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Zhang Z, Shi L, Liu N, Jia B, Mei K, Zhang L, Zhang X, Lu Y, Lu J, Yao Y. Coverage and impact of influenza vaccination among children in Minhang District, China, 2013-2020. Front Public Health 2023; 11:1193839. [PMID: 37711236 PMCID: PMC10499390 DOI: 10.3389/fpubh.2023.1193839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/18/2023] [Indexed: 09/16/2023] Open
Abstract
Background Young children have a great disease burden and are particularly vulnerable to influenza. This study aimed to assess the direct effect of influenza vaccination among children and to evaluate the indirect benefit of immunizing children. Methods The influenza vaccination records for all children born during 2013-2019 in Minhang District and surveillance data for reported influenza cases were obtained from the Minhang CDC. 17,905 children were recorded in the vaccination system and included in this study. Descriptive epidemiology methods were used for data analysis, including an ecological approach to estimate the number of influenza cases averted by vaccination and linear regression to estimate the reduction in influenza cases in the general population per thousand additional childhood vaccination doses. Results During the study period, the annual vaccination coverage rate ranged from 10.40% in 2013-2014 to 27.62% in 2015-2016. The estimated number of influenza cases averted by vaccination ranged from a low of 0.28 (range: 0.23-0.34) during 2013-2014 (PF: 6.15%, range: 5.11-7.38%) to a high of 15.34 (range: 12.38-18.51) during 2017-2018 (PF: 16.54%, range: 13.79-19.30%). When increasing vaccination coverage rate by 10% in each town/street, a ratio of 7.27-10.69% cases could be further averted on the basis of observed cases. In four selected periods, the number of influenza cases in the general population was most significantly correlated with the cumulative childhood vaccination doses in the prior 2-5 months, and the reduction in influenza cases ranged from 0.73 to 3.18 cases per thousand additional childhood vaccination doses. Conclusion Influenza vaccination among children is estimated to have direct effects in terms of averted cases and might provide an underlying indirect benefit to the general population. Vaccination coverage in high-coverage areas should be further expanded to avert more influenza cases.
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Affiliation(s)
- Zhaowen Zhang
- Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Liming Shi
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Nian Liu
- Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Biyun Jia
- Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Kewen Mei
- Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Liping Zhang
- Minhang Center for Disease Control and Prevention, Shanghai, China
| | - XuanZhao Zhang
- Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Yihan Lu
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Jia Lu
- Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Ye Yao
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
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D'Ambrosio F, Lanza TE, Messina R, Villani L, Pezzullo AM, Ricciardi W, Rosano A, Cadeddu C. Influenza vaccination coverage in pediatric population in Italy: an analysis of recent trends. Ital J Pediatr 2022; 48:77. [PMID: 35578296 PMCID: PMC9109451 DOI: 10.1186/s13052-022-01271-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/04/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Influenza is a major cause of morbidity, mortality and exacerbation of extant chronic disease worldwide. Influenza vaccination is thus fundamental to reduce the burden of disease. In this study, we describe the trend of influenza vaccination coverage in the seasons 2010/11-2020/21 among children aged < 2, 2-4 and 5-8 in Italy. METHODS We analyzed the trend of influenza vaccination coverage in the pediatric population in Italy from the 2010/11 to the 2020/21 season at national and regional level and observed the incidence of influenza-like illness (ILI) in the pediatric population between 2010/11 and 2020/21. RESULTS In the period 2010/11-2019/20 the highest value of coverage (4.5%) was reached in the age group 2-4 and 5-8 (season 2010/11 and 2011/12, respectively), while the lowest belonged to the < 2 group (1.1% in the season 2015/16). In the season 2020/2021 all the age groups reported a substantial increase of coverage compared with the previous season. The highest value (19.0%) was reported in the age group 2-4, followed by the group 5-8 and < 2 (13.1 and 9.2%, respectively). Considering the rates of annual ILI cases, the highest value for the 0-4 age group was 18.5% in the 2011/12 season; for the 5-14 age group, the highest value was 27.7% in the 2010/11 season. CONCLUSIONS Over the past 11 years pediatric influenza vaccination coverage in Italy has been low, with relevant differences across regions and seasons, albeit a general increase in coverage has been observed in the 2020/21 season. Universal influenza vaccination for children should be considered as a priority for the high incidence in this age group. Further research is needed to improve knowledge and comparability of coverage rates, and to identify the best practices for organizational models of delivery which can support the improvement of trends, the acceptability and accessibility by parents and awareness in stakeholders and decision makers.
