Serveur d'exploration sur la grippe en Espagne

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Influenza vaccination coverages among high risk subjects and health care workers in Spain. Results of two consecutive National Health Surveys (2011-2014).

Identifieur interne : 000136 ( Main/Exploration ); précédent : 000135; suivant : 000137

Influenza vaccination coverages among high risk subjects and health care workers in Spain. Results of two consecutive National Health Surveys (2011-2014).

Auteurs : Jenaro Astray-Mochales [Espagne] ; Ana L Pez De Andres [Espagne] ; Valentín Hernandez-Barrera [Espagne] ; Cristina Rodríguez-Rieiro [Espagne] ; Pilar Carrasco Garrido [Espagne] ; María D. Esteban-Vasallo [Espagne] ; Maria Felicitas Domínguez-Berj N [Espagne] ; Isabel Jimenez-Trujillo [Espagne] ; Rodrigo Jiménez-García [Espagne]

Source :

RBID : pubmed:27595448

Descripteurs français

English descriptors

Abstract

OBJECTIVES

We aim to describe influenza vaccination coverage for the Spanish population using data from two consecutive nation-wide representative health surveys. The data was analysed by high risk groups, health care workers (HCWs) and immigrants. Also, coverage trends were analysed.

MATERIAL AND METHODS

The 2011/12 Spanish National Health Survey (N=21,007) and the 2014 European Health Interview Survey for Spain (N=22,842) were analysed. Influenza vaccination status was self-reported. Time trends for were estimated by a multivariate logistic regression model.

RESULTS

Overall vaccination uptake was similar in 2011/12 and 2014, 19.1% and 18.9%, respectively, (p>0.05). 47% of the subjects surveyed were in the groups for which vaccination was recommended with coverages of 41.1% in 2011/12 and 40% in 2014 (p>0.05). In both surveys, uptake among subjects with a chronic disease was three times higher than uptake in subjects who did not have these diseases. In 2011/12 and 2014, 20% and 27.6% of health workers were vaccinated. Subjects born outside Spain were vaccinated less frequently than Spanish-born subjects (9.3% vs 20.4% and 8.9% vs 20%). Within the diseases studied, the best uptake was for patients with heart disease (52.5% in 2011/12 and 51.1% in 2014) and patients with diabetes (50.5% and 51.8%). Multivariate analysis showed that older age, having a chronic disease or being a HCW increases the possibility of being vaccinated whereas being born outside Spain decreased it.

CONCLUSIONS

Seasonal influenza vaccine uptake rates in the recommended target groups, patients with chronic conditions and health care workers, in Spain are unacceptably low and seem to be stable in the post pandemic seasons. This finding should alert health authorities to the need to work directly with health care providers on the indications for this vaccine and to study strategies that make it possible to increase vaccination uptake.


DOI: 10.1016/j.vaccine.2016.08.065
PubMed: 27595448


Affiliations:


