Encuesta nacional para pediatras de Argentina: vacunación en la práctica diaria, percepción de conocimientos y barreras / National survey for pediatricians in Argentina: Vaccination in daily practice, perception of knowledge and barriers

Introducción. El descenso de las coberturas de vacunación fue muy significativo en la última década. Los pediatras son una pieza fundamental para recuperar coberturas y aumentar la confianza en la vacunación. Objetivos. Describir la percepción de los pediatras acerca del conocimiento y prácticas sobre vacunas, e identificar barreras en el acceso. Métodos. Estudio analítico observacional, mediante encuesta en línea. Se incluyeron variables del perfil del profesional, capacitación y barreras en inmunizaciones. Resultados. Participaron 1696 pediatras (tasa de respuesta: 10,7 %), media de 50,4 años. El 78,7 % fueron mujeres. El 78,2 % contaba con ≥10 años de ejercicio profesional. El 78,4 % realizaba atención ambulatoria y el 56,0 % en el subsector privado. El 72,5 % realizó una capacitación en los últimos 2 años. Se manifestaron "capacitados" para transmitir a sus pacientes los beneficios de las vacunas: 97,2 %; objetivos de campañas: 87,7 %; contraindicaciones: 82,4 %; efectos adversos: 78,9 %; recupero de esquemas: 71,2 %; notificación de ESAVI: 59,5 %. La proporción fue estadísticamente superior, en todos los aspectos, en pediatras con ≥10 años de ejercicio y en aquellos con capacitación reciente (p ≤ 0,01). Barreras identificadas en el acceso a la vacunación: falsas contraindicaciones (62,3 %); falta temporaria de vacunas (46,4 %); motivos culturales (41,4 %); horario restringido del vacunatorio (40,6 %). Conclusiones. La percepción del grado de capacitación fue variable según el aspecto de la vacunación. Aquellos con mayor tiempo de ejercicio profesional y con actualización reciente se manifestaron con mayor grado de capacidad. Se identificaron múltiples barreras frecuentes asociadas al acceso en la vacunación.

Introduction. The decline in vaccination coverage has been very significant in the past decade. Pediatriciansplay a key role in catching-up coverage and increasing confidence in vaccination. Objectives. To describe pediatricians' perceptions of vaccine knowledge and practices and to identify barriers to access. Methods. Observational, analytical study using an online survey. Variables related to professional profile, training and barriers to vaccination were included. Results. A total of 1696 pediatricians participated (response rate: 10.7%). Their mean age was 50.4 years; 78.7% were women; 78.2% had ≥ 10 years of experience; 78.4% provided outpatient care and 56.0%, in the private subsector; and 72.5% received training in the past 2 years. Respondents described themselves as "trained" in convey the following aspects to their patients: benefits of vaccines: 97.2%; campaign objectives: 87.7%; contraindications: 82.4%; adverse effects: 78.9%; catchup vaccination: 71.2%; reporting of events supposedly attributable to vaccination or immunization: 59.5%. The proportion was statistically higher in all aspects, among pediatricians with ≥ 10 years of experience and those who received training recently (p ≤ 0.01). The barriers identified in access to vaccination were false contraindications (62.3%), temporary vaccine shortage (46.4%), cultural reasons (41.4%), and restricted vaccination center hours (40.6%). Conclusions. The perception of the level of training varied depending on the vaccination-related aspect. Pediatricians with more years of professional experience and those who received recent updates perceivedthemselves as more trained. Multiple barriers associated with access to vaccination were identified.

Estruturação do plano de imunização no combate a covid-19: (des)ordem nos acordos entre os poderes / Structuring the immunization plan to fight covid-19: (dis)order in agreements between the powers / Estructura del plan de inmunización para combatir el covid-19: (des)orden en acuerdos entre potencias

Objetivo: Fomentar o debate acerca da ordenação do plano de vacinação nacional, considerando os aspectos organizacionais entre união, estados e municípios. Métodos: Revisão de literatura, tendo como base os periódicos Cientific Electronic Library Online (SCIELO), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) e Biblioteca Virtual de Saúde (BVS), usando como descritores: Pandemia, Vacina e Plano de Imunização. Com essa busca foram encontradas, inicialmente, 48 publicações. Após a realização da análise, foram incluídos 11 artigos científicos na revisão. Os textos foram submetidos à análise de conteúdo semântica. Resultados: Foram levantadas duas categorias: estratégias de combate a pandemia do covid-19 no Brasil, e a manipulação da sociedade civil e a desordem da cobertura vacinal. Conclusão: as reflexões aqui apresentadas podem contribuir para que os profissionais de enfermagem desenvolvam uma postura reflexiva frente a demanda vacinal, processo de planejamento e percepções da sociedade civil, podendo desencadear uma melhora na preparação para a educação em saúde. (AU)

Objective: To encourage the debate about the ordering of the national vaccination plan, considering the organizational aspects between the union, states and municipalities. Methods: Literature review, based on scientific journals Electronic Library Online (SCIELO), Coordination for the Improvement of Higher Education Personnel (CAPES) and Virtual Health Library (VHL), using as descriptors: Pandemia, Vaccine and Immunization Plan. With this search, 48 publications were initially found. After the analysis, 11 scientific articles were included in the review. The texts were subjected to semantic content analysis. Results: Two categories were raised: strategies to combat the covid-19 pandemic in Brazil, and the manipulation of civil society and the disorder of vaccination coverage. Conclusion: The reflections presented here can contribute for nursing professionals to develop a reflexive posture in face of the vaccine demand, planning process and civil society perceptions, which can trigger an improvement in the preparation for health education. (AU)

Objetivo: Fomentar el debate sobre la ordenación del plan nacional de vacunación, considerando los aspectos organizativos entre sindicato, estados y municipios. Métodos: Revisión de la literatura, con base en revistas científicas Biblioteca Electrónica en Línea (SCIELO), Coordinación para el Perfeccionamiento del Personal de Educación Superior (CAPES) y Biblioteca Virtual en Salud (BVS), utilizando como descriptores: Pandemia, Vacuna y Plan de Inmunización. Con esta búsqueda se encontraron inicialmente 48 publicaciones. Después del análisis, se incluyeron 11 artículos científicos en la revisión. Los textos fueron sometidos a análisis de contenido semántico. Resultados: Se plantearon dos categorías: estrategias para combatir la pandemia de covid-19 en Brasil y la manipulación de la sociedad civil y el desorden de la cobertura de vacunación. Conclusión: Las reflexiones aquí presentadas pueden contribuir para que los profesionales de enfermería desarrollen una postura reflexiva ante la demanda de vacunas, el proceso de planificación y las percepciones de la sociedad civil, lo que puede desencadenar una mejora en la preparación para la educación en salud. (AU)

