Conocimiento, actitudes y prácticas de mujeres gestantes respecto a la vacunación / Knowledge, attitudes and practices of pregnant women regarding vaccination

INTRODUCCIÓN: La vacunación durante el embarazo ha demostrado ser una medida segura y efectiva que protege a la mujer gestante y al feto contra enfermedades inmunoprevenibles. OBJETIVO: Determinar los conocimientos, actitudes y prácticas de mujeres gestantes respecto a la vacunación en el marco de la pandemia por el virus SARS-CoV-2. MATERIALES Y MÉTODOS: Estudio observacional de corte transversal realizado en Instituciones Prestadoras de Servicios de Salud Públicas de los 19 municipios de Casanare, Colombia, entre enero y marzo de 2022. Los datos se recolectaron mediante un instrumento de medición documentado que incluyó 22 ítems agrupados en cuatro secciones: datos sociodemográficos, conocimiento, actitudes y prácticas sobre vacunación. RESULTADOS: La media de puntuación de conocimientos fue 5,9 (DE 1,9) de un máximo de 10. El 93,7% cree que la vacunación es realmente necesaria durante el embarazo. Los factores asociados al nivel adecuado de conocimiento incluyeron el grupo de edad entre 26-30 años (OR: 2,27; IC 95%: 1,21-4,25; p = 0,011), estar en el tercer trimestre de embarazo (OR: 2,37; IC 95%: 1,12-5,01; p = 0,024) y contar con un nivel educativo básico, medio o superior (OR: 10,45; IC 95%: 2,37-46,03; p = 0,002). CONCLUSIÓN: Es esencial fortalecer las estrategias de información, educación y comunicación, para promover la vacunación segura durante el embarazo.

BACKGROUND: Vaccination during pregnancy has proven to be a safe and effective measure that protects pregnant woman and the fetus against immuno-preventable diseases. AIM: To determine the knowledge, attitudes and practices of pregnant women regarding vaccination in the context of the SARS-CoV-2 pandemic. METHODS: A cross-sectional observational study was conducted at public health care institutions in the 19 municipalities of Casanare, Colombia, from January to March 2022. Data were collected using a documented measurement instrument that included 22 items grouped into four sections: sociodemographic data, knowledge, attitudes and practices about vaccination. RESULTS: The mean knowledge score was 5.9 (SD: 1.9) of a maximun of 10; 93.7% believed that vaccination was really necessary during pregnancy. Factors associated with adequate level of knowledge included age group 26-30 years (OR: 2.27; 95% CI: 1.21-4.25; p = 0.011), being in the third trimester of pregnancy (OR: 2.37; 95% CI: 1.12-5.01; p = 0.024) and having basic, intermediate or higher education (OR: 10.45; 95% CI: 2.37-46.03; p = 0.002). CONCLUSIONS: It is essential to strengthen information, education and communication strategies to promote safe vaccination during pregnancy.

Sentimentos de pré-adolescentes e adolescentes quanto à vacinação contra o papilomavirus humano / Feelings of pre-adolescents and adolescents regarding vaccination against human papillomavirus / Sentimientos de preadolescentes y adolescentes cuanto a la vacunación contra el papilomavirus humano

Objetivo: identificar os sentimentos de pré-adolescentes e adolescentes quanto à vacinação contra o papilomavirus humano. Método: trata-se de um estudo fenomenológico, com abordagem qualitativa, realizado com 10 participantes, sendo pré- adolescentes e adolescentes, cujas quais foram vacinadas na sala de vacina de uma Unidade Básica de Saúde de um município de Minas Gerais. Os depoimentos foram gravados e transcritos na íntegra para posterior análise. O tratamento dos dados se deu por meio de Análise de Conteúdo. Resultados: a maioria das entrevistadas atribuiu à significação da vacinação relacionada ao fato de prevenir o câncer de colo uterino. O desconhecimento sobre a finalidade da vacina HPV fica em evidência em alguns depoimentos. O medo da vacina também ficou em evidência, tendo como justificativa o fato de ser injeção, da dor, da agulha e por medo da reação. Como medidas de prevenção, foram citadas o uso de preservativo e a ida periódica ao ginecologista. Seis das participantes não souberam informar nenhuma medida de prevenção contra o papilomavirus humano. Conclusão: as participantes do estudo entendem a importância da vacinação contra o papilomavirus humano, embora seis participantes, bem como suas famílias, informaram ter receio pela dor da vacinação ou possíveis eventos adversos pós-vacinais.(AU)

