RESUMEN
Vaccination coverage (VC) against pertussis can increase when management practices and policies at primary care centres (PCCs) are reinforced. From 2011 to 2015, we performed a case-control study to evaluate VC among pertussis patients treated at PCCs in Barcelona, Spain. We recorded pertussis in patients from 8- to 16-year-olds at 52 PCCs. Pertussis cases had laboratory diagnostic and controls were healthy outpatients visiting the same facility for reasons other than cough. DTaP/dTap VC was recorded as either proper vaccination status (five doses recorded) or improper vaccination status (<5 doses recorded). We used a logistic regression model to estimate OR and 95% CI. We included 229 cases and 576 controls. VC was higher in cases (mean 5.01, s.e.: 0.57) than in controls (4.89, s.e.: 0.73). Around 69% of the cases had received DTaP primary immunisation after 2-5 years and 31.4% of cases had the dTap booster immunisation after 7-10 years. The 87% of children 5-9 years were properly vaccinated. We found no protection from becoming ill among properly vaccinated children (OR 1.87; 95% CI 1.22-2.85). The highest VC was observed in patients with confirmed pertussis, which was likely due to a more exhaustive follow-up of the VC in these patients. Being properly vaccinated against pertussis will probably not increase VC.
Asunto(s)
Vacunas contra Difteria, Tétanos y Tos Ferina Acelular/administración & dosificación , Cobertura de Vacunación/estadística & datos numéricos , Tos Ferina/prevención & control , Adolescente , Estudios de Casos y Controles , Niño , Femenino , Humanos , Masculino , España/epidemiología , Tos Ferina/epidemiologíaRESUMEN
INTRODUCTION: Children aged less than 2 years old and those with chronic diseases have a high risk of complications and hospitalization due to influenza. Despite the broad consensus in the literature on the indication for annual immunization of these patients, less than 30 % of the children with high-risk underlying conditions are immunized each year. The aim of this study is to determine the influenza vaccine coverage in children with high-risk underlying conditions admitted to a university hospital. PATIENTS AND METHODS: We performed a cross-sectional study of patients aged from 6 months to 18 years old with high-risk medical conditions and who had been hospitalized between January and May, 2005 in the Vall d'Hebron University Hospital (Barcelona). Influenza vaccine coverage, factors associated with immunization, and the reasons for nonvaccination were analyzed. RESULTS: Overall vaccine coverage was 23.5 %. The highest vaccination coverage was found in patients with congenital heart disease, chronic respiratory disease, and asthma (43.2 %, 42.9 % and 28.6 %, respectively). The factors most frequently associated with influenza vaccination were the type of underlying disease, having been immunized against influenza in the previous season, having received the pneumococcal vaccine, and age younger than 5 years. The main reason for nonvaccination was the lack of influenza vaccine recommendation by health professionals (95.3 %). CONCLUSIONS: Influenza vaccine coverage in children with high-risk conditions is low. Strategies to increase awareness among health professionals on the importance of recommending influenza immunization are required.
Asunto(s)
Vacunas contra la Influenza/uso terapéutico , Vacunación/estadística & datos numéricos , Adolescente , Niño , Preescolar , Estudios Transversales , Femenino , Hospitales Universitarios/estadística & datos numéricos , Humanos , Lactante , Gripe Humana/prevención & control , Masculino , Admisión del PacienteRESUMEN
Introducción Los niños menores de 2 años y los afectos de patologías de base son los que presentan un mayor riesgo de complicaciones y hospitalizaciones a causa de la gripe. A pesar del amplio consenso en la literatura médica en la indicación de vacunación antigripal anual en estos pacientes, menos del 30 % de niños con condiciones de alto riesgo son inmunizados anualmente. El objetivo de este estudio es conocer la cobertura vacunal antigripal en los niños ingresados en un hospital de tercer nivel con patologías de riesgo. Pacientes y métodos Estudio de prevalencia en pacientes de 6 meses a 18 años con patologías de riesgo ingresados entre enero y mayo de 2005 en el Hospital Universitario Vall d'Hebron de Barcelona. Se analizan las coberturas vacunales frente a la gripe, factores asociados a la inmunización, así como los motivos de no vacunación. Resultados La cobertura vacunal global observada ha sido del 23,5 %. Los pacientes afectados de cardiopatías, enfermedad respiratoria crónica y asma son los que presentan coberturas de vacunación más elevadas (43,2, 42,9 y 28,6 %, respectivamente). El tipo de patología de base, el antecedente de vacunación en la temporada anterior, estar vacunado frente al neumococo y ser menor de 5 años son las variables más asociadas a la vacunación antigripal en estos pacientes. El principal motivo de no vacunación ha sido la falta de recomendación por parte de los profesionales sanitarios que atienden a estos pacientes (95,3 %). Conclusiones La cobertura vacunal frente a la gripe en niños que tienen indicación es baja. Se requieren estrategias para aumentar la concienciación de los profesionales sanitarios sobre la importancia de recomendar esta vacunación
Introduction Children aged less than 2 years old and those with chronic diseases have a high risk of complications and hospitalization due to influenza. Despite the broad consensus in the literature on the indication for annual immunization of these patients, less than 30 % of the children with high-risk underlying conditions are immunized each year. The aim of this study is to determine the influenza vaccine coverage in children with high-risk underlying conditions admitted to a university hospital. Patients and methods We performed a cross-sectional study of patients aged from 6 months to 18 years old with high-risk medical conditions and who had been hospitalized between January and May, 2005 in the Vall d'Hebron University Hospital (Barcelona). Influenza vaccine coverage, factors associated with immunization, and the reasons for nonvaccination were analyzed. Results Overall vaccine coverage was 23.5 %. The highest vaccination coverage was found in patients with congenital heart disease, chronic respiratory disease, and asthma (43.2 %, 42.9 % and 28.6 %, respectively). The factors most frequently associated with influenza vaccination were the type of underlying disease, having been immunized against influenza in the previous season, having received the pneumococcal vaccine, and age younger than 5 years. The main reason for nonvaccination was the lack of influenza vaccine recommendation by health professionals (95.3 %). Conclusions Influenza vaccine coverage in children with high-risk conditions is low. Strategies to increase awareness among health professionals on the importance of recommending influenza immunization are required