Browsing by Author "Tuells Hernández, José Vicente"

Background: Pregnant women should receive two vaccines during pregnancy due to maternal-foetal complications and risks as well as the influenza and pertussis vaccinations. The goal was to evaluate vaccination coverage against influenza and pertussis in pregnant women, following midwife professional advice during the pregnancy follow-up; Methods: Prospective cohort study of 1017 pregnancies during the vaccination campaign in 2015–2016. To estimate the degree of consistency between the coverage declared by mothers and that registered in the Nominal Vaccination Registry (NVR), we used the Cohen’s kappa index (k); Results: 95.4% were registered in the NVR. Vaccination coverage recorded against influenza was 64.2% (95% CI: 61.2–67.2), and 89.8% (95% CI: 87.9–91.7) against pertussis. The coverage of the pregnant women interviewed was 61.7% (95% CI: 58.1–67.3)) for influenza and 92.3% (95% CI: 91.4–95.3) for pertussis. Subsequent interviews of 67.2% of the women produced a kappa agreement index between the data obtained from interviews and those recorded in the NVR of 0.974 (IC95%: 98.0–99.6) for influenza, and 0.921 (IC95%: 98.1–99.7) for pertussis. The women identified midwives as the main source of vaccination information and advice 88.4% (IC95%: 85.8–90.9); Conclusions: The NVR is an effective platform for estimating immunisation coverage in pregnant women. The degree of agreement between declared vaccinations and registered vaccinations was high for both vaccines.

Due to the COVID-19 pandemic, physical therapists have had to adopt a set of specific protection measures, which have had an impact on their clinical activity and economy. The objective was to evaluate the impact of the COVID-19 pandemic on the work of Spanish physical therapists, as well as their attitudes and predisposition to vaccination. An online questionnaire was divided into five sections: (1) demographic and professional data; (2) labor impact; (3) precautions and infection-control measures; (4) economic impact; and (5) vaccine acceptance and adverse effects. Of the 666 participants, 62.1% showed a reduction in their working hours motivated by: fear of infection (p = 0.007), financial issues (p = 0.002) and being in quarantine or isolation (p < 0.001). Of these, 36.4% were forced to close the clinic, 62.7% requested help from the government, but only 12.04% mentioned that it was adequate. The main prevention measures adopted were the use of gels and masks and, in the private sector, disinfection with ozone or ultraviolet light (p < 0.05). The acceptance of the vaccine was high, 87.5%, being lower among the group over 40 years of age, self-employed, widowed or separated. More adverse effects were mentioned after receiving the AstraZeneca-Oxford vaccine, compared to Pfizer-BioNTech or Moderna. In conclusion, this study assessed for the first time that the COVID-19 pandemic in Spain had a negative impact on work and finances of physical therapists. The vaccine was widely accepted, in part by the economic impact that an infection in the work setting could signify.

A good perception of the vaccines administered during pregnancy favors immunization coverage, which is still not optimal for the influenza vaccine. To understand the predisposition towards vaccination in future pregnancies, a study was performed that evaluated the experiences of women with the vaccine or influenza. A cross-sectional study was conducted through telephone interviews given to a total of 683 postpartum women in two health departments from the Valencia Community (Spain). This interview asked about their intention of becoming vaccinated in future pregnancies and whether they were favor or against vaccination. Most of them, 98.5% (n = 673 [95% CI: 97.6–99.4]) (p < 0.001) declared having received the systematic vaccines throughout their lives. The ones who were vaccinated against influenza, 91.9% (n = 387 [95% CI: 89.2–94.6]) (p < 0.001) manifested they would do so in future pregnancies. The probability of future non-vaccination was modeled, which was related to an unfavorable opinion towards vaccines (OR = 4.07 [95% CI: 2.01–8.24]) (p < 0.001), having su ered from influenza during pregnancy (OR = 3.84 [95% CI: 1.41–10.42]) (p < 0.05), and not having been vaccinated during previous pregnancies (OR = 38.47 [95% CI: 23.58–62.76]) (p < 0.001). Vaccination during pregnancy increases the intent of vaccination in the future.

