Humoral response after a BNT162b2 heterologous third dose of COVID-19 vaccine following two doses of BBIBP-CorV among healthcare personnel in Peru.

Background: The inactivated virus vaccine, BBIBP-CorV, was principally distributed across low- and middle-income countries as primary vaccination strategy to prevent poor COVID-19 outcomes. Limited information is available regarding its effect on heterologous boosting. We aim to evaluate the immunogenicity and reactogenicity of a third booster dose of BNT162b2 following a double BBIBP-CorV regime. Methods: We conducted a cross-sectional study among healthcare providers from several healthcare facilities of the Seguro Social de Salud del Perú - ESSALUD. We included participants two-dose BBIBP-CorV vaccinated who presented a three-dose vaccination card at least 21 days passed since the vaccinees received their third dose and were willing to provide written informed consent. Antibodies were determined using LIAISON® SARS-CoV-2 TrimericS IgG (DiaSorin Inc., Stillwater, USA). Factors potentially associated with immunogenicity, and adverse events, were considered. We used a multivariable fractional polynomial modeling approach to estimate the association between anti-SARS-CoV-2 IgG antibodies' geometric mean (GM) ratios and related predictors. Results: We included 595 subjects receiving a third dose with a median (IQR) age of 46 [37], [54], from which 40% reported previous SARS-CoV-2 infection. The overall geometric mean (IQR) of anti-SARS-CoV-2 IgG antibodies was 8,410 (5,115 - 13,000) BAU/mL. Prior SARS-CoV-2 history and full/part-time in-person working modality were significantly associated with greater GM. Conversely, time from boosting to IgG measure was associated with lower GM levels. We found 81% of reactogenicity in the study population; younger age and being a nurse were associated with a lower incidence of adverse events. Conclusions: Among healthcare providers, a booster dose of BNT162b2 following a full BBIBP-CorV regime provided high humoral immune protection. Thus, SARS-CoV-2 previous exposure and working in person displayed as determinants that increase anti-SARS-CoV-2 IgG antibodies.

Results and Feasibility of the Virtual Inspection of Clinical Trials During Pandemic of COVID-19 in Peru.

OBJECTIVE: This study aimed to describe the results of inspection of clinical trials (CTs) and the feasibility of conducting inspections virtually in Peruvian Social Security hospitals during the pandemic of COVID-19. METHODS: This study described 25 CTs that were inspected during August 2021-November 2021. The data for the variables were obtained from the CT inspection database of the Social Security Sub-directorate of Regulation and Management of Health Research which includes minutes and inspection reports. We describe the characteristics of the CT included and findings during the inspections using relative and absolute frequencies. Likewise, we evaluated the feasibility of virtual inspection through a self-administered questionnaire. RESULTS: According to the findings of the inspection, 60% of CTs were on biological products, and 60% were focused on infectiology. Additionally, 64% of CTs were implemented in Lima, 52% were conducted in level IV health facilities, and 72% were funded by the pharmaceutical sector. The lack of submission of requested documents (16/25) and inadequate access to the internet (9/15) and source documents (4/15) were the primary observations during the inspection. Regarding the feasibility of virtual supervisions, most interviewees rated their understanding of instruction form as "normal" and its content as "adequate." Similarly, in the virtual self-assessment matrix, a large proportion of interviewees rated comprehension as "normal" (7/15) and its content as "adequate" (13/15). The quality of the virtual supervision process was 8.6 ± 1.1 on a scale of 1-10. CONCLUSION: Discrepancies in records and failure to submit requested documents were the main observations. Most interviewees considered the material to be adequate and gave an overall good rating to the virtual inspection process.

Post-vaccination seropositivity against SARS-CoV-2 in peruvian health workers vaccinated with BBIBP-CorV (Sinopharm).