Objective: to identify the feelings of pre-adolescents and adolescents regarding vaccination against human papillomavirus. Method: this is a phenomenological study, with a qualitative approach, carried out with 10 participants, being pre-adolescents and adolescents, whose vaccinations were performed in the vaccination room of a Basic Health Unit in a municipality in Minas Gerais. The testimonies were recorded and transcribed in full for later analysis. The treatment of the data took place through Content Analysis. Results: most interviewees attributed the meaning of vaccination to the fact that it prevents cervical cancer. The lack of knowledge about the purpose of the HPV vaccine is evident in some statements. The fear of the vaccine was also in evidence, justified by the fact that it was an injection, pain, needle and for fear of the reaction. As preventive measures, the use of condoms and periodic visits to the gynecologist were mentioned. Six of the participants were unable to report any preventive measures against human papillomavirus. Conclusion: the participants understand the importance of vaccination against human papillomavirus, although six participants, as well as their families, reported being afraid of the pain of vaccination or possible post-vaccination adverse events.(AU)

Objetivo: identificar los sentimientos de preadolescentes y adolescentes con respecto a la vacunación contra el virus del papiloma humano. Método: se trata de un estudio fenomenológico, con abordaje cualitativo, realizado con 10 participantes, siendo preadolescentes y adolescentes, cuyas vacunaciones se realizaron en la sala de vacunación de una Unidad Básica de Salud de un municipio de Minas Gerais. Los testimonios fueron registrados y transcritos íntegramente para su posterior análisis. El tratamiento de los datos se realizó mediante Análisis de Contenido. Resultados: la mayoría de las entrevistadas atribuyó la importancia de la vacunación relacionada con el hecho de prevenir el cáncer de cuello uterino. La falta de conocimiento sobre el propósito de la vacuna contra el VPH es evidente en algunas declaraciones. El miedo a la vacuna también se evidenció, justificado por el hecho de que fue una inyección, dolor, aguja y por miedo a la reacción. Como medidas preventivas se mencionaron el uso de condones y visitas periódicas al ginecólogo. Seis de los participantes no pudieron informar ninguna medida preventiva contra el virus del papiloma humano. Conclusión: los participantes del estudio comprenden la importancia de la vacunación contra el virus del papiloma humano, aunque seis participantes, así como sus familiares, informaron tener miedo al dolor de la vacunación o posibles eventos adversos posvacunación.(AU)

Willingness to vaccinate against influenza A (H1N1)pdm09 among Brazilian civil servants: Pró-Saúde cohort study / Disposição para vacinar contra influenza A (H1N1)pdm09 entre funcionários técnico-administrativos universitários: estudo de coorte Pró-Saúde

ABSTRACT: Objective: To investigate sociodemographic factors associated with the willingness to take the pandemic influenza vaccine. Methods: This is a cross-sectional study of Brazilian civil servants participating in the fourth wave (2012-2013) of the longitudinal Pró-Saúde Study. Associations were expressed as odds ratios (OR) and 95% confidence intervals (95%CI), estimated by multivariate logistic regression models. Results: Among 2,828 participants, 15.9% would not be willing to vaccinate in the future if the Brazilian Ministry of Health promoted a new vaccination campaign against pandemic influenza. Not willing to vaccinate in the future was strongly associated with not taking the pandemic influenza vaccine in 2010 (OR = 9.0, 95%CI 6.9 - 11.6). Among the unvaccinated, females, those aged > 60 years, and non-health care workers were less willing to vaccinate in the future. Again, in the vaccinated group, females were less willing to vaccinate. Conclusion: Multidisciplinary efforts should be encouraged in order to identify reasons for refusing vaccination, focusing on the individual and group perceptions of susceptibility, severity, benefits, and barriers to vaccination. Such information is needed to identify target groups for the delivery of customized interventions towards preventing emerging pandemics, such as avian influenza and COVID-19.

RESUMO: Objetivo: Investigar fatores sociodemográficos associados à disposição em adotar a vacina contra influenza pandêmica. Métodos: Estudo transversal entre servidores técnico-administrativos participantes da quarta onda (2012-2013) do estudo longitudinal Pró-Saúde. Associações foram expressas como razões de chances (RC) e intervalos de confiança de 95% (IC 95%), estimados mediante modelos de regressão logística multivariada. Resultados: Entre os 2.828 participantes, 15,9% não estariam dispostos a serem vacinados no futuro se o Ministério da Saúde do Brasil promovesse uma nova campanha de vacinação contra influenza pandêmica. Não estar disposto a ser vacinado no futuro foi fortemente associado a não receber a vacina contra influenza pandêmica em 2010 (RC = 9,0, IC95% 6,9 - 11,6). Entre os não vacinados, mulheres, maiores de 60 anos e profissionais de outras áreas que não a saúde estavam menos dispostos a serem vacinados no futuro. Novamente, para aqueles vacinados, as mulheres estavam menos dispostas a serem vacinadas. Conclusão: Abordagens multidisciplinares devem ser estimuladas para identificar as razões para recusa vacinal, com foco nas percepções individual e coletivas sobre suscetibilidade, gravidade, benefícios e barreiras à vacinação. Essas informações são necessárias para identificar grupos-alvo para a oferta de intervenções particularizadas para a prevenção de pandemias emergentes, como a de influenza aviária e de covid-19.

