With the arrival of winter, respiratory infections multiply and greatly impact our lives, in some cases they can lead to hospitalization and, in the most extreme scenarios, death. According to the National Institute of Statistics, it is estimated that in 2022 there were 42,979 deaths due to diseases of the respiratory system, making it the third cause of death in Spain.
Respiratory diseases affect all ages, however, certain population groups are affected to a greater extent. This is the case of those over 65 years of age, pregnant women or children. There are also other groups, such as health workers, where vaccination coverage does not reach – not even remotely – the established objectives. Therefore, the challenge to help prevent them and cover all age groups is to design and execute an effective vaccination campaign.
“Although in recent years the media and social focus has been on COVID-19, we nurses know how crucial the winter vaccination campaign is,” explains Pilar Fernández, director of the Higher Institute of Health Training (ISFOS) during the webinar Winter vaccination campaignheld by the training institute of General Nursing Council (CGE), with the collaboration of Pfizer.
«This year, we will have a double vaccination campaign for all ages, because respiratory infections are not just a thing for adults, since the little ones in the house also get infected and, above all, they are the main transmitters of these diseases. In this new campaign we have the opportunity to increase activity among the health personnel themselves, because despite them being the ones who care for and promote the vaccination act, paradoxically we have a much lower percentage of coverage than desired in this group. , Add.
Winter vaccination campaign
The winter vaccination campaign presents new features and challenges to face, but, above all, with well-planned organization. The most important thing will be to achieve good vaccination coverage for both flu and COVID-19, so we will attend a double vaccination campaign, which, as a novelty in all of Spain, will be aimed at all age groups.
«It has been observed that the highest incidence of flu, by age group, is recorded among those under fifteen years of age, especially those under five years of age, who are also having a considerable rate of admission. Regarding COVID-19, it seems that since August there has been a new increase in cases at a general level, probably due to the variants of the virus, which have completely changed since this year and we are witnessing an immune escape from the already existing vaccines. , which justifies the planning of this year’s campaign,” explains Olga Vicente, a doctor specializing in Family and Community Medicine at the La Marazuela Health Center, in Madrid.
Increase coverage and reduce incidents, the great challenges of this campaign
Regarding the planning and management of the campaign, healthcare directorates and Primary Care management have a fundamental role. «We have center managers and nurses who have been working on prevention and promotion since the pandemic. The majority are specialist nurses who have double coordination with the entire technical integration direction that communicates with Public Health and with the health centers where there are vaccine managers who work on the task of vaccination and recruitment, who calculate the number of doses and that they develop a communication plan so that nothing fails,” says Inmaculada García, nursing care director of the South Area of Madrid.
Furthermore, the main challenge of this campaign is to reduce incidents and increase coverage, insisting on opportunistic vaccination. «With a well-planned campaign, incidents regarding lack of stock or breaks in cold chains will be minimized. Thus, our promotion and prevention nurses focus on vaccinating the greatest number of patients over 65 years of age, promoting the vaccine in pregnant women and continuing to raise awareness among health workers to have adequate coverage. Last year we lowered coverage levels and health professionals were the group with the lowest vaccination rate. Only 43.9% coverage was achieved when the target was 75%. In the case of pregnant women we went from 60% to 53.3% and in the case of those over 65 years of age the goal was 75% and we only reached 69.7%,” García continues.
News
In this campaign we are witnessing social changes with a progressive aging of the population. This fact, together with the “characteristics of immunity at certain ages, means that there is an increasingly greater need to provide protection to more population groups and, therefore, vaccination programs are becoming broader and more extensive every day. Furthermore, the lines of vaccine research are also advancing to precisely respond to the protection needs of these vulnerable people, which justifies including, for example, children under five years of age in the flu campaign,” explains Marina. Moreno, nurse at the Torres de la Alameda Health Center and expert in Advanced Practice in Vaccination.
In addition to the target population groups to be vaccinated this year, the modification in the composition of the vaccines to be used is incorporated as a novelty, so that a response can be given to the antigenic variations of bacteria and viral strains responsible for respiratory infections and to cover the protection needs of the most vulnerable people. For this 2023-2024 season and following the WHO recommendations, the available flu vaccines will all be quadrivalent and the COVID-19 vaccines will be monovalent against the omicron strain variant, predominant at the moment.
«Increased protection for adults at risk»
«For the prevention of pneumococcal disease and its invasive forms – another of the most prevalent respiratory infections at this time -, the majority of the Autonomous Communities have already incorporated a new conjugate vaccine with additional serotypes compared to its predecessor, which will provide protection increased for adults at risk,” continues Moreno.
Respiratory infections “also entail a big problem and that is that different pathogens circulate in the same season, which increases the risk of coinfection and, therefore, worsens the prognosis of infected people. The confirmation of this fact and the need to avoid missed vaccination opportunities has motivated another of the key points of this campaign and that is that double vaccination against flu and COVID-19 is addressed for the target population in the same vaccination event and, In addition, opportunistic screening and vaccination against other serious infections such as pneumococcal disease is recommended for people who have an indication,” explains this Advanced Practice nurse.
Situation in Valencia
The novelty in the Valencian Community in this winter vaccination campaign lies in the prevention against flu with the administration of Fluenz Tetra. «A vaccine for children between 2 and 5 years old without clinical immunodeficiencies, developed from live attenuated viruses and with which it has already been tested and has great scientific evidence. In minors with serious pathologies, this vaccine is not recommended and can even be harmful,” explains Laura Almudéver, president of the Valencia College of Nursing (COENV) and Primary Care nurse.
Likewise, the president of the COENV also highlights the “essential” function of nurses in the population immunization process because “vaccinating is much more than pricking” it means “humanizing the process.” Almudéver emphasizes that vaccinating for a nurse “is introducing myself, checking data, asking for health history, administering the vaccine, explaining side effects, saying goodbye and informing them to wait 15 minutes in case urgent complications appear, it is resolving doubts, it is managing that the vaccines are in the refrigerator when the patient arrives, is maintaining the cold chain, is being constantly updated; In short, it is all this and much more.
Avoid possible errors
The new vaccination campaign involves the use of millions of doses, which implies unprecedented logistical management. A process that can instill errors or generate cracks in it. For this, Marina Moreno, one of the speakers of the webinar wanted to give a brief reminder about the need to avoid all security gaps that may be generated during the vaccination process.
«We are witnessing a campaign with an absolutely spectacular logistical deployment; There are millions of doses that we are going to be handling and we have to avoid errors and risk situations that are repeated year after year and that can compromise the immunogenicity of the vaccines that are going to be administered. There must be an established plan to prevent breaks in the cold chain, which is the main problem involved in the storage and handling of vaccines in health centers, in addition to providing for an adjusted dose calculation to respond to the needs of the population and face this logistical challenge that we face,” argues this Advanced Practice nurse.
«We nurses have to make a call to all health personnel about these issues and encourage them to take care of this process, because vaccines are the best prevention tool available for healthy people, but, above all, for the most vulnerable. and who most need all the protection possible,” he adds.
Nursing leadership
The nursing role in the immunization of the population is not limited to the mere administration of the vaccine. Health education, the prevention they carry out and their proactivity is what largely determines the success of this intervention. «We are the health professionals closest to the patients and, therefore, it is up to us to implement strategies that allow the capture and measurement of coverage in the different risk groups, therefore, we must take advantage of any contact to establish the recommendation vaccination at all ages. The objective is clear, to achieve unprecedented vaccine coverage that allows us to be one step ahead of respiratory infection at all ages,” concludes Pilar Fernández, director of ISFOS.
2023-10-19 12:07:00
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