Zika virus is a flavivirus that can be spread by mosquito vectors, sexual contact, infected blood products, and perinatal transmission.¹ In May 2015, a large outbreak of Zika virus infection was detected in northeastern Brazil that yielded an exceedingly high number of microcephaly cases.² Thereafter, the epidemic rapidly spread to other countries in the Americas and Asia. In the United States, the first case of non–travel-related, locally transmitted Zika virus infection was reported in Florida in July 2016.³

During the Zika virus (ZIKV) epidemic in Rio de Janeiro from September 2015 through June 2016, a prospective cohort study involving symptomatic pregnant women who had ZIKV infection confirmed by reverse-transcriptase–polymerase-chain-reaction assay was established.¹ The study was approved by the institutional review boards at Fundação Oswaldo Cruz in Rio de Janeiro and the University of California, Los Angeles, and all the women provided written informed consent for themselves and their children.

The COVID-19 pandemic has affected the entire world, and the vaccine has emerged as a source of hope for return to normal life. Still, various countries have reported high vaccine hesitancy rates. It is important to know the vaccine hesitancy profile in Brazil to help design adequate communication strategies. A voluntary, anonymous online survey was conducted from January 22 to 29, 2021, including resident Brazilian adults to assess factors related to vaccine hesitancy. Sociodemographic and epidemiological data were analyzed. A bivariate analysis was conducted with the independent variables, with vaccine hesitancy as the outcome variable, and a multivariate logistic model was used to calculated adjusted odds ratios. The sample included 173,178 respondents, and vaccine hesitancy was found in 10.5%. The principal factors associated with vaccine hesitancy were the following: assigning importance to the vaccinés efficacy (AOR = 16.39), fear of adverse reactions (AOR = 11.23), and assigning importance to the vaccinés country of origin (AOR = 3.72). Other risk factors were the following: male gender (AOR = 1.62), having children (AOR = 1.29), 9 years of schooling or less (AOR = 1.31), living in the Central-West region (AOR = 1.19), age ≥ 40 years (AOR = 1.17), and monthly income < U$788.68 (AOR = 1.13). The two vaccines available in Brazil, Covishield and CoronaVac, showed similar confidence, 80.13% and 76.36%, respectively, despite the higher rejection of the latter vaccinés Chinese origin. This online survey confirms the low vaccine hesitancy rate among Brazilians and allowed the identification of a profile that can assist the elaboration of communication strategies to increase vaccine adherence. National Institute of Women, Children and Adolescents Health Fernandes Figueira, FIOCRUZ, Rio de Janeiro, Brazil.

Zika virus (ZIKV) infection during pregnancy can cause a spectrum of central nervous system (CNS) abnormalities.^1-3 Infants severely affected by ZIKV classically present with microcephaly, other structural brain abnormalities, ocular abnormalities, congenital contractures, and profound neurologic impairment.² Clinical findings of ZIKV-exposed neonates with severe congenital ZIKV have been well described, including among several neuroimaging reports,^2-6 but the utility of neuroimaging for less severely affected infants is unclear. This study describes neuroimaging (computed tomography [CT] and/or magnetic resonance imaging [MRI]) findings and clinical outcomes in ZIKV-exposed infants with a range of clinical findings at birth. Our primary aims were as follows: (1) to review neuroimaging of infants with antenatal ZIKV exposure and to determine whether neuroimaging (CT and/or MRI) findings were associated with infant clinical outcomes and (2) to determine whether the gestational age at in utero ZIKV infection was associated with neuroimaging findings.