Reasons for non-vaccination against influenza among older adults with hypertension in Brazil: a cross-sectional study

ABSTRACT The aim of this study was to estimate the prevalence of non-vaccination against influenza among Brazilian older adults with systemic arterial hypertension and determine the main reasons for non-adherence. A cross-sectional study was conducted using data from older adults (≥ 60 years of age) with hypertension who participated in the 2013 National Health Survey and reported not having been vaccinated against flu over the previous 12 months (n = 1,295). The analyses were performed using the Stata 14.0 software. The data were weighted because of the sampling design. An estimated 3,026,080 older adults with hypertension had not received a flu vaccine over the 12 months prior to the survey (22.6%). No significant associations were found with sex, age group or schooling. The prevalence of unvaccinated older adults was lower in the southern and southeastern regions of Brazil than in the northern and northeastern regions, even after adjusting for age. The prevalence was higher among individuals without private health insurance. The main reasons for non-vaccination were fear of a reaction, rarely having the flu and not believing in the protection of the vaccine. The present findings underscore the need for healthcare professionals to explain to the population the benefits of the vaccine for preventing severe influenza (protective effect and possible reactions) and for secondary prevention of cardiovascular events. Increasing the prevalence of vaccination in older adults with hypertension and other cardiovascular diseases is of fundamental importance within the realm of public health as a strategy for reducing occurrences of complications and deaths associated with influenza.

Percepções acerca da importância das vacinas e da recusa vacinal numa escola de medicina / Perceptions on the importance of vaccination and vaccine refusal in a medical school

RESUMO Objetivo: Identificar a percepção da importância das vacinas e os riscos da recusa vacinal entre alunos de Medicina e médicos. Métodos: Estudo transversal realizado por meio da aplicação de questionários sobre vacinas, recusa vacinal e suas repercussões acerca da saúde pública e individual. A amostra, de 92 sujeitos, foi selecionada numa escola privada de Medicina: grupo 1 (53 estudantes do primeiro ao quarto ano) e grupo 2 (39 médicos). Os dados colhidos foram tabulados no programa Microsoft Excel e analisados estatisticamente com o teste exato de Fisher. Resultados: Os dois grupos consideram o Programa Nacional de Imunizações confiável e reconhecem a importância das vacinas, mas 64,2% dos estudantes e 38,5% dos médicos desconhecem o número de doenças infecciosas evitáveis pelas vacinas no calendário básico. A maioria dos entrevistados possuía carteira de vacinas, mas nem todos receberam vacina influenza 2015. Conheciam pessoas que recusavam vacinas e/ou recusavam vacinar seus filhos (respectivamente, 54,7 e 43,3% dos estudantes e 59,0 e 41,0% dos médicos). Dos médicos, 48,7% já atenderam pacientes que se recusaram a receber vacinas. Consideram causas de recusa vacinal: medo de eventos adversos, razões filosóficas, religiosas e desconhecimento sobre gravidade e frequência das doenças. Aspectos éticos da recusa vacinal e possibilidades legais de exigir vacinas para crianças não são consenso. Conclusões: Alunos de Medicina e médicos não se vacinam adequadamente, apresentam dúvidas sobre calendário vacinal, segurança das vacinas e recusa vacinal. Melhorar sua capacitação é importante estratégia para manter as coberturas vacinais e abordar a recusa vacinal de forma ética.

ABSTRACT Objective: To identify the perception of medical students and physicians on the importance of vaccination and the risks of vaccine refusal. Methods: Cross-sectional study with application of questionnaires about vaccines, vaccine refusal and its repercussions on public and individual health. A sample of 92 subjects was selected from a private medical school: group 1 (53 students from first to fourth grades) and group 2 (39 physicians). Data collected were tabulated in the Microsoft Excel Program and analyzed by Fisher's exact test. Results: Both groups considered the National Immunization Program reliable and recognized the importance of vaccines, but 64.2% of students and 38.5% of physicians are unaware of the vaccine-preventable infectious diseases in the basic immunization schedule. Most of the interviewees had a personal vaccine registry, but not all had received the 2015 influenza vaccine. Both groups had known people who refused vaccines for themselves or for their children (respectively, 54.7 and 43.3% of students and 59.0 and 41.0% of physicians). The total of 48.7% of physicians had already assisted vaccine refusers. Appointed causes of vaccine refusal were: fear of adverse events, philosophical and religious reasons and lack of knowledge about severity and frequency of diseases. Ethical aspects of vaccine refusal and legal possibilities of vaccine requirements for children are not consensus. Conclusions: Medical students and doctors are not adequately vaccinated and have queries about the vaccination schedule, vaccine safety and vaccine refusal. Improving these professionals' knowledge is an important strategy to maintain vaccine coverage and address vaccine refusal ethically.

