Scientific Letter
More is not always better. Individual guideline or systematic vaccination against pneumococcus
Más no siempre es mejor. Pauta individual o calendario sistemático en vacuna antineumocócica
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Individual guideline or systematic vaccination against pneumococcus" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1031 "Ancho" => 1565 "Tamanyo" => 85598 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Porcentaje de niños que recibieron 3.ª dosis VNC13 pertenecientes a grupos de riesgo.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "An Lieve Dirk Boone, María Besó-Delgado, Ana María Alguacil-Ramos, Eliseo Pastor-Villalba, Antonio Portero-Alonso" "autores" => array:5 [ 0 => array:2 [ "nombre" => "An Lieve Dirk" "apellidos" => "Boone" ] 1 => array:2 [ "nombre" => "María" "apellidos" => 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Individual guideline or systematic vaccination against pneumococcus" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "320" "paginaFinal" => "321" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "An Lieve Dirk Boone, María Besó-Delgado, Ana María Alguacil-Ramos, Eliseo Pastor-Villalba, Antonio Portero-Alonso" "autores" => array:5 [ 0 => array:4 [ "nombre" => "An Lieve Dirk" "apellidos" => "Boone" "email" => array:1 [ 0 => "boone_an@gva.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "María" "apellidos" => "Besó-Delgado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Ana María" "apellidos" => "Alguacil-Ramos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Eliseo" "apellidos" => "Pastor-Villalba" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Antonio" "apellidos" => "Portero-Alonso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Preventiva, Hospital Clínico Universitario de Valencia, Valencia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Coordinación y Promoción de la Salud y Prevención en las Etapas de la Vida, Dirección General de Salud Pública, Valencia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Más no siempre es mejor. Pauta individual o calendario sistemático en vacuna antineumocócica" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1031 "Ancho" => 1566 "Tamanyo" => 84987 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Percentage of children that received the third dose of PCV13 that belonged to risk groups.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The inclusion of the 13-valent pneumococcal conjugate vaccine in the routine immunization schedule of the Autonomous Community of Valencia (ACV) started on March 1, 2015 for children born January 1, 2015 and after,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> in accordance with the agreement of the Interterritorial Council of the Spanish Public Health System of January 14, 2015.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Scientific associations such as the Asociación Española de Pediatría (Spanish Association of Paediatrics) had included it with a 2<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 dose schedule when given as part of the routine immunization schedule and a 3<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 schedule if the choice to vaccinate was made on a case-to-case basis.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> A 3<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 schedule was recommended for all children belonging to risk groups.</p><p id="par0015" class="elsevierStylePara elsevierViewall">A document for health care professionals that explained the 2<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 schedule to be implemented<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> was drafted in the ACV in February 2015 and reviewed by scientific associations in the field of paediatrics: Sociedad Valenciana de Pediatría (Valencian Association of Paediatrics), Asociación Valenciana de Pediatría en Atención Primaria (Valencian Association of Primary Care Paediatrics), Asociación de Pediatría Extrahospitalaria de Alicante (Association of Outpatient Paediatrics of Alicante) and the Advisory Committee on Vaccines of the ACV.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Despite these recommendations, some paediatricians continue to recommend the 3<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 schedule in all children and not only those in risk groups, because they believe it is necessary to achieve herd immunity.</p><p id="par0025" class="elsevierStylePara elsevierViewall">For this reason, we set out to determine the PCV13 coverage rates and dose schedules used from the time it was included in the routine immunization schedule of the ACV<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> in children born between January 1 and September 30, 2015, and assessing potential additional costs for parents and the health care system.