A prática da enfermagem frente aos eventos adversos pós-vacinação

Abstract

Português / Inglês www.scielo.br/reeusp RESUMOEste arti go tem como objeti vos identi fi car eventos adversos pós-vacinação, foco da práti ca da enfermagem, em base de dados do Sistema de Informação de Eventos Adversos Pós-Vacinação e discuti r a atuação do enfermeiro na sua vigilância. Uti lizaram-se dados secundários referentes às vacinas aplicadas na rede pública de saúde brasileira, no período de 1999 a 2008, totalizando 65.442 registros, sendo 59.899 confi rmados e 1.403 associados com outra vacina. Os 16 eventos de atuação da enfermagem perfi zeram 21.727 registros. Embora representem 35,4% dos registros, os dados não refl etem a realidade, pois sua fi dedignidade depende da rede de conhecimento que engloba diagnósti co, noti fi cação e inclusão no sistema. Discuti ram-se as intervenções para os eventos de maior prevalência: febre e eventos locais. A maioria das intervenções estabelecidas no manual de eventos adversos estava de acordo com a literatura, porém verifi caram-se diferenças de conteúdo entre as condutas para um mesmo evento decorrente de vacinas diferentes. DESCRITORES Vacinação Enfermagem em saúde pública Sistemas de informação ABSTRACTThe objecti ves of this arti cle are to identi fy the adverse events following vaccinati on, the focus if nursing practi ce, using the Post-Vaccinati on Adverse Events Informati on System database, and discuss on the nurses' practi ce on the surveillance for those events. Secondary data were those regarding the vaccines applied in the Brazilian public health system, in the period from 1999 to 2008, totaling 65,442 registers, 59,899 of which were confi rmed and 1,403 were associated with another vaccine. The 16 nursing practi ce events totaled 21,727 registers. Although they account for 35.4% of the registers, the data do not refl ect the reality, because their reliability depends on the knowledge network that comprises diagnosis, noti fi cati on and inclusion in the system. Discussions were made on interventi ons for the most prevalent events: fever and local events. Most interventi ons established in the adverse events manual was in agreement with the literature, though there were diff erences in the content between conducts for the same event due to diff erent vaccines.

Prevalência e fatores associados à ocorrência de eventos adversos pós-vacinação em crianças

“…Also, they may contribute to reduce the losses of opportunities for immunization, as the decisions at the moment of the vaccination screening and post-vaccination follow-up will be made more safely. (3,11,12) Specific measures to prevent AEFI, including proper screening to verify possible contraindications or the need to postpone vaccines, continuous training for vaccinators, and education in health may contribute to the quality and safety of immunization, thus ensuring the advances verified in the eradication and control of diseases preventable by immunization. It is important to mention that the evidence on the safety and effectiveness of vaccines in the routine of immunization in children and adults are significantly favorable.…”

“…In their historic context, it is possible to identify important advances in the reduction of morbidity and mortality rates and in the control of communicable diseases, such as the global eradication of smallpox and the eradication of urban yellow fever in Brazil. (1)(2)(3)(4)(5)(6) Expanding and keeping high and homogeneous immunization coverage is necessary to achieve and maintain these achievements. It is important to mention that the expansion of vaccination coverage leads to the probability of occurrence of adverse events following immunization (AEFI), as vaccines are pharmacological products and are not exempt from causing adverse events in certain individuals.…”

“…Their intensity, however, may vary from mild and expected effects such as local manifestation to moderate and severe events and rare cases, classified as unexpected. (1,3,7) Considering the characteristics of the vaccinees, children under one year old represent the most AEFI-affected group. The highest concentration of vaccines offered and doses applied take place in this age group.…”

“…On the other hand, confirmed cases of AEFI should be disclosed in order to enable health professionals to become aware of them and consequently adopt specific preventive measures, as well as prescribe immunizations with a higher level of safety. (1,3,6) Considering the relevance of information on AEFI for public health, safe immunization, and maintenance of the advances in the control of immunopreventable diseases, the objective of the present study was to characterize AEFI in children under one year old.…”

Care provided by the nursing team in care of post-vaccination adverse events / Cuidados prestados pela equipe de enfermagem no atendimento aos eventos adversos pós-vacinais / Cuidados realizados por la equipo de enfermería...

“…Dentre as ações que são previstas no PNI estão à vigilância do evento adverso pós-vacinal (EAPV), considerado como uma reação clínica, indesejada em alguém que recebeu algum imunobiológicos (2) . Os EAPV, mesmo sendo indesejados são esperados devido à natureza e as características dos imunobiológicos.…”