Strategies for expanding childhood vaccination in the Americas following the COVID-19 pandemic.

Objective: To provide an overview of the status of the childhood vaccination schedule in the Americas, outline program structures, and identify updated implementation strategies to improve vaccination coverage following the COVID-19 pandemic. Methods: A group of experts in pediatrics, epidemiology, vaccines, and global and public health discussed the current status of the childhood vaccination schedule in the Americas, describing the program structure and identifying new implementation strategies that have the potential to improve vaccination coverage in the post-pandemic context, after the challenges COVID-19 presented for more than two years. Results: The Americas currently face a high risk of resurgence of diseases that were previously controlled or eliminated. Therefore, it is important to find new strategies to educate citizens on the risks associated with lower vaccination rates, especially in children. Conclusions: New strategies along with strong mobilization of the population and advocacy by citizens are necessary to prevent antivaccination groups from gaining a stronger presence in the region and jeopardizing the credibility of the Expanded Program on Immunization.

Strategies for expanding childhood vaccination in the Americas following the COVID-19 pandemic / Estrategias para ampliar la vacunación infantil en la Región de las Américas después de la pandemia de COVID-19 / Estratégias para ampliar a vacinação infantil nas Américas depois da pandemia de COVID-19

[ABSTRACT]. Objective. To provide an overview of the status of the childhood vaccination schedule in the Americas, outline program structures, and identify updated implementation strategies to improve vaccination coverage following the COVID-19 pandemic. Methods. A group of experts in pediatrics, epidemiology, vaccines, and global and public health discussed the current status of the childhood vaccination schedule in the Americas, describing the program structure and identifying new implementation strategies that have the potential to improve vaccination coverage in the post-pandemic context, after the challenges COVID-19 presented for more than two years. Results. The Americas currently face a high risk of resurgence of diseases that were previously controlled or eliminated. Therefore, it is important to find new strategies to educate citizens on the risks associated with lower vaccination rates, especially in children. Conclusions. New strategies along with strong mobilization of the population and advocacy by citizens are necessary to prevent antivaccination groups from gaining a stronger presence in the region and jeopardizing the credibility of the Expanded Program on Immunization.

[RESUMEN]. Objetivo. Presentar un panorama general de la situación del calendario de vacunación infantil en la Región de las Américas, describir la estructura de los programas y encontrar estrategias actualizadas para su ejecución a fin de mejorar la cobertura de vacunación después de la pandemia de COVID-19. Métodos. Un grupo de expertos en pediatría, epidemiología, vacunas y salud pública y mundial analizó la situación actual del calendario de vacunación infantil en la Región de las Américas, mediante la descripción de la estructura de los programas y la búsqueda de nuevas estrategias de ejecución capaces de mejorar la cobertura de vacunación en el contexto posterior a la pandemia de COVID-19, una vez superados los desafíos planteados por esta durante más de dos años. Resultados. En este momento, en la Región de las Américas hay un riesgo alto de reaparición de enferme- dades previamente controladas o eliminadas. En consecuencia, es importante contar con nuevas estrategias para la educación de salud de la ciudadanía sobre los riesgos asociados a las tasas bajas de vacunación, especialmente en la población infantil. Conclusiones. Es necesario contar con nuevas estrategias, acompañadas de una fuerte movilización de la población y una promoción por parte de la ciudadanía, para evitar que los grupos que generan mensajes antivacunas aumenten su presencia en la Región y pongan en peligro la credibilidad del Programa Ampliado de Inmunización.

[RESUMO]. Objetivo. Apresentar um panorama da situação do calendário de vacinação infantil nas Américas, definir a estrutura do programa e identificar estratégias de implementação atualizadas para melhorar a cobertura vacinal depois da pandemia de COVID-19. Métodos. Um grupo de especialistas em pediatria, epidemiologia, vacinas e saúde pública e global discutiu a situação atual do calendário de vacinação infantil nas Américas, descrevendo a estrutura dos programas e identificando novas estratégias de implementação que poderiam melhorar a cobertura vacinal no contexto pós-pandemia, na sequência dos desafios impostos pela COVID-19 durante mais de dois anos. Resultados. Atualmente, as Américas enfrentam um grande risco de ressurgimento de doenças já controla- das ou eliminadas. Desse modo, é importante identificar novas estratégias para conscientizar os cidadãos sobre os riscos decorrentes da queda das taxas de vacinação, sobretudo em crianças. Conclusões. É necessário adotar novas estratégias, aliadas a uma forte mobilização da população e pro- moção da causa pelos cidadãos, a fim de impedir que os grupos antivacinas fortaleçam sua presença na região e coloquem em risco a credibilidade do Programa Ampliado de Imunização.

