Effectiveness of influenza vaccination in preventing influenza in primary care, Navarre, Spain, 2021/22

Compared with individuals unvaccinated in the current and three previous influenza seasons, in 2021/22, influenza vaccine effectiveness at primary care level was 37% (95% CI: 16 to 52) for current season vaccination, regardless of previous doses, and 35% (95% CI: -3 to 45) for only previous seasons vaccination. Against influenza A(H3N2), estimates were 39% (95% CI: 16 to 55) and 24% (95% CI: -8 to 47) suggesting moderate effectiveness of current season vaccination and possible remaining effect of prior vaccinations.This study was supported by the Influenza Monitoring Vaccine Effectiveness in Europe (I-MOVE) Network funded by the European Centre for Disease Prevention and Control (RS/2021/DRP/12984) and by the Instituto de Salud Carlos III with the European Regional Development Fund (PI20/01323, CM19/00154, and INT21/00100).S

La Enfermería Geriátrica en el Espacio Europeo de Educación Superior

Problema: ¿Cómo se están estructurando las asignaturas relacionadas con la especialidad de Enfermería Geriátrica en la formación de Grado de Enfermería? Material y método: guías docentes de las universidades, escuelas/facultades de Enfermería, pertenecientes a la Conferencia Nacional de Directores de Centros Universitarios de Enfermería (CNDCUE). Análisis descriptivo de la asignatura que abordan los cuidados de enfermería durante la etapa de la vejez. Conclusiones: existe divergencia en el planteamiento de las asignaturas en las guías analizadas. Se ha modificado la denominación previa y común a todos los centros: Enfermería Geriátrica. El número de competencias propuestas es elevado, lo que puede complicar la evaluación formativa

Influenza Vaccine Effectiveness in Preventing Laboratory-Confirmed Influenza Cases and Hospitalizations in Navarre, Spain, 2022–2023

We estimated influenza vaccine effectiveness (IVE) in preventing outpatient and hospitalized cases in the 2022–2023 season. A test-negative design included a representative sample of outpatients and all hospitalized patients with influenza-like illness (ILI) from October 2022 to May 2023 in Navarre, Spain. ILI patients were tested by PCR for influenza virus. Influenza vaccination status was compared between confirmed influenza cases and test-negative controls. Among 3321 ILI patients tested, IVE to prevent influenza cases was 34% (95% confidence interval (CI): 16 to 48) overall, 85% (95%CI: 63 to 94) against influenza B, and 28% (95%CI: 3 to 46) against A(H3N2). Among 558 outpatients, 222 (40%) were confirmed for influenza: 55% A(H3N2), 11% A(H1N1), and 31% B. Overall, IVE to prevent outpatient cases was 48% (95%CI: 8 to 70), 88% (95%CI: 3 to 98) against influenza B, and 50% (95%CI: −4 to 76) against A(H3N2). Of 2763 hospitalized patients, 349 (13%) were positive for influenza: 64% A(H3N2), 17% A(H1N1), and 8% B. IVE to prevent hospitalization was 24% (95%CI: −1 to 42) overall, 82% (95%CI: 49 to 93) against influenza B, and 16% (95%CI: −17 to 40) against A(H3N2). No IVE was observed in preventing influenza A(H1N1). IVE was high to prevent influenza B, moderate against A(H3N2) and null against A(H1N1). A lower proportion of influenza B cases may explain the smaller IVE in hospitalized patients than in outpatients. The null IVE against A(H1N1) was consistent with the observed antigenic drift and supports the new composition of the 2023–2024 influenza vaccine

Aluminium-containing vaccines in sheep: comprehensive long-term studies at the inoculation point

Trabajo presentado en el 9th International Sheep Veterinary Congress, celebrado en Harrowgate (Reino Unido), del 22 al 26 de mayo de 2017Aluminium is the most common adjuvant used in sheep vaccines in order to improve the reaction against bacterial or viral antigens. The inoculation is associated with a strong, local inflammatory reaction where the antigen recognition takes place. These reactions are considered transient and it is said that they disappear after a few weeks. To the best of our knowledge no study has followed the evolution of the vaccine inoculation site for a long period of time. Here, we present a comprehensive long-term study aiming to evaluate the evolution of the post-inoculation inflammatory reactions and to fully characterize them. Three groups (n=28 each) of sex-matched three-month-old lambs were used. Each group followed a parallel inoculation schedule that lasted 15 months: Group A was subcutaneously inoculated with commercial vaccines against known ovine diseases (following manufacturers’ recommendations), all of them containing aluminium hydroxide as adjuvant; Group B received the same amount of aluminium-adjuvant alone (considering the vaccine used in each time in Group A); Group C received PBS. Animals received a total of 19 inoculations during the above-mentioned 15 months and they were finally euthanized. Inoculation point and local lymph node were assessed in vivo and post mortem. In vivo, an evaluation by palpation was carried out each 40 days. Post mortem studies included gross and microscopic pathology, microbiology, scanning transmission electron microscopy (STEM) and energy-dispersive X-ray (EDX) spectroscopy. At in vivo palpation, reactions consisted of hard, subcutaneous nodules that were associated with lymph node reactivity. Inoculation nodules were more palpable in the case of vaccines than those observed in the case of adjuvant alone. At post mortem, nodules were found in vaccinated (100 %) and aluminium-inoculated (85.7 %) animals. Up to 15 nodules were recovered from the subcutaneous tissue of some vaccinated animals. Histologically, inoculation reactions consisted in foreign body granulomas that showed central necrosis almost only in commercial vaccines. In both, aluminium and vaccines granulomas, the microbiological procedures were negative. By STEM, reactive macrophages contained intracytoplasmic aggregates of a spiculated material frequently surrounded by a membrane, this material being identified as aluminium by EDX. Intracytoplasmic aluminium aggregates were of larger size in the case of vaccine granulomas. It is concluded that in sheep, aluminium-induced granulomas can be persistent and last more than 15 months. This persistence implies a chronic but active immune reaction that could be related to some previously-described vaccine secondary effects included in the ovine ASIA syndromePeer reviewe