Perfil epidemiológico e fatores associados à covid-19 em um município do Espírito Santo / Epidemiological profile and factors associated with covid-19 in a municipality of Espírito Santo

Objetivo: avaliar o perfil e os fatores associados à covid-19 em residentes no município de Alegre, Espírito Santo. Métodos: foi realizado um estudo epidemiológico com delineamento transversal no município de Alegre, por meio de inquérito domiciliar, entre os meses de novembro e dezembro de 2021. A análise descritiva foi realizada por meio de distribuição de frequências para as variáveis categóricas e por mediana e intervalo interquartil para as variáveis contínuas. Os fatores associados foram analisados por regressão de Poisson com variância robusta. Resultados: foram entrevistadas 687 pessoas, das quais 18,8% reportaram ter contraído a covid-19. A infecção foi mais frequente entre mulheres e pessoas mais jovens, especialmente antes da vacinação. A vacina inicial mais usada foi a Coronavac (42,6%), enquanto a dose de reforço foi predominantemente da Pfizer (86,30%). Cerca de um terço das aplicações de vacina resultou em reações adversas, destacando-se febre (56%), dor no corpo (31%) e dor de cabeça (41%). A automedicação foi comum, com 76,9% dos entrevistados utilizando medicamentos para tratar a covid-19, sendo a Azitromicina (26,4%), Ivermectina (24,0%) e Dipirona (10,8%) as mais citadas. Fatores como consultas médicas recentes e automedicação foram associados à ocorrência de covid-19. Conclusão: os resultados deste estudo podem ajudar a conscientizar a população sobre fatores que podem agravar a doença, destacando a importância do reforço nas medidas de prevenção.

Objective: to evaluate the profile and factors associated with covid-19 in residents of the municipality of Alegre through a household survey between the months of November and December 2021. Methods: An epidemiological study with a cross-sectional design was carried out in the city of Alegre in 2021. The descriptive analysis was carried out using frequency distribution for categorical variables and the median and interquartile range for continuous variables. Associated factors were analyzed using Poisson regression with robust variance. Results: 687 people were interviewed, with 18.8% reporting having contracted covid-19. Infection was more common among women and younger people, especially before vaccination. The most used initial vaccine was Coronavac (42.6%), while the booster dose was predominantly from Pfizer (86.30%). Around a third of vaccine applications resulted in adverse reactions, including fever (56%), body pain (31%) and headache (41%). Self-medication was common, with 76.9% of respondents using medications to treat covid-19, with Azithromycin (26.4%), Ivermectin (24.0%), and Dipyrone (10.8%) being the most cited. Factors such as recent medical appointments and self-medication have been associated with the occurrence of covid-19. Conclusion: the results of this study can help raise awareness among the population about factors that can worsen the disease, highlighting the importance of reinforcing prevention measures.

Lineamientos técnicos para la vigilancia de eventos supuestamente atribuible a la vacunación o inmunización y errores programáticos / Technical guidelines for monitoring events allegedly attributable to vaccination or immunization and programme errors

La vacunación tiene la capacidad de salvar vidas, así como la prevención y control de las enfermedades inmunoprevenibles; dando la oportunidad a los niños y niñas de crecer saludables y con cariño. Para el cumplimiento de todo lo relacionado a la recepción, notificación, análisis, evaluación y seguimiento de acciones correctivas, las siguientes instancias; Dirección Nacional de Medicamentos DNM, Superintendencia de Productos Sanitarios, Dirección de Inmunizaciones, Dirección de Epidemiología y Laboratorio Nacional de Salud Pública, en conjunto con el Centro Nacional de farmacovigilancia (CNFV), deben establecer directrices que permitan notificar y realizar el seguimiento de cualquier evento supuestamente atribuible a la vacunación e inmunización. ESAVI y error programático relacionado a la vacunación y/o a la ejecución de las actividades de vacunación e inmunización

Vaccination has the capacity to save lives, as well as the prevention and control of immunopreventable diseases; giving children the opportunity to grow up healthy and caring. For the fulfilment of all matters related to the receipt, notification, analysis, evaluation and follow-up of corrective actions, the following instances; National Directorate of Medicines DNM, Superintendence of Medical Devices, Directorate of Immunizations, Directorate of Epidemiology and National Laboratory of Public Health, in conjunction with the National Pharmacovigilance Centre (CNFV)should establish guidelines for reporting and monitoring any event allegedly attributable to vaccination and immunization. ESAVI and programme error related to vaccination and/or the implementation of vaccination and immunization activities.

Establecimiento del esquema de purificación de los antígenos de SOBERANA®02, SOBERANA®Plus y SOBERANA 01 / Establishment of the purification scheme for SOBERANA®02, SOBERANA®Plus and SOBERANA 01 antigens

La urgente necesidad de desarrollar y producir vacunas seguras y efectivas para garantizar la reducción de la propagación del coronavirus de tipo 2 causante del síndrome respiratorio agudo severo, hizo que el Centro de Inmunología Molecular y el Instituto Finlay de Vacunas, desarrollaran dos vacunas y un candidato vacunal contra la COVID-19, que tienen como componente la molécula del dominio de unión al receptor (aa 319-541) del virus. Para establecer el proceso productivo, se realizaron experimentos en los posibles pasos del proceso de purificación de la molécula del dominio de unión al receptor (aa 319-541), con vistas a su posterior transferencia tecnológica a escala industrial. Dicha molécula está fusionada con una etiqueta de hexahistidina en su extremo C-terminal y presenta nueve residuos de cisteína en su secuencia que forman cuatro enlaces disulfuros intramoleculares, quedando una cisteína libre que permite obtener dos moléculas: dimérica y monomérica, antígenos que forman parte de las vacunas SOBERANA®02 y SOBERANA®Plus y el candidato vacunal SOBERANA 01. Se determinaron las mejores condiciones de adsorción de las matrices cromatográficas de afinidad por quelatos metálicos, intercambio catiónico y exclusión molecular. Se evaluó el desempeño del proceso a escala piloto y se caracterizó la molécula de acuerdo a sus propiedades físico-químicas y biológicas. Los resultados obtenidos mostraron un 60,02 ± 5,15por ciento de recuperación total de la proteína de interés, con más del 98% de pureza en ambas moléculas, una eficiente remoción de contaminantes y una antigenicidad mayor del 90por ciento referido al monómero control del dominio de unión al receptor con 99 por ciento de pureza, lo que demuestra que el proceso establecido es eficiente en la obtención de un producto con la calidad requerida(AU)

