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Article ; Online: 50 years of the Brazilian National Immunization Program and the Immunization Agenda 2030

Jadher Pércio / Eder Gatti Fernandes / Ethel Leonor Maciel / Nísia Verônica Trindade de Lima

Epidemiologia e Serviços de Saúde, Vol 32, Iss

2023 Volume 3

Keywords	Medicine ; R ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	Ministério da Saúde do Brasil
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Outbreak investigation in cargo ship in times of COVID-19 crisis, Port of Santos, Brazil

Eder Gatti Fernandes / Janice da Silva Santos / Helena Keico Sato

Revista de Saúde Pública, Vol

2020 Volume 54

Abstract: ABSTRACT In February 2020, a Chinese cargo ship docked at the Port of Santos with reports of crew members with a feverish and respiratory condition. A team was gathered to verify the existence of suspected cases of COVID-19 inside the vessel and define ... ...

Abstract	ABSTRACT In February 2020, a Chinese cargo ship docked at the Port of Santos with reports of crew members with a feverish and respiratory condition. A team was gathered to verify the existence of suspected cases of COVID-19 inside the vessel and define its clearance. All 25 crew members were interviewed, and no suspected cases were found. The vessel was then cleared for port activities. The investigation resulted from the implementation of the contingency plan to face a public health emergency of international importance and several surveillance entities cooperated.
Keywords	Coronavirus Infections ; epidemiology ; prevention & control ; Ships ; International Health Regulations ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2020-03-01T00:00:00Z
Publisher	Universidade de São Paulo
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Safety and immunogenicity of an inactivated SARS-CoV-2 vaccine (CoronaVac) in inadvertently vaccinated healthy children

Eder Gatti Fernandes / Giselle Ibette Silva López-Lopes / Valeria Oliveira Silva / Rosemeire Yamashiro / Karen Cristina Rolim Madureira / Juliana Failde Gallo / José Angelo Lindoso / Helena Keico Sato / Núbia Virginia D’Avila Limeira de Araujo / Maria Ligia Bacciotte Ramos Nerger / Luis Fernando Macedo Brigido

Revista do Instituto de Medicina Tropical de São Paulo, Vol

2021 Volume 63

Abstract: ABSTRACT Twenty-seven children aged seven months to 5 years were inadvertently vaccinated with a COVID-19 vaccine, the CoronaVac (Sinovac, China), an inactivated SARS-CoV-2 vaccine, in two different cities of Sao Paulo State, Brazil. After the event, ... ...

Abstract	ABSTRACT Twenty-seven children aged seven months to 5 years were inadvertently vaccinated with a COVID-19 vaccine, the CoronaVac (Sinovac, China), an inactivated SARS-CoV-2 vaccine, in two different cities of Sao Paulo State, Brazil. After the event, these children were monitored by local pediatricians and serum samples were collected at the first visit and 30 days after vaccination and tested for SARS-CoV-2 S1 serology with Ortho total IgG anti-S1 protein and Cpass, an ACE2 receptor binding domain inhibition assay. Only one child had a mild symptom after vaccination, with no other adverse events documented up to the 30 days follow-up. Of 27 children tested 3-9 days after vaccination, 5 (19%) had positive serology suggesting a previous natural SARS-CoV-2 infection, with all 19 tested on day 30 after vaccination and presenting with positive tests, with an increment of antibody titers in those initially positive. A low Cpass binding inhibition was observed in the first collection in 11 seronegative cases, with high titers among those anti-S1 positive. All children showed an important increase in antibody titers on day 30. The event allowed the documentation of a robust serological response to one dose of CoronaVac in this small population of young children, with no major adverse effects. Although it was an unfortunate accident, this event may contribute with future vaccine strategies in this age group. The data suggest that CoronaVac is safe and immunogenic for children.
Keywords	COVID-19 vaccines ; Adverse events ; Brazil ; Arctic medicine. Tropical medicine ; RC955-962
Subject code	630
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	Universidade de São Paulo
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Previous BCG vaccination is associated with less severe clinical progression of COVID-19

Susan Martins Pereira / Florisneide Rodrigues Barreto / Ramon Andrade de Souza / Carlos Antonio de Souza Teles Santos / Marcos Pereira / Enny Santos da Paixão / Carla Cristina Oliveira de Jesus Lima / Marcio Santos da Natividade / Ana Angélica Bulcão Portela Lindoso / Eder Gatti Fernandes / Evonio Barros Campelo Junior / Julia Moreira Pescarini / Kaio Vinicius Freitas de Andrade / Fernanda Mattos de Souza / Elisangela Alves de Britto / Ceuci Nunes / Maria Yuri Ichihara / Margareth Dalcolmo / Anete Trajman /

