Calendario vacunal de la Asociación Española de Pediatría: recomendaciones 2005

[Vaccination schedule of the Spanish Association of Pediatrics: recommendations 2007]

The Vaccine Advisory Committee of the Spanish Association of Pediatrics provides information on the new developments in vaccines that have taken place in 2006 and recommends certain modifications to the Immunization Schedule for 2007. To ensure early protection, the measles-mumps-rubella (MMR) vaccine booster dose should be administered when children start school (3-4 years). Based on existing scientific evidence, the importance of universal heptavalent conjugate pneumococcal vaccination, as occurs in most similar European countries and in the autonomous community of Madrid in Spain, is confirmed. The safety and efficacy of rotavirus and human papilloma virus vaccines, as well as their use in our environment, is discussed and the role of pediatricians in their implementation is stressed. The recommended immunization schedule for children and adolescents starting vaccination late is also discussed.

Calendario de vacunación de la Asociación Española de Pediatría: recomendaciones 2006

Based on the evidence available, the Vaccines Advisory Committee (VAC) of the Spanish Association of Pediatrics reports and comments on the new developments in vaccines that have taken place in 2005 and recommends some modifications to the vaccination schedule for 2006. In agreement with changes in the product monographs for the meningococcal C vaccine, the VAC recommends two doses for the three commercially available preparations with a booster dose in the second year of life. The European Medicines Evaluation Agency (EMEA) has temporarily suspended the sale of the Hexavac vaccine due to doubts about its long-term protection against hepatitis B. The VAC continues to support the use of these combined vaccines. Currently only Infranrix Hexa is available in Spain. The recommendation of vaccinating adolescents with a booster dose of pertussis vaccine via the administration of an acellular preparation of low antigenic load together with the adult diphtheria and tetanus vaccine remains valid. Vaccination against chickenpox in susceptible children aged more than 12 months old continues to be recommended. There is wide coverage for the 7-valent pneumococcal conjugate vaccine in many areas of Spain. In view of the studies published, the VAC reiterates the need for universal immunization by introducing this vaccine in the official vaccination schedule. Finally, other vaccines not included in this schedule are discussed, with special mention of the advisability of influenza vaccination in children, according to the recommendations of the VAC available at the beginning of each season on the web site of the Spanish Association of Pediatrics www.aeped.es; www. vacunasaep.org.

Epidemiology and surveillance of pertussis among infants in Catalonia, Spain, during 1997-2001

BACKGROUND

Despite high levels of vaccination coverage in Spain and Catalonia (98% in 2002), pertussis is a significant cause of morbidity among infants. The study aim was to estimate the incidence of hospitalizations for pertussis among infants from 1997 through 2001 in Catalonia.

METHODS

A retrospective review of records for patients <12 months of age with a diagnosis of pertussis (International Classification of Diseases, 9th revision, code 033) at discharge from 11 Catalonian hospitals was performed.

RESULTS

Three hundred forty-six patients were identified, 62 (1997), 28 (1998), 59 (1999), 150 (2000) and 47 (2001), of whom 284 (82%) were <4 months of age. The incidence of hospitalizations because of whooping cough from 1997 through 2001 in Catalonia was estimated at 118 cases per 100,000 inhabitants <12 months of age. Symptoms included paroxysmal cough (95%), cyanosis (67.9%), vomiting (36.7%) and apneic episodes (27.7%). Three infants (0.8%) died, all <2 months of age. Two hundred thirty-four patients (67.6%) were unvaccinated (222 patients were <3 months of age). Six patients (1.7%) were fully vaccinated (3 doses). Considering that only 220 patients <12 months of age were reported through the Catalonian Notification System in 1997-2001, at least 126 hospitalizations (36.4%) for pertussis were not reported to this system (mean difference per year, 32.6%; range, 8.4-56%).

CONCLUSIONS

In this study, hospitalizations exceeded the number of notifications by at least 32.6%; therefore, the real incidence is likely to be greatly underestimated. Pertussis incidence remains high among infants, most of whom are <4 months of age and have had no or 1 dose of vaccine.