The urgent need to develop and produce safe and effective vaccines to guarantee the reduction of the spread of the type 2 coronavirus that causes severe acute respiratory syndrome, led the Center for Molecular Immunology and the Finlay Vaccine Institute to develop two vaccines and one candidate vaccine to combat the 2019 coronavirus pandemic. As part of the establishment of the production process, experiments were carried out on the possible steps of the purification process of the receptor binding domain molecule (aa 319-541) with a view to its subsequent technological transfer on an industrial scale. This molecule is fused with a hexahistidine tag at its C-terminal end and has nine cysteine residues in its sequence that form four intramolecular disulfide bonds; leaving a free cysteine that allows two molecules to be obtained: dimeric and monomeric, which constitute the antigens of the SOBERANA®02 and SOBERANA®Plus vaccines and the SOBERANA 01 vaccine candidate. The best adsorption conditions of the chromatographic matrices of affinity for metal chelates, cationic exchange and molecular exclusion were determined. The performance of the process was evaluated on a pilot scale and the molecule was characterized according to its physical-chemical and biological properties. The results obtained showed a 60.02 ± 5.15percent total recovery of the protein of interest with more than 98% purity in both molecules, an efficient removal of contaminants and an antigenicity greater than 90percent referred to the control monomer of the domain receptor binding with 99% purity; which demonstrates that the established process is efficient in obtaining a product with the required quality(AU)

Efficacy of current vaccines against recently isolated foot and mouth disease virus type A South America (Venezuela) in Egypt 2022

Foot and mouth disease is a highly contagious viral disease that poses a significant economic threat to cloven-hoofed animals, including cattle and sheep. The emergence of a novel foot and mouth disease virus-A isolate, FMDV-A-Egy-AHRI-RL385-Ven-2022, in Egypt in 2022 has raised concerns about its potential impact on existing vaccination programs. Given that vaccination is a key strategy for foot and mouth disease virus control, the present study was aimed to assess the cross-protective efficacy of both local and imported inactivated vaccines against this new threat. Through challenge experiments and serum neutralization tests, we observed limited effectiveness of both vaccine types. The calculated r1-values at 28 days post-vaccination indicated a minimal immune response to FMDV-A-Egy-AHRI-RL385-Ven-2022 (0.176 and 0.175 for local and imported vaccines, respectively). Challenge experiments further confirmed these findings, revealing 0percent protection from the local vaccine and only 20percent rotection from imported vaccines by day 7 post-challenge. These results underscore the urgent need to update existing foot and mouth disease virus vaccines in Egypt by incorporating the newly circulating FMDV-A-Egy-AHRI-RL385-Ven-2022 strain. This proactive measure is crucial to prevent future outbreaks and ensure effective disease control(AU)

La fiebre aftosa es una enfermedad vírica muy contagiosa que supone una importante amenaza económica para los animales biungulados, entre ellos el ganado vacuno y ovino. La aparición de un nuevo aislado del virus A de la fiebre aftosa, el FMDV-A-Egy-AHRI-RL385-Ven-2022, en Egipto en 2022 ha suscitado preocupación por su posible impacto en los programas de vacunación existentes. Dado que la vacunación es una estrategia clave para el control del virus de la fiebre aftosa, el objetivo del presente estudio fue evaluar la eficacia protectora cruzada de las vacunas inactivadas locales e importadas frente a esta nueva amenaza. Mediante experimentos de desafío y pruebas de seroneutralización, observamos una eficacia limitada de ambos tipos de vacuna. Los valores r1 calculados a los 28 días posvacunación indicaron una respuesta inmunitaria mínima frente a FMDV-A-Egy-AHRI-RL385-Ven-2022 (0,176 y 0,175 para las vacunas local e importada, respectivamente). Los experimentos de provocación confirmaron aún más estos resultados, revelando un 0 por ciento de protección de la vacuna local y sólo un 20 por ciento de protección de las vacunas importadas al séptimo día después de la provocación. Estos resultados subrayan la urgente necesidad de actualizar las vacunas existentes contra el virus de la fiebre aftosa en Egipto incorporando la nueva cepa circulante FMDV-A-Egy-AHRI-RL385-Ven-2022. Esta medida proactiva es crucial para prevenir futuros brotes y garantizar un control eficaz de la enfermedad(AU)

Risk Perceptions Regarding COVID-19 and Compliance with Protective Measures of Midwifery and Nursing Senior Students / Percepções de Risco Relacionadas à COVID-19 e Cumprimento de Medidas de Proteção de Estudantes Séniores de Obstetrícia e Enfermagem / Percepciones de Riesgo con respecto a COVID-19 y Cumplimiento de Medidas de Protección en Estudiantes Seniors de Obstetricia y Enfermería

ABSTRACT Objective: This study aims to examine the risk perceptions of midwifery and nursing senior students regarding COVID-19 and compliance with vaccination and protective measures. Method: This cross-sectional study was conducted in two academic years on senior midwifery and nursing students (n = 358). In the present study, the descriptive characteristics of the students and the COVID-19 risk perception scale were used. Results: The students' COVID-19 Risk Perception Scale scores were at a moderate level and a similar level in both years of this study. More than 80% of the students were fully vaccinated, and the family history of COVID-19 was positive in approximately half of them. In the second year of the pandemic, they paid less attention to social distance and avoidance of being indoors. Conclusion: Although the COVID-19 risk perceptions of future health professional students remained at a similar level during the examined period, it was found that in the second year of the pandemic, they started to get used to the process and paid less attention to social protective measures.

