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Simonetti V, Tomietto M, Comparcini D, Pastore F, Stefanizzi P, Tafuri S, Cicolini G. The community nurse's role on the promotion of papillomavirus vaccination among young students: A study protocol. Hum Vaccin Immunother 2024; 20:2314383. [PMID: 38356279 PMCID: PMC10877978 DOI: 10.1080/21645515.2024.2314383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 02/01/2024] [Indexed: 02/16/2024] Open
Abstract
Vaccination is the principal strategy for primary prevention of infection by Human Papilloma Virus (HPV), which causes different pathological conditions, up to cancer, in both males and females. However, to date, knowledge among adolescents and their parents about the HPV vaccine is still low. The aim of this quasi-experimental, multicenter study is to assess the effectiveness of a digital educational intervention, conducted by a multidisciplinary health-care team including a Community Nurse, to increase adolescents' HPV vaccination uptake, their knowledge, self-efficacy, feelings and involvement in HPV vaccine decision-making, and parents' vaccination hesitancy. The study will be carried out among a population of students (and their parents), aged between 11 and 13, at secondary schools in Italy. Validated questionnaires will be administered to both students and parents at baseline (T0) and 3 months after a digital educational intervention (T1). The findings may be useful in evaluating and deepening a methodology for designing and implementing educational interventions, embedded in the school setting, that could promote the achievement of outcomes within the broader process of youth's health promotion.
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Affiliation(s)
- Valentina Simonetti
- Department of Medicine and Surgery, Casamassima, “LUM University” Giuseppe Degennaro, Bari, Italy
| | - Marco Tomietto
- Department of Nursing, Midwifery, and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Dania Comparcini
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, Bari, Italy
| | - Francesco Pastore
- Department of Biomedicine and Prevention, TorVergata University, Rome, Italy
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, Bari, Italy
| | - Giancarlo Cicolini
- Department of Precision and Regenerative Medicine and Ionian Area - (DiMePRe-J), ”Aldo Moro” University of Bari, Bari, Italy
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Stefanizzi P, Moscara L, Palmieri C, Martinelli A, Di Lorenzo A, Venerito V, Germinario CA, Tafuri S. Safety profile of recombinant adjuvanted anti-herpes zoster vaccine (RZV) in high-risk groups: Data from active surveillance program. Puglia (Italy), 2021-23. Vaccine 2024; 42:2966-2974. [PMID: 38582693 DOI: 10.1016/j.vaccine.2024.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/06/2024] [Accepted: 03/08/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Since 2021 a recombinant adjuvanted anti-Herpes Zoster vaccine(Recombinant Zoster Vaccine, RZV) is offered in Italy to high-risk patients. Few real-life data about RZV safety are available in target populations. OBJECTIVES This study investigates Adverse Events Following Immunization(AEFIs), baseline disease flare-ups, and Herpes Zoster (HZ) episodes occurring after RZV administration in a heterogeneous population of fragile patients to design its safety profile. METHODS This is a retrospective population-based study. RZV-vaccinated patients at Bari Policlinico General Hospital vaccination clinic from October 1st, 2021, to March 31st, 2023, were enrolled. Subjects were screened for reason of RZV eligibility and baseline chronic pathologies. AEFIs occurred in the first 7-days post-vaccination period were collected, and baseline disease flare-ups and post-vaccination HZ episodes were assessed via a 3-month follow-up. RESULTS Five-hundred-thirty-eight patients were included and total of 1,031 doses were administered. Most patients were vaccinated due to ongoing immunosuppressive therapy(54.65 %); onco-hematological and cardiovascular conditions were the most common chronic baseline pathologies. Out of 1,031 follow-ups, 441 AEFI cases were reported(42.7/100). The most common symptoms were injection site pain/itching(35.60/100), asthenia/malaise(11.44/100), and fever (10.09/100). Four serious AEFIs occurred(0.38/100). Older age, male sex, and history of cardiovascular diseases(OR:0.71; 95CI:0.52-0.98; p-value <0.05) were found to decrease AEFIs risk, while endocrine-metabolic illnesses(OR:1.61; 95CI:1.15-2.26; p-value <0.05) increased it. Twelve patients(2.23 %) reported a flare-up/worsening of their baseline chronic condition within the first three months after vaccination(mean interval 31.75 days, range 0-68 days). Patients with rheumatological illnesses had a higher risk of relapse(OR:16.56; 95CI:3.58-76.56; p-value <0.001), while male sex behaved as a protective factor. Twelve patients who completed the vaccination cycle(2.43%) had at least one HZ episode by the long-term follow-up. CONCLUSIONS The study demonstrates RZV safety in a significant number of high-risk patients. Hence, RZV should be actively offered as part of tailored vaccination programs to decrease the burden of HZ in fragile populations.
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Affiliation(s)
- Pasquale Stefanizzi
- Hygiene Unit - Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy.
| | - Lorenza Moscara
- Hygiene Unit - Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Claudia Palmieri
- Hygiene Unit - Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Andrea Martinelli
- Hygiene Unit - Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Antonio Di Lorenzo
- Hygiene Unit - Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Vincenzo Venerito
- Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy
| | - Cinzia Annatea Germinario
- Hygiene Unit - Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Silvio Tafuri
- Hygiene Unit - Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
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Caggiano G, Fioriti S, Morroni G, Apollonio F, Triggiano F, D'Achille G, Stefanizzi P, Dalfino L, Ronga L, Mosca A, Sparapano E, De Carlo C, Signorile F, Grasso S, Barchiesi F, Montagna MT. Genotypic and phenotypic characteristics of Candida parapsilosis bloodstream isolates: Health Care Associated Infections in a teaching Hospital in Italy. J Infect Public Health 2024; 17:967-974. [PMID: 38631066 DOI: 10.1016/j.jiph.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/09/2024] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Candidemia is the most common healthcare associated invasive fungal infection. Over the last few decades, candidemia caused by Candida species other than Candida albicans, particularly the Candida parapsilosis complex, has emerged worldwide. The aims of this study were: to analyze the genotypic and phenotypic characteristics of C. parapsilosis strains isolated from blood cultures and the environment in a hospital in southern Italy, to study the possible source of infection and to correlate the isolated strains. METHODS From April to October 2022, cases of candidemia due to C. parapsilosis in patients admitted to a hospital in the Apulia region were investigated. However, 119 environmental samples from the intensive care unit were collected for identification of the likely environmental reservoir of infection. Routine antifungal (amphotericin B, anidulafungin, fluconazole) susceptibility was performed on all isolates. Whole genome sequencing was performed to study the genotypic correlation of the isolates. Biofilm biomass and metabolic activity were also quantified for all isolates. RESULTS A total of 43 C. parapsilosis isolates were cultured from the bloodstream of each patient in different departments, and seven surface samples were positive for C. parapsilosis. Most of the isolated yeasts (41/50; 85 %) were resistant to fluconazole and were genetically related to each other, suggesting an ongoing clonal outbreak of this pathogen. The fluconazole-susceptible isolates produced significantly more biofilm than did the resistant isolates. Metabolic activity was also higher for fluconazole-susceptible than resistant isolates. CONCLUSION Cross-transmission of the microorganisms is suggested by the phenotypic similarity and genetic correlation between clinical and environmental strains observed in our study.
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Affiliation(s)
- Giuseppina Caggiano
- Interdisciplinary Department of Medicine, Hygiene Section, University of Bari Aldo Moro, Piazza G. Cesare 11, Bari 70124, Italy.
| | - Simona Fioriti
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Gianluca Morroni
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Francesca Apollonio
- Interdisciplinary Department of Medicine, Hygiene Section, University of Bari Aldo Moro, Piazza G. Cesare 11, Bari 70124, Italy
| | - Francesco Triggiano
- Interdisciplinary Department of Medicine, Hygiene Section, University of Bari Aldo Moro, Piazza G. Cesare 11, Bari 70124, Italy
| | - Gloria D'Achille
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Hygiene Section, University of Bari Aldo Moro, Piazza G. Cesare 11, Bari 70124, Italy
| | - Lidia Dalfino
- Department of Precision-Regenerative Medicine and Jonic Area (DiMePRe-J), Section of Anesthesiology and Intensive Care Medicine, University of Bari Aldo Moro
| | - Luigi Ronga
- Microbiology and Virology Unit, Azienda OU Policlinico of Bari, Piazza Giulio Cesare 11, Bari 70124, Italy
| | - Adriana Mosca
- Interdisciplinary Department of Medicine, Microbiology Section, University of Bari Aldo Moro, Piazza G. Cesare 11, Bari 70124, Italy
| | - Eleonora Sparapano
- Microbiology and Virology Unit, Azienda OU Policlinico of Bari, Piazza Giulio Cesare 11, Bari 70124, Italy
| | - Carmela De Carlo
- Microbiology and Virology Unit, Azienda OU Policlinico of Bari, Piazza Giulio Cesare 11, Bari 70124, Italy
| | - Fabio Signorile
- Clinic of Infectious diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Policlinic of Bari, Piazza Giulio Cesare 11, Bari 70124, Italy
| | - Salvatore Grasso
- Department of Precision-Regenerative Medicine and Jonic Area (DiMePRe-J), Section of Anesthesiology and Intensive Care Medicine, University of Bari Aldo Moro
| | - Francesco Barchiesi
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy; Clinic of Infectious Diseases, Azienda Sanitaria Territoriale 1, Pesaro-Urbino, Italy.
| | - Maria Teresa Montagna
- Interdisciplinary Department of Medicine, Hygiene Section, University of Bari Aldo Moro, Piazza G. Cesare 11, Bari 70124, Italy
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Bianchi FP, Rizzi D, Daleno A, Stefanizzi P, Migliore G, Tafuri S. Assessing the temporal and cause-effect relationship between myocarditis and mRNA COVID-19 vaccines. A retrospective observational study. Int J Infect Dis 2024; 141:106960. [PMID: 38365084 DOI: 10.1016/j.ijid.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/20/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVE In 2021, the US Centers for Disease Control and Prevention reported increased cases of myocarditis and pericarditis in the United States after mRNA COVID-19 vaccines. Our study aims to estimate the incidence of myocarditis in Apulia (Southern Italy) and the cause-effect relationship between COVID-19 mRNA vaccines and the risk of myocarditis. METHODS The Apulian regional archive of hospital discharge forms was used to define the cases of myocarditis in Apulia, considering data from 2017 to 2022. The overall vaccination status of patients was assessed via data collected from the Regional Immunization Database. The history of SARS-CoV-2 infection was extracted from the Italian Institute of Health platform. RESULTS Since 2017, 5687 cases of myocarditis have been recorded in Apulian subjects; the overall incidence described a decreasing trend, with a slight increase in 0-40 years-old subjects. From 2021 to 2022, 2,930,276 doses of COVID-19 mRNA vaccines were administered; a diagnosis of myocarditis after the second dose of the mRNA vaccine was reported for 894 (0.03%) of Apulian inhabitants, with an incidence rate of 17.9 × 1,000,000 persons-month. The multivariate analysis, adjusted for age, sex, underlying medical conditions, and diagnosis of COVID-19, showed that mRNA vaccination is a protective factor for myocarditis even in younger subjects (aOR = 0.4; 95% CI = 0.3-0.5). CONCLUSION A temporal association between an exposure and an outcome is not equivalent to a causal association. Our study underlines how an approach that considers the other potential causes of myocarditis (primarily COVID-19) and a causality assessment must be prioritized in the study of the topic.
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Affiliation(s)
- Francesco Paolo Bianchi
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy; Azienda Ospedaliero Universitaria Policlinico Giovanni XXIII, Bari, Italy
| | - Donato Rizzi
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Antonio Daleno
- Azienda Ospedaliero Universitaria Policlinico Giovanni XXIII, Bari, Italy
| | - Pasquale Stefanizzi
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Giovanni Migliore
- Azienda Ospedaliero Universitaria Policlinico Giovanni XXIII, Bari, Italy
| | - Silvio Tafuri
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy.
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Di Lorenzo A, Stefanizzi P, Tafuri S. Are we saying it right? Communication strategies for fighting vaccine hesitancy. Front Public Health 2024; 11:1323394. [PMID: 38249411 PMCID: PMC10796481 DOI: 10.3389/fpubh.2023.1323394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/12/2023] [Indexed: 01/23/2024] Open
Abstract
Vaccine hesitancy is a multi-faceted phenomenon, deeply rooted in cultural, socioeconomic and personal background. Communication is deemed fundamental in fighting vaccine hesitancy. Medical communication should be accessible, relying both on an emotional approach and accurate information. Trained professionals should curate communication with the public.
