Missed vaccinations and critical care admission: all you may wish to know or rediscover—a narrative review

Pittet, Laure F; Abbas, Mohamed; Siegrist, Claire‐Anne; Pittet, Didier

doi:10.1007/s00134-019-05862-0

Cited by 8 publications

(8 citation statements)

References 118 publications

(116 reference statements)

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“…Conforme relatado na literatura, pacientes que recebem o diagnóstico, em sua maioria, possuem histórico inadequado de imunização, quando apresentam-se para o atendimento médico (BRASIL, 2019;CAMPOS, 2020;LARRUBIA, 2021;PITTET, 2020;RODRIGO, 2014). A maior probabilidade de imunização incorreta está relacionada às populações rurais e adultos mais velhos, sendo que 70% dos casos diagnosticados concentram-se na faixa etária de 30 a 69 anos (BRASIL, 2019;FILHO, 2000;GOUVEIA, 2009;PITTET, 2020). O caso relatado corrobora o risco elevado de desenvolvimento desta patologia, notando-se história vacinal desconhecida, idade maior que 50 anos e histórico de trabalho em área rural, possibilitando contato com o bacilo.…”

Section: Discussionunclassified

“…O Tétano Acidental (TA), quadro infeccioso não transmissível, é um distúrbio do sistema nervoso central, de elevada letalidade que, apesar de evitável através de vacinação segura e amplamente disponível, é ainda considerado um grave problema de saúde pública (GOUVEIA, 2009;PITTET, 2020;SILVA, 2020). Sua incidência mundial é estimada em 1 milhão de casos por ano, ocorrendo em torno de 300-500 mil óbitos (CAMPOS, 2020;GOV, 2021;LISBOA, 2011;PITTET, 2020). Entre os anos de 2012 a 2021 foram registrados 2.381 casos de Tétano acidental no Brasil, sendo 274 na Região Centro-Oeste (11.5%), que ocupa a 5˚ posição em relação às demais regiões do país.…”

Section: Introductionunclassified

“…A implementação de programas de vacinação, aliada à profilaxia do tétano póstraumático em adultos e ao aperfeiçoamento dos cuidados de terapia intensiva, reduziram significativamente a sua incidência, especialmente nos países desenvolvidos (PITTET, 2020;RODRIGO, 2014;SILVA, 2020). A despeito deste declínio, o tétano permanece como doença negligenciada e endêmica nos países em desenvolvimento, sendo causa importante de morbimortalidade, não se associando com um concomitante declínio na letalidade (BRAUNER, 2002;HERNANDES, 2000;PITTET, 2020;SEXTON, 2017;SILVA, 2020).…”

Section: Introductionunclassified

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Cuidados intensivos em variante cefálica do Tétano acidental tratada com Imunoglobulina humana: relato de caso

Maciel¹,

Serafim²,

Debona³

2023

Braz. J. Hea. Rev.

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O Tétano Acidental é um distúrbio do sistema nervoso caracterizado por espasmos musculares. Apesar de evitável através de vacinação segura e amplamente disponível, configura-se como grave problema de saúde pública, sendo causa importante de elevada morbimortalidade e letalidade. Pode manifestar-se como doença localizada, na qual inclui-se a variante cefálica, forma mais grave da doença. O diagnóstico é essencialmente clínico, baseado em critérios clínicos e epidemiologia sugestiva. O tratamento é melhor realizado em Unidade de Terapia Intensiva, através de cuidados de suporte, base para evitar suas complicações. Relatada a experiência do manejo de um paciente com diagnóstico de variante Cefálica, rara, do Tétano Acidental Grave, atendido na Unidade de Terapia Intensiva de um hospital público do Distrito Federal, tendo evoluído favoravelmente, a despeito do estabelecimento de suporte intensivo e de medidas terapêuticas precoces. O conhecimento acerca desta doença e de sua variante grave, é de extrema relevância, devido à associação a fatores de pior prognóstico e à sua importância clínica, pelas complicações descritas. Reiterando a necessidade de maior conhecimento por parte dos profissionais de saúde, visando-se minimização de atrasos diagnósticos e de evolução desfavorável.

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Section: Discussionunclassified

Section: Introductionunclassified

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Cuidados intensivos em variante cefálica do Tétano acidental tratada com Imunoglobulina humana: relato de caso

Maciel¹,

Serafim²,

Debona³

2023

Braz. J. Hea. Rev.

