RESUMO
BACKGROUND: Vaccine-preventable respiratory infections impact on healthcare systems globally. Despite availability of vaccines, fluctuations in vaccination rates, pathogen virulence and community transmission dynamics mean that these respiratory infections continue to pose substantial public health risks. To understand trends in vaccine-preventable respiratory infections, we analysed linked data from emergency department (ED), hospitalisations and deaths in New South Wales, Australia, from 2012 to 2022. METHODS: ED presentations with respiratory infection like illness were linked to hospitalisation and death records. Age-standardised rates of ED presentations, proportions subsequently hospitalised for acute respiratory infection (ARI) and specific vaccine-preventable disease diagnoses and 28-day mortality rates were estimated by year and age. RESULTS: From 2012 to 2022, there were 3,127,090 ARI-like ED presentations. Age-standardised rates increased until 2020, declined in 2021 and rebounded in 2022. Across all years, of these ARI-like ED presentations, 16.6% were hospitalised for acute respiratory infections, including pneumonia (7.9%), influenza (1.1%), RSV disease (1.3%), COVID-19 (0.8%) and pneumococcal disease (0.3%). Proportions hospitalised were highest in those aged 65+ years, except for RSV, which was highest in children aged 0-4 years. The highest 28-day mortality post-ARI-like ED presentation was observed with COVID-19 in adults aged 65+ years at 13.1%. CONCLUSIONS: This study highlights the continuing burden of vaccine-preventable respiratory infections on an Australian healthcare system. These data can be used to monitor the effectiveness of vaccination programmes and other public health interventions. Future efforts should focus on enhancing surveillance and data linkage to improve precision and guide targeted public health strategies.
Assuntos
Serviço Hospitalar de Emergência , Hospitalização , Infecções Respiratórias , Humanos , Infecções Respiratórias/prevenção & controle , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/mortalidade , New South Wales/epidemiologia , Hospitalização/estatística & dados numéricos , Hospitalização/tendências , Idoso , Pessoa de Meia-Idade , Pré-Escolar , Adulto , Criança , Lactente , Adolescente , Adulto Jovem , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Masculino , Idoso de 80 Anos ou mais , Vacinação/estatística & dados numéricos , Doenças Preveníveis por Vacina/epidemiologia , Doenças Preveníveis por Vacina/prevenção & controle , Recém-Nascido , COVID-19/prevenção & controle , COVID-19/epidemiologia , COVID-19/mortalidade , Influenza Humana/prevenção & controle , Influenza Humana/epidemiologia , Influenza Humana/mortalidadeRESUMO
The role of immunization in public health is crucial, offering widespread protection against infectious diseases and underpinning societal well-being. However, achieving optimal vaccination coverage is impeded by vaccine hesitancy, a significant challenge that necessitates comprehensive strategies to understand and mitigate its effects. We propose the integration of Population Health Management principles with Immunization Information Systems (IISs) to address vaccine hesitancy more effectively. Our approach leverages systematic health determinants analysis to identify at-risk populations and tailor interventions, thereby promoting vaccination coverage and public health responses. We call for the development of an enhanced version of the Italian National Vaccination Registry, which aims to facilitate real-time tracking of individuals' vaccination status while improving data accuracy and interoperability among healthcare systems. This registry is designed to overcome current barriers by ensuring robust data protection, addressing cultural and organizational challenges, and integrating behavioral insights to foster informed public health campaigns. Our proposal aligns with the Italian National Vaccination Prevention Plan 2023-2025 and emphasizes proactive, evidence-based strategies to increase vaccination uptake and contrast the spread of vaccine-preventable diseases. The ultimate goal is to establish a data-driven, ethically sound framework that enhances public health outcomes and addresses the complexities of vaccine hesitancy within the Italian context and beyond.