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Affiliation(s)
- Antonio Di Lorenzo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Pasquale Stefanizzi
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Silvio Tafuri
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
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6
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Bianchi FP, Stefanizzi P, Cuscianna E, Di Lorenzo A, Migliore G, Tafuri S, Germinario CA. Influenza vaccine coverage in 6months-64 years-old patients affected by chronic diseases: A retrospective cohort study in Italy. Hum Vaccin Immunother 2023; 19:2162301. [PMID: 36715009 PMCID: PMC10012954 DOI: 10.1080/21645515.2022.2162301] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
At the beginning of each flu season, the Italian Ministry of Health defines the categories at higher risk of influenza complications, for which vaccination is actively and freely offered. The vaccine coverage (VC) of the influenza vaccine in subjects from 6 months to 64 years of age suffering from diseases that increase the risk of complications from influenza during the 2020-2021 season was evaluated. Our study wants to evaluate the VCs of the influenza vaccine in these subjects during the 2020/2021 season in Apulia. The digital archives relative to the Apulian population were used. A retrospective cohort study design was performed. 484,636 Apulian residents aged between 6 months and 64 years suffered from at least one chronic disease; 139,222 of 484,636 subjects received the influenza vaccine (VC: 28.7%) from October 2020 to January 2021. Considering the single comorbidities, the greatest values are found for pathologies for which major surgical interventions are planned and chronic renal failure/adrenal insufficiency patients, while the worst for chronic liver diseases and pathologies for which major surgical interventions are planned. In any case, it would seem that better VC is achieved in subjects with more than one chronic condition. Influenza vaccination must be promoted as a central public health measure, also because by reducing the burden on hospitals, it can greatly benefit the management of COVID-19 patients. Greater efforts by public health institutions must be implemented in order to achieve better VC in the target categories, including chronic patients.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Eustachio Cuscianna
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Antonio Di Lorenzo
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Giovanni Migliore
- Health Direction, Bari Policlinico University General Hospital, Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
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Bianchi FP, Stefanizzi P, Cuscianna E, Riformato G, Di Lorenzo A, Giordano P, Germinario CA, Tafuri S. COVID-19 vaccination hesitancy among Italian parents: A systematic review and meta-analysis. Hum Vaccin Immunother 2023; 19:2171185. [PMID: 36698309 PMCID: PMC10012888 DOI: 10.1080/21645515.2023.2171185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
In May 2021, the Italian government extended the COVID-19 vaccination campaign to 12- to 18-year-old subjects and, starting December 2021, vaccines were also offered to children between 5 and 11 years-old. Despite these efforts, suboptimal vaccination coverages are reported. The purpose of this review is to estimate the proportion of parents/caregivers of children and adolescents expressing COVID-19 vaccine hesitancy in Italy. The vaccine hesitation rate among parents of minors was 55.1% (95%CI: 43.8-66.1%). A higher value was evidenced in studies focusing on children (59.9%; 95%CI = 43.7-75.1%) compared to the ones focusing on adolescents (51.3%; 95%CI = 34.5-68.0%). The main reasons for unwillingness were the belief that the vaccine was unsafe or ineffective, fear of adverse events, and considering COVID-19 a non-threatening disease. The implementation of effective communication campaigns and health educational programs on safe pediatric vaccinations is essential to support strategies to bolster vaccination confidence.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Eustachio Cuscianna
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Giacomo Riformato
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Antonio Di Lorenzo
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Paola Giordano
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | | | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
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8
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Bianchi FP, Stefanizzi P, Di Lorenzo A, De Waure C, Boccia S, Daleno A, Migliore G, Tafuri S. Attitudes toward influenza vaccination in healthcare workers in Italy: A systematic review and meta-analysis. Hum Vaccin Immunother 2023; 19:2265587. [PMID: 37849235 PMCID: PMC10586073 DOI: 10.1080/21645515.2023.2265587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/27/2023] [Indexed: 10/19/2023] Open
Abstract
Healthcare workers (HCWs) are among the at-risk groups for whom influenza vaccination is strongly recommended. To assess the proportion of Italian HCWs with positive attitudes toward influenza vaccination, we conducted a systematic review of relevant literature and a meta-analysis. Our focus was on the influenza seasons from 2017/18 to 2021/22. The prevalence of favorable attitudes toward vaccination varied, ranging from 12% during the 2017/18 influenza season to 59% in the 2020/21 season. The significant increase in the 2020/21 season can be attributed to adaptations necessitated by the COVID-19 pandemic. During the 2021/22 influenza season, there was a decline in vaccination coverage (37%), likely due to the absence of a robust preventive culture. Various strategies have been employed to enhance HCWs' attitudes to achieve higher vaccination rates, but none of them have demonstrated satisfactory results. Policymakers should consider implementing a policy of mandatory vaccination to ensure elevated vaccination coverage among HCWs.
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Affiliation(s)
- Francesco Paolo Bianchi
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
- Health Direction, University-General Hospital Policlinico, Bari, Italy
| | - Pasquale Stefanizzi
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Antonio Di Lorenzo
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Chiara De Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, University Cattolica of Sacred Hearth, Rome, Italy
- Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Daleno
- Health Direction, University-General Hospital Policlinico, Bari, Italy
| | - Giovanni Migliore
- Health Direction, University-General Hospital Policlinico, Bari, Italy
| | - Silvio Tafuri
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
- Health Direction, University-General Hospital Policlinico, Bari, Italy
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Stefanizzi P, Bianchi FP, Moscara L, Martinelli A, Di Lorenzo A, Gesualdo L, Simone S, Rendina M, Tafuri S. Determinants of compliance to influenza and COVID-19 vaccination in a cohort of solid organ transplant patients in Puglia, Southern Italy (2017-2022). Hum Vaccin Immunother 2023; 19:2266932. [PMID: 37842986 PMCID: PMC10580794 DOI: 10.1080/21645515.2023.2266932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 09/30/2023] [Indexed: 10/17/2023] Open
Abstract
Influenza and Coronavirus Disease 2019 (COVID-19) vaccination are recommended in both solid organ transplant (SOT) candidates and recipients. In Puglia, Southern Italy, an active vaccination offer program has been activated targeting these patients. This study aims at investigating vaccination coverage (VC) for both vaccines in a SOT patients' cohort, as well as at identifying the vaccination compliance determinant. This is a retrospective, population-based study. The study population consists of the SOT patients who accessed Bari's "Policlinico" General Hospital during 2017-2022. Patients were contacted and, after providing their consent, asked their immunization status regarding influenza and COVID-19 and whether they had already undergone transplant or were waiting to do so. Regression models were fitted to investigate the determinants of VCs for influenza vaccination (2021/22 and 2022/23 seasons) and for COVID-19 vaccination (three-dose base cycle, first and second booster doses). Three-hundred and ten SOT patients were identified; 85.2% (264/310) had already undergone SOT. VCs were suboptimal, especially for constant yearly influenza vaccination (17.7%) and COVID-19 vaccination's second booster (1.94%). Logistic regression highlighted that influenza VCs are higher for SOT recipients than SOT candidates, as well as for older patients, although when considering both vaccination seasons only age significantly impact the vaccination uptake. Older age was the only influential variable for COVID-19 VC. VCs for SOT patients seem to be unsatisfying. Stronger interventions are required.
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Affiliation(s)
- Pasquale Stefanizzi
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Paolo Bianchi
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Lorenza Moscara
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Andrea Martinelli
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Antonio Di Lorenzo
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Loreto Gesualdo
- Nephrology, Dialysis and Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Bari, Italy
| | - Simona Simone
- Nephrology, Dialysis and Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Bari, Italy
| | - Maria Rendina
- Section of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Silvio Tafuri
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
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Stefanizzi P, Di Lorenzo A, Martinelli A, Moscara L, Stella P, Ancona D, Tafuri S. Adverse events following immunization (AEFIs) with anti-meningococcus type B vaccine (4CMenB): Data of post-marketing active surveillance program. Apulia Region (Italy), 2019-2023. Vaccine 2023; 41:7096-7102. [PMID: 37891052 DOI: 10.1016/j.vaccine.2023.09.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/06/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023]
Abstract
The four-component recombinant-DNA anti-meningococcus B vaccine (4CMenB) has been approved by the European Medicines Agency in 2013. In Italy, 4CMenB is recommended since 2017 for use in infants under one year of age. Due to the strong evidence of increased risk of fever after administration, surveillance of adverse events following immunization (AEFIs) is a priority for 4CMenB. This cross-sectional prospective study aims at investigating 4CMenB's safety profile. The study population is represented by infants under twelve months of age vaccinated with 4CMenB in selected ambulatories in Apulia, a region in South-Eastern Italy, from October 1st, 2020, to March 31st, 2023. Parents were provided with a post-vaccination diary covering up to seven days after immunization and were contacted one week after the vaccination day. Information about AEFIs was collected, and reactions were classified following World Health Organization guidelines. For serious AEFIs, causality assessment was carried out. AEFI risk determinants were investigated via logistic regression. A total of 4,773 diaries were completed, with 78.13 % of them (3,729/4,773) containing one or more AEFI reports. Systemic reactions such as malaise, drowsiness/insomnia and fatigue were the most common ones, followed by fever and local pain, tenderness, redness and swelling. Twenty-three cases of serious AEFIs were reported. Following causality assessment, 78.26 % of serious adverse events (18/23) were deemed to have a consistent causal association with the administration of 4CMenB (reporting rate: 0.38 %). Three infants were hospitalized following vaccination, but no cases of death or permanent/severe impairment were reported. Prophylactic paracetamol administration showed a significant protective effect against the risk of manifesting fever within the first 24 h after administration (OR: 0.75; p < 0.005). Our data confirms existing evidence regarding the safety of 4CMenB vaccination in babies under 2 years of age, but also highlight a significant risk of fever after vaccination. Prophylactic paracetamol administration could represent a protective factor against fever, especially during the first 24 h after vaccination.
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Affiliation(s)
- Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy.
| | - Antonio Di Lorenzo
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Andrea Martinelli
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Lorenza Moscara
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | | | | | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
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11
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Gianfredi V, Berti A, Stefanizzi P, D’Amico M, De Lorenzo V, Moscara L, Di Lorenzo A, Venerito V, Castaldi S. COVID-19 Vaccine Knowledge, Attitude, Acceptance and Hesitancy among Pregnancy and Breastfeeding: Systematic Review of Hospital-Based Studies. Vaccines (Basel) 2023; 11:1697. [PMID: 38006029 PMCID: PMC10675759 DOI: 10.3390/vaccines11111697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
The risk of unfavourable outcomes for SARS-CoV-2 infection is significant during pregnancy and breastfeeding. Vaccination is a safe and effective measure to lower this risk. This study aims at reviewing the literature concerning the anti-SARS-CoV-2 vaccine's acceptance/hesitancy among pregnant and breastfeeding women attending hospital facilities. A systematic review of literature was carried out. Hospital-based observational studies related to vaccination acceptance, hesitancy, knowledge and attitude among pregnant and breastfeeding women were included. Determinants of acceptance and hesitancy were investigated in detail. Quality assessment was done via the Johann Briggs Institute quality assessment tools. After literature search, 43 studies were included, 30 of which only focused on pregnant women (total sample 25,862 subjects). Sample size ranged from 109 to 7017 people. Acceptance of the SARS-CoV-2 vaccine ranged from 16% to 78.52%; vaccine hesitancy ranged between 91.4% and 24.5%. Fear of adverse events for either the woman, the child, or both, was the main driver for hesitancy. Other determinants of hesitancy included religious concerns, socioeconomic factors, inadequate information regarding the vaccine and lack of trust towards institutions. SARS-CoV-2 vaccine hesitancy in hospitalized pregnant women appears to be significant, and efforts for a more effective communication to these subjects are required.
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Affiliation(s)
- Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (V.G.); (A.B.); (M.D.); (V.D.L.); (S.C.)
| | - Alessandro Berti
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (V.G.); (A.B.); (M.D.); (V.D.L.); (S.C.)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70121 Bari, Italy; (L.M.); (A.D.L.)
| | - Marilena D’Amico
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (V.G.); (A.B.); (M.D.); (V.D.L.); (S.C.)
| | - Viola De Lorenzo
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (V.G.); (A.B.); (M.D.); (V.D.L.); (S.C.)
| | - Lorenza Moscara
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70121 Bari, Italy; (L.M.); (A.D.L.)
| | - Antonio Di Lorenzo
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70121 Bari, Italy; (L.M.); (A.D.L.)
| | - Vincenzo Venerito
- Rheumatology Unit, Department of Precision and Regenerative Medicine, Jonic Area, University of Bari “Aldo Moro”, 70121 Bari, Italy;
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (V.G.); (A.B.); (M.D.); (V.D.L.); (S.C.)
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35, 20122 Milan, Italy
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12
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De Maria L, Delvecchio G, Sponselli S, Cafaro F, Caputi A, Giannelli G, Stefanizzi P, Bianchi FP, Stufano A, Tafuri S, Lovreglio P, Boffetta P, Vimercati L. SARS-CoV-2 Infections, Re-Infections and Clinical Characteristics: A Two-Year Retrospective Study in a Large University Hospital Cohort of Vaccinated Healthcare Workers. J Clin Med 2023; 12:6800. [PMID: 37959268 PMCID: PMC10647276 DOI: 10.3390/jcm12216800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
At the University Hospital of Bari, during the first year after the start of the mandatory vaccination campaign with BNT162b2 mRNA COVID-19 vaccine, the preliminary results of an observational study showed a significant prevalence of SARS-CoV-2 breakthrough infections (BIs) among healthcare workers (HCWs), but no hospitalization or deaths. In the present study, we extended the observation period (January 2021-January 2023) with the aim of determining the incidence, characteristics and clinical course of SARS-CoV-2 BIs among 6213 HCWs. All HCWs were regularly monitored and screened. To allow return to work after BI, the protocol required one negative nasopharyngeal swab test followed by a medical examination certifying complete clinical recovery. We observed an overall incidence rate of SARS-CoV-2 BIs of 20.2%. Females were most affected, especially in the nurse group compared with doctors and other HCWs (p < 0.0001). Cardiovascular diseases were the most frequent comorbidity (n = 140; 11.4%). The source of infection was non-occupational in 52.4% of cases. Most cases (96.9%) showed minor symptoms and only two cases of hospitalization (one in intensive care unit), 13 cases of re-infection and no deaths were recorded. Our results confirm that SARS-CoV-2 infection can break vaccination protection but the clinical course is favorable.
