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Attwell K, Hannah A. Convergence on Coercion: Functional and Political Pressures as Drivers of Global Childhood Vaccine Mandates. Int J Health Policy Manag 2022; 11:2660-2671. [PMID: 35397484 PMCID: PMC9818102 DOI: 10.34172/ijhpm.2022.6518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 02/05/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Vaccine hesitancy is a global problem with diverse local policy responses, from voluntaristic to coercive. Between 2015 and 2017, California, Australia, France, and Italy increased the coerciveness of their childhood vaccine regimes. Despite this apparent convergence, there is little evidence of imposition, policy learning, or diffusion - the drivers that are usually discussed in scholarly literature on policy convergence. The fact that the four governments were oriented across the political spectrum, with quite different political and institutional systems, further indicates an empirical puzzle. METHODS To better understand the drivers of enhanced vaccine mandates, a crucial issue during the coronavirus disease 2019 (COVID-19) global rollout, this article engages with four case studies assembled from qualitative analysis of semi-structured in-country interviews and document analysis between November 2018 and November 2020. Key informants had specific expert knowledge or played a role in the introduction or implementation of the new policies. Interview transcripts were coded inductively and deductively, augmented with extensive analysis of legal, policy, academic and media documents. RESULTS The case analysis identifies two key and interacting elements in government decisions to tighten vaccine mandates: functional and political pressures. Policy-makers in Italy and France were primarily driven by functional challenges, with their vaccination governance systems under threat from reduced population compliance. California and Australia did not face systemic threats to the functioning of their systems, but activists utilised local opportunities to heighten political pressure on decision makers. CONCLUSION In four recent cases of high-income jurisdictions making childhood vaccination policies more coercive, vaccine hesitancy alone could not explain why the policies arose in these jurisdictions and not others, while path dependency alone could not explain why some jurisdictions with mandates made them more coercive. Explanation lies in restrictive mandates being attractive for governments, whether they face systemic functional problems in vaccine governance, or political pressures generated by media and activists. Mandates can be framed as targeting whole populations or localised groups of refusers, and implemented without onerous costs or policy complexity.
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Affiliation(s)
- Katie Attwell
- Political Science and International Relations, School of Social Sciences, University of Western Australia, Perth, WA, Australia
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Sabbatucci M, Odone A, Signorelli C, Siddu A, Maraglino F, Rezza G. Improved Temporal Trends of Vaccination Coverage Rates in Childhood after the Mandatory Vaccination Act, Italy 2014-2019. J Clin Med 2021; 10:2540. [PMID: 34201199 PMCID: PMC8230222 DOI: 10.3390/jcm10122540] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/23/2021] [Accepted: 06/04/2021] [Indexed: 11/28/2022] Open
Abstract
Maintaining high vaccine coverage (VC) for pediatric vaccinations is crucial to ensure herd immunity, reducing the risk of vaccine-preventable diseases (VPD). The Italian vaccination Law (n. 119/2017) reinforced mandates for polio, diphtheria, tetanus, and hepatitis B, extending the mandate to pertussis, Haemophilus influenzae type b, chickenpox, measles, mumps, and rubella, for children up to 16 years of age. We analyzed the national temporal trends of childhood immunization rates from 2014 to 2019 to evaluate the impact of the mandatory reinforcement law set in 2017 as a sustainable public health strategy in Italy. In a 3-year period, 9 of the 10 compulsory vaccinations reached the threshold of 95% and VC for chicken pox increased up to 90.5%, significantly. During the same period, the recommended vaccinations (against meningococcus B and C, pneumococcus, and rotavirus) also recorded a significant increase in VC trends. In conclusion, although the reinforcement of compulsory vaccination generated a wide public debate that was amplified by traditional and social media, the 3-year evaluation highlights positive results.
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Affiliation(s)
- Michela Sabbatucci
- Department Infectious Diseases, National Institute of Health, 00161 Rome, Italy
- Ministry of Health, Directorate General Health Prevention, Communicable Diseases and International Prophylaxis, 20379 Rome, Italy; (A.S.); (F.M.); (G.R.)
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Carlo Signorelli
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy;
| | - Andrea Siddu
- Ministry of Health, Directorate General Health Prevention, Communicable Diseases and International Prophylaxis, 20379 Rome, Italy; (A.S.); (F.M.); (G.R.)
| | - Francesco Maraglino
- Ministry of Health, Directorate General Health Prevention, Communicable Diseases and International Prophylaxis, 20379 Rome, Italy; (A.S.); (F.M.); (G.R.)
| | - Giovanni Rezza
- Ministry of Health, Directorate General Health Prevention, Communicable Diseases and International Prophylaxis, 20379 Rome, Italy; (A.S.); (F.M.); (G.R.)
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Rapisarda V, Vella F, Ledda C, Barattucci M, Ramaci T. What Prompts Doctors to Recommend COVID-19 Vaccines: Is It a Question of Positive Emotion? Vaccines (Basel) 2021; 9:vaccines9060578. [PMID: 34205935 PMCID: PMC8229710 DOI: 10.3390/vaccines9060578] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/24/2021] [Accepted: 05/27/2021] [Indexed: 01/02/2023] Open
Abstract
Vaccines are among the most successful and cost-effective public health tools and have greatly contributed to eliminating or controlling several serious vaccine-treatable diseases over the past century. To curb the spread of COVID-19, efficacious vaccination is emerging as essential in mitigating the disease and preventing deaths. Health care workers (HCW) are one of the first groups to receive vaccinations, so it is important to consider their attitudes to COVID-19 vaccination to better address barriers to widespread vaccination acceptance. This study aimed to evaluate variables that are linked with the recommendation of vaccines and intention to take-up vaccination against COVID-19 among the HCWs, in the context of the current pandemic. The study was conducted during the first week of the vaccination campaign dedicated to Italian HCWs, beginning in December 2020, and it involved all doctors in a public hospital in Sicily. The following questionnaires were administered: (1) The perceived vaccine trust questionnaire, measuring the degree of trust in vaccines by healthcare professionals both in general and for the protection of healthcare professionals themselves and patients; (2) the positive and negative affect scale-state (PANAS), for assessing positive and negative emotions in relation to their work as “frontline care providers”; (3) The locus of control of behaviour (LCB) to measure the extent to which subjects perceive responsibility for their personal behaviour (internal vs. external); (4) recommendation vaccines item, referring to the intention to recommend vaccination. The findings suggest that socio-demographic control variables (age, gender, and seniority) showed little or no predictive power in vaccine recommendation, while vaccine confidence, positive emotions, and internal locus of control were excellent predictors of vaccine recommendations by doctors. Younger doctors, both in age and experience, are more confident in vaccines and recommend them more frequently. It is essential to improve institutional communication addressed to doctors to enhance their role as vaccination facilitators.
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Affiliation(s)
- Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy; (V.R.); (F.V.); (C.L.)
| | - Francesca Vella
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy; (V.R.); (F.V.); (C.L.)
- Faculty of Human and Social Sciences, University of Enna “Kore”, 94100 Enna, Italy;
| | - Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy; (V.R.); (F.V.); (C.L.)
