ABSTRACT
Background: Vaccination is an extremely safe public health intervention, but rare IgE-mediated adverse events must be identified to avoid the risk of anaphylaxis in the event of reexposure. However, using only clinical history to diagnose previous allergic reactions may lead to overdiagnosis of vaccine allergy and even to the use of medical exemptions as a subterfuge to mandatory vaccination. Methods: We conducted a retrospective study to describe the outcomes of patients with a history of vaccine or vaccine component allergy who were evaluated at our unit from 2011 to 2017. Data on allergy history, skin test results, vaccines prescribed, and adverse events were retrieved from the medical records at the Centro de Referência para Imunobiológicos Especiais (Reference Center of Special Immunobiologicals)-Fiocruz, in Rio de Janeiro, Brazil. Results: Of 34 adults with history of allergy to vaccine or vaccine components, 32 (94.1%) were successfully vaccinated without serious adverse events after our evaluation. In 12 patients (35%), the time elapsed between the allergy symptoms and evaluation in the Centro de Referência para Imunobiológicos Especiais-Fiocruz was more than 10 years. Conclusion: Specialized care and use of skin tests allowed safe vaccination of the majority of patients. An objective, systematic evaluation of a history of vaccine allergy can prevent its improper use to avoid mandatory vaccination and reduce missed opportunities for immunization.
ABSTRACT
Con el objetivo de conocer la situación nutricional de los alumnos de la unidad educativa "Santiago Mariño", fué realizada en el año 2005 una evaluación antropométrica de 236 escolares, a los cuales se les pesó, talló y tomó su edad en años cumplidos. El déficit de peso para la edad fue de 10,1%, de los cuales 5,9%, presentan peso deficiente o desnutrición global y 4,2% están a riesgo de desnutrición. El déficit de peso para la talla, fue de 18,3%, lo cual significa que los mismos presentan desnutrición aguda. El indicador talla para la edad registró un déficit de 5,1%, significando 1,7% de desnutrición crónica y 3,4% a riesgo de desnutrición. Las niñas tienen una probabilidad de 2,9 veces más de presentar exceso de talla para la edad que los varones (p>0.05). Según el Indice de Masa Corporal 13,6% de los alumnos sufren déficit nutricional y 3,4% obesidad.
As to assess the nutritional status of the pupils in "Santiago Mariño" school, an anthropometric evaluation was performed during 2005 on 236 students, determining height, weight and checking their exact age. 10.1% of the sample showed weight deficit according to age, among them, 5.9% had defficient weight or global undernowrishment and 4.2% were on risk. Weight deficit according to height was 18.3% which implies acute under nourishment. Indicator size / age showed a 5.1% deficit which means 1.7% of cronic undernourishment and 3.4% of risk. Female pupils have a 2.9% higher probability of reporting excess of height according to age in comparison with boys (1>0.05). According to Mass Corporal index nutritional deficit was assessed in 13.6% of the pupils and obesity in 3.4%.