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Affiliation(s)
- Luigi De Maria
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Giuseppe Delvecchio
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Stefania Sponselli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Francesco Cafaro
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Antonio Caputi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Gianmarco Giannelli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | | | - Angela Stufano
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Piero Lovreglio
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA;
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
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13
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Moscara L, Venerito V, Martinelli A, Di Lorenzo A, Toro F, Violante F, Tafuri S, Stefanizzi P. Safety profile and SARS-CoV-2 breakthrough infections among HCWs receiving anti-SARS-CoV-2 and influenza vaccines simultaneously: an Italian observational study. Vaccine 2023; 41:5655-5661. [PMID: 37544827 DOI: 10.1016/j.vaccine.2023.07.043] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 08/08/2023]
Abstract
In October/December 2021, World Health Organization and other international agencies recommended the offer of the third dose of anti-SARS-CoV-2 vaccine. In this period, the routine offer of seasonal influenza vaccination was also guaranteed and simultaneous administration of the two vaccines was encouraged. This study aims to evaluate the safety profile and to estimate the incidence of SARS-CoV-2 breakthrough infections in subjects receiving the anti-SARS-CoV-2 and influenza vaccines simultaneously. The study population was represented by healthcare workers (HCWs) of Bari Policlinico General Hospital who received the influenza (Flucelvax Tetra®) and/or anti-SARS-CoV-2 vaccination (BNT162b2 mRNA COVID-19 vaccine, Comirnaty®) either in coadministration or separately in October 2021. Reports of adverse events following immunization (AEFIs) were investigated to study the safety of both vaccines in coadministration and in separate-instance administration. Post-vaccination SARS-CoV-2 breakthrough infection was also studied. 942 HCWs accepted to join our study. 610/942 received both vaccines simultaneously. 25.26 % subjects (238/942) were only vaccinated against SARS-CoV-2, while the remaining 94 HCWs received the influenza vaccination first and subsequently received the anti-SARS-CoV2 booster dose. 717 HCWs reported AEFIs (Reporting Rate 76.1 per 100 subjects). Simultaneous administration of the two vaccines was not related with an increase of the rate of AEFIs compared to the single administration of SARS-CoV-2 vaccine, but the AEFIs' rate was lower among subjects who received only influenza vaccine. Post-vaccination SARS-CoV-2 infections were notified for 41.5 % of enrolled subjects (391/942). Incidence of breakthrough infection and symptomatic disease was not significantly different between the simultaneous administration group and other subjects. Our data suggests that simultaneous administration of a quadrivalent influenza vaccine and an mRNA anti-SARS-CoV-2 vaccine neither affected the safety of said products nor was associated with a higher risk of SARS-CoV-2 breakthrough infection.
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Affiliation(s)
- L Moscara
- Hygiene Unit - Interdisciplinary Department of Medicine; University of Bari "Aldo Moro", Italy
| | - V Venerito
- Rheumatology Unit - Department of Precision and Regenerative Medicine - Jonic Area, University of Bari "Aldo Moro", Italy
| | - A Martinelli
- Hygiene Unit - Interdisciplinary Department of Medicine; University of Bari "Aldo Moro", Italy
| | - A Di Lorenzo
- Hygiene Unit - Interdisciplinary Department of Medicine; University of Bari "Aldo Moro", Italy
| | - F Toro
- Hygiene Unit - Interdisciplinary Department of Medicine; University of Bari "Aldo Moro", Italy
| | - F Violante
- Hygiene Unit - Interdisciplinary Department of Medicine; University of Bari "Aldo Moro", Italy
| | - S Tafuri
- Hygiene Unit - Interdisciplinary Department of Medicine; University of Bari "Aldo Moro", Italy
| | - P Stefanizzi
- Hygiene Unit - Interdisciplinary Department of Medicine; University of Bari "Aldo Moro", Italy.
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14
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Gianfredi V, Stefanizzi P, Berti A, D’Amico M, De Lorenzo V, Lorenzo AD, Moscara L, Castaldi S. A Systematic Review of Population-Based Studies Assessing Knowledge, Attitudes, Acceptance, and Hesitancy of Pregnant and Breastfeeding Women towards the COVID-19 Vaccine. Vaccines (Basel) 2023; 11:1289. [PMID: 37631857 PMCID: PMC10459271 DOI: 10.3390/vaccines11081289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
The anti-SARS-CoV-2 vaccination is recommended for pregnant women due to the high risk of complications. However, pregnancy has been associated with vaccine hesitancy. Our review aims at summarizing the existing literature about anti-SARS-CoV-2 vaccine hesitancy in pregnant and lactating women. The research was conducted on PubMed/MEDLINE, ExcerptaMedica Database (EMBASE), and Scopus, according to PRISMA guidelines. Articles regarding the COVID-19 vaccine's acceptance and/or refusal by pregnant and lactating women were selected. Only observational, population-based studies were included. The Joanna Briggs Institute quality assessment tools were employed. A total of 496 articles were retrieved, and after the selection process, 21 papers were included in the current analysis. All the included studies were cross-sectional, mostly from Europe and North America. The sample sizes ranged between 72 and 25,111 subjects. All of them included pregnant subjects, except one that focused on breastfeeding women only. Vaccine hesitancy rates ranged from 26% to 57% among different studies. Fear of adverse events and lack of knowledge were shown to be the main drivers of hesitancy. Approximately half of the studies (11/21) were classified as low quality, the remaining (9/21) were classified as moderate, and only one study was classified as high quality. Primigravidae were also shown to be more likely to accept anti-SARS-CoV-2 vaccination. Our findings confirm significant anti-SARS-CoV-2 vaccine hesitancy among pregnant women. Information gaps should be addressed to contain concerns related to adverse events.
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Affiliation(s)
- Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (V.G.); (A.B.); (M.D.); (V.D.L.); (S.C.)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70121 Bari, Italy; (A.D.L.); (L.M.)
| | - Alessandro Berti
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (V.G.); (A.B.); (M.D.); (V.D.L.); (S.C.)
| | - Marilena D’Amico
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (V.G.); (A.B.); (M.D.); (V.D.L.); (S.C.)
| | - Viola De Lorenzo
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (V.G.); (A.B.); (M.D.); (V.D.L.); (S.C.)
| | - Antonio Di Lorenzo
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70121 Bari, Italy; (A.D.L.); (L.M.)
| | - Lorenza Moscara
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70121 Bari, Italy; (A.D.L.); (L.M.)
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (V.G.); (A.B.); (M.D.); (V.D.L.); (S.C.)
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35, 20122 Milan, Italy
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15
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Leonardelli M, Mele F, Marrone M, Germinario CA, Tafuri S, Moscara L, Bianchi FP, Stefanizzi P. The Effects of the COVID-19 Pandemic on Vaccination Hesitancy: A Viewpoint. Vaccines (Basel) 2023; 11:1191. [PMID: 37515007 PMCID: PMC10386622 DOI: 10.3390/vaccines11071191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/23/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
Vaccination hesitancy is considered by the World Health Organization as a danger to global health. In recent years, vaccine hesitancy rates to COVID-19 have been studied worldwide. In our study, we aim to provide an overview of the concept of vaccine hesitancy, with regard to the post-COVID era, and to provide prevention and management strategies. A search of the international literature until March 2023 was conducted in the PubMed database. The 5723 papers found were divided into two groups: prior to the COVID-19 era and from 2021 onward. Papers about the vaccine hesitation phenomenon are becoming more common during the SARS-CoV-2 pandemic and following the marketing that the vaccine companies have carried out on the different types of COVID-19 vaccines. It is advisable that healthcare authorities, at the national and international level, as well as healthcare professionals, at the local level, should promote a series of activities to reduce the vaccine hesitancy rate.
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Affiliation(s)
- Mirko Leonardelli
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Federica Mele
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Maricla Marrone
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | | | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
| | - Lorenza Moscara
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
| | | | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
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16
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Di Lorenzo A, Martinelli A, Bianchi FP, Scazzi FL, Diella G, Tafuri S, Stefanizzi P. The safety of pneumococcal vaccines at the time of sequential schedule: data from surveillance of adverse events following 13-valent conjugated pneumococcal and 23-valent polysaccharidic pneumococcal vaccines in newborns and the elderly, in Puglia (Italy), 2013-2020. Ann Ig 2023; 35:459-467. [PMID: 36477097 DOI: 10.7416/ai.2022.2551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Background Nowadays, two types of anti-pneumococcal vaccine are available: pneumococcal 13-valent conjugate vaccine (PCV13), first licensed in the United States (US) in 2013, and pneumococcal 23-valent polysaccaridic vaccine (PPSV23), first licensed in the US in 1999. These vaccines are recommended in Italy for the immunization of newborns and of the elderly, using a combined sequential schedule for the latter. This report aims to describe the PCV13- and PPSV23-related AEFIs notified in Puglia in 2013-2020, in order to design these products' safety profile in a real-life scenario, three years after the official recommendation about the sequential schedule for people over 60 years of age. Methods This is a retrospective observational study. Data were gathered from the list of AEFIs notified following PCV13 and PPSV23 administration in Puglia in 2013-2020. The number of administered vaccine doses was obtained from the regional immunization database. AEFIs were classified according to WHO's algorithm, and causality assessment was carried out in case of serious AEFIs. Results From January 2013 to December 2020, 764,183 doses of PCV13 and 40,382 doses of PPSV23 were administered in Puglia. In the same period, 71 PCV13 AEFIs (Reporting Rate: 9.29 x100,000 doses) and 5 PPSV23 AEFIs (Reporting Rate: 12.4 x100,000 doses) were reported. The overall male/female ratio in AEFIs was 0.85. The majority of AEFIs occurred in subjects aged less than 2 (64/76, 84.2%), while 10 out of 76 (13.2%) occurred in patients aged 60 or older. 22 AEFIs were classified as serious and for 12 (54.5%) causality assessment showed a consistent relationship with immunization. The most commonly reported symptoms were fever (Reporting Rate: 4.72 x100,000 doses) and neurological symptoms (Reporting Rate: 3.23 x100,000 doses). Only one death was notified, classified as non-vaccine-related. Conclusions The benefit of pneumococcal vaccination appears to be greater than the risk of AEFIs for both PCV13 and PPSV23. In fact, AEFIs occur in less than 0.1‰ of patients and the majority of AEFIs are mild and self-limiting.
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Affiliation(s)
- A Di Lorenzo
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - A Martinelli
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - F P Bianchi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - F L Scazzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - G Diella
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - S Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - P Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
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17
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Sponselli S, De Maria L, Caputi A, Stefanizzi P, Bianchi FP, Delvecchio G, Foti C, Romita P, Ambrogio F, Zagaria S, Giannelli G, Tafuri S, Vimercati L. Infection Control among Healthcare Workers and Management of a Scabies Outbreak in a Large Italian University Hospital. J Clin Med 2023; 12:jcm12113830. [PMID: 37298025 DOI: 10.3390/jcm12113830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/25/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023] Open
Abstract
This retrospective observational study describes the results of an ad-hoc designated prevention protocol aimed at containing the spread of the scabies infestation among healthcare workers (HCWs) of a large University Hospital in Italy. The outbreak started on October 2022 and a preventive protocol was set up thanks to a multidisciplinary approach. HCWs at high scabies risk were defined as subjects working in Operative Units with a scabies prevalence higher than 2%, close contacts of a confirmed case of scabies, or HCWs with signs and symptoms of the disease. All cases at high scabies risk underwent a dermatological examination, and the infested HCWs were suspended from work until definitive healing. Mass drug administration was established for all HCWs working in Operative Units with a scabies prevalence higher than 2%. Until March 2023, out of 183 screening dermatological examinations, 21 (11.5%) were diagnostic for scabies. Between 11 October 2022 (date of the first diagnosed scabies case) and 6 March 2023 (the end of incubation period related to the last case detected), the frequency of scabies was 0.35% (21 scabies cases/6000 HCWs). The duration of the outbreak in our hospital was 14.7 weeks. Statistical analysis shows a significant association between scabies and being a nurse and having an allergy to dust mites. We obtained a low frequency of scabies infection, limiting the duration of the outbreak and the related economic burden.
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Affiliation(s)
- Stefania Sponselli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Luigi De Maria
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Antonio Caputi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | | | - Giuseppe Delvecchio
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Caterina Foti
- Department of Biomedical Science and Human Oncology, University of Bari, 70124 Bari, Italy
| | - Paolo Romita
- Department of Biomedical Science and Human Oncology, University of Bari, 70124 Bari, Italy
| | - Francesca Ambrogio
- Department of Biomedical Science and Human Oncology, University of Bari, 70124 Bari, Italy
| | - Silvia Zagaria
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Gianmarco Giannelli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
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Venerito V, Stefanizzi P, Cantarini L, Lavista M, Galeone MG, Di Lorenzo A, Iannone F, Tafuri S, Lopalco G. Immunogenicity and Safety of Adjuvanted Recombinant Zoster Vaccine in Rheumatoid Arthritis Patients on Anti-Cellular Biologic Agents or JAK Inhibitors: A Prospective Observational Study. Int J Mol Sci 2023; 24:ijms24086967. [PMID: 37108130 PMCID: PMC10138868 DOI: 10.3390/ijms24086967] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/06/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
Rheumatoid arthritis (RA) patients on JAK inhibitors (JAKi) have an increased HZ risk compared to those on biologic DMARDs (bDMARDs). Recently, the Adjuvanted Recombinant Zoster Vaccine (RZV) became available worldwide, showing good effectiveness in patients with inflammatory arthritis. Nevertheless, direct evidence of the immunogenicity of such a vaccine in those on JAKi or anti-cellular bDMARDs is still lacking. This prospective study aimed to assess RZV immunogenicity and safety in RA patients receiving JAKi or anti-cellular bDMARDs that are known to lead to impaired immune response. Patients with classified RA according to ACR/EULAR 2010 criteria on different JAKi or anti-cellular biologics (namely, abatacept and rituximab) followed at the RA clinic of our tertiary center were prospectively observed. Patients received two shots of the RZV. Treatments were not discontinued. At the first and second shots, and one month after the second shot, from all patients with RA, a sample was collected and RZV immunogenicity was assessed and compared between the treatment groups and healthy controls (HCs) receiving RZV for routine vaccination. We also kept track of disease activity at different follow-up times. Fifty-two consecutive RA patients, 44 females (84.61%), with an average age (±SD) of 57.46 ± 11.64 years and mean disease duration of 80.80 ± 73.06 months, underwent complete RZV vaccination between February and June 2022 at our center. At the time of the second shot (1-month follow-up from baseline), anti-VZV IgG titer increased significantly in both groups with similar magnitude (bDMARDs: 2258.76 ± 897.07 mIU/mL; JAKi: 2059.19 ± 876.62 mIU/mL, p < 0.001 for both from baseline). At one-month follow-up from the second shot, anti-VZV IgG titers remained stable in the bDMARDs group (2347.46 ± 975.47) and increased significantly in the JAKi group (2582.65 ± 821.59 mIU/mL, p = 0.03); still, no difference was observed between groups comparing IgG levels at this follow-up time. No RA flare was recorded. No significant difference was shown among treatment groups and HCs. RZV immunogenicity is not impaired in RA patients on JAKi or anti-cellular bDMARDs. A single shot of RZV can lead to an anti-VZV immune response similar to HCs without discontinuing DMARDs.