OBJECTIVE: To estimate the prevalence of post-vaccination seropositivity against SARS-CoV-2 and identify its predictors in Peruvian Social Health Insurance (EsSalud) personnel in 2021. METHODS: We conducted a cross-sectional study in a representative simple stratified sample of EsSalud workers. We evaluated IgG anti-SARS-CoV-2 antibodies response (seropositivity) by passive (previous infection) and active immunization (vaccination), and epidemiological and occupational variables obtained by direct interview and a data collection form. Descriptive and inferential statistics were used with correction of sample weights adjusted for non-response rate, and crude and adjusted odds ratio (OR) and geometric mean ratio (GMR) with their respective 95% confidence intervals (95%CI) were estimated. RESULTS: We enrolled 1077 subjects. Seropositivity was 67.4% (95%CI: 63.4-71.1). Predictors of seropositivity were age (negative relation; p < 0.001), previous infection (aOR = 11.7; 95%CI: 7.81-17.5), working in COVID-19 area (aOR = 1.47; 95%CI: 1.02-2.11) and time since the second dose. In relation to antibody levels measured by geometric means, there was an association between male sex (aGMR = 0.77; 95%CI: 0.74-0.80), age (negative relation; p < 0.001), previous infection (aGMR = 13.1; 95%CI:4.99-34.40), non-face-to-face/licensed work modality (aGMR = 0.78; 95%CI: 0.73-0.84), being a nursing technician (aGMR = 1.30; 95%CI: 1.20-1.41), working in administrative areas (aGMR = 1.17; 95%CI: 1.10-1.25), diagnostic support (aGMR = 1.07; 95%CI: 1.01-1.15), critical care (aGMR = 0.85; 95%CI: 0.79-0.93), and in a COVID-19 area (aGMR = 1.30; 95%CI: 1.24-1.36) and time since receiving the second dose (negative relation; p < 0.001). CONCLUSIONS: Seropositivity and antibody levels decrease as the time since receiving the second dose increases. Older age and no history of previous infection were associated with lower seropositivity and antibody values. These findings may be useful for sentinel antibody surveillance and the design of booster dose strategies.

Autoimmune encephalitis after BBIBP-CorV (Sinopharm) COVID-19 vaccination: a case report.

BACKGROUND: Vaccination is an important public health strategy; however, many neurological adverse effects are associated with COVID-19 vaccination, being encephalitis a rare manifestation. CASE PRESENTATION: We present the case of a 33-year-old woman who received the first dose of the BBIBP-CorV vaccine against COVID-19 on April 4 and the second dose on April 28, 2021. Three days after receiving the second dose, she experienced a subacute episode of headache, fever, insomnia, and transient episodes of environment disconnection. We obtained negative results for infectious, systemic, and oncological causes. Brain magnetic resonance imaging showed lesions in the bilateral caudate nucleus and nonspecific demyelinating lesions at the supratentorial and infratentorial compartments. The results of the neuronal autoantibodies panel were negative. She had an adequate response to immunoglobulin and methylprednisolone; however, she experienced an early clinical relapse and received a new cycle of immunosuppressive treatment followed by a satisfactory clinical evolution. CONCLUSIONS: We report the first case of severe encephalitis associated with BBIBP-CorV (Sinopharm) vaccination in Latin America. The patient had atypical imaging patterns, with early clinical relapse and a favorable response to corticosteroid therapy.

Mass Media Use to Learn About COVID-19 and the Non-intention to Be Vaccinated Against COVID-19 in Latin America and Caribbean Countries.

Background: The Latin American and Caribbean (LAC) region has been one of the regions most affected by the COVID-19 pandemic, with countries presenting some of the highest numbers of cases and deaths from this disease in the world. Despite this, vaccination intention is not homogeneous in the region, and no study has evaluated the influence of the mass media on vaccination intention. The objective of this study was to evaluate the association between the use of mass media to learn about COVID-19 and the non-intention of vaccination against COVID-19 in LAC countries. Methods: An analysis of secondary data from a Massachusetts Institute of Technology (MIT) survey was conducted in collaboration with Facebook on people's beliefs, behaviors, and norms regarding COVID-19. Crude and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95%CI) were calculated to evaluate the association between the use of mass media and non-vaccination intention using generalized linear models of the Poisson family with logarithmic link. Results: A total of 350,322 Facebook users over the age of 18 from LAC countries were included. 50.0% were men, 28.4% were between 18 and 30 years old, 41.4% had a high school education level, 86.1% lived in the city and 34.4% reported good health condition. The prevalence of using the mass media to learn about COVID-19 was mostly through mixed media (65.8%). The non-intention of vaccination was 10.8%. A higher prevalence of not intending to be vaccinated against COVID-19 was found in those who used traditional media (aPR = 1.36; 95%CI: 1.29-1.44; p < 0.001) and digital media (aPR = 1.70; 95%CI: 1.24-2.33; p = 0.003) compared to those using mixed media. Conclusion: We found an association between the type of mass media used to learn about COVID-19 and the non-intention of vaccination. The use of only traditional or digital information sources were associated with a higher probability of non-intention to vaccinate compared to the use of both sources.

Prevalence and factors associated with not receiving the booster dose of the COVID-19 vaccine in adults in Latin America and the Caribbean.

