Palavras-Chave: Coronavirus; Análise Espacial; Epidemiologia; Brasil

We aimed to describe the impact of pertussis on adolescents, adults, and older adults over 2007–2018 in selected Latin American countries by reviewing the literature. We searched the Medline, Embase, Scopus, LILACS, Scielo, Google Scholar, CAPES Journals Web-portal, and Cochrane databases for observational epidemiological studies, clinical trials, and systematic reviews of primary studies. Data were extracted and analyzed for all individuals aged ≥10 years. Of 6,891 studies identified only 25 were eligible. Studies were conducted in Brazil (14), Argentina (4), Colombia (4), Mexico (2) and Chile (1). Epidemiological data among target population were limited. No studies clearly assessed the status of asymptomatic or oligosymptomatic B. pertussis carriers in these age groups. Among all pertussis cases identified, the percentage of patients ≥10 years-old ranged between 2.1% and 66.7% depending on country and sample characteristics. The definition of cases, diagnostic methods, and age groups were not consistent across studies.

The pneumococcal conjugate vaccination (PCV) was introduced into the Brazilian Childhood National Immunization Program in 2010; however, universal pneumococcal vaccination for older adults has not been implemented yet. Our aim is to evaluate the trends in pneumococcal meningitis incidence and case fatality rate (CFR) across all age groups from 2007 to 2019 using data from the National Surveillance System. The pre-PCV (2007–2009) and post-PCV (2011–2019) periods were compared; changes in incidence and CFR were assessed by joinpoint regression. Additional analyses of bacterial meningitis were performed to compare the patterns and trends. Over the 13-year period, 81,203 and 13,837 cases were classified as bacterial and pneumococcal meningitis, respectively. S. pneumoniae was the main etiological agent of bacterial meningitis in adults aged ≥50 years and the most lethal in all age groups. In the post-PCV period, a 56.5% reduction in the average incidence was seen in pneumococcal meningitis in the pediatric population. In contrast, there was an increasing trend among adults. The CFR for pneumococcal and bacterial meningitis remained stable in most age groups during the study period. These findings highlight the value of expanding pneumococcal vaccination policies, including vaccines that provide better indirect protection from children to adults and broadening vaccination to older adults.

Background: Yellow fever (YF) is an arbovirus with variable severity, including severe forms with high mortality. The vaccination is the most effective measure to protect against the disease. Non-serious and serious adverse events have been described in immunocompromised individuals, but previous studies have failed to demonstrate this association. This systematic review assessed the risk of adverse events after YF vaccination in immunocompromised individuals compared with its use in non-immunocompromised individuals.Methods: A search was conducted in the MEDLINE, LILACS, EMBASE, SCOPUS, DARE, Toxiline, Web of Science and grey literature databases for publications until February 2021. Randomized and quasi-randomized clinical trials and observational studies that included immunocompromised participants (individuals with HIV infection, organ transplants, with cancer, who used immunosuppressive drugs for rheumatologic diseases and those on immunosuppressive therapy for other diseases) were selected. The methodological quality of observational or non-randomized studies was assessed by the ROBINS-I tool. Two meta-analyses were performed, proportion and risk factor analyses, to identify the summary measure of relative risk (RR) in the studies that had variables suitable for combination.Results: Twenty-five studies were included, most with risk of bias classified as critical. Thirteen studies had enough data to carry out the proposed meta-analyses. Seven studies without a comparator group had their results aggregated in the proportion meta-analysis, identifying an 8.5% [95% confidence interval (CI) 0.07–21.8] risk of immunocompromised individuals presenting adverse events after vaccination. Six cohort studies were combined, with an RR of 1.00 (95% CI 0.78–1.29). Subgroup analysis was performed according to the aetiology of immunosuppression and was also unable to identify an increased risk of adverse events following vaccination.Conclusions: It is not possible to affirm that immunocompromised individuals, regardless of aetiology, have a higher risk of adverse events after receiving the YF vaccine.

In April 2024, a hybrid meeting organized by the WHO, PAHO, and MPP during the World Bank Spring Meetings focused on financing mRNA-based technologies in Low- and Middle-Income Countries (LMICs). This meeting sought to engage multilateral development banks (MDBs) and stakeholders in financing the expansion of vaccine production and enhancing pandemic preparedness. The COVID-19 pandemic underscored the disparities in vaccine production and distribution, highlighting the need for localized production to improve global health equity. The WHO’s mRNA Technology Transfer Programme, initiated in 2021, aims to build local capacity for mRNA vaccine development and manufacturing. Key sessions covered during the meeting include innovative investment models, with MDBs discussing funding instruments and the necessity of an integrated ecosystem for sustainable vaccine manufacturing. Challenges such as technological risks and the need for higher risk appetite were addressed, along with innovative financing mechanisms like blended financing. An analysis of capital and operational expenditures for mRNA vaccine facilities was presented, projecting significant production capacity in LMICs within a decade. Panelists emphasized the need for sustainable R&D investment and shared experiences in securing funding for mRNA technology. The meeting underscored the importance of collaboration, innovative financing, ecosystem development, and public–private partnerships, marking a pivotal step towards advancing mRNA technology in LMICs to tackle global health challenges.

We conducted a systematic review and a meta-analysis to assess the risk of serious adverse events in the elderly after yellow fever vaccination compared to the non-elderly population. We searched multiple databases and grey literature, and we selected research without language and publication date restrictions. Studies were analyzed in a descriptive way and meta-analyzed and expressed in terms of prevalence ratio and risk ratio with a 95% confidence interval, depending on the degree of heterogeneity found. A total of 18 studies were included and 11 were meta-analyzed. The results obtained through the meta-analysis showed a risk of serious adverse events after yellow fever vaccination three times higher for the elderly when compared to the non-elderly population and five times higher for persons > 70 years. In relation to adverse event types, viscerotropic disease associated with the yellow fever vaccine had a risk that was six times higher when compared to the population < 60 years. The evidence found supports that the vaccine indication in individuals > 60 years of age should be based on a careful analysis of individual benefit-risk assessments. The results found suggest a higher risk of events for individuals > 70 years, especially for viscerotropic and neurotropic disease associated with YFV contraindicating the use of the YFV in this age group.