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Affiliation(s)
- Vincenzo Venerito
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Polyclinic Hospital, University of Bari, 70124 Bari, Italy
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70121 Bari, Italy
| | - Luca Cantarini
- Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, University of Siena, 53100 Siena, Italy
| | - Marlea Lavista
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Polyclinic Hospital, University of Bari, 70124 Bari, Italy
| | - Maria Grazia Galeone
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Polyclinic Hospital, University of Bari, 70124 Bari, Italy
| | - Antonio Di Lorenzo
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70121 Bari, Italy
| | - Florenzo Iannone
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Polyclinic Hospital, University of Bari, 70124 Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70121 Bari, Italy
| | - Giuseppe Lopalco
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Polyclinic Hospital, University of Bari, 70124 Bari, Italy
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19
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Bianchi FP, Stefanizzi P, Di Lorenzo A, Cuscianna E, Tafuri S, Germinario CA. Vaccine coverage for recommended vaccines among splenectomised patients in Apulia, South Italy: a retrospective cohort study. BMJ Open 2023; 13:e069316. [PMID: 36990496 PMCID: PMC10069564 DOI: 10.1136/bmjopen-2022-069316] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE Splenectomised/asplenic patients have a 10-50 fold higher risk than the general population of developing overwhelming postsplenectomy infection. To control this risk, these patients have to receive a specific immunisation schedule, before or in the 2 weeks after the surgical intervention. The study aims to estimate vaccine coverage (VC) for recommended vaccines among splenectomised patients in Apulia (South Italy), and to define the determinants of vaccination uptake in this population. DESIGN Retrospective cohort study. SETTING Apulia, Southern Italy. PARTICIPANTS 1576 splenectomised patients. METHODS The Apulian regional archive of hospital discharge forms (SDOs) was used to define the splenectomised Apulian inhabitants. The study period went from 2015 to 2020. The vaccination status for Streptococcus pneumoniae (13-valent conjugate anti-pneumococcal vaccine+PPSV23), Haemophilus influenzae type b (Hib; one dose), Neisseria meningitidis ACYW135 (two doses), Neisseria meningitidis B (two doses) and influenza (at least one dose of influenza vaccine before an influenza season after splenectomy) was assessed via data collected from the Regional Immunisation Database (GIAVA). In order to define a subject as fully immunised, we considered the Centers for Diseases Control and Prevention guidelines to define the optimal immunisation status. RESULTS Since 2015, 1576 Apulian inhabitants have undergone splenectomy; the VC for anti-Neisseria meningitidis B vaccine was 30.9%, for anti-Neisseria meningitidis ACYW135 was 27.7%, for anti-Streptococcus pneumoniae was 27.0%, for anti-Hib was 30.1%, and 49.2% received at least one dose of influenza vaccine before an influenza season after splenectomy. None of the patients splenectomised in 2015 and 2016 had received the recommended MenACYW135 and PPSV23 booster doses 5 years after completing the basal cycles. CONCLUSIONS The results of our study highlight low VC values among Apulian splenectomised patients. The task of public health institutions is to implement new strategies aimed at increasing VC in this population, implementing educational measures for patients and families, training for general practitioners and specialists, and ad hoc communication campaigns.
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Affiliation(s)
| | | | - Antonio Di Lorenzo
- Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | | | - Silvio Tafuri
- Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
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Stefanizzi P, Provenzano S, Santangelo OE, Dallagiacoma G, Gianfredi V. Past and Future Influenza Vaccine Uptake Motivation: A Cross-Sectional Analysis among Italian Health Sciences Students. Vaccines (Basel) 2023; 11:vaccines11040717. [PMID: 37112629 PMCID: PMC10143571 DOI: 10.3390/vaccines11040717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
Despite its effectiveness in the prevention of seasonal flu, influenza vaccination uptake remains low, even among healthcare workers (HCWs), despite their occupational risk. The aim of this study was to explore the association between main reasons for accepting or refusing influenza vaccination and the decision to receive the vaccination during both previous and following year among health sciences students. A multi-center, cross-sectional study was performed using a validated online questionnaire. Data were analyzed by performing univariable and multivariable logistic analysis. Data from over 3000 participants showed that avoiding the spread of infection to family members and the general population (aOR: 43.55), as well as to patients (aOR: 16.56) were the main reasons associated with the highest probability of taking the influenza vaccination the following year. On the contrary, not considering influenza as a severe disease was the reason associated with the lowest probability for past (aOR: 0.17) and future vaccination (aOR: 0.01). Therefore, the importance of vaccination to protect others should always be the core of vaccination campaigns for health sciences students, together with tools to increase their awareness of the severity of this disease.
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Affiliation(s)
- Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70121 Bari, Italy
| | | | - Omar Enzo Santangelo
- Regional Health Care and Social Agency of Lodi, ASST Lodi, Piazza Ospitale 10, 26900 Lodi, Italy
| | - Giulia Dallagiacoma
- Department of Public Health, Experimental and Forensic Medicine, School of Public Health, University of Pavia, 27100 Pavia, Italy
- Department of Global Public Health, Karolinska Institute, 171 77 Stockholm, Sweden
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal 36, 20133 Milan, Italy
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21
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Bianchi FP, Stefanizzi P, Rizzi D, Signorile N, Cuscianna E, Daleno A, Migliore G, Tafuri S. Burden of COVID-19 disease and vaccine coverages in Apulian splenectomized patients: A retrospective observational study. Br J Haematol 2023. [PMID: 36942786 DOI: 10.1111/bjh.18731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/13/2023] [Accepted: 02/19/2023] [Indexed: 03/23/2023]
Abstract
Splenectomy/asplenia is a condition associated with immune-compromission and specific vaccines are recommended for these patients, including the anti-COVID-19 vaccine. Among the high-risk group for which vaccination was prioritized in Italy, the immunocompromised patients after therapies or treatments were included. The Apulian regional archive of hospital discharge forms was used to define the list of splenectomized Apulian inhabitants, considering data from 2015 through 2020. The overall vaccination status of asplenic patients was assessed via data collected from the Regional Immunization Database. The history of SARS-CoV-2 infection and the infectious disease outcomes were extracted from the Italian Institute of Health platform "Integrated surveillance of COVID-19 cases in Italy". 1219 Apulian splenectomized inhabitants were included; the incidence rate of SARS-CoV-2 infection was 15.0 per 100 persons-year with a proportion of re-infection equal to 6.4%; the proportion of hospitalization was 2.9%, with a case-fatality rate of 2.6%. The vaccine coverage (VC) for the anti-COVID-19 vaccine basal routine was 64.2%, for the first booster dose was 15.4%, and for the second booster dose was 0.6%. A multifactorial approach is needed to increase the vaccination uptake in this sub-group population and to increase the awareness of the asplenia-related risks to patients and health personnel.
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Affiliation(s)
- Francesco Paolo Bianchi
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
- Azienda Ospedaliero Universitaria Policlinico Giovanni XXIII, Bari, Italy
| | - Pasquale Stefanizzi
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
- Azienda Ospedaliero Universitaria Policlinico Giovanni XXIII, Bari, Italy
| | - Donato Rizzi
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Noemi Signorile
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Eustachio Cuscianna
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Antonio Daleno
- Azienda Ospedaliero Universitaria Policlinico Giovanni XXIII, Bari, Italy
| | - Giovanni Migliore
- Azienda Ospedaliero Universitaria Policlinico Giovanni XXIII, Bari, Italy
| | - Silvio Tafuri
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
- Azienda Ospedaliero Universitaria Policlinico Giovanni XXIII, Bari, Italy
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22
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Bianchi FP, Stefanizzi P, Martinelli A, Brescia N, Tafuri S. COVID-19 vaccination hesitancy in people affected by diabetes and strategies to increase vaccine compliance: A systematic narrative review and meta-analysis. Vaccine 2023; 41:1303-1309. [PMID: 36690559 PMCID: PMC9860503 DOI: 10.1016/j.vaccine.2023.01.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 01/09/2023] [Accepted: 01/15/2023] [Indexed: 01/22/2023]
Abstract
INTRODUCTION People affected by diabetes are at higher risk for complications from certain vaccine-preventable diseases. Suboptimal vaccination coverages are reported in this population sub-group. The purpose of this study is to estimate the proportion of diabetic patients who express hesitation to the COVID-19 vaccine worldwide. METHODS Seven studies were included in the meta-analysis and systematic review, selected from scientific articles available in the MEDLINE/PubMed, Google Scholar and Scopus databases from 2020 to 2022. The following terms were used for the search strategy: (adherence OR hesitancy OR compliance OR attitude) AND (covid* OR SARS*) AND (vaccin* OR immun*) AND (diabet*). RESULTS The vaccine hesitation rate among persons with diabetes was 27.8 % (95 %CI = 15.6-41.9 %). In the comparison of vaccine hesitancy between sexes and educational status, the RRs were 0.90 (95 %CI = 0.71-1.15) and 0.88 (95 %CI = 0.76-1.02), respectively. The main reasons of unwillingness were lack of information, opinion that the vaccine was unsafe or not efficient, and fear of adverse events. CONCLUSIONS In order to achieve a high vaccination coverage, multifactorial approach is needed, which requires major social, scientific and health efforts. The success of the vaccination campaign in this population depends on the capillarity and consistency of the interventions implemented.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Italy
| | - Andrea Martinelli
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Italy
| | - Nazario Brescia
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Italy.
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23
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De Maria L, Sponselli S, Caputi A, Stefanizzi P, Pipoli A, Giannelli G, Delvecchio G, Tafuri S, Inchingolo F, Migliore G, Bianchi FP, Boffetta P, Vimercati L. SARS-CoV-2 Breakthrough Infections in Health Care Workers: An Italian Retrospective Cohort Study on Characteristics, Clinical Course and Outcomes. J Clin Med 2023; 12:jcm12020628. [PMID: 36675555 PMCID: PMC9864312 DOI: 10.3390/jcm12020628] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The aim of this study was to determine the characteristics, clinical course and outcomes of COVID-19 breakthrough infections (BIs) among healthcare workers (HCWs) of an Italian University Hospital. METHODS A retrospective observational study was conducted on 6111 HCWs, from January 2021 to February 2022. The study population was offered the full vaccination with BNT162b2 mRNA COVID-19 vaccine. To allow return to work after BI, the protocol required one negative nasopharyngeal RT-PCR swab followed by a medical examination to assess the HCW's health status. Laboratory tests, instrumental tests and specialist evaluations were carried out if necessary. RESULTS The cases of BIs observed numbered 582 (9.7%). The frequency of BIs was significantly higher in females than in males (67% vs. 33%; p = 0.03), and in nurses than in all other professional categories (p = 0.001). A total of 88% of the HCWs affected by BI were still symptomatic after the negative swab. None of the instrumental tests carried out showed any new findings of pathological significance. All cases showed progressive disappearance of symptoms, such that no cases of long COVID and no hospitalization or deaths were recorded. CONCLUSIONS Our results confirm that SARS-CoV-2 infections occur even after a full vaccination course; however, the clinical course is favorable and severe outcomes are reduced.
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Affiliation(s)
- Luigi De Maria
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Stefania Sponselli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Antonio Caputi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
- Correspondence: (A.C.); (L.V.); Tel.: +39-08-0547-8256 (L.V.)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Antonella Pipoli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Gianmarco Giannelli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Giuseppe Delvecchio
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | | | - Giovanni Migliore
- General Direction, Policlinico Regional Hospital of Bari, 70124 Bari, Italy
| | | | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
- Correspondence: (A.C.); (L.V.); Tel.: +39-08-0547-8256 (L.V.)
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24
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Bianchi FP, Stefanizzi P, Migliore G, Melpignano L, Daleno A, Vimercati L, Marra M, Working Group CR, Tafuri S. A COVID-19 nosocomial cluster in a university hospital in southern Italy: a social network analysis. Ann Ig 2023; 35:39-48. [PMID: 35442385 DOI: 10.7416/ai.2022.2519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Healthcare workers on duty at the hospital are at high risk of COVID-19 infection. However, despite the introduction of risk-lowering practices in the hospital setting, there have been many cases of SARS-COV-2 infection among Health Care Workers. Fast and efficient contact tracing and Sars-CoV-2 PCR-based testing of the close contacts of Health Care Workers with confirmed infections are essential steps to limit nosocomial outbreaks. METHODS This cross-sectional study was conducted at Bari Policlinico General University-Hospital (Apulia, Italy) and describes the management of a cluster of SARS-COV-2 infections in three Operative Units. The contact tracing activities and the measures implemented to control the outbreak are described. RESULTS Among the 186 Health Care Workers active in the cluster setting, there were 9 (4.8%) confirmed cases, including the index case. Due to the outbreak, three Operative Units were closed to limit virus circulation. Health Care Workers with confirmed infections tested negative after a mean of 28.0±6.6 days (range: 13-37) and none required hospitalization. CONCLUSIONS Protection of the health of Health Care Workers during the COVID-19 pandemic should be a public health priority. However, despite recent recommendations and the implementation of protective measures, SARS-COV-2 infections of Health Care Workers remain at a high rate, indicative of the continued high risk of cluster onset in the nosocomial setting.
