ABSTRACT
Objectives: To describe the use of economic evaluation to update the antigens dispensed by the Colombian Expanded Program on Immunization (EPI) from 2000 and 2021. Method(s): a review of economic evaluation of vaccines (EEV) studies conducted by the Expanded Program of Immunization in Colombia between 2000 and 2021. A literature search was carried out in different databases complemented with information obtained from different stakeholders who participated in the updating process. Result(s): In 2000, sponsored by the Pan-American Health Office of the World Health Organization (PAHO/WHO), was conducted the cost-effectiveness analysis of vaccination against Hemophilus influenzae type b was the first economic evaluation of vaccines (EEV) conducted ever in Colombia. Between 2005 and 2007, 4 EEV (Rotavirus, Heptavalent Pneumococcus, Influenza and Hepatitis A) were carried out in order to inform the decision process at local level in Bogota DC, the Colombian capital. Between 2007 and 2010, the Ministry of Health sponsored 8 EEV (Rotavirus, 7- and 10-valent pneumococcus, Influenza, Hepatitis A, chickenpox, tetanus in men, and HPV) which were used to decide about the introduction of new vaccines at national level. Subsequently, with the support of PAHO's PROVAC initiative, Colombia went from having 6 EPI vaccines in the 1990s, to 21 EPI vaccines that currently protect against 29 diseases, not including the vaccines used against COVID-19 which Colombia have been using since March 2021. Conclusion(s): Colombia has been one of the middle-income countries with the highest number of vaccines included in its EPI in the last 20 years and the use of the EEV has been essential for decision-making.Copyright © 2023
ABSTRACT
Objectives: To describe the mortality from diabetes mellitus before and after the first year of the COVID 19 pandemic in Colombia. Method(s): We conducted an ecological study to describe mortality from DM in Colombia by sex and age groups, before and in the first year of the pandemic in Colombia. We obtained DM mortality data from the national agency for population statistics (known as DANE for its initials in Spanish) which collects vital statistics in Colombia. We analyzed anonymized mortality records coded as DM (code 601 from causes of mortality grouped according to the list 6/67 of the PAHO for ICD, 10th revision) for 2019-2020 considering only the underlying cause of death. The variables considered were year of registration of death, number of deaths per year, sex, age, and underlying cause of death. Result(s): In 2019 and 2020 there were 244,355 and 300,853 deaths by all causes respectively. Out of 56,498 (23.1%) excess deaths, 46,019 were due to COVID-19 (code U071). Deaths from DM for were 7,967 (3.26% out of total;2.71% men - 3.94% women) in 2019 and 10,198 (3.39% out of total;2.82% men - 4.15% women) in 2020. The increase for deaths from DM was 28% (n=2,231) 32.7% for men(n=1,193) and 24% for women (n=1,038). Conclusion(s): The COVID-19 pandemic increased deaths from DM in Colombia with a greater impact on men. Priority should be given to rebuild health care services for chronic diseases.Copyright © 2023
ABSTRACT
Objective: Colombia has an expanded program of immunization of >22 biologics mainly for younger than 6 years old. We aimed to estimate vaccination coverage in children under 6 years old in San Jacinto (Bolivar), in a post-conflict and COVID-19 pandemic scenario. Methods: We conducted a cross-sectional survey from October to November of 2021, in a Caribbean municipality of Colombia (24,910 population) mostly affected by the armed conflict. A two-stage cluster sampling was used with a precision of 5.5% and a design effect of 2, considering a non-response rate of 20%. We collected data on immunization record cards and other basic sociodemographic information from surveys of caregivers of children. Absolute and timely-vaccine coverages adjusted by age were estimated. Data analysis was performed in Stata 13. Results: Out of 187 surveyed children, 159 (85.3%) had vaccination card. BCG (tuberculosis) vaccine had the greater coverage (99,3%), followed by Hb, pentavalent, and polio (>98%). All biologics showed absolute coverages greater than 90%, except for yellow fever (82.6%) and 5-year boosters (70% for MMR [measles, mumps, rubella] booster and 73% for polio and DPT booster). Age-appropriate timely vaccination coverages were lower than absolutes for all biologics. BCG and hepatitis B had coverages of 97% and initial doses of pentavalent, pneumococcal, polio, MMR, and first and second doses of rotavirus reported coverages greater than 91%. Second and third or booster dosages of pentavalent, polio, pneumococcal and booster of DPT, polio, and MMR had coverages between 70-80%. Lowest timely vaccination coverage were yellow fever (2.3%) and influenza (42.8% for first and 26.5% for second dosage). Conclusion: Although most vaccination coverages were greater than 90%, probably the mobility restrictions due to the pandemic severely impacted the timing of vaccination. Other plausible reasons are the timely flow of vaccines (opportunity in administration and vaccine shortages).
