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Bianchi FP, Stefanizzi P, Trerotoli P, Tafuri S. Sex and age as determinants of the seroprevalence of anti-measles IgG among European healthcare workers: A systematic review and meta-analysis. Vaccine 2022; 40:3127-3141. [PMID: 35491343 DOI: 10.1016/j.vaccine.2022.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/14/2022] [Accepted: 04/04/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The international literature shows good evidence of a significant rate of measles susceptibility among healthcare workers (HCWs). As such, they are an important public health issue. METHODS We conducted a systematic review and meta-analysis to estimate the prevalence of susceptible HCWs in EU/EEA countries and in the UK and to explore the characteristics (sex and age differences) and management of those found to be susceptible. RESULTS Nineteen studies were included in the meta-analysis. The prevalence of measles-susceptible HCWs was 13.3% (95 %CI: 10.0-17.0%). In a comparison of serosusceptible female vs. male HCWs, the RR was 0.92 (95 %CI = 0.83-1.03), and in a comparison of age classes (born after vs. before 1980) the RR was 2.78 (95 %CI = 2.20-3.50). The most recent studies proposed the mandatory vaccination of HCWs. DISCUSSION According to our meta-analysis, the prevalence of serosusceptible European HCWs is 13%; HCWs born in the post-vaccination era seem to be at higher risk. Healthcare professionals susceptible to measles are a serious epidemiological concern. Greater efforts should therefore be made to identify those who have yet to be vaccinated and actively encourage their vaccination.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - Paolo Trerotoli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy.
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Zanella B, Boccalini S, Biamonte MA, Giorgetti D, Menicacci M, Bonito B, Ninci A, Tiscione E, Puggelli F, Mereu G, Bonanni P, Bechini A. A Study of Hepatitis A Seroprevalence in a Paediatric and Adolescent Population of the Province of Florence (Italy) in the Period 2017-2018 Confirms Tuscany a Low Endemic Area. Vaccines (Basel) 2021; 9:1194. [PMID: 34696301 PMCID: PMC8538179 DOI: 10.3390/vaccines9101194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/06/2021] [Accepted: 10/14/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Italy is considered an area with very low HAV (hepatitis A virus) endemicity. Currently in Italy the anti-HAV vaccine is recommended only for specific risk groups and there is no universal vaccination program. The aim of this study was to assess the level of immunity against hepatitis A in a sample of children and adolescents from the province of Florence. Methods: A total of 165 sera were collected from subjects aged 1 to 18 years, proportionally selected according to the general population size and stratified by age and sex. A qualitative evaluation of anti-HAV antibodies was performed using the enzyme-linked immunosorbent assay (ELISA). Anamnestic and vaccination status data were also collected. Results: Our study showed a hepatitis A seroprevalence of 9.1% in the enrolled population. A statistically significant difference in the prevalence of anti-HAV was found between Italian and non-Italian subjects. About half of the population having anti-HAV antibodies was reported to be vaccinated, and no cases of hepatitis A were found. Conclusions: The data from our study confirmed Tuscany as an area with low HAV endemicity and showed that hepatitis A seroprevalence is significantly higher in foreign children and adolescents. The presence of more seropositive subjects than those vaccinated was probably due to a natural immunization achieved through a subclinical infection and/or to underreporting of the surveillance systems.
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Affiliation(s)
- Beatrice Zanella
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B.); (E.T.); (P.B.)
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B.); (E.T.); (P.B.)
| | - Massimiliano Alberto Biamonte
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (M.A.B.); (D.G.); (M.M.); (A.N.)
| | - Duccio Giorgetti
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (M.A.B.); (D.G.); (M.M.); (A.N.)
| | - Marco Menicacci
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (M.A.B.); (D.G.); (M.M.); (A.N.)
| | - Benedetta Bonito
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B.); (E.T.); (P.B.)
| | - Alessandra Ninci
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (M.A.B.); (D.G.); (M.M.); (A.N.)
| | - Emilia Tiscione
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B.); (E.T.); (P.B.)
| | | | | | - Working Group DHS
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (M.A.B.); (D.G.); (M.M.); (A.N.)
| | | | | | - Paolo Bonanni
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B.); (E.T.); (P.B.)
| | - Angela Bechini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B.); (E.T.); (P.B.)
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Kuznetsova L, Cortassa G, Trilla A. Effectiveness of Mandatory and Incentive-Based Routine Childhood Immunization Programs in Europe: A Systematic Review of the Literature. Vaccines (Basel) 2021; 9:vaccines9101173. [PMID: 34696280 PMCID: PMC8538772 DOI: 10.3390/vaccines9101173] [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: 08/26/2021] [Revised: 09/25/2021] [Accepted: 09/30/2021] [Indexed: 11/16/2022] Open
Abstract
There is a lack of comprehensive and systematic data and evidence regarding the effectiveness of mandatory and incentive-based vaccination schemes. The results of such programs in some countries have not been adequately studied. A number of countries have recently introduced tightening vaccination measures, and it is important to analyze and assess the results of these programs. The unprecedented situation due to the COVID-19 pandemic and mass vaccination made the topic of the effectiveness of vaccination policies and mandates even more relevant. The aim of the study is to assess childhood vaccination programs implemented in selected countries. The study focuses on initiatives implemented in the European Region of the World Health Organization (WHO). A total of 466 full-text articles were assessed for eligibility, and 26 articles on seven countries were included in the synthesis. Additionally, we obtained and performed an analysis of data on the impact of COVID-19 on vaccine coverage and incidence of vaccine-preventable diseases, and the implementation of vaccine mandates in the selected countries. The evidence collected and analyzed in this review allowed us to conclude that the introduction of children routine vaccination mandates increases vaccine coverage and reduces the incidence of vaccine-preventable diseases when compared to the situation before the introduction of the mandates.