RESUMO Objetivo: Este estudo tem como objetivo examinar as percepções de risco de estudantes sêniores de obstetrícia e enfermagem em relação à COVID-19 e o cumprimento das medidas de vacinação e proteção. Método: Este estudo transversal foi realizado ao longo de dois anos acadêmicos com estudantes sêniores de obstetrícia e enfermagem (n = 358). No presente estudo, foram utilizadas as características descritivas dos estudantes e a escala de percepção de risco da COVID-19. Resultados: As pontuações dos estudantes na Escala de Percepção de Risco da COVID-19 situaram-se num nível moderado e semelhante em ambos os anos do estudo. Mais de 80% dos estudantes estavam totalmente vacinados, e aproximadamente metade deles tinha histórico familiar de COVID-19. No segundo ano da pandemia, prestaram menos atenção ao distanciamento social e aos hábitos de evitar permanência em espaços fechados. Conclusão: Embora as percepções de risco da COVID-19 dos futuros profissionais de saúde tenham permanecido em níveis semelhantes durante o período examinado, verificou-se que, no segundo ano da pandemia, começaram a acostumar-se com o processo e prestaram menos atenção às medidas de proteção social.

RESUMEN Objetivo: Este estudio tiene como objetivo examinar las percepciones de riesgo de los estudiantes seniors de obstetricia y enfermería con respecto a COVID-19 y su cumplimiento con la vacunación y las medidas de protección. Método: Este estudio transversal se llevó a cabo en dos años académicos con estudiantes seniors de obstetricia y enfermería (n = 358). En el presente estudio, se utilizaron las características descriptivas de los estudiantes y la escala de percepción de riesgo de COVID-19. Resultados: Las puntuaciones en la Escala de Percepción de Riesgo de COVID-19 de los estudiantes estaban en un nivel moderado y similar en ambos años de este estudio. Más del 80% de los estudiantes estaban completamente vacunados y la historia familiar de COVID-19 fue positiva en aproximadamente la mitad de ellos. En el segundo año de la pandemia, prestaron menos atención a la distancia social y a evitar estar en interiores. Conclusión: Aunque las percepciones de riesgo de COVID-19 de los futuros profesionales de la salud se mantuvieron en un nivel similar durante el período examinado, se encontró que en el segundo año de la pandemia, empezaron a acostumbrarse al proceso y prestaron menos atención a las medidas de protección social.

Headache as the most prevalent post-vaccination adverse event after Covid-19 vaccination / Dor de cabeça como evento adverso pós-vacinação mais prevalente após a vacinação contra Covid-19

BACKGROUND: In 2020, the first vaccines were approved, according to the WHO. However, speculations arose regarding their efficacy and post-vaccination adverse events (AEFV). OBJECTIVE: To evaluate the prevalence of headache as AEFI from the SARSCoV-2 vaccine in Piauí, Brazil. METHODS: This is a quantitative, observational, cross-sectional, and prevalence study. Data were provided by the Post-Vaccination Adverse Event Information System (SI-AEFV), from reported cases from January to September 2021. Data were analyzed, and the research was approved by the UFPI Research Ethics Committee. RESULTS: A total of 2,008 cases were analyzed. Headache was reported in 752 cases (27.99%) as an AEFV after vaccination against SARS-CoV-2. In most cases, patients were from Teresina (67.62%), of brown race/ethnicity (52.67%), female (79.00%), and the majority were not healthcare professionals (54.27%). The most common age of patients, with the original data, was 33 years. After data correction, the most common age was 28 years. The majority of these cases were not severe (96.44%), and the majority of cases were associated with the first dose of the Covid-19-Covishield-Oxford/AstraZeneca vaccine (43.18%).CONCLUSION: Thus, it is concluded from the partial analysis of the results that headache is the most common adverse event after vaccination against SARS-CoV-2. The profile of patients with the most notifications was brown women aged 30 to 40 years who received the first dose of the Covid-19-Covishield-Oxford/AstraZeneca vaccine. Regarding the severity of events, the vast majority were considered non-severe, and no deaths were mentioned, demonstrating the safety of immunobiologicals.

FUNDAMENTO: Em 2020, foram aprovadas as primeiras vacinas, segundo a OMS. No entanto, surgiram especulações quanto à sua eficácia e eventos adversos pós-vacinais (EAPV). OBJETIVO: Avaliar a prevalência de cefaleia como EAPV da vacina SARSCoV-2 no Piauí, Brasil. MÉTODOS: Trata-se de um estudo quantitativo, observacional, transversal e de prevalência. Os dados foram fornecidos pelo Sistema de Informação de Eventos Adversos Pós-Vacinação (SI-AEFV), dos casos notificados no período de janeiro a setembro de 2021. Os dados foram analisados ​​e a pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da UFPI. RESULTADOS: Foram analisados ​​2.008 casos. Cefaleia foi relatada em 752 casos (27,99%) como EAPV após vacinação contra SARS-CoV-2. Na maioria dos casos, os pacientes eram procedentes de Teresina (67,62%), de raça/etnia parda (52,67%), do sexo feminino (79,00%) e a maioria não era profissional de saúde (54,27%). A idade mais comum dos pacientes, com os dados originais, era de 33 anos. Após correção dos dados, a idade mais comum foi 28 anos. A maioria desses casos não foi grave (96,44%), e a maioria dos casos esteve associada à primeira dose da vacina Covid-19-Covishield-Oxford/AstraZeneca (43,18%).CONCLUSÃO: Assim, conclui-se a partir da análise parcial dos resultados de que cefaleia é o evento adverso mais comum após vacinação contra SARS-CoV-2. O perfil dos pacientes com mais notificações foi de mulheres pardas com idade entre 30 e 40 anos que receberam a primeira dose da vacina Covid-19-Covishield-Oxford/AstraZeneca. Quanto à gravidade dos eventos, a grande maioria foi considerada não grave e não foram mencionados óbitos, demonstrando a segurança dos imunobiológicos.