BACKGROUND: Booster doses have been described as effective in reducing hospitalizations and deaths from the new variants. However, its coverage is heterogeneous in Latin America and the Caribbean (LAC), one of the regions most affected by the pandemic. We aimed to assess the factors associated with not receiving a coronavirus disease 2019 (COVID-19) vaccine booster dose in adults from LAC. METHODS: We analyzed a secondary database compiled by the University of Maryland and Facebook assessing the global impact of COVID-19. We included Facebook users over 18 years of age who resided in LAC and responded to the survey between February 13, 2022, and March 14, 2022. We evaluated sociodemographic characteristics, comorbidities, food, and economic insecurity, mental health, and vaccination-related practices. We calculated crude (cPR) and adjusted (aPR) prevalence ratios with their respective 95% confidence intervals (95%CI). RESULTS: The sample included 154,841 adults from 20 LAC countries. 33.7% (n = 46,459) reported not receiving the COVID-19 booster vaccine. Being under 75 years old, having a college, high school, pre-university, primary, or lower education, having no or 1 to 2 comorbidities, living in a town, having food insecurity, depressive symptoms, and having had COVID-19, were associated with a higher prevalence of not receiving the booster dose. In contrast, being female or non-binary and having anxiety symptoms were associated with a lower prevalence of not receiving the booster dose. CONCLUSIONS: Approximately three out of 10 adults surveyed in LAC reported not having received the booster vaccine. Authorities must design campaigns that promote receiving a booster dose considering the factors found.

The Neutrophil-to-Lymphocyte Ratio and the Platelet-to-Lymphocyte Ratio as Predictors of Mortality in Older Adults Hospitalized with COVID-19 in Peru.

Background: The prognostic value of the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in patients with COVID-19 is rarely described in older adults. We aimed to estimate the prognostic value of NLR and PLR, determining the mortality of adults over 60 years of age hospitalized for COVID-19 in three hospitals in Peru from March to May 2020. Methods: We performed a secondary analysis of data from a retrospective cohort carried out in Lambayeque, Peru, from March 18 to May 13, 2020. Older adults hospitalized for COVID-19 were included. The outcome variable was in-hospital mortality by all causes, while the exposure variable was the NLR and PLR (categorized in tertiles and numerically, performing a logarithmic transformation). We included sociodemographic variables, comorbidities, vital functions, laboratory markers, and treatment received during hospital stay. We evaluated the association between NLR and PLR using the hazard ratio (HR) in a Cox regression model. We estimated HR with their respective 95% confidence intervals (95% CI). We estimated cumulative/dynamic time-dependent ROC curves and reported area under the curve ROC (AUC-ROC) for 15-, 30-, and 60-day mortality with their respective simultaneous confidence intervals (confidence bands (CB)). Also, we estimated an optimal cut-off point based on the maximally selected rank statistics. Results: A total of 262 hospitalized older adults were analyzed, 71.8% (n = 188) of whom were male with a median age of 70 years (interquartile range: 65-78). The mean NLR and PLR were 16.8 (95% CI: 14.9-18.7; SD: 15.5) and 50.3 (95% CI: 44.6-55.9; SD: 46.3), respectively. The mortality rate was 68.7% (95% CI: 62.7-74.3). The adjusted Cox regression analysis showed that the high NLR (adjusted HR (aHR) = 2.12; 95% CI: 1.43-3.14) and PLR (aHR = 1.90; 95% CI: 1.30-2.79) tertiles were associated with a higher risk of mortality. The maximum AUC-ROC values at 60 days of follow-up for NLR and PLR were 0.713 (95%CB: 0.627-0.800) and 0.697 (95%CB: 0.583-0.754), respectively. Conclusions: The NLR and PLR are predictors of higher risk of mortality, and these results suggest that both could be reliable and practical markers for the identification of older adults at high risk of mortality by COVID-19. NLR and PLR have prognostic value, with an AUC greater than 0.5; however, by themselves, they are weak prognostic markers. It is important to carry out future studies incorporating these two markers into preexisting models or designing new ones considering them.

Prevalence of parents' non-intention to vaccinate their children and adolescents against COVID-19: A comparative analysis in Colombia and Peru.