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“…Some VPDs are highly contagious and can cause healthcare-associated infections with severe complications, especially in individuals with comorbidities or immune-depression, in new-borns and pregnant women [ 4 , 5 ]. Intensive care units are related to a higher number of infections, due to a higher chance of exposure and the presence of patients with a higher risk of complications [ 6 , 7 , 8 ]. Cases of infection within an intensive care unit can have significant clinical and organisational consequences: they can compromise unstable medical conditions or susceptible HCWs, and they can also cause economic, occupational, personal and family implications [ 4 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Knowledge, Attitudes and Behaviours of Health Care Workers towards Vaccine-Preventable Diseases and Recommended Vaccinations: An Observational Study in a Teaching Hospital

et al. 2023

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Background: Recommended vaccinations are the cheapest and most effective measure to reduce the risk of transmission and related complications, especially in high-risk healthcare settings. This study aimed to evaluate the knowledge, attitudes and behaviours of HCWs in relation to national recommendations. Methods: A transversal study was conducted through administration of a questionnaire by personal interview. The following care units were involved: Paediatric, Neonatal, Cardiac Surgery and General Intensive Care Units and Infectious Diseases Unit. Results: The study sample comprised 308 HCWs. Half the sample were aware of the vaccination recommendations, with occupation and age found to be predictive factors (OR = 9.38, 95%CI: 2.07–42.41; OR = 0.36, 95%CI: 0.22–0.60). A higher percentage defined the diseases as a risk for their patients’ health, although this perception was lower in the over-40 age group. In several cases, there were statistically significant differences between the care units (p < 0.001). Around three-quarters of the sample agreed that vaccination should be mandatory; willingness to undergo a future booster vaccination was statistically correlated with the variables of age and care unit (p < 0.001, p = 0.03). Conclusion: The protection of health in the workplace can be achieved through some strategic actions, such as the implementation of educational strategies, and protocols for the monitoring of immunocompetence and the improvement of vaccination.

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“…Worst outcomes are well illustrated by the severity of measles infection, which carries a 40% to 70% fatality rate among immunocompromised patients, despite adequate treatment, up to 35-fold higher compared with immunocompetent hosts [ 3 ]. Measles and other vaccine-preventable diseases have recently re-emerged in many regions, mostly due to declining vaccine uptake [ 4 , 5 ]. As herd protection cannot be relied on, prevention of vaccine-preventable diseases in vulnerable population is key.…”

Section: Introductionmentioning

confidence: 99%

Vaccination of immune compromised children—an overview for physicians

Pittet

Posfay‐Barbe

2021

Eur J Pediatr

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Immune compromised children are threatened by a higher risk of infections; some of these are preventable by vaccination. Primary care physicians play a fundamental role in optimising vaccination status. In this narrative review, we present the evidence on vaccine safety and immunogenicity in immune compromised children and discuss in which conditions live-attenuated vaccines can possibly be used. Vaccination schedules differ in some of these conditions, including the use of vaccines with higher antigenic contents (e.g. high-dose hepatitis B vaccine), additional vaccine doses (e.g. 2-dose schedule meningococcal vaccine), more frequent booster doses (e.g. life-long pneumococcal vaccine booster), supplementary vaccines (e.g. meningococcal B vaccine) and use of vaccines beyond the age of usual recommendation (e.g. Haemophilus influenza type b vaccine after 5 years of age). Serological monitoring is a useful tool for customizing vaccination schedule in immune compromised children, confirming adequate vaccine response and documenting seroprotection (especially against measles and varicella). Finally, verification of vaccination status of all household members can prevent them being vector of transmission of an infection to the immune compromised children. Conclusion: Intensified information strategies are needed to improve trust, rectify perceived risks and improve vaccine acceptability; primary physicians can play a critical role in the latter. What is Known:• Physician’s awareness is key to success, since it repeatedly correlates with higher vaccination rates What is New:• The vaccination status of immunocompromised children is rarely up-to-date• Knowing the latest vaccine recommendations is challenging, as they differ for each medical condition and change periodically• This review summarises the vaccine recommendations for children with compromised immune systems and highlights how paediatricians play a key role in coordinating their application

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Missed vaccinations and critical care admission: all you may wish to know or rediscover—a narrative review

Cited by 8 publications

References 118 publications

Cuidados intensivos em variante cefálica do Tétano acidental tratada com Imunoglobulina humana: relato de caso

Cuidados intensivos em variante cefálica do Tétano acidental tratada com Imunoglobulina humana: relato de caso

Analysis of Knowledge, Attitudes and Behaviours of Health Care Workers towards Vaccine-Preventable Diseases and Recommended Vaccinations: An Observational Study in a Teaching Hospital

Vaccination of immune compromised children—an overview for physicians

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