Assuntos
Cobertura Vacinal , Vacinação , Humanos , Itália , Cobertura Vacinal/estatística & dados numéricos , Vacinação/psicologia , Vacinação/estatística & dados numéricos , Hesitação Vacinal/estatística & dados numéricos , Hesitação Vacinal/psicologia , Programas de Imunização , Sistemas de Informação , Saúde Pública , Sistema de Registros , Vacinas/administração & dosagem , Doenças Preveníveis por Vacina/prevenção & controleRESUMO
BACKGROUND: The objective of this study is to estimate the burden of selected immunization-preventable infectious diseases in Spain using the Burden of Communicable Diseases in Europe (BCoDE) methodology, as well as focusing on the national immunization programme and potential new inclusions. METHODS: The BCoDE methodology relies on an incidence and pathogen-based approach to calculate disease burden via disability-adjusted life year (DALY) estimates. It considers short and long-term sequelae associated to an infection via outcome trees. The BCoDE toolkit was used to populate those trees with Spanish-specific incidence estimates, and de novo outcome trees were developed for four infections (herpes zoster, rotavirus, respiratory syncytial virus [RSV], and varicella) not covered by the toolkit. Age/sex specific incidences were estimated based on data from the Spanish Network of Epidemiological Surveillance; hospitalisation and mortality rates were collected from the Minimum Basic Data Set. A literature review was performed to design the de novo models and obtain the rest of the parameters. The methodology, assumptions, data inputs and results were validated by a group of experts in epidemiology and disease modelling, immunization and public health policy. RESULTS: The total burden of disease amounted to 163.54 annual DALYs/100,000 population. Among the selected twelve diseases, respiratory infections represented around 90% of the total burden. Influenza exhibited the highest burden, with 110.00 DALYs/100,000 population, followed by invasive pneumococcal disease and RSV, with 25.20 and 10.57 DALYs/100,000 population, respectively. Herpes zoster, invasive meningococcal disease, invasive Haemophilus influenza infection and hepatitis B virus infection ranked lower with fewer than 10 DALYs/100,000 population each, while the rest of the infections had a limited burden (< 1 DALY/100,000 population). A higher burden of disease was observed in the elderly (≥ 60 years) and children < 5 years, with influenza being the main cause. In infants < 1 year, RSV represented the greatest burden. CONCLUSIONS: Aligned with the BCoDE study, the results of this analysis show a persisting high burden of immunization-preventable respiratory infections in Spain and, for the first time, highlight a high number of DALYs due to RSV. These estimates provide a basis to guide prevention strategies and make public health decisions to prioritise interventions and allocate healthcare resources in Spain.
Assuntos
Doenças Transmissíveis , Anos de Vida Ajustados por Deficiência , Humanos , Espanha/epidemiologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Lactente , Pré-Escolar , Adulto Jovem , Adolescente , Doenças Transmissíveis/epidemiologia , Criança , Incidência , Saúde da População/estatística & dados numéricos , Recém-Nascido , Idoso de 80 Anos ou mais , Efeitos Psicossociais da Doença , Programas de Imunização , Doenças Preveníveis por Vacina/epidemiologia , Doenças Preveníveis por Vacina/prevenção & controle , Anos de Vida Ajustados por Qualidade de VidaRESUMO
In the face of the ever-present burden of emerging and reemerging infectious diseases, there is a growing need to comprehensively assess individual- and population-level immunity to vaccine-preventable diseases (VPDs). Many of these efforts, however, focus exclusively on antibody-mediated immunity, ignoring the role of T cells. Aimed at clinicians, public health practioners, and others who play central roles in human vaccine research but do not have formal training in immunology, we review how vaccines against infectious diseases elicit T cell responses, what types of vaccines elicit T cell responses, and how T cell responses are measured. We then use examples to demonstrate six ways that T cells contribute to protection from VPD, including directly mediating protection, enabling antibody responses, reducing disease severity, increasing cross-reactivity, improving durability, and protecting special populations. We conclude with a discussion of challenges and solutions to more widespread consideration of T cell responses in clinical vaccinology.
Assuntos
Imunidade Celular , Linfócitos T , Doenças Preveníveis por Vacina , Vacinas , Humanos , Linfócitos T/imunologia , Doenças Preveníveis por Vacina/prevenção & controle , Doenças Preveníveis por Vacina/imunologia , Vacinas/imunologia , Imunidade Celular/imunologia , Reações Cruzadas/imunologia , Animais , VacinaçãoRESUMO
We modeled the impact of local vaccine mandates on the spread of vaccine-preventable infectious diseases, which in the absence of vaccines will mainly affect children. Examples of such diseases are measles, rubella, mumps, and pertussis. To model the spread of the pathogen, we used a stochastic SIR (susceptible, infectious, recovered) model with two levels of mixing in a closed population, often referred to as the household model. In this model, individuals make local contacts within a specific small subgroup of the population (e.g., within a household or a school class), while they also make global contacts with random people in the population at a much lower rate than the rate of local contacts. We considered what would happen if schools were given freedom to impose vaccine mandates on all of their pupils, except for the pupils that were exempt from vaccination because of medical reasons. We investigated first how such a mandate affected the probability of an outbreak of a disease. Furthermore, we focused on the probability that a pupil that was medically exempt from vaccination, would get infected during an outbreak. We showed that if the population vaccine coverage was close to the herd-immunity level, then both probabilities may increase if local vaccine mandates were implemented. This was caused by unvaccinated pupils possibly being moved to schools without mandates.