| | | | - Tiziana Ramaci
- Faculty of Human and Social Sciences, University of Enna “Kore”, 94100 Enna, Italy;
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BOCCALINI SARA, PANATTO DONATELLA, MENNINI FRANCESCOSAVERIO, MARCELLUSI ANDREA, BINI CHIARA, AMICIZIA DANIELA, LAI PIEROLUIGI, MICALE ROSANNATINDARA, FRUMENTO DAVIDE, AZZARI CHIARA, RICCI SILVIA, BONITO BENEDETTA, DI PISA GIULIA, IOVINE MARIASILVIA, LODI LORENZO, GIOVANNINI MATTIA, MOSCADELLI ANDREA, PAOLI SONIA, PENNATI BEATRICEMARINA, PISANO LAURA, BECHINI ANGELA, BONANNI PAOLO. [ Health Technology Assessment (HTA) of the introduction of additional cohorts for anti-meningococcal vaccination with quadrivalent conjugate vaccines in Italy]. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E1-E128. [PMID: 34622076 PMCID: PMC8452280 DOI: 10.15167/2421-4248/jpmh2021.62.1s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- SARA BOCCALINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
- Autore corrispondente: Sara Boccalini, Dipartimento di Scienze della Salute, Università degli Studi di Firenze, 50134 Firenze, Italia - Tel.: 055-2751084 E-mail:
| | - DONATELLA PANATTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - FRANCESCO SAVERIO MENNINI
- Economic Evaluation and HTA - CEIS (EEHTA - CEIS), Facoltà di Economia, Università di Roma "Tor Vergata"
- Institute for Leadership and Management in Health, Kingston University, London, UK
| | - ANDREA MARCELLUSI
- Economic Evaluation and HTA - CEIS (EEHTA - CEIS), Facoltà di Economia, Università di Roma "Tor Vergata"
| | - CHIARA BINI
- Economic Evaluation and HTA - CEIS (EEHTA - CEIS), Facoltà di Economia, Università di Roma "Tor Vergata"
| | - DANIELA AMICIZIA
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - PIERO LUIGI LAI
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | | | - DAVIDE FRUMENTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - CHIARA AZZARI
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - SILVIA RICCI
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - BENEDETTA BONITO
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - GIULIA DI PISA
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | | | - LORENZO LODI
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - MATTIA GIOVANNINI
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - ANDREA MOSCADELLI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - SONIA PAOLI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | | | - LAURA PISANO
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - ANGELA BECHINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - PAOLO BONANNI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
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Di Camillo C, Vittucci AC, Antilici L, Ciarlitto C, Linardos G, Concato C, Lancella L, Villani A. Pertussis in early life: underdiagnosed, severe, and risky disease. A seven-year experience in a pediatric tertiary-care hospital. Hum Vaccin Immunother 2021; 17:705-713. [PMID: 32755440 PMCID: PMC7993225 DOI: 10.1080/21645515.2020.1791617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/10/2020] [Accepted: 06/28/2020] [Indexed: 10/23/2022] Open
Abstract
AIM Pertussis continues to be a common worldwide infection in pediatric and adult populations.We aimed to study epidemiological and clinical characteristics of infants and children admitted for pertussis to a tertiary-care hospital and to investigate the risk factors for pediatric intensive care unit (PICU) admission. MATERIALS AND METHODS With a retrospective study, we analyzed all medical reports of patients admitted to Bambino Gesù Children's Hospital in Rome from January 2011 to December 2018 with a diagnosis of pertussis. RESULTS We examined 195 patients. The majority of hospitalized children (66.15%) were <3 months of age. No mother had received pertussis containing vaccine during pregnancy. Ten cases required admission in PICU. The age at admission was lower in PICU patients with respect to ward patients (42.8 vs 240 days; p < .0007), length of hospital stay was longer in PICU group (24.7 vs 7.52 days; p < .003). Patients who needed PICU admission had greater white blood cell count at hospital admission compared with those hospitalized in the pediatric ward. One infant died and one had encephalitis. CONCLUSIONS Pertussis is a remerging disease. In infants, it is associated with significant morbidity and mortality. In recent years, many countries have implemented different vaccination strategies and public health measures to prevent the increase in pertussis cases. Maternal vaccination has been shown to be highly protective for infants <3 months of age before they can develop their own immunity via vaccination.
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Affiliation(s)
- Chiara Di Camillo
- Academic Department of Pediatrics, Pediatric and Infectious Disease Unit, Children’s Hospital Bambino Gesù (IRCCS), Rome, Italy
| | - Anna Chiara Vittucci
- Academic Department of Pediatrics, Pediatric and Infectious Disease Unit, Children’s Hospital Bambino Gesù (IRCCS), Rome, Italy
| | - Livia Antilici
- Academic Department of Pediatrics, Tor Vergata University of Rome, Rome, Italy
| | - Claudia Ciarlitto
- Academic Department of Pediatrics, Tor Vergata University of Rome, Rome, Italy
| | - Giulia Linardos
- Virology Unit, Bambino Gesù Children’s Hospital (IRCCS), Rome, Italy
| | - Carlo Concato
- Virology Unit, Bambino Gesù Children’s Hospital (IRCCS), Rome, Italy
| | - Laura Lancella
- Academic Department of Pediatrics, Pediatric and Infectious Disease Unit, Children’s Hospital Bambino Gesù (IRCCS), Rome, Italy
| | - Alberto Villani
- Academic Department of Pediatrics, Pediatric and Infectious Disease Unit, Children’s Hospital Bambino Gesù (IRCCS), Rome, Italy
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Bigaard J, Franceschi S. Vaccination against HPV: boosting coverage and tackling misinformation. Mol Oncol 2021; 15:770-778. [PMID: 33058497 PMCID: PMC7931130 DOI: 10.1002/1878-0261.12808] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/18/2020] [Accepted: 09/25/2020] [Indexed: 11/06/2022] Open
Abstract
The availability of human papillomavirus (HPV) vaccines and screening tests has raised the possibility of globally eliminating cervical cancer, which is caused by HPV. Cervical cancer is a very common malignancy worldwide, especially among deprived women. High vaccination coverage is key to the containment and eventual elimination of the infection. Public HPV vaccination programmes in Italy and Denmark were swiftly established and are among the most successful worldwide. Still, in both countries, it has been challenging to achieve and maintain the recommended coverage of > 80% in girls. In a well-studied Italian region, vaccination coverage in girls at age 15 years (World Health Organization's gold standard) reached 76% in 2015 but decreased to 69% in 2018, likely due to work overload in public immunization centres. In Denmark, doubts about safety and efficacy of the HPV vaccine generated a decline in coverage among girls age 12-17, from 80% in 2013 down to 37% in 2015, when remedial actions made it rise again. Insights from these two countries are shared to illustrate the importance of monitoring coverage in a digital vaccine registry and promptly reacting to misinformation about vaccination.
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Affiliation(s)
- Janne Bigaard
- The Danish Cancer SocietyPrevention & InformationCopenhagenDenmark
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7
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Vaccination Status of Mothers and Children from the 'Mamma & Bambino' Cohort. Vaccines (Basel) 2021; 9:vaccines9020168. [PMID: 33671412 PMCID: PMC7921954 DOI: 10.3390/vaccines9020168] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 01/12/2023] Open
Abstract
According to the evidence demonstrating vaccines’ safety and effectiveness in anticipation of and during pregnancy, several countries have established immunization programs during the periconceptional period. Here, we evaluated vaccination status among 220 mother–child pairs, using data from the ‘Mamma & Bambino’ cohort. The self-reported data were evaluated at delivery, and with planned follow-ups at 1–2 years after delivery. In general, we noted that the vaccination status among the women was heterogeneous, ranging from 8.3% (vaccine against Human Papillomavirus, HPV) to 65.6% (vaccine against Diphtheria Tetanus and Pertussis, DTaP). Excluding the women who contracted the diseases in the past, the main ground for refusal was the lack of information. We also demonstrated that increasing age was associated with higher odds of not being vaccinated against Measles-Mumps-Rubella (MMR; OR = 1.12; 95% CI = 1.04–1.21; p = 0.004), HPV (OR = 1.20; 95% CI = 1.08–1.33; p = 0.001) and DTaP (OR =1.09; 95% CI = 1.01–1.18; p = 0.040). As expected, we showed that the proportion of newborns vaccinated with the Hexavalent and Pneumococcal vaccines was high (99.5% and 98.6%, respectively), while the vaccination coverage against MMRV did not reach the auspicated threshold (84.1%). Overall, these results underlined the need for the improvement of women’s knowledge about the recommendations for vaccination, especially during pregnancy.
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Brunelli L, Valent F, Romanese F, Tricarico P, Pellizzaro A, d'Angelo M, Benetollo PP, Iob A, Forgiarini M, Brusaferro S. Parental trust and beliefs after the discovery of a six-year-long failure to vaccinate. Hum Vaccin Immunother 2021; 17:583-587. [PMID: 32750274 PMCID: PMC7899632 DOI: 10.1080/21645515.2020.1777820] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND In Italy vaccine hesitancy worsened after a failure to vaccinate episode that took place in Friuli Venezia-Giulia Region until early 2017 which undermined herd immunity by leaving unprotected more than 5,444 children. METHODS Between May and June 2017, 2,557 parents were surveyed at the local vaccination clinic where they were invited within the subsequent extraordinary vaccination campaign. The aim of the survey was to evaluate whether the multi-channel extraordinary vaccination campaign had reached the target population and to know parental beliefs and trusted sources of information after the failure to vaccinate event. RESULTS While 279 parents were non-hesitant (10.9%) and 1,491 hesitant acceptors (58.3%), just 38 (1.5%) refused to have their children revaccinated. Overall, the most consulted sources of information were print media (18.8%), physicians (16.0%), relatives and friends (12.1%). The majority of parents considered vaccination as a fundamental practice (73.9%), but many were worried about potential side effects (38.8%) or doubtful about the effectiveness of some vaccines (11.0%). According to parents, 19.7% of them (57) changed their opinion about vaccines after the Codroipo case. CONCLUSIONS After the Codroipo case, most parents chose to have their children re-vaccinated and just a little proportion refused the re-administration of vaccines. More studies are needed to confirm the importance of a coherent multi-channel communication strategy using both traditional and new media in order to counteract vaccine hesitancy.