Vaccination access in Primary Care from the user's perspective: senses and feelings about healthcare services / Acceso a la vacunación en la Atención Primaria en la voz del usuario: sentidos y sentimientos frente a la atención / Acesso à vacinação na Atenção Primária na voz do usuário: sentidos e sentimentos frente ao atendimento

Abstract Objective: To understand the feelings, senses, perceptions and perspectives of Users regarding access to vaccination in Primary Health Care. Method: This is a Holistic-Qualitative Multiple Case Study, based on Comprehensive Sociology of Everyday Life with 74 participants representing four microregions of health in the Western Extended Region of Minas Gerais. Data collection occurred between June 2016 and April 2017. In order to analyse the data, we used the Thematic Content Analysis, obeying the technique of cross-synthesis of the cases. Results: The results reveal the senses perceived by Users in the experience of vaccination and the feelings regarding care, showing that interpersonal relations between population and health professionals are determinant in the access to vaccination. The constant expansion of the official immunization schedule increased access, however, geographical and social aspects, the lack of knowledge about vaccination and the recurrent lack of immunobiological were referred to as barriers to immunization access. Final considerations: We emphasized the need to reinforce more equitable policies and effective communication as a means to promote the credibility of the services with Users.

Resumen Objetivo: Comprender los sentimientos, sentidos, percepciones y perspectivas de usuarios frente al acceso a la vacunación en la Atención Primaria de Salud. Método: Se trata de un Estudio de Casos Múltiples Holístico-cualitativo, fundamentado en la Sociología Comprensiva del Cotidiano, con 74 representantes de cuatro microrregiones de la salud de la Región Ampliada Oeste del estado de Minas Gerais. La recolección de datos ocurrió entre junio 2016 y abril 2017. Para el análisis de los datos, se utilizó el Análisis de Contenido Temático, obedeciendo a la técnica de la síntesis cruzada de los casos. Resultados: Los resultados revelan los sentidos percibidos por los usuarios en la vivencia de vacunación y los sentimientos frente a la atención, evidenciando que las relaciones interpersonales entre la población y los profesionales de salud son determinantes en el acceso a la vacunación. La constante ampliación del calendario básico de inmunización amplió el acceso. Sin embargo, aspectos como los geográficos y sociales, la falta de conocimiento sobre vacunación y la recurrente falta de inmunobiológico fueron referidos como barreras al acceso a la inmunización. Consideraciones finales: Se resalta la necesidad de reforzar políticas más equitativas y la comunicación efectiva como medio de promover la credibilidad de los servicios junto a los usuarios.

Resumo Objetivo: Compreender os sentimentos, sentidos, percepções e perspectivas de usuários frente ao acesso à vacinação na Atenção Primária à Saúde. Método: Trata-se de um Estudo de Casos Múltiplos Holístico-Qualitativo, fundamentado na Sociologia Compreensiva do Cotidiano com 74 participantes representantes de quatro microrregiões de saúde da Região Ampliada Oeste de Minas Gerais. A coleta de dados ocorreu entre junho de 2016 e abril de 2017. Para a análise dos dados, utilizou-se a Análise de Conteúdo Temática, obedecendo à técnica da síntese cruzada dos casos. Resultados: Os resultados revelam os sentidos percebidos pelos usuários na vivência em vacinação e os sentimentos frente ao atendimento, evidenciando que as relações interpessoais entre a população e os profissionais de saúde são determinantes no acesso à vacinação. A constante ampliação do calendário básico de imunização ampliou o acesso, entretanto, aspectos geográficos e sociais, a falta de conhecimento sobre vacinação e a recorrente falta de imunobiológico foram referidos como barreiras ao acesso à imunização. Considerações finais: Ressalta-se a necessidade de reforçar políticas mais equitativas e a comunicação efetiva como meio de promover a credibilidade dos serviços junto aos usuários.