Studies on injection site reactions caused by aluminium-containing products in sheep

Trabajo presentado en el 3rd joint European Congress of the ESVP, ESTP and ECVP, celebrado en Lyon (Francia), del 30 de agosto al 2 de septiembre de 2017Introduction: Aluminium (Al) containing adjuvants are widely used in sheep vaccines to promote an effective immune reaction against antigens but induce local injection-site reactions. This work aims to characterize these reactions and to determine the role of the Al in its genesis. Materials and Methods: 84 lambs divided into 3 groups (n=28 each) were inoculated with a different substance: A) Vaccines containing aluminium hydroxide; B) Aluminium hydroxide only; C) PBS. Animals received 19 subcutaneous inoculations along 15 months. Injection-site reactions and the regional lymph node (LN) were studied by gross and microscopic pathology, microbiology, fluorescence microscopy with lumogallion, Transmission Electron Microscopy (TEM), Energy Dispersive X-Ray Spectroscopy (EDS) and Graphite Furnace Atomic Absorption Spectroscopy (GFAAS). Results: Injection-site reactions consisted ofgranulomas that were more numerous (p<0.001) and with more severe central necrosis (p=0.021) in group A than in group B. Most of the vaccinated lambs (76.9%) showed more than 7 granulomas and all granulomas could be recovered in certain cases. Macrophages in the granulomas showed an orange fluorescence emission (590 nm), typical of Al. Similar groups of macrophages were observed in the regional LN. By TEM, macrophages in the granulomas contained aggregates of a spiculated electrondense material identified as Al by EDS. Group A showed longer Al particles than group B (p<0.001). By GFAAS, group A showed higher Al concentration in the regional LN than group B (p<0.001). Conclusions: Al induces persistent, immunomediated subcutaneous granulomas and the reactions are more severe in vaccinated animals. Al can reach the regional lymph nodPeer reviewe

Granulomas Following Subcutaneous Injection With Aluminum Adjuvant-Containing Products in Sheep

The use of vaccines including aluminum (Al)–based adjuvants is widespread among small ruminants and other animals. They are associated with the appearance of transient injection site nodules corresponding to granulomas. This study aims to characterize the morphology of these granulomas, to understand the role of the Al adjuvant in their genesis, and to establish the presence of the metal in regional lymph nodes. A total of 84 male neutered lambs were selected and divided into 3 treatment groups of 28 animals each: (1) vaccine (containing Al-based adjuvant), (2) adjuvant-only, and (3) control. A total of 19 subcutaneous injections were performed in a time frame of 15 months. Granulomas and regional lymph nodes were evaluated by clinicopathological means. All of the vaccine and 92.3% of the adjuvant-only lambs presented injection-site granulomas; the granulomas were more numerous in the group administered the vaccine. Bacterial culture in granulomas was always negative. Histologically, granulomas in the vaccine group presented a higher degree of severity. Al was specifically identified by lumogallion staining in granulomas and lymph nodes. Al median content was significantly higher (P < .001) in the lymph nodes of the vaccine group (82.65 μg/g) compared with both adjuvant-only (2.53 μg/g) and control groups (0.96 μg/g). Scanning transmission electron microscopy demonstrated aggregates of Al within macrophages in vaccine and adjuvant-only groups. In these two groups, Al-based adjuvants induce persistent, sterile, subcutaneous granulomas with macrophage-driven translocation of Al to regional lymph nodes. Local translocation of Al may induce further accumulation in distant tissues and be related to the appearance of systemic signs.Peer reviewe

Clinicopathological studies in lambs repetitively inoculated with products containing alimunium adjuvants

Trabajo presentado en el 11th International Congress on Autoimmunity, celebrado en Lisboa (Portugal), del 16 al 20 de mayo de 2018The use of aluminum-containing vaccine adjuvants is widespread in the Spanish small ruminant industry. These compounds were related to an episode of vaccine adverse reactions which gave rise to a process known today as the ovine ASIA syndrome. An in vivo model of this syndrome was established. Eighty-four lambs were selected, divided into three groups (n=28 each) and submitted to an intensive inoculation program with: i) Vaccines containing aluminum hydroxide as adjuvant; ii) The adjuvant only; iii) PBS. Nineteen inoculations were performed during 15 months. A comprehensive in vivo follow-up was performed, including clinical examinations and behavioral and cognitive tests. After euthanasia, the pathology of different tissues was studied grossly, microscopically and by electron microscopy. The presence of aluminum in tissues was studied by energy dispersive X-ray spectroscopy, graphite furnace atomic absorption spectroscopy and lumogallion fluorescent staining. Animals in the vaccinated and adjuvant-inoculated groups presented persistent injection-site granulomas with intramacrophagic aluminum. Persistency was higher in the vaccinated group (p<0.001), reaching 15 months in some cases. There was translocation of aluminum to the regional lymph nodes (p<0.001) and lumbar spinal cord (p<0.001). Vaccinated and adjuvant-inoculated animals showed an increase in aggressive interactions (p<0.001) and stereotypies (p<0.001) and a decrease in affiliative interactions (p<0.001) when compared with the control group. Differences were more marked with higher number of doses applied. Repetitive inoculation of aluminum-hydroxide only or combined into commercial vaccines to experimental lambs induces highly persistent injection site granulomas, accumulation of aluminum in distant tissues and changes in the inter-individual interaction patterns.Peer reviewe