Research progress on immunological properties of ESAT-6 secreted by Mycobacterium tuberculosis and its role in new vaccines / 细胞与分子免疫学杂志

Early secreted antigenic target of 6 kDa protein (ESAT-6) is the major virulence factor of Mycobacterium tuberculosis (MTB), which can resist the clearance of MTB in bodies by inhibiting macrophage phagocytosis and autophagy reaction, thus impeding the immune defense function of the body against MTB infection. In addition, ESAT-6-induced apoptosis of macrophage and massive necrosis of innate immune cells can foster MTB proliferation and colonization, leading to systemic MTB infection. Moreover, ESAT-6 hampers the protective immune response of Th1 cells, reducing the secretion of pro-inflammatory cytokines and contributing to immune dysfunction, thus accelerating the course of MTB infection. During the process, the high immunogenicity of ESAT-6 can be leveraged as a dominant antigen in the development of new TB vaccines, making it a promising candidate with broad prospects for further development.

Vacinas e desinformação: uma análise de conteúdo sobre fake newsapuradas por plataformas de debunkingem redes sociais / Vaccines and disinformation: a content analysis on fake news verified by debunking platforms on social networks / Vacunas y desinformación: un análisis de contenidos sobre fake news verificadas por las plataformas de debunking en las redes sociales

O impacto das fake news chegou à área da saúde e a desconfiança em relação às vacinas trouxe de volta doenças até então erradicadas. Mas como os discursos antivacinasão construídos nas redes sociais? Neste trabalho, 80fake news com foco nas vacinas foram coletadas de sites brasileiros que realizam debunking, uma estratégia de detecção e desmascaramento de desinformação e fake news. A partir da aplicação de um protocolo analítico, mapeamos as principais características presentes na elaboração dessas publicações. A análise de conteúdo revelou que o Facebook e o WhatsApp são as redes preferidas para esse tipo de compartilhamento. Cerca de 59% dos conteúdos são totalmente falsos e a maioria dos discursos destaca possíveis riscos das vacinas como estratégias de convencimento. As fontes mais referenciadas são supostamente médicos e cientistas, para criar confiabilidade. O levantamento aponta ainda que 60% das publicações apresentaram erros gramaticais e ortográficos na elaboração dos textos

The impact of fake news reached the health area and distrust in relation to vaccines brought back diseases that had been eradicated. But how are these anti-vaccine discourses constructed in social medias? In this paper, 80 fake news stories focusing on vaccines were collected through Brazilian websites that perform debunking, a strategy for detecting and unmasking misinformation and fake news. From the application of an analytical protocol, the main characteristics present in the elaboration of these publications were mapped. Content analysis revealed that Facebook and WhatsApp are the preferred medias for this type of sharing. About 59% of the contents are totally false and most of the speeches highlight the risks of vaccines as a convincing strategy. The most referenced sources are supposedly doctors and scientists to create re-liability. The survey also points out that 60% of publications have grammatical and spelling errors in the preparation of texts

El impacto de las fake news llegó al área de la salud y la desconfianza en las vacunas trajo de vuelta enfermedades erradicadas. Pero, ¿cómo se construyen los discursos antivacunas en las redes sociales? En este trabajo, se recopilaron 80 noticias falsas centradas en vacunas a través de sitios web brasileños que realizan debunking, una estrategia para detectar y desenmascarar información errónea y noticias falsas. A partir de la aplicación de un protocolo analítico, mapeamos las principales características presentes en la elaboración de estas publicaciones. El análisis de contenido reveló que Facebook y WhatsApp son las redes preferidas para este tipo de intercambio. Alrededor del 59% del contenido es completamente falso y la mayoría destaca los posibles riesgos de las vacunas como estrategias convincentes. Las fuentes más referenciadas son supuestamente médicos y científicos para crear confiabilidad. La encuesta señala que el 60% de las publicaciones tenían errores gramaticales y ortográficos

O discurso antivacina no ontem e no hoje: a Revolta da Vacina e a pandemia da covid-19, uma abordagem a partir da Análise do Discurso / The anti-vaccine discourse yesterday and today: the Vaccine Revolt and the covid-19 pandemic, a Discourse Analysis approach / El discurso antivacunas ayer y hoy: la Revuelta de las Vacunas y la pandemia da covid-19, una aproximación desde el Análisis del Discurso

A pesquisa pretende identificar elementos ideológicos e históricos diante das formações discursivas do discurso antivacina no Brasil, à luz do passado (Revolta da Vacina) e do presente (pandemia da covid-19). Metodologicamente, trata-se de uma pesquisa documental-qualitativa. O corpus de análise é composto por seis enunciados, três da Revolta da Vacina e três da covid-19, tendo como método a Análise do Discurso. Como resultado, foram identificadas três facetas do discurso antivacina: a) medo do desconhecido e desconfiança na eficácia dos imunizantes; b) honra em jogo e interesse institucional sobre a vacinação; c) liberdade e morte, obrigatoriedade da vacina. Conclui-se que, ainda que o discurso antivacina no Brasil seja tão antigo quanto o primeiro método de vacinação, é fundamental superar o fosso entre comunidade científica e sociedade em geral, a fim de combater desinformação com informação científica, levando o fantasma do discurso antivacina ao esquecimento

The research aims to identify ideological and historical elements in the face of the discursive formations of the anti-vaccine discourse in Brazil, in the light of the past (Vaccine Revolt) and the present (covid-19 pandemic). Methodologically, this is a documentary-qualitative research. The corpus of analysis is com-posed of six statements, three from the Vaccine Revolt and three from the covid-19, using Discourse Anal-ysis as method. A result, three facets of the anti-vaccine discourse were identified: a) fear of the unknown and distrust in the effectiveness of immunizers; b) honor at stake and institutional interest in vaccination; c) freedom and death, the mandatory vaccine. It is concluded that, although the anti-vaccination discourse in Brazil is as old as the first vaccination method, overcoming the gap between scientific community and society in general is essential, in order to fight misinformation with scientific information, taking the ghost from the anti-vaccine discourse to oblivion

