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Safety of two-dose schedule of COVID-19 adsorbed inactivated vaccine (CoronaVac; Sinovac/Butantan) and heterologous additional doses of mRNA BNT162b2 (Pfizer/BioNTech) in immunocompromised and immunocompetent individuals
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Miyaji, Karina Takesaki

; Ibrahim, Karim Yaqub

; Infante, Vanessa

; Moreira, Raquel Megale

; Santos, Carolina Ferreira dos Belizário, Juliana de Cássia Pinto, Maria Isabel de Moraes Marinho, Ana Karolina Barreto Berselli Pereira, Juliana Marquezi Mello, Liliane Saraiva de Silva, Vitor Gabriel Lopes da Sato, Paula Keiko Strabelli, Tânia Mara Varejão Ragiotto, Lucas Pacheco, Pedro Henrique Theotonio de Mesquita Braga, Patricia Emilia Loch, Ana Paula Precioso, Alexander Roberto Sartori, Ana Marli Christovam França, João Ítalo Lima, Marcos Alves de Ando, Mauricio Cesar Sampaio Rodrigues, Camila Cristina Martini Song, Alice Tung Wan Lara, Amanda Nazareth Belizário, Ana Cristina Lima, Anna Helena Simões Bortulucci de Zanetti, Ariane Cristina Barboza Paulo, Audrey Rose da Silveira Amancio de Rosa, Barbara Miranda dos Santos Moraes, Bruna Del Guerra de Carvalho Oliveira, Bruna Ribeiro de Picone, Camila de Melo Aranda, Carolina Sanches Troli, Carolinne Paioli Kokron, Cristina M. Terrabuio, Debora Raquel Benedita Abdala, Edson David Neto, Elias Nakanishi, Érika Yoshie Shimoda Lima, Fabiana Mascarenhas Souza Firmino, Fabio Batista Santos, Fernanda Barone Alves dos Bacal, Fernando Fatobene, Giancarlo Santana, Jaqueline Oliveira Kalil, Jorge Barbosa, Julia Gonçalves, Leandro Peres Otuyama, Leonardo Jun Pierrotti, Ligia Camera Compte, Livia Caroline Mariano Marinho, Livia Chaer, Livia Netto Seguro, Luis Fernando Azevedo, Luiz Sergio Ueda, Márcia Aiko Terreri, Maria Teresa Barros, Myrthes Anna Maragna Toledo Grecco, Octávio Sejas, Odeli Nicole Encinas Musqueira, Priscila Tavares Ito, Raquel Keiko de Luca Teixeira, Samia Silveira Souza Fidalgo, Serafim Costa, Silvia Figueiredo Campos, Silvia Vidal Fernandes, Tamiris Hinsching Rocha, Vanderson Geraldo Coelho, Vivian Caso

Revista do Instituto de Medicina Tropical de São Paulo

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2025, Volume 67 elocation e2

Abstract: En | Text: En | PDF: En

ABSTRACT Immunocompromised individuals were considered high-risk for severe disease due to SARS COV-2 infection. This study aimed to describe the safety of two doses of COVID-19 adsorbed inactivated vaccine (CoronaVac; Sinovac/Butantan), followed by additional doses of mRNA BNT162b2 (Pfizer/BioNTech) in immunocompromised (IC) adults, compared to immunocompetent/healthy (H) individuals. This phase 4, multicenter, open label study included solid organ transplant and hematopoietic stem cell transplant recipients, cancer patients and people with inborn errors of immunity with defects in antibody production, rheumatic, end-stage chronic kidney or liver disease, who were enrolled in the IC group. Participants received two doses of CoronaVac and additional doses of mRNA BNT162b2. Adverse reactions (AR) data were collected within seven days after each vaccination. Serious adverse events and of special interest (AESI) were monitored throughout the study. We included 241 immunocompromised and 100 immunocompetent subjects. Arthralgia, fatigue, myalgia, and nausea were more frequent in the IC group after CoronaVac. Following the first additional dose of mRNA BNT162, pain, induration, and tenderness at injection site, fatigue and myalgia were more frequent in the H group. A heart transplant recipient had a graft rejection temporally associated with the second CoronaVac dose, but there was no literature evidence of causal association. Four cases of AESI were considered related to the vaccine: three erythema multiforme after CoronaVac, all in IC participants, and one paresthesia after mRNA, in a H participant. Our findings were comparable to other studies that evaluated the safety of COVID-19 vaccines in different immunocompromised populations. Both vaccines were safe for immunocompromised participants.

