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1.
BMC Health Serv Res ; 24(1): 1216, 2024 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-39390544

RESUMO

BACKGROUND: Infant vaccination coverage rates in Peru have declined in recent years, exacerbated by the COVID-19 pandemic. Introduction of the fully-liquid diphtheria, tetanus, and acellular pertussis (DTaP)-inactivated polio vaccine (IPV)-hepatitis B (HB)-Haemophilus influenzae type B (Hib) hexavalent vaccine (DTaP-IPV-HB-Hib) in Peru's infant National Immunization Program may help improve coverage. We evaluated costs and healthcare outcomes, including coverage, of switching from a pentavalent vaccine containing whole-cell pertussis component (DTwP-HB-Hib) plus IPV/oral polio vaccine (IPV/OPV) to the hexavalent vaccine for the primary vaccination scheme (2, 4 and 6 months). METHODS: The analysis was performed over a 5-year period on a cohort of children born in Peru in 2020 (N = 494,595). Four scenarios were considered: the pentavalent plus IPV/OPV scheme (S1); replacing the pentavalent plus IPV/OPV scheme with the hexavalent scheme (S2); expanded delivery of the pentavalent plus IPV/OPV scheme (S3); expanded delivery of the hexavalent scheme (S4). Vaccine coverage and incidence of adverse reactions (ARs) were estimated using Monte Carlo simulations and previous estimates from the literature. Cases of vaccine-preventable diseases were estimated using a Markov model. Logistical and healthcare costs associated with these outcomes were estimated. Impact of key variables (including coverage rates, incidence of ARs and vaccine prices) on costs was evaluated in sensitivity analyses. RESULTS: The overall cost from a public health payer perspective associated with the pentavalent plus IPV/OPV vaccine scheme (S1) was estimated at $56,719,350, increasing to $61,324,263 (+ 8.1%), $59,121,545 (+ 4.2%) and $64,872,734 (+ 14.4%) in scenarios S2, S3 and S4, respectively. Compared with the status quo (S1), coverage rates were estimated to increase by 3.1% points with expanded delivery alone, and by 9.4 and 14.3% points, if the hexavalent vaccine is deployed (S2 and S4, respectively). In both scenarios with the hexavalent vaccine (S2 and S4), pertussis cases would also be 5.7% and 8.7% lower, and AR rates would decrease by 32%. The cost per protected child would be reduced when the hexavalent vaccine scheme. Incidence of ARs was an important driver of cost variability in the sensitivity analysis. CONCLUSIONS: Implementation of the hexavalent vaccine in Peru's National Immunization Program has a positive public health cost consequence.


Assuntos
Vacinas Anti-Haemophilus , Programas de Imunização , Vacina Antipólio de Vírus Inativado , Cobertura Vacinal , Vacinas Combinadas , Humanos , Peru/epidemiologia , Lactente , Vacinas Anti-Haemophilus/economia , Vacinas Anti-Haemophilus/administração & dosagem , Cobertura Vacinal/estatística & dados numéricos , Cobertura Vacinal/economia , Vacina Antipólio de Vírus Inativado/economia , Vacina Antipólio de Vírus Inativado/administração & dosagem , Programas de Imunização/economia , Vacinas Combinadas/economia , Vacinas contra Hepatite B/economia , Vacinas contra Hepatite B/administração & dosagem , Feminino , Vacina contra Difteria, Tétano e Coqueluche/economia , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Masculino , Vacinas contra Difteria, Tétano e Coqueluche Acelular/economia , Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , COVID-19/prevenção & controle , COVID-19/economia , COVID-19/epidemiologia , Análise Custo-Benefício , SARS-CoV-2 , Coqueluche/prevenção & controle , Coqueluche/economia , Coqueluche/epidemiologia
2.
Cien Saude Colet ; 29(10): e02512024, 2024 Oct.
Artigo em Português | MEDLINE | ID: mdl-39292031

RESUMO

This article analyzes the films produced and broadcast between 1976 and 1978 by the National Agency and the Public Relations Office (ARP) for the campaign to publicize the mandatory vaccination that was instituted by the National Immunization Plan (PNI), created in 1975 and regulated by Decree No. 78,231 of August 12, 1976. The objective is to understand the narrative constructed through images and speeches aimed at convincing the population to make vaccination a culturally accepted practice. To achieve this, we examine the legislation on the subject during the period under analysis, namely the civil-military dictatorship. The dictatorial regime is approached based on the conceptual aspects that guide the analysis of the appropriation of health campaigns as propaganda and investments in a private and curative health model. We can therefore conclude that the initiative to create the PNI is a hiatus in this process of privatizing health, since it is not an action guided by the dictatorship's responsibility for the health of the population, but an action that involved the management of multiple actors in the health field, and which was embraced by the regime because it was a process directly linked to interests connected to the country's conservative modernization project.


