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Álvarez Aldeán J, José Álvarez García F, de la Calle Fernández-Miranda M, Figueras Falcón T, Iofrío de Arce A, López Rojano M, Rivero Calle I, Suy Franch A. Vaccination in pregnancy. Consensus document of the CAV-AEP and the SEGO. An Pediatr (Barc) 2024; 100:268-274. [PMID: 38565447 DOI: 10.1016/j.anpede.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 04/04/2024] Open
Abstract
During pregnancy, physiological changes in the immune response make pregnant women more susceptible to serious infection, increasing the risk for the mother as well as the foetus, newborn and infant. All women should be correctly and fully vaccinated as they enter their reproductive years, especially against diseases such as tetanus, hepatitis B, measles, rubella and varicella. In addition to the recommended vaccines, in risk situations, inactivated vaccines could be administered to women who were not correctly vaccinated before, while attenuated vaccines are contraindicated. Despite the fact that vaccination during pregnancy is a very important preventive measure and the existing recommendations from public health authorities, scientific societies and health professionals, the vaccination coverage could clearly be improved, especially against influenza and SARS-CoV-2, so any health professional involved in the care of pregnant women should proactively recommend these vaccines. The Spanish Association of Pediatrics (AEP), through its Advisory Committee on Vaccines, and the Spanish Society of Gynaecology and Obstetrics (SEGO) recommend vaccination against the following diseases during pregnancy: against influenza and COVID-19, in any trimester of pregnancy and during the postpartum period (up to 6 months post birth) in women not vaccinated during pregnancy; against pertussis, with the Tdap vaccine, between weeks 27 and 36 of gestation (in the CAV-AEP recommendations, preferably between weeks 27 and 28); and against RSV, with RSVPreF, between weeks 24 and 36 of gestation, preferably between weeks 32 and 36.
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Affiliation(s)
- Javier Álvarez Aldeán
- Servicio de Pediatría, Hospital Costa del Sol, Asociación Española de Pediatría (CAV-AEP), Marbella, Málaga, Spain
| | - Francisco José Álvarez García
- Centro de Salud de Llanera, Asturias Departamento de Medicina. Universidad de Oviedo. Asociación Española de Pediatría (CAV-AEP), Oviedo, Spain.
| | - Maria de la Calle Fernández-Miranda
- Sección de Obstetricia, Hospital Universitario la Paz, Facultad de Medicina, Universidad Autónoma de Madrid, Sociedad Española de Ginecología y Obstetricia, Madrid, Spain
| | - Tatiana Figueras Falcón
- Unidad Medicina Materno Fetal, Servicio de Obstetricia y Ginecologia, Complejo Hospitalario Universitario Insular Materno-Infantil de Las Palmas, Sociedad Española de Ginecología y Obstetricia, Las Palmas de Gran Canaria, Spain
| | - Antonio Iofrío de Arce
- Centro de Salud El Ranero, Comité Asesor de Vacunas de la Asociación Española de Pediatría (CAV-AEP), Murcia, Spain
| | - Marta López Rojano
- Servicio de Medicina Maternofetal, BCNatal-Centro de Medicina Maternofetal y Neonatal de Barcelona (Hospital Clínic de Barcelona y Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Sociedad Española de Ginecología y Obstetricia, Barcelona, Spain
| | - Irene Rivero Calle
- Sección de Pediatría Clínica, Infectológica y Traslacional, Hospital Clínico Universitario de Santiago de Compostela, Sociedad Española de Infectología Pediátrica (SEIP), Grupo Genética, Vacunas, Infecciones y Pediatría (GENVIP). Asociación Española de Pediatría (CAV-AEP), Santiago de Compostela, A Coruña, Spain
| | - Anna Suy Franch
- Sección de Obstetricia, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Sociedad Española de Ginecología y Obstetricia, Barcelona, Spain
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Álvarez García FJ, Iofrío de Arce A, Álvarez Aldeán J, Garcés-Sánchez M, Garrote Llanos E, Montesdeoca Melián A, Navarro Gómez M, Pineda Solas V, Rivero Calle I, Ruiz-Contreras J, Serrano Marchuet P. Immunisation schedule of the Spanish Association of Pediatrics: 2024 recommendations. An Pediatr (Barc) 2024; 100:34-45. [PMID: 38220359 DOI: 10.1016/j.anpede.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/04/2023] [Indexed: 01/16/2024] Open
Abstract
The AEP Immunization Calendar for 2024, with its immunization recommendations for pregnant women, children and adolescents residing in Spain, marks the 25th edition since the first one was introduced in 1995, being annual since 2003, as a vaccination calendar, and since 2023 as immunization schedule due to the inclusion of a monoclonal antibody for the prevention of RSV disease. Novelties for this year include the following: The rest of the recommendations from the previous calendar remain unchanged.