https://doi.org/10.1590/s1678-9946202567002

School-based HPV vaccination program implementation in municipalities of the São Paulo State, Brazil, from 2015 to 2018
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Piorelli, Roberta de Oliveira

; Sato, Helena Keiko

; Araújo, Nubia Virgínia D’Ávilla Limeira de

; Braga, Patrícia Emília

; Miyaji, Karina Takesaki

; Sartori, Ana Marli Christovam

Cadernos de Saúde Pública

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2025, Volume 41 N. 2 elocation e00127423

Abstract: Pt Es En | Text: Pt Es En | PDF: Pt | PDF: Es | PDF: En

A vacina contra o 4vHPV foi introduzida no Programa Nacional de Imunizações em 2014, com vacinação em escolas e unidades de saúde. Dados sobre a implementação do programa de vacinação contra o HPV nas escolas, no Brasil são escassos. Este estudo transversal e exploratório buscou compreender melhor as ações de vacinação contra o HPV e as barreiras para a implementação da vacinação escolar nos municípios do Estado de São Paulo, no período de 2015 a 2018, sob a ótica dos responsáveis pela realização das ações. Em novembro de 2018, foi enviado um questionário aos grupos regionais de vigilância estaduais para ser respondido pelos responsáveis pelas ações de vacinação nos municípios. O questionário continha seis questões abertas sobre as ações de vacinação contra o HPV realizadas pelos municípios no período de 2015 a 2018, incluindo se a vacinação escolar havia sido implementada ou não, uma descrição do programa, as barreiras para implementá-lo, como o programa foi avaliado e os planos do município para o programa de vacinação contra o HPV nos próximos anos. Dos 645 municípios, 233 (36,1%) responderam ao questionário. A maioria deles implementou ações de educação ou vacinação nas escolas. As barreiras relatadas foram escassez de recursos humanos em saúde, preocupações da equipe de educação com a vacinação nas escolas, e alunos e pais não familiarizados com a vacinação contra o HPV. Aumentar a conscientização sobre a doença e a prevenção do HPV entre alunos e pais, garantir recursos humanos adequados e construir uma parceria robusta entre os setores de saúde e educação são essenciais para um programa de vacinação escolar bem-sucedido.

La vacuna contra el 4vVPH se incluyó en el Programa Nacional de Inmunización brasileño en 2014, con vacunación en escuelas y centros de salud. Los datos sobre la implementación del programa de vacunación contra el VPH en escuelas de Brasil son escasos. Este estudio transversal y exploratorio se propone comprender las acciones de vacunación contra el VPH y las barreras para la implementación de la vacunación en escuelas en los municipios del estado de São Paulo, en el período de 2015 a 2018, desde la perspectiva de los responsables de llevar a cabo las acciones. En noviembre de 2018, se envió un cuestionario a los grupos regionales de vigilancia de los estados para ser respondido por los responsables de las acciones de vacunación en los municipios. El cuestionario contenía seis preguntas abiertas sobre las acciones de vacunación contra el VPH llevadas a cabo por los municipios en el período de 2015 a 2018, relacionadas a si se había implementado o no la vacunación escolar, una descripción del programa, las barreras para implementarla, cómo se evaluó el programa y los planes del municipio para el programa de vacunación contra el VPH en los próximos años. De los 645 municipios, 233 (36,1%) respondieron al cuestionario. La mayoría de ellos implementaron acciones de educación o vacunación en las escuelas. Las barreras reportadas fueron la escasez de recursos humanos en salud, las preocupaciones del equipo educativo con la vacunación en las escuelas, y los estudiantes y padres que no están familiarizados con la vacunación contra el VPH. Una mayor concientización entre los estudiantes y sus padres sobre la enfermedad y la prevención del VPH, la garantía de recursos humanos adecuados y la creación de una sólida asociación entre los sectores de la salud y de la educación son fundamentales para que el programa de vacunación escolar sea exitoso.

4vHPV vaccine was introduced into the Brazilian National Immunization Program in 2014, with vaccination at schools and healthcare facilities. Data on HPV vaccination program implementation in Brazil are scarce. This cross-sectional, exploratory study aimed to get a better understanding of the HPV vaccination actions and barriers to implement the school-based vaccination in municipalities of the São Paulo State, from 2015 to 2018, from the point of view of people who were responsible for conducting the actions. In November 2018, a questionnaire was sent to the state’s regional surveillance groups to be answered by people responsible for the vaccination actions in the municipalities. The questionnaire consisted of six open questions on HPV vaccination actions taken by the municipalities, from 2015 to 2018, including whether the school-based vaccination had been implemented or not, a program description, the barriers to implement it, how the program was evaluated, and the municipality plans regarding HPV vaccination program in the following years. 233 (36.1%) of the 645 municipalities answered the questionnaire. Most of them implemented both education or vaccination actions at schools. Reported barriers were health human resources shortage, education staff concerns on vaccination within schools, and students’ and parents’ unfamiliarity with HPV vaccination. Raising awareness on HPV infection and prevention among students and parents, ensuring appropriate human resources, and building a partnership between the health and education sectors are critical to have a successful school-based program.