ABSTRACT
Objective Colombia designed and adopted a vaccination plan against COVID-19 that will immunize 35 million people. The study aim was to detect the level of willingness to accept vaccination against COVID-19. Methods A telephone survey of 11,721 people aged 80 and over, affiliated with a health insurer, was carried out. The respondents were the affiliates or their relatives or caregivers. Results The average age was 85.0 years (SD: 4.5), with no differences between sexes;3,344 (28.5%) referred to a previous diagnostic test for COVID-19 and 73 were positive, giving an incidence of 622.8 per 100,000 people (95% CI: 491-778). Regarding attitude to vaccination against SARS-CoV-2, 1/4 respondents refrained from giving an opinion or were neutral. When the respondent was a relative, the acceptance of the vaccine was 60.4% (95% CI: 59.5-61.3) with differences by gender: men 62.2% (95% CI: 60.8-63.6) and women 59.2 (95% CI: 58.0-60.3), P < .05. When the respondent was the potential recipient of the vaccine, the acceptance of the vaccine was 61.7% (95% CI: 59.4-64.0) and this also differed by gender: 70.2% in men (95% CI: 66, 9-73.5) and 55.1% in women (95% CI: 52.0-58.3), P < .05. Conclusion The relatively low acceptance of vaccination against COVID-19 in Colombia poses significant challenges to achieve herd immunity that would allow control of the pandemic.
ABSTRACT
Resumen Objetivo Colombia diseñó y adoptó un plan de vacunación contra la COVID-19. El objetivo de esta investigación fue conocer la disposición para aceptar la vacunación contra esa enfermedad de personas de 80 y más años. Métodos Se realizó una encuesta telefónica a 11.721 personas de 80 y más años, afiliadas a una aseguradora de salud, en la que se indagó sobre la intención a recibir la vacuna. Los respondientes fueron los afiliados o sus familiares o cuidadores. Resultados El promedio de edad fue 85,0 años (SD: 4,5), sin diferencias entre sexos;3.344 participantes (28,5%) refirieron el antecedente de haberse realizado una prueba diagnóstica previa de COVID-19 y 73 resultaron positivos. La incidencia acumulada de infección por SARS-CoV-2 desde marzo de 2020 fue de 622,8 por 100.000 personas (IC95%: 491-778 por 100.000). Respecto a la actitud hacia la vacunación contra la COVID-19, uno de cada 4 respondientes se abstuvo de opinar o se manifestó neutro. Cuando el respondiente era un familiar, la aceptación de la vacuna era del 60,4% (IC95%: 59,5-61,3) con diferencias por sexo: entre los hombres era del 62,2% (IC95%: 60,8-63,6) y en mujeres del 59,2 (IC95%: 58,0-60,3), con p<0,05. Cuando el respondiente fue el potencial receptor de la vacuna, la aceptación de la vacuna fue del 61,7% (IC95%: 59,4-64,0) y también difería por sexos: 70,2% en hombres (IC95%: 66,9-73,5) y 55,1% en mujeres (IC95%: 52,0-58,3), con p<0,05. Conclusión La relativamente baja aceptación de la vacunación contra la COVID-19 en Colombia plantea retos importantes para lograr el control de la pandemia. Objective Colombia designed and adopted a vaccination plan against COVID-19 that will immunize 35 million people. The study aim was to detect the level of willingness to accept vaccination against COVID-19. Methods A telephone survey of 11,721 people aged 80 and over, affiliated with a health insurer, was carried out. The respondents were the affiliates or their relatives or caregivers. Results The average age was 85.0 years (SD: 4.5), with no differences between sexes;3,344 (28.5%) referred to a previous diagnostic test for COVID-19 and 73 were positive, giving an incidence of 622.8 per 100,000 people (95% CI: 491-778). Regarding attitude to vaccination