Assuntos
Doenças Transmissíveis , Surtos de Doenças , Instituições Acadêmicas , Vacinação , Humanos , Surtos de Doenças/prevenção & controle , Criança , Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/transmissão , Doenças Preveníveis por Vacina/prevenção & controle , Doenças Preveníveis por Vacina/epidemiologia , Processos Estocásticos , Imunidade Coletiva , Vacinas/administração & dosagem , Sarampo/prevenção & controle , Sarampo/epidemiologia , Probabilidade , Simulação por Computador , Caxumba/prevenção & controle , Caxumba/epidemiologia , Programas Obrigatórios , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/legislação & jurisprudência , Rubéola (Sarampo Alemão)/prevenção & controle , Rubéola (Sarampo Alemão)/epidemiologia , Vacinação CompulsóriaRESUMO
Vaccination is one of the greatest public health achievements of the 20th century, with a tremendous impact in the prevention and control of diseases. However, the recent reemergence of vaccine-preventable diseases calls for a need to evaluate current vaccination practices and disparities in vaccination between high-income countries and low-and-middle-income countries. There are massive deficits in vaccine availability and coverage in resource-constrained settings. Therefore, this perspective seeks to highlight the reemergence of vaccine-preventable diseases in Africa within the lens of health equity and offer recommendations on how the continent should be prepared to deal with the myriad of its health systems challenges. Among the notable factors contributing to the reemergence, stand health inequities affecting vaccine availability and the dynamic vaccine hesitancy. Strengthening health systems and addressing health inequities could prove useful in halting the reemergence of vaccine-preventable diseases.
Assuntos
Equidade em Saúde , Vacinação , Doenças Preveníveis por Vacina , Humanos , Doenças Preveníveis por Vacina/prevenção & controle , Doenças Preveníveis por Vacina/epidemiologia , África/epidemiologia , Vacinação/estatística & dados numéricos , Vacinas/administração & dosagem , Vacinas/provisão & distribuição , Hesitação Vacinal/estatística & dados numéricos , Doenças Transmissíveis Emergentes/prevenção & controle , Doenças Transmissíveis Emergentes/epidemiologiaRESUMO
Despite vaccines being instrumental in reducing vaccine-preventable disease, adult vaccination rates in the United States (US) are below optimal levels. To better understand factors affecting vaccination rates, we analyzed trends in adult vaccination coverage using data from the Behavioral Risk Factor Surveillance System (BRFSS) and conducted a targeted literature review (TLR) on interventions to improve adult vaccination rates in the US. Both the BRFSS analysis and the TLR focused on influenza; pneumococcal disease; tetanus and diphtheria or tetanus, diphtheria, and acellular pertussis; herpes zoster; and human papillomavirus vaccination for US adults aged 18-64 years. The TLR additionally included hepatitis A and hepatitis B vaccination. Vaccination coverage rates (VCRs) and changes in VCRs were calculated using the 2011-2019 BRFSS survey data. For the TLR, the MEDLINE and MEDLINE In-Process databases were searched for articles on vaccination interventions published between January 2015 and June 2021. The BRFSS analysis showed that changes in VCRs were generally modest and positive for most states over the study period. The TLR included 32 articles that met the eligibility criteria; intervention strategies that improved adult vaccination outcomes incorporated an educational component, vaccination reminders or reinforcement at the point of care, or authorized non-clinician members of the healthcare team to vaccinate. Furthermore, interventions combining more than one approach appeared to enhance effectiveness. The strategies identified in this TLR will be valuable for policymakers and stakeholders to inform the development and implementation of evidence-based policies and practices to improve adult vaccination coverage.
Assuntos
Cobertura Vacinal , Humanos , Estados Unidos , Cobertura Vacinal/estatística & dados numéricos , Adulto , Adulto Jovem , Pessoa de Meia-Idade , Adolescente , Sistema de Vigilância de Fator de Risco Comportamental , Vacinação/estatística & dados numéricos , Feminino , Masculino , Programas de Imunização/estatística & dados numéricos , Bases de Dados Factuais , Vacinas contra Influenza/administração & dosagem , Doenças Preveníveis por Vacina/prevenção & controleRESUMO
High-quality vaccine-preventable disease (VPD) surveillance data are critical for timely outbreak detection and response. In 2019, the World Health Organization (WHO) African Regional Office (AFRO) began transitioning from Epi Info, a free, CDC-developed statistical software package with limited capability to integrate with other information systems, affecting reporting timeliness and data use, to District Health Information Software 2 (DHIS2). DHIS2 is a free and open-source software platform for electronic aggregate Integrated Disease Surveillance and Response (IDSR) and case-based surveillance reporting. A national-level reporting system, which provided countries with the option to adopt this new system, was introduced. Regionally, the Epi Info database will be replaced with a DHIS2 regional data platform. This report describes the phased implementation from 2019 to the present. Phase one (2019-2021) involved developing IDSR aggregate and case-based surveillance packages, including pilots in the countries of Mali, Rwanda, and Togo. Phase two (2022) expanded national-level implementation to 27 countries and established the WHO AFRO DHIS2 regional data platform. Phase three (from 2023 to the present) activities have been building local capacity and support for country reporting to the regional platform. By February 2024, eight of 47 AFRO countries had adopted both the aggregate IDSR and case-based surveillance packages, and two had successfully transferred VPD surveillance data to the AFRO regional platform. Challenges included limited human and financial resources, the need to establish data-sharing and governance agreements, technical support for data transfer, and building local capacity to report to the regional platform. Despite these challenges, the transition to DHIS2 will support efficient data transmission to strengthen VPD detection, response, and public health emergencies through improved system integration and interoperability.