</p><p id="par0030" class="elsevierStylePara elsevierViewall">We conducted a cross-sectional descriptive study using data collected from the Vaccine Information System (Sistema de Información Vacunal [SIV])<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> of both the Nominal Vaccine Register (Registro de Vacunas Nominal [RVN]) and the Vaccine Repository Register (Registro de Vacunas de Almacén [RVA]), using the Population Information System (Sistema de Información Poblacional [SIP]) or public health card as a population register.</p><p id="par0035" class="elsevierStylePara elsevierViewall">We studied the following variables: health area and basic health zone, age, number of administered doses, vaccine lot number, and risk-group membership. We performed the statistical analysis with Microsoft Excel<span class="elsevierStyleSup">®</span> 2003.</p><p id="par0040" class="elsevierStylePara elsevierViewall">In the period under study, 31<span class="elsevierStyleHsp" style=""></span>815 children were born, and 42<span class="elsevierStyleHsp" style=""></span>005 PCV13 doses administered, out of which 23<span class="elsevierStyleHsp" style=""></span>670 were first doses, 16<span class="elsevierStyleHsp" style=""></span>096 second doses and 2239 third doses. The mean age-adjusted vaccine coverage rate was 93.6% for the first dose (95% IC, 93.5–93.7), 88.5% for the second dose (95% CI, 88.3–88.6) and 20.4% for the third dose (95% CI, 20.1–20.7). Of the children that received a third dose, 92.6% did not belong to any risk groups. The proportion of children with no risk that received the first dose was 98.3%.</p><p id="par0045" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> shows the percentage of children born in 2015 that belonged to risk groups and received a third dose of PCV13 by health area.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Of the 24 health areas of the ACV, four had coverage rates for a third dose of PCV13 vaccine that exceeded 49% (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">In these health areas, 91.9% of the third doses were not supplied by the public health system, so we assume that these doses were purchased at pharmacies by parents.</p><p id="par0060" class="elsevierStylePara elsevierViewall">The total expenditure in third doses for children that did not belong to any risk group in the ACV amounted to 158<span class="elsevierStyleHsp" style=""></span>176.48€, of which 43<span class="elsevierStyleHsp" style=""></span>304.80€ corresponded to the Valencian Public Health System for vaccination events that were covered under the tax laws<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> of the Government of the ACV.</p><p id="par0065" class="elsevierStylePara elsevierViewall">The PCV13 vaccine coverage rate in the ACV in 2014, before the vaccine was included in the routine immunization schedule, was 67%,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> which already sufficed to achieve herd immunity. Therefore, a third dose at age 6 months is not justified by the vaccination coverage rates either before or after the inclusion of the PCV13 vaccine in the routine schedule, save in children belonging to risk groups.</p><p id="par0070" class="elsevierStylePara elsevierViewall">High coverage rates have been achieved since the PCV13 vaccine was first included in the routine immunization schedule, so a third dose at 6 months would not be indicated except in at-risk children. The additional and inefficient costs for both parents and the Department of Public Health are considerable. When it comes to vaccination, more is not always better, so we must apply the best and most efficient scientific evidence that is currently available for the benefit of the population and immunization programmes.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Boone ALD, Besó-Delgado M, Alguacil-Ramos AM, Pastor-Villalba E, Portero-Alonso A. Más no siempre es mejor. Pauta individual o calendario sistemático en vacuna antineumocócica. An Pediatr (Barc). 2016;85:320–321.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1031 "Ancho" => 1566 "Tamanyo" => 84987 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Percentage of children that received the third dose of PCV13 that belonged to risk groups.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">ACV, Autonomous Community of Valencia; CI, confidence interval.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Area \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Third dose</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Children not at risk</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Coverage (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">68.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58.2–79.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">96.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">169 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53.7–65.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">167 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">98.