against SARS-CoV-2, 1/4 respondents refrained from giving an opinion or were neutral. When the respondent was a relative, the acceptance of the vaccine was 60.4% (95% CI: 59.5-61.3) with differences by gender: men 62.2% (95% CI: 60.8-63.6) and women 59.2 (95% CI: 58.0-60.3), P<.05. When the respondent was the potential recipient of the vaccine, the acceptance of the vaccine was 61.7% (95% CI: 59.4-64.0) and this also differed by gender: 70.2% in men (95% CI: 66, 9-73.5) and 55.1% in women (95% CI: 52.0-58.3), P<.05. Conclusion The relatively low acceptance of vaccination against COVID-19 in Colombia poses significant challenges to achieve herd immunity that would allow control of the pandemic.
ABSTRACT
Objective: Colombia designed and adopted a vaccination plan against COVID-19 that will immunize 35 million people. The aim study was to know the willingness to accept the vaccination against COVID-19. Methods: A telephone survey of 11,721 people aged 80 and over, affiliated with a health insurer, was carried. The respondents were the affiliates or their relatives or caregivers. Results: The average age was 85.0 years (SD: 4.5), with no differences between sexes; 3,344 (28.5%) referred a previous diagnostic test for COVID-19 and 73 were positive for an incidence of 622.8 per 100,000 people (95%CI: 491-778). Regarding the attitude with the vaccination against SARS-CoV-2, 1/4 respondents refrained from giving an opinion or was neutral. When the respondent was a relative, the acceptance of the vaccine was 60.4% (95% CI: 59.5-61.3) with differences by gender: men 62.2% (95% CI: 60.8-63.6) and women of 59.2 (95% CI: 58.0-60.3), P < 0.05. When the respondent was the potential recipient of the vaccine, the acceptance of the vaccine was 61.7% (95% CI: 59.4-64.0) and also differed by gender: 70.2% in men (95% CI: 66, 9-73.5) and 55.1% in women (95% CI: 52.0-58.3), P < 0.05. Conclusion: The relatively low acceptance of vaccination against COVID-19 in Colombia poses significant challenges to achieve herd immunity that allows control of the pandemic.
ABSTRACT
Objectives: Testing is widely accepted as critical to fighting the COVID-19 pandemic. To understand the dynamics of tests conducted could help to assess a country response to the pandemic. In that sense, our aim was to verify if there is a relationship between pandemic dynamics and molecular tests conducted in Colombia. Methods: We retrieved publicly available data from The Colombian National Institute of Health from March 2 to December 31, 2020, on testing and outcomes related to COVID-19. Pearson correlation coefficients were calculated between molecular tests conducted per 100000 persons and death or incidence rate per 100000 people of every department of Colombia. To assess if there a cyclic relationship between the daily number of molecular tests and daily COVID-19 cases in Colombia, we executed a cointegration analysis and evaluated the hypothesis with an augmented Dickey-Fuller (ADF) test. A critical value of -3.42 for rejecting the null hypothesis at 5% was used. Results: There was a positive correlation between molecular tests conducted and COVID-19 incidence and death rate (r = 0.79, p < 0.01 and r = 0.64, p < 0.01, respectively). The cointegration (ADF) test revealed a statistically significant and closely time-dependent stochastic structure between daily COVID-19 cases and number of molecular tests (ADF, -3.50;p < 0.01). Conclusions: In Colombia, the molecular tests conducted are reactive to COVID-19 incidence and, in contrast to other scenarios, the molecular testing increase does not reduce COVID-19 incidence or mortality.