https://doi.org/10.1590/0102-311xen127423

Immunogenicity of COVID-19 adsorbed inactivated vaccine (CoronaVac) and additional doses of mRNA BNT162b2 vaccine in immunocompromised adults compared with immunocompetent persons COVID19 COVID 19 COVID-1 CoronaVac (CoronaVac BNTb BNT b BNT162b COVID1 1 COVID-
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Ibrahim, Karim Yaqub

; Moreira, Raquel Megale

; Santos, Carolina Ferreira dos

; Strabelli, Tânia Mara Varejão

; Belizário, Juliana de Cássia

; Pinto, Maria Isabel de Moraes

; Marinho, Ana Karolina Barreto Berselli

; Pereira, Juliana Marquezi

; Mello, Liliane Saraiva de

; Ando, Mauricio Cesar

; Silva, Vitor Gabriel Lopes da

; Sato, Paula Keiko

; Lima, Marcos Alves de

; França, João Italo Dias

; Loch, Ana Paula

; Miyaji, Karina Takesaki

; Infante, Vanessa

; Precioso, Alexander Roberto

; Sartori, Ana Marli Christovam

Revista do Instituto de Medicina Tropical de São Paulo

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2024, Volume 66 elocation e24

Abstract: En | Text: En | PDF: En

ABSTRACT Inactivated COVID-19 vaccines data in immunocompromised individuals are scarce. This trial assessed the immunogenicity of two CoronaVac doses and additional BNT162b2 mRNA vaccine doses in immunocompromised (IC) and immunocompetent (H) individuals. Adults with solid organ transplant (SOT), hematopoietic stem cell transplant, cancer, inborn immunity errors or rheumatic diseases were included in the IC group. Immunocompetent adults were used as control group for comparison. Participants received two CoronaVac doses within a 28-day interval. IC received two additional BNT162b2 doses and H received a third BNT162b2 dose (booster). Blood samples were collected at baseline, 28 days after each dose, pre-booster and at the trial end. We used three serological tests to detect antibodies to SARS-CoV-2 nucleocapsid (N), trimeric spike (S), and receptor binding domain (RBD). Outcomes included seroconversion rates (SCR), geometric mean titers (GMT) and GMT ratio (GMTR). A total of 241 IC and 100 H adults participated in the study. After two CoronaVac doses, IC had lower SCR than H: anti-N, 33.3% vs 79%; anti-S, 33.8% vs 86%, and anti-RBD, 48.5% vs 85%, respectively. IC also showed lower GMT than H: anti-N, 2.3 vs 15.1; anti-S, 58.8 vs 213.2 BAU/mL; and anti-RBD, 22.4 vs 168.0 U/mL, respectively. After the 3rd and 4th BNT162b2 doses, IC had significant anti-S and anti-RBD seroconversion, but still lower than H after the 3rd dose. After boosting, GMT increased in IC, but remained lower than in the H group. CoronaVac two-dose schedule immunogenicity was lower in IC than in H. BNT162b2 heterologous booster enhanced immune response in both groups. COVID19 COVID 19 COVID-1 scarce BNTb BNT b BNT162b (IC (H SOT, SOT , (SOT) cancer comparison 28day day interval booster. . (booster) baseline 2 prebooster pre end SARSCoV2 SARSCoV SARS CoV SARS-CoV- N, N (N) S, S (S) RBD. RBD (RBD) SCR, (SCR) (GMT GMTR. GMTR (GMTR) 24 10 study antiN, antiN anti anti-N 333 33 3 33.3 79% 79 antiS, antiS 338 8 33.8 86 86% antiRBD, antiRBD RBD, 485 48 5 48.5 85 85% respectively 23 2. 15.1 151 15 1 588 58 58. 2132 213 213. BAU/mL BAUmL BAU mL 224 22 4 22. 1680 168 0 168. UmL U U/mL rd th boosting twodose groups COVID1 COVID- (SOT (booster SARS-CoV (N (S (RBD (SCR (GMTR 33. 7 48. 15. 21 16

https://doi.org/10.1590/s1678-9946202466024

Adverse events following immunization of elderly with COVID-19 inactivated virus vaccine (CoronaVac) in Southeastern Brazil: an active surveillance study
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Miyaji, Karina Takesaki