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Affiliation(s)
- F P Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - P Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - G Migliore
- Hospital Direction, Bari Policlinico General Hospital, Bari, Italy
| | - L Melpignano
- Hospital Direction, Bari Policlinico General Hospital, Bari, Italy
| | - A Daleno
- Hospital Direction, Bari Policlinico General Hospital, Bari, Italy
| | - L Vimercati
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
| | - M Marra
- Hospital Direction, Bari Policlinico General Hospital, Bari, Italy
| | - C R Working Group
- CR Working Group: Fabio Amoruso, Luca Capodiferro, Gloria Mannarini, Andrea Martinelli, Giulia Massari, Donato Russo, Valerio Sblendorio, Giuseppe Spinelli, Stefania Sponselli, Edoardo Maria Terlizzi, Monica Tota
| | - S Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
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25
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Bianchi FP, Stefanizzi P, Migliore G, Martinelli A, Vimercati L, Germinario CA, Tafuri S. Prevalence of healthcare workers fully vaccinated against hepatitis B without circulating antibodies in Italy and role of age at baseline cycle vaccination: a systematic review and meta-analysis. Expert Rev Vaccines 2023; 22:139-147. [PMID: 36564923 DOI: 10.1080/14760584.2023.2162507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Healthcare workers (HCWs) susceptible to hepatitis B represent an important public health concern. National and international guidelines recommend assessing the hepatitis B immune status of all HCWs and possibly vaccinating those found to be seronegative (non-responders). We conducted a meta-analysis to estimate the rate of hepatitis B sero-susceptibility among HCWs in Italy and to explore possible options for the management of non-responders. AREAS COVERED Nineteen studies, selected from scientific articles available in the Scopus, MEDLINE/PubMed and ISI Web of Knowledge databases between 1 January 2016 and 22 April 2022, were included. The prevalence of HBV-susceptible HCWs was 27.1% (95%CI = 23.2-31.7%). In a comparison by sex (males vs. females) the RR was 1.16 (95%CI = 1.03-1.31), and by full-cycle vaccination period (adolescence vs. infancy) the RR was 0.30 (95%CI = 0.25-0.37). Occupational health screenings for hepatitis B, with subsequent vaccination of non-responders, and exclusion of susceptible HCWs from high-risk settings have been common management strategies. EXPERT OPINION It is highly probable that a proportion of the next generation of medical students and HCWs will not show circulating IgG on serologic evaluation. Therefore, more targeted efforts are needed to identify these individuals and actively immunize them.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | | | - Andrea Martinelli
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | | | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
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26
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Diella G, Caggiano G, Apollonio F, Triggiano F, Stefanizzi P, Fasano F, Pace L, Marcotrigiano V, Sorrenti DP, Sorrenti GT, Galante D, Montagna MT. SARS-CoV-2 RNA viability on high-touch surfaces and evaluation of a continuous-flow ozonation treatment. Ann Ig 2023; 35:112-120. [PMID: 36222607 DOI: 10.7416/ai.2022.2547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND The COVID-19 emergency has highlighted the importance of prevention systems and environ-mental microbiological monitoring as fundamental elements in the response to epidemics and other such threats to individual and collective health. The use of automated "No-touch" room disinfection systems eliminates or reduces the dependence on operators, thus allowing an improvement in the effectiveness of terminal disinfection. STUDY DESIGN In the present study, we focused on possible SARS-CoV-2 contamination of surfaces of com-mercial services, and the effectiveness of ozone treatment on the virus. METHODS Analyses were conducted on 4-7 October and 27-30 December 2021 in four supermarkets in an Apulian city; supermarkets A and B were equipped with an ozonisation system, while C and D were without any environmental remediation. RESULTS SARS-CoV-2 RNA was detected by real-time RT-PCR only in December, in 6% of the surfaces tested, and all examined samples were found to be negative after viral culture, since no cytopathic effect was observed. A statistically significant difference emerged from the comparison of October vs. December (p = 0.0289), but no statistically significant difference (p = 0.6777) emerged from the comparison between supermarkets with and without the ozonisation system. CONCLUSIONS Although no important changes were observed by treating the environments with ozonisation systems, further studies are needed to validate the effectiveness of environmental treatments with airborne disinfectants.
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Affiliation(s)
- G Diella
- Interdisciplinary Department of Medicine, Section of Hygiene, Aldo Moro University of Bari, Italy
| | - G Caggiano
- Interdisciplinary Department of Medicine, Section of Hygiene, Aldo Moro University of Bari, Italy
| | - F Apollonio
- Interdisciplinary Department of Medicine, Section of Hygiene, Aldo Moro University of Bari, Italy
| | - F Triggiano
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - P Stefanizzi
- Interdisciplinary Department of Medicine, Section of Hygiene, Aldo Moro University of Bari, Italy
| | - F Fasano
- Interdisciplinary Department of Medicine, Section of Hygiene, Aldo Moro University of Bari, Italy
| | - L Pace
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Foggia, Italy
| | - V Marcotrigiano
- Department of Prevention, Food Hygiene and Nutrition Service, Local Health Unit Barletta-Andria-Trani, Trani, Italy
| | - D P Sorrenti
- Department of Prevention, Food Hygiene and Nutrition Service, Local Health Unit Barletta-Andria-Trani, Trani, Italy
| | - G T Sorrenti
- Department of Prevention, Food Hygiene and Nutrition Service, Local Health Unit Barletta-Andria-Trani, Trani, Italy
| | - D Galante
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Foggia, Italy
| | - M T Montagna
- Interdisciplinary Department of Medicine, Section of Hygiene, Aldo Moro University of Bari, Italy
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Stefanizzi P, Ferorelli D, Scazzi FL, Di Lorenzo A, Martinelli A, Trinchera C, Moscara L, Miniello E, Di Bona D, Tafuri S. Allergic adverse events following immunization: Data from post-marketing surveillance in Apulia region (South of Italy). Front Immunol 2023; 14:1074246. [PMID: 36923411 PMCID: PMC10008905 DOI: 10.3389/fimmu.2023.1074246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/16/2023] [Indexed: 03/01/2023] Open
Abstract
Introduction Among adverse events following immunization (AEFIs), allergic reactions elicit the most concern, as they are often unpredictable and can be life-threatening. Their estimates range from one in 1,000,000 to one in 50,000 vaccine doses. This report describes allergic events following immunization reported from 2020 to 2021 in Puglia, a region in the South-East of Italy with around 4 million inhabitants. Its main objective is to describe the allergic safety profile of currently employed vaccines. Materials and methods This is a retrospective observational study. The study period spanned from January 2020 to December 2021, and the whole Apulian population was included in the study. Information regarding AEFIs reported in Puglia during the study period was gathered from the Italian Drug Authority's pharmacovigilance database (National Pharmacovigilance Network, RNF). The overall number of vaccine doses administered was extrapolated by the Apulian online immunization database (GIAVA). Reporting rates were calculated as AEFIs reported during a certain time span/number of vaccine doses administered during the same period. Results 10,834,913 vaccine doses were administered during the study period and 95 reports of allergic AEFIs were submitted to the RNF (reporting rate 0.88/100,000 doses). 27.4% of the reported events (26/95) were classified as serious (reporting rate 0.24/100,000 doses). 68 out of 95 (71.6%) adverse events were at least partially resolved by the time of reporting and none of them resulted in the subject's death. Conclusions Allergic reactions following vaccination were rare events, thus confirming the favourable risks/benefits ratio for currently marketed vaccines.
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Affiliation(s)
- Pasquale Stefanizzi
- Bari Policlinico General Hospital, Interdisciplinary Department of Medicine, Bari, Italy
| | - Davide Ferorelli
- Bari Policlinico General Hospital, Interdisciplinary Department of Medicine, Bari, Italy
| | - Francesco Livio Scazzi
- Bari Policlinico General Hospital, Interdisciplinary Department of Medicine, Bari, Italy
| | - Antonio Di Lorenzo
- Bari Policlinico General Hospital, Interdisciplinary Department of Medicine, Bari, Italy
| | - Andrea Martinelli
- Bari Policlinico General Hospital, Interdisciplinary Department of Medicine, Bari, Italy
| | - Chiara Trinchera
- Bari Policlinico General Hospital, Interdisciplinary Department of Medicine, Bari, Italy
| | - Lorenza Moscara
- Bari Policlinico General Hospital, Interdisciplinary Department of Medicine, Bari, Italy
| | - Enrico Miniello
- Bari Policlinico General Hospital, Interdisciplinary Department of Medicine, Bari, Italy
| | - Danilo Di Bona
- Bari Policlinico General Hospital, Department of Emergency and Organ Transplantation, Bari, Italy
| | - Silvio Tafuri
- Bari Policlinico General Hospital, Interdisciplinary Department of Medicine, Bari, Italy
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Bianchi FP, Stefanizzi P, Cuscianna E, Di Lorenzo A, Martinelli A, Tafuri S. Effectiveness of on-site influenza vaccination strategy in Italian healthcare workers: a systematic review and statistical analysis. Expert Rev Vaccines 2023; 22:17-24. [PMID: 36409195 DOI: 10.1080/14760584.2023.2149500] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION One of the main determinants of non-adherence to influenza vaccination among healthcare workers (HCWs) is lack of time to attend vaccination services. Therefore, international Public Health Organizations have recommended on-site influenza vaccination in order to improve vaccination coverage among HCWs. AREAS COVERED We conducted a systematic narrative review of the relevant literature to evaluate the effectiveness of this strategy among HCWs in Italy. Fifteen studies, selected among scientific articles available in MEDLINE/PubMed, ISI Web of Knowledge and Scopus and published from January 1st, 2018, to May 31st, 2022, were included. A significant relationship was evidenced between influenza vaccine uptake and adoption of an on-site outpatient clinic (OR = 2.06; 95%CI = 1.43-2.95). The review highlighted a significant increase in VC when on-site vaccination was implemented (even exceeding +150% compared to the previous season), among other measures. Nevertheless, none of the reported experiences proved to meet the minimum target of 75% VC among HCWs. EXPERT OPINION Despite strategies to achieve greater willingness to immunize in this category, mandatory vaccination appears to be the only one that can guarantee protection for HCWs and the patients they care for.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Eustachio Cuscianna
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Antonio Di Lorenzo
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Andrea Martinelli
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
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Venerito V, Stefanizzi P, Martinelli A, Fornaro M, Galeone MG, Tafuri S, Iannone F, Lopalco G. Anti-SARS-CoV-2 antibody decay after vaccination and immunogenicity of the booster dose of the BNT162b2 mRNA vaccine in patients with psoriatic arthritis on TNF inhibitors. Clin Exp Rheumatol 2023; 41:166-169. [PMID: 36441661 DOI: 10.55563/clinexprheumatol/hptln9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Scanty data on the anti- SARS-CoV-2 IgG level decay after two-dose BNT162b2 vaccination have been published in patients with psoriatic arthritis (PsA) on TNF inhibitors (TNFi). Similarly, no reports on the immunogenicity of a booster dose in such patients have been provided yet.We aimed to investigate the IgG level decay after two-dose BNT162b2 vaccination and the immunogenicity and safety of the booster dose in PsA patients on TNFi. METHODS Forty patients with classified PsA on TNFi undergoing booster dose with the BNT162b2 mRNA SARS- CoV-2 vaccine (BioNTech/Pfizer) were enrolled. Fifteen days after the third shot, serum IgG levels against SARS-CoV-2 (Abbott®ARCHITECT i2000SR, positivity cut-off 50 AU/mL) were assayed in all patients. Clinimetrics and treatment data were gathered. TNFi treatment was not discontinued. Sera from healthcare professionals were considered as healthy controls for 1:1 propensity score-matching. Student's t-test and logistic regression were used for investigating differences in immunogenicity between groups and predictors of antibody response. RESULTS Even though the decay of IgG levels showed similar magnitude between groups, PsA patients had a lower IgG level than matched controls at 4 months after two-dose vaccination (2009.22±4050.22 vs. 6206.59±4968.33 AU/mL, respectively p=0.0006). Booster dose restored IgG levels to a similar extent in both groups (15846.47±12876.48 vs. 20374.46±12797.08 AU/ml p=0.20, respectively). Clinical Disease Activity Index (CDAI) did not change before and after vaccination (6.68±4.38 vs. 4.95±4.20, p=0.19). CONCLUSIONS A BNT162b2 booster dose should be recommended in PsA patients on TNFi as its administration restores anti-SARS-CoV-2 IgG levels similar to healthy individuals.
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Affiliation(s)
- Vincenzo Venerito
- Rheumatology Unit, Department of Emergency and Organ Transplantations, University of Bari Aldo Moro, Bari, Italy
| | - Pasquale Stefanizzi
- Hygiene and Preventive Medicine Unit, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Andrea Martinelli
- Hygiene and Preventive Medicine Unit, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Marco Fornaro
- Rheumatology Unit, Department of Emergency and Organ Transplantations, University of Bari Aldo Moro, Bari, Italy
| | - Maria Grazia Galeone
- Rheumatology Unit, Department of Emergency and Organ Transplantations, University of Bari Aldo Moro, Bari, Italy
| | - Silvio Tafuri
- Rheumatology Unit, Department of Emergency and Organ Transplantations, University of Bari Aldo Moro, Bari, Italy
| | - Florenzo Iannone
- Rheumatology Unit, Department of Emergency and Organ Transplantations, University of Bari Aldo Moro, Bari, Italy
| | - Giuseppe Lopalco
- Rheumatology Unit, Department of Emergency and Organ Transplantations, University of Bari Aldo Moro, Bari, Italy.
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Stefanizzi P, Bianchi FP, Ascatigno L, Pantaleo N, Martinelli A, Di Lorenzo A, Notarnicola A, Fischetti F, Tafuri S. Incidence of SARS-COV-2 infection among swimming athletes: data from real life in Apulia (Italy), July 2020/August 2021. Ann Ig 2023; 35:34-38. [PMID: 35452071 DOI: 10.7416/ai.2022.2520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND As other indoor sports facilities, swimming pools were closed in Italy from March to May 2020 and from October 2020 to July 2021 due to the outbreak of the COVID-19 pandemic; access to these facilities was restricted to athletes of national relevance. This decision was based on "precautionary principles" and without evidence of a high risk of SARS-COV-2 circulation among swimming pools' attendants. The aim of this paper is to describe the pattern of SARS-COV-2 circulation among swimming athletes in Apulia (Southern Italy). STUDY DESIGN The study aims to investigate the hypothesis that attending a pool increases the risk of SARS-COV-2 infection. The outcome measure is the incidence of SARS-COV-2 infection among swimming athletes compared with the general population. METHODS This is a retrospective cross-sectional study carried out in Apulia, Southern Italy. The study was performed through the analysis of both the database of the Italian Swimming Federation and the SARS-COV-2 infections in Apulia Region, from July 2020 to August 2021. RESULTS Among 2,939 federally licensed athletes, 221 had an history of SARS-COV-2 infection from July 2020 to August 2021, with an incidence of 75.2 /1,000. In the general Apulian population, during the same time span, the incidence of SARS-COV-2 infection was 67.3/1,000 and - considering the incidence rate ratio - there is no difference between the two populations (IRR=1.1; 95% CI=0.9-1.3; p>0.05). CONCLUSIONS The incidence of SARS-COV-2 infection in Apulian swimmers showed no significant differences with the general population.