Assuntos
Vigilância da População , Software , Doenças Preveníveis por Vacina , Organização Mundial da Saúde , Humanos , África/epidemiologia , Doenças Preveníveis por Vacina/prevenção & controle , Doenças Preveníveis por Vacina/epidemiologiaRESUMO
BACKGROUND: Immunization against vaccine-preventable diseases prior to pregnancy is an important measure of primary prevention both for the mother and the unborn child. We analyzed immunity rates against measles, mumps, rubella, varicella, and pertussis in pregnant employees in Germany prior to significant changes in legal conditions in 2020, to provide a basis of comparison for future research. METHODS: We analyzed occupational-medical routine data in three collectives of pregnant women with an occupational risk of infection in the years 2018 and 2019: 1: hospital staff with regular access to an in-house company physician (n = 148); 2: employees in childcare with regular access to external occupational-health services (n = 139); 3: teachers with no regular access to occupational healthcare (n = 285). Immune status was assessed by a physician based on vaccination certificates, laboratory results, and medical documentation on prior infections. We compared immunity rates against measles, rubella, varicella, and pertussis as well as full immunity against all targeted vaccine-preventable diseases. RESULTS: Altogether, n = 572 pregnant women were included in our study. Of these women, 96.5 % were immune to rubella, 95.8 % to varicella, 88.3 % to measles, 82.7 % to mumps, and 67.8 % to pertussis. Only 56.2 % of the women had full immunity against all targeted vaccine-preventable diseases. Collective 1 showed the highest immunity rates against measles and pertussis as well as the highest rate of full immunity against all targeted vaccine-preventable diseases. The immunity rates against rubella and varicella did not differ significantly between the collectives. With the exception of rubella, the lowest immunity rates during pregnancy were found in Collective 3. CONCLUSION: We found pregnancy-relevant immunity gaps in all our study groups with significant differences between the collectives. Considering the potentially devastating consequences of infections during pregnancy, all medical professionals and health-policy makers should be involved in an increased effort to improve vaccination rates prior to pregnancy.
Assuntos
Varicela , Sarampo , Rubéola (Sarampo Alemão) , Vacinação , Doenças Preveníveis por Vacina , Humanos , Feminino , Alemanha/epidemiologia , Gravidez , Sarampo/prevenção & controle , Sarampo/imunologia , Adulto , Rubéola (Sarampo Alemão)/prevenção & controle , Rubéola (Sarampo Alemão)/imunologia , Varicela/prevenção & controle , Varicela/imunologia , Varicela/epidemiologia , Doenças Preveníveis por Vacina/prevenção & controle , Doenças Preveníveis por Vacina/imunologia , Doenças Preveníveis por Vacina/epidemiologia , Caxumba/prevenção & controle , Caxumba/imunologia , Gestantes , Coqueluche/prevenção & controle , Coqueluche/imunologia , Adulto JovemRESUMO
Objective: The survival rates of children with acute lymphoblastic leukemia (ALL) have improved over the years, but infections remain a significant cause of morbidity and mortality. Chemotherapy has a range of harmful side effects including the loss of protective antibodies against vaccine-preventable diseases. The objective of this study was to evaluate the serological status of pediatric ALL cases before and after intensive chemotherapy. Materials and Methods: Children treated and followed for ALL at Dokuz Eylül University were included in this retrospective cross-sectional study. Antibody levels against hepatitis A, hepatitis B, and rubella were routinely assessed at both the time of diagnosis and 6 months after completion of chemotherapy. Measles, mumps, and varicella antibody levels were evaluated at only 6 months after treatment. Results: Seventy-eight children who completed chemotherapy for ALL were enrolled in the study. All participants had non-protective antibody levels for at least one of the diseases. The highest seropositivity rate was found for hepatitis A (55.1%) and the lowest for measles (17.9%) after chemotherapy. Overall, 50.7%, 30.6%, and 45.7% of the patients significantly lost their humoral immunity against hepatitis B, hepatitis A, and rubella, respectively. Patients in the higher-risk group for ALL had lower seropositivity rates than patients of the other risk groups. There were statistically significant relationships between the protective antibody rates for hepatitis A and varicella and the ages of the patients. Except for hepatitis A vaccination, pre-chemotherapy vaccination did not affect post-chemotherapy serology. On the other hand, all children with a history of varicella before diagnosis showed immunity after chemotherapy. Conclusion: Patients with ALL, including those previously fully vaccinated, are at great risk of infection due to the decrease in protective antibody levels after chemotherapy. There is a need for routine post-chemotherapy serological testing and re-vaccination based on the results obtained.
