obtained by the municipalities and variables of the external context were performed. RESULTS: 275 out of a total of 295 existing vaccination rooms were evaluated. Immunobiological agent conservation in the West macro-region obtained an average score of 4 points (standard score, 0 to 15). There was a poor availability of immunization supplies aimed at immunobiological agent conservation, and work processes, that require improvement. Small municipalities presented better immunobiological agent conservation (p=0.011). CONCLUSION: Immunobiological agent conservation in vaccination rooms in the Western health macro-region of Minas Gerais State was considered inadequate.

Computerization of primary health care: the manager as a change agent.

OBJECTIVE: To analyze factors associated with the implementation of software systems of the e-SUS Primary Care strategy in municipalities of Minas Gerais. METHODS: This is a cross-sectional study conducted with municipal managers of the e-SUS Primary Care strategy. A sample of cities stratified according to population size was selected. Descriptive, bivariate, and multivariate analyzes were performed to identify factors associated with the implementation of the systems. RESULTS: In 49.1% (95%CI: 39.5-58.8) of the municipalities investigated, some of the e-SUS Primary Care systems were implemented. Time working as a strategy manager (OR: 3.03) and training for Primary Care professionals in the municipality (OR: 2.28) were associated with the implementation of the systems. CONCLUSION: The presence of a trained manager leading the implementation process impacted the implementation of the e-SUS AB strategy software systems in the municipalities of Minas Gerais. It is also essential to highlight the need to improve the technological infrastructure for the computerization of Primary Care.

Adverse events following immunization in pregnant women from Minas Gerais.

OBJECTIVE: To analyze the distribution of adverse events following immunization (AEFI) in pregnant women in the state of Minas Gerais, between 2015 and 2019. METHODS: This is an epidemiological, descriptive study conducted with AEFI data from 2015 to 2019, recorded in the Adverse Events Surveillance Information System, in the state of Minas Gerais (MG), Brazil. A total of 670 AEFI were analyzed in pregnant women. The estimates were presented in proportions, according to the year of occurrence, health macro-region of Minas Gerais and immunobiological administered. RESULTS: The year in which there were the most records was 2017 (36.8%). Among the 14 macro-regions, the ones with the lowest and highest number of records were the Vale do Jequitinhonha (0.5%) and Center (31.8%), respectively. The vaccines contraindicated during pregnancy represented 27.6% of the total notifications. The total of 69.5% of the cases were considered immunization errors. In 75.9% of the records, the variable of medical care was ignored, and in 73.7% of the cases no information on the evolution was presented. CONCLUSION: This study shows the need for continuing education for the multidisciplinary team, in order to reduce cases of AEFI and ensure the adequate completion of notifications by health professionals.

Vaccination as a scheduled demand: a day in the life of users.

OBJECTIVES: to understand vaccination as a scheduled demand and access to this demand in a day in the life of health services, from the perspective of users. METHODS: holistic-qualitative multiple case study, based on the Quotidian Comprehensive Sociology, with 74 users from four health microregions of the Extended Western Region of Minas Gerais State. RESULTS: scheduling vaccination demand in a day in the life of services is compromised by the fragility in data record, by computerized systems underutilization and by the loss of the immunization tracking card, resulting in missed opportunities of immunization and unnecessary revaccinations. The Primary Health Care team's non-involvement also compromised access to this action. Final Considerations: there is a need for more effort to be dispensed with for the effective use of computerized systems and Permanent Education of professionals in order to take advantage of all the opportunities of orientations and referrals of users to the vaccination room.

Structural and procedural conditions in National Immunization Program Information System establishment.

OBJECTIVES: to analyze structural and process conditions in National Immunization Program Information System establishment. METHODS: a cross-sectional study conducted in 307 vaccination rooms in the state of Minas Gerais in 2017. For data collection, a multidimensional questionnaire was used. Descriptive data analysis was performed. RESULTS: vaccination rooms have basic inputs necessary for System establishment. The greatest problems relate to professional practice. Low enrollment of population, failures in the active search for absentees, vaccine scheduling and absence of reports to monitor vaccination coverage were identified. Training was considered insufficient and ineffective. CONCLUSIONS: Immunization Information System is an essential technological innovation for the management of immunization actions. However, the production of timely records and the use of information are still challenges. Investments in training are required to ensure System's management and operationalization activities.

Acceptance and use of the Information System of the National Immunization Program.