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Affiliation(s)
- Francisco José Álvarez García
- Centro de Salud de Llanera, Lugo de Llanera, Asturias, Departamento de Medicina, Universidad de Oviedo, Oviedo, Asturias, Spain.
| | | | | | - María Garcés-Sánchez
- Centro de Salud Nazaret, Valencia, Investigadora adscrita al Área de Vacunas, FISABIO, Valencia, Spain
| | - Elisa Garrote Llanos
- Sección de Infectología, Hospital Universitario Basurto, Bilbao, Facultad de Medicina, Universidad del País Vasco, UPV-EHU, Bilbao, Vizcaya, Spain
| | | | - Marisa Navarro Gómez
- Servicio de Pediatría, Hospital Universitario Gregorio Marañón, Departamento de Pediatría, Facultad de Medicina, Universidad Complutense de Madrid, CIBER ISCIII y IISGM, Madrid, Spain
| | - Valentín Pineda Solas
- Sección de Infectología Pediátrica, Hospital Universitario Parc Tauli-Sabadell, Barcelona, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Irene Rivero Calle
- Sección de Pediatría Clínica, Infectológica y Traslacional, Hospital Clínico Universitario de Santiago de Compostela, La Coruña, Sociedad Española de Infectología Pediátrica (SEIP), Miembro del Grupo Genética, Vacunas, Infecciones y Pediatría (GENVIP), Santiago de Compostela, La Coruña, Spain
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Iofrío de Arce A, Álvarez García FJ. Nirsevimab and other strategies for the prevention of RSV infection. An Pediatr (Barc) 2023; 99:221-223. [PMID: 37739824 DOI: 10.1016/j.anpede.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 09/24/2023] Open
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García FJÁ, Tejada AMG, Heras IG, de Arce AI, Llop FM, Herreros FN, Martín JJP, Marchuet PS, Rodríguez JV. Vaccination schedule for adolescents. Consensus of the AEV, CAV-AEP and SEMA. An Pediatr (Barc) 2023; 99:122-128. [PMID: 37487775 DOI: 10.1016/j.anpede.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 07/26/2023] Open
Abstract
We present the consensus document on the immunization schedule for adolescents developed by 3 scientific societies: the Spanish Association of Pediatrics (AEP), through its Advisory Committee on Vaccines (CAV-AEP), the Spanish Society of Adolescent Medicine (SEMA) and the Spanish Association of Vaccinology (AEV). There are particularities in infectious disease during adolescence, such as an increased susceptibility to pertussis, poorer outcomes of chickenpox, mumps and hepatitis A, a high incidence of sexually transmitted infections or increased prevalence of meningococcal carriage. The document analyses the schedule for adolescents in the context of vaccination policy overall. It contemplates the vaccines to be included in the immunization schedule for healthy adolescents: against invasive meningococcal disease (tetravalent ACWY and B), against human papillomavirus (which should be gender-neutral), against pertussis, against influenza and against SARS-CoV-2 (in unvaccinated individuals and at-risk groups). It is worth noting that the 4CMenB vaccine appears to confer some protection against gonococcal infection, which would be a considerable added value for adolescents. The vaccination of adolescents belonging to risk groups or travelling abroad also needs to be contemplated, as is the case in any other age group. Vaccination against hepatitis A, which is included in the routine immunization schedule of Catalonia, Ceuta and Melilla from the second year of life, should also be considered a priority in adolescents traveling to endemic areas.
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Affiliation(s)
- Francisco José Álvarez García
- Centro de Salud de Llanera. Asturias, Departamento de Medicina, Universidad de Oviedo, Comité Asesor de Vacunas de la Asociación Española de Pediatría, Spain.