Este artigo analisa os filmes produzidos e veiculados, entre 1976 e 1978, pela Agência Nacional e pela Assessoria de Relações Públicas (ARP) para a campanha de divulgação da vacinação obrigatória que foi instituída pelo Plano Nacional de Imunizações (PNI), criado em 1975, e regulamentado pelo Decreto nº 78.231, de 12 de agosto de 1976. O objetivo é compreender a narrativa construída através de imagens e discursos visando tornar a vacina uma prática culturalmente aceita. Para isso, recorre-se à legislação que versa sobre o tema no período analisado, qual seja na ditadura civil-militar. O regime ditatorial é abordado a partir dos aspectos conceituais que orientam as análises sobre a apropriação das campanhas de saúde como propaganda e dos investimentos em um modelo de saúde privada e curativista. Conclui-se, assim, que a iniciativa de criação do PNI trata-se de um hiato nesse processo de privatização da saúde, já que não é uma ação orientada pela responsabilidade da ditadura para com a saúde da população, mas sim, uma ação que envolveu a gerência de múltiplos atores do campo da saúde, e que foi encampada pelo regime por se tratar de um processo diretamente atrelado a interesses ligados ao projeto de modernização conservadora do país.


Assuntos
Promoção da Saúde , Programas de Imunização , Meios de Comunicação de Massa , Vacinação , Humanos , Programas de Imunização/organização & administração , Vacinação/legislação & jurisprudência , Promoção da Saúde/métodos , Brasil , Propaganda , Programas Nacionais de Saúde/organização & administração , Programas Obrigatórios , História do Século XX , Vacinação Compulsória
3.
J Glob Health ; 14: 04199, 2024 09 27.
Artigo em Inglês | MEDLINE | ID: mdl-39325925

RESUMO

Background: As part of the Immunisation Agenda 2030, the World Health Organization set a goal to reduce the number of children who did not receive any routine vaccine by 50% by 2030. We aimed to describe the patterns of vaccines received for children with zero, one, and up to full vaccination, while considering newly deployed vaccines (pneumococcal conjugate vaccine (PCV) and rotavirus (ROTA) vaccine) alongside longstanding ones such as the Bacille Calmete-Guérin (BCG), diphtheria, tetanus, and pertussis (DPT), and poliomyelitis vaccines, and measles-containing vaccines (MCVs). Methods: We used data from national household surveys (Demographic and Health Surveys and Multiple Indicator Cluster Surveys) carried out in 43 low- and middle-income countries since 2014. We calculated the immunisation cascade as a score ranging from zero to six, considering BCG, polio, DPT, and ROTA vaccines, and the MCV and PCV. We also described the most prevalent combination of vaccines. The analyses were pooled across countries and stratified by household wealth quintiles. Results: In the pooled analyses with all countries combined, 9.0% of children failed to receive any vaccines, 58.6% received at least one dose of each of the six vaccines, and 47.2% were fully vaccinated with all doses. Among the few children receiving 1-5 vaccines, the most frequent were BCG vaccines, polio vaccines, DPT vaccines, PCV, ROTA vaccines, and MCV. Conclusions: Targeting children with their initial vaccine is crucial, as those who receive a first vaccine are more likely to undergo subsequent vaccinations. Finding zero-dose children and starting their immunisation is essential to leaving no one behind during the era of Sustainable Development Goals.


Assuntos
Programas de Imunização , Humanos , Lactente , Pré-Escolar , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Esquemas de Imunização , Vacinas contra Rotavirus/administração & dosagem , Vacina contra Sarampo/administração & dosagem , Cobertura Vacinal/estatística & dados numéricos , Vacina BCG/administração & dosagem , Vacinas Pneumocócicas/administração & dosagem , Feminino , Masculino , Vacinação/estatística & dados numéricos , Países em Desenvolvimento
5.
Hum Vaccin Immunother ; 20(1): 2395685, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-39233398

RESUMO

The aim was to estimate the vaccination timeliness defined as the proportion of children under 6 years of age who received their immunization in the time range established by the Colombian Expanded Immunization Program (EIP). A retrospective cohort study that collected reports of vaccination opportunities between 2014 and 2019 provided by the Ministry of Health. Age, sex, city, ethnicity, health system affiliation regimen, vaccine applied, and timing of vaccination were considered for the time range under study. A total of 3,370,853 immunized children were included from all regions of the country. More than 80% of children had a timeliness to get most vaccines. The exceptions were yellow fever (17%) and seasonal influenza (42%). No differences in timeliness were found according to geographic region or by health system affiliation regime, but the average timeliness for all vaccines of children of the indigenous population (65.8% ±18.4%) was lower than that of the rest of the population (78·6% ± 19·3%) (p = 0·021). The timeliness for vaccination under the EIP of Colombia is high, with proportions of 72-96%, but intergroup differences were identified, mainly lower timeliness among indigenous people. These findings warrant improvement strategies that would guarantee the immunization of the entire child population.