Assuntos
Imunidade Humoral , Leucemia-Linfoma Linfoblástico de Células Precursoras , Humanos , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/imunologia , Estudos Retrospectivos , Estudos Transversais , Masculino , Feminino , Criança , Pré-Escolar , Imunidade Humoral/efeitos dos fármacos , Adolescente , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Doenças Preveníveis por Vacina/imunologia , Doenças Preveníveis por Vacina/prevenção & controle , LactenteRESUMO
BACKGROUND: Infections are responsible for approximately 13% of cancer cases worldwide and many of these infections can be prevented by vaccination. Human papillomavirus (HPV) and hepatitis B virus (HBV) are among the most common infections that cause cancer deaths globally, despite effective prophylactic vaccines being available. This analysis aims to estimate the global burden and economic impact of vaccine-preventable cancer mortality across World Health Organization (WHO) regions. METHODS: The number of deaths and years of life lost (YLL) due to five different vaccine-preventable cancer forms (oral cavity, liver, laryngeal, cervical, and oropharyngeal cancer) in each of the WHO regions (African, Eastern Mediterranean, European, the Americas, South-East Asia Pacific, and Western Pacific) were obtained from the Institute for Health Metrics Evaluation global burden of disease dataset. Vaccine-preventable mortality was estimated considering the fraction attributable to infection, to estimate the number of deaths and YLL potentially preventable through vaccination. Data from the World Bank on GDP per capita were used to estimate the value of YLL (VYLL). The robustness of these results was explored with sensitivity analysis. Given that several Epstein-Barr virus (EBV) vaccines are in development, but not yet available, the impact of a potential vaccine for EBV was evaluated in a scenario analysis. RESULTS: In 2019, there were 465,740 potentially vaccine-preventable cancer deaths and 14,171,397 YLL across all WHO regions. The estimated economic impact due to this mortality was $106.3 billion globally. The sensitivity analysis calculated a range of 403,025-582,773 deaths and a range in productivity cost of $78.8-129.0 billion. In the scenario analysis EBV-related cancer mortality increased the global burden by 159,723 deaths and $32.4 billion. CONCLUSION: Overall, the findings from this analysis illustrate the high economic impact of premature cancer mortality that could be potentially preventable by vaccination which may assist decision-makers in allocating limited resources among competing priorities. Improved implementation and increased vaccination coverage of HPV and HBV should be prioritized to decrease this burden.
Assuntos
Saúde Global , Neoplasias , Humanos , Neoplasias/mortalidade , Neoplasias/economia , Feminino , Masculino , Carga Global da Doença , Efeitos Psicossociais da Doença , Doenças Preveníveis por Vacina/prevenção & controle , Doenças Preveníveis por Vacina/economia , Pessoa de Meia-Idade , Adulto , Modelos Econométricos , Infecções por Papillomavirus/prevenção & controle , Infecções por Papillomavirus/economia , Anos de Vida Ajustados por Qualidade de VidaRESUMO
The surge in recommended vaccinations for child's has spurred the development of combination vaccines, notably hexavalent vaccines, which provide multiple immunizations in a single dose. These vaccines offer various advantages, such as streamlining vaccination schedules, minimizing injection-related pain and exposure to preservatives, expanding vaccine coverage, and reducing administration costs. However, the intricate and expensive development of these vaccines presents substantial challenges, requiring increased investment and healthcare provider education to optimize their utilization and sustain high vaccination rates. Turkey, known for its robust vaccine coverage, strategic geographic location, and the influx of refugees, is at a critical juncture for integrating hexavalent vaccines into national programs. This transition is especially relevant given the rising vaccine hesitancy and the potential resurgence of vaccine-preventable diseases. This review assesses the deployment of hexavalent vaccines, examining their benefits and challenges through clinical trials and global experiences, with a specific emphasis on Turkiye's public health context.