Strategies for expanding childhood vaccination in the Americas following the COVID-19 pandemic / Estrategias para ampliar la vacunación infantil en la Región de las Américas después de la pandemia de COVID-19 / Estratégias para ampliar a vacinação infantil nas Américas depois da pandemia de COVID-19

ABSTRACT Objective. To provide an overview of the status of the childhood vaccination schedule in the Americas, outline program structures, and identify updated implementation strategies to improve vaccination coverage following the COVID-19 pandemic. Methods. A group of experts in pediatrics, epidemiology, vaccines, and global and public health discussed the current status of the childhood vaccination schedule in the Americas, describing the program structure and identifying new implementation strategies that have the potential to improve vaccination coverage in the post-pandemic context, after the challenges COVID-19 presented for more than two years. Results. The Americas currently face a high risk of resurgence of diseases that were previously controlled or eliminated. Therefore, it is important to find new strategies to educate citizens on the risks associated with lower vaccination rates, especially in children. Conclusions. New strategies along with strong mobilization of the population and advocacy by citizens are necessary to prevent antivaccination groups from gaining a stronger presence in the region and jeopardizing the credibility of the Expanded Program on Immunization.

RESUMEN Objetivo. Presentar un panorama general de la situación del calendario de vacunación infantil en la Región de las Américas, describir la estructura de los programas y encontrar estrategias actualizadas para su ejecución a fin de mejorar la cobertura de vacunación después de la pandemia de COVID-19. Métodos. Un grupo de expertos en pediatría, epidemiología, vacunas y salud pública y mundial analizó la situación actual del calendario de vacunación infantil en la Región de las Américas, mediante la descripción de la estructura de los programas y la búsqueda de nuevas estrategias de ejecución capaces de mejorar la cobertura de vacunación en el contexto posterior a la pandemia de COVID-19, una vez superados los desafíos planteados por esta durante más de dos años. Resultados. En este momento, en la Región de las Américas hay un riesgo alto de reaparición de enfermedades previamente controladas o eliminadas. En consecuencia, es importante contar con nuevas estrategias para la educación de salud de la ciudadanía sobre los riesgos asociados a las tasas bajas de vacunación, especialmente en la población infantil. Conclusiones. Es necesario contar con nuevas estrategias, acompañadas de una fuerte movilización de la población y una promoción por parte de la ciudadanía, para evitar que los grupos que generan mensajes antivacunas aumenten su presencia en la Región y pongan en peligro la credibilidad del Programa Ampliado de Inmunización.

RESUMO Objetivo. Apresentar um panorama da situação do calendário de vacinação infantil nas Américas, definir a estrutura do programa e identificar estratégias de implementação atualizadas para melhorar a cobertura vacinal depois da pandemia de COVID-19. Métodos. Um grupo de especialistas em pediatria, epidemiologia, vacinas e saúde pública e global discutiu a situação atual do calendário de vacinação infantil nas Américas, descrevendo a estrutura dos programas e identificando novas estratégias de implementação que poderiam melhorar a cobertura vacinal no contexto pós-pandemia, na sequência dos desafios impostos pela COVID-19 durante mais de dois anos. Resultados. Atualmente, as Américas enfrentam um grande risco de ressurgimento de doenças já controladas ou eliminadas. Desse modo, é importante identificar novas estratégias para conscientizar os cidadãos sobre os riscos decorrentes da queda das taxas de vacinação, sobretudo em crianças. Conclusões. É necessário adotar novas estratégias, aliadas a uma forte mobilização da população e promoção da causa pelos cidadãos, a fim de impedir que os grupos antivacinas fortaleçam sua presença na região e coloquem em risco a credibilidade do Programa Ampliado de Imunização.

Association between Marital Status and In-Hospital Death in Acute Myocardial Infarction Patients in Puerto Rico.

OBJECTIVE: The purpose of this study was to determine if there is an association between marital status (single, married, divorced/separated, and widowed) and inhospital mortality in patients with acute myocardial infarction (AMI) from Puerto Rico in 2007, 2009, and 2011. METHODS: This study was a secondary data analysis of information retrieved from the Puerto Rican Cardiovascular Surveillance System obtained from the University of Puerto Rico for the residents of Puerto Rico during the study years. The sample included individuals aged 18 or older who presented with an incidental AMI. Univariate and multivariate logistic regression models were used to assess the association between marital status and in hospital mortality after an AMI. Covariates included age, sex, social history, and comorbidities. RESULTS: Among the study participants, 414 were single, 1,811 were married, 153 were separated/divorced, and 472 were widowed. Widowed status was more common in the elderly population, age groups 75-84 and ≥85, than any other marital status representing 37.9% and 30.7% respectively (p-value < 0.001). The adjusted OR were 0.6 (95% confidence interval (CI) 0.3-1.4), 0.6 (95% CI 0.2-2.0), and 0.9 (95% CI 0.5-1.7) for single, divorced/separated, and widowed patients respectively when compared with married patients. CONCLUSION: No noticeable association was found between marital status and inhospital mortality in patients with incidental AMI in Puerto Rico during the years of 2007, 2009, and 2011. Further research may be required to investigate mortality rates during the time period following hospital discharge.