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Affiliation(s)
- Laura Brunelli
- Dipartimento di Area Medica, Università Degli Studi di Udine , Udine, Italy
| | - Francesca Valent
- Istituto di Igiene Ed Epidemiologia Clinica, Azienda Sanitaria Universitaria Integrata di Udine , Udine, Italy
| | - Federico Romanese
- Dipartimento di Area Medica, Università Degli Studi di Udine , Udine, Italy
| | | | - Alice Pellizzaro
- Dipartimento di Area Medica, Università Degli Studi di Udine , Udine, Italy
| | - Matteo d'Angelo
- Dipartimento di Area Medica, Università Degli Studi di Udine , Udine, Italy
| | - Pier Paolo Benetollo
- Azienda per l'Assistenza Sanitaria No.3 Del Friuli Venezia Giulia , Gemona, Italy
| | - Andrea Iob
- Azienda per l'Assistenza Sanitaria No.3 Del Friuli Venezia Giulia , Gemona, Italy
| | - Mariarita Forgiarini
- Azienda per l'Assistenza Sanitaria No.3 Del Friuli Venezia Giulia , Gemona, Italy
| | - Silvio Brusaferro
- Dipartimento di Area Medica, Università Degli Studi di Udine , Udine, Italy
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Increasing Measles Seroprevalence in a Sample of Pediatric and Adolescent Population of Tuscany (Italy): A Vaccination Campaign Success. Vaccines (Basel) 2020; 8:vaccines8030512. [PMID: 32911762 PMCID: PMC7565840 DOI: 10.3390/vaccines8030512] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/01/2020] [Accepted: 09/04/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Despite the National Plan for the Elimination of Measles and congenital Rubella (NPEMcR), in 2017, a measles outbreak occurred in Italy, due to sub-optimal vaccination coverage (<95%) for many years. Since that year, the anti-measles vaccination became compulsory in minors (0–16 years) for school attendance. The aim of our study was to assess the immunity/susceptibility against measles in a representative sample of pediatric and adolescent (1–18 years) residents of the province of Florence (Tuscany, Italy), and to compare these results with two previous surveys (2003 and 2005–2006). Methods: The enzyme-linked immunosorbent assay (ELISA) was applied for a qualitative measurement of anti-measles antibodies on 165 sera. The anamnestic and vaccination status was also collected. Results: No measles notification was reported. The overall seropositivity was 88.5%; mostly in the 5–9 years old subjects (97.9%). Among the 152 vaccinated, 92.1% were positive. The seropositivity persisted after many years since the last dose of vaccine and tended to be more long-lasting in those who had received two or three doses. The susceptibility towards measles decreased over time, reaching a lower value in the current survey (8.5%) than in 2003 (30.8%) and in 2005–2006 (25.5%). Conclusions: This study confirmed the anti-measles vaccination campaign success, which allowed for the increase in vaccination coverage and immunity levels against measles in the Florentine pediatric and adolescent population following the NPEMcR implementation.
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Nasso C, Mecchio A, Rottura M, Valenzise M, Menniti-Ippolito F, Cutroneo PM, Squadrito V, Squadrito F, Pallio G, Irrera N, Arcoraci V, Altavilla D. A 7-Years Active Pharmacovigilance Study of Adverse Drug Reactions Causing Children Admission to a Pediatric Emergency Department in Sicily. Front Pharmacol 2020; 11:1090. [PMID: 32765282 PMCID: PMC7379477 DOI: 10.3389/fphar.2020.01090] [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: 04/30/2020] [Accepted: 07/06/2020] [Indexed: 01/22/2023] Open
Abstract
Children represent one of the most susceptible groups to adverse drug reactions (ADRs), as a consequence of physiological growth and maturation of different organ systems. The aim of this study was to characterize the frequency, preventability and seriousness of ADRs recorded in the Pediatric Emergency Department (ED) of the University hospital of Messina, in Sicily. All the suspected adverse reactions to drugs and vaccines collected from 2012 to 2018 were selected and then analyzed. Only adverse drug reactions (ADRs) with a probable or possible causality assessment were included, according to the Naranjo Algorithm and the World Health Organization criteria; the preventability assessment using Schumock and Thornton criteria was also carried out. The Medical Dictionary for Regulatory Activities (MedDRA) was used to group ADRs. Of 75,935 admissions to the Pediatric ED, 120 were due to suspected ADRs. The rate of hospital admission due to ADRs (75.8%) was significantly greater than that of patients without ADRs (11.9%). Among pediatric patients with ADRs the median (Q1–Q3) age was 29.5 (12–73.25) months. Most of ADRs were observed in infants and children (43.3% and 41.7%, respectively vs adolescents, 15%). In addition, in children with ADRs, females [41 (14–105)] were older than males [23 (11–45)] (p=0.044). Most adverse reactions were serious (75.8%) and 20.8% were preventable or probably preventable; however, the majority of serious ADRs (93.4%) resulted without sequelae. The reactions were found to be as probable (54.2%) or possible (45.8%). Vaccines (n=63), antibacterials (n=31) and anti-inflammatory medicines (n=14) were the most frequently drugs involved. Organ toxicity mapping due to vaccines was general disorders and administration site conditions (65.1%), nervous disorders (50.2%), cutaneous disorders (35%), followed by gastrointestinal disorders (20.6%). Cutaneous disorders (76%) gastrointestinal (20.7%), general (15.5%), and nervous disorders (8.6%) were the organ toxicity mapping due to drugs. Active pharmacovigilance has an essential role in supporting the development of strategies aimed at intervention to reduce admissions due to ADRs. Our data suggest that ADRs represent the first cause of hospitalization to the Pediatric Emergency Department. Furthermore, according to the literature, vaccines and antibiotics are the most frequent cause of adverse drug reactions in children.
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Affiliation(s)
- Chiara Nasso
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Anna Mecchio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Michelangelo Rottura
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Mariella Valenzise
- Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, Messina, Italy
| | | | - Paola Maria Cutroneo
- Sicilian Regional Pharmacovigilance Center, Clinical Pharmacology Unit, University Hospital of Messina, Messina, Italy
| | - Violetta Squadrito
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Francesco Squadrito
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giovanni Pallio
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Natasha Irrera
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Vincenzo Arcoraci
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Domenica Altavilla
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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Gesualdo F, D'Ambrosio A, Agricola E, Russo L, Campagna I, Ferretti B, Pandolfi E, Cristoforetti M, Tozzi AE, Rizzo C. How do Twitter users react to TV broadcasts dedicated to vaccines in Italy? Eur J Public Health 2020; 30:510-515. [PMID: 32073598 PMCID: PMC7292342 DOI: 10.1093/eurpub/ckaa022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Social media monitoring during TV broadcasts dedicated to vaccines can provide information on vaccine confidence. We analyzed the sentiment of tweets published in reaction to two TV broadcasts in Italy dedicated to vaccines, one based on scientific evidence [Presadiretta (PD)] and one including anti-vaccine personalities [Virus (VS)]. METHODS Tweets about vaccines published in an 8-day period centred on each of the two TV broadcasts were classified by sentiment. Differences in tweets' and users' characteristics between the two broadcasts were tested through Poisson, quasi-Poisson or logistic univariate regression. We investigated the association between users' characteristics and sentiment through univariate quasi-binomial logistic regression. RESULTS We downloaded 12 180 tweets pertinent to vaccines, published by 5447 users; 276 users tweeted during both broadcasts. Sentiment was positive in 50.4% of tweets, negative in 37.7% and neutral in 10.1% (remaining tweets were unclear or questions). The positive/negative ratio was higher for VS compared to PD (6.96 vs. 4.24, P<0.001). Positive sentiment was associated to the user's number of followers (OR 1.68, P<0.001), friends (OR 1.83, P<0.001) and published tweets (OR 1.46, P<0.001) and to being a recurrent user (OR 3.26, P<0.001). CONCLUSIONS Twitter users were highly reactive to TV broadcasts dedicated to vaccines. Sentiment was mainly positive, especially among very active users. Displaying anti-vaccine positions on TV elicited a positive sentiment on Twitter. Listening to social media during TV shows dedicated to vaccines can provide a diverse set of data that can be exploited by public health institutions to inform tailored vaccine communication initiatives.
