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

Uno de los campos de mayor importancia en la promoción de la salud es la prevención de las enfermedades infecciosas mediante las vacunas. Vacuna es cualquier preparación destinada a generar inmunidad contra una enfermedad estimulando la producción de anticuerpos. Hay dos tipos básicos: vivas atenuadas e inactivadas; sus características son diferentes y condicionan su uso. Las propiedades principales de una vacuna son seguridad y eficacia protectora. Las vacunas pueden administrarse en base a indicaciones individualizadas según distintos factores (personales, ambientales…) o de forma sistemática como parte de los calendarios vacunales. En España, el primer calendario de vacunación infantil se implantó en 1975. Actualmente son las comunidades autónomas las responsables de establecer las recomendaciones vacunales. La incidencia de las enfermedades frente a las que se vacuna y las coberturas de vacunación son los criterios de valoración esenciales de los programas vacunales. En España la incidencia de enfermedades inmunoprevenibles es baja. En cuanto a las coberturas vacunales, son altas en la infancia, pero en adolescentes, adultos y grupos de riesgo no siempre son adecuadas

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

[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.

[Occupational exposures to blood and biological material in healthcare workers. EPINETAC Project 1996-2000]. / Exposición ocupacional a sangre y material biológico en personal sanitario. Proyecto EPINETAC 1996-2000.

BACKGROUND AND OBJECTIVE: The bloodborne injury is the most frequent risk in healthcare workers. Among them, the hollow-bore needlesticks are the most associated with the risk of acquire a bloodborne infection. In this study, occupational percutaneous injuries and risk factors associated to hollow-bore needlesticks registered in a national multicenter surveillance system are described. PATIENTS AND METHOD: Prospective and analytical study of percutaneous injuries registered in the surveillance system EPINETAC (Exposure Prevention Information Network) in Spain between 1996-200. A descriptive analysis of the variables related to the exposed healthcare worker, the exposure and their mechanism and the source patient is performed. The incidence rates were calculated by 100 occupied beds and by job category. A multivariable analysis is performed in order to know the risk factors most associated to hollow-bore needle. RESULTS: 16,374 percutaneous injuries has been registered, which 87% are hollow-bore needlesticks. The incidence rate has been 11.8 expositions per 100 occupied beds. Midwives are the most risky workers (9 injuries per 100 occupied beds). The risk factors most associated to hollow-bore needlesticks are the following: job category of midwife (OR = 7.5 95% CI, 4.1-13.7) and student nurse (OR = 2.1; 95% CI, 1.2-3.7), recapping (OR = 28.8; 95% CI, 16.5-50.6), working in venipuncture room (OR = 3.3; 95% CI, 1.2-9.5) or in the dialysis unit (OR = 2.5; 95% CI, 1.4-4.3). CONCLUSIONS: The incidence of occupational percutaneous injuries in Spain is similar to those described in other countries using comparable surveillance systems. The risk of hollow-bore needlestick is directly related to job category, work experience, work area and the activities that the healthcare worker does.

Exposición ocupacional a sangre y material biológico en personal sanitario. Proyecto EPINETAC 1996-2000 / Occupational exposures to blood and biological material in healthcare workers. EPINETAC Project 1996-2000

FUNDAMENTO Y OBJETIVO: Los accidentes por exposición a material biológico son los más frecuentes en los trabajadores sanitarios. Entre ellos, las lesiones percutáneas producidas por agujas canuladas son las que se asocian a un mayor riesgo de adquisición de infecciones por microorganismos de transmisión sérica. En este trabajo se describen las exposiciones ocupacionales percutáneas y los factores de riesgo asociados a las causadas por agujas canuladas, recogidos en un sistema de vigilancia multicéntrico nacional. PACIENTES Y MÉTODO: Estudio prospectivo y analítico de las exposiciones percutáneas notificadas al sistema EPINETAC (Exposure Prevention Information Network) en España entre 1996 y 2000. Se realiza un estudio descriptivo de las variables relacionadas con el profesional expuesto, la exposición y su mecanismo de producción, y el paciente fuente de la exposición. Se han calculado las incidencias de exposición por cada 100 camas y por categoría laboral. Se ha realizado un análisis multivariable para conocer los factores de riesgo asociados a las exposiciones por agujas canuladas. RESULTADOS: Se ha declarado un total de 16.374 accidentes percutáneos, el 87 por ciento con aguja canulada. La incidencia de exposiciones ha sido de 11,8 exposiciones por cada 100 camas. Las matronas son el colectivo profesional con mayor riesgo (9 exposiciones por cada 100 matronas). Los factores que se asocian más a los accidentes con aguja canulada han sido los siguientes: categoría laboral de matrona (odds ratio [OR] = 7,5; intervalo de confianza [IC] del 95 por ciento, 4,1-13,7) y estudiantes de enfermería (OR = 2,1; IC del 95 por ciento, 1,2-3,7), reencapuchado de la aguja (OR = 28,8; IC del 95 por ciento, 16,5-50,6), trabajar en el área de extracciones (OR = 3,3; IC del 95 por ciento, 1,2-9,5) y en hemodiálisis (OR = 2,5; IC del 95 por ciento, 1,4-4,3). CONCLUSIONES: La incidencia de exposición ocupacional percutánea en España es similar a la descrita en otros países que usan sistemas de vigilancia comparables. El riesgo de exposición con agujas canuladas está directamente relacionado con la categoría laboral, la experiencia profesional, el área de trabajo y la actividad realizada (AU)