; Itto, Lucas Yuji Umesaki

; Jacintho, Lucas Caue

; Sales, Amanda Caroline Ribeiro

; Hiratsuka, Marcel

; Leonel, Fabio Campos

; Higa-Taniguchi, Keila Tomoko

; Picone, Camila Melo

; Lara, Amanda Nazareth

; Rodrigues, Camila Cristina Martini

; Lopes, Marta Heloisa

; Sartori, Ana Marli Christovam

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e56

Abstract: En | Text: En | PDF: En

ABSTRACT Healthcare workers, the elderly and other vulnerable populations were the first to receive COVID-19 vaccines in public health programs. There were few vaccine safety data available on the elderly. This observational study aimed to evaluate the inactivated vaccine (CoronaVac) safety in the elderly, at the beginning of the vaccination program, in Sao Paulo city, Brazil. The elderly people that received CoronaVac at the Reference Center for Special Immunobiologicals (CRIE) or at home, administered by the Interdisciplinary Home Care Team (NADI) of the Hospital das Clinicas were invited to participate in this phase 4 observational study. The vaccination schedule included two CoronaVac doses 28 days apart. The information on solicited and unsolicited adverse events following immunization were collected by phone calls on days 4 and 8 after each vaccine dose. We enrolled 158 adults aged 65 to 101 years (mean of 84.1 years); 63.9% were females and 95.6% had chronic conditions, 21.5% had moderate or severe impairment in daily living activities; 34.2% were pre-frail and 19.6% were frail. We were able to contact 95.6% and 91.6% of the vaccinated people, after the first and second doses, respectively; 31.8% and 23.4% of the contacted participants reported some adverse events (AE) following the first and second doses, respectively. Pain at the injection site, fatigue, myalgia and headaches were the most frequent solicited AE. Most AE were mild to moderate. There were eight severe adverse events, but none of them were considered related to the vaccine. The CoronaVac was safe and well tolerated by these adults of advanced age with frailty and comorbidities.

https://doi.org/10.1590/s1678-9946202264056

Adverse events following yellow fever vaccination in immunocompromised persons
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Lara, Amanda Nazareth

; Miyaji, Karina Takesaki

; Ibrahim, Karim Yaqub

; Lopes, Marta Heloisa

; Sartori, Ana Marli Christovam

Revista do Instituto de Medicina Tropical de São Paulo

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2021, Volume 63 elocation e13

Abstract: En | Text: En | PDF: En

ABSTRACT This observational retrospective study conducted during an yellow fever (YF) outbreak in Sao Paulo, Brazil, in 2017-2018, describes adverse events (AE) following YF vaccination of immunocompromised persons. Risks and benefits of vaccination were individually evaluated by physicians. AE were assessed by phone call or electronic mail, 14 to 90 days after vaccination. Three hundred and eighty one immunocompromised persons received a full-dose of YF vaccine. Their age ranged from 1.4 to 89.3 years (median 50.8 years); 53% were women; 178 (46.7%) had chronic kidney disease, 78 (20.5%) had immune-mediated inflammatory diseases; 94 (24.7%) were using or had recently used immunosuppressive/ immunomodulatory drugs. All of them denied previous YF vaccination. We were able to contact 341 (89.5%) vaccinees: 233 (68.3%) of them received the YF vaccine from BioManguinhos and 108 (31.7%) received the vaccine from Sanofi-Pasteur; 130 (38.1%) vaccinees received other vaccines (up to 4) simultaneously with the the YF vaccine, mostly hepatitis B (59 vaccinees), pneumococcal polysaccharide 23-valent (46), influenza (43) and diphtheria-tetanus (dT, 41). One hundred and eleven vaccinees (32.6%) reported at least one AE: 79 (23.2%) presented systemic AE, 44 (12.9%) had local AE and 12 had both, local and systemic AE. The most common AE was pain at the injection site (41 persons, 12%), myalgia (34; 10%), fever (25; 7.3%) and headache (16; 4.7%). There was no statistically significant difference on the AE frequency according to the vaccine producer. There were four severe AE: one hospitalization and three deaths, considered not related to the YF vaccine.

https://doi.org/10.1590/s1678-9946202163013 675 downloads

Low tetanus-diphtheria-acellular pertussis (Tdap) vaccine coverage among healthcare workers in a quaternary university hospital in São Paulo, Brazil: need for continuous surveillance and implementation of active strategies
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Randi, Bruno Azevedo