We aimed to estimate the prevalence and factors associated with parents' non-intention to vaccinate their children and adolescents against COVID-19 in Colombia and Peru. We performed a secondary analysis using a database generated by the University of Maryland and Facebook (Facebook, Inc). We Included adult (18 and over) Facebook users residing in LAC who responded to the survey between May 20, and November 5, 2021. We Included sociodemographic characteristics, comorbidities, mental health, economic and food insecurity, compliance with mitigation strategies against COVID-19, and practices related to vaccination against this disease. We estimated crude (cPR) and adjusted (aPR) prevalence ratios with their respective 95 %CI. We analyzed a sample of 44,678 adults from Colombia and 24,302 from Peru. The prevalence of parents' non-intention to vaccinate their children and adolescents against COVID-19 was 7.41 % (n = 3,274) for Colombia and 6.64 % (n = 1,464) for Peru. In Colombia, age above 35 years old, compliance with physical distancing, use of masks, having economic insecurity, anxiety symptoms, having a chronic condition or more comorbidities, and being vaccinated were associated with a higher probability of vaccinating children and adolescents against COVID-19. In Peru, female gender, compliance with physical distancing, use of masks, having economic insecurity, anxiety symptoms, having a chronic condition or more comorbidities, having had COVID-19, and being vaccinated were associated with a higher probability of vaccinating children against COVID-19. Living in a town, a village, or a rural area was associated with a higher prevalence of non-intention to vaccinate children and adolescents against COVID-19. About 9 out of 10 parents in Colombia and Peru intend to vaccinate their children and adolescents against COVID-19. This intention is associated with some factors which are similar between the two countries, as well as other factors and variations among the different regions of each country.

Factors Associated with Not Receiving a Booster Dose of COVID-19 Vaccine in Peru.

To determine the factors associated with not receiving the booster dose for COVID-19 in Peru, a cross-sectional study by secondary analysis of a University of Maryland and Facebook survey database assessing the global impact of COVID-19 was conducted. Data of Peruvian users of this social network over 18 years of age who answered the survey between 13 February 2022 and 14 April 2022 were analyzed. We evaluated the association between sociodemographic characteristics, comorbidities, and history of COVID-19 with having received a booster dose for COVID-19. Crude (cPR) and adjusted (aPR) prevalence ratios with their respective 95% confidence intervals (95%CI) were calculated. A sample of 20,814 adults, 21.5% of whom reported not receiving the booster dose, was analyzed. People under 75 years of age had a higher prevalence of not having received the booster dose. Likewise, having a university education (aPR = 1.03; 95%CI: 1.02-1.05), secondary, or pre-university education (aPR = 1.07; 95%CI: 1.05-1.09), or having a primary level or less (aPR = 1.11; 95%CI: 1.05-1.18), were associated with a higher prevalence of not receiving the booster, compared to individuals with a postgraduate education. Being employed (aPR = 1.01; 95%CI: 1.00-1.02), having had COVID-19 (aPR = 1.03; 95%CI: 1.01-1.04) and living in a town (aPR = 1.05; 95%CI: 1.02-1.07) or in a rural area (aPR = 1.06; 95%CI: 1.03-1.10), compared to living in the city, had a similar association. On the contrary, the female gender was associated with a lower prevalence of not receiving the booster (aPR = 0.97; 95%CI: 0.96-0.99). Sociodemographic characteristics and a history of having had COVID-19 were associated with the probability of not having received the booster dose for COVID-19 in the Peruvian population.

Post-Vaccinal Encephalitis with Early Relapse after BNT162b2 (COMIRNATY) COVID-19 Vaccine: A Case Report.

We describe the case of a 72-year-old man who received the first dose of the BNT162b2 (COMIRNATY) vaccine against COVID-19 on 18 May 2021, and the second dose on 9 September 2021. One day after receiving the first dose, he cursed with malaise, headache, fever, confusion, aggressiveness, and gait alterations. We performed serum and cerebrospinal fluid (CSF) tests (finding elevated proteins in CSF) with negative results for infectious, systemic, and neoplastic causes. We performed brain nuclear magnetic resonance imaging (MRI), finding circumscribed encephalitis at the anterior frontal and bilateral temporal lobes. We were unable to perform a panel of antineuronal antibodies. The patient was readmitted due to early clinical relapse four days after receiving his second dose. We found sequelae lesions at the frontal level but with new demyelinating lesions at the left temporal level in brain MRI. We indicated methylprednisolone, and he presented a favorable improvement. We report an encephalitis case of probable autoimmune etiology after vaccination with BNT162b2, which presented early clinical relapse after receiving the second dose and presented a favorable response to methylprednisolone.