HPV vaccine acceptance is high among adults in Mexico, particularly in people living with HIV / Aceptación de la vacuna contra VPH es alta entre adultos en México, especialmente en personas con VIH

Abstract: Objective. To measure HPV vaccine acceptance in diverse Mexican adult popula­tions, taking into account HIV status. Materials and methods: A total of 1 329 men and women, with and without HIV, participated in one of three intervention studies, offering HPV vaccination, carried out in the states of Morelos, Tlaxcala and Mexico City; either the bivalent (Morelos n=103, Tlaxcala n=127) or quadrivalent HPV-vaccine (Mexico City n=1 099) was offered. Results: HPV vaccine was accepted by 80.3% of participants; acceptance was higher in people living with HIV than those without (84.4 vs. 78%, p=0.004). Women had greater HPV infection knowledge (p<0.0001) than men and slightly higher (p=0.4) vaccine acceptance. The main reason for vaccine non-acceptance among HIV-positive participants was their doctor recommended they not get vaccinated. Conclusion: Acceptance of HPV-vaccine was high in men and women regardless of HIV status. Even higher rates of acceptability may be achieved by educating healthcare providers to recommend HPV vaccine to their patients.

Resumen: Objetivo. Medir la aceptación de la vacuna de VPH en una muestra diversa de población adulta mexicana, teniendo en cuenta su estado de VIH. Material y métodos: 1 329 hombres y mujeres con y sin VIH participaron en tres estudios de intervención, realizados en los estados de Morelos, Tlaxcala y Ciudad de México. Se ofreció la vacuna bivalente (Morelos n=103, Tlaxcala n=127) o la cuadrivalente (Ciudad de México n=1 099) contra VPH. Resultados: La vacuna fue aceptada por 80.3% de los participantes; la aceptación fue mayor en personas que viven con VIH que en aquéllas que no (84.4 vs. 78%, p=0.004). Las mujeres (p<0.0001) tenían mayor conocimientos sobre VPH que los hombres y una aceptación de la vacuna ligeramente mayor (p=0.4). El motivo principal de la no aceptación de la vacuna entre personas con VIH fue que su médico recomendó que no se vacunaran. Conclusión: La aceptación de la vacuna contra el VPH fue alta en hombres y mujeres, independientemente del estado de VIH. Se pueden lograr mayores tasas de aceptabilidad educando a los proveedores de atención médica para que recomienden la vacuna contra el VPH a sus pacientes.

Influence of socio-demographic characteristics in the self-care of people with heart failure / Influencia de las características sociodemográficas en el autocuidado de personas con insuficiencia cardiaca / Influência de características sociodemográficas no autocuidado de pessoas com insuficiência cardíaca

ABSTRACT Objective: To determine the influence of socio-demographic characteristics in the self-care of people with heart failure (HF). Method: Cross-sectional, analytical study, held in three private hospitals in Fortaleza, Ceará, Brasil, with 57 hospitalized patients. The data were collected through a demographic characterization form and a self-care assessment scale and were analyzed with inferential statistics, using mean comparison tests. Results: Self-care was best assessed in people with higher education level, higher household income and in a relationship. Conclusion: The socio-demographic characteristics influenced seven self-care practices: dietary control; monitoring of body weight; effort in labor activities; knowledge about HF; up-to-date vaccination record; leisure activities; and family and social support network with strong bonds. The higher prevalence of answers indicating satisfactory self-care practices among the patients occurred in the areas of health promotion and tolerance to stress.

RESUMEN Objetivo: Averiguar la influencia de las características sociodemográficas en el autocuidado de personas con insuficiencia cardíaca (IC). Método: Estudio transversal, analítico, realizado en tres hospitales privados de Fortaleza, Ceará, Brasil, con 57 pacientes internados. Los datos fueron recolectados por medio de formulario de caracterización sociodemográfica y de escala de evaluación del autocuidado y fueron analizados con estadística inferencial, utilizando pruebas de comparación de promedios. Resultados: El autocuidado fue mejor evaluado en personas con mayor escolaridad, renta familiar más alta y con pareja. Conclusión: Las características sociodemográficas influenciaron siete prácticas de autocuidado: el control dietético; el monitoreo del peso corporal; el esfuerzo en la actividad laboral; el conocimiento sobre la IC; el esquema de vacunación actualizado; las actividades de ocio; y la red de apoyo familiar y social con vínculos fuertes. La mayor prevalencia de respuestas indicativas de las prácticas de autocuidado satisfactorias entre los pacientes ocurrió en los ámbitos de la promoción de la salud y de la tolerancia al estrés.