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Affiliation(s)
- P Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - F P Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - L Ascatigno
- Italian Swimming Federation, Apulia Committee, Bari, Italy
| | - N Pantaleo
- Italian Swimming Federation, Apulia Committee, Bari, Italy
| | - A Martinelli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - A Di Lorenzo
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - A Notarnicola
- Degree Course in Sport and Movement Science, School of Medicine, Aldo Moro University of Bari, Italy
| | - F Fischetti
- Degree Course in Sport and Movement Science, School of Medicine, Aldo Moro University of Bari, Italy
| | - S Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
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Stefanizzi P, Bianchi FP, Martinelli A, Di Lorenzo A, De Petro P, Graziano G, Lattanzio S, Diella G, Stella P, Ancona D, Tafuri S. Safety profile of MenB-FHBp vaccine among adolescents: data from surveillance of Adverse Events Following Immunization in Puglia (Italy), 2018-2020. Hum Vaccin Immunother 2022; 18:2041359. [PMID: 35201942 PMCID: PMC9009947 DOI: 10.1080/21645515.2022.2041359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
MenB-FHBp was licensed in Europe in 2017 from the age of 10. In the “postmarketing life” of a new vaccine, surveillance of Adverse Events Following Immunization (AEFI) is crucial, to better understand the pattern of safety and the effectiveness. This paper describes the MenB-FHBp AEFIs notified in Puglia in 2018–2021, to take a picture of the safety profile of this vaccine in the real life, four years after its introduction in Italy. This is a retrospective observational study. Data were collected from the list of AEFIs notified after MenB-FHBp vaccine administration in Puglia in 2018–2020, and the number of doses of this vaccine administered in the same period. AEFIs were classified according to WHOʻs algorithm, and causality assessment was carried out for serious AEFIs. From January 2018 to December 2020, in Puglia, 43,061 doses of MenB-FHBp were administered and 42 MenB-FHBp AEFIs (reporting rate: 97.5 per 100,000 doses administered) were reported. Among these, 12 were classified as severe (28.6%; reporting rate 27.9 per 100,000 doses). Overall, the male/female ratio in AEFIs was 1:1. The median age of people who suffered from AEFIs was 12 years (range 11–13). For the 11 serious AEFIs for which the classification was “consistent causal association,” the diagnosis was hyperpyrexia (reporting rate 13.9 per 100,000 doses), fainting (rate 4.6 per 100,000 doses), urticaria (rate 2,3 per 100,000 doses), convulsions (rate 2,3 per 100,000 doses), and vomit (rate 2,3 per 100,000 doses). No deaths or impairment were notified in studied AEFIs. The picture of MenB-FHBp vaccine supports that the risk of AEFIs is in line with previous published data and in general acceptable.
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Affiliation(s)
- Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Francesco Paolo Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Andrea Martinelli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Antonio Di Lorenzo
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Paola De Petro
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Giusi Graziano
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Sabrina Lattanzio
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Giusy Diella
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Paolo Stella
- Regional Pharmacovigilance Center, Puglia Region, Italy
| | | | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
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Bianchi FP, Stefanizzi P, Diella G, Martinelli A, Di Lorenzo A, Gallone MS, Tafuri S. Prevalence and management of rubella susceptibility in healthcare workers in Italy: A systematic review and meta-analysis. Vaccine X 2022; 12:100195. [PMID: 36032697 PMCID: PMC9399279 DOI: 10.1016/j.jvacx.2022.100195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/18/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction In the pre-vaccination era, all adults acquired immunity status due to natural infections during childhood and adolescence, whereas universal mass vaccination has changed the seroepidemiology of rubella among adults, showing lack of immunity in some subgroups. National and international guidelines recommend evaluating all healthcare workers (HCWs) for their immune status to rubella and possibly vaccinating those who are seronegative. We conducted a systematic review and meta-analysis to estimate the susceptibility rate to rubella among HCWs in Italy and to explore possible options for the management of those found to be susceptible. Methods Eight studies were included in the meta-analysis, selected from scientific papers available in the MEDLINE/PubMed and Google Scholar (till page 10) databases between January 1, 2015 and November 30, 2021. The following terms were used for the search strategy: (sero* OR seroprevalence OR prevalence OR susceptibilit* OR immunit* OR immunogenict*) AND (healthcare worker* OR health personnel OR physician* OR nurse OR student*) AND (rubella OR german measles OR TORCH) AND (Italy) Results The prevalence of rubella-susceptible HCWs was 9.0 % (95 %CI: 6.4–12.1 %). In a comparison of female vs. male serosusceptible HCWs, the RR was 0.67 (95 %CI = 0.51–0.88). Occupational medicine examinations for rubella screening with possible subsequent vaccination of seronegatives and exclusion of susceptible HCWs from high-risk settings were common management strategies. Conclusions HCWs susceptible to rubella are an important epidemiological concern in Italy, and efforts to identify and actively offer the vaccine to this population should be increased.
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Mele F, Tafuri S, Stefanizzi P, D Amati A, Calvano M, Leonardelli M, Macorano E, Duma S, De Gabriele G, Introna F, De Donno A. Cerebral venous sinus thrombosis after COVID-19 vaccination and congenital deficiency of coagulation factors: Is there a correlation? Hum Vaccin Immunother 2022; 18:2095166. [PMID: 35895937 DOI: 10.1080/21645515.2022.2095166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
In January 2020, SARS-COV-2 infection spread worldwide and was declared "pandemic" by WHO. Because of the high contagiousness of the virus and devastating effects of the epidemic on public health, numerous efforts have been made to develop suitable vaccines to prevent the infection. Among the side effects developed by patients who undergone vaccination, there are common symptoms but also more serious reactions such as the thrombosis syndromes. This paper presents two cases of thrombosis temporally associated with live-vectored Covid vaccination similar to vaccine-induced thrombocytopenia (VITT) in patients with inherited thrombophilia (respectively, the deficiency of protein S and a Factor II mutation). The clinical manifestation caused by VITT is characterized by widespread thrombosis especially affecting intracranial venous sinus, which may cause massive bleeding and intracranial hemorrhage. Although this condition is widely described in literature, there is no evident correlation between this side effect and inherited condition of thrombophilia. The authors suggest that the presence of inherited thrombophilia should be better investigated and, if necessary, screened during the anamnestic data collection before the vaccine administration, leading the healthcare professional to choose the appropriate vaccine to the patient.
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Affiliation(s)
- Federica Mele
- Department of Interdisciplinary Medicine, Section of Legal Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Antonio D Amati
- Department of Emergency and Organ Transplantation, Section of Pathology, Aldo Moro University of Bari, Bari, Italy
| | - Mariagrazia Calvano
- Department of Interdisciplinary Medicine, Section of Legal Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Mirko Leonardelli
- Department of Interdisciplinary Medicine, Section of Legal Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Enrica Macorano
- Department of Interdisciplinary Medicine, Section of Legal Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Stefano Duma
- Department of Interdisciplinary Medicine, Section of Legal Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Giovanni De Gabriele
- Department of Interdisciplinary Medicine, Section of Legal Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Francesco Introna
- Department of Interdisciplinary Medicine, Section of Legal Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Antonio De Donno
- Department of Interdisciplinary Medicine, Section of Legal Medicine, Aldo Moro University of Bari, Bari, Italy
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Moscara L, Tafuri S, Gagliardi D, Stefanizzi P. Immunogenicity and safety of BNT162b2 mRNA COVID-19 vaccine in a subject affected by Shapiro's syndrome: A case report. Hum Vaccin Immunother 2022; 18:2094148. [PMID: 35763557 DOI: 10.1080/21645515.2022.2094148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Shapiro's syndrome (SS) is a rare neurological disorder characterized by spontaneous periodic hypothermia and hyperhidrosis without identifiable systemic causes or brain injuries. We present the case of F. a young patient, without agenesis of the corpus callosum and with episodes of recurrent hypothermia, who was successfully immunized against SARS-CoV-2 via vaccination. F. was born on 2012 and started suffering from episodes of hypothermia at the age of three, with body temperature reaching as low as 32.8°C Hypothermia episodes were initially associated with ibuprofen intake, but were later defined as symptoms of SS. No SARS-CoV-2 infections had been reported before vaccination. The subject received the first dose of pediatric formulation anti-SARS-CoV-2 Comirnaty vaccine on 11 January 2022 and the second dose on 5 February 2022. A one-week follow-up for adverse events was performed via telephone contact after both administrations. Further contact occurred one month after immunization. Anti-SARS-CoV-2 IgG titers were evaluated fifteen days after administration of the second dose. Following vaccination, slight fluctuations in body temperature and local adverse events were noted. These adverse events were not worrying; the vaccine's safety profile is therefore confirmed. The child also developed an excellent antibody titer (>28x103 AU/ml), thus suggesting a good immune response.
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Affiliation(s)
- Lorenza Moscara
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Delio Gagliardi
- Neurology Unit, Children Hospital "Giovanni XXIII", Bari Policlinico University Hospital, Bari, Italy
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
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Stefanizzi P, Tafuri S, Bianchi FP. Immunogenicity of third dose of anti-SARS-CoV-2 vaccine co-administered with influenza vaccine: An open question. Hum Vaccin Immunother 2022; 18:2094653. [PMID: 35820047 DOI: 10.1080/21645515.2022.2094653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
In October 2021, the Italian Ministry of Health has planned the offer of a booster dose of anti-SARS-CoV-2 vaccine for healthcare workers (HCWs), recommending the simultaneous administration of the third anti-SARS-CoV-2 dose and the influenza vaccine. The immunogenicity and serological response of co-administration are questioned. This is a retrospective cohort pilot study. We evaluated in a sample of HCWs the serological response 1 month after the administration of the third dose, comparing it between subjects who chose for co-administration (Cominarty+Flucelvax) and subjects who preferred the administration of the anti-SARS-CoV-2 vaccine. The study population comprised 20 HCWs, 9 (45.0%) chose co-administration (Group 1), and 11 (55.0%) preferred the administration of the COVID-19 vaccine alone (Group 2). A statistical significant difference of the variation of IgG anti-spike-protein antibodies between the serological evaluation at 1 month after the third dose and the serological evaluation 1 month after the basal routine with Comirnaty between Group 1 (-4,842.9; 95%CI = -15,799.2-6,113.2) and Group 2 (9,258.9; 95%CI = 1,081.0-17,435.9; p-value = 0.029) was reported. New scientific evidences are necessary to clarify this critical issue to guarantee both the best immunogenicity of COVID-19 vaccination and an high vaccine coverage for influenza vaccination.
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Affiliation(s)
- Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
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Lattanzio S, Stefanizzi P, D’ambrosio M, Cuscianna E, Riformato G, Migliore G, Tafuri S, Bianchi FP. Waste Management and the Perspective of a Green Hospital-A Systematic Narrative Review. Int J Environ Res Public Health 2022; 19:ijerph192315812. [PMID: 36497884 PMCID: PMC9738387 DOI: 10.3390/ijerph192315812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 11/17/2022] [Accepted: 11/25/2022] [Indexed: 05/20/2023]
Abstract
The concept of a "green hospital" is used in reference to a hospital that includes the environment as part of its quality services and one that pays attention to the sustainable design of buildings. Waste disposal represents a potential risk for the environment; therefore, waste collection from healthcare centers is a key environmental issue. Our study aims to systematically review the experiences acquired in worldwide nosocomial settings related to the management of healthcare waste. Nineteen studies, selected between January 2020 and April 2022 on Scopus, MEDLINE/PubMed and Web of Science databases were included in our systematic narrative review. Operating room and hemodialysis activities seem to be the procedures most associated with waste production. To deal with waste production, the 5Rs rule (reduce, reuse, recycle, rethink and research) was a common suggested strategy to derive the maximum practical benefit while generating the minimum amount of waste. In this context, the COVID-19 pandemic slowed down the greening process of nosocomial environments. Waste management requires a multifactorial approach to deal with medical waste management, even considering the climate change that the world is experiencing. Education of health personnel and managers, regulation by governmental institutions, creation of an "environmental greening team", and awareness of stakeholders and policymakers are some of the measures needed for the greening of healthcare facilities.
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Affiliation(s)
- Sabrina Lattanzio
- Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Marilena D’ambrosio
- Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Eustachio Cuscianna
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Giacomo Riformato
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | | | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
- Correspondence: ; Tel.: +39-80-5478473; Fax: +39-80-5478472
| | - Francesco Paolo Bianchi
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
- Bari Policlinico University Hospital, 70124 Bari, Italy
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Tomietto M, Comparcini D, Simonetti V, Papappicco CAM, Stefanizzi P, Mercuri M, Cicolini G. Attitudes toward COVID-19 vaccination in the nursing profession: validation of the Italian version of the VAX scale and descriptive study. Ann Ig 2022; 34:572-584. [PMID: 35142334 DOI: 10.7416/ai.2022.2502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
FOREWARD Nurses' attitudes towards COVID-19 vaccination is a relevant issue, for the protection of the vulnerable people they care for, and the key role they play in promoting health behaviors that encourage trust and adherence to vaccination among population. This study aimed to validate the Italian version of the Vaccination Attitudes Examination (VAX) scale and to describe nurses' attitudes towards COVID-19 vaccination. DESIGN A cross-sectional study was carried out from May to June 2021. Descriptive statistics, Explorative and Confirmatory Factor Analyses have been performed. METHODS An online survey was carried out in Italy. The VAX scale referring to the COVID-19 vaccine was used. FINDINGS 430 nurses participated in the study, mainly female (73.2%). Mean age was 40.2 years. VAX scale revealed an optimal reliability; Exploratory Factor Analysis and Confirmatory Analysis supported a 4-factors model. VAX scale mean scores showed low mistrust about vaccine's benefit (2.03±1.07), concerns about commercial profiteering (2.33±1.39) and preference for natural immunity (2.90±1.37). More worries concerning unexpected future effects were found (4.46±1.36). Gender, taking care of a frail person in family, having children or working in a COVID-19 setting are no significantly related to vaccination attitude. Participants from northern Italy expressed greater confidence in vaccine's benefits, the younger had significant lower scores about commercial profiteering. CONCLUSIONS The Italian version of the VAX scale resulted a reliable tool to assess the nurses' attitudes towards COVID-19 vaccination. An overall positive nurses' attitude towards the COVID-19 vaccination was highlighted. The concern about unforeseen future effects suggested the need to increase the information on this issue. CLINICAL RELEVANCE The results provided a valid and reliable tool to measure vaccination attitudes in the Italian context. This study could strengthen the health policies with educational interventions of healthcare workers through specific vaccination pathways. The healthcare professionals' vaccination attitudes play the key role also in promoting vaccination uptake in the population.