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Le document en format XML

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<nlm:affiliation>Department of Epidemiology, Directorate of Health Promotion and Prevention, Ministry of Health, Community of Madrid, C/ Julián Camarillo, 4B, 28037 Madrid, Spain. Electronic address: jenaro.astray@salud.madrid.org.</nlm:affiliation>
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<name sortKey="Esteban Vasallo, Maria D" sort="Esteban Vasallo, Maria D" uniqKey="Esteban Vasallo M" first="María D" last="Esteban-Vasallo">María D. Esteban-Vasallo</name>
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<name sortKey="Hernandez Barrera, Valentin" sort="Hernandez Barrera, Valentin" uniqKey="Hernandez Barrera V" first="Valentín" last="Hernandez-Barrera">Valentín Hernandez-Barrera</name>
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<name sortKey="Rodriguez Rieiro, Cristina" sort="Rodriguez Rieiro, Cristina" uniqKey="Rodriguez Rieiro C" first="Cristina" last="Rodríguez-Rieiro">Cristina Rodríguez-Rieiro</name>
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<name sortKey="Esteban Vasallo, Maria D" sort="Esteban Vasallo, Maria D" uniqKey="Esteban Vasallo M" first="María D" last="Esteban-Vasallo">María D. Esteban-Vasallo</name>
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<region nuts="2" type="communauté">Communauté de Madrid</region>
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<name sortKey="Dominguez Berj N, Maria Felicitas" sort="Dominguez Berj N, Maria Felicitas" uniqKey="Dominguez Berj N M" first="Maria Felicitas" last="Domínguez-Berj N">Maria Felicitas Domínguez-Berj N</name>
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<country xml:lang="fr">Espagne</country>
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<placeName>
<region nuts="2" type="communauté">Communauté de Madrid</region>
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<name sortKey="Jimenez Trujillo, Isabel" sort="Jimenez Trujillo, Isabel" uniqKey="Jimenez Trujillo I" first="Isabel" last="Jimenez-Trujillo">Isabel Jimenez-Trujillo</name>
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<nlm:affiliation>Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón, 28922 Madrid, Spain. Electronic address: Isabel.jimenez@urjc.es.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón, 28922 Madrid</wicri:regionArea>
<placeName>
<region nuts="2" type="communauté">Communauté de Madrid</region>
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<name sortKey="Jimenez Garcia, Rodrigo" sort="Jimenez Garcia, Rodrigo" uniqKey="Jimenez Garcia R" first="Rodrigo" last="Jiménez-García">Rodrigo Jiménez-García</name>
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<nlm:affiliation>Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón, 28922 Madrid, Spain. Electronic address: rodrigo.jimenez@urjc.es.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón, 28922 Madrid</wicri:regionArea>
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<region nuts="2" type="communauté">Communauté de Madrid</region>
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<title level="j">Vaccine</title>
<idno type="eISSN">1873-2518</idno>
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<date when="2016" type="published">2016</date>
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<term>Adolescent (MeSH)</term>
<term>Adult (MeSH)</term>
<term>Aged (MeSH)</term>
<term>Comorbidity (MeSH)</term>
<term>Emigrants and Immigrants (statistics & numerical data)</term>
<term>Epidemiologic Studies (MeSH)</term>
<term>Female (MeSH)</term>
<term>Health Personnel (statistics & numerical data)</term>
<term>Health Surveys (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Influenza Vaccines (administration & dosage)</term>
<term>Influenza Vaccines (therapeutic use)</term>
<term>Influenza, Human (prevention & control)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
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<term>Vaccination Coverage (statistics & numerical data)</term>
<term>Young Adult (MeSH)</term>
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<term>Adolescent (MeSH)</term>
<term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Comorbidité (MeSH)</term>
<term>Couverture vaccinale (statistiques et données numériques)</term>
<term>Enquêtes de santé (MeSH)</term>
<term>Espagne (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Grippe humaine (prévention et contrôle)</term>
<term>Humains (MeSH)</term>
<term>Jeune adulte (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Personnel de santé (statistiques et données numériques)</term>
<term>Sujet âgé (MeSH)</term>
<term>Vaccins antigrippaux (administration et posologie)</term>
<term>Vaccins antigrippaux (usage thérapeutique)</term>