Assuntos
Programas de Imunização , Esquemas de Imunização , Vacinação , Humanos , Colômbia , Estudos Retrospectivos , Feminino , Masculino , Programas de Imunização/estatística & dados numéricos , Lactente , Pré-Escolar , Vacinação/estatística & dados numéricos , Vacinas/administração & dosagem , Fatores de Tempo , Criança , Recém-Nascido , Cobertura Vacinal/estatística & dados numéricos
7.
Epidemiol Serv Saude ; 33(spe2): e20231216, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-39194084

RESUMO

OBJECTIVE: To describe timely vaccination completion and obstacles in the first 24 months of life in Brazil, examining associations with maternal race/skin color. METHODS: Study participants were 37,801 children born in 2017 and 2018 included in the National Immunization Coverage Survey. We calculated prevalence and 95% confidence intervals for timely vaccine completeness and obstacles at 5, 12 and 24 months of life, according to maternal race/skin color. Associations were analyzed using logistic regression. RESULTS: 7.2% (95%CI 6.3;8.2) of mothers faced difficulties in taking their children to be vaccinated, and 23.4% (95%CI 21.7;25.1) were not vaccinated when taken. These proportions were 75% (95%CI 1.25;2.45) and 97% (95%CI 1.57;2.48) higher, respectively, among Black mothers. At least one vaccination was delayed among 49.9% (95%CI 47.8;51.9) and 61.1% (95%CI 59.2;63.0) of children by 5 and 12 months, respectively. These rates were higher among Black/mixed race mothers. CONCLUSION: There are racial inequalities in both the obstacles faced and in vaccination rates in Brazil. MAIN RESULTS: Marked racial inequalities were found in the obstacles to vaccination of children under 24 months in Brazil and to timely vaccination at 5 months and in the first year of life. IMPLICATIONS FOR SERVICES: Racial inequalities in the occurrence of vaccination shortcomings in health services, in the objective restrictions faced by families in taking their children to vaccination centers and in incomplete vaccination in a timely manner need to be addressed by the Brazilian National Health System. PERSPECTIVES: Equal public policies to address barriers to vaccination and qualification of health services need to be implemented. Studies need to deepen understanding of the structural determinants that lead to racial disparities.


Assuntos
Disparidades em Assistência à Saúde , Mães , Vacinação , Humanos , Brasil , Lactente , Vacinação/estatística & dados numéricos , Feminino , Estudos Retrospectivos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Mães/estatística & dados numéricos , Pré-Escolar , Masculino , Cobertura Vacinal/estatística & dados numéricos , Recém-Nascido , Adulto , Estudos de Coortes , Fatores Socioeconômicos , População Negra/estatística & dados numéricos , Fatores de Tempo , Programas de Imunização/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Adulto Jovem , População Branca/estatística & dados numéricos
8.
Washington, D.C.; PAHO; 2024-08-06. (PAHO/CIM/24-0013).
Não convencional em Inglês | PAHO-IRIS | ID: phr-60938

RESUMO

As national immunization programs grapple with how to increase vaccine uptake for both vaccines against COVID and those that form part of the routine immunization schedule, they should consider the role of behavioral and social drivers of vaccination (BeSD), which help us understand the beliefs and experiences that influence vaccine uptake. The present document includes answers to questions submitted to PAHO about behavioral and social drivers of vaccination with the goal of helping immunization programs understand these factors; what the BeSD framework is and what its four domains – thinking and feeling, social processes, motivation, and practical issues – are; how social and behavioral data can be collected, analyzed, and used to implement and evaluate interventions to increase uptake; what tools are available to do this; the special considerations needed when considering health workers´ role in promoting vaccination; the relationship between BeSD and risk communication and community engagement (RCCE) for vaccination; and the definition and relationship between key social and behavioral terms like vaccine confidence and vaccine hesitancy. Additionally, the document presents the new spectrum on intentions toward vaccination and answers questions about how to handle anti-vaccine advocates (“anti-vaxxers”) and vaccine refusers; managing misinformation and disinformation related to vaccination and engaging in social listening; and using the BeSD framework to change risk perceptions about vaccine-preventable diseases and vaccination. Resources developed by WHO and PAHO that are related to behavioral and social drivers of vaccination are also listed and linked for easy access by the user of the FAQ document.


Assuntos
Imunização , Programas de Imunização , Vacinas , Vacinas contra COVID-19 , Vacinação , Ciências do Comportamento
9.
J Trop Pediatr ; 70(4)2024 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-39122656

RESUMO

Bacillus Calmette-Guerin (BCG) vaccination and tuberculosis (TB) incidence in children under 1 year of age are critical public health indicators in Brazil. The coronavirus disease 2019 pandemic disrupted vaccination coverage (VC), potentially impacting TB incidence. Understanding regional disparities in VC and TB incidence can inform targeted interventions. We conducted an observational and ecological study using BCG vaccination data (2019-21) and TB incidence (2020-22) for all births in Brazil. Data were collected from public health databases, stratified by state, and analyzed using descriptive and analytical statistics to explore VC and TB incidence. Between 2019 and 2021, average BCG VC was 79.59%, with significant variation among states (P < .001). Only four states achieved minimum recommended coverage (>90%). TB incidence varied significantly among states (P = .003). There was a notable decline in VC from 2019 (90.72%) to 2021 (78.67%) (P < .001). This study highlights regional disparities in BCG VC and TB incidence among Brazilian states. Lower VC post-pandemic may increase TB incidence, requiring targeted interventions in states with inadequate coverage. The findings underscore the importance of sustaining vaccination programs amidst public health crises and implementing strategies to enhance access and uptake.


