Lack of confidence in vaccine may explain low adherence of pregnant

[Tonka]

http://www.estadao.com.br/noticias/...sao-de-gravidas-diz-especialista,540224,0.htm

Portuguese to English translation


Lack of confidence in vaccine may explain low adherence of pregnant

Only 50% of the women sought the positions of vaccination against swine flu since March
April 19, 2010 | 50 8am
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The low demand for pregnant women, the vaccine against influenza A (H1N1) (flu) can be explained by a lack of confidence among obstetricians in the product. This is the opinion of Rosana Ritchmann, medical infectologist Hospital Emilio Ribas, Sao Paulo.


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"There is still some resistance not only of the patient. The patient will report her to the doctor in confidence. And if he is insecure with respect to vaccination, surely she (the mother) will not seek the posts to be vaccinated," said Rosana .

According to the Ministry of Health, from March 22 until the morning of Wednesday, 14, 51.1% of pregnant women had sought the vaccination posts. The number of concern to the ministry, since pregnant women are one of the most vulnerable to the disease: one in three deaths this year in Brazil is related to pregnant women. Last year, of the 2,051 recorded deaths from the disease, 189 were pregnant. Last year alone, the Emilio Ribas Hospital, where Rosana works, one in ten pregnant women died from H1N1.

"It's a lot in terms of risk of death for pregnant women and all that we already know of influenza vaccine strains by another, not by H1N1, gives us safely to indicate the vaccine at any time during pregnancy," he warned Rosana.

She said H1N1 is not yet fully known and it is impossible to determine, for example, if a new wave of illness could still occur this year. But being vaccinated against the flu is a guarantee of prevention. "If you protect this year and will take next year, you will have an antibody titer, an amount of protection even better. The fact that this year, come or not the second wave of illness does not mean that staff eventually have to repent of having been vaccinated. Quite the contrary. You will be protected, "he said.

The doctor noted that texts that are reproduced on the internet and that induce people not to vaccinate should not be taken into account. "We can not understand why people will give up a prevention, which is safe, versus a possible treatment in which we asked several questions. We Tamiflu last year? We. Many people died? Died. He had very case that was handled properly and we lost the patient. With children, we knew the correct dose. And the world does not know why it's a very new thing. But prevention is the best measure. "

Until April 23, the posts will pregnant women, chronically ill, children 6 months to less than 2 years and youth 20 to 29 years to be vaccinated against influenza.

 

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Re: Lack of confidence in vaccine may explain low adherence of pregnant

http://www.correiobraziliense.com.b...+DAS+GRAVIDAS+FORAM+VACINADAS+ATE+AGORA.shtml

Portuguese to English translation

Brasilia reports that only 51% of pregnant women were vaccinated so far


Luiza Seixas

Published: 17/04/2010 11:20

The queues at health posts in the Federal District confirms the concern of the Health Minister, Jose Gomes, who this week lamented the membership is still low for pregnant women and chronically ill to immunization against influenza A (H1N1) influenza virus. In the Health Centre No. 8, South Wing in the last five days, from 1855 vaccinated, only 28 were women and 189 patients with chronic diseases. A very small number and unexpected, according to center manager, medical Jussara Coelho.

For the specialist, this segment of the population is still afraid. And the reason is simple: doctors usually do not recommend vaccinations for pregnant women to not just be any complication with the baby - the only vaccines that are used are tetanus and hepatitis B.

"In the case of H1N1, does not have to discuss. We need to vaccinate. They're running a big risk with the flu. I know that fear exists because it is a new thing, but it is unnecessary. Dangerous is running out of vaccine, "said Jussara. Compared to patients with chronic diseases, the doctor believes that the biggest fear of them is in relation to an altered response. "For these patients, I recommend a medical orientation and previous examinations to determine whether the immune system is prepared to receive the vaccine. But we do not know of cases with an altered response, "he added.

This low demand explains the most recent figures released by the ministry. Expected by the target organ to vaccinate about 3 million women and 3 million chronic, only 51.1% and 48.5%, respectively, were met. While all other groups of the first steps, like those of children from six months to two years and health professionals, have already reached the expected, ie 80%.

"That worries us a lot because of the 50 deaths registered in 2010, 16 were pregnant. We are considering the hypothesis that they are waiting until the last minute, as they can be vaccinated until May 21, but we do not recommend it. We are experiencing an early winter, which causes more people from clumping and increase the risk of catching the flu, "said Secretary of Health Surveillance of the Ministry, Gerson Penna.

For him if the Brazilian Federation of Gynecology and Obstetrics (Febrasgo) is reiterating the words of the court, there is no reason to fear. "The sooner we protect, the better for everyone," he added.

