ABSTRACT
OBJECTIVE: To identify all post-BNT162b2 vaccination (BioNTech and Pfizer) events during the ensuing 12 months in patients with systemic lupus erythematosus (SLE) from the Immuno-Rheumatology Department at Cayetano Heredia Hospital's cohort, Lima, Perú. METHODS: A 12-month follow-up study was conducted from the first dose of immunization with the BNT162b2 vaccine, which was given between May and June 2021, to SLE patients from this cohort. RESULTS: The initial population was constituted by 100 patients (100 patients received the 1st dose, 90 the 2nd dose, and 85 the 3rd dose of this vaccine); 33 patients presented a SLE reactivation (flare), 9% (9/100) post 1st dose, 26.6% (24/90) post 2nd dose, and 16.4% (14/85) post 3rd dose. The most common types of flare were articular (26) and renal (14) with 5/33 (15.1%) requiring hospitalization for flare management. A negative association with flare occurrence was found between the use of hydroxychloroquine RR 0.43 (0.21-0.85) and the opposite was the case for azathioprine RR 2.70 (1.39-5.25). During follow-up, 26 patients developed SARS-CoV-2 infection of whom three required hospitalization, one of whom died. CONCLUSIONS: 33 of 100 SLE patients immunized with BNT162b2 vaccine against SARS-CoV-2, presented SLE flares (47 episodes in total); 5 of these patients required in-hospital management and all fully recovered; 26 patients had SARS-CoV-2 infection; three required hospitalization, one died.
Subject(s)
COVID-19 , Lupus Erythematosus, Systemic , Humans , BNT162 Vaccine , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/administration & dosage , Follow-Up Studies , Immunization , Lupus Erythematosus, Systemic/drug therapy , SARS-CoV-2 , VaccinationABSTRACT
RESUMEN Objetivo: Identificar aspectos críticos de la Cadena de Frío en el Perú Metodología: Estudio descriptivo. Se analizaron datos del Ministerio de Economía y Finanzas (MEF) y del Ministerio de Salud (MINSA) de los años 2020-2021, así como los registros administrativos de las Estrategias Sanitarias Regionales de inmunizaciones del MINSA en 2020. Se consideraron aspectos técnicos de la Norma Técnica de Manejo de cadena de frío, como es obsolescencia, dotación, funcionalidad y capacidad de almacenamiento. Resultados: En el año 2020, en términos de obsolescencia el 61.8% de los equipos de cadena de frío a nivel nacional presentaban obsolescencia, siendo regiones claves como Lima Metropolitana (capital del país) la más afectada con un 88%. En cuanto a la dotación de equipos, el 9% de los establecimientos de salud del primer nivel carecen de equipos de refrigeración, siendo Loreto la región con mayor déficit 46%, seguida de Huancavelica con un 21% de brecha. En términos de funcionamiento, se registra que el 84% de los equipos a nivel nacional funcionan, y el 16% reportan fallas técnicas, lo cual representa alto riesgo en la seguridad y potencia inmunogénica de las vacunas a prever. En términos de capacidad, al considerar el almacenamiento trimestral o mensual para las vacunas contra la COVID-19 u otras emergencias sanitarias se identificaron brechas significativas. Conclusiones: Existen riesgos en la operatividad, suministro y capacidad de almacenamiento de las vacunas del esquema nacional de inmunizaciones de Perú incluso ante emergencias sanitarias.
ABSTRACT Objective: The aim of this study was to identify critical aspects of the Cold Chain in the immunization process in Peru. Methodology: A descriptive study was conducted, analyzing data from the Ministry of Economy and Finance (MEF) and the Ministry of Health (MINSA) for the years 2020-2021, as well as administrative records from the MINSA's Regional Health Strategies for immunizations in 2020. Technical aspects established in the Health Technical Standard for Cold Chain Management, such as obsolescence, allocation, functionality, and storage capacity were taken into account. Results: In the year 2020, at the national level, 61.8% of the cold chain equipment showed obsolescence, with some regions exceeding 75%, with Lima's metropolitan region being the most affected at 88%. Concerning equipment allocation, 9% of the first-level health facilities lacked refrigeration equipment, with Loreto having the highest deficit (46%), followed by Huancavelica with a 21% gap. The overall equipment functionality nationwide was 84%, meaning that 16% of health facilities experienced technical failures, affecting vaccine's storage capacity and posing risks to their safety and immunogenicity. Significant gaps were identified when considering quarterly or monthly storage for COVID-19 vaccines or other health emergencies. Conclusions: This study highlights potential risks in the operability and storage capacity of the national immunization program's vaccines in Peru during contingencies such as the COVID-19 pandemic or other health emergencies.