Manoel Barral-Netto / Ibrahim Abubakar / Mauricio Lima Barreto / Ricardo Arraes de Alencar Ximenes / Laura Cunha Rodrigues

BMC Medicine, Vol 21, Iss 1, Pp 1-

2023 Volume 7

Abstract: Abstract Background BCG vaccination, originally used to prevent tuberculosis, is known to “train” the immune system to improve defence against viral respiratory infections. We investigated whether a previous BCG vaccination is associated with less severe ...

Abstract	Abstract Background BCG vaccination, originally used to prevent tuberculosis, is known to “train” the immune system to improve defence against viral respiratory infections. We investigated whether a previous BCG vaccination is associated with less severe clinical progression of COVID-19 Methods A case-control study comparing the proportion with a BCG vaccine scar (indicating previous vaccination) in cases and controls presenting with COVID-19 to health units in Brazil. Cases were subjects with severe COVID-19 (O2 saturation < 90%, severe respiratory effort, severe pneumonia, severe acute respiratory syndrome, sepsis, and septic shock). Controls had COVID-19 not meeting the definition of “severe” above. Unconditional regression was used to estimate vaccine protection against clinical progression to severe disease, with strict control for age, comorbidity, sex, educational level, race/colour, and municipality. Internal matching and conditional regression were used for sensitivity analysis. Results BCG was associated with high protection against COVID-19 clinical progression, over 87% (95% CI 74–93%) in subjects aged 60 or less and 35% (95% CI − 44–71%) in older subjects. Conclusions This protection may be relevant for public health in settings where COVID-19 vaccine coverage is still low and may have implications for research to identify vaccine candidates for COVID-19 that are broadly protective against mortality from future variants. Further research into the immunomodulatory effects of BCG may inform COVID-19 therapeutic research.
Keywords	BCG ; Bacillus Calmette-Guérin ; COVID-19 ; SARS-CoV-2 ; Coronavirus disease 2019 ; Severity ; Medicine ; R
Subject code	610
Language	English
Publishing date	2023-04-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Cost-effectiveness analysis of universal maternal immunization with tetanus-diphtheria-acellular pertussis (Tdap) vaccine in Brazil

Sartori, Ana Marli Christovam / Eder Gatti Fernandes / Hillegonda Maria Dutilh Novaes / Juliana Yukari Kodaira Viscondi / Ligia Castellon Figueiredo Gryninger / Patrícia Coelho de Soárez

Vaccine. 2016 Mar. 18, v. 34, no. 13

2016

Abstract: Pertussis incidence has increased significantly in Brazil since 2011, despite high coverage of whole-cell pertussis containing vaccines in childhood. Infants <4 months are most affected. This study aimed to evaluate the cost-effectiveness of introducing ... ...

Abstract	Pertussis incidence has increased significantly in Brazil since 2011, despite high coverage of whole-cell pertussis containing vaccines in childhood. Infants <4 months are most affected. This study aimed to evaluate the cost-effectiveness of introducing universal maternal vaccination with tetanus-diphtheria-acellular pertussis vaccine (Tdap) into the National Immunization Program in Brazil.Economic evaluation using a decision tree model comparing two strategies: (1) universal vaccination with one dose of Tdap in the third trimester of pregnancy and (2) current practice (no pertussis maternal vaccination), from the perspective of the health system and society. An annual cohort of newborns representing the number of vaccinated pregnant women were followed for one year. Vaccine efficacy were based on literature review. Epidemiological, healthcare resource utilization and cost estimates were based on local data retrieved from Brazilian Health Information Systems. Costs of epidemiological investigation and treatment of contacts of cases were included in the analysis. No discount rate was applied to costs and benefits, as the temporal horizon was one year. Primary outcome was cost per life year saved (LYS). Univariate and best- and worst-case scenarios sensitivity analysis were performed.Maternal vaccination of one annual cohort, with vaccine effectiveness of 78%, and vaccine cost of USD$12.39 per dose, would avoid 661 cases and 24 infant deaths of pertussis, save 1800 years of life and cost USD$28,942,808 and USD$29,002,947, respectively, from the health system and societal perspective. The universal immunization would result in ICERs of USD$15,608 and USD$15,590 per LYS, from the health system and societal perspective, respectively. In sensitivity analysis, the ICER was most sensitive to discounting of life years saved, variation in case-fatality, disease incidence, vaccine cost, and vaccine effectiveness.The results indicate that universal maternal immunization with Tdap is a cost-effective intervention for preventing pertussis cases and deaths in infants in Brazil.
Keywords	childhood ; cost effectiveness ; cost estimates ; decision support systems ; disease incidence ; epidemiological studies ; health information ; health services ; information systems ; models ; neonates ; pregnancy ; pregnant women ; vaccination ; vaccines ; Brazil
Language	English
Dates of publication	2016-0318
Size	p. 1531-1539.
Publishing place	Elsevier Ltd
Document type	Article
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2016.02.026
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Neurologic Disease after Yellow Fever Vaccination, São Paulo, Brazil, 2017–2018