Mass Media Use to Learn About COVID-19 and the Non-intention to Be Vaccinated Against COVID-19 in Latin America and Caribbean Countries

Background The Latin American and Caribbean (LAC) region has been one of the regions most affected by the COVID-19 pandemic, with countries presenting some of the highest numbers of cases and deaths from this disease in the world. Despite this, vaccination intention is not homogeneous in the region, and no study has evaluated the influence of the mass media on vaccination intention. The objective of this study was to evaluate the association between the use of mass media to learn about COVID-19 and the non-intention of vaccination against COVID-19 in LAC countries. Methods An analysis of secondary data from a Massachusetts Institute of Technology (MIT) survey was conducted in collaboration with Facebook on people's beliefs, behaviors, and norms regarding COVID-19. Crude and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95%CI) were calculated to evaluate the association between the use of mass media and non-vaccination intention using generalized linear models of the Poisson family with logarithmic link. Results A total of 350,322 Facebook users over the age of 18 from LAC countries were included. 50.0% were men, 28.4% were between 18 and 30 years old, 41.4% had a high school education level, 86.1% lived in the city and 34.4% reported good health condition. The prevalence of using the mass media to learn about COVID-19 was mostly through mixed media (65.8%). The non-intention of vaccination was 10.8%. A higher prevalence of not intending to be vaccinated against COVID-19 was found in those who used traditional media (aPR = 1.36;95%CI: 1.29–1.44;p < 0.001) and digital media (aPR = 1.70;95%CI: 1.24–2.33;p = 0.003) compared to those using mixed media. Conclusion We found an association between the type of mass media used to learn about COVID-19 and the non-intention of vaccination. The use of only traditional or digital information sources were associated with a higher probability of non-intention to vaccinate compared to the use of both sources.

Consumption of Herbal Supplements or Homeopathic Remedies to Prevent COVID-19 and Intention of Vaccination for COVID-19 in Latin America and the Caribbean.

Users of complementary and alternative medicine (CAM) have a lower intention to receive vaccines. Furthermore, Latin America and the Caribbean (LAC) region are among the most affected areas by the COVID-19 pandemics and present a high proportion of CAM users. Therefore, this study evaluates the association between the consumption of herbal supplements or homeopathic remedies to prevent COVID-19 and the intention to vaccinate against COVID-19 in the LAC region. We conducted a secondary data analysis of a Massachusetts Institute of Technology (MIT) survey with Facebook to assess COVID-19 beliefs, behaviours, and norms. Crude and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95% CI) were calculated using generalized linear models of the Poisson family with the log link function. The prevalence of the use of products to prevent COVID-19 was the following: consumption of herbal supplements (7.2%), use of homeopathic remedies (4.8%), and consumption of garlic, ginger, and lemon (11.8%). An association was found between using herbal supplements (19.0% vs. 12.8%; aPR = 1.44; 95% CI: 1.30-1.58), the use of homeopathic remedies (20.3% vs. 12.3%; aPR = 1.58; 95% CI: 1.25-1.98), and the consumption of garlic, ginger, and lemon (18.9% vs. 11.9%; aPR = 1.55; 95% CI: 1.50-1.61) and non-intention to vaccinate against COVID-19. In the LAC population, there is an association between using herbal supplements, using homeopathic remedies and consuming garlic, ginger, and lemon to prevent infection by COVID-19 and non-intention to vaccinate against this disease. Therefore, it is necessary to design targeted strategies for groups that consume these products as preventive measures against COVID-19 to increase vaccination coverage and expand the information regarding transmission and prevention strategies for SARS-CoV-2.

Spontaneous resolution of intussusception after COVID-19 infection found at laparoscopy in a 6-year-old.

The incidence of intussusception is 2.5 per 1000 live births, and infants between 4 and 10 months of age represent the highest frequency peak. Cases of intussusception with acute COVID-19 infection have been reported in infants under one year of age and with one death associated with MIS-C. However, we have not found reports of intussusception in schoolchildren. We report the case of a 6-year-old male with two days of illness that began with a sensation of temperature rise, headache, abdominal pain, liquid stools with mucus and no blood, hyporexia, chills, and food vomiting. He presented a negative result for the detection of SARS-CoV-2 antigen, negative SARS-CoV-2 IgM/IgG serology positive (lateral flow immunochromatography test), in addition to total IgM/IgG antibodies in 11.88 COI by means of a test of electrochemiluminescence. An abdominal ultrasound was performed that concluded invagination, for which an exploratory laparoscopy was performed and the patient evolved favorably. 13 cases of intussusception associated with acute COVID-19 infection have been described in this group. However, no reports of intussusception have been described after COVID-19 infection in school age. We recommend ruling out active or past SARS-CoV-2 infection in children with gastrointestinal symptoms and, if it exists, ruling out invagination by means of abdominal ultrasound.