Assuntos
Doenças Preveníveis por Vacina , Vacinas Combinadas , Humanos , Programas de Imunização , Esquemas de Imunização , Turquia , Vacinação , Cobertura Vacinal , Hesitação Vacinal/estatística & dados numéricos , Doenças Preveníveis por Vacina/prevenção & controle , Vacinas Combinadas/administração & dosagem , Vacinas Combinadas/imunologiaRESUMO
BACKGROUND: Outbreaks of vaccine-preventable diseases (VPDs) in healthcare workers (HCWs) can result in morbidity and mortality and cause significant disruptions to healthcare services, patients, and visitors as well as an added burden on the healthcare system. This scoping review aimed to describe the epidemiology of VPD outbreaks in HCWs caused by diseases that are prevented by the 10 vaccines recommended by the World Health Organization for HCWs. METHODS: In April 2022, CINAHL, MEDLINE, Global Health, and EMBASE were searched for all articles reporting on VPD outbreaks in HCWs since the year 2000. Articles were included regardless of language and study type. Clinical and epidemiological characteristics of VPD outbreaks were described. RESULTS: Our search found 9363 articles, of which 216 met the inclusion criteria. Studies describing 6 of the 10 VPDs were found: influenza, measles, varicella, tuberculosis, pertussis, and rubella. Most articles (93%) were from high- and upper-middle-income countries. While most outbreaks occurred in hospitals, several influenza outbreaks were reported in long-term-care facilities. Based on available data, vaccination rates among HCWs were rarely reported. CONCLUSIONS: We describe several VPD outbreaks in HCWs from 2000 to April 2022. The review emphasizes the need to understand the factors influencing outbreaks in HCWs and highlights the importance of vaccination among HCWs.
Assuntos
Surtos de Doenças , Pessoal de Saúde , Vacinação , Doenças Preveníveis por Vacina , Humanos , Pessoal de Saúde/estatística & dados numéricos , Surtos de Doenças/prevenção & controle , Doenças Preveníveis por Vacina/epidemiologia , Doenças Preveníveis por Vacina/prevenção & controle , Vacinação/estatística & dados numéricos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controleRESUMO
BACKGROUND: Ensuring vaccination coverage reaches established herd immunity thresholds (HITs) is the cornerstone of any vaccination programme. Diverse migrant populations in European countries have been associated with cases of vaccine-preventable diseases (VPDs) and outbreaks, yet it is not clear to what extent they are an under-immunized group. METHODS: We did a systematic review and meta-analysis to synthesize peer-reviewed published primary research reporting data on the immune status of migrants in EU/EEA countries, the UK and Switzerland, calculating their pooled immunity coverage for measles, mumps, rubella and diphtheria using random-effects models. We searched on Web of Science, Embase, Global Health and MEDLINE (1 January 2000 to 10 June 2022), with no language restrictions. The protocol is registered with PROSPERO (CRD42018103666). FINDINGS: Of 1103 abstracts screened, 62 met eligibility criteria, of which 39 were included in the meta-analysis. The meta-analysis included 75 089 migrants, predominantly from outside Europe. Pooled immunity coverage among migrant populations was well below the recommended HIT for diphtheria (n = 7, 57.4% [95% confidence interval (CI): 43.1-71.7%] I2 = 99% vs HIT 83-86%), measles (n = 21, 83.7% [95% CI: 79.2-88.2] I2 = 99% vs HIT 93-95%) and mumps (n = 8, 67.1% [95% CI: 50.6-83.6] I2 = 99% vs HIT 88-93%) and midway for rubella (n = 29, 85.6% [95% CI: 83.1-88.1%] I2 = 99% vs HIT 83-94%), with high heterogeneity across studies. INTERPRETATION: Migrants in Europe are an under-immunized group for a range of important VPDs, with this study reinforcing the importance of engaging children, adolescents and adults in 'catch-up' vaccination initiatives on arrival for vaccines, doses and boosters they may have missed in their home countries. Co-designing strategies to strengthen catch-up vaccination across the life course in under-immunized groups is an important next step if we are to meet European and global targets for VPD elimination and control and ensure vaccine equity.