Background and Objectives:To describe the knowledge and attitudes related to the acceptanceof the flu vaccine during pregnancy in women, from two Health Departments of the ValencianCommunity (VC), during the 2015–2016 season, after receiving prenatal care.Materials and Methods:A prospective observational study was conducted during the annual vaccine season of womenascribed to prenatal care. A midwife offered flu vaccine advice and afterwards conducted a telephonepoll of a representative sample, in order to find out the reason for accepting or rejecting the vaccine.Results:Of the 1017 expectant women who received advice about the vaccine, 77.4% (95% CI:74.8–79.9%) declared their intention to vaccinate. After the recommendation, the vaccine coveragewas 61.6%, with a percentage of accordance of 98.8% (95% CI: 98.0–99.6%) between the coveragedeclared and the Nominal Vaccination Registry (NVR) of the VC. Additionally, 67.2% of the expectantwomen were interviewed (n=683). Most were aware of the recommendation and identified thehealth center and the midwife as the main sources of information. The internet was a consistentsource in favor of vaccination 80.8% (n=42). The obstetric variables (risk during the pregnancy,end of pregnancy, and feeding the newborn) did not have a statistically significant relationship withthe vaccination. The women declared a high adherence to the vaccinations present in the childvaccination calendar, but rejected (31.3%) the flu vaccine, as they had not received it previouslyand did not want it because of their expectant state.Conclusions:The women positively evaluatedthe effectiveness and safety of the vaccines. However, with the flu vaccine, “not being previouslyvaccinated” and the “doubts about its safety” represented more than half of the reasons put forthfor its rejection. Ensuring that the flu vaccine is perceived as more effective and acceptable throughthe messages directed towards the expectant mothers, directly through the midwives or through thecommunication media and social networks, will result in an increase of vaccine coverage.

Health professionals are the most influential and main sources of information about vaccines for the general population, as they are regarded as role models by patients and society. The objective of the present study was to determine the knowledge and attitudes of a group of university Nursing students about vaccines, as well as their sources of information and their education needs. A cross-sectional study was performed through a questionnaire (55 items) provided to Nursing students at two Spanish universities. A total of 1122 students participated in the study. The mean score obtained for knowledge about vaccines was 44.6 4.3, and for attitudes towards vaccines, it was 37.2 3.9. Hepatitis B (94.7%) and the Flu (89%) are the two main vaccines they should receive as health workers. The main source of information was the family environment (65.6%). Most of them considered that post-graduate education about vaccines should be provided by academic entities (universities, 62.7%). Among the health professionals, Nurses (85.5%) must be better educated and trained on the subject of vaccines. It is therefore necessary to delve into and complete the nurses’ training on vaccines, to educate them about the risks at the individual level, and their decisive role as promoters of the vaccination strategy for the general population. Universities must become the leaders in vaccine education and training.

Antecedentes. La aparición de nuevas enfermedades infecciosas, como el COVID-19, supone un reto en el seguimiento de la gestación y la prevención de complicaciones obstétricas y neonatales. La revisión exploratoria tiene el objetivo de revisar la información disponible en mujeres embarazadas infectadas por los coronavirus MERS-CoV, SARS-CoV, SARS-CoV-2 para evaluar las similitudes y diferencias en las características clínicas de las madres y los resultados neonatales. Métodos. Realizamos una búsqueda bibliográfica (revisión exploratoria) acorde a las pautas de PRISMA entre marzo y abril del 2020 en las bases de datos de MEDLINE, SciELO, y CUIDEN y el Centro de Información sobre el COVID-19 de Elsevier. Resultados. Analizamos 20 artículos con un total de 102 casos: 9 de MERS-CoV, 14 de SARS-CoV y 79 de SARS-CoV-2. La fiebre (75,5%) y la neumonía (73,5%) resultaron ser los síntomas más frecuentes en las gestantes infectadas. Las complicaciones obstétricas más frecuentes fueron la amenaza de parto prematuro (23,5%) y la cesárea (74,5%). No se documentó ninguna transmisión vertical en los neonatos. Conclusiones. Los tres coronavirus producen una neumonía con sintomatología muy similar, resultando más leve en el caso de SARS-CoV-2. A pesar de las complicaciones obstétricas documentadas, los resultados neonatales son favorables en su mayoría. Es preciso aumentar el conocimiento para mejorar y prevenir las complicaciones obstétricas y neonatales de estas infecciones en mujeres embarazadas. / Background. The appearance of new infectious diseases, such as COVID-19, poses a challenge in monitoring pregnancy and preventing obstetric and neonatal complications. A scoping review has the objective to review the information available in pregnant women infected with the MERS-CoV, SARSCoV, SARS-CoV-2 coronaviruses to assess the similarities in terms of and differences in the clinical characteristics of the mothers and neonatal outcomes. Methods. We carried out a bibliographic search (scoping review) according to the PRISMA guidelines between March and April 2020 in the MEDLINE, SciELO, and CUIDEN databases and the Elsevier COVID-19 Information Center. Results. We analyzed 20 articles with a total of 102 cases. 9 of MERS-CoV, 14 of SARS-CoV and 79 of SARS-CoV-2. Fever (75.5%) and pneumonia (73.5%) were the most frequent symptoms in infected pregnant women. The most frequent obstetric complications were the threat of premature delivery (23.5%) and caesarean section (74.5%). No vertical transmission was documented in any of the infants. Conclusions. All three coronaviruses produce pneumonia with very similar symptoms, being milder in the case of SARSCoV2. Despite documented obstetric complications, neonatal outcomes are mostly favorable. Increased knowledge is needed to improve and prevent obstetric and neonatal complications from these infections in pregnant women.