La investigación tiene como objetivo identificar elementos ideológicos e históricos frente a las formaciones discursivas del discurso antivacunas en Brasil, la luz del pasado (Revuelta de las Vacunas) y del presente (pandemia de covid-19). Metodológicamente se trata de una investigación documental-cualitativa. El corpus consta de seis enunciados, tres de la Revuelta de las Vacunas y tres del covid-19, utilizando como método el Análisis del Discurso. Como resultado, se identificaron tres facetas del discurso antivacunas: a) miedo a lo desconocido y desconfianza en la efectividad de los inmunizadores; b) honor en juego e interés institucional en la vacunación; c) libertad y muerte, vacunación obligatoria. Se concluye que, aunque el discurso antivacunas en Brasil es tan antiguo como el primer método de vacunación, es fundamental superar la brecha entre la comunidad científica y la sociedad, para combatir con información científica la desinformación, liderando el fantasma de la el discurso antivacunas al olvido

Aceptación, rechazo y vacilación a recibir la vacuna contra COVID-19: estudio multicéntrico / Acceptance, rejection and hesitancy to receive the vaccine against COVID-19: a multicenter study

Objetivos: Determinar la predisposición a recibir esta vacuna contra SARS-CoV-2. Materiales y métodos: Se aplicó un diseño observacional de corte transversal en la población adulta del Paraguay entre mayo y octubre 2022. se aplicó el cuestionario de Kotta et al previamente validado, el cual fue difundido por redes sociales. Resultados: Se incluyeron 303 encuestados, con edad media 34 ± 12 años y predominio del sexo femenino (64,0%). En la muestra, 51,8% padeció COVID-19 y 97,3% ya recibió al menos una dosis de la vacuna. Se detectó que 58,4% aceptada la vacuna, 17,8% vacilaba en recibirla y 23,7% la rechazaba. La aceptación fue más frecuente en los varones (p 0,05). Conclusión: En el momento epidemiológico de disponibilidad universal de la vacuna y habiendo aún sujetos afectados por COVID-19, el rechazo a la misma fue 23,7%.

Objectives: To determine the predisposition to receive this vaccine against SARS-CoV-2. Materials and methods: An observational cross-sectional design was applied in the adult population of Paraguay between May and October 2022. The previously validated questionnaire of Kotta et al was applied, which was disseminated through social networks. Results: 303 respondents were included, with a mean age of 34 ± 12 years and predominance of the female sex (64.0%). In the sample, 51.8% suffered from COVID-19 and 97.3% have already received at least one dose of the vaccine. It was detected that 58.4% accepted the vaccine, 17.8% hesitated to receive it and 23.7% rejected it. Acceptance was more frequent in males (p 0.05). Conclusion: At the epidemiological moment of universal availability of the vaccine and with subjects still affected by COVID-19, rejection of it was 23.7%.

Manual de organización y funciones de la Dirección de Inmunizaciones / Manual of organization and functions of the Directorate of Immunizations

La Dirección de Inmunizaciones, es una dirección especializada del Ministerio de Salud de El Salvador, que tiene asignada la rectoría de todos los aspectos relacionados a la vacunación e inmunización de la población salvadoreña. Esta Dirección es el resultado de una acción conjunta entre los países de la Región de las Américas y de organismos internacionales como la Organización Mundial de la Salud (OMS), su interés es contribuir con acciones tendientes a lograr coberturas universales de vacunación, con el fin de disminuir las tasas de mortalidad y morbilidad causadas por las enfermedades inmunoprevenibles y está sujeta conforme a la Ley de Vacunas. En este sentido y para documentar la organización y funcionamiento de dicha Dirección, se ha elaborado el presente manual como un instrumento técnico normativo de gestión institucional, en el cual se integra la organización y funcionamiento de las diferentes dependencias que lo componen, se describen y establecen los objetivos generales y específicos, las relaciones de autoridad y dependencia de cada ambiente, así como las relaciones de trabajo internas y externas. Tiene el propósito de identificar con claridad las funciones de cada una de las áreas administrativas que la integran, evitar la duplicidad de funciones, conocer las líneas de comunicación y de mando; permitiendo así contar con un instrumento técnico administrativo integrado, que sirva de referencia y consulta a todo el personal laborando en la institución

The Immunization Directorate is a specialized department of the Ministry of Health of El Salvador, who is assigned the rectory of all aspects related to vaccination and immunization of the Salvadoran population. This Address is the result of an action collaboration between the countries of the Region of the Americas and international organizations such as the World Health Organization (WHO), its interest is to contribute with actions aimed at achieving universal vaccination coverage, in order to reduce the rates of mortality and morbidity caused by vaccine preventable diseases and is subject to according to the Vaccination Law. In this sense and to document the organization and operation of said Directorate, has prepared this manual as a regulatory technical management instrument institution, which integrates the organization and operation of the different dependencies that compose it, describe and establish the general objectives and specific, the relationships of authority and dependency of each environment, as well as the internal and external working relationships. Its purpose is to clearly identify the functions of each of the areas that integrate it, avoid duplication of functions, know the lines of communication and command; thus allowing to have a technical administrative instrument integrated, that serves as a reference and consults all the personnel working in the institution

Infección con SARS-CoV2, antes y después de la vacunación, en funcionarios de un hospital de mediana y alta complejidad / Sars-CoV2 infection, before and after vaccination, in health care workers of a medium and high complexity hospital

Introducción: La pandemia de COVID-19 evidenció la importancia de los trabajadores esen-ciales de la salud. Objetivo: Estimar la ocurrencia de la infección por el virus Sars_CoV2 en funcionarios de un hospital, antes y después de implementación del programa de vacunación institucional y la fracción preventiva atribuible a la vacunación. Material y métodos: Estudio de cohorte histórica, teniendo como punto de inicio la fecha del primer funcionario diagnosticado con la Covid19 en el Hospital. Alrededor de mil traba-jadores fueron examinados, durante el periodo de estudio comprendido entre junio de 2020 y octubre 2021. Se utilizó el estadístico de Kaplan-Meier, para comparar la velocidad de infección y la fracción preventiva atribuible al programa de vacunación. Resultados. Hubo diferencias estadísticamente significativas en la reducción de casos según tipo de trabajo, los trabajadores asistenciales experimentaron una reducción del 58,1%, de 124 a 52 y la diferencia en la mediana de la velocidad de infección, antes y después, Log Rank = 127,4 gl = 1 p = 0,000; los administrativos 51,7% de 29 a 14, mediana log Rank = 34,4 gl = 1 p = 0,000, y los operativos 45,5% de 11 a 6, mediana Log Rank = 13,5 gl = 1 p = 0,000. La fracción atribuible preventiva entre los asistenciales fue 47,5% (37,4­54,9); 85,2% (77,7­88,9) en administrativos y una reducción no significativa de 43,6% (-20,7, 63,2) en operativos. Conclusiones: Los trabajadores asistenciales tienen un riesgo alto de contraer la infección por Sars_CoV2. Fue una acertada decisión vacunar a todos los trabajadores del hospital, el impacto es demostrable.