Gender Differences in Depressive and Anxiety Symptoms During the First Stage of the COVID-19 Pandemic: A Cross-Sectional Study in Latin America and the Caribbean.

Background: Previous studies have suggested that the pandemic impact on mental health could vary according to gender. We aimed to evaluate the gender influence in the prevalence of depressive and anxiety symptoms in Latin American and the Caribbean (LAC) countries in the first stage of the COVID-19 pandemic. Methods: We conducted a secondary analysis employing the Facebook-COVID-19 Symptom Survey developed by the University of Maryland. We categorized gender as men, women, and non-binary. The outcomes were the presence of anxiety or depressive symptoms, measured with two adapted questions extracted from the Kessler Psychological Distress Scale (K10). We used generalized linear models from the Poisson family, considering the survey's complex sampling. We calculated crude and adjusted prevalence ratios (PR) with their 95% confidence intervals (95% CI) and explored interactions with gender using the adjusted Wald test. Results: We included 1,338,320 adults from LAC countries; 48.0, 50.6, and 1.4% were men, women, and non-binary participants, respectively. The overall prevalence of anxiety or depressive symptoms was 44.8 and 46.6%, respectively. We found interactions between gender and the rest of the independent variables. In the non-binary group, the association between age and anxiety symptomatology was lost after an age of 55 years. Furthermore, whereas living in a town was associated with a lower prevalence of anxiety and depression symptomatology in men and women, this did not happen among non-binary individuals. Compliance with physical distancing was associated with a lower prevalence of anxiety and depression symptomatology among women (anxiety: PRa = 0.98; 95% CI = 0.97-0.99; p < 0.001, depression: PRa = 0.96; 95% CI = 0.95-0.97; p < 0.001) and only anxiety in non-binary participants (anxiety: PRa = 0.92; 95% CI = 0.88-0.98; p = 0.005). This was not evidenced among men participants (anxiety: PRa = 0.99; 95% CI = 0.96-1.01; p = 0.199, depression: PRa = 0.98; 95% CI = 0.96-1.00; p = 0.084). In addition, compliance with handwashing was associated with a higher prevalence of anxiety symptomatology among men (PRa = 1.06; 95% CI = 1.05-1.11; p < 0.001) and women participants (PRa = 1.03; 95% CI = 1.01-1.05; p = 0.016). Conclusion: Approximately 4 out of 10 participants had anxiety or depressive symptoms. Women and non-binary gender people had more symptoms of anxiety or depression. The factors associated with these symptoms varied according to gender. It is essential to evaluate gender-related strategies to improve mental health during the COVID-19 pandemic.

Prevalence and factors associated with the intention to be vaccinated against COVID-19 in Peru. / Prevalencia y factores asociados a la intención de vacunarse contra la COVID-19 en el Perú.

OBJECTIVES: To estimate the prevalence and factors associated with the intention to be vaccinated (ITV) against COVID-19 in Peru. MATERIALS AND METHODS: Analytical cross-sectional study using the survey conducted by the University of Maryland, USA, on Facebook. The dependent variable is the ITV. Crude and adjusted prevalence ratios (PR) were calculated, with their 95% confidence intervals (95% CI) using generalized linear models of the Poisson family, in order to evaluate the association of sociodemographic variables, compliance with community mitigation strategies, symptoms of COVID-19, mental health and acceptance of vaccination before the recommendation (AVR) by various actors and health authorities, with the ITV. RESULTS: Data from 17,162 adults were analyzed. The overall prevalence of the ITV was 74.9%. A lower prevalence of the ITV was associated with the female sex (PR=0.95; 95% CI: 0.94-0.97), living in a town (PR=0.95; 95% CI: 0.91-0.99) or village or other rural area (PR=0.90; 95% CI: 0.86-0.93) and the AVR of politicians (PR=0.89; 95% CI: 0.87-0.92). Conversely, having COVID-19 symptoms (PR=1.06; 95% CI: 1.03-1.09), economic insecurity (PR=1.04; 95% CI: 1.01-1.06), fears of becoming seriously ill or that a family member becomes seriously ill from COVID-19 (PR=1.49; 95% CI: 1.36-1.64) and the AVR of family and friends (PR=1.10; 95% CI: 1.08-1.12), healthcare workers (PR=1.29; 95% CI: 1.26-1.32), World Health Organization (PR=1.34; 95% CI: 1.29-1.40) and government officials (PR=1.18; 95% CI: 1.15-1.22) was associated with a higher prevalence of the ITV. CONCLUSIONS: Three-quarters of the respondents had the ITV. There are potentially modifiable factors that could improve vaccine acceptance.