The chairman of the Obstetrics Febrasgo, Corinthian Mariani Neto, noted that if the illness is seen as serious for the whole population, raises this point when it comes to pregnant women because they are generally of lower immunity. "Worse is expected to catch the flu and call for remedy. It may be too late. He did not always act effectively. And the vaccine to immunize people know that already, "said Corinthian.

This fear in relation to immunization is present in almost all pregnant women. Early in the campaign, pregnant Glaura Deise de Oliveira, 33 years, said she was scared because there were several e-mails that read against the vaccine. But not to harm, asked the opinion of his doctor. "He made it clear that all these comments were made by ignorant people who should read more about it. I stayed quiet and decided to vaccinate, "he said.

"I know there are many people afraid, but it is best to avoid a serious illness. And since I discovered recently that she was pregnant, my obstetrician has recommended the vaccine, "said Amanda de Carvalho, 27, who is also pregnant and was vaccinated last Tuesday.

Strip-doubt

What is influenza A (H1N1)?
It is an acute respiratory illness caused by the pandemic virus (H1N1) in 2009. This new subtype of influenza virus, the same way as others, is transmitted from person to person primarily through coughing or sneezing and contact with respiratory secretions of infected people.

What is the difference between ordinary flu and pandemic influenza (H1N1) in 2009?
They are caused by different subtypes of influenza virus. The symptoms are very similar and overlap: sudden fever, cough, headache, muscle aches, joint pain and rhinorrhea.

If the process of developing a vaccine is usually long, as it was possible to produce a pandemic vaccine so quickly?
The laboratories had prior experience with the production of vaccine against seasonal influenza virus vaccine (administered annually in the elderly in Brazil), and invested in technology to prepare the vaccine's preventive pandemic virus. Brazil, for example, has invested in the adequacy of the production process by the Instituto Butantan.

The vaccine used in Brazil is safe and effective?
She is already in use in other countries and has been observed for its use and the occurrence of serious adverse events. The vaccine registers an average effectiveness greater than 95%. The maximum antibody response is observed between the 14th and 21st days after vaccination.

Why there will not be vaccinating the entire population?
Mass vaccination to contain the pandemic is not the focus of the established strategy for dealing with the second pandemic wave in the world. For one simple reason, that restraint is no longer possible in the world. Moreover, there is no availability in sufficient quantity to meet the entire world population. There is also the limitation of production capacity by producing laboratories for delivery before the second wave countries in the Southern Hemisphere

Why vaccinate the pregnant woman, if there is no indication that group of vaccination with flu vaccine (seasonal)?
There is no contraindication to vaccination of pregnant women with the vaccine used against seasonal influenza (flu), but it's not made in the annual campaigns for prioritizing a higher risk group - the population over 60 years. The women, however, are considered high risk for pandemic influenza H1N1.

There is, therefore, risk to the mother and fetus?
According to World Health Organization (WHO) and in accordance with safety standards declared by the laboratories producing the vaccine is safe for pregnant women. There is no evidence that it may cause fetal harm or affect reproductive capacity, or also on the occurrence of abortion in countries where it was administered.

Vaccination of pregnant is done at any age of gestation?
Yes will be used as a vaccine containing no adjuvant, it is suitable for any gestational age. The vaccine containing the adjuvant could only be administered from the 2nd trimester of pregnancy. The Ministry of Health has chosen then, by vaccinating the mother only with the vaccine without adjuvant to not disturb the operation of vaccination and to avoid any complications in pregnant women inadvertently vaccinated before the 2nd trimester of pregnancy with the vaccine containing the adjuvant would to be attributed to the vaccine.

Why vaccinate patients with chronic diseases?
In the pandemic of 2009, among the cases of SARS by the H1N1 influenza virus, we observed a high percentage of people with chronic diseases. The patients with chronic respiratory diseases, for example, was the most frequently, with 24.4% of the records, followed by cardiovascular disease and other chronic diseases. These situations characterize people who need protection are already in a vulnerable situation.

Who had the flu pandemic and laboratory confirmation should get the vaccine?
Yes, when a person is infected by influenza A virus, acquired immunity to that specific subtype of virus that infected her. So, who already had the flu pandemic, in principle, is immune, although there are records of some patients who developed a second infection. The duration of immunity may vary from person to person, but if this virus mutates, a new infection can occur.

What is the incidence of side effects so far?
The WHO estimates that were distributed about 80 million doses of vaccine against pandemic influenza, and by the end of November, were vaccinated approximately 65 million people. The vast majority of what is reported is similar to seasonal vaccine administered to elderly, who are mild reactions: local pain, low fever, muscle pain, which resolves in about 48 hours.

In the event that the virus persists for many years, I'm gonna need me reimunizar?
If no mutation of the virus is not required revaccination