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Affiliation(s)
- Francesco Gesualdo
- Predictive and Preventive Medicine Research Unit, Multifactorial and Complex Disease Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Angelo D'Ambrosio
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Eleonora Agricola
- Predictive and Preventive Medicine Research Unit, Multifactorial and Complex Disease Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Luisa Russo
- Predictive and Preventive Medicine Research Unit, Multifactorial and Complex Disease Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Ilaria Campagna
- Predictive and Preventive Medicine Research Unit, Multifactorial and Complex Disease Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Beatrice Ferretti
- Predictive and Preventive Medicine Research Unit, Multifactorial and Complex Disease Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Elisabetta Pandolfi
- Predictive and Preventive Medicine Research Unit, Multifactorial and Complex Disease Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Marco Cristoforetti
- Information and Communication Technology Department, Fondazione Bruno Kessler, Trento, Italy
| | - Alberto E Tozzi
- Predictive and Preventive Medicine Research Unit, Multifactorial and Complex Disease Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Caterina Rizzo
- Predictive and Preventive Medicine Research Unit, Multifactorial and Complex Disease Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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12
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Tavoschi L, Quattrone F, D’Andrea E, Ducange P, Vabanesi M, Marcelloni F, Lopalco PL. Twitter as a sentinel tool to monitor public opinion on vaccination: an opinion mining analysis from September 2016 to August 2017 in Italy. Hum Vaccin Immunother 2020; 16:1062-1069. [PMID: 32118519 PMCID: PMC7227677 DOI: 10.1080/21645515.2020.1714311] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 12/18/2019] [Accepted: 01/06/2020] [Indexed: 11/29/2022] Open
Abstract
Social media have become a common way for people to express their personal viewpoints, including sentiments about health topics. We present the results of an opinion mining analysis on vaccination performed on Twitter from September 2016 to August 2017 in Italy. Vaccine-related tweets were automatically classified as against, in favor or neutral in respect of the vaccination topic by means of supervised machine-learning techniques. During this period, we found an increasing trend in the number of tweets on this topic. According to the overall analysis by category, 60% of tweets were classified as neutral, 23% against vaccination, and 17% in favor of vaccination. Vaccine-related events appeared able to influence the number and the opinion polarity of tweets. In particular, the approval of the decree introducing mandatory immunization for selected childhood diseases produced a prominent effect in the social discussion in terms of number of tweets. Opinion mining analysis based on Twitter showed to be a potentially useful and timely sentinel system to assess the orientation of public opinion toward vaccination and, in future, it may effectively contribute to the development of appropriate communication and information strategies.
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Affiliation(s)
- Lara Tavoschi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Filippo Quattrone
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Eleonora D’Andrea
- Dipartimento di Ingegneria dell’Informazione, University of Pisa, Pisa, Italy
| | - Pietro Ducange
- Dipartimento di Ingegneria dell’Informazione, University of Pisa, Pisa, Italy
| | - Marco Vabanesi
- Department of Neurology, San Raffaele Scientific Institute and University, Milan, Italy
| | | | - Pier Luigi Lopalco
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
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13
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Costantino C, Casuccio A, Sannasardo CE, Vella C, Scarpitta F, Randazzo MA, Foresta A, Casuccio N, Ventura G, Bono SE, Vitale F, Restivo V. Public health strategies adopted to manage the increase of accesses to vaccination services, as a result of the application of the law 119/2017. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:35-40. [PMID: 32275265 PMCID: PMC7975909 DOI: 10.23750/abm.v91i3-s.9413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/24/2020] [Indexed: 11/25/2022]
Abstract
Background and aim of the work: In response to the alarming reduction of vaccination coverage rates, Italian Ministry of Health approved the law number 119/2017, which has extended the number of mandatory vaccinations, for school attendance, from four to ten. The present study aims to evaluate accesses to the vaccination services of the Palermo Local Health Unit (LHU) and the variation of the vaccination coverage rates for hexavalent and measles, mumps, rubella and varicella (MMRV) vaccines, after the implementation of the law 119/2017. Methods: An extent of opening hours and an involvement of other health-care professionals in the vaccination services of the Palermo LHU have been adopted to manage the excess of accesses after the introduction of 119/2017 law and to limit the discomfort of general population. Vaccination accesses and coverage rates were calculated from the electronic immunization registers. Results: An overall increase of about 15% of single vaccination accesses was observed in the three semester after the introduction of the law in the LHU of Palermo. A peak of 35,516 accesses was observed during the second semester of 2017 (+ 30% compared to the same semesters of 2016 and 2018). From 2016 to 2018, coverage rates for full hexavalent cycle and first dose of MMRV, at 24 and 36 months, and for full MMRV cycle and fourth dose of diphtheria, tetanus, pertussis, poliomyelitis (DTPa+IPV), among 6 years old children, showed considerable increases. Conclusions: Law 199/2017 demonstrated a high efficacy in increase vaccination coverage rates also in Sicily. The synergy established between the LHU and the University of Palermo allowed an excellent management of the accesses to vaccination services, making it possible to respond to the public health needs of the general population.
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Affiliation(s)
- Claudio Costantino
- University of Palermo - Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE).
| | - Alessandra Casuccio
- University of Palermo - Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE).
| | - Claudia Emilia Sannasardo
- University of Palermo - Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE).
| | - Carlotta Vella
- University of Palermo - Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE).
| | - Francesco Scarpitta
- University of Palermo - Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE).
| | | | - Angelo Foresta
- Local Health Unit of Palermo, Department of Medical Prevention.
| | - Nicolò Casuccio
- Local Health Unit of Palermo, Department of Medical Prevention.
| | - Gianmarco Ventura
- University of Palermo - Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE).
| | - Stefania Enza Bono
- University of Palermo - Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE).
| | - Francesco Vitale
- University of Palermo - Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE).
| | - Vincenzo Restivo
- University of Palermo - Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE).
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14
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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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15
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Signorelli C, Priori M, Odone A, Vezzosi L, Colucci ME, Affanni P, Veronesi L, Maio T. [New challenges in vaccination policies: the role of General Practitioners]. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:135-140. [PMID: 32275278 PMCID: PMC7975910 DOI: 10.23750/abm.v91i3-s.9452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 11/25/2022]
Abstract
New challenges in vaccination policies: the role of General Practitioners. The phenomenon of “Vaccine Hesintacy” and the consequent decrease in vaccination coverage with the re-ignition of some epidemic outbreaks has led Italian national and regional authorities to set a new vaccination plan (PNPV 2017-19) and even coercive measures such as the the Law n.119/2017. In addition, there have been initiatives by scientific societies also in order to increase involvement of professionals in information and education campaigns. Among the professional figures involved, the general practitioners represents the starting point from which to regain the citizen’s trust. This article assesses their important role in the implementation of vaccination policies in Italy by identifying the essential points of the campaigns carried out on their patients.
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Affiliation(s)
- Carlo Signorelli
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy. Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | | | - Anna Odone
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy.
| | | | | | - Paola Affanni
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
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16
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Croci R, Rossi D, Colucci ME, Odone A, Signorelli C. Trends in childhood vaccinations coverage in Lombardy Region after the National Vaccine Prevention Plan (2017-19) and the new law on mandatory vaccinations. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:71-76. [PMID: 32275270 PMCID: PMC7975904 DOI: 10.23750/abm.v91i3-s.9458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 11/23/2022]
Abstract
In Italy, over the last decade, the spread of vaccine hesitancy has caused a steep decrease in vaccination coverage rates, both at the national and regional level. In this study, we pool and critically analyze childhood immunization coverage rates (2011-2018) in Lombardy, Italy’s most populated region, and compare them to national trends. Overall, childhood vaccination coverage in Lombardy is slightly higher the Italian national average. In 2017, the law on mandatory vaccinations came into force, acting as a powerful tool for coverage increase.
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Affiliation(s)
| | | | | | - Anna Odone
- University Vita-Salute San Raffaele, Milan.
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17
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Gori D, Costantino C, Odone A, Ricci B, Ialonardi M, Signorelli C, Vitale F, Fantini MP. The Impact of Mandatory Vaccination Law in Italy on MMR Coverage Rates in Two of the Largest Italian Regions (Emilia-Romagna and Sicily): An Effective Strategy to Contrast Vaccine Hesitancy. Vaccines (Basel) 2020; 8:vaccines8010057. [PMID: 32019092 PMCID: PMC7158674 DOI: 10.3390/vaccines8010057] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 01/18/2020] [Accepted: 01/23/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Vaccine hesitancy has increased worldwide, leading to reduction in vaccination coverage rates. In particular, reduction in the coverage for the trivalent Measles-Mumps-Rubella vaccine has led to an increase of measles cases. The aim of this study is to analyze the coverage rates for the MMR vaccine in the Emilia-Romagna Region (RER) and Sicily Region (SR) between 2009 and 2018, and to correlate any significant change to index events which could have modified the trend of vaccination rates. Methods: Official aggregate data on vaccination coverage at 24 months provided by the RER and the SR were analyzed through trend analysis and related to important index events. Results: The two regions showed similar results; both achieved the lowest coverage rates in 2015 and both showed an increase in the rates after the introduction of mandatory vaccinations for access to schools. In 2018, both reached the starting point before the decrease. Conclusions: Our results confirm the effectiveness of legislative coercive measures in favor of vaccination. A potential decrease in the coverage rates may be observed as a result of an attenuation of the positive effects of coercive measures over time. It is thus necessary to combine these measures together with information campaigns and political initiatives at different levels (i.e., national, regional).