OBJETIVOS: Estimar la prevalencia y los factores asociados a la intención de vacunación (IDV) contra la COVID-19 en el Perú. MATERIALES Y MÉTODOS: Estudio transversal analítico utilizando una encuesta realizada por la Universidad de Maryland, EUA, en Facebook. La variable dependiente fue la IDV. Se calcularon razones de prevalencia (RP) crudas y ajustadas, con sus intervalos de confianza al 95% (IC95%), mediante modelos lineales generalizados de la familia Poisson para evaluar la asociación de variables sociodemográficas, el cumplimiento de estrategias comunitarias de mitigación, los síntomas de la COVID-19, la salud mental y la aceptación de la vacunación ante la recomendación (AVR) por diversos actores y autoridades sanitarias. RESULTADOS: Se analizaron los datos de 17 162 adultos. La prevalencia general de la IDV fue del 74,9%. Se asociaron a una menor prevalencia de la IDV ser de sexo femenino (RP = 0,95; IC95%: 0,94-0,97), vivir en un pueblo (RP = 0,95; IC95%: 0,91-0,99) o en una aldea u otra área rural (RP = 0,90; IC95%: 0,86-0,93) y la AVR de políticos (RP = 0,89; IC95%: 0,87-0,92). Contrariamente, tener síntomas de COVID-19 (RP = 1,06; IC95%: 1,03-1,09), inseguridad económica (RP = 1,04; IC95%: 1,01-1,06), miedo a enfermar o que un familiar enferme de COVID-19 (RP = 1,49; IC95%: 1,36-1,64) y la AVR de familiares y amigos (RP = 1,10; IC95%: 1,08-1,12), trabajadores de la salud (RP = 1,29; IC95%: 1,26-1,32), la Organización Mundial de la Salud (RP = 1,34; IC95%: 1,29-1,40) y funcionarios del gobierno (RP = 1,18; IC95%: 1,15-1,22) se asociaron con mayor prevalencia de IDV. CONCLUSIONES: Tres cuartas partes de los encuestados manifiestan IDV. Existen factores potencialmente modificables que podrían mejorar la aceptación de la vacuna.

COVID-19 symptomatology and compliance with community mitigation strategies in Latin America early during the COVID-19 pandemic.

INTRODUCTION: Community mitigation strategies (CMS) have demonstrated to be effective in the reduction of transmission and incidence of COVID-19, especially in the population with symptoms associated with the disease. The aim of this study was to evaluate the association between the presence of COVID-19 symptoms and adherence to CMS in Latin American adults. METHODS: We carried out a secondary analysis of a database developed by the University of Maryland and Facebook social network during the COVID-19 pandemic. We included Latin American adults that used the Facebook platform and participated in a survey conducted from April 23 to May 23, 2020. The principal outcome variable was reported compliance with the three main CMS (physical distancing, use of face masks, and hand washing). The exposure variable included symptoms suspicious for COVID-19 defined as the presence of three or more symptoms of an acute clinical case of COVID-19. We performed generalized linear models of the Poisson family with a logarithmic link function to evaluate the association between the presence of COVID-19 symptoms and reported compliance with CMS. We calculated crude and adjusted prevalence ratios (PR) with their 95% confidence intervals (95%CI). RESULTS: We analyzed 1,310,690 adults from Latin America; 48.1% were male and 42.9% were under 35 years of age. The prevalence of suspicious symptoms of COVID-19 was 18.5% and reported compliance with the three CMS was 45.3%. The countries with the highest proportion of reported compliance with the three CMS were Peru, Bolivia and Panama, while those with the lowest reported compliance were Costa Rica, Nicaragua and Honduras. In the adjusted model, people with suspicious symptoms for COVID-19 had a 14% lower compliance with the three CMS (aPR = 0.86; 95%CI: 0.85-0.87; p < 0.001). CONCLUSIONS: Less than half of the participants complied with the CMS, and those presenting suspicious symptoms for COVID-19 had lower reported compliance with the three CMS.

Prevalence and Factors Associated with Parents' Non-Intention to Vaccinate Their Children and Adolescents against COVID-19 in Latin America and the Caribbean.

