[Vaccination--General concepts. Systematic vaccination schedules for the child and adult in Spain. Impact of vaccination programs]. / Conceptos generales. Calendarios de vacunación sistemática del niño y del adulto en España. Impacto de los programas de vacunación.

One area of major importance in promoting health is the prevention of infectious diseases through vaccination. Vaccine is any preparation intended to generate immunity against a disease by stimulating the production of antibodies. There are two basic types: live attenuated and inactivated, with different characteristics that determine their use. The main properties of a vaccine are safety and protective efficacy. The vaccines can be administered based on individualized directions depending on various factors (personal, environmental…), or systematically as part of the immunization schedules. In Spain, the first childhood immunization schedule was implemented in 1975. The Autonomous Communities are currently responsible for establishing vaccine recommendations. The incidence of vaccine-preventable diseases and vaccination coverage are essential criteria for the evaluation of vaccination programs. In Spain the incidence of vaccine-preventable diseases is low. Vaccination coverage is high in childhood, but in adolescents, adults and groups at risk it is not always appropriate.

[Influenza vaccination in healthcare workers. Strategies to achieve compliance in a general hospital]. / Vacunación frente a la gripe en trabajadores de un hospital general. Estrategias para incrementar su cobertura.

BACKGROUND AND OBJECTIVE: Since healthcare workers can transmit the influenza virus to high risk patients, they should be vaccinated prior to the influenza season. In this study we describe the influenza vaccination coverage in healthcare workers in a general hospital and study its evolution over the last years. SUBJECTS AND METHOD: Descriptive epidemiological study to determine the anti-influenza vaccination coverage in healthcare workers in a hospital during 2002-2003 and 2003-2004 seasons. The variables studied in each season were sex, age and professional category. RESULTS: During each of the campaigns, 1,215 and 2,287 workers were vaccinated. The vaccination coverage increased significantly (p < 0.01) (20.2% in 2002-2003 and 38% in 2003-2004). Men were vaccinated more than women although the coverage increase was significant in both sexes (p < 0.01). During the 2002-2003 season, workers older than 50 years (24.4%) had the greatest coverage, while during 2003-2004 those older than 31 years (48.7%) were the ones with more coverage. By professional categories, the medical staff (33.8% in 2002-2003 and 59.9% in 2003-2004) had a greater vaccination acceptance. The coverage increase during these two years was significant in all healthcare workers (p < 0.01). CONCLUSIONS: A significant increase in the vaccination coverage has been observed during the two seasons studied. This fact can be related to the changes introduced in the informative strategies and the performance of more active vaccination campaigns which connect vaccination to employment areas.

[Accidents with exposure to biological material contaminated with HIV in workers at a third level hospital in Madrid]. / Accidentes con exposición a material biológico contaminado por VIH en trabajadores de un hospital de tercer nivel de Madrid (1986-2001).

BACKGROUND: Human Immunodeficiency Virus (HIV) is an occupational hazard among healthcare professionals accidentally contaminated with HIV-positive blood. This study is aimed at describing the characteristics of the accidents involving blood of HIV-positive patients recorded over a sixteen-year period at a general hospital. METHODS: Epidemiological study of the accidents reported in 2001 involving biological material from an HIV-positive source by the healthcare personnel of a general hospital throughout the 1986-2001 period entailing the presence of biological material from HIV-positive serology individuals. Individual, time and place-related variables, in addition to the initial serologies and those throughout the protocolized follow-up were studied for those individuals involved in these accidents. RESULTS: A total 550 accidents entailing an HIV-positive source were reported. The average number of accidents was 34.4/year. The accidental exposure rate for the period under study was 7.5/1000 workers/year. The professional group showing the highest accident rate was the nursing staff (54.4%). Percutaneous injuries were the most frequent (80.2%). The mean exposure rate was 2.6/100 beds/year. The anatomical areas involved to the greatest degree were the fingers (75.6%). A total 53.4% of those injured completed the serological follow-up without having shown any seroconversion. CONCLUSIONS: Throughout the sixteen-year period under study, the annual incidence of accidents involving an HIV-positive source increased from the 27 accidents reported in 1986 to the 60 accidents reported in 1990, there having been a downward trend as of that point in time, to the point of 12 accidents having been recorded in 2001.

[Vaccination of adolescents and adults]. / La vacunación en el adolescente y en el adulto.

Today nobody doubts about the need of maintaining adults and teenagers dully vaccinated, among other reasons because they had not been vaccinated when they were young, due to the need of a booster dose, or due to the availability of new vaccines. Several international organisms recommend the vaccination to teenagers and adults bearing in mind several factors, such as the type of vaccine, age, sex, occupation and medical situation of the person to be vaccinated. The recommended vaccines will produce a positive effect, reducing the morbi-mortality rates among the vaccinated.

[Vaccine storage cold chain at primary care centers in one area of Madrid: keeping the chain intact and degree of knowledge]. / Cadena del frío para la conservación de las vacunas en los centros de atención primaria de un area de Madrid: mantenimiento y nivel de conocimientos.

BACKGROUND: Vaccines are heat-labile medications, and to guarantee their immunogenicity and safeguarding effectiveness as part of immunization programs, it is absolutely essential that the "Cold Chain" go unbroken. Fundamental thereto is the personnel responsible for the vaccines, who must know the stability-related characteristics of each preparation so as to prevent handling errors. The purpose of this study was that of ascertaining how the cold chain is kept intact in primary care systems in one healthcare area of the Autonomous Community of Madrid, as well as determining the degree of information possessed by those responsible for vaccines as far as their heat-stability is concerned. METHODS: A cross-sectional study has been made at 46 primary care vaccination points. The data was gathered by means of a personal interview by one single researcher. RESULTS: The participation rate was 93.5% (43/46). In all cases, there was a maximum and minimum thermometer and monthly temperature record. An unsuitable temperature was found in three cases (6.97%). The percentage of professionals who were aware of the effect freezing has on vaccines varied greatly: 53.5%, 51.2%, 44.2% and 53.5% for diphtheria-tetanus-pertussis (DTP), hepatitis B (HBV), oral polio (OPV) and measles-mumps-rubella (MMR) respectively. And only 32% were familiar with the shake test. CONCLUSION: The professionals were found to be properly trained regarding the effect which high temperatures have on vaccines, but it is necessary for their training with regard to the instability of adsorbed preparations when frozen must be further strengthened.