Assuntos
Vacina BCG , COVID-19 , Tuberculose , Cobertura Vacinal , Humanos , Brasil/epidemiologia , Vacina BCG/administração & dosagem , Cobertura Vacinal/estatística & dados numéricos , Incidência , Lactente , Tuberculose/epidemiologia , Tuberculose/prevenção & controle , COVID-19/prevenção & controle , COVID-19/epidemiologia , Feminino , Programas de Imunização , Masculino , Vacinação/estatística & dados numéricos , SARS-CoV-2 , Disparidades em Assistência à Saúde , Recém-Nascido
10.
Medicina (B Aires) ; 84(4): 734-740, 2024.
Artigo em Espanhol | MEDLINE | ID: mdl-39172573

RESUMO

A new dengue vaccine has recently been licensed in Argentina, with the Argentine government planning to acquire it in order to develop a vaccination strategy. As the disease is gradually following a path to endemicity in some regions of the country, the incorporation of these vaccines will have the potential to tackle the growing incidence of the disease and to reduce the disease burden. However, the establishment of the vaccination programme may also be susceptible of threats related to the epidemiological shift of the disease. Selecting a specific age group for the vaccine may result in a change in the peak incidence to other age groups more susceptible to severe forms of the disease, such as children or the elderly. Furthermore, the perception of protection following vaccine introduction in one jurisdiction may reduce adherence to vector control activities, increasing the risk of virus introduction and transmission in other areas not prioritised by the vaccination strategy, and the risk of other arboviral diseases such as Zika and chikungunya fever. These and other potential limitations to be considered prior to the implementation of vaccination programmes are discussed in this article, with a series of recommendations on how to address these concerns. These recommendations can help decision makers and public health practitioners at this early stage of the vaccination programme development.


Una nueva vacuna contra el dengue ha sido recientemente aprobada en Argentina, y el gobierno argentino se encuentra planificando su adquisición para desarrollar una estrategia de vacunación. Mientras la enfermedad se está dirigiendo gradualmente hacia la endemicidad en algunas regiones del país, la incorporación de estas vacunas tendrá el potencial de atacar la creciente incidencia de la enfermedad y de reducir su carga. Sin embargo, el establecimiento de un programa de vacunación puede también ser susceptible de amenazas relacionadas con el cambio epidemiológico de la enfermedad. La selección de un grupo de edad específico para la vacunación puede resultar en un cambio en el pico de la incidencia hacia otros grupos de edad más vulnerables a las formas graves de la enfermedad, como los niños o los ancianos. Además, la percepción de protección luego de la introducción de la vacuna en una jurisdicción puede reducir la adherencia a las actividades de control del vector, incrementando el riesgo de introducción y transmisión del virus en otras áreas no priorizadas por la estrategia de vacunación, y aumentando el riesgo de otras arbovirosis como las fiebres Zika y chikungunya. Estas y otras potenciales limitaciones para ser consideradas antes de la implementación de los programas de vacunación son discutidas en este artículo, en conjunto con una serie de recomendaciones sobre cómo abordar estas preocupaciones. Estas recomendaciones pueden resultar de utilidad para los tomadores de decisión y actores sanitarios, en esta etapa temprana del desarrollo de un programa de vacunación.


Assuntos
Vacinas contra Dengue , Dengue , Argentina/epidemiologia , Humanos , Vacinas contra Dengue/administração & dosagem , Dengue/prevenção & controle , Dengue/epidemiologia , Programas de Imunização , Vacinação/estatística & dados numéricos
11.
Expert Rev Vaccines ; 23(1): 773-778, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39167081

RESUMO

INTRODUCTION: Dengue disease represents a large and growing global threat to public health, accounting for a significant burden to health systems of endemic countries. The World Health Organization's (WHO) Strategic Advisory Group of Experts (SAGE) and the European Medicines Agency (EMA) currently recommend the use of TAK-003 dengue vaccine in high dengue burden and transmission settings for countries considering vaccination as part of their integrated management strategy for prevention and control of Dengue. AREAS COVERED: This paper describes the main conclusions of a workshop held by the Arbovirus Committee of the Latin American Society of Pediatric Infectious Diseases (SLIPE) in November 2023, to generate consensus recommendations on the introduction of this new vaccine in the region. Considerations were made regarding the molecular epidemiology of dengue infection in the Americas and the need for more precise phylogenetic classification and correlation with clinical outcome and disease severity. EXPERT OPINION: Introduction of dengue vaccine should be considered as an strategy for health entities in the region, with participation of social sectors, scientific societies, and ministries of health that could be able to create a successful vaccination program.