| | - Ana María Grande Tejada
- Hospital Materno Infantil de Badajoz, Departamento de Medicina. Universidad de Extremadura, Asociación Española de Vacunología, Spain
| | - Ignacio Güemes Heras
- Unidad de Cuidados Intensivos de Neonatología y Pediatría, Hospital La Salud, Universidad Católica de Valencia, Sociedad Española de Medicina de la Adolescencia, Spain
| | - Antonio Iofrío de Arce
- Centro de Salud El Ranero, Murcia, Comité Asesor de Vacunas de la Asociación Española de Pediatría, Spain
| | | | - Félix Notario Herreros
- Servicio Pediatría y Adolescencia, Clínica Rosario, Grupo HLA, Albacete, Sociedad Española Medicina de la Adolescencia, Spain
| | - Jaime Jesús Pérez Martín
- Dirección General de Salud Pública y Adicciones, Comunidad de Murcia, Asociación Española de Vacunología, Spain
| | - Pepe Serrano Marchuet
- Equipo de Pediatría territorial del Garraf, Barcelona, Comité Asesor de Vacunas de la Asociación Española de Pediatría, Spain
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Álvarez García FJ, Cilleruelo Ortega MJ, Álvarez Aldeán J, Garcés-Sánchez M, Garrote Llanos E, Iofrío de Arce A, Montesdeoca Melián A, Navarro Gómez ML, Pineda Solas V, Rivero Calle I, Ruiz-Contreras J, Serrano Marchuet P. Immunisation schedule of the Spanish Association of Paediatrics: 2023 Recommendations. An Pediatr (Barc) 2023; 98:58.e1-58.e10. [PMID: 36599520 DOI: 10.1016/j.anpede.2022.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/06/2022] [Indexed: 01/04/2023] Open
Abstract
As it does every year, the CAV-AEP publishes the update of its recommendations for the use of vaccines in children, adolescents and pregnant women residing in Spain. The 2 + 1 schedule is maintained in infants (at 2, 4 and 11 months), including preterm infants, with the hexavalent vaccine (DTaP-IPV-Hib-HB) and the pneumococcal 13-valent conjugate vaccine. A booster dose with DTaP-IPV is needed at 6 years for those who received the 2 + 1 series with hexavalent vaccine as infants, in addition to 1 dose of dTap in adolescence. Routine vaccination of pregnant women with a dose of dTap is recommended in each pregnancy, preferably between weeks 27 and 32 of gestation, although can be given from 20 weeks if there is risk of preterm delivery. All infants should receive the rotavirus vaccine (2-3 doses) and the 4CMenB vaccine (2 + 1 series). All children aged 6-59 months should be vaccinated against influenza each year. The MenACWY vaccine should be given routinely at 12 months of age and in adolescence between ages 12 and 18 years. The recommendations for the MMR vaccine (12 months and 3-4 years) and varicella vaccine (15 months and 3-4 years) also remain unchanged, using the MMRV vaccine for the second dose. Recommendations for the use of SARS-CoV-2 vaccines in the paediatric age group will be updated periodically on the CAV-AEP website. The HPV vaccine is indicated in all adolescents, regardless of sex, at age 12 years. Novelties include the recommendation of routine administration of nirsevimab to neonates and infants aged less than 6 months for passive immunization against RSV, and the recommendations regarding the hexavalent vaccine are consolidated in a single section.
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Affiliation(s)
| | - María José Cilleruelo Ortega
- Servicio de Pediatría, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, Spain; Departamento de Pediatría, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - María Garcés-Sánchez
- Centro de Salud Nazaret, Valencia, Spain; Área de Vacunas, FISABIO, Valencia, Spain
| | - Elisa Garrote Llanos
- Sección de Infectología, Hospital Universitario de Basurto, Bilbao, Spain; Facultad de Medicina, Universidad del País Vasco, UPV-EHU, Bilbao, Spain
| | | | | | - María Luisa Navarro Gómez
- Servicio de Pediatría, Hospital Universitario Gregorio Marañón, Madrid, Spain; Departamento de Pediatría, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Valentín Pineda Solas
- Sección de Infectología Pediátrica, Hospital Universitario Parc Tauli-Sabadell, Sabadell, Barcelona, Spain; Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Irene Rivero Calle
- Sección de Pediatría Clínica, Infectológica y Traslacional, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain; Grupo Genética, Vacunas, Infecciones y Pediatría (GENVIP), La Coruña, Spain
| | - Jesús Ruiz-Contreras
- Servicio de Pediatría, Hospital Universitario 12 de Octubre, Madrid, Spain; Departamento de Pediatría, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