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Affiliation(s)
- Floriana D'Ambrosio
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Teresa Eleonora Lanza
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Rosaria Messina
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Leonardo Villani
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Angelo Maria Pezzullo
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Aldo Rosano
- National Institute for Public Policies Analysis (INAPP), Rome, Italy
| | - Chiara Cadeddu
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
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Yang X, Zhao H, Li Z, Zhu A, Ren M, Geng M, Li Y, Qin Y, Feng L, Peng Z, An Z, Zheng J, Li Z, Feng Z. Influenza Vaccine Effectiveness in Mainland China: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2021; 9:vaccines9020079. [PMID: 33498688 PMCID: PMC7912587 DOI: 10.3390/vaccines9020079] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/20/2021] [Accepted: 01/20/2021] [Indexed: 12/03/2022] Open
Abstract
Influenza endangers human health but can be prevented in part by vaccination. Assessing influenza vaccine effectiveness (VE) provides scientific evidence for developing influenza vaccination policy. We conducted a systematic review and meta-analysis of studies that evaluated influenza VE in mainland China. We searched six relevant databases as of 30 August 2019 to identify studies and used Review Manager 5.3 software to analyze the included studies. The Newcastle–Ottawa scale was used to assess the risk of publication bias. We identified 1408 publications, and after removing duplicates and screening full texts, we included 21 studies in the analyses. Studies were conducted in Beijing, Guangzhou, Suzhou, and Zhejiang province from the 2010/11 influenza season through the 2017/18 influenza season. Overall influenza VE for laboratory confirmed influenza was 36% (95% CI: 25–46%). In the subgroup analysis, VE was 45% (95% CI: 18–64%) for children 6–35 months who received one dose of influenza vaccine, and 57% (95% CI: 50–64%) who received two doses. VE was 47% (95% CI: 39–54%) for children 6 months to 8 years, and 18% (95% CI: 0–33%) for adults ≥60 years. For inpatients, VE was 21% (95% CI: −11–44%). We conclude that influenza vaccines that were used in mainland China had a moderate effectiveness, with VE being higher among children than the elderly. Influenza VE should be continuously monitored in mainland China to provide evidence for policy making and improving uptake of the influenza vaccine.
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Affiliation(s)
- Xiaokun Yang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
| | - Hongting Zhao
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
| | - Zhili Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
| | - Aiqin Zhu
- Division of Infectious Disease Prevention and Disinfection Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai 200136, China;
| | - Minrui Ren
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
| | - Mengjie Geng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
| | - Yu Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
| | - Ying Qin
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China;
| | - Zhibin Peng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
| | - Zhijie An
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 102206, China;
| | - Jiandong Zheng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
- Correspondence: (J.Z.); (Z.L.); (Z.F.); Tel.: +86-010-5890-0541 (J.Z.); +86-010-5890-0543 (Z.L.); +86-010-5890-0309 (Z.F.)
| | - Zhongjie Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
- Correspondence: (J.Z.); (Z.L.); (Z.F.); Tel.: +86-010-5890-0541 (J.Z.); +86-010-5890-0543 (Z.L.); +86-010-5890-0309 (Z.F.)
| | - Zijian Feng
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
- Correspondence: (J.Z.); (Z.L.); (Z.F.); Tel.: +86-010-5890-0541 (J.Z.); +86-010-5890-0543 (Z.L.); +86-010-5890-0309 (Z.F.)
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Rossi D, Croci R, Affanni P, Odone A, Signorelli C. [Influenza vaccination coverage in Lombardy Region: a twenty-year trend analysis (1999-2019)]. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:141-145. [PMID: 32275279 PMCID: PMC7975897 DOI: 10.23750/abm.v91i3-s.9455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 12/19/2022]
Abstract
Influenza vaccination coverage in Lombardy Region: a twenty-year trend analysis (1999-2019). Recent events and phenomena, such as A(H1N1) pandemic in 2009, “Fluad case” (2014-2015) and the spread of vaccine hesitancy, affected influenza vaccination coverage rates in Italy. In this study, the annual coverage rates in Lombardy Region and in Italy (from 1999-2000 season) have been critically described and compared. Regarding both the general population and the elderly over-65s, Lombardy’s coverages always remained consistently below the national average. However, declines and peaks occurred simultaneously. The current slight recovery, both at national and regional level, is not sufficient. Coverages are still widely below the recommended thresholds.
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Affiliation(s)
| | | | | | - Anna Odone
- Università Vita-Salute San Raffaele, Milano.