Assuntos
Vacinas contra Dengue , Dengue , Epidemiologia Molecular , Humanos , Vacinas contra Dengue/imunologia , Vacinas contra Dengue/administração & dosagem , Dengue/prevenção & controle , Dengue/epidemiologia , América Latina/epidemiologia , Vírus da Dengue/imunologia , Vírus da Dengue/genética , Vacinação/métodos , Filogenia , Organização Mundial da Saúde , Programas de Imunização
12.
BMJ Open ; 14(7): e072314, 2024 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-38964793

RESUMO

OBJECTIVES: No consensus exists about the best COVID-19 vaccination strategy to be adopted by low-income and middle-income countries. Brazil adopted an age-based calendar strategy to reduce mortality and the burden on the healthcare system. This study evaluates the impact of the vaccination campaign in Brazil on the progression of the reported COVID-19 deaths. METHODS: This ecological study analyses the dynamic of vaccination coverage and COVID-19 deaths in hospitalised adults (≥20 years) during the first year of the COVID-19 vaccination roll-out (January to December 2021) using nationwide data (DATASUS). We stratified the adult population into 20-49, 50-59, 60-69 and 70+ years. The dynamic effect of the vaccination campaign on mortality rates was estimated by applying a negative binomial regression. The prevented and possible preventable deaths (observed deaths higher than expected) and potential years of life lost (PYLL) for each age group were obtained in a counterfactual analysis. RESULTS: During the first year of COVID-19 vaccination, 266 153 517 doses were administered, achieving 91% first-dose coverage. A total of 380 594 deaths were reported, 154 091 (40%) in 70+ years and 136 804 (36%) from 50-59 or 20-49 years. The mortality rates of 70+ decreased by 52% (rate ratio [95% CI]: 0.48 [0.43-0.53]) in 6 months, whereas rates for 20-49 were still increasing due to low coverage (52%). The vaccination roll-out strategy prevented 59 618 deaths, 53 088 (89%) from those aged 70+ years. However, the strategy did not prevent 54 797 deaths, 85% from those under 60 years, being 26 344 (45%) only in 20-49, corresponding to 1 589 271 PYLL, being 1 080 104 PYLL (68%) from those aged 20-49 years. CONCLUSION: The adopted aged-based calendar vaccination strategy initially reduced mortality in the oldest but did not prevent the deaths of the youngest as effectively as compared with the older age group. Countries with a high burden, limited vaccine supply and young populations should consider other factors beyond the age to prioritise who should be vaccinated first.


Assuntos
Vacinas contra COVID-19 , COVID-19 , SARS-CoV-2 , Humanos , Brasil/epidemiologia , COVID-19/prevenção & controle , COVID-19/mortalidade , COVID-19/epidemiologia , Pessoa de Meia-Idade , Idoso , Vacinas contra COVID-19/administração & dosagem , Adulto , Masculino , Feminino , Adulto Jovem , Cobertura Vacinal/estatística & dados numéricos , Programas de Imunização , Vacinação/estatística & dados numéricos
13.
Vaccine ; 42(24): 126105, 2024 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-38991916

RESUMO

OBJECTIVE: To analyze COVID-19 vaccine uptake in children and to investigate factors associated with two outcomes variables: (a) not even beginning; (b) not completing the COVID-19 vaccine series. METHODS: We used data of children aged 6-7 years from the 2015 Pelotas c Birth Cohort Study. COVID-19 vaccination status was collected from immunization cards and National Immunization Program Information System. Adjusted analyses were performed using a hierarchical model to identify factors associated with the two study outcomes. RESULTS: Among 3867 children, 20.7 % (95 % CI, 19.5 %-22.0 %) did not even begin the 2-dose primary COVID-19 vaccine series, and 28.2 % (95 % CI, 26.6 %-29.8 %) did not complete the series with the second dose. Children not even beginning the COVID-19 vaccine series were more likely to have a White mother, not to have obesity, to have a history of COVID-19 infection, to have received non-recommended drugs for COVID-19, to be afraid of needles, and to have an incomplete diphtheria-tetanus-pertussis (DTP) and poliovirus immunization schedule. Not completing the 2-dose series was associated with lower maternal age and education, mother's self-identification as White or Brown, lower household income, lack of access to health services, not having completed the DTP and poliovirus immunization schedule and living with a person with a history of infection with COVID-19. CONCLUSION: The results highlight a vaccine-hesitant parents' group who chose not beginning the COVID-19 vaccine series of their children and, another group of parents who failure to complete the child's series due to difficulty accessing health services.