<term>Émigrants et immigrants (statistiques et données numériques)</term>
<term>Études épidémiologiques (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en">
<term>Influenza Vaccines</term>
</keywords>
<keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr">
<term>Vaccins antigrippaux</term>
</keywords>
<keywords scheme="MESH" qualifier="prevention & control" xml:lang="en">
<term>Influenza, Human</term>
</keywords>
<keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr">
<term>Grippe humaine</term>
</keywords>
<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en">
<term>Emigrants and Immigrants</term>
<term>Health Personnel</term>
<term>Vaccination Coverage</term>
</keywords>
<keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr">
<term>Couverture vaccinale</term>
<term>Personnel de santé</term>
<term>Émigrants et immigrants</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en">
<term>Influenza Vaccines</term>
</keywords>
<keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr">
<term>Vaccins antigrippaux</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Comorbidity</term>
<term>Epidemiologic Studies</term>
<term>Female</term>
<term>Health Surveys</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Spain</term>
<term>Young Adult</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr">
<term>Adolescent</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Comorbidité</term>
<term>Enquêtes de santé</term>
<term>Espagne</term>
<term>Femelle</term>
<term>Humains</term>
<term>Jeune adulte</term>
<term>Mâle</term>
<term>Sujet âgé</term>
<term>Études épidémiologiques</term>
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<front>
<div type="abstract" xml:lang="en">
<p>
<b>OBJECTIVES</b>
</p>
<p>We aim to describe influenza vaccination coverage for the Spanish population using data from two consecutive nation-wide representative health surveys. The data was analysed by high risk groups, health care workers (HCWs) and immigrants. Also, coverage trends were analysed.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>MATERIAL AND METHODS</b>
</p>
<p>The 2011/12 Spanish National Health Survey (N=21,007) and the 2014 European Health Interview Survey for Spain (N=22,842) were analysed. Influenza vaccination status was self-reported. Time trends for were estimated by a multivariate logistic regression model.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>Overall vaccination uptake was similar in 2011/12 and 2014, 19.1% and 18.9%, respectively, (p>0.05). 47% of the subjects surveyed were in the groups for which vaccination was recommended with coverages of 41.1% in 2011/12 and 40% in 2014 (p>0.05). In both surveys, uptake among subjects with a chronic disease was three times higher than uptake in subjects who did not have these diseases. In 2011/12 and 2014, 20% and 27.6% of health workers were vaccinated. Subjects born outside Spain were vaccinated less frequently than Spanish-born subjects (9.3% vs 20.4% and 8.9% vs 20%). Within the diseases studied, the best uptake was for patients with heart disease (52.5% in 2011/12 and 51.1% in 2014) and patients with diabetes (50.5% and 51.8%). Multivariate analysis showed that older age, having a chronic disease or being a HCW increases the possibility of being vaccinated whereas being born outside Spain decreased it.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSIONS</b>
</p>
<p>Seasonal influenza vaccine uptake rates in the recommended target groups, patients with chronic conditions and health care workers, in Spain are unacceptably low and seem to be stable in the post pandemic seasons. This finding should alert health authorities to the need to work directly with health care providers on the indications for this vaccine and to study strategies that make it possible to increase vaccination uptake.</p>
</div>
</front>
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<PMID Version="1">27595448</PMID>
<DateCompleted>
<Year>2017</Year>
<Month>12</Month>
<Day>06</Day>
</DateCompleted>
<DateRevised>
<Year>2017</Year>
<Month>12</Month>
<Day>13</Day>
</DateRevised>
<Article PubModel="Print-Electronic">
<Journal>
<ISSN IssnType="Electronic">1873-2518</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>34</Volume>
<Issue>41</Issue>
<PubDate>
<Year>2016</Year>
<Month>09</Month>
<Day>22</Day>
</PubDate>
</JournalIssue>
<Title>Vaccine</Title>
<ISOAbbreviation>Vaccine</ISOAbbreviation>
</Journal>
<ArticleTitle>Influenza vaccination coverages among high risk subjects and health care workers in Spain. Results of two consecutive National Health Surveys (2011-2014).</ArticleTitle>
<Pagination>
<MedlinePgn>4898-4904</MedlinePgn>
</Pagination>
<ELocationID EIdType="pii" ValidYN="Y">S0264-410X(16)30761-7</ELocationID>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/j.vaccine.2016.08.065</ELocationID>