; Miyaji, Karina Takesaki Lara, Amanda Nazareth Ibrahim, Karim Yaqub Infante, Vanessa Rodrigues, Camila Cristina Martines Lopes, Marta Heloísa Sartori, Ana Marli Christovam

Brazilian Journal of Infectious Diseases

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aug 2019, Volume 23 N. 4 Pages 231 - 236

Abstract: En | Text: En | PDF: En

Abstract Introduction: Vaccination with tetanus-diphtheria-acellular pertussis (Tdap) has been recommended for healthcare workers (HCWs) by Brazilian Ministry of Health since November 2014. Objective: To describe the strategies implemented to improve Tdap uptake, cumulative vaccine coverage after each intervention, variables associated to Tdap vaccination, and reasons for non-vaccination among HCWs of the main building of a quaternary hospital attached to the Sao Paulo University Medical School. Methods: A list of HCWs eligible for pertussis vaccination was generated. From April to December 2015, the following interventions were implemented: note on intern journal reminding the importance of pertussis vaccination; email to the head nurses strengthening vaccine recommendations; lectures on pertussis and Tdap for physicians of Obstetrics and Neonatology Clinics; on-site vaccination by mobile teams at the Obstetrics, Neonatology, and Anesthesiology Clinics. Vaccine coverage was accessed at the end of each month. Multivariate Poisson regression model with a robust error variance was used to evaluate variables associated with Tdap vaccination. Reasons for non-vaccination were evaluated from January to May 2017 through phone calls for HCWs who had not received Tdap. Results: The study included 456 HCWs. After the interventions, Tdap coverage raised from 2.8% to 41.2%. In the multivariate analysis, occupation (physician), working place (obstetrics or anesthesiology) and influenza vaccination in 2015 were independently associated to Tdap vaccination. The main reason for non-vaccination was unawareness of Tdap recommendations. Conclusions: Tdap uptake among HCWs was low in our hospital. Providing vaccination at convenient places/times for HCW seems to be the most efficient strategy to increase vaccine uptake.

https://doi.org/10.1016/j.bjid.2019.06.007 393 downloads

Adverse events following Quadrivalent HPV vaccination reported in Sao Paulo State, Brazil, in the first three years after introducing the vaccine for routine immunization (March 2014 to December 2016)
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Mauro, Alexandre Blikstad

; Fernandes, Eder Gatti Miyaji, Karina Takesaki Arantes, Benedito Antônio Valente, Maria Gomes Sato, Helena Keico Sartori, Ana Marli C.

Revista do Instituto de Medicina Tropical de São Paulo

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2019, Volume 61 elocation e43

Abstract: En | Text: En | PDF: En

ABSTRACT In March 2014, the Quadrivalent human papilloma virus vaccine (4vHPV) was introduced in the female adolescents vaccination schedule of the National Immunization Program (PNI). A school-based vaccination program was implemented. We conducted a retrospective, descriptive study of the adverse events that took place after HPV vaccination, reported to the Adverse Events Following Immunization (AEFI) Information System in Sao Paulo State, from March 2014 to December 2016. All reports that fit the definitions of the 2014 National Manual on AEFI surveillance were included. AEFI risk was estimated by dividing the number of reports by the number of vaccine doses administered in the period. In the three-year period, 3,390,376 HPV vaccine doses were administered and 465 AEFI reports were registered, with 1,378 signs and symptoms. The reporting rate was 13.72 per 100,000 vaccine doses administered. The reports peaked in the first year of the program. The most frequent AEFI was syncope, with 5.7 reports per 100,000 doses administered, followed by dizziness, malaise, headache and nausea. Overall, 39 AEFI cases (8.4%) were classified as severe , with a reporting rate of 1.15 per 100,000 vaccine doses administered. Most cases were classified as severe because of hospitalization. Among them, there were cases of Guillain-Barré Syndrome, deep vein thrombosis, seizures and miscarriage. All young women recovered without sequelae. We identified five clusters of AEFI reports in four cities; the larger AEFI cluster occurred in the city of Bertioga, in September 2014, involving 13 female adolescents. Our data are in accordance with those from other countries and corroborate the safety of HPV vaccines.

https://doi.org/10.1590/s1678-9946201961043 2253 downloads

Prospective cohort studies to evaluate the safety and immunogenicity of the 2013, 2014, and 2015 seasonal influenza vaccines produced by Instituto Butantan
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Mondini, Gabriella Braga, Patricia Emilia Lopes, Marta Heloisa Sartori, Ana Marli Christovam Miyaji, Karina Takesaki Infante, Vanessa Randi, Bruno Azevedo Timenetsky, Maria do Carmo Sampaio Tavares Ferreira, Juliana Caires de Oliveira Achili Sakita, Neusa Keico Precioso, Alexander Roberto