Introduction: The COVID-19 pandemic highlighted the importance of essential health care workers.Objective: To estimate the occurrence of Sars_CoV2 virus infection in hospital staff before and after implementation of the institutional vaccination program and the preventive fraction attributable to vaccination. Material and methods: Historical cohort study, having as starting point the date of the first employee diagnosed with Covid19 in the Hospital. About one thousand workers were exa-mined, during the study period from June 2020 to October 2021. The Kaplan-Meier statistic was used to compare the infection, rate and the preventive fraction attributable to the vac-cination program. Results: There were statistically significant differences in the reduction of cases according to type of work, with the assistential workers experiencing a reduction of 58.1%, from 124 to 52 and the difference in median infection rate, before and after, Log Rank = 127.4 gl = 1 p = 0.000; the administrative 51.7% from 29 to 14, median Log Rank = 34.4 gl = 1 p = 0.000, and the operatives 45.5% from 11 to 6, median Log Rank = 13.5 gl = 1 p = 0.000. The preventive attributable fraction among assistants was 47.5% (37.4-54.9); 85.2% (77.7-88.9) in adminis-trative and a non-significant reduction of 43.6% (-20.7, 63.2) in operatives.Conclusions: Healthcare workers are at high risk of contracting Sars_CoV2 infection. It was a wise decision to vaccinate all hospital workers, the impact is demonstrable.

A review of the epidemiology, diagnosis, treatment, vaccines and economic impact of human monkeypox (Mpox) outbreaks

The current monkeypox outbreak is a public health emergency of international concern and is coming in the wake of the SARS-CoV-2 pandemic. Human monkeypox is a viral zoonotic infection caused by monkeypox virus, an enveloped double-stranded DNA virus of the genus Orthopoxvirus and family Poxviridae that also contain smallpox, cowpox, Orf, and vaccinia viruses. Online databases including PubMed, Google Scholar and Web of Science were searched to obtain relevant publications on the epidemiology, treatment, vaccines and the economic impacts of the current monkeypox (Mpox) outbreak.

Determinants of COVID-19 vaccine acceptance amongst doctors practising in Cross River State, Nigeria

Background: COVID-19 vaccine is one of the most effective public health intervention approaches for prevention of COVID-19. Despite its well-known efficacy and safety, significant proportion of frontline COVID-19 healthcare workers remain hesitant about accepting the vaccine for whatever reasons. This study aimed to determine acceptance rate and determinants of vaccine refusal among doctors in Cross River State, Nigeria. Methodology: This was a cross-sectional survey of doctors using structured online questionnaire administered via the WhatsApp platform of the medical doctors' association, in order to assess their rate of acceptance of COVID-19 vaccines, and reasons for vaccine refusal. The predictors of vaccine acceptance were analysed by univariate and multivariate logistic regression analyses. Results: Of the 443 medical doctors targeted on the WhatsApp platform, 164 responded to the questionnaire survey, giving a response rate of 37.0% (164/443). The mean age of the respondents is 38 ±6.28 years, 91 (55.5%) are 38 years old and above, 97 (59.1%) are males and 67 (40.9%) are females, giving a male-to-female ratio of 1.4:1. The greater proportion of the respondents are physicians (70/148, 47.3%) and about three-quarter of the participants (127/164, 77.4%) had received COVID-19 vaccine. The proportion of physicians who had received COVID-19 vaccine (57/70, 81.4%) was more than the proportion of general practitioners (31/42, 73.8%) and surgeons (24/35, 68.6%). Low perceived benefit of vaccination was the main reason given for COVID-19 vaccine refusal (45.9%, 17/37). No significant association was found between vaccine refusal and suspected predictors (p>0.05). Conclusion: Our study revealed high rate of COVID-19 vaccine acceptance among medical doctors especially among the physicians, with the surgeons showing lowest acceptance rate. A significant proportion would not take vaccine because they perceived it lacks much benefits. To raise vaccine acceptance among doctors, more efforts on vaccine literacy that would target doctors from all sub-specialties especially surgeons and incorporate vaccine benefits should be made.

A review of the recent advances on Lassa fever with special reference to molecular epidemiology and progress in vaccine development

Lassa fever, a viral hemorrhagic fever caused by the Lassa virus (LASV), is endemic in West Africa and is associated with high morbidity and mortality. At least three of the four proposed seven lineages of LASV are found in Nigeria, where the multimammate rat, Mastomys natalensis, serves as the primary reservoir. Endemic countries report approximately 200,000 infections and 5,000 deaths annually, with Nigeria experiencing thousands of infections and hundreds of deaths including healthcare workers. The aim of this review is to provide scientific information for better understanding of the evolutionary biology, molecular epidemiology, pathogenesis, diagnosis, and prevention of Lassa fever in Nigeria and other endemic regions worldwide, which can lead to improved control efforts and reduce morbidity and mortality from recurrent epidemics. To achieve this aim, observational studies such as case series, cross-sectional and cohort studies published between December 2017 and September 2022 were searched for on various online databases including Google Scholar, Africa Journals Online (AJOL), Research Gates, PubMed, PMIC, NCDC, and WHO websites. Although the origin and evolutionary history, and the transmission dynamics of Lassa virus have been revealed through recent molecular epidemiological studies, the factors that drive the evolution of the virus remain unclear. Genetic changes in the viral genome may have enabled the virus to adapt to humans. Diagnosis of Lassa fever has also advanced from basic serological tests to more sophisticated methods such as quantitative real time polymerase chain reaction (qRT-PCR) and sequencing, which are particularly useful for identifying outbreak strains. Several vaccines, including recombinant vesicular stomatitis virus (rVSV), virus-like particle (VLP), and DNA-based vaccines, have shown promise in animal models and some have progressed to phase 2 clinical trials. Preventing and controlling Lassa fever is critical to safeguard the health and well-being of affected communities. Effective measures such as rodent control, improved sanitation, and early detection and isolation of infected individuals are essential for reducing transmission. Ongoing research into the genetic and ecological factors that drive the evolution of Lassa virus is necessary to reduce the impacts of Lassa fever