Assuntos
Coorte de Nascimento , Vacinas contra COVID-19 , COVID-19 , Humanos , Criança , Feminino , COVID-19/prevenção & controle , COVID-19/epidemiologia , Vacinas contra COVID-19/administração & dosagem , Masculino , Brasil/epidemiologia , Vacinação/estatística & dados numéricos , SARS-CoV-2/imunologia , Programas de Imunização/estatística & dados numéricos , Esquemas de Imunização , Cobertura Vacinal/estatística & dados numéricos , Estudos de Coortes
14.
Washington, D.C.; United States; 2024-07-29. (OPS/CIM/24-0010).
Não convencional em Espanhol | PAHO-IRIS | ID: phr-60874

RESUMO

A medida que los programas nacionales de inmunización intentan aumentar la aceptación de las vacunas contra el COVID-19 y las que forman parte del esquema de vacunación de rutina, deben considerar el papel de los factores conductuales y sociales de la vacunación (BeSD), que nos ayudan a comprender las creencias y experiencias que influyen en la aceptación de las vacunas. El presente documento incluye respuestas a preguntas presentadas a la OPS sobre los impulsores conductuales y sociales de la vacunación con el objetivo de ayudar a los programas de inmunización a comprender estos factores; qué es el marco BeSD y cuáles son sus cuatro dominios: pensamiento y sentimiento, procesos sociales, motivación y cuestiones prácticas; cómo se pueden recopilar, analizar y utilizar los datos sociales y conductuales para implementar y evaluar las intervenciones destinadas a aumentar la aceptación; de qué herramientas se dispone para ello; las consideraciones especiales necesarias a la hora de considerar el papel de los trabajadores sanitarios en la promoción de la vacunación; la relación entre el DSBE y la comunicación de riesgos y el compromiso de la comunidad (RCCE) para la vacunación; y la definición y relación entre términos sociales y conductuales clave como confianza en la vacuna y vacilación ante la vacuna. Además, el documento presenta el nuevo espectro de intenciones hacia la vacunación y responde a preguntas sobre cómo tratar a los defensores antivacunas ("anti-vaxxers") y a los que se niegan a vacunarse; cómo gestionar la desinformación y la desinformación relacionadas con la vacunación y cómo participar en la escucha social; y cómo utilizar el marco BeSD para cambiar la percepción del riesgo.


Assuntos
Imunização , Programas de Imunização , Vacinas contra COVID-19 , Vacinação , Vacinas , Ciências do Comportamento
15.
Vaccine ; 42(23): 126043, 2024 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-38879409

RESUMO

OBJECTIVES: The 13-valent pneumococcal conjugate vaccine (PCV13) has been recommended for infants in Argentina's national immunization program (NIP) in a 2 + 1 schedule since 2012. Licensure of the 15-valent vaccine (PCV15) is anticipated soon, and the 20-valent vaccine (PCV20) recently received regulatory approval. This cost-effectiveness analysis examined the public health and economic implications of transitioning from PCV13 to either PCV15 or PCV20 in Argentina's pediatric NIP. METHODS: A decision-analytic Markov model was used with a 10-year time horizon and a 3.0% annual discount rate for costs and benefits. Vaccine effectiveness estimates were derived from Argentinian surveillance data, PCV13 clinical effectiveness and impact studies, and PCV7 efficacy studies. Population, epidemiologic, and economic inputs were obtained from literature and Argentinian-specific data. The study adopted a healthcare system perspective; sensitivity and scenario analyses were conducted to assess input parameters and structural uncertainty. RESULTS: Compared with PCV13, PCV20 was estimated to avert an additional 7,378, 42,884, and 172,389 cases of invasive pneumococcal disease (IPD), all-cause pneumonia, and all-cause otitis media (OM), respectively, as well as 3,308 deaths, resulting in savings of United States Dollars (USD) 50,973,962 in direct medical costs. Compared with PCV15, PCV20 was also estimated to have greater benefit, averting an additional 6,140, 35,258, and 142,366 cases of IPD, pneumonia, and OM, respectively, as well as 2,624 deaths, resulting in savings of USD 37,697,868 in direct medical costs. PCV20 was associated with a higher quality-adjusted life year gain and a lower cost (i.e., dominance) versus both PCV13 and PCV15. Results remained robust in sensitivity analyses and scenario assessments. CONCLUSION: Over a 10-year horizon, vaccination with PCV20 was expected to be the dominant, cost-saving strategy versus PCV13 and PCV15 in children in Argentina. Policymakers should consider the PCV20 vaccination strategy to achieve the greatest clinical and economic benefit compared with lower-valent options.