RESUMO Objetivo: Averiguar a influência de características sociodemográficas no autocuidado de pessoas com insuficiência cardíaca (IC). Método: Estudo transversal, analítico, realizado em três hospitais privados de Fortaleza, Ceará, Brasil, com 57 pacientes internados. Os dados foram coletados por meio de formulário de caracterização sociodemográfica e de escala de avaliação do autocuidado e foram analisados com estatística inferencial, utilizando-se testes de comparação de médias. Resultados: O autocuidado foi melhor avaliado em pessoas com maior escolaridade, renda familiar mais alta e companheiro. Conclusão: As características sociodemográficas influenciaram sete práticas de autocuidado: controle dietético; monitoramento do peso corporal; esforço na atividade laboral; conhecimento sobre a IC; esquema vacinal atualizado; atividades de lazer; e rede de suporte familiar e social com vínculos fortes. A maior prevalência de respostas indicativas de práticas de autocuidado satisfatórias entre os pacientes ocorreu nos domínios de promoção da saúde e tolerância ao estresse.

Factors Influencing University Nursing Students' Measles Vaccination Rate During a Community Measles Outbreak

PURPOSE: The purpose of this study was to survey the current state of measles vaccination in university nursing students during a measles outbreak and to identify factors influencing nursing students' vaccination rate. METHODS: In 2014, this study used a self-administered questionnaire to survey 380 university nursing students. Factors influencing measles vaccination were identified through logistic regression analysis using variables between the vaccinated and nonvaccinated groups. RESULTS: Measles vaccination rate was 52.1%. The vaccination rate was significantly higher in juniors, seniors, and those who had heard about measles. In relation to health beliefs, the measles vaccination rate was higher when perceived benefits were high and perceived barriers were low. CONCLUSIONS: A systematic measles vaccination program targeting nursing students upon their entry to university is needed. In order to increase the measles vaccination rate, application of effective promotion campaigns and education programs is necessary.

¿Por qué no se vacunan nuestras pacientes?: motivos por los que las pacientes fuera de los programas de vacunación sistemática, con infección por el virus del Papiloma Humano, deciden decir no a la vacuna / Reasons for non-vaccination in women outside the routine immunization programs

Objetivo: Conocer los motivos de la no vacunación en mujeres fuera de los programas de vacunación sistemática. Metodología: Se evaluaron mediante cuestionario 226 mujeres con infección por VPH. A todas ellas se les había informado de su patología, del VPH y de la vacuna y se les había recomendado el uso del preservativo previamente. Resultados: El 66,7 por ciento tenían pareja estable; 75 por ciento utilizaban preservativo. La edad de inicio de relaciones sexuales fue 17,8 años y el 47,3 por ciento de las pacientes habían tenido 5 ó más parejas a lo largo de su vida. El 72 por ciento conocía su infección por VPH y el 48,8 por ciento su lesión. El 63,7 por ciento no se vacunó: principalmente rechazaron la vacuna por el precio (49,5 por ciento), información insuficiente (18,7 por ciento) u otras causas como la disparidad de opiniones entre los médicos que la atendieron (15 por ciento). Conclusiones: El coste de la vacuna y el conocimiento sobre el VPH son determinantes para la aceptación de la vacunación.

Objective: The aim of the study was to determine the reasons for non-vaccination in women outside the routine immunization programs. Method: There were evaluated by questionnaire 226 women with HPV infection. All of them had been informed of their disease and type of HPV infected by. We all had recommended the vaccine and the condom use previously. Results: 66.7 percent had a steady partner, 75 percent used condoms. The age of first sexual relationship was 17.8 years old and 47.3 percent of patients had 5 or more partners during their lifetime. 72 percent knew their HPV infection and 48.8 percent knew their injury. 63.7 percent were not vaccinated: they rejected the vaccine mainly for the price (49.5 percent), insufficient information (18.7 percent) or other causes such as primary care opposite point of view (15 percent). Conclusions: The prize of the vaccine and the HPV knowledge are crucial to the acceptance of vaccination.

Vacuna contra el virus del papiloma humano en adolescentes: Análisis mediante grupos focales / Human papilloma virus vaccination in teenage girls: a focus group evaluation

Objetivo La obtención de niveles de cobertura bajos frente a la vacunación contra el virus del papiloma humano, ha planteado la necesidad de analizar las causas que están afectando a la toma de decisiones sobre la administración de la vacuna, a partir de las manifestaciones de aquellas directamente implicadas, las adolescentes. Métodos Por tanto, se ha planteado la realización de una evaluación mediante la utilización de la metodología de grupos focales. Se han realizado un grupo piloto y cuatro grupos focales en el Instituto Tirant lo Blanc de Gandía con adolescentes pertenecientes a distintas poblaciones del departamento, incluyendo en los mismos adolescentes vacunadas, no vacunadas y con vacunación incorrecta. Resultados Las su experiencia, conocimientos y opiniones respecto a la vacunación frente al VPH que pueden resumirse en la existencia de ideas erróneas y una carencia importante de conocimientos. Conclusión Es necesario un cambio de dirección basado en el desarrollo de campañas educativas, que sirvan para poder obrar con responsabilidad y poder al mismo tiempo tomar decisiones adecuadas.