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Affiliation(s)
- Davide Gori
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy;
- Correspondence:
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (C.C.); (F.V.)
| | - Anna Odone
- School of Medicine, University Vita-Salute San Raffaele, 20132 Milan, Italy; (A.O.); (C.S.)
| | - Beatrice Ricci
- School of Hygiene and Preventive Medicine, University of Bologna, 40138 Bologna, Italy; (B.R.); (M.I.)
| | - Magda Ialonardi
- School of Hygiene and Preventive Medicine, University of Bologna, 40138 Bologna, Italy; (B.R.); (M.I.)
| | - Carlo Signorelli
- School of Medicine, University Vita-Salute San Raffaele, 20132 Milan, Italy; (A.O.); (C.S.)
| | - Francesco Vitale
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (C.C.); (F.V.)
| | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy;
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18
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Gentile L, Cuda A, Dallagiacoma G, Provenzano S, Santangelo OE, Navaro M, D’Aloisio F, Gianfredi V. Opinion, knowledge and attitude of public health residents towards the new mandatory vaccination law in Italy. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-019-01171-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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19
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Boccalini S, Bechini A, Sartor G, Paolini D, Innocenti M, Bonanni P, Panatto D, Lai PL, Zangrillo F, Marchini F, Lecini E, Iovine M, Amicizia D, Landa P. [Health Technology Assessment of meningococcal B vaccine (Trumenba ®) in adolescent in Italy]. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E1-E94. [PMID: 32047867 PMCID: PMC7007189 DOI: 10.15167/2421-4248/jpmh2019.60.3s2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- S Boccalini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - A Bechini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - G Sartor
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - D Paolini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - M Innocenti
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - P Bonanni
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - D Panatto
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - P L Lai
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - F Zangrillo
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - F Marchini
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - E Lecini
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - M Iovine
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - D Amicizia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - P Landa
- Dipartimento di Economia, Università degli Studi di Genova
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20
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Costantino C, Ledda C, Genovese C, Contrino E, Vitale E, Maida CM, Squeri R, Vitale F, Rapisarda V. Immunization Status against Measles of Health-Care Workers Operating at Three Sicilian University Hospitals: An Observational Study. Vaccines (Basel) 2019; 7:vaccines7040175. [PMID: 31684158 PMCID: PMC6963751 DOI: 10.3390/vaccines7040175] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 10/31/2019] [Accepted: 11/01/2019] [Indexed: 11/16/2022] Open
Abstract
Measles is a highly contagious vaccine-preventable disease (VPD) that also commonly affects health-care workers (HCWs). Measles immunization of HCWs was strongly recommended by international health authorities, in order to limit the spreading of the illness to susceptible patients and colleagues. An observational study, evaluating the immunization and vaccination status against measles of HCWs working at three Sicilian university hospitals, was conducted. All subjects not completely immune (vaccinated with only one dose in their lifetime), not immune (not vaccinated or not naturally immunized), and with an unknown immunization status were considered not immunized. Among HCWs operating in the three Sicilian university hospitals, 54.6% were not immune against measles. The average age of not immune HCWs was 51.3 (SD ± 9.8), ranging between 25 and 71 years old. In particular, 46.9% of HCWs not immunized worked in “at-risk” hospital units, based on medical conditions of patients which increases the probability of contracting an infection. Vaccination coverage rates observed against measles are considerably lower than other European countries and inadequate. It is therefore crucial to tackle vaccine hesitancy among HCWs, promoting strategies targeted to evaluate immunization status against VPDs and to significantly increase vaccine coverages, such as tailored training and vaccination offer or compulsory vaccination programs.
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Affiliation(s)
- Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy.
| | - Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Cristina Genovese
- Department of Biomedical Sciences, Dental Sciences and Morpho-functional images, University of Messina, 98125 Messina, Italy.
| | - Eleonora Contrino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy.
| | - Ermanno Vitale
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Carmelo Massimo Maida
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy.
| | - Raffaele Squeri
- Department of Biomedical Sciences, Dental Sciences and Morpho-functional images, University of Messina, 98125 Messina, Italy.
| | - Francesco Vitale
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy.
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
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21
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D'Ancona F, D'Amario C, Maraglino F, Rezza G, Ricciardi W, Iannazzo S. Introduction of new and reinforcement of existing compulsory vaccinations in Italy: first evaluation of the impact on vaccination coverage in 2017. ACTA ACUST UNITED AC 2019; 23. [PMID: 29871721 DOI: 10.2807/1560-7917.es.2018.23.22.1800238] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In June 2017, a decree-law to increase the number of mandatory vaccinations from 4 to 10 for minors up to 16-years-old was issued in Italy. The vaccination coverage for 2017 showed a positive impact for all the vaccines, particularly for the measles, mumps and rubella vaccine at 91.6% for the year 2017, showing a 4.4% increase compared with 2016 (87.2%). Continued monitoring is needed to evaluate the medium to long-term effects of the law.
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22
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Gori D, Ialonardi M, Odone A, Ricci B, Pascucci MG, Frasca G, Venturi S, Signorelli C, Fantini MP. Vaccine Hesitancy and Mandatory Immunizations in Emilia-Romagna Region: the case of MMR vaccine. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:394-397. [PMID: 31580332 PMCID: PMC7233739 DOI: 10.23750/abm.v90i3.8865] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 11/23/2022]
Abstract
Background and aim: An increase of vaccine hesitancy has spread worldwide and lead to reduction in coverage rates. The trivalent Measles-Mumps-Rubella (MMR) vaccine has been one of the most targeted leading due to possible (but never proven) adverse effects. This resulted in an increase of measles cases. The aim of the study is to analyze the 24-months coverage rates for the MMR vaccine in Emilia-Romagna Region (RER) between 2007 and 2018 and to correlate any significant changes to index events. Methods: Official aggregate data on vaccination coverage at 24-month provided by the RER and the Italian Ministry of health were analyzed and discussed. Results: From 2012 to 2015 a significant reduction in vaccination rates has been registered. In the following years an increase was recorded temporarily related to national and regional laws. Conclusion: The mandatory vaccination strategies seem to be in the short period effective in RER to counteract the growing population neegative attitudes towards vaccination and mitigate vaccine hesitancy. (www.actabiomedica.it) Premesse e obiettivi: Un aumento dell’esitazione vaccinale si è diffusa in tutto il mondo e ha portato alla riduzione significativa dei tassi di copertura. Il vaccino trivalente morbillo-parotite-rosolia (MMR) è stato uno dei più interessati a causa di presunti (e mai dimostrati) effetti collaterali e il calo della copertura di questa vaccinazione ha portato ad un aumento dei casi di morbillo. L’obiettivo della ricerca è quello di analizzare i tassi di copertura per il vaccino MMR a 24 mesi di età nella Regione Emilia-Romagna (RER) tra il 2007 e il 2018 e di correlare eventuali cambiamenti significativi ad eventi esterni. Metodi: Sono stati analizzati e discussi i dati aggregati ufficiali sulla copertura vaccinale a 24 mesi forniti dalla Regione e dal Ministero della Salute. Risultati: Dal 2012 al 2015 è stata registrata una riduzione significativa dei tassi di vaccinazione. Negli anni seguenti è stato registrato un aumento temporalmente correlato all’entrata in vigore delle leggi nazionali e regionali. Conclusioni: Le strategie di vaccinazione obbligatorie sembrano essere efficaci nel breve periodo nella RER per contrastare l’atteggiamento della popolazione nei confronti della vaccinazione e mitigare l’esitazione vaccinale.
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Affiliation(s)
- Davide Gori
- University of Bologna, Department of Biomedical and Neuromotor Sciences.