Background. To study influenza vaccination uptake in pregnant women from three Health Departments in the Valencian Community (Spain) during the 2014-15 flu season, to identify degree of knowledge, sources of information and attitudes toward immunization against influenza. Methods. Multicentre cross-sectional descriptive study during the 2014-15 vaccination campaign. Vaccine coverage was determined using the Nominal Vaccination Registry (NVR). Subsequently, a telephone survey was carried out on a sample of vaccinated and unvaccinated postpartum women. Results. The NVR had information on 934 (59.5%) out of 1,569 postpartum women; distribution per Health Departments was: 420 (44.9%), 161 (17.2%) and 353 (37.8%) in La Ribera, Torrevieja and Elx-Crevillent respectively. Vaccine uptake was 27.9% (n = 261). According to the “Country of Origin” variable, 77.5% (n = 724) of women were Spanish, with a vaccination rate of 26.7% (n = 193), compared to 22.5% (n = 210) who were non-Spanish, with a rate of 32.4% (n = 68). The main source of information was midwives for 83.7% (n = 159) of vaccinated pregnant women and for 44.6% (n = 127) of non-vaccinated women. The main reasons for vaccine refusal were lack of awareness (29.5%, n = 84) and not considering it necessary (25.6%, n = 73). Conclusion. Despite their high willingness to be vaccinated after receiving information about the flu vaccine, the vaccination coverage in pregnant women studied is still low and can be improved. Health professionals need new information strategies to extend vaccine uptake to a larger number of pregnant women in Spain. Midwife advice plays an essential role in transmitting information on influenza vaccination in pregnant women and has a significant impact on uptake. / Objetivos. Investigar la cobertura de la vacunación antigripal en gestantes en tres Departamentos de Salud de la Comunidad Valenciana (España) durante la temporada 2014-15, y evaluar su aceptabilidad, fuentes de información y motivos de rechazo hacia la inmunización contra la gripe. Métodos. Estudio descriptivo transversal multicéntrico en la campaña vacunal 2014-15. La cobertura vacunal se identificó a través del Registro Nominal de Vacunas (RVN). Posteriormente, se realizaron 2 encuestas telefónicas a un mínimo muestral de puérperas vacunadas y no vacunadas. Resultados. De 1.569 puérperas, 934 (59,5%) disponen de información en el RVN; la distribución por Departamentos: 420 (44,9%), 161 (17,2%) y 353 (37,8%) en La Ribera, Torrevieja y Elx-Crevillent respectivamente. Se obtuvo una cobertura vacunal del 27,9% (n=261). Según la variable “País de Origen”, el 77,5% (n=724) es española, con una tasa vacunal del 26,7% (n=193), frente al 22,5% (n=210) extranjera, con el 32,4% (n=68). La principal fuente de información fue la matrona en el 83,7% (n=159) de gestantes vacunadas y el 44,6% (n=127) en no vacunadas. Los principales motivos de rechazo fueron el desconocimiento (29,5%; n=84) y el no considerarse imprescindible (25,6%; n=73). Conclusiones. A pesar de su alta predisposición a vacunarse después de recibir información sobre la vacuna contra la gripe, la cobertura de vacunación en mujeres embarazadas estudiadas es aún baja y puede mejorarse. Son necesarias nuevas estrategias de formación e información por parte de los profesionales sanitarios para obtener un mayor número de gestantes vacunadas. El consejo de la matrona es un factor esencial en la emisión de la información sobre la vacunación antigripal recibida por las gestantes estudiadas.