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Affanni P, Colucci ME, Capobianco E, Bracchi MT, Zoni R, Viani I, Caruso L, Carlone L, Arcuri C, Veronesi L. Immunity status against tetanus in young migrants: a seroprevalence study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:77-84. [PMID: 32275271 PMCID: PMC7975914 DOI: 10.23750/abm.v91i3-s.9438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM OF THE WORK Thanks to the highly effective vaccine, tetanus became sporadic in high-income countries with well-established primary childhood immunization programs, but it is common in low-income countries. The migrants, leaving countries with poor immunization programs or where vaccinations have been interrupted, may represent a new risk group for tetanus in host countries. A seroprevalence study was conducted to estimate the immunological status against tetanus in young migrants without vaccination documentation. METHODS After a careful assessment by vaccination services of the Local Health Authority, all migrants recently arrived in Italy were included in the serosurvey. Titers of anti-tetanus toxoid were measured using a commercial ELISA kit. Subjects were stratified by age and by WHO region. Antibody titers <0.10 IU/ml were considered to be seronegative, between 0.10 and 1.00 IU/ml as intermediate protection, and >1.00 IU/ml high protection. RESULTS From January 2004 to December 2019, 2,326 blood samples were collected. Mean age was 13.9 years with no differences between WHO regions. The percentage of the subjects without protective antibodies was 22.3%, with an intermediate level was 45.2%, with high titer was 32.5%. Among migrant coming from African and Eastern Mediterranean WHO regions, the highest percentages of seronegative titers and, at the same time, the low percentages of high protective levels were found. Titers decreased with age. CONCLUSIONS The significant proportion of seronegative migrants and the decrease of protective titers increasing age, confirm the importance of the evaluation of the immunological status to employ the appropriate vaccination strategy.
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Affiliation(s)
| | | | | | | | - Roberta Zoni
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Isabella Viani
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Luca Caruso
- Department of Medicine and Surgery, University of Parma, Italy.
| | | | - Carlo Arcuri
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, Italy.
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Palandri L, Morgado M, Colucci ME, Affanni P, Zoni R, Mezzetta S, Bizzarro A, Veronesi L. Reorganization of Active Surveillance of Acute Flaccid Paralysis (AFP) in Emilia-Romagna, Italy: a two-step Public Health intervention. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:85-91. [PMID: 32275272 PMCID: PMC7975913 DOI: 10.23750/abm.v91i3-s.9436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM OF THE WORK The International Health Regulations Emergency Committee declared in 2014 that poliovirus circulation is a public health emergency of international concern. In 2017 and 2018 Italy was classified at intermediate risk of poliovirus reintroduction based on suboptimal poliovirus surveillance. Acute flaccid paralysis active surveillance is the gold standard in the polio eradication process. The aims of this study were to investigate the causes of reduced acute flaccid paralysis case reporting in Emilia-Romagna in the last few years (step 1) and to study a public health intervention to restore an adequate level of acute flaccid paralysis surveillance in that region (step 2). METHODS In the first step a context analysis was performed by analysing the 2015-2017 Hospital Discharge Registers in Emilia-Romagna with the ICD-9-CM differential diagnosis codes for acute flaccid paralysis. Data from context analysis was then used to plan a new regional collaborative network of acute flaccid paralysis active surveillance. RESULTS The active surveillance network was, at the end of the study, composed by 49 doctors from both hospital administrations and clinical wards from 4 University Hospitals and 7 Local Health Authorities throughout the Region. In 15 months, 7 acute flaccid paralysis cases have been reported; 85,7% received a full clinical and virological investigation and 83,3% completed the 60 day's follow-up. The mean response to each e-mail was 48,5% (SD 7,5%). CONCLUSIONS In 2019, the Emilia-Romagna's active surveillance system reached the sensitivity, completeness of case investigation and follow-up required to achieve the minimum levels for certification standard surveillance.
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Affiliation(s)
- Lucia Palandri
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
| | - Mariana Morgado
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Maria Eugenia Colucci
- Department of Medicine and Surgery, University of Parma, Italy. Reference Centre for Polio and AFP surveillance in Emilia-Romagna.
| | - Paola Affanni
- Department of Medicine and Surgery, University of Parma, Italy. Reference Centre for Polio and AFP surveillance in Emilia-Romagna.
| | - Roberta Zoni
- Department of Medicine and Surgery, University of Parma, Italy. Reference Centre for Polio and AFP surveillance in Emilia-Romagna.
| | - Sandra Mezzetta
- Department of Medicine and Surgery, University of Parma, Italy. Reference Centre for Polio and AFP surveillance in Emilia-Romagna.
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