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Veronesi L, Colucci ME, Capobianco E, Bracchi MT, Zoni R, Palandri L, Affanni P. Immunity status against poliomyelitis in young migrants: a seroprevalence study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:28-34. [PMID: 31517887 PMCID: PMC7233651 DOI: 10.23750/abm.v90i9-s.8700] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 01/13/2023]
Abstract
Background and aim of the work: Recent seroprevalence studies in different population groups have shown low antibody titers against poliomyelitis, especially in young adults. This, together with the reduction of vaccination rates, could favor the reintroduction of poliovirus in long-time polio-free countries. Within the Surveillance system of acute flaccid paralysis, a prevalence study was conducted to estimate the immunological status associated with poliomyelitis in young migrants. Methods: Local Health Authority collected serum samples in young migrants, without vaccination documentation. Antibodies levels were assessed with a long incubation neutralization assay. Subjects were stratified by age and by WHO region. Seroprotection was defined by a titer equal or above 1:8 and titers > 1:2 were log-transformed and evaluated as geometric mean titers (GMTs). Results: From January 2004 to August 2017, 1138 blood samples were collected. Mean age was 13.3 years with no differences between WHO regions. The percentage of antibody titers below 1:8 was 6.0% versus poliovirus 1 (PV1), 7.7% versus poliovirus 2 (PV2) and 15% versus poliovirus 3 (PV3). The GMTs were 45.5, 29.5 and 20 towards PV1, PV2 and PV3 respectively. In each WHO region, the GMTs towards PV3 were consistently the lowest, and the Europeans showed the lowest GMTs both towards PV2 and PV3 (27.5 and 15.3 respectively). GMTs decreased with age. Conclusion: The low GMTs and the clear tendency to decrease with increasing age of the subjects, especially against to PV1, confirm the framework of attention that polio is receiving at national and international level. (www.actabiomedica.it)
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Lombardi N, Crescioli G, Bettiol A, Tuccori M, Rossi M, Bonaiuti R, Ravaldi C, Levi M, Mugelli A, Ricci S, Lippi F, Azzari C, Bonanni P, Vannacci A. Vaccines Safety in Children and in General Population: A Pharmacovigilance Study on Adverse Events Following Anti-Infective Vaccination in Italy. Front Pharmacol 2019; 10:948. [PMID: 31543816 PMCID: PMC6728926 DOI: 10.3389/fphar.2019.00948] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 07/24/2019] [Indexed: 12/20/2022] Open
Abstract
Background: The concern for adverse events following immunization (AEFI) and anti-vaccination movements that lacked scientific evidence-based supports may reduce vaccine uptake in the general population. Thus, the aims of the present study were to characterize AEFI in general population (all age groups), in terms of frequency, preventability, and seriousness and to define predictors of their seriousness in children. Methods: A retrospective study was performed on suspected AEFI reports for children and adults who received any form of vaccinations, collected in Tuscany, Italy, between 1 January and 31 December 2017. Patients’ characteristics, suspected vaccines, and AEFI description were collected. Causality and preventability were assessed using WHO and Schumock and Thornton algorithms, respectively. Logistic regression was used to estimate the reporting odds ratios of potential predictors of AEFI seriousness in children. Results: A total of 223 suspected AEFI reports were collected, and the majority of them were defined as non-serious (76.7%). Reports were mostly related to one vaccine, and to a median of two to five strains/toxoids. The total number of simultaneously administered strains/toxoids and the presence of allergens did not correlate with AEFI seriousness. Considering vaccines with a high number of administered doses (≥60,000 doses), the rates estimated for serious AEFI reports were always very low, ranging between 0.01 and 0.2/1,000 doses. Twenty-four vaccines (8,993 doses) were not related to any AEFI. Conclusion: Results of present study showed that AEFI were very rare; the vast majority of them was non-serious and, despite the claims of anti-vaccination movements, the simultaneous administration of vaccines was safe and did not influence the risk of reporting a serious AEFI, particularly in children.
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Affiliation(s)
- Niccolò Lombardi
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence, Italy
| | - Giada Crescioli
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence, Italy
| | - Alessandra Bettiol
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence, Italy
| | - Marco Tuccori
- Tuscan Regional Centre of Pharmacovigilance, Florence, Italy.,Unit of Adverse Drug Reactions Monitoring, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marco Rossi
- Tuscan Regional Centre of Pharmacovigilance, Florence, Italy.,Centre of Pharmacovigilance, University Hospital of Siena, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Roberto Bonaiuti
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence, Italy
| | - Claudia Ravaldi
- CiaoLapo, Charity for Healthy Pregnancy, Stillbirth and Perinatal Grief Support, Prato, Italy.,Department of Health Sciences, University of Florence, Florence, Italy
| | - Miriam Levi
- Epidemiology Unit, Department of Prevention, Local Health Unit Tuscany Centre, Florence, Italy
| | - Alessandro Mugelli
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence, Italy
| | - Silvia Ricci
- Department of Pediatric Immunology, University of Florence, Florence, Italy.,Meyer Children's Hospital, Florence, Italy
| | - Francesca Lippi
- Department of Pediatric Immunology, University of Florence, Florence, Italy.,Meyer Children's Hospital, Florence, Italy
| | - Chiara Azzari
- Department of Health Sciences, University of Florence, Florence, Italy.,Department of Pediatric Immunology, University of Florence, Florence, Italy.,Meyer Children's Hospital, Florence, Italy
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Alfredo Vannacci
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence, Italy.,Tuscan Regional Centre of Pharmacovigilance, Florence, Italy.,CiaoLapo, Charity for Healthy Pregnancy, Stillbirth and Perinatal Grief Support, Prato, Italy
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25
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Marchi S, Monti M, Viviani S, Montomoli E, Trombetta CM. Measles in pregnancy: a threat for Italian women? Hum Vaccin Immunother 2019; 15:2851-2853. [PMID: 31184988 PMCID: PMC6930100 DOI: 10.1080/21645515.2019.1621146] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Measles in pregnancy may lead to serious sequelae for newborns and mothers. In Italy assessment of immunity against measles is not recommended as pregnancy screening. This study aimed to assess the immunity against measles in pregnant women from Apulia Region in Southern Italy between 2016 and 2017. Overall, 96.9% of pregnant women were positive for anti-measles IgG, younger women aged 19–29 years had a seroprevalence below 90%. No samples were positive for anti-measles IgM. In conclusion, younger pregnant women showed to be at higher risk of contracting measles during pregnancy. These findings have implication for measles vaccination policy and highlight the need for measles antibody testing in pregnancy screening in Italy.
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Affiliation(s)
- Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Martina Monti
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.,VisMederi srl, Siena, Italy
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GENOVESE C, PICERNO I, TRIMARCHI G, CANNAVÒ G, EGITTO G, COSENZA B, MERLINA V, ICARDI G, PANATTO D, AMICIZIA D, ORSI A, COLOSIO C, MARSILI C, LARI C, PALAMARA M, VITALE F, CASUCCIO A, COSTANTINO C, AZARA A, CASTIGLIA P, BIANCO A, CURRÀ A, GABUTTI G, STEFANATI A, SANDRI F, FLORESCU C, MARRANZANO M, GIORGIANNI G, FIORE V, PLATANIA A, TORRE I, CAPPUCCIO A, GUILLARI A, FABIANI L, GIULIANI A, APPETITI A, FAUCI VLA, SQUERI A, RAGUSA R, SQUERI R. Vaccination coverage in healthcare workers: a multicenter cross-sectional study in Italy. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E12-E17. [PMID: 31041405 PMCID: PMC6477557 DOI: 10.15167/2421-4248/jpmh2019.60.1.1097] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 02/12/2019] [Indexed: 11/16/2022]
Abstract
Introduction In recent years, a phenomenon known as "vaccine hesitancy" has spread throughout the world, even among health workers, determining a reduction in vaccination coverage (VC).A study aimed at evaluating VC among healthcare workers (HCWs) in 10 Italian cities (L'Aquila, Genoa, Milan, Palermo, Sassari, Catanzaro, Ferrara, Catania, Naples, Messina) was performed. Materials and methods Annex 3 of the Presidential Decree n. 445 of 28 December 2000 was used to collect information on the vaccination status of HCWs. The mean and standard deviation (SD) were calculated with regard to the quantitative variable (age), while absolute and relative frequencies were obtained for categorical data (sex, professional profile, working sector, vaccination status). The connection between VC and the categorical variables was evaluated by chi-square method (statistical significance at p < 0.05). The statistical analyses were performed by SPSS and Stata software. Results A total of 3,454 HCWs participated in the project: 1,236 males and 2,218 females.The sample comprised: physicians (26.9%), trainee physicians (16.1%), nurses (17.2%) and other professional categories (9.8%). Low VC was generally recorded. Higher VC was found with regard to polio, hepatitis B, tetanus and diphtheria, while coverage was very low for measles, mumps, rubella, pertussis, chickenpox and influenza (20-30%). Conclusions This study revealed low VC rates among HCWs for all the vaccinations. Measures to increase VC are therefore necessary in order to prevent HCWs from becoming a source of transmission of infections with high morbidity and/or mortality both within hospitals and outside.