OBJECTIVE: to analyze the acceptance and use of the Information System of the National Immunization Program in primary health care vaccination rooms. METHOD: a unique case study of a qualitative approach in the light of the Unified Theory of Acceptance and Use of Technology. Data collection included an interview with 18 professionals responsible for the implementation of the information system, observation of vaccination rooms in 12 municipalities of the West Macro-region of Minas Gerais, selected from a preliminary study. Data was systematized and analyzed through Content Analysis. RESULTS: the interviewees are satisfied with the usefulness and ease of the system usage, but do not have the same satisfaction with the organizational infrastructure due to the lack of computers and low Internet connectivity in the health units, as well as with the incipient training for the use of the information system and the lack of skills with the technology among the human resources. CONCLUSION: nursing professionals perceive advantages in the acceptance and use of the Information System of the National Immunization Program. It was clear that the vaccinated individual's history control and the decrease of records in paper are evidenced as facilitators of this acceptance. The system was considered reliable and secure.

Evaluation of digital vaccine card in nursing practice in vaccination room.

OBJECTIVE: develop and evaluate a vaccine application for mobile devices, with update integrated with the National Immunization Program Information System, for care in vaccination rooms. METHOD: methodological research based on the Pressman System Development Life Cycle theory developed in three stages: integrative literature review, computational development, and application evaluation. The product was evaluated as to satisfaction, using a validated questionnaire, and as to usability by the System Usability Scale. RESULTS: the application functionalities were based on the survey of technological Innovations on immunization, published in the scientific literature. It displays user vaccines directly from the National Immunization Program Information System, notifies about upcoming vaccines, and enables the inclusion of vaccine cards of dependents. The evaluation resulted in users' mean score of 90.5 ± 11.1 and health professionals' mean score of 84.2 ± 19.4. CONCLUSION: the application is a technological tool with potential to improve the work process in vaccination rooms and to reach the goals of vaccine coverage. It synchronizes data with the National Immunization Program Information System, thus enabling the maintenance of people's vaccination history.

Vaccination and adolescent knowledge: health education and disease prevention. / A vacinação e o saber do adolescente: educação em saúde e ações para a imunoprevenção.

A cross-sectional study in conjunction with a health extension program was conducted with 605 adolescents aged between 13 and 18 years from 22 public schools in Divinópolis, Brazil. The aim of the study was to determine the vaccination status of the adolescents and their level of knowledge of communicable and vaccine-preventable diseases. Three-stage cluster sampling was used comprising schools, classes, and students. The findings show that vaccination coverage among adolescents was 45.1% and yellow fever was shown to have the lowest coverage rate (64%). The most mentioned diseases when the adolescents were asked which vaccinations they had had were infantile paralysis (60.7%), yellow fever (56%), tetanus (34%), and measles (28.6%). Extension activities were conducted with 6,650 people, comprising vaccination (2,334 doses administered), aimed at expanding vaccination coverage, and health education activities with 2,839 adolescents directed at sexually transmitted diseases, family planning; and licit and illicit drugs. The study had a positive impact in terms of the expansion of vaccination coverage and the extension activities played an essential role in increasing the adolescents' knowledge of the themes addressed.

Estudo transversal em interface com a extensão em 22 escolas públicas de Divinópolis, Minas Gerais, Brasil, que compõe 605 adolescentes entre 13 e 18 anos. Teve por objetivo analisar a situação vacinal de adolescentes do 9º ano do ensino fundamental e o conhecimento sobre doenças transmissíveis e as imunopreveníveis. Foi utilizada amostragem por conglomerados em três estágios de seleção: escolas, turmas e alunos. Identificou-se baixa cobertura vacinal entre os adolescentes, 45,1%, a vacina contra a febre amarela apresentou a menor cobertura, 64%; quando perguntados sobre quais as doenças e as infecções que acreditavam estar imunizados, prevaleceu as vacinas contra Paralisia Infantil (60,7%), Febre Amarela (56,0%), Tétano (34,0%) e Sarampo (28,6%). Versaram-se intervenções extensionistas com 6.650 pessoas direcionadas à vacinação (2.334 doses administradas) com o intuito de ampliar a cobertura vacinal e a realização de ações educativas (2.839 adolescentes participantes) sobre doenças sexualmente transmissíveis; planejamento familiar; drogas lícitas e ilícitas. O estudo apresentou impacto positivo pela ampliação da cobertura vacinal e as ações de extensão foram essenciais para o conhecimento sobre os temas propostos.

Collective construction of bundle for immunobiological agents conservation best practices.

OBJECTIVE: to construct collectively with nursing professionals bundle for best practices of cold chain maintenance of immunobiological agents conservation at the local level. METHOD: a qualitative research of convergent care type. Bundle construction was guided by the Evidence-Based Practice criterion. Data collection was carried out from October to December 2016, through five workshops, with the participation of 21 professionals from 7 vaccination rooms of a municipality of Minas Gerais State. The framework developed by Morse and Field was adopted for data analysis. RESULTS: through bundle, care is taken regarding refrigeration equipment temperature monitoring, contingency plan performance, recyclable ice coil setting and chamber use as refrigeration equipment. FINAL CONSIDERATIONS: the chosen interventions began to guide the practice and promote a care based on safety and quality.