<Abstract>
<AbstractText Label="OBJECTIVES">We aim to describe influenza vaccination coverage for the Spanish population using data from two consecutive nation-wide representative health surveys. The data was analysed by high risk groups, health care workers (HCWs) and immigrants. Also, coverage trends were analysed.</AbstractText>
<AbstractText Label="MATERIAL AND METHODS">The 2011/12 Spanish National Health Survey (N=21,007) and the 2014 European Health Interview Survey for Spain (N=22,842) were analysed. Influenza vaccination status was self-reported. Time trends for were estimated by a multivariate logistic regression model.</AbstractText>
<AbstractText Label="RESULTS">Overall vaccination uptake was similar in 2011/12 and 2014, 19.1% and 18.9%, respectively, (p>0.05). 47% of the subjects surveyed were in the groups for which vaccination was recommended with coverages of 41.1% in 2011/12 and 40% in 2014 (p>0.05). In both surveys, uptake among subjects with a chronic disease was three times higher than uptake in subjects who did not have these diseases. In 2011/12 and 2014, 20% and 27.6% of health workers were vaccinated. Subjects born outside Spain were vaccinated less frequently than Spanish-born subjects (9.3% vs 20.4% and 8.9% vs 20%). Within the diseases studied, the best uptake was for patients with heart disease (52.5% in 2011/12 and 51.1% in 2014) and patients with diabetes (50.5% and 51.8%). Multivariate analysis showed that older age, having a chronic disease or being a HCW increases the possibility of being vaccinated whereas being born outside Spain decreased it.</AbstractText>
<AbstractText Label="CONCLUSIONS">Seasonal influenza vaccine uptake rates in the recommended target groups, patients with chronic conditions and health care workers, in Spain are unacceptably low and seem to be stable in the post pandemic seasons. This finding should alert health authorities to the need to work directly with health care providers on the indications for this vaccine and to study strategies that make it possible to increase vaccination uptake.</AbstractText>
<CopyrightInformation>Copyright © 2016 Elsevier Ltd. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y">
<Author ValidYN="Y">
<LastName>Astray-Mochales</LastName>
<ForeName>Jenaro</ForeName>
<Initials>J</Initials>
<AffiliationInfo>
<Affiliation>Department of Epidemiology, Directorate of Health Promotion and Prevention, Ministry of Health, Community of Madrid, C/ Julián Camarillo, 4B, 28037 Madrid, Spain. Electronic address: jenaro.astray@salud.madrid.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>López de Andres</LastName>
<ForeName>Ana</ForeName>
<Initials>A</Initials>
<AffiliationInfo>
<Affiliation>Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón, 28922 Madrid, Spain. Electronic address: ana.lopez@urjc.es.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Hernandez-Barrera</LastName>
<ForeName>Valentín</ForeName>
<Initials>V</Initials>
<AffiliationInfo>
<Affiliation>Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón, 28922 Madrid, Spain. Electronic address: valentin.hernandez@urjc.es.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Rodríguez-Rieiro</LastName>
<ForeName>Cristina</ForeName>
<Initials>C</Initials>
<AffiliationInfo>
<Affiliation>Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón, 28922 Madrid, Spain. Electronic address: rodriguezrieiro@gmail.com.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Carrasco Garrido</LastName>
<ForeName>Pilar</ForeName>
<Initials>P</Initials>
<AffiliationInfo>
<Affiliation>Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón, 28922 Madrid, Spain. Electronic address: pilar.carrasco@urjc.es.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Esteban-Vasallo</LastName>
<ForeName>María D</ForeName>
<Initials>MD</Initials>
<AffiliationInfo>
<Affiliation>Department of Epidemiology, Directorate of Health Promotion and Prevention, Ministry of Health, Community of Madrid, C/ Julián Camarillo, 4B, 28037 Madrid, Spain. Electronic address: maria.estebanv@salud.madrid.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Domínguez-Berjón</LastName>
<ForeName>Maria Felicitas</ForeName>
<Initials>MF</Initials>
<AffiliationInfo>
<Affiliation>Department of Epidemiology, Directorate of Health Promotion and Prevention, Ministry of Health, Community of Madrid, C/ Julián Camarillo, 4B, 28037 Madrid, Spain. Electronic address: felicitas.dominguez@salud.madrid.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Jimenez-Trujillo</LastName>
<ForeName>Isabel</ForeName>
<Initials>I</Initials>
<AffiliationInfo>
<Affiliation>Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón, 28922 Madrid, Spain. Electronic address: Isabel.jimenez@urjc.es.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Jiménez-García</LastName>