Prácticas y consejería de actividad física en médicos generalistas de Argentina / Argentinean general practitioners' practice and counseling regarding physical activity

Objetivo Acercamiento a la práctica de la actividad física del médico generalista, así como a la consejería en actividad física que realizan a sus pacientes. Métodos Estudio exploratorio transversal con 115 médicos generalistas (82 mujeres y 33 hombres), por medio de una encuesta en línea, auto-diligenciada, en el Congreso Anual de Médicos Generalistas del 2011. Resultados Un 76 % de las mujeres siempre ofrece la consejería en actividad física, por su parte en hombres manifestaron casi siempre con un 33 % siendo la mayor frecuencia. En la presencia de enfermedades no-transmisibles las mujeres aconsejan siempre en un 73 % y los hombres en un 27 %. En cuanto a la evaluación se muestra mayor frecuencia a realizar preguntas generales sobre la cantidad de actividad física mujeres 97 % (n=62) y hombres 93 % (n=25). La realización regular de actividad física los datos fueron mujeres un 35 % (n=23) y en hombres un 46 % (n=12). Conclusiones No se encuentran relaciones entre el nivel de actividad física con la presencia de la consejería, así como con los conocimientos. Se encontró que los médicos generalistas identifican la actividad física como importante para sus pacientes, aunque tienen estilo de vida poco activo. En cuanto a la consejería se sugiere la necesidad de capacitar los médicos generalistas en la prescripción de la actividad física.(AU)

Objective Investigating general practitioners' (GP) physical activity and to what extent their own physical activity affects counselling their patients in clinical practice. Methodology This was a cross-sectional, exploratory study; sample size was 115 (82 women and 33 men). The survey involved using a self-administered questionnaire at the GPs' annual congress in 2011, using a specially-designed, on-line questionnaire. Results This questionnaire revealed that about 76% of the female GPs did give advice concerning physical activity to their patients while the respective prevalence in men was 33 %. Regarding advice concerning physical activity to patients having non-communicable diseases, 73 % of women GPs always seemed to recommend physical activity for them while the corresponding prevalence in men was 27 %. Around 97 % (n=62) of the female GPs and 93 % (n=25) of male GPs asked their patients about their physical activity pattern; however, this study revealed that only 35 % (n=23) of male and 46 % (n=12) of female GPS were actually familiar with the latest recommendations concerning physical activity. Conclusion No relationship was found between GPs' physical activity level and their counselling in practice concerning physical activity or their current knowledge of the topic. The study showed that GPs stated that physical activity was important for their patients, although few of them engaged in types of physical activity during their leisure-time. There would thus seem to be an urgent need for training GPs in prescribing physical activity at primary healthcare level to increase their patients' involvement in some form of physical activity.(AU)

[Argentinean general practitioners' practice and counseling regarding physical activity]. / Prácticas y consejería de actividad física en médicos generalistas de Argentina.

OBJECTIVE: Investigating general practitioners' (GP) physical activity and to what extent their own physical activity affects counselling their patients in clinical practice. METHODOLOGY: This was a cross-sectional, exploratory study; sample size was 115 (82 women and 33 men). The survey involved using a self-administered questionnaire at the GPs' annual congress in 2011, using a specially-designed, on-line questionnaire. RESULTS: This questionnaire revealed that about 76% of the female GPs did give advice concerning physical activity to their patients while the respective prevalence in men was 33 %. Regarding advice concerning physical activity to patients having non-communicable diseases, 73 % of women GPs always seemed to recommend physical activity for them while the corresponding prevalence in men was 27 %. Around 97 % (n=62) of the female GPs and 93 % (n=25) of male GPs asked their patients about their physical activity pattern; however, this study revealed that only 35 % (n=23) of male and 46 % (n=12) of female GPS were actually familiar with the latest recommendations concerning physical activity. CONCLUSION: No relationship was found between GPs' physical activity level and their counselling in practice concerning physical activity or their current knowledge of the topic. The study showed that GPs stated that physical activity was important for their patients, although few of them engaged in types of physical activity during their leisure-time. There would thus seem to be an urgent need for training GPs in prescribing physical activity at primary healthcare level to increase their patients' involvement in some form of physical activity.