Ana Freitas Ribeiro / Bruno Fukelmann Guedes / Jamal M.A.H. Sulleiman / Francisco Tomaz Meneses de Oliveira / Izabel Oliva Marcilio de Souza / Juliana Silva Nogueira / Rosa Maria Nascimento Marcusso / Eder Gatti Fernandes / Guilherme Sciascia do Olival / Pedro Henrique Fonseca Moreira de Figueiredo / Ana Paula Rocha Veiga / Flávia Esper Dahy / Natália Nasser Ximenes / Lecio Figueira Pinto / José Ernesto Vidal / Augusto Cesar Penalva de Oliveira

Emerging Infectious Diseases, Vol 27, Iss 6, Pp 1577-

2021 Volume 1587

Abstract: Yellow fever (YF) vaccine can cause neurologic complications. We examined YF vaccine–associated neurologic disease reported from 3 tertiary referral centers in São Paulo, Brazil, during 2017–2018 and compared the performance of criteria established by ... ...

Abstract	Yellow fever (YF) vaccine can cause neurologic complications. We examined YF vaccine–associated neurologic disease reported from 3 tertiary referral centers in São Paulo, Brazil, during 2017–2018 and compared the performance of criteria established by the Yellow Fever Vaccine Working Group/Centers for Disease Control and Prevention and the Brighton Collaboration. Among 50 patients who met inclusion criteria, 32 had meningoencephalitis (14 with reactive YF IgM in cerebrospinal fluid), 2 died, and 1 may have transmitted infection to an infant through breast milk. Of 7 cases of autoimmune neurologic disease after YF vaccination, 2 were acute disseminated encephalomyelitis, 2 myelitis, and 3 Guillain-Barré syndrome. Neurologic disease can follow fractional vaccine doses, and novel potential vaccine-associated syndromes include autoimmune encephalitis, opsoclonus-myoclonus-ataxia syndrome, optic neuritis, and ataxia. Although the Brighton Collaboration criteria lack direct vaccine causal assessment, they are more inclusive than the Centers for Disease Control and Prevention criteria.
Keywords	encephalitis ; aseptic meningitis ; Guillain-Barré syndrome ; myelitis ; optic neuritis ; autoimmune encephalitis ; Medicine ; R ; Infectious and parasitic diseases ; RC109-216
Subject code	610
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	Centers for Disease Control and Prevention
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Surto de sarampo na regiao metropolitana de Campinas, SP

Eder Gatti Fernandes / Maria Emilia Braite de Oliveira / Joao Fred / Luzia Auxiliadora Carelli / Gisele Dias de Freitas Lima / Helena Keico Sato / Ana Lucia Frugis Yu

Revista de Saúde Pública, Vol 47, Iss 6, Pp 1213-

2013 Volume 1217

Abstract: O Brasil não apresenta circulação endêmica do vírus do sarampo desde o ano 2000. Entre maio e junho de 2011, a Região Metropolitana de Campinas, Estado de São Paulo, registrou três casos de sarampo. Foram descritos casos, as medidas de controle, a busca ... ...

Abstract	O Brasil não apresenta circulação endêmica do vírus do sarampo desde o ano 2000. Entre maio e junho de 2011, a Região Metropolitana de Campinas, Estado de São Paulo, registrou três casos de sarampo. Foram descritos casos, as medidas de controle, a busca de possível fonte e de casos secundários. A caracterização genotípica do vírus identificou o genótipo D4, circulante no continente europeu. Não foram encontrados casos índice ou secundários. As medidas de controle efetuadas, aliadas à cobertura vacinal adequada da Região Metropolitana de Campinas contribuíram para que a transmissão da doença fosse interrompida.
Keywords	Sarampion ; epidemiologia ; Virus del Sarampion ; aislamiento & purificacion ; Brotes de Enfermedades ; Zonas Metropolitanas ; Epidemiologia Descriptiva ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2013-12-01T00:00:00Z
Publisher	Universidade de São Paulo
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The search for yellow fever virus vaccine in breast milk of inadvertently vaccinated women in Brazil