Assuntos
Análise Custo-Benefício , Infecções Pneumocócicas , Vacinas Pneumocócicas , Vacinas Conjugadas , Vacinas Pneumocócicas/economia , Vacinas Pneumocócicas/administração & dosagem , Vacinas Pneumocócicas/imunologia , Humanos , Argentina/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Infecções Pneumocócicas/economia , Infecções Pneumocócicas/epidemiologia , Lactente , Vacinas Conjugadas/economia , Vacinas Conjugadas/administração & dosagem , Vacinas Conjugadas/imunologia , Pré-Escolar , Programas de Imunização/economia , Cadeias de Markov , Anos de Vida Ajustados por Qualidade de Vida , Criança , Feminino , Masculino , Análise de Custo-Efetividade
16.
Cad Saude Publica ; 40(6): e00165023, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38922226

RESUMO

Vaccines are often undervalued or underused for a variety of reasons, and vaccine hesitancy is a global challenge that threatens vaccine acceptance and the goals of immunization programs. This review aimed to describe the barriers and facilitators to vaccination in Latin America. The study design was a systematic review and thematic synthesis of qualitative studies reporting on the knowledge or attitudes of adults, parents of children at vaccination age, adolescents and health professionals towards vaccination in Latin America. The databases searched were PubMed, CENTRAL, Scopus, LILACS, SciELO, and CINAHL. A total of 56 studies were included. Facilitators included vaccination being recognized as an effective strategy for preventing infectious diseases and as a requirement for access to social assistance programs, schooling or employment. Recommendations from health professionals and positive experiences with health services were also identified as facilitators. The main barriers were lack of information or counseling, structural problems such as shortages of vaccines and limited hours of operation, the inability to afford over-the-counter vaccines or transportation to health facilities, certain religious beliefs, misconceptions and safety concerns. Qualitative research can contribute to understanding perceptions and decision-making about vaccination and to designing policies and interventions to increase coverage.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pesquisa Qualitativa , Vacinação , Humanos , América Latina , Vacinação/psicologia , Hesitação Vacinal/psicologia , Acessibilidade aos Serviços de Saúde , Programas de Imunização , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adolescente , Adulto , Pessoal de Saúde/psicologia
17.
Rev Paul Pediatr ; 42: e2023116, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38836806

RESUMO

OBJECTIVE: To analyze the vaccination coverage and abandonment rates among children under two years old in Brazil, from 2015 to 2021. METHODS: A time-series ecological study. The dependent variables of the research were "vaccination coverage" and "abandonment rate", both assessed by Brazilian region. The data were extracted in July 2022 from the Information System of the National Immunization Program. The Prais-Winsten technique was used for the trend analysis, with the aid of the STATA 16.0 software. RESULTS: The mean vaccination coverage in Brazil was 76.96%, with a decreasing trend during the period (Annual Percent Change=-5.12; confidence interval - CI95% -7.81; -2.34); in 2015, the rate was 88.85% and it dropped to 62.35% in 2021. In turn, the overall abandonment rate was 24.00% in 2015 and 9.01% in 2021, with a mean of 10.48% and a stationary trend (Annual Percentage Change=-9.54; CI95% -22.92; 6.12). In 2021, all the vaccines presented coverage values below 74.00% in the country. CONCLUSIONS: The vaccination coverage rate trend among children under two years old was stationary or decreasing for all the immunobiologicals in all Brazilian regions, with the exception of yellow fever in the South and Southeast regions. There was an increase in the abandonment rate trend for the Meningococcal C vaccine in the country and, specifically in relation to the regions, for BCG in the North, Northeast, and Midwest and for Meningococcal C in the North and Northeast.


Assuntos
Cobertura Vacinal , Humanos , Brasil , Cobertura Vacinal/estatística & dados numéricos , Lactente , Programas de Imunização/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Fatores de Tempo
18.
Washington, D.C.; OPAS; 2024-06-25. (OPAS/CIM/24-0010).
Não convencional em Português | PAHO-IRIS | ID: phr-60410

RESUMO

Como os programas nacionais de imunização buscam aumentar a adesão às vacinas contra a COVID-19 e àquelas que fazem parte do calendário de imunização de rotina, eles devem considerar o papel dos fatores comportamentais e sociais da vacinação (BeSD), que nos ajudam a entender as crenças e experiências que influenciam a adesão à vacina. Este documento inclui respostas a perguntas enviadas à OPAS sobre os motivadores comportamentais e sociais da vacinação com o objetivo de ajudar os programas de imunização a entender esses fatores; o que é a estrutura de BeSD e quais são seus quatro domínios: pensamento e sentimento, processos sociais, motivação e questões práticas; como os dados sociais e comportamentais podem ser coletados, analisados e usados para implementar e avaliar intervenções para aumentar a adesão; quais ferramentas estão disponíveis para isso; as considerações especiais necessárias ao considerar o papel dos profissionais de saúde na promoção da vacinação; a relação entre BeSD e a comunicação de risco e o envolvimento da comunidade (RCCE) para a vacinação; e a definição e a relação entre os principais termos sociais e comportamentais, como confiança e hesitação na vacina. Além disso, o documento apresenta o novo espectro de intenções em relação à vacinação e responde a perguntas sobre como lidar com antivaxxers e recusadores de vacinas; como gerenciar a desinformação relacionada à vacinação e como se envolver na escuta social; e como usar a estrutura do BeSD para mudar a percepção de risco.