We aimed to estimate the prevalence and factors associated with parents' non-intention to vaccinate their children and adolescents against COVID-19 in Latin America and the Caribbean (LAC). We performed a secondary analysis using a database generated by the University of Maryland and Facebook (Facebook, Inc., Menlo Park, CA, USA). We included adult (18 and over) Facebook users residing in LAC who responded to the survey between 20 May 2021 and 14 July 2021. We included sociodemographic characteristics, comorbidities, mental health, economic and food insecurity, compliance with mitigation strategies against COVID-19, and practices related to vaccination against this disease. We estimated the crude (cPR) and adjusted (aPR) prevalence ratios with their respective 95%CI. We analyzed a sample of 227,740 adults from 20 LAC countries. The prevalence of parents' non-intention to vaccinate their children and adolescents against COVID-19 was 7.8% (n = 15,196). An age above 35 years old, educational level above college, compliance with physical distancing, use of masks, having economic insecurity, having had COVID-19, anxiety symptoms, depressive symptoms, having a chronic condition or two or more comorbidities, and being vaccinated were associated with a lower prevalence of non-intention to vaccinate children and adolescents against COVID-19. Living in a town, a village, or a rural area was associated with a higher prevalence of non-intention to vaccinate children and adolescents against COVID-19. Approximately nine out of ten parents in LAC intended to vaccinate their children and adolescents against COVID-19. Our results allow for understanding parents' intentions to vaccinate children and adolescents and help promote and develop education strategies for national vaccination plans against COVID-19.

Prevalence and factors associated with food insecurity in Latin America and the Caribbean during the first wave of the COVID-19 pandemic.

OBJECTIVE: We assessed the prevalence of food insecurity (FI) and its associated factors in Latin American and the Caribbean (LAC) early during the COVID-19 pandemic. METHODS: We performed secondary data analysis of a survey conducted by Facebook and the University of Maryland. We included adults surveyed from April to May 2020. FI was measured by concerns about having enough to eat during the following week. Sociodemographic, mental health, and COVID-19-related variables were collected. We performed generalized Poisson regressions models considering the complex sampling design. We estimated crude and adjusted prevalence ratios with their 95% confidence intervals. RESULTS: We included 1,324,272 adults; 50.5% were female, 42.9% were under 35 years old, 78.9% lived in a city, and 18.6% had COVID-19 symptoms. The prevalence of food insecurity in LAC was 75.7% (n = 1,016,841), with Venezuela, Nicaragua, and Haiti with 90.8%, 86.7%, and 85.5%, respectively, showing the highest prevalence. Gender, area of residence, presence of COVID-19 symptoms, and fear of getting seriously ill or that a family member gets seriously ill from COVID-19 were associated with a higher prevalence of food insecurity. In contrast, increasing age was associated with a lower prevalence. CONCLUSION: The prevalence of food insecurity during the first stage of the COVID-19 pandemic in LAC was high and was associated with sociodemographic and COVID-19-related variables.

Cross-sectional analysis of COVID-19 vaccine intention, perceptions and hesitancy across Latin America and the Caribbean.

BACKGROUND: Determinants of vaccine acceptance are multifactorial, complex, and in most cases, context-dependent. We determined the prevalence of COVID-19 vaccination intention (VI) and fear of its adverse effects (FAE) as well as their associated factors in Latin America and the Caribbean (LAC). METHODS: We conducted a secondary cross-sectional analysis of a database collected by the University of Maryland and Facebook. We included participants aged 18 and over from LAC surveyed, January 15 to February 1, 2021. We evaluated VI, FAE, sociodemographic characteristics, COVID-19 symptomatology, compliance with community mitigation strategies, food and economic insecurity, mental health evaluation and the influence in VI when recommended by different stakeholders. We calculated crude and adjusted prevalence ratios with their 95%CIs. RESULTS: We analyzed 472,521 responses by Latin American adults, finding a VI and FAE prevalence of 80.0% and 81.2%, respectively. We found that female and non-binary genders were associated with a lower probability of VI and a higher probability of FAE. Besides, living in a town, village or rural area and economic insecurity was associated with a higher FAE probability. The fears of becoming seriously ill, a family member becoming seriously ill from COVID-19 and having depressive symptoms were associated with a higher probability of VI and FAE. CONCLUSION: Eight out of 10 adults in LAC have VI and FAE. The factors identified are useful for the development of communication strategies to reduce FAE frequency. It is necessary to guarantee mass vaccination and support the return of economic activities.