FUNDAMENTOS // Los anticuerpos neutralizantes frente al SARS-CoV-2 han resultado una herramienta eficaz para el análisis de la inmunidad generada frente a la COVID-19. Numerosos estudios de seroprevalencia realizados en diferentes colectivos han permitido trazar un mapa global sobre la cobertura vacunal mediante el uso de pruebas serológicas rápidas de inmunocromatografía de flujo lateral con fines clínicos y epidemiológicos. El objetivo de nuestro estudio fue determinar el grado de inmunidad frente al SARS-CoV-2 asociado a la presencia de anticuerpos neutralizantes en personal administrativo, docentes y estudian-tes de la Universidad de Alicante, mediante un test serológico rápido, así como conocer su experiencia sobre la vacunación frente a la COVID-19.MÉTODOS // Se diseñó un estudio epidemiológico, transversal, basado en la prevalencia de anticuerpos frente a la proteína S (espícula o Spike) del SARS-CoV-2. Participaron un total de 888 personas. El estudio se llevó a cabo con un único test (6 de julio a 22 de julio de 2021). Mediante regresión logística se calcularon Odds Ratios ajustadas según sexo, edad, tipo de vacuna, número de dosis de vacuna recibidas, pauta completa de vacunación y haber padecido la COVID-19.RESULTADOS // Las vacunas recibidas mayoritariamente fueron Vaxzevria® y Comirnaty®, con un 73,3% entre ambas; el 67,2% presentó pauta completa. Los resultados del test rápido de anticuerpos neutralizantes OJABIO dieron un resultado positivo en el 61,4% de la muestra. La posibilidad de un resultado positivo en el test OJABIO estuvo fuertemente asociada a haber padecido la COVID-19, haber recibido dos dosis, estar vacunado con Spikevax® o Comirnaty®o pertenecer al grupo de dieciocho a veintinueve años. Un total de 712 sujetos respondieron a un cuestionario (80%) paralelo sobre los efectos adversos y las preferencias entre las distintas vacunas contra la COVID-19.CONCLUSIONES // El estado de vacunación frente a la COVID-19 en la comunidad universitaria a los seis meses de la puesta en marcha de las estrategias nacionales de inmunización refleja una baja cobertura asociada, a pesar de la excelente predisposición a vacunarse. Los test rápidos de anticuerpos neu-tralizantes (AcN) pueden ser de utilidad para orientar las estrategias de inmunización y para decidir el momento de administrar nuevas dosis de refuerzo.

Vaccine hesitancy has increased in the past few years, influenced by the socio-cultural differences, political populism, or concerns related to the effectiveness and safety of some vaccines, resulting a feeling of distrust. This feeling can become a barrier against the achievement of the immunity necessary to stop the expansion of COVID-19. The aim of this study was to evaluate the acceptance of the vaccine against COVID-19 in Spain, as well as to identify the factors that have an influence on the concerns and attitudes of people against accepting the vaccine in the months prior to the start of vaccination on December 2020. An online questionnaire was created to obtain information about (1) sociodemographic characteristics; (2) concerns and sources of information about vaccines; and (3) attitudes about vaccination and state of health. A multivariate logistic regression was performed to identify the influencing factors. Of the 2501 participants, 1207 (48.3%) would accept the COVID-19 vaccine, 623 (24.9%) were hesitant, and 671 (26.8%) would reject it. The logistic regression showed that being male, older than 60, married, retired, with a high level of education, or with a leftist political inclination, could increase the probability of accepting the COVID-19 vaccine. Disinformation and the lack of political consensus were the main sources of distrust. The patients with hypertension, immunodepression, hypercholesterolemia, or respiratory disease, or were overweight, showed a greater acceptance to the vaccine, while those with cancer took the longest to accept it. A low acceptance of the vaccine against COVID-19 was observed among the Spanish population in the phase prior to its availability, and the main fears of the population were identified. It is necessary to offer correct and transparent information about these vaccines to reduce the concerns and increase the trust of the population, to thereby guarantee the success of the vaccination campaigns.