La fièvre de Lassa, une fièvre hémorragique virale causée par le virus de Lassa (LASV), est endémique en Afrique de l'Ouest et est associée à une morbidité et une mortalité élevées. Au moins trois des quatre lignées proposées de LASV se trouvent au Nigeria, où le rat multimammaire, Mastomys natalensis, sert de réservoir principal. Les pays endémiques signalent environ 200,000 infections et 5,000 décès par an, le Nigéria connaissant des milliers d'infections et des centaines de décès, y compris des travailleurs de la santé. L'objectif de cette revue est de fournir des informations scientifiques pour une meilleure compréhension de la biologie évolutive, de l'épidémiologie moléculaire, de la pathogenèse, du diagnostic et de la prévention de la fièvre de Lassa au Nigeria et dans d'autres régions endémiques du monde, ce qui peut conduire à des efforts de contrôle améliorés et réduire la morbidité et la mortalité des épidémies récurrentes. Pour atteindre cet objectif, des études observationnelles telles que des séries de cas, des études transversales et de cohorte publiées entre décembre 2017 et septembre 2022 ont été recherchées sur diverses bases de données en ligne, notamment Google Scholar, Africa Journals Online (AJOL), Research Gate, PubMed, PMIC, Sites Web du NCDC et de l'OMS. Bien que l'origine et l'histoire évolutive, ainsi que la dynamique de transmission du virus de Lassa aient été révélées par des études épidémiologiques moléculaires récentes, les facteurs qui déterminent l'évolution du virus restent flous. Des modifications génétiques du génome viral pourraient avoir permis au virus de s'adapter à l'homme. Le diagnostic de la fièvre de Lassa est également passé des tests sérologiques de base à des méthodes plus sophistiquées telles que la réaction quantitative en chaîne par polymérase en temps réel (qRTPCR) et le séquençage, qui sont particulièrement utiles pour identifier les souches épidémiques. Plusieurs vaccins, y compris le virus recombinant de la stomatite vésiculeuse (rVSV), les particules pseudo-virales (VLP) et les vaccins à base d'ADN, se sont révélés prometteurs dans des modèles animaux et certains ont progressé vers des essais cliniques de phase 2. La prévention et le contrôle de la fièvre de Lassa sont essentiels pour préserver la santé et le bien-être des communautés touchées. Des mesures efficaces telles que le contrôle des rongeurs, l'amélioration de l'assainissement et la détection et l'isolement précoces des personnes infectées sont essentielles pour réduire la transmission. Des recherches continues sur les facteurs génétiques et écologiques qui déterminent l'évolution du virus de Lassa sont nécessaires pour réduire les impacts de la fièvre de Lassa.

A covid-19 como um analisador do sofrimento de enfermeiras: um ensaio teórico / Covid-19 as a suffering analyzer for female nurses: a theoretical essay / El covid-19 como analizador de sufrimiento de enfermeras: un ensayo teórico

Este ensaio propõe que a Covid-19 pode operar como um analisador, dentro da perspectiva da análise institucional, iluminando um determinado modo de organização social que promove profundas desigualdades e ameaça a vida em diversos níveis e revelando as condições sociais, institucionais e políticas de produção de sofrimento no corpo profissional de Enfermagem. A pandemia desvelou um conjunto de marcas relacionadas à profissão, agravadas pela crise sanitária, reforçando a naturalização das relações de cuidado atribuídas ao feminino, bem como um conjunto de clivagens e hierarquias internas à profissão a partir da sinergia de marcadores da diferença, como gênero, cor/raça, classe e geração. Além disso, este trabalho mostra a presença de uma necropolítica nas respostas à pandemia que banaliza a vida e permite morrer determinados grupos sociais. A ideia de "profissionais de linha de frente" é criticada em suas metáforas bélicas, mas tomada como figura de linguagem em sua potência para afirmar que existem corpos que, pelas marcas sociais e históricas e pela interdependência do cuidado, são mais presentes e exigidos e, portanto, mais vulneráveis à doença e ao sofrimento dela decorrente.(AU)

The essay proposes that Covid-19 can operate as an analyzer, within the perspective of institutional analysis, illuminating a certain mode of social organization that promotes profound inequalities and threatens life at various levels, revealing the social, institutional and political conditions for the production of suffering in the professional nursing body. The pandemic would unveil a set of marks related to the profession, aggravated by the sanitary crisis, reinforcing the naturalization of the care relations attributed to the feminine, as well as a set of cleavages and internal hierarchies to the profession from the synergy of markers of difference as gender, color/race, class and generation. The work shows the presence of necropolitics in responses to the pandemic, which trivializes life and allows certain social groups to die. The idea of "front-line professionals" is criticized in its war metaphors, but taken as a figure of speech in its potency to affirm that there are bodies that by social and historical marks, and by the interdependence of care, are more present and demanded, and therefore more vulnerable to disease and the resulting suffering.(AU)

El ensayo propone que el Covid-19 puede funcionar como analizador, desde la perspectiva del análisis institucional, revelando las condiciones sociales, institucionales y políticas de producción de sufrimiento de enfermeras. La pandemia revela algunas marcas relacionadas con la profesión, agravadas por la crisis de salud, reforzando la naturalización de la atribución del cuidado a lo femenino y un conjunto de jerarquías internas de la profesión. El trabajo también muestra la presencia de una necropolítica en las respuestas a la pandemia. La idea de "profesionales de primera línea" es criticada, pero tomada como una figura del lenguaje en su potencia para afirmar que hay cuerpos que, por las marcas sociales e históricas y por la interdependencia del cuidado, están más presentes y demandados, y por lo tanto más vulnerables a la enfermedad.(AU)