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Affiliation(s)
- C. GENOVESE
- Department of Biomedical Sciences, Dental Sciences and Morpho-functional images, University of Messina, Italy
- Cristina Genovese, Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, via Consolare Valeria, 98125 Messina, Italy - E-mail:
| | - I.A.M. PICERNO
- Department of Biomedical Sciences, Dental Sciences and Morpho-functional images, University of Messina, Italy
| | - G. TRIMARCHI
- Department of Economy, University of Messina, Italy
| | - G. CANNAVÒ
- Medical Direction Universitary Hospital“G. Martino”, Messina, Italy
| | - G. EGITTO
- Medical Direction Universitary Hospital“G. Martino”, Messina, Italy
| | - B. COSENZA
- Department of Biomedical Sciences, Dental Sciences and Morpho-functional images, University of Messina, Italy
| | - V. MERLINA
- Department of Biomedical Sciences, Dental Sciences and Morpho-functional images, University of Messina, Italy
| | - G. ICARDI
- Hygiene Unit, “Ospedale Policlinico San Martino IRCCS”, Genoa, Italy
- Department of Health Sciences, University of Genoa, Italy
| | - D. PANATTO
- Department of Health Sciences, University of Genoa, Italy
| | - D. AMICIZIA
- Department of Health Sciences, University of Genoa, Italy
| | - A. ORSI
- Hygiene Unit, “Ospedale Policlinico San Martino IRCCS”, Genoa, Italy
- Department of Health Sciences, University of Genoa, Italy
| | - C. COLOSIO
- Department of Health Sciences of the University of Milan, International Centre for Rural Health of the SS. Paolo and Carlo Hospital, Milan, Italy
| | - C. MARSILI
- Department of Health Sciences of the University of Milan, International Centre for Rural Health of the SS. Paolo and Carlo Hospital, Milan, Italy
| | - C. LARI
- Medical Direction of the SS. Paolo and Carlo Hospital, Milan, Italy
| | - M.A.R. PALAMARA
- Department of Biomedical Sciences, Dental Sciences and Morpho-functional images, University of Messina, Italy
| | - F. VITALE
- Department of Science for Health Promotion and Mother-Child Care “G. D’Alessandro”, University of Palermo, Italy
| | - A. CASUCCIO
- Department of Science for Health Promotion and Mother-Child Care “G. D’Alessandro”, University of Palermo, Italy
| | - C. COSTANTINO
- Department of Science for Health Promotion and Mother-Child Care “G. D’Alessandro”, University of Palermo, Italy
| | - A. AZARA
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | - P. CASTIGLIA
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | - A. BIANCO
- Department of Health Sciences, University of Catanzaro “Magna Græcia”, Catanzaro, Italy
| | - A. CURRÀ
- Department of Health Sciences, University of Catanzaro “Magna Græcia”, Catanzaro, Italy
| | - G. GABUTTI
- Department of Medical Sciences, University of Ferrara, Italy
| | - A. STEFANATI
- Department of Medical Sciences, University of Ferrara, Italy
| | - F. SANDRI
- Department of Medical Sciences, University of Ferrara, Italy
| | - C. FLORESCU
- Department of Medical Sciences, University of Ferrara, Italy
| | - M. MARRANZANO
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, Italy
| | - G. GIORGIANNI
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, Italy
| | - V. FIORE
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, Italy
| | - A. PLATANIA
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, Italy
| | - I. TORRE
- Department of Public Health, University “Federico II” of Naples, Italy
| | - A. CAPPUCCIO
- Department of Public Health, University “Federico II” of Naples, Italy
| | - A. GUILLARI
- Department of Public Health, University “Federico II” of Naples, Italy
| | - L. FABIANI
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Italy
| | - A.R. GIULIANI
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Italy
| | - A. APPETITI
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Italy
| | - V. LA FAUCI
- Department of Biomedical Sciences, Dental Sciences and Morpho-functional images, University of Messina, Italy
| | - A. SQUERI
- Department of Biomedical Sciences, Dental Sciences and Morpho-functional images, University of Messina, Italy
| | - R. RAGUSA
- University Hospital“Vittorio Emanuele”, Catania, Italy
| | - R. SQUERI
- Department of Biomedical Sciences, Dental Sciences and Morpho-functional images, University of Messina, Italy
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27
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Contemporary vaccination policy in the European Union: tensions and dilemmas. J Public Health Policy 2019; 40:166-179. [DOI: 10.1057/s41271-019-00163-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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28
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Facciolà A, Visalli G, Orlando A, Bertuccio MP, Spataro P, Squeri R, Picerno I, Di Pietro A. Vaccine hesitancy: An overview on parents' opinions about vaccination and possible reasons of vaccine refusal. J Public Health Res 2019; 8:1436. [PMID: 30997357 PMCID: PMC6444379 DOI: 10.4081/jphr.2019.1436] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 02/28/2019] [Indexed: 11/23/2022] Open
Abstract
Background. Vaccine hesitancy has increased worldwide with a subsequent decreasing of vaccination rates and outbreaks of vaccine-preventable diseases (i.e. measles, poliomyelitis and pertussis) in several developed countries, including Italy. Design and Methods. We conducted a survey to investigate the attitudes of a parents’ sample about vaccinations by the distribution of questionnaires in six lower secondary schools of the Italian city of Messina. Results. Regarding vaccinations carried out on children, the declared vaccination coverage rates ranged widely between good coverage percentages for some vaccinations (Measles-Mumps-Rubella, Diphtheria-Tetanus-Pertussis), and very low coverage rates for others, especially for “new” vaccinations (HPV, meningococcal, pneumococcal). The vaccinations carried out correlated negatively with both parents’ age and their level of education. Moreover, a favourable parents’ opinion was strongly influenced by a favourable opinion of the physician, while an unfavourable parents’ opinion seemed conditioned by a direct or indirect knowledge of people harmed by vaccines. In addition, our data show that parents do not often know or partially know the real composition of the vaccines and the diseases prevented by vaccinations. Conclusions. Data analysis shows that parents are, theoretically, favourable towards vaccinations but have little knowledge of such practices, sometimes not being unaware of the types of vaccines administrated to their children. Health education and communication of correct information are certainly the cornerstones to improve the situation and to fight the widespread and non-grounded fears about vaccines. Significance for public health The argument of the vaccine hesitancy is particularly important for public health because, due to the parents’ refusal to vaccine their children, we have assisted in last years to the recruitment of vaccine preventable diseases in many countries. This refusal is due especially to an unjustified fear about potential side effects of vaccines. However, many studies have shown that vaccines are sure and efficacies. Health education of parents is the cornerstone on which the public health should build the fight to the vaccine hesitancy and improve the vaccination coverages.
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Affiliation(s)
| | - Giuseppa Visalli
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy
| | - Annalisa Orlando
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy
| | - Maria Paola Bertuccio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy
| | - Pasquale Spataro
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy
| | - Raffaele Squeri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy
| | - Isa Picerno
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy
| | - Angela Di Pietro
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy
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The impact of demographic changes, exogenous boosting and new vaccination policies on varicella and herpes zoster in Italy: a modelling and cost-effectiveness study. BMC Med 2018; 16:117. [PMID: 30012132 PMCID: PMC6048801 DOI: 10.1186/s12916-018-1094-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 06/05/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The present study aims to evaluate the cost-effectiveness of the newly introduced varicella and herpes zoster (HZ) vaccination programmes in Italy. The appropriateness of the introduction of the varicella vaccine is highly debated because of concerns about the consequences on HZ epidemiology and the expected increase in the number of severe cases in case of suboptimal coverage levels. METHODS We performed a cost-utility analysis based on a stochastic individual-based model that considers realistic demographic processes and two different underlying mechanisms of exogenous boosting (temporary and progressive immunity). Routine varicella vaccination is given with a two-dose schedule (15 months, 5-6 years). The HZ vaccine is offered to the elderly (65 years), either alone or in combination with an initial catch-up campaign (66-75 years). The main outcome measures are averted cases and deaths, costs per quality-adjusted life years gained, incremental cost-effectiveness ratios, and net monetary benefits associated with the different vaccination policies. RESULTS Demographic processes have contributed to shaping varicella and HZ epidemiology over the years, decreasing varicella circulation and increasing the incidence of HZ. The recent introduction of varicella vaccination in Italy is expected to produce an enduring reduction in varicella incidence and, indirectly, a further increase of HZ incidence in the first decades, followed by a significant reduction in the long term. However, the concurrent introduction of routine HZ vaccination at 65 years of age is expected to mitigate this increase and, in the longer run, to reduce HZ burden to its minimum. From an economic perspective, all the considered policies are cost-effective, with the exception of varicella vaccination alone when considering a time horizon of 50 years. These results are robust to parameter uncertainties, to the two different hypotheses on the mechanism driving exogenous boosting, and to different demographic projection scenarios. CONCLUSIONS The recent introduction of a combined varicella and HZ vaccination programme in Italy will produce significant reductions in the burden of both diseases and is found to be a cost-effective policy. This programme will counterbalance the increasing trend of zoster incidence purely due to demographic processes.