Objective The low immunization coverage levels for the human papilloma virus vaccine has led to a need to analyze the causes that affect the decision to vaccinate, as expressed by those directly involved in making this decision -teenage girls. Methodology Therefore, we proposed an assessment with a focus group methodology. An evaluation with a pilot group and four focal groups was carried out in Tirant lo Blanc of Gandia secondary school. The girls that made up the groups belonged to different populations within the health department, including vaccinated, non-vaccinated, and incorrectly vaccinated teenage girls. Results The girls talked about their experiences, knowledge and opinions with respect to HPV vaccination, which could be summarized as showing a large knowledge gap and the existence of erroneous ideas. Conclusion A change in direction, involving the development of educational campaigns that empowers girls and their families to make suitable decisions, is necessary.

Factors associated with future commitment and past history of human papilloma virus vaccination among female college students in northern Taiwan / 부인종양

OBJECTIVE: To investigate factors influencing commitment to human papilloma virus (HPV) vaccination and prior vaccination among female college students in northern Taiwan. METHODS: A quota sample of 400 female college students was recruited from nine colleges in northern Taiwan during March 2013. Of these, 398 completed the self administered questionnaire which was designed based on the health promotion model. RESULTS: The results showed that factors associated with prior vaccination behavior were family history of gynecologic malignancy, ever being advised to get HPV vaccination, perceived barriers of action and perceived self-efficacy. Predictors for commitment to HPV vaccination in the next 6 months were the cost of vaccination, ever being advised to get HPV vaccination, perceived self-efficacy and situational influences. Perceived self-efficacy was significantly influenced by relationship status, past receipt of a recommendation for HPV vaccination and level of knowledge about HPV. CONCLUSION: When formulating vaccination policies, governmental or medical institutions should include these factors to promote vaccination.

Representações de idosos sobre a vacina da gripe / Representations of the elderly on the influenza vaccine

O presente estudo objetivou conhecer as representações sociais de saúde e imunização para idosos vacinados/não vacinados com a Influenza. Adotamos como referencial teórico a Teoria das Representações Sociais, tendo cunho qualitativo. A pesquisa foi desenvolvida com trinta idosos, sendo quinze vacinados contra a gripe e quinze não vacinados. Realizou-se entrevista individual, utilizando questionário para caracterização e Teste de Associação Livre de Palavras (TALP) como instrumentos de coleta. A análise ocorreu através da Teoria do Núcleo Central, pela ordem das evocações. Os dados revelaram diferenças entre as representações para os dois grupos: os idosos vacinados representaram a saúde como sinônimo de bem-estar, que possibilita a manutenção das atividades cotidianas, e a imunização como algo que protege de diversos males; já aqueles não vacinados definiram saúde como produto da vontade divina, e a vacina como algo que protege, mas que causa variadas reações, o que os desencoraja a utilizá-la. O estudo apontou para a importância de educar em saúde e desmitificar o imaginário sobre esta como também acerca de vacinas, uma vez que hábitos saudáveis precisam ser cada dia mais estimulados, minimizando os altos índices de morbimortalidade evitáveis.

This study sought to understand the social representations of health and immunization for elderly individuals vaccinated and unvaccinated with influenza vaccine. The theoretical benchmark adopted was the Theory of Social Representations of a qualitative nature. The research was carried out with thirty elderly individuals, fifteen of whom were vaccinated against influenza and fifteen who were not. Individual interviews were conducted using a questionnaire for characterization and the Free Word Association of Test (TALP) as data collection instruments and analysis was conducted using Central Nucleus Theory. TALP data revealed differences between the representations for the elderly of the two groups. Those vaccinated considered health as being synonymous with well-being, permitting the conduct of daily activities and immunization as something that protects them from various evils. However, those who remained unvaccinated defined health as a product of divine will and immunization as something that protects, but has side effects, which discouraged them from taking it. The study indicated the importance of health education and demystification of misconceptions about vaccines, since healthy habits must be increasingly encouraged, thereby reducing the high rates of preventable morbidity and mortality.