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">211 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46.8–51.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">195 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">92.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">D \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">220 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">55.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52.6–57.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">210 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">95.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">662 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">632 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">95.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1261760.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Health areas with the highest coverage rates for the PCV13 vaccine in the ACV, and percentage of children that did not belong to any risk groups.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Instrucciones de la Dirección General de Salud Pública con relación a la vacunación sistemática infantil frente al neumococo en los niños nacidos a partir del 1 de enero de 2015. Conselleria de Sanidad. DGSP. Available at: <a id="intr0010" class="elsevierStyleInterRef" href="http://www.sp.san.gva.es/DgspPortal/docs/Instruccion_DGSP_neumo_ninyos.pdf">http://www.sp.san.gva.es/DgspPortal/docs/Instruccion_DGSP_neumo_ninyos.pdf</a> [accessed 21.12.15]." ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Calendario de Vacunación de la Asociación Española de Pediatría. Recomendaciones" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "en representación del Comité Asesor de Vacunas de la Asociación Española de Pediatría (CAV-AEP)" "etal" => true "autores" => array:6 [ 0 => "D. Moreno-Pérez" 1 => "F.J. Álvarez García" 2 => "J. Arístegui Fernández" 3 => "M.J. Cilleruelo Ortega" 4 => "J.M. Corretger Rauet" 5 => "A.N. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 8 | 11 |
| 2024 October | 36 | 27 | 63 |
| 2024 September | 46 | 29 | 75 |
| 2024 August | 51 | 54 | 105 |
| 2024 July | 36 | 24 | 60 |
| 2024 June | 53 | 24 | 77 |
| 2024 May | 33 | 30 | 63 |
| 2024 April | 35 | 27 | 62 |
| 2024 March | 41 | 35 | 76 |
| 2024 February | 37 | 27 | 64 |
| 2024 January | 40 | 27 | 67 |
| 2023 December | 17 | 23 | 40 |
| 2023 November | 25 | 22 | 47 |
| 2023 October | 30 | 30 | 60 |
| 2023 September | 18 | 24 | 42 |
| 2023 August | 17 | 14 | 31 |
| 2023 July | 41 | 40 | 81 |
| 2023 June | 25 | 22 | 47 |
| 2023 May | 35 | 18 | 53 |
| 2023 April | 12 | 20 | 32 |
| 2023 March | 19 | 17 | 36 |
| 2023 February | 27 | 23 | 50 |
| 2023 January | 11 | 18 | 29 |
| 2022 December | 36 | 17 | 53 |
| 2022 November | 29 | 34 | 63 |
| 2022 October | 37 | 42 | 79 |
| 2022 September | 40 | 19 | 59 |
| 2022 August | 33 | 50 | 83 |
| 2022 July | 24 | 28 | 52 |
| 2022 June | 47 | 24 | 71 |
| 2022 May | 29 | 27 | 56 |
| 2022 April | 24 | 21 | 45 |
| 2022 March | 37 | 36 | 73 |
| 2022 February | 20 | 29 | 49 |
| 2022 January | 39 | 30 | 69 |
| 2021 December | 30 | 40 | 70 |
| 2021 November | 27 | 39 | 66 |
| 2021 October | 70 | 66 | 136 |
| 2021 September | 24 | 40 | 64 |
| 2021 August | 18 | 45 | 63 |
| 2021 July | 28 | 18 | 46 |
| 2021 June | 31 | 35 | 66 |
| 2021 May | 39 | 40 | 79 |
| 2021 April | 83 | 63 | 146 |
| 2021 March | 36 | 25 | 61 |
| 2021 February | 38 | 36 | 74 |
| 2021 January | 42 | 18 | 60 |
| 2020 December | 20 | 21 | 41 |
| 2020 November | 23 | 17 | 40 |
| 2020 October | 48 | 18 | 66 |
| 2020 September | 13 | 15 | 28 |
| 2020 August | 22 | 10 | 32 |
| 2020 July | 12 | 17 | 29 |
| 2020 June | 11 | 8 | 19 |
| 2020 May | 30 | 15 | 45 |
| 2020 April | 21 | 9 | 30 |
| 2020 March | 13 | 9 | 22 |
| 2020 February | 29 | 12 | 41 |
| 2020 January | 14 | 8 | 22 |
| 2019 December | 20 | 17 | 37 |
| 2019 November | 38 | 14 | 52 |
| 2019 October | 11 | 10 | 21 |
| 2019 September | 22 | 12 | 34 |
| 2019 August | 29 | 17 | 46 |
| 2019 July | 38 | 32 | 70 |
| 2019 June | 23 | 29 | 52 |
| 2019 May | 29 | 21 | 50 |
| 2019 April | 45 | 17 | 62 |
| 2019 March | 23 | 13 | 36 |
| 2019 February | 32 | 12 | 44 |
| 2019 January | 31 | 21 | 52 |
| 2018 December | 34 | 22 | 56 |
| 2018 November | 58 | 31 | 89 |
| 2018 October | 66 | 24 | 90 |
| 2018 September | 23 | 11 | 34 |
| 2018 August | 1 | 0 | 1 |
| 2018 June | 2 | 0 | 2 |
| 2018 May | 5 | 0 | 5 |
| 2018 April | 13 | 0 | 13 |
| 2018 March | 25 | 0 | 25 |
| 2018 February | 9 | 0 | 9 |
| 2018 January | 11 | 0 | 11 |
| 2017 December | 21 | 0 | 21 |
| 2017 November | 12 | 0 | 12 |
| 2017 October | 19 | 0 | 19 |
| 2017 September | 12 | 0 | 12 |
| 2017 August | 11 | 0 | 11 |
| 2017 July | 19 | 0 | 19 |
| 2017 June | 17 | 7 | 24 |
| 2017 May | 17 | 19 | 36 |
| 2017 April | 19 | 19 | 38 |
| 2017 March | 10 | 4 | 14 |
| 2017 February | 10 | 7 | 17 |
| 2017 January | 3 | 1 | 4 |
| 2016 December | 31 | 19 | 50 |
| 2016 November | 0 | 14 | 14 |
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