Assuntos
Migrantes , Doenças Preveníveis por Vacina , Humanos , Migrantes/estatística & dados numéricos , Europa (Continente) , Doenças Preveníveis por Vacina/prevenção & controle , Doenças Preveníveis por Vacina/imunologia , Cobertura Vacinal/estatística & dados numéricos , Rubéola (Sarampo Alemão)/prevenção & controle , Rubéola (Sarampo Alemão)/imunologia , Caxumba/prevenção & controle , Caxumba/imunologia , Vacinação/estatística & dados numéricos , Imunidade Coletiva , Sarampo/prevenção & controle , Sarampo/imunologia , Sarampo/epidemiologia , Difteria/prevenção & controle , Difteria/imunologiaRESUMO
As part of the Immunization Agenda 2030, a global strategy for comprehensive vaccine-preventable disease (VPD) surveillance was developed. The strategy provides guidance on the establishment of high-quality surveillance systems that are 1) comprehensive, encompassing all VPD threats faced by a country, in all geographic areas and populations, using all laboratory and other methodologies required for timely and reliable disease detection; 2) integrated, wherever possible, taking advantage of shared infrastructure for specific components of surveillance such as data management and laboratory systems; 3) inclusive of all relevant data needed to guide immunization program management actions. Such surveillance systems should generate data useful to strengthen national immunization programs, inform vaccine introduction decision-making, and reinforce timely and effective detection and response. All stakeholders in countries and globally should work to achieve this vision.
Assuntos
Saúde Global , Programas de Imunização , Doenças Preveníveis por Vacina , Humanos , Doenças Preveníveis por Vacina/prevenção & controle , Doenças Preveníveis por Vacina/epidemiologia , Vacinas/administração & dosagem , Vigilância em Saúde Pública , Vacinação , Imunização/métodos , Imunização/tendências , Vigilância da População/métodosRESUMO
Whilst the largely limited health system and funds are already overstretched while responding to multiple epidemics, ongoing vaccine-preventable diseases (VPD) including polio and measles continue to be a public health threat and expose the weaknesses of the public health system in many African countries. The surge in VPD outbreaks during epidemics appears to be a common trend in Africa, often due to reduced vaccination coverage. The World Health Organization reported that, in 2021, nearly 25 million children missed their first measles dose, 5 million more than in 2019. The drop in childhood immunizations was partly attributed to the COVID-19 pandemic which has caused significant interruption in public health services delivery and reduced vaccination coverage. Vaccines help reduce the incidence of VPD. Therefore, effective VPD outbreak response mechanisms and strategies that include ramping up catch-up campaigns for immunization during epidemic troughs including the provision of vaccines outside clinics as well as assessing newer vaccine delivery models during pandemics are essential to minimize the impact of VPD outbreaks during emerging epidemics. Ensuring access to vaccines to address outbreaks and provide supplemental vaccination is essential if we are to be a VPD-free region.
Assuntos
Sarampo , Doenças Preveníveis por Vacina , Vacinas , Criança , Humanos , Pandemias , Doenças Preveníveis por Vacina/epidemiologia , Doenças Preveníveis por Vacina/prevenção & controle , Vacinação , África/epidemiologia , Sarampo/epidemiologia , Sarampo/prevenção & controle , Programas de ImunizaçãoRESUMO
Global immunization programs have saved tens of millions of lives over the last 2 decades. Now, the recent successes of COVID-19 vaccines having saved more than 3 million lives in North America during the pandemic may open the door to accelerate technologies for other emerging infection vaccines. New vaccines for respiratory syncytial virus, norovirus, influenza, herpes simplex virus, shingles, dengue fever, enteric bacterial infections, malaria, and Chagas disease are advancing through clinical development and could become ready for delivery over the next 5 years. The successful delivery of these new vaccines may require expanded advocacy and communications efforts.
Assuntos
COVID-19 , Vacinas contra Influenza , Doenças Preveníveis por Vacina , Vacinas , Humanos , Vacinação , Vacinas contra COVID-19 , Doenças Preveníveis por Vacina/epidemiologia , Doenças Preveníveis por Vacina/prevenção & controle , Hesitação Vacinal , COVID-19/prevenção & controle , Vacinas contra Influenza/uso terapêuticoRESUMO
INTRODUCTION: The WHO 2030 Immunization Agenda (IA-2030) harmonizes immunization activity plans at community, national, regional and global levels. Additionally, medical societies play an important role. The Latin American Group of Experts on Infant Immunization, established in 2018, advises on the harmonization, update, and optimization of infant vaccination programs in Latin America and the Caribbean (LAC). In September 2021, 41 such experts from 13 LAC countries met to develop recommendations for increasing regional vaccination coverage to avoid the reemergence of vaccine-preventable diseases and/or the occurrence of outbreaks. AREAS COVERED: The following items were evaluated: (i) immunization challenges before and during the COVID-19 pandemic; (ii) the status of current immunization programs, particularly infant pertussis and polio vaccination; (iii) possible solutions for overcoming vaccination challenges and achieving regional vaccination coverage targets. EXPERT OPINION/COMMENTARY: Medical societies provide valuable recommendations to guide and update vaccination schedules. In the LAC region, possible strategies to achieve target vaccination rates include the use of combination vaccines, strengthening surveillance systems, improving school attendance, advancing vaccine education and confidence, striving for vaccination equity, widening operational capacity, creating strategic alliances, and strengthening the role of medical groups. It is hoped that these recommendations will be implemented in the LAC region.