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Affiliation(s)
- M Tomietto
- Full Professor, Department of Nursing, Midwifery and Health, Faculty of Health Sciences, Northumbria University, New-castle Upon Tyne, UK
| | - D Comparcini
- Ward Manager, Azienda Ospedaliera Universitaria "Ospedali Riuniti", Ancona, Italy
| | - V Simonetti
- Research Fellow, Department of Biomedical Science and Human Oncology, University "Aldo Moro" of Bari, Italy
| | - C A M Papappicco
- Department of Intensive Respiratory Care Unit, San Paolo Hospital of Bari, Italy
| | - P Stefanizzi
- Researcher, Department of Biomedical Science and Human Oncology, University "Aldo Moro" of Bari, Italy
| | - M Mercuri
- Nurse Director, Degree Course in Nursing of Ancona, Politecnica delle Marche University, Ancona, Italy
| | - G Cicolini
- Researcher, Department of Biomedical Science and Human Oncology, University "Aldo Moro" of Bari, Italy
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Bianchi FP, Stefanizzi P, Di Gioia MC, Brescia N, Lattanzio S, Tafuri S. How to deal with COVID-19 vaccine hesitancy in pregnant and breastfeeding women? A meta-analysis. Eur J Public Health 2022. [PMCID: PMC9594199 DOI: 10.1093/eurpub/ckac129.665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Pregnant and breastfeeding women are at an increased risk of severe illness from COVID-19 compared to people who are not pregnant. Therefore, the CDC recommends COVID-19 vaccination for women who are pregnant, breastfeeding, and trying to become pregnant or who may become pregnant in the future. Despite this, low vaccination coverages are reported in this population sub-group. The purpose of this study is to estimate the proportion of pregnant and breastfeeding women expressing hesitation to the COVID-19 vaccine worldwide. Determinants of vaccine compliance and options suggestedto address vaccine hesitancy were also analyzed. Methods Forty-six studies were included in the meta-analysis and systematic review, selected from scientific articles available in the MEDLINE/PubMed, Google Scholar, and Scopus databases between January 1, 2020 and February 6, 2022. The following terms were used for the search strategy: (adherence OR hesitancy OR compliance OR attitude) AND (covid* OR SARS*) AND (vaccin* OR immun*) AND (pregnan* OR post-partum OR breastfeeding OR lactating). Results The vaccine hesitation rate was 48.4% (95%CI=43.4-53.4%). In a sub analysis by study period, the pooled prevalence of vaccine hesitation was 40.0% (95%CI=31.6-46.6%) considering surveys administered in 2020, 58.0% (95%CI=48.9-66.9%) considering surveys administered in the first semester of 2021, and 38.1% (95%CI=25.9-51.2%) considering surveys administered in the second semester of 2021. The main reasons for vaccine hesitation were lack of information about vaccination, opinion that the vaccine is unsafe, and fear of adverse events for both mother and fetus/child. Conclusions In order to achieve high vaccination coverage, a multifactorial approach is needed, requiring major social, scientific, and health efforts. The success of the vaccination campaign in this population depends on the capillarity and consistency of the interventions implemented. Key messages • Vaccine hesitancy can be a determining factor in the success (or otherwise) of the anti-COVID-19 immunization campaign. • Vaccine hesitancy in pregnant and breastfeeding women is a genuine public health concern worldwide.
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Affiliation(s)
- FP Bianchi
- Interdisciplinary Department of Medicine, University of Study of Bari , Bari, Italy
| | - P Stefanizzi
- Interdisciplinary Department of Medicine, University of Study of Bari , Bari, Italy
| | - MC Di Gioia
- Interdisciplinary Department of Medicine, University of Study of Bari , Bari, Italy
| | - N Brescia
- Interdisciplinary Department of Medicine, University of Study of Bari , Bari, Italy
| | - S Lattanzio
- Interdisciplinary Department of Medicine, University of Study of Bari , Bari, Italy
| | - S Tafuri
- Interdisciplinary Department of Medicine, University of Study of Bari , Bari, Italy
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Dellino M, Lamanna B, Vinciguerra M, Tafuri S, Stefanizzi P, Malvasi A, Di Vagno G, Cormio G, Loizzi V, Cazzato G, Tinelli R, Cicinelli E, Pinto V, Daniele A, Maiorano E, Resta L, De Vito D, Scacco S, Cascardi E. SARS-CoV-2 Vaccines and Adverse Effects in Gynecology and Obstetrics: The First Italian Retrospective Study. Int J Environ Res Public Health 2022; 19:ijerph192013167. [PMID: 36293746 PMCID: PMC9603573 DOI: 10.3390/ijerph192013167] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/03/2022] [Accepted: 10/11/2022] [Indexed: 05/15/2023]
Abstract
The most common effects reported by the Italian Medicine Agency following administration of SARS-CoV-2 vaccine are myalgia, soreness to the arm of inoculation, fever, and asthenia. To date, there are no specific and official reports registered by the Italian Medicine Agency on possible alterations of the menstrual cycle, or of the female reproductive system, following the vaccine. Actually, clinical experience showed a spread of transient adverse drug reactions of the menstrual cycle, following the administration of all COVID-19 vaccine types, both mRNA and Adenovirus vectored ones. In this work, we conducted the first retrospective study on Italian patients vaccinated for SARS-CoV-2 in the period between April 2021 and April 2022, to report the onset of menstrual changes after the vaccine in order to understand: etiology, duration of possible adverse effects, and the extent of the phenomenon. We recruited 100 women aged 18-45, vaccinated for SARS-CoV-2, who were asked to complete a questionnaire consisting of 12 multiple choice questions about the effects of the vaccine on the reproductive system. Thirty-seven of them received three doses of the vaccine, while the remaining 63 received two doses. Symptoms such as delayed menstruation and abnormal uterine bleeding (metrorrhagia, menometrorrhagia, and menorrhagia) were generally reported within the first three weeks of vaccination, especially after the second dose, with a percentage of 23% and 77%, respectively. These preliminary data suggest that this problem may be broader and deserving of further investigation in the future.
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Affiliation(s)
- Miriam Dellino
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
- Clinic of Obstetrics and Gynecology, “San Paolo” Hospital, ASL Bari, 70132 Bari, Italy
| | - Bruno Lamanna
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
- Fetal Medicine Research Institute, King’s College Hospital, London SE5 9RS, UK
| | - Marina Vinciguerra
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
| | - Silvio Tafuri
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
| | - Pasquale Stefanizzi
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
| | - Antonio Malvasi
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
| | - Giovanni Di Vagno
- Clinic of Obstetrics and Gynecology, “San Paolo” Hospital, ASL Bari, 70132 Bari, Italy
| | - Gennaro Cormio
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
| | - Vera Loizzi
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
| | - Gerardo Cazzato
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
- Department of Emergency and Organ Transplantation, Pathology Section, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Raffaele Tinelli
- Department of Obstetrics and Gynecology, “Valle d’Itria” Hospital, 74015 Martina Franca, Italy
| | - Ettore Cicinelli
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
| | - Vincenzo Pinto
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
| | - Antonella Daniele
- Experimental Oncology, Center for Study of Heredo-Familial Tumors, IRCCS Istituto Tumori “Giovanni Paolo II” Bari, 70124 Bari, Italy
| | - Eugenio Maiorano
- Department of Emergency and Organ Transplantation, Pathology Section, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Leonardo Resta
- Department of Emergency and Organ Transplantation, Pathology Section, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Danila De Vito
- Department of Basic Medical Sciences and Neurosciences, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Salvatore Scacco
- Department of Basic Medical Sciences and Neurosciences, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy
- Correspondence: (S.S.); (E.C.)
| | - Eliano Cascardi
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
- Pathology Unit, FPO-IRCCS Candiolo Cancer Institute, Str. Provinciale 142 km 3.95, 10060 Candiolo, Italy
- Correspondence: (S.S.); (E.C.)
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Bianchi FP, Stefanizzi P, De Maria L, Martinelli A, Diella G, Larocca AMV, Vimercati L, Tafuri S. Vaccination Offer during the Occupational Health Surveillance Program for Healthcare Workers and Suitability to Work: An Italian Retrospective Cohort Study. Vaccines (Basel) 2022; 10:vaccines10101633. [PMID: 36298499 PMCID: PMC9610769 DOI: 10.3390/vaccines10101633] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
The active immunization of health care workers (HCWs) is a crucial measure to avoid nosocomial infection; nevertheless, vaccine coverage (VC) among health personnel in Italy is unsatisfactory. To improve VC in the healthcare set, the Hygiene and Occupational Medicine departments of Bari Policlinico General University Hospital applied a specific program. The operative procedure demands that in the context of the occupational medical examination, all workers are evaluated for susceptibility to vaccine-preventable diseases (VDPs), with immunization prophylaxis offered to those determined to be susceptible. This study analyzed data from workers who attended the biological risk assessment protocol from December 2017 to October 2021 (n = 1477), who were evaluated for the immune status for measles, mumps, rubella, and varicella. Among the enrolled subjects, non-protective antibody titers were higher for measles and mumps (13%), followed by rubella (11%) and varicella (8%). Appropriate vaccinations were offered to all susceptible HCWs, and HCWs were re-tested one month after immunization. The seroconversion rate after the administration of one or more booster dose(s) was over 80%. Overall, 2.5% of the subjects refused the offered vaccine(s); the main determinant of immunization compliance was younger age (aOR = 0.86; 95%CI = 0.80–0.92). Especially during the COVID-19 pandemic, VPDs may still present a hazard in nosocomial environment. Our experience suggests that, despite hospital procedures and dedicated human assets, satisfactory VC cannot be reached without the provision of federal regulations. Nevertheless, public health policymakers have to improve the promotion of vaccine prophylaxis and education to reach higher VC.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
| | - Luigi De Maria
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
| | - Andrea Martinelli
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
| | - Giusy Diella
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
| | | | - Luigi Vimercati
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
- Correspondence: ; Tel.: +39-80-5478473; Fax: +39-80-5478472
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Marrone M, Buongiorno L, Stellacci A, Cazzato G, Stefanizzi P, Tafuri S. COVID-19 Vaccination Policies: Ethical Issues and Responsibility. Vaccines (Basel) 2022; 10:vaccines10101602. [PMID: 36298467 PMCID: PMC9607585 DOI: 10.3390/vaccines10101602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/10/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
The World Health Organization (WHO) declared coronavirus 2 (SARS-CoV-2, COVID-19) a global pandemic on 11 March 2020. The emergence of the reliability of vaccines, the fear of possible vaccination-related side effects, and mass-media information created situations in which families and even health professionals developed hesitations regarding the need for vaccines, with a consequent decrease in vaccination coverage. This study discusses ethical issues and responsibility for the possible side effects of SARS-CoV-2 vaccination raised by vaccination policies.
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Affiliation(s)
- Maricla Marrone
- Section of Legal Medicine, Department of Interdisciplinary Medicine, Bari Policlinico Hospital, University of Bari, 70124 Bari, Italy
- Correspondence: (M.M.); (G.C.)
| | - Luigi Buongiorno
- Section of Legal Medicine, Department of Interdisciplinary Medicine, Bari Policlinico Hospital, University of Bari, 70124 Bari, Italy
| | - Alessandra Stellacci
- Section of Legal Medicine, Department of Interdisciplinary Medicine, Bari Policlinico Hospital, University of Bari, 70124 Bari, Italy
| | - Gerardo Cazzato
- Department of Emergency and Organ Transplantation, Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy
- Correspondence: (M.M.); (G.C.)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
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Tomietto M, Simonetti V, Comparcini D, Stefanizzi P, Cicolini G. A large cross-sectional survey of COVID-19 vaccination willingness amongst healthcare students and professionals: Reveals generational patterns. J Adv Nurs 2022; 78:2894-2903. [PMID: 35301774 PMCID: PMC9111790 DOI: 10.1111/jan.15222] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/24/2022] [Accepted: 02/13/2022] [Indexed: 12/24/2022]
Abstract
AIMS To determine coronavirus disease 2019 (COVID-19) vaccination hesitancy in healthcare professionals and healthcare students in Italy across four generations (baby boomers, generations X, Y and Z). DESIGN A cross-sectional descriptive study was performed through an online survey conducted from May to June 2021. The STROBE guidelines were adopted for reporting. METHODS Data were collected by initially sending a survey link to a convenience sample of healthcare professionals and students, which was followed by snowball sampling. The VAX scale was validated and adopted. An ANOVA was performed to detect differences in vaccine-hesitancy beliefs between the four generational groups. RESULTS The survey was completed by 1226 healthcare professionals and students. Worries about unforeseen future effects accounted for the higher vaccination hesitancy factor across generations. More positive attitudes towards COVID-19 vaccination were expressed by members of generation Z than by members of generation Y and baby boomers. Members of generation X had the highest vaccination hesitancy scores in the overall scale. CONCLUSION The results suggest that public health campaigns should take into account the generational differences in COVID-19 vaccination hesitancy to achieve higher levels of vaccine acceptance, including amongst healthcare professionals and students. IMPACT Vaccination is the most effective strategy to tackle the COVID-19 pandemic. The advice of health professionals strongly influences vaccination willingness in the general population. A consideration of the generational patterns in the COVID-19 vaccination hesitancy of healthcare workers and students may increase vaccination uptake in these populations, which in turn may lead to greater public acceptance of the vaccine.