<ForeName>Rodrigo</ForeName>
<Initials>R</Initials>
<AffiliationInfo>
<Affiliation>Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón, 28922 Madrid, Spain. Electronic address: rodrigo.jimenez@urjc.es.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList>
<PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic">
<Year>2016</Year>
<Month>08</Month>
<Day>29</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo>
<Country>Netherlands</Country>
<MedlineTA>Vaccine</MedlineTA>
<NlmUniqueID>8406899</NlmUniqueID>
<ISSNLinking>0264-410X</ISSNLinking>
</MedlineJournalInfo>
<ChemicalList>
<Chemical>
<RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D007252">Influenza Vaccines</NameOfSubstance>
</Chemical>
</ChemicalList>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList>
<MeshHeading>
<DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D015897" MajorTopicYN="N">Comorbidity</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D054242" MajorTopicYN="N">Emigrants and Immigrants</DescriptorName>
<QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D016021" MajorTopicYN="N">Epidemiologic Studies</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D006282" MajorTopicYN="N">Health Personnel</DescriptorName>
<QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D006306" MajorTopicYN="N">Health Surveys</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D007252" MajorTopicYN="N">Influenza Vaccines</DescriptorName>
<QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName>
<QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D013030" MajorTopicYN="N">Spain</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D000073887" MajorTopicYN="N">Vaccination Coverage</DescriptorName>
<QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM">
<Keyword MajorTopicYN="Y">Coverage</Keyword>
<Keyword MajorTopicYN="Y">Influenza</Keyword>
<Keyword MajorTopicYN="Y">Public health policy</Keyword>
<Keyword MajorTopicYN="Y">Trends</Keyword>
<Keyword MajorTopicYN="Y">Vaccines</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData>
<History>
<PubMedPubDate PubStatus="received">
<Year>2016</Year>
<Month>04</Month>
<Day>02</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="revised">
<Year>2016</Year>
<Month>07</Month>
<Day>13</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted">
<Year>2016</Year>
<Month>08</Month>
<Day>22</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez">
<Year>2016</Year>
<Month>9</Month>
<Day>6</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed">
<Year>2016</Year>
<Month>9</Month>
<Day>7</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline">
<Year>2017</Year>
<Month>12</Month>
<Day>7</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList>
<ArticleId IdType="pubmed">27595448</ArticleId>
<ArticleId IdType="pii">S0264-410X(16)30761-7</ArticleId>
<ArticleId IdType="doi">10.1016/j.vaccine.2016.08.065</ArticleId>
</ArticleIdList>
</PubmedData>
</pubmed>
<affiliations>
<list>
<country>
<li>Espagne</li>
</country>
<region>
<li>Communauté de Madrid</li>
</region>
</list>
<tree>
<country name="Espagne">
<region name="Communauté de Madrid">
<name sortKey="Astray Mochales, Jenaro" sort="Astray Mochales, Jenaro" uniqKey="Astray Mochales J" first="Jenaro" last="Astray-Mochales">Jenaro Astray-Mochales</name>
</region>
<name sortKey="Carrasco Garrido, Pilar" sort="Carrasco Garrido, Pilar" uniqKey="Carrasco Garrido P" first="Pilar" last="Carrasco Garrido">Pilar Carrasco Garrido</name>
<name sortKey="Dominguez Berj N, Maria Felicitas" sort="Dominguez Berj N, Maria Felicitas" uniqKey="Dominguez Berj N M" first="Maria Felicitas" last="Domínguez-Berj N">Maria Felicitas Domínguez-Berj N</name>
<name sortKey="Esteban Vasallo, Maria D" sort="Esteban Vasallo, Maria D" uniqKey="Esteban Vasallo M" first="María D" last="Esteban-Vasallo">María D. Esteban-Vasallo</name>
<name sortKey="Hernandez Barrera, Valentin" sort="Hernandez Barrera, Valentin" uniqKey="Hernandez Barrera V" first="Valentín" last="Hernandez-Barrera">Valentín Hernandez-Barrera</name>
<name sortKey="Jimenez Garcia, Rodrigo" sort="Jimenez Garcia, Rodrigo" uniqKey="Jimenez Garcia R" first="Rodrigo" last="Jiménez-García">Rodrigo Jiménez-García</name>
<name sortKey="Jimenez Trujillo, Isabel" sort="Jimenez Trujillo, Isabel" uniqKey="Jimenez Trujillo I" first="Isabel" last="Jimenez-Trujillo">Isabel Jimenez-Trujillo</name>
<name sortKey="L Pez De Andres, Ana" sort="L Pez De Andres, Ana" uniqKey="L Pez De Andres A" first="Ana" last="L Pez De Andres">Ana L Pez De Andres</name>
<name sortKey="Rodriguez Rieiro, Cristina" sort="Rodriguez Rieiro, Cristina" uniqKey="Rodriguez Rieiro C" first="Cristina" last="Rodríguez-Rieiro">Cristina Rodríguez-Rieiro</name>
</country>
</tree>
</affiliations>
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