Assuntos
Vacinação , Vacinas contra COVID-19 , Programas de Imunização , Imunização
19.
Infect Dis (Lond) ; 56(11): 983-990, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38913347

RESUMO

BACKGROUND: Until 2005, when a single dose of vaccine was implemented in one-year-old children, the Hepatitis A virus (HAV) was responsible for approximately 90% of acute hepatitis cases in the paediatric population in Argentina. However, despite vaccination success, sporadic outbreaks of HAV still occur among adults. This study aimed to assess the seroepidemiology of HAV in Argentina, analysing IgG and IgM antibodies against HAV in a large population, both vaccinated and unvaccinated. METHODS: The study included 16,982 patients attending a hospital from 2001 to 2023. The cohort was divided into two groups: 16,638 individuals who were not reached by the vaccination program implemented in 2005 and 344 children who were covered by the universal vaccination. RESULTS: Anti-HAV IgG was detected in 56.7% of cases. The rate was significantly higher in individuals born after 2005 (77.7%) compared to those born before (56.3%), p < 0.001. The age groups 19-40 and 41-60 years showed the anti-HAV IgG lowest rates. On the other hand, 100/3956 cases (2.5%) with suspected acute hepatitis were positive for Anti-HAVIgM. Notably, none of these were born after the mandatory vaccine rollout. CONCLUSIONS: The study of this large cohort contributes to the understanding of the seroepidemiology of HAV. Although the implementation of the vaccine achieved its main goal, the age segment between 19 and 60 years does not reach the estimated threshold to achieve herd immunity. These findings reveal the importance of targeting vaccination campaigns, provide essential insights for public health planning, and guide future immunisation strategies against HAV in Argentina.


Assuntos
Anticorpos Anti-Hepatite A , Vacinas contra Hepatite A , Hepatite A , Imunoglobulina G , Imunoglobulina M , Humanos , Argentina/epidemiologia , Estudos Soroepidemiológicos , Hepatite A/epidemiologia , Hepatite A/prevenção & controle , Adulto , Masculino , Feminino , Pessoa de Meia-Idade , Adulto Jovem , Anticorpos Anti-Hepatite A/sangue , Criança , Vacinas contra Hepatite A/administração & dosagem , Vacinas contra Hepatite A/imunologia , Adolescente , Pré-Escolar , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Lactente , Vacinação/estatística & dados numéricos , Vírus da Hepatite A/imunologia , Idoso , Programas de Imunização
20.
Vaccine ; 42(18): 3851-3856, 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38749822

RESUMO

BACKGROUND: Case-control studies involving test-negative (TN) and syndrome-negative (SN) controls are reliable for evaluating influenza and rotavirus vaccine effectiveness (VE) during a random vaccination process. However, there is no empirical evidence regarding the impact in real-world mass vaccination campaigns against SARS-CoV-2 using TN and SN controls. OBJECTIVE: To compare in the same population the effectiveness of SARS-CoV-2 vaccination on COVID-19-related hospitalization rates across a cohort design, TN and SN designs. METHOD: We conducted an unmatched population-based cohort, TN and SN case-control designs linking data from four data sources (public primary healthcare system, hospitalization registers, epidemiological surveillance systems and the national immunization program) in a Chilean municipality (Rancagua) between March 1, 2021 and August 31, 2021. The outcome was COVID-19-related hospitalization. To ensure sufficient sample size in the unexposed group, completion of follow-up in the cohort design, and sufficient time between vaccination and hospitalization in the case-control design, VE was estimated comparing 8-week periods for each individual. RESULTS: Among the 191,505 individuals registered in the primary healthcare system of Rancagua in Chile on March 1, 2021; 116,453 met the cohort study's inclusion criteria. Of the 9,471 hospitalizations registered during the study period in the same place, 526 were COVID-19 cases, 108 were TN controls, and 1,628 were SN controls. For any vaccine product, the age- and sex-adjusted vaccine effectiveness comparing fully and nonvaccinated individuals was 67.2 (55.7-76.3) in the cohort design, whereas it was 67.8 (44.1-81.4) and 77.9 (70.2-83.8) in the TN and SN control designs, respectively. CONCLUSION: The VE of a COVID-19 vaccination program based on age and risk groups tended to differ across the three observational study designs. The SN case-control design may be an efficient option for evaluating COVID-19 VE in real-world settings.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Hospitalização , Vacinação em Massa , SARS-CoV-2 , Eficácia de Vacinas , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Chile/epidemiologia , Pessoa de Meia-Idade , Hospitalização/estatística & dados numéricos , Masculino , Feminino , Adulto , Idoso , Vacinas contra COVID-19/imunologia , Vacinas contra COVID-19/administração & dosagem , Estudos de Casos e Controles , Adolescente , SARS-CoV-2/imunologia , Vacinação em Massa/métodos , Vacinação em Massa/estatística & dados numéricos , Adulto Jovem , Criança , Pré-Escolar , Lactente , Estudos de Coortes , Programas de Imunização , Idoso de 80 Anos ou mais
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