Revista do Instituto de Medicina Tropical de São Paulo

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2018, Volume 60 elocation e37

Abstract: En | Text: En | PDF: En

ABSTRACT Annual vaccination is the most effective way to prevent seasonal influenza illness. Instituto Butantan (IB) performed clinical studies with its 2013, 2014 and 2015 seasonal trivalent influenza vaccines (inactivated split-virion). Prospective cohort studies were carried out to describe the safety and immunogenicity of Instituto Butantan influenza vaccines, in healthy adults and elderly, from 2013 to 2015. Immediately after the informed consent was signed, participants underwent blood collection followed by vaccination. On study days 1, 2 and 3 post-vaccination participants were contacted by the staff to evaluate the occurrence of solicited (local and systemic) and non-solicited adverse reactions. On study day 21 (+7) subjects returned to the clinical site for final safety assessments and blood collection to evaluate post-vaccination immunogenicity. The immunogenicity analyses were performed by means of hemagglutination inhibition (HI) assay. The immunogenicity endpoints were: seroprotection (SPR) and seroconversion (SCR) rates and the geometric mean HI antibody titer ratio (GMTR). The 2013 study was conducted at the Centro de Referência para Imunobiológicos Especiais (CRIE) and at the Centro de Pesquisa Clínica do Instituto da Criança, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo while the 2014 and 2015 studies were conducted at CRIE. The vaccine composition followed the WHO recommendation for the Southern hemisphere seasonal influenza vaccine. Forty-seven healthy adults and 13 elderly participated in the 2013 study, 60 healthy adults and 60 elderly in the 2014 study, and 62 healthy adults and 57 elderly in the 2015 study. In the 2013, 2014 and 2015 studies, pain was the most frequent local adverse reaction and headache the most frequent systemic adverse reaction. All observed adverse reactions were classified as mild or moderate and none as severe. SPR >70% and SPR >60% were observed in adults and elderly, respectively, for the three vaccine viruses, in the 2013, 2014 and 2015 studies. SCR >40% was observed in adults, for the three vaccine viruses, only in the 2014 study and SCR >30% was observed in the elderly, for the three vaccine viruses, only in the 2013 and 2014 studies. GMTR >2.5 among adults, for the three vaccine viruses was only observed in the 2013 study and GMTR >2.0 was observed among elderly, for the three vaccine viruses, in the 2013, 2014 and 2015 studies. The 2013, 2014 and 2015 seasonal influenza vaccines produced by Instituto Butantan were safe and immunogenic according to the immunogenicity criteria defined by the European Medicines Agency (EMA).

https://doi.org/10.1590/s1678-9946201860037 1796 downloads

Prevalence and titers of yellow fever virus neutralizing antibodies in previously vaccinated adults
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Miyaji, Karina Takesaki Avelino-Silva, Vivian Iida Simões, Marisol Freire, Marcos da Silva Medeiros, Carlos Roberto de Braga, Patrícia Emilia Neves, Maria Angélica Acalá Lopes, Marta Heloisa Kallas, Esper Georges Sartori, Ana Marli Christovam

Revista do Instituto de Medicina Tropical de São Paulo

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2017, Volume 59 elocation e2

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: The World Health Organization (WHO) recommends one single dose of the Yellow Fever (YF) vaccine based on studies of antibody persistency in healthy adults. We assessed the prevalence and titers of YF virus neutralizing antibodies in previously vaccinated persons aged ≥ 60 years, in comparison to younger adults. We also evaluated the correlation between antibody titers and the time since vaccination among participants who received one vaccine dose, and the seropositivity among participants vaccinated prior to or within the past 10 years. Methods: previously vaccinated healthy persons aged ≥ 18 years were included. YF virus neutralizing antibody titers were determined by means of the 50% Plaque Reduction Neutralization Test. Results: 46 persons aged ≥ 60 years and 48 persons aged 18 to 59 years were enrolled. There was no significant difference in the prevalence of YF virus neutralizing antibodies between the two groups (p = 0.263). However, titers were significantly lower in the elderly (p = 0.022). There was no correlation between YF virus neutralizing antibody titers and the time since vaccination. There was no significant difference in seropositivity among participants vaccinated prior to or within the past 10 years. Conclusions: the clinical relevance of the observed difference in YF virus neutralizing antibody titers between the two groups is not clear.

https://doi.org/10.1590/s1678-9946201759002 2791 downloads

10.