Outpatient-Based Pneumococcal Vaccine Campaign and Survey of Perceptions about Pneumococcal Vaccination in Patients and Doctors

PURPOSE: Despite the ready availability of pneumococcal vaccine, vaccination rates are quite low in South Korea. This study was designed to assess perceptions and awareness about pneumococcal vaccines among subjects at risk and find strategies to increases vaccine coverage rates. MATERIALS AND METHODS: A cross sectional, community-based survey was conducted to assess perceptions about the pneumococcal vaccine at a local public health center. In a tertiary hospital, an outpatient-based pneumococcal vaccine campaign was carried out for the elderly and individuals with chronic co-morbidities from May to July of 2007. RESULTS: Based on the survey, only 7.6% were ever informed about pneumococcal vaccination. The coverage rates of the pneumococcal vaccine before and after the hospital campaign showed an increased annual rate from 3.39% to 5.91%. The most common reason for vaccination was "doctor's advice" (53.3%). As for the reasons for not receiving vaccination, about 75% of high risk patients were not aware of the pneumococcal vaccine, which was the most important barrier to vaccination. Negative clinician's attitude was the second most common cause of non-vaccination. CONCLUSION: Annual outpatient-based campaigns early in the influenza season may improve pneumococcal vaccine coverage rates. Doctor's advice was the most important encouraging factor for vaccination.

Aceptabilidad y conocimientos sobre la vacunación contra el virus del papiloma humano (VPH) en médicos ginecólogos de la Argentina

OBJETIVO: Evaluar entre los ginecólogos argentinos la aceptabilidad y prescripción de la vacuna contra el virus del papiloma humano (VPH), los conocimientos sobre sus características y uso, y las nociones médico-biológicas sobre infección por VPH y cáncer cervicouterino. MATERIAL Y MÉTODOS: Entre noviembre de 2009 y marzo de 2010 se encuestaron a 686 ginecólogos vía internet. RESULTADOS: Más de 80% de los encuestados prescribe la vacuna, conoce sus características y administración, y considera la necesidad de continuar con el tamizaje cervical en mujeres vacunadas. El 37% posee un conocimiento global de la relación entre vacuna y detección/tratamiento de la patología cervical. De los encuestados, 25% subestima la magnitud de la infección, ≈30% no reconoce el rol etiológico del VPH en la enfermedad, y ≈40% posee un conocimiento global del manejo de la infección. CONCLUSIONES: La aceptabilidad de la vacuna contra el VPH es alta. Debe reforzarse la capacitación de los profesionales sobre vacunación y patología cervical, así como las nociones médico-biológicas sobre infección por VPH y cáncer cervicouterino.

OBJECTIVE: To evaluate HPV vaccine acceptability and prescription; knowledge about HPV vaccine; and knowledge about HPV infection and cervical cancer among Argentinean gynecologists. MATERIALS AND METHODS: Between November 2009 and March 2010 we carried out an internet survey of 686 gynecologists. RESULTS: More than 80% of gynecologists prescribed HPV vaccine, knew characteristics of HPV vaccines, and knew that women will still need regular cervical cancer screening after HPV vaccination; 37% had global knowledge about relationship between vaccine, detection and treatment of cervical cancer; 25% underestimated the epidemiological extent of HPV infections, ≈30% was not aware of the causative relationship between HPV infection and cervical cancer and ≈40% had global knowledge about management of HPV infection. CONCLUSIONS: HPV vaccine acceptability is high. Physicians need to be fully informed on HPV vaccination and cervical cancer as well as HPV infection management.

Deconstructing social resistance to pulse polio campaign in two north indian districts.

Objective: To gain an insight into the phenomenon of social resistance and rumors against pulse polio campaign. Design: Qualitative, community-based investigation, mapping perceptions of various stakeholders through in-depth interviews (IDIs), focus group discussions (FGDs), non-formal interactions and observations. Setting: Moradabad and JP Nagar districts of Uttar Pradesh. Subjects: IDIs (providers 33, mothers 33, community leaders 10); FGDs (providers 4, mothers 8) and non-formal interactions (156) with community leaders, parents, businessmen, journalists (Hindi and Urdu media), mobilizers, vaccinators and supervisors. Results: A distinct machination of social resistance and rumors against oral polio vaccine during supplementary immunization activities (SIA) was observed in some minority dominated areas. The pattern can be understood through a model that emerged through qualitative evidence. Inspite of all this, most parents in minority areas supported the SIAs. Only a few clusters from extremely marginalized sections continued to evade SIAs, with an endemic pattern. Through social osmosis, these rumors reached majority community as well and some parents were affected. However, in such cases, the resistance was sporadic and transient. Conclusion: While the program’s focus was on microbiological issues, the obstacles to polio eradication lie in the endemicity of social (and/or cultural) resistance in some pockets, leading to clustering of perpetually unimmunized children - inspite of good coverage of SIAs at macro level. This may sustain low levels of wild poliovirus transmission, and there can be exceptions to the robustness of the pulse approach. A micro level involvement of volunteers from marginalized pockets of minorities might be able to minimize or eliminate this resistance.