FREQUENCY OF VACCINE-RELATED ADVERSE EVENTS IN PATIENTS WITH RHEUMATIC DISEASE

BackgroundPatients with rheumatic diseases are at greater risk of developing serious infections due to dysregulation of the immune system and the use of immunosuppressants1. Therefore, preventing infection is crucial, with vaccination being the most important primary prevention intervention, leading to a lower rate of hospital admissions due to infections. However, vaccine hesitancy among persons with rheumatic diseases is widespread due to concerns regarding the safety of vaccines2.ObjectivesDescribe the frequency of adverse events associated with vaccination in patients with rheumatic diseases.MethodsObservational, descriptive, cross-sectional and retrospective study was carried out in patients with rheumatic diseases from the Rheumatology Department of the Hospital Regional 1° de Octubre ISSSTE, from February to May 2022;it included patients over 18 years of age with an established diagnosis of rheumatic disease who had received a vaccine;the researcher applied the vaccine-associated adverse events survey to those patients who agreed to participate by signing the informed consent. The sample size was of 95 patients. Descriptive statistics and summary measures were employed for analysis. We used the chi-square test or Fisher's exact test (when <5) for the comparative analysis of the frequencies of nominal qualitative variables. P<0.05 was considered significant.ResultsThe survey was applied to 115 patients. 85.2% were women;mean age 57.9 years;61.7% had rheumatoid arthritis (RA), followed by systemic lupus erythematosus (SLE) in 13.9%. 55.6% of the patients were treated with steroids, 52.2% received bDMARDs and 48.7% csDMARDs. Patients received various vaccines, of which the most frequent was the one for COVID-19, with 99.1% of included patients having received at least one dose, followed by influenza in 30.4%. 78% of the patients who received at least one dose of a vaccine against COVID-19 presented ≥1 adverse events. The disease in which the highest frequency of adverse events occurred was RA, without this difference being statistically significant (Table 1). The adverse events according to the type of COVID-19 vaccine were the following: Sputnik-V 80%, Pfizer 76.6% and AstraZeneca 76.1%, without statistically significant difference between vaccine types. The most frequently occurring adverse events were injection site pain (80.1%), headache (30.7%), and fatigue (30.7%);In addition, the main vaccine-associated musculoskeletal symptoms were joint pain, myalgia, and morning joint stiffness (Figure 1), which on most cases improved after a NSAID use. Joint pain was more frequent after the second dose of certain vaccine types.Table 1.Frequency of AE after COVID-19 vaccination in patients according to disease.AE (%)pRA560.790SLE140.326Spondyloarthritis40.068Osteoarthritis60.614ConclusionVaccination-associated AE occurred more frequently than reported in international studies;however, they were not more serious. Providing this information to patients is important to improve vaccine acceptance. In addition, the administration of NSAID after the application of the vaccine could be proposed to reduce the presence of side effects.References[1]Rotondo, Cinzia, et. al. Preliminary Data on Post Market Safety Profiles of COVID 19 Vaccines in Rheumatic Diseases: Assessments on Various Vaccines in Use, Different Rheumatic Disease Subtypes, and Immunosuppressive Therapies: A Two-Centers Study. Vaccines, 2021;9(7):730-440.[2]Furer, Victoria, et. al. 2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases. Ann Rheum Dis 2020;79:39–52.AcknowledgementsTo the residents and staff at HR 1 Octubre for their help in compilating data.Disclosure of InterestsDaniel Xavier Xibille Friedmann Speakers bureau: GSK, Lilly, UCB, Paid instructor for: GSK, Lilly, UCB, Consultant of: GSK, Lilly, UCB, Vanessa Balderas Reyes: None declared, María Olvera: None declared, María Alcocer León: None declared, ALFREDO ALEXANDRI REYES SALINAS Paid instructor for: Abbvie, Janssen, ovartis, Minerva Rodríguez Falcón: None declared, Sandra Miriam Carrillo Vazquez Speakers bureau: Abbvie, Janssen, UCB, Paid instructor for: Abbvie, Janssen, UCB, Consultant of: Abbvie, Janssen, UCB.

Involving parents in the remote diagnosis of Autism during the COVID-19 pandemic: a case study

Objective To evaluate the feasibility of remotely providing a diagnosis of autism during the Coronavirus Disease pandemic of 2019. Methods A child psychiatrist guided the parents' Autism Diagnostic Observation Schedule (ADOS-2) administration to assess their child's developmental delay through a video conference. Trained clinicians (n = 10) rated the recorded procedure. Interrater reliability for each item was evaluated using the kappa statistic and percent agreement. Results The mean percent agreement across all items was 96%, range = 85.96-100%, and mean weighted kappa = .81, range = .44-1. Conclusions This study highlights the feasibility of providing early identification and continuous psychiatric care during a pandemic lockdown.

Biosecurity and airway management in the pediatric patient with SARS-CoV-2 infection

The first confirmed case of COVID-19 (SARS-CoV-2) in our country occurred on February 27, 2020, according to the Mexican Ministry of Health. The staff engaged in pediatric care has developed training strategies to serve their patients and to be part of the pandemic response staff. Learning biosecurity mechanisms is significant to prevent further spread of the virus and strengthen health care teams with the purpose of preventing contagion. That is why we consider that the pediatricians in Mexico should be trained to determine the type of personal protective equipment and protection strategies before, during and after ventilating patients, also when performing cardiopulmonary resuscitation maneuvers, procedures that are aerosol generators. Considering that a long epidemic is expected in our country, we present this article that serves as part of the knowledge required to document good practices for treating COVID-19.

Termination of the individual contract of work due to unforeseen circumstances or force majeure that makes it impossible to work in times of pandemic covid-19

At this time humanity is going through a worldwide infectious pandemic that can be transmitted by an infected person to others through coughing, sneezing, or exhaling. This virus is caused by severe acute respiratory syndrome (SARC-Cov2), called Corona Virus Disease 2019. The symptoms are fever, dry cough, tiredness, shortness of breath or feeling of shortness of breath, chest pain or pressure, incapacity talking or moving among others. Negatively damaging life, it also affects the economic, labor, and social part. The Ministry of Labor (MRL) registers 66,400 disassociated from what is going through the pandemic, in these moments of crisis for humanity. The face-to-face workday is suspended nationally and internationally in order to protect health, prevent overcrowding and the spread of the outbreak. © 2020, University of Cienfuegos, Carlos Rafael Rodriguez. All rights reserved.