Zika virus
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Lopes, Marta Heloisa Miyaji, Karina Takesaki Infante, Vanessa

Revista da Associação Médica Brasileira

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feb 2016, Volume 62 N. 1 Pages 4 - 9

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1806-9282.62.01.4 6907 downloads

11.

Spontaneous reporting of adverse events following pandemic influenza A (H1N1) immunization in a reference center in the State of Sao Paulo, Brazil
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Oliveira, Danise Senna Lara, Amanda Nazareth Luiz, Andre Machado Miyaji, Karina Takesaki Sartori, Ana Marli Christovam Lopes, Marta Heloisa

Revista da Sociedade Brasileira de Medicina Tropical

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jun 2013, Volume 46 N. 3 Pages 348 - 351

Abstract: En | Text: En | PDF: En

Introduction This paper describes adverse events (AEs) temporally associated to the pandemic influenza A (H1N1) vaccine observed in a reference center in São Paulo, Brazil, during a 2010 mass vaccination campaign. Methods A retrospective study involving persons who sought medical care for AEs following influenza vaccination. Data were retrieved from medical records, vaccine AE notification forms, and a computerized system for immunobiological registration. Results Sixty-six vaccinees sought medical care for AEs after immunization. The most frequent AEs were fever, headache, myalgia, and pain at the injection site. No serious AEs were reported. Conclusions Few vaccinees spontaneously reported AEs to influenza A (H1N1) vaccine at this center.

https://doi.org/10.1590/0037-8682-1265-2013 2259 downloads Cited 1 time in SciELO

12.

Campaign, counseling and compliance with influenza vaccine among older persons
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Avelino-Silva, Vivian Iida Avelino-Silva, Thiago Junqueira Miraglia, Joao Luiz Miyaji, Karina Takesaki Jacob-Filho, Wilson Lopes, Marta Heloisa

Clinics

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2011, Volume 66 N. 12 Pages 2031 - 2035

Abstract: En | Text: En | PDF: En

OBJECTIVES: Population aging raises concerns regarding the increases in the rates of morbidity and mortality that result from influenza and its complications. Although vaccination is the most important tool for preventing influenza, vaccination program among high-risk groups has not reached its predetermined aims in several settings. This study aimed to evaluate the impacts of clinical and demographic factors on vaccine compliance among the elderly in a setting that includes a well-established annual national influenza vaccination campaign. METHODS: This cross-sectional study included 134 elderly patients who were regularly followed in an academic medical institution and who were evaluated for their influenza vaccination uptake within the last five years; in addition, the demographic and clinical characteristics and the reasons for compliance or noncompliance with the vaccination program were investigated. RESULTS: In total, 67.1% of the participants received the seasonal influenza vaccine in 2009. Within this vaccinationcompliant group, the most common reason for vaccine uptake was the annual nationwide campaign (52.2%; 95% CI: 41.4-62.9%); compared to the noncompliant group, a higher percentage of compliant patients had been advised by their physician to take the vaccine (58.9% vs. 34.1%; p,0.01). CONCLUSION: The education of patients and health care professionals along with the implementation of immunization campaigns should be evaluated and considered by health authorities as essential for increasing the success rate of influenza vaccination compliance among the elderly.

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13.

Avaliação da correlação entre o dióxido de carbono expirado e o débito cardíaco em pacientes submetidos à cirurgia cardíaca com circulação extracorpórea
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Miyaji, Karina Takesaki Buscati, Roberto Iara Rodriguez, Antônio José Arraiz Machado, Luciano Brandão Malbouisson, Luiz Marcelo Sá Carmona, Maria José Carvalho

Revista Brasileira de Anestesiologia

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oct 2004, Volume 54 N. 5 Pages 625 - 633