Eder Gatti Fernandes / Juliana Silva Nogueira / Victor Bertollo Gomes Porto / Helena Keico Sato

Revista do Instituto de Medicina Tropical de São Paulo, Vol 62

Abstract: ABSTRACT Eleven lactating women were inadvertently vaccinated with 17DD yellow fever vaccine in a small city of Sao Paulo State, Brazil. Their infants were being exclusively breast-fed and the breastfeeding was interrupted for 10 days. Serum and ... ...

Abstract	ABSTRACT Eleven lactating women were inadvertently vaccinated with 17DD yellow fever vaccine in a small city of Sao Paulo State, Brazil. Their infants were being exclusively breast-fed and the breastfeeding was interrupted for 10 days. Serum and breastmilk were collected from the vaccinated mothers and tested for the presence of genomic RNA of the vaccine strain 8, 10 and 15 days after vaccination. Viral RNA was not detected in any of the serum and human milk samples tested and the infants remained asymptomatic. Our result strengthens the effectineness of stopping breastfeeding for 10 days after the inadvertent yellow fever vaccination of lactating women.
Keywords	yellow fever vaccine ; breast feeding ; adverse events ; brazil ; Arctic medicine. Tropical medicine ; RC955-962
Language	English
Publisher	Universidade de São Paulo
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: 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)

Alexandre Blikstad Mauro / Eder Gatti Fernandes / Karina Takesaki Miyaji / Benedito Antônio Arantes / Maria Gomes Valente / Helena Keico Sato / Ana Marli C. Sartori

Revista do Instituto de Medicina Tropical de São Paulo, Vol 61

Abstract: 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 ... ...

Abstract	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.
Keywords	Papillomavirus vaccines ; Human papillomavirus recombinant vaccine Quadrivalent ; genotypes 6 ; 11 ; 16 ; 18 ; Adverse effects Adverse Drug Reaction Reporting Systems ; Immunization Stress Related Response ; Vaccination ; Arctic medicine. Tropical medicine ; RC955-962
Subject code	630
Language	English
Publisher	Universidade de São Paulo
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Ocorrência de eventos adversos após o uso da vacina adsorvida difteria, tétano e pertussis (acelular) – dTpa –, São Paulo, SP, 2015-2016

Vera Lúcia Gattás / Expedito José Albuquerque Luna / Ana Paula Sayuri Sato / Eder Gatti Fernandes / Lourdes R.A. Vaz-de-Lima / Helena Keiko Sato / Euclides A. de Castilho

Epidemiologia e Serviços de Saúde

Abstract: Resumo Objetivo descrever a ocorrência de eventos adversos pós-vacinação (EAPV) com a vacina dTpa durante a gestação. Métodos estudo descritivo, com dados de relatos das participantes de estudo de efetividade e imunogenicidade realizado em dois hospitais ...

Abstract	Resumo Objetivo descrever a ocorrência de eventos adversos pós-vacinação (EAPV) com a vacina dTpa durante a gestação. Métodos estudo descritivo, com dados de relatos das participantes de estudo de efetividade e imunogenicidade realizado em dois hospitais de São Paulo, SP, Brasil, entre 2015 e 2016. Resultados das 201 mães incluídas no estudo, 48 (23,9%) apresentaram pelo menos um EAPV; foram identificados 60 sintomas relacionados ao uso da dTpa – dor (22,4%), inchaço (2,5%), febre (1,5%), sono (1,0%), vermelhidão (0,5%), vômito (0,5%), dor de cabeça (0,5%), reação local (0,5%) e cansaço (0,5%); não foram registrados eventos adversos raros, muito raros ou extremamente raros; todos os eventos foram considerados esperados e estão descritos em bula; todos tiveram desfecho para cura sem sequelas. Conclusão a dTpa, na forma adotada pelo Programa Nacional de Imunizações (PNI), é segura; não foram identificados eventos adversos inesperados entre as gestantes imunizadas com a vacina.
Keywords	Vacinas contra Difteria ; Tétano e Coqueluche Acelular ; Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos ; Segurança ; Vigilância ; Medicine ; R ; Public aspects of medicine ; RA1-1270
Language	English
Publisher	Ministério da Saúde do Brasil
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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