Assuntos
COVID-19 , Doenças Preveníveis por Vacina , Lactente , Humanos , América Latina/epidemiologia , Cobertura Vacinal , Doenças Preveníveis por Vacina/epidemiologia , Doenças Preveníveis por Vacina/prevenção & controle , Pandemias/prevenção & controle , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinação , Imunização , Região do Caribe/epidemiologia , Programas de ImunizaçãoRESUMO
Introducción: La evaluación clínica de vacunas anti-COVID-19 en edades pediátricas, es un desafío en tiempos de pandemia; responde a la urgencia de muestras representativas que contribuyan a la reproducibilidad del estudio en la población real. Objetivo: Caracterizar a los adolescentes participantes del ensayo clínico con la vacuna anti-COVID-19 Abdala, evaluar el cumplimiento del esquema de vacunación y estimar si son representativos de este grupo poblacional. Métodos: Se utilizaron los datos de un ensayo fase II, monocéntrico, no controlado con la vacuna Abdala. Se incluyeron 703 sujetos; 207 (29,4 por ciento) fueron adolescentes de entre 12 y 18 años, aparentemente sanos o con enfermedades crónicas controladas, valoración nutricional entre 10 y 90 percentil y voluntariedad para participar. Se estudiaron datos sociodemográficos, antecedentes patológicos personales, hábitos tóxicos y cumplimiento del esquema de vacunación. Resultados: El promedio de edad fue de 15 años, predominó el sexo femenino (51,7 por ciento), el color de la piel blanca (55,6 por ciento) y la valoración nutricional por encima del 75 hasta el 90 percentil (40,6 por ciento). El 9,6 por ciento tuvo hábitos tóxicos como hábito de fumar e ingestión de bebidas alcohólicas. El 51,2 por ciento presentó algún antecedente patológico personal, con mayor prevalencia para asma bronquial, rinitis y otras alergias. El 95,8 por ciento cumplió con el esquema de vacunación. Conclusiones: Las características sociodemográficas, los antecedentes patológicos personales y hábitos tóxicos descritos en los adolescentes del estudio son representativos para este grupo poblacional de Cuba. Se alcanzó un óptimo cumplimiento del esquema de vacunación(AU)
Introduction: The clinical evaluation of anti-COVID-19 vaccines in pediatric population, is a challenge in times of pandemic, to respond to the urgency of representative samples that contribute to the reproducibility of the study in the real population. Objective: To characterize the adolescents participating in the clinical trial with the Abdala anti-COVID-19 vaccine, to evaluate compliance with the vaccination schedule and to estimate whether they are representative of this population group. Methods: Data from a phase II trial with Abdala vaccine were used. A total of 703 subjects were included, 207 (29.4 percent) of them were adolescents, between 12 and 18 years of age, with apparently healthy or controlled chronic diseases, nutritional assessment between 10 and 90 percentiles, and willingness to participate in the study. Sociodemographic data, personal pathological history, toxic habits and compliance with the vaccination scheme of 3 doses every 14 days were the variables studied. Results: The average age was 15 years, it was predominant female sex (51.7 percent), white skin color (55.6 percent) and nutritional assessment above 75 to 90 percentiles (40.6 percent). The 9.6 percent had toxic habits such as smoking and ingestion of alcoholic beverages. Some personal pathological history was in 51.2 percent with a higher prevalence for bronchial asthma, rhinitis and other allergies. The vaccination scheme was fulfilled for 95.8 percent of individuals. Conclusions: Sociodemographic characteristics, pathological history and toxic habits described for adolescents on the study are representative for this population group in Cuba. The vaccination schedule had an optimal compliance(AU)
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Adolescente , Voluntários Saudáveis , Doenças Preveníveis por Vacina/prevenção & controle , Vacinas contra COVID-19/administração & dosagem , Esquemas de Imunização , Ensaio Clínico , Adesão à Medicação , COVID-19/prevenção & controleRESUMO
O diretor da Organização Pan-Americana da Saúde (OPAS), Jarbas Barbosa, convoca os países a intensificarem urgentemente os programas de vacinação, já que o risco de surtos de doenças nas Américas atinge o nível mais alto em 30 anos devido a queda na cobertura vacinal.