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

JUSTIFICATIVA E OBJETIVOS: O CO2 expirado (P ET CO2) reflete, além da ventilação pulmonar (eliminação), a produção de dióxido de carbono (metabolismo) e o fluxo sangüíneo pulmonar (circulação). Quando o metabolismo e a ventilação são constantes, o CO2 expirado reflete o fluxo sangüíneo pulmonar e, desta forma, o débito cardíaco (DC). Este estudo tem como objetivo a avaliação da correlação entre o dióxido de carbono expirado (P ET CO2) e o débito cardíaco em pacientes submetidos à cirurgia cardíaca com circulação extracorpórea (CEC). MÉTODO: Foram estudados 25 pacientes submetidos à cirurgia de revascularização miocárdica com CEC. Após a intubação traqueal iniciou-se a monitorização da P ET CO2. A determinação do débito cardíaco (DC) foi feita por método de termodiluição com o uso de cateter de Swan-Ganz e a PaCO2 foi avaliada através de gasometria arterial. Os parâmetros do estudo foram avaliados em quatro momentos: logo após a indução da anestesia geral; antes da circulação extracorpórea, ao término da circulação extracorpórea e ao final da cirurgia. RESULTADOS: O teste estatístico não demonstrou uma correlação entre o CO2 expirado e o DC, assim como o gradiente de dióxido de carbono arterial e expirado (Ga-eCO2) e o DC. Foi encontrada correlação entre a variação dos valores da P ET CO2, Ga-eCO2 e DC em relação ao basal antes da CEC com perda da correlação após a CEC até o final da cirurgia. CONCLUSÕES: Neste estudo, onde se avaliam pacientes submetidos à cirurgia cardíaca com CEC, as alterações de relação ventilação/perfusão ocorridas ao longo do procedimento são, provavelmente, os fatores determinantes da diminuição da correlação entre o débito cardíaco e o valor de dióxido de carbono expirado.

BACKGROUND AND OBJECTIVES: End-tidal carbon dioxide (P ET CO2) not only reflects pulmonary ventilation but also carbon dioxide production (metabolism) and pulmonary blood supply (circulation). During constant metabolism and ventilation, P ET CO2 reflects pulmonary blood perfusion, thus cardiac output (CO). This study aimed at evaluating the correlation between P ET CO2 levels and CO during cardiac surgery with cardiopulmonary bypass (CPB). METHODS: Participated in this study 25 patients submitted to coronary artery bypass grafting (CABG) with CPB. End-tidal CO2 monitoring started after tracheal intubation. Cardiac output was determined by thermodilution with pulmonary artery catheter (Swan-Ganz). Carbon dioxide partial blood pressure (PaCO2) was obtained with arterial blood gases analysis. Studied parameters were evaluated in the following moments: immediately after general anesthesia induction, before cardiopulmonary bypass, at cardiopulmonary bypass completion and at surgery completion. RESULTS: Statistical analysis has not shown correlation between P ET CO2 and CO2, or between P ET CO2-PaCO2 gradient (Ga-eCO2) and CO. There has been correlation between P ET CO2, Ga-eCO2 and CO values variation as compared to baseline values before CPB, with loss of correlation after CPB until surgery completion. CONCLUSIONS: In this study, where patients submitted to cardiac surgery with CPB were evaluated, ventilation/perfusion changes throughout the procedure might have been the factors determining decreased correlation between cardiac output and end tidal CO2.

JUSTIFICATIVA Y OBJETIVOS: El CO2 expirado (P ET CO2) refleja, además de la ventilación pulmonar (eliminación), la producción de dióxido de carbono (metabolismo) y el flujo sanguíneo pulmonar (circulación). Cuando el metabolismo y la ventilación son constantes, el CO2 expirado refleja el flujo sanguíneo pulmonar y, de esta forma, el débito cardíaco (DC). Este estudio tiene como objetivo la evaluación de la correlación entre el dióxido de carbono expirado (P ET CO2) y el débito cardíaco en pacientes sometidos a la cirugía cardíaca con circulación extracorpórea (CEC). MÉTODO: Fueron estudiados 25 pacientes sometidos a la cirugía de revascularización miocárdica con CEC. Después de la intubación traqueal tuvo inicio la monitorización de la P ET CO2. La determinación del débito cardíaco (DC) fue hecha por método de termodiluición con el uso de catéter de Swan-Ganz y la PaCO2 fue evaluada a través de gasometría arterial. Los parámetros del estudio fueron evaluados en cuatro momentos: luego después de la inducción de la anestesia general; antes de la circulación extracorpórea, al término de la circulación extracorpórea y al final de la cirugía. RESULTADOS: El teste estadístico no demostró una correlación entre el CO2 expirado y el DC, así como el gradiente de dióxido de carbono arterial y expirado (Ga-eCO2) y el DC. Fue encontrada correlación entre la variación de los valores de la P ET CO2, Ga-eCO2 y DC en relación al basal antes de la CEC con pérdida de la correlación después de la CEC hasta el final de la cirugía. CONCLUSIONES: En este estudio, donde se evalúan pacientes sometidos a cirugía cardíaca con CEC, las alteraciones de relación ventilación/perfusión ocurridas a lo largo del procedimiento son, probablemente, los factores determinantes de la diminución de la correlación entre el débito cardíaco y el valor de dióxido de carbono expirado.

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