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Álvarez García FJ, Cilleruelo Ortega MJ, Álvarez Aldeán J, Garcés-Sánchez M, Garrote Llanos E, Iofrío de Arce A, Montesdeoca Melián A, Navarro Gómez ML, Pineda Solas V, Rivero Calle I, Ruiz-Contreras J, Serrano Marchuet P. Calendario de inmunizaciones de la Asociación Española de Pediatría: recomendaciones 2023. An Pediatr (Barc) 2023. [DOI: 10.1016/j.anpedi.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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Álvarez García FJ, Cilleruelo Ortega MJ, Álvarez Aldeán J, Garcés-Sánchez M, Garrote Llanos E, Iofrío de Arce A, Montesdeoca Melián A, Navarro Gómez ML, Pineda Solas V, Rivero Calle I, Ruiz-Contreras J, Serrano Marchuet P. Calendario de vacunaciones de la Asociación Española de Pediatría: Recomendaciones 2022. An Pediatr (Barc) 2022. [DOI: 10.1016/j.anpedi.2021.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Álvarez García FJ, Cilleruelo Ortega MJ, Álvarez Aldeán J, Garcés-Sánchez M, García Sánchez N, Garrote Llanos E, Hernández Merino Á, Iofrío de Arce A, Montesdeoca Melián A, Navarro Gómez ML, Ruiz-Contreras J. [Immunisation schedule of the Pediatric Spanish Association: 2021 recommendations]. An Pediatr (Barc) 2021; 94:53.e1-53.e10. [PMID: 33419517 DOI: 10.1016/j.anpedi.2020.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/03/2020] [Indexed: 10/22/2022] Open
Abstract
The CAV-AEP annually publishes the immunisation schedule considered optimal for all children and adolescent resident in Spain, taking into account the available evidence. The 2+1 schedule is recommended (2, 4, and 11 months) with hexavalent vaccines (DTPa-VPI-Hib-HB) and with 13-valent pneumococcal conjugate.A 6-year booster is recommended, preferably with DTPa (if available), with a dose of polio for those who received 2+1 schemes, as well as vaccination with Tdpa in adolescents and in each pregnancy, preferably between 27 and 32 weeks. Rotavirus vaccine should be systematic for all infants. Meningococcal B vaccine, with a 2+1 schedule, should be included in routine calendar. In addition to the inclusion of the conjugated tetravalent meningococcal vaccine (MenACWY) at 12 years of age with catch up to 18 years, inclusive, the CAV recommends this vaccine to be also included at 12 months of age, replacing MenC. Likewise, it is recommended in those over 6 weeks of age with risk factors or who travel to countries with a high incidence of these serogroups. Two-dose schedules for triple viral (12 months and 3-4 years) and varicella (15 months and 3-4 years) will be used. The second dose could be applied as a tetraviral vaccine. Universal systematic vaccination against HPV is recommended, regardless of gender, preferably at 12 years, and greater effort should be made to improve coverage. The 9 genotype extends coverage for both genders.
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Affiliation(s)
| | - María José Cilleruelo Ortega
- Servicio de Pediatría, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, España; Departamento de Pediatría, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, España
| | | | - María Garcés-Sánchez
- Centro de Salud Nazaret, Valencia, España; Área de Vacunas, FISABIO, Valencia, España
| | - Nuria García Sánchez
- Centro de Salud Delicias Sur, Zaragoza, España; Departamento de Pediatría, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España
| | - Elisa Garrote Llanos
- Sección de Infectología, Hospital Universitario Basurto, Bilbao, España; Facultad de Medicina, Universidad del País Vasco, UPV-EHU, Bilbao, España
| | | | | | | | - María Luisa Navarro Gómez
- Servicio de Pediatría, Hospital Universitario Gregorio Marañón, Madrid, España; Departamento de Pediatría, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - Jesús Ruiz-Contreras
- Servicio de Pediatría, Hospital Universitario 12 de Octubre, Madrid, España; Departamento de Pediatría, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
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Álvarez García FJ, Cilleruelo Ortega MJ, Álvarez Aldeán J, Garcés-Sánchez M, García Sánchez N, Garrote Llanos E, Hernández Merino Á, Iofrío de Arce A, Merino Moína M, Montesdeoca Melián A, Navarro Gómez ML, Ruiz-Contreras J, Álvarez García FJ, Cilleruelo Ortega MJ, Álvarez Aldeán J, Garcés-Sánchez M, García Sánchez N, Garrote Llanos E, Hernández Merino Á, Iofrío de Arce A, Merino Moína M, Montesdeoca Melián A, Navarro Gómez ML, Ruiz-Contreras J. Calendario de vacunaciones de la Asociación Española de Pediatría: recomendaciones 2020. An Pediatr (Barc) 2020; 92:52.e1-52.e10. [DOI: 10.1016/j.anpedi.2019.10.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/22/2019] [Accepted: 10/26/2019] [Indexed: 12/19/2022] Open
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