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Affiliation(s)
- Marco Tomietto
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Valentina Simonetti
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Dania Comparcini
- Politecnica delle Marche University of Ancona, Ancona, Italy
- Azienda Ospedaliera Universitaria "Ospedali Riuniti" di Ancona, Ancona, Italy
| | - Pasquale Stefanizzi
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Giancarlo Cicolini
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
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Larocca AMV, Bianchi FP, Bozzi A, Tafuri S, Stefanizzi P, Germinario CA. Long-Term Immunogenicity of Inactivated and Oral Polio Vaccines: An Italian Retrospective Cohort Study. Vaccines (Basel) 2022; 10:vaccines10081329. [PMID: 36016217 PMCID: PMC9413249 DOI: 10.3390/vaccines10081329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/13/2022] [Accepted: 08/13/2022] [Indexed: 11/16/2022] Open
Abstract
Oral and inactivated poliovirus (PV) vaccines have contributed toward the global eradication of wild PV2 and PV3, as well as the elimination of PV1 in most countries. While the long-term (>5−10 years) persistence of protective antibodies in ≥80% of the population vaccinated with ≥3−4 doses of oral poliovirus vaccine (OPV) has been demonstrated, the duration of immunity in people vaccinated with the inactivated poliovirus vaccine (IPV) is still unclear. This study evaluated the seroprevalence of anti-PV neutralizing antibodies and the long-term immunogenicity conferred by OPV and IPV in a sample of medical students from the University of Bari (April 2014−October 2020). The levels of neutralizing PV1, PV2, and PV3 antibodies in blood samples taken during the assessments were evaluated. Neutralizing antibodies against PV1, PV2, and PV3 were present in >90% of the study participants, with rates of >99%, >98%, and ~92−99%, respectively. IPV resulted in a higher immunological response than OPV against PV3. Protective antibodies against all three viruses persisted for at least 18 years after administration of the last vaccine dose. Until PV1 is completely eradicated, maximum vigilance from public health institutions must be maintained.
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Affiliation(s)
| | - Francesco Paolo Bianchi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Anna Bozzi
- Hygiene Department, Bari Policlinico General Hospital, 70124 Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
- Correspondence: ; Tel.: +39-80-5478473; Fax: +39-80-5478472
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Cinzia Annatea Germinario
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
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Sgherza N, Curci P, Rizzi R, Dell’Olio G, Perfetto A, Battisti O, Pizzileo N, Strafella V, De Trizio G, Troiano T, Stefanizzi P, Tafuri S, Musto P. P-159: Effectiveness of anti-SARS-CoV-2 vaccine “booster” dose in patients with multiple myeloma. Clinical Lymphoma Myeloma and Leukemia 2022. [PMCID: PMC9403040 DOI: 10.1016/s2152-2650(22)00489-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Inchingolo AD, Malcangi G, Ceci S, Patano A, Corriero A, Vimercati L, Azzollini D, Marinelli G, Coloccia G, Piras F, Barile G, Settanni V, Mancini A, De Leonardis N, Garofoli G, Palmieri G, Isacco CG, Rapone B, Scardapane A, Curatoli L, Quaranta N, Ribezzi M, Massaro M, Jones M, Bordea IR, Tartaglia GM, Scarano A, Lorusso F, Macchia L, Larocca AMV, Aityan SK, Tafuri S, Stefanizzi P, Migliore G, Brienza N, Dipalma G, Favia G, Inchingolo F. Effectiveness of SARS-CoV-2 Vaccines for Short- and Long-Term Immunity: A General Overview for the Pandemic Contrast. Int J Mol Sci 2022; 23:ijms23158485. [PMID: 35955621 PMCID: PMC9369331 DOI: 10.3390/ijms23158485] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/22/2022] [Accepted: 07/27/2022] [Indexed: 11/22/2022] Open
Abstract
Background: The recent COVID-19 pandemic produced a significant increase in cases and an emergency state was induced worldwide. The current knowledge about the COVID-19 disease concerning diagnoses, patient tracking, the treatment protocol, and vaccines provides a consistent contribution for the primary prevention of the viral infection and decreasing the severity of the SARS-CoV-2 disease. The aim of the present investigation was to produce a general overview about the current findings for the COVID-19 disease, SARS-CoV-2 interaction mechanisms with the host, therapies and vaccines’ immunization findings. Methods: A literature overview was produced in order to evaluate the state-of-art in SARS-CoV-2 diagnoses, prognoses, therapies, and prevention. Results: Concerning to the interaction mechanisms with the host, the virus binds to target with its Spike proteins on its surface and uses it as an anchor. The Spike protein targets the ACE2 cell receptor and enters into the cells by using a special enzyme (TMPRSS2). Once the virion is quietly accommodated, it releases its RNA. Proteins and RNA are used in the Golgi apparatus to produce more viruses that are released. Concerning the therapies, different protocols have been developed in observance of the disease severity and comorbidity with a consistent reduction in the mortality rate. Currently, different vaccines are currently in phase IV but a remarkable difference in efficiency has been detected concerning the more recent SARS-CoV-2 variants. Conclusions: Among the many questions in this pandemic state, the one that recurs most is knowing why some people become more seriously ill than others who instead contract the infection as if it was a trivial flu. More studies are necessary to investigate the efficiency of the treatment protocols and vaccines for the more recent detected SARS-CoV-2 variant.
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Affiliation(s)
- Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Sabino Ceci
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Assunta Patano
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Alberto Corriero
- Unit of Anesthesia and Resuscitation, Department of Emergencies and Organ Transplantations, Aldo Moro University, 70121 Bari, Italy; (A.C.); (M.R.); (N.B.)
| | - Luigi Vimercati
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Daniela Azzollini
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Giovanni Coloccia
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Fabio Piras
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Giuseppe Barile
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Vito Settanni
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Nicole De Leonardis
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Grazia Garofoli
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Giulia Palmieri
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Ciro Gargiulo Isacco
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Arnaldo Scardapane
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Luigi Curatoli
- Department Neurosciences & Sensory Organs & Musculoskeletal System, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Nicola Quaranta
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
- Department Neurosciences & Sensory Organs & Musculoskeletal System, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Mario Ribezzi
- Unit of Anesthesia and Resuscitation, Department of Emergencies and Organ Transplantations, Aldo Moro University, 70121 Bari, Italy; (A.C.); (M.R.); (N.B.)
| | - Maria Massaro
- Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy;
| | - Megan Jones
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy;
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
- Correspondence: (F.L.); (F.I.); Tel.: +39-3282132586 (F.L.)
| | - Luigi Macchia
- Department of Emergency and Organ Transplantation (D.E.T.O.), University of Bari Aldo Moro, 70124 Bari, Italy;
| | - Angela Maria Vittoria Larocca
- Hygiene Complex Operating Unit, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Place Giulio Cesare 11 BARI CAP, 70124 Bari, Italy;
| | | | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, University of Bari, 70121 Bari, Italy;
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University Hospital of Bari, 70100 Bari, Italy; (P.S.); (G.M.)
| | - Giovanni Migliore
- Interdisciplinary Department of Medicine, University Hospital of Bari, 70100 Bari, Italy; (P.S.); (G.M.)
| | - Nicola Brienza
- Unit of Anesthesia and Resuscitation, Department of Emergencies and Organ Transplantations, Aldo Moro University, 70121 Bari, Italy; (A.C.); (M.R.); (N.B.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Gianfranco Favia
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
- Correspondence: (F.L.); (F.I.); Tel.: +39-3282132586 (F.L.)
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46
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Porru S, Monaco MGL, Spiteri G, Carta A, Pezzani MD, Lippi G, Gibellini D, Tacconelli E, Dalla Vecchia I, Sala E, Sansone E, De Palma G, Bonfanti C, Lombardo M, Terlenghi L, Pira E, Mansour I, Coggiola M, Ciocan C, Godono A, Tardon A, Rodriguez-Suarez MM, Fernandez-Tardon G, Jimeno-Demuth FJ, Castro-Delgado RV, Iglesias Cabo T, Scapellato ML, Liviero F, Moretto A, Mason P, Pavanello S, Volpin A, Vimercati L, Tafuri S, De Maria L, Sponselli S, Stefanizzi P, Caputi A, Gobba F, Modenese A, Casolari L, Garavini D, D’Elia C, Mariani S, Filon FL, Cegolon L, Negro C, Ronchese F, Rui F, De Michieli P, Murgia N, Dell’Omo M, Muzi G, Fiordi T, Gambelunghe A, Folletti I, Mates D, Calota VC, Neamtu A, Perseca O, Staicu CA, Voinoiu A, Fabiánová E, Bérešová J, Adamčáková ZK, Nedela R, Lesňáková A, Holčíková J, Boffetta P, Abedini M, Ditano G, Asafo SS, Visci G, Violante FS, Zunarelli C, Verlato G. SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers. Vaccines (Basel) 2022; 10:vaccines10081193. [PMID: 36016081 PMCID: PMC9415790 DOI: 10.3390/vaccines10081193] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 12/23/2022] Open
Abstract
Background: The research aimed to investigate the incidence of SARS-CoV-2 breakthrough infections and their determinants in a large European cohort of more than 60,000 health workers. Methods: A multicentric retrospective cohort study, involving 12 European centers, was carried out within the ORCHESTRA project, collecting data up to 18 November 2021 on fully vaccinated health workers. The cumulative incidence of SARS-CoV-2 breakthrough infections was investigated with its association with occupational and social–demographic characteristics (age, sex, job title, previous SARS-CoV-2 infection, antibody titer levels, and time from the vaccination course completion). Results: Among 64,172 health workers from 12 European health centers, 797 breakthrough infections were observed (cumulative incidence of 1.2%). The primary analysis using individual data on 8 out of 12 centers showed that age and previous infection significantly modified breakthrough infection rates. In the meta-analysis of aggregated data from all centers, previous SARS-CoV-2 infection and the standardized antibody titer were inversely related to the risk of breakthrough infection (p = 0.008 and p = 0.007, respectively). Conclusion: The inverse correlation of antibody titer with the risk of breakthrough infection supports the evidence that vaccination plays a primary role in infection prevention, especially in health workers. Cellular immunity, previous clinical conditions, and vaccination timing should be further investigated.
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Affiliation(s)
- Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (M.G.L.M.); (G.S.)
- Correspondence: ; Tel.: +39-0458124294
| | | | - Gianluca Spiteri
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (M.G.L.M.); (G.S.)
| | - Angela Carta
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (M.G.L.M.); (G.S.)
| | - Maria Diletta Pezzani
- Infectious Diseases Unit, University Hospital of Verona, 37134 Verona, Italy; (M.D.P.); (E.T.)
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
| | - Davide Gibellini
- Section of Microbiology, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
| | - Evelina Tacconelli
- Infectious Diseases Unit, University Hospital of Verona, 37134 Verona, Italy; (M.D.P.); (E.T.)
- Section of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
| | - Ilaria Dalla Vecchia
- Section of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
| | - Emma Sala
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, University Hospital ASST Spedali Civili, 25121 Brescia, Italy; (E.S.); (G.D.P.)
| | - Emanuele Sansone
- Unit of Occupational Health and Industrial Hygiene, Department of Medical Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy;
| | - Giuseppe De Palma
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, University Hospital ASST Spedali Civili, 25121 Brescia, Italy; (E.S.); (G.D.P.)
- Unit of Occupational Health and Industrial Hygiene, Department of Medical Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy;
| | - Carlo Bonfanti
- Department of Molecular and Translational Medicine, Institute of Microbiology, University of Brescia-ASST Spedali Civili, 25121 Brescia, Italy; (C.B.); (L.T.)
| | - Massimo Lombardo
- Chief Executive Office, ASST Spedali Civili di Brescia, 25121 Brescia, Italy;
| | - Luigina Terlenghi
- Department of Molecular and Translational Medicine, Institute of Microbiology, University of Brescia-ASST Spedali Civili, 25121 Brescia, Italy; (C.B.); (L.T.)
| | - Enrico Pira
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.P.); (I.M.); (C.C.); (A.G.)
- Occupational Medicine Unit, University Hospital Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy;
| | - Ihab Mansour
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.P.); (I.M.); (C.C.); (A.G.)
| | - Maurizio Coggiola
- Occupational Medicine Unit, University Hospital Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy;
| | - Catalina Ciocan
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.P.); (I.M.); (C.C.); (A.G.)
- Occupational Medicine Unit, University Hospital Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy;
| | - Alessandro Godono
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.P.); (I.M.); (C.C.); (A.G.)
| | - Adonina Tardon
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Marta-Maria Rodriguez-Suarez
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Guillermo Fernandez-Tardon
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Francisco-Jose Jimeno-Demuth
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Rafael-Vicente Castro-Delgado
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Tania Iglesias Cabo
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (M.L.S.); (F.L.); (A.M.); (P.M.); (S.P.)
- University Hospital of Padova, 35128 Padova, Italy;
| | - Filippo Liviero
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (M.L.S.); (F.L.); (A.M.); (P.M.); (S.P.)
- University Hospital of Padova, 35128 Padova, Italy;
| | - Angelo Moretto
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (M.L.S.); (F.L.); (A.M.); (P.M.); (S.P.)
- University Hospital of Padova, 35128 Padova, Italy;
| | - Paola Mason
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (M.L.S.); (F.L.); (A.M.); (P.M.); (S.P.)
- University Hospital of Padova, 35128 Padova, Italy;
| | - Sofia Pavanello
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (M.L.S.); (F.L.); (A.M.); (P.M.); (S.P.)
- University Hospital of Padova, 35128 Padova, Italy;
| | - Anna Volpin
- University Hospital of Padova, 35128 Padova, Italy;
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Luigi De Maria
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Stefania Sponselli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Antonio Caputi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41125 Modena, Italy; (F.G.); (A.M.)
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41125 Modena, Italy; (F.G.); (A.M.)
| | - Loretta Casolari
- Health Surveillance Service, University Hospital of Modena, 41125 Modena, Italy; (L.C.); (D.G.); (C.D.); (S.M.)
| | - Denise Garavini
- Health Surveillance Service, University Hospital of Modena, 41125 Modena, Italy; (L.C.); (D.G.); (C.D.); (S.M.)
| | - Cristiana D’Elia
- Health Surveillance Service, University Hospital of Modena, 41125 Modena, Italy; (L.C.); (D.G.); (C.D