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Affiliation(s)
- Lidia Kuznetsova
- Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain;
- Correspondence:
| | - Giorgio Cortassa
- Emergency Department, Hospital Santa Corona, 17027 Pietra Ligure, Italy;
| | - Antoni Trilla
- Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain;
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Zanella B, Bechini A, Bonito B, Del Riccio M, Ninci A, Tiscione E, Bonanni P, Boccalini S. A Study of Varicella Seroprevalence in a Pediatric and Adolescent Population in Florence (Italy). Natural Infection and Vaccination-Acquired Immunization. Vaccines (Basel) 2021; 9:vaccines9020152. [PMID: 33672915 PMCID: PMC7918443 DOI: 10.3390/vaccines9020152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Varicella is a well-known infectious disease that can have severe complications, also in young children. The Universal Varicella Vaccination (UVV) program was introduced in Tuscany (Italy) in 2003, with a two-dose vaccine schedule given to children between their 13th and 15th month, and at 5–6 years old, as a monovalent for varicella (V) or tetravalent (measles, mumps, rubella and varicella (MMRV)) formulation. Although varicella notifications have dramatically fallen in the last two decades, varicella disease underreporting remains a challenge. Methods: A qualitative immunoenzymatic test (ELISA) was used to measure the presence of anti-varicella antibodies in 165 sera of subjects aged 1–18 years residing in the province of Florence (Italy). Information regarding the anamnestic and vaccination status (including disease notification) was also collected. Results: Our study showed an overall varicella seropositivity of 75.8% (reaching the maximum at 96.3% in the 15–18 years age group). We found that varicella disease notification had been recorded for only 7/165 subjects; however, since 42/165 recalled having had the disease, we can hypothesize that some of them must have been underreported. Furthermore, our study showed that the presence of antibodies after the varicella vaccination remained over time, lasting up to 12 years. Conclusions: Although varicella seroprevalence is <95% in almost all our age groups (except for the 15–18 years age group), our data are encouraging and reflect the success of the introduction of the UVV program and the vaccination campaigns promoted in the Tuscany region.
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Affiliation(s)
- Beatrice Zanella
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (B.B.); (E.T.); (P.B.); (S.B.)
| | - Angela Bechini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (B.B.); (E.T.); (P.B.); (S.B.)
- Correspondence: ; Tel.: +39-055-2751081
| | - Benedetta Bonito
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (B.B.); (E.T.); (P.B.); (S.B.)
| | - Marco Del Riccio
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (M.D.R.); (A.N.); (W.G.D.)
| | - Alessandra Ninci
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (M.D.R.); (A.N.); (W.G.D.)
| | - Emilia Tiscione
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (B.B.); (E.T.); (P.B.); (S.B.)
| | - Working Group DHS
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (M.D.R.); (A.N.); (W.G.D.)
| | | | | | - Paolo Bonanni
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (B.B.); (E.T.); (P.B.); (S.B.)
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (B.B.); (E.T.); (P.B.); (S.B.)
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Zanella B, Boccalini S, Bonito B, Del Riccio M, Manzi F, Tiscione E, Bonanni P, Bechini A. Rubella Seroprevalence Boost in the Pediatric and Adolescent Population of Florence (Italy) as a Preventive Strategy for Congenital Rubella Syndrome (CRS). Vaccines (Basel) 2020; 8:E599. [PMID: 33053851 PMCID: PMC7712445 DOI: 10.3390/vaccines8040599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/07/2020] [Accepted: 10/09/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Despite the availability of an effective vaccine since the 1970s, rubella disease and, importantly, congenital rubella syndrome (CRS) remain a public health concern. The aim of this study was to analyze the rubella seroprevalence in the children population of the province of Florence and compare the obtained results to a previous survey conducted in 2005-2006. METHODS A qualitative measurement of anti-rubella antibodies was performed on 165 sera using the enzyme-linked immunosorbent Assay (ELISA). The anamnestic and vaccination status was also collected. RESULTS Our study highlighted a very high rubella seroprevalence (85-100%) in our enrolled population. In the vaccinated group (153/165), 98.7% of them were positive to rubella antibodies. CONCLUSIONS Our study showed the highest seroprevalence rate reached in the province of Florence for rubella in the last 15 years, thanks to the several successful vaccination campaigns promoted in the Tuscany region. Our findings in pediatric and adolescent subjects are a key factor in preventing CRS in adult life, specifically in childbearing women. Thus, the set goal will be to keep the awareness about the vaccination for this preventable disease high.
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Affiliation(s)
- Beatrice Zanella
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B); (E.T.); (P.B.)
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B); (E.T.); (P.B.)
| | - Benedetta Bonito
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B); (E.T.); (P.B.)
| | - Marco Del Riccio
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (M.D.R.); (F.M.); (W.D.G.)
| | - Federico Manzi
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (M.D.R.); (F.M.); (W.D.G.)
| | - Emilia Tiscione
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B); (E.T.); (P.B.)
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B); (E.T.); (P.B.)
| | - Working Group DHS
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (M.D.R.); (F.M.); (W.D.G.)
| | | | | | - Angela Bechini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B); (E.T.); (P.B.)
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