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30
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Odone A, Tramutola V, Morgado M, Signorelli C. Immunization and media coverage in Italy: an eleven-year analysis (2007-17). Hum Vaccin Immunother 2018; 14:2533-2536. [PMID: 29993316 PMCID: PMC6284508 DOI: 10.1080/21645515.2018.1486156] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 05/09/2018] [Accepted: 05/25/2018] [Indexed: 10/28/2022] Open
Abstract
Immunization polices in Italy has recently reached important milestones, including the approval of the National Immunization Prevention Plan and of a new law mandatory immunization; this stimulating a lively debate at the scientific, political and societal-level, reflected on the media. We applied a model previously published to quantitatively and qualitatively assess media coverage on vaccines and immunization-related topics on the most read Italian newspaper, "Corriere della Sera", over an 11-year study period (2007-2017). We retrieved relevant key words and articles, reported on included articles' topic, position, approach to immunization and on other selected indicators' summary statistics, temporal trends and correspondence with key epidemiological and policy events. Over the study period the quote "vaccin*" was mentioned on average 325 times per year; with an increase of 150% after the approval of the new law on mandatory immunization in 2017. In the same year, on average, two first-page articles per week were published on the topic. We report a clear association between key events (i.e the H1N1 influenza pandemic, the "Fluad case", the approval of the new law on mandatory immunization) and their media coverage. Overall, 84% of articles had a positive attitude towards immunization, this share decreasing to 79% when only considering articles published after the approval of the law on mandatory vaccination. Media play a crucial role in channelling health-related information and significantly influence health behaviours. We urge public institutions, health authorities and the scientific community not to underestimate the opportunity to monitor media coverage on key healthcare topics and to convey evidence-based health education messages through the media.
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Affiliation(s)
- A. Odone
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - V. Tramutola
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - M. Morgado
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - C. Signorelli
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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31
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Bozzola E, Spina G, Russo R, Bozzola M, Corsello G, Villani A. Mandatory vaccinations in European countries, undocumented information, false news and the impact on vaccination uptake: the position of the Italian pediatric society. Ital J Pediatr 2018; 44:67. [PMID: 29898770 PMCID: PMC6001041 DOI: 10.1186/s13052-018-0504-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 05/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND High rates of vaccination coverage are important in preventing infectious diseases. Enforcing mandatory vaccinations is one of the strategies that some Countries adopted to protect the community when vaccination coverage is not satisfactory. In Italy, in 2017 vaccination against diphtheria, tetanus, pertussis, hepatitis B, poliovirus, Haemophilus influenzae type b, measles, mumps, rubella and varicella became compulsory in childhood. In order to contrast vaccination policies, anti-vaccination campaigns contribute to the spread of fake news. Among them, there is the false information that Italy is the only one country with mandatory vaccination policy. Aim of our study is confronting vaccination policies in children under 18 months against among different European countries for the following vaccines: diphtheria, tetanus, pertussis, hepatitis B, poliovirus, Haemophilus influenzae type b, measles, mumps, rubella and varicella. METHODS Information on policies of mandatory or recommended vaccinations of the European Countries were gathered by ECDC and compared to the Italian one. RESULTS European Countries recommend or contemplate compulsory vaccines. Among them, eleven Countries (35.4%) have mandatory vaccinations for at least one out of diphtheria, tetanus, pertussis, hepatitis B, poliovirus, Haemophilus influenzae type b, measles, mumps, rubella and varicella vaccine. CONCLUSION Not only in Italy, vaccination against diphtheria, tetanus, pertussis, hepatitis B, poliovirus, Haemophilus influenzae type b, measles, mumps, rubella and varicella is mandatory in children under 18 months. Other European countries adopted compulsory policies in order to prevent the spread of infectious diseases and to protect the community.
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Affiliation(s)
- Elena Bozzola
- Bambino Gesù Children Hospital, Pediatric and Infectious Diseases Unit, Rome, Italy
| | - Giulia Spina
- Bambino Gesù Children Hospital, Pediatric and Infectious Diseases Unit, Rome, Italy
| | - Rocco Russo
- Maternity and Pediatrics Services – Local Health Units Benevento, Benevento, Italy
| | - Mauro Bozzola
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | | | - Alberto Villani
- Bambino Gesù Children Hospital, Pediatric and Infectious Diseases Unit, Rome, Italy
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Mita V, Arigliani M, Zaratti L, Arigliani R, Franco E. Italian Physicians' Opinions on Rotavirus Vaccine Implementation. Pathogens 2017; 6:pathogens6040056. [PMID: 29099756 PMCID: PMC5750580 DOI: 10.3390/pathogens6040056] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 10/27/2017] [Accepted: 10/31/2017] [Indexed: 11/29/2022] Open
Abstract
Rotavirus (RV) infection is the main cause of severe acute gastroenteritis (GE) in the pediatric population and has a major impact in both developing and industrialized countries. The reduction of severe RVGE cases, followed by death or hospitalization, is considered the main benefit of RV vaccination, even though its implementation often faces obstacles. In Italy, the recently approved National Immunization Plan aims to overcome the differences among regions, offering a universal free RV vaccination. The aim of the study was to evaluate the opinions on benefit and acceptability of RV vaccination related to the perception of the burden of RV disease. Data were collected from 108 physicians in 2015 by a questionnaire consisting of 12 questions; some answers were compared with those obtained with a similar tool in 2011. The majority of respondents (76.2%) was convinced of the benefit of the vaccine and 57.4% recommended it routinely, but more than half indicated a <25% adherence to RV vaccination among their patients. As the main reasons of vaccine refusal, skepticism about the vaccine (60.4%) and its cost (34.1%) were indicated. Our data confirm that more information and counselling are needed to increase RV vaccine coverage.
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Affiliation(s)
- Valentin Mita
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy.
| | - Michele Arigliani
- Department of Clinical and Experimental Medical Sciences, University Hospital of Udine, 33100 Udine, Italy.
| | - Laura Zaratti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy.
| | - Raffaele Arigliani
- Department of Pediatrics, Università Politecnica delle Marche, 60126 Ancona, Italy.
| | - Elisabetta Franco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy.
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Signorelli C, Odone A, Florindo N, Fabi M, Vanelli M. A new Journal section on Health System's Research: purpose and rationale. ACTA BIO-MEDICA : ATENEI PARMENSIS 2017; 88:247-248. [PMID: 29083327 DOI: 10.23750/abm.v88i3.6815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 10/11/2017] [Indexed: 11/23/2022]
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Chiesa V, Odone A, Signorelli C. Forensic Epidemiology in Italy: principles and practice. ACTA BIO-MEDICA : ATENEI PARMENSIS 2017; 88:360-364. [PMID: 29083343 DOI: 10.23750/abm.v88i3.6742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 09/11/2017] [Indexed: 11/23/2022]
Abstract
Forensic epidemiology (FE) implies the use of epidemiological data in the processes and the involvement of epidemiologists in judicial proceedings. FE is essential for the assessment of causal association between the exposure to specific agents and the occurrence of diseases. In this paper we describe FE principles and applications in the Italian context as in recent years FE emerged increasingly as well as the need of experienced and trained epidemiological experts able to navigate legal proceedings. In the literature, the principles of FE have been widely described by different authors, among them: Kennet Rothman who introduced the definition of cause, Sir Austin Bradford Hill who proposed an analytic framework to assess the causal association, and recently by Sana Loue who described the actual legislation and application of FE in the United States. Despite the legislation varies among different countries epidemiological methods and theories represent the foundation for the application of FE we illustrate in this paper. The association between environmental pollution and disease, mobile phones and cancer, vaccines and autism, asbestos and pleural mesothelioma are all situations that underscore the need for FE investigations in criminal acts. Causal association is a complex process: in real life only in limited cases causal associations are assessed by gathering robust scientific evidence, while cases with doubts and situations where different approaches to questions may lead to discordant arguments to questions may lead to discordant arguments are more frequent. Therefore, during the assessment of causation in civil and criminal matters the choice the epidemiological expert - with his knowledge and expertise - and the evidence from well-designed studies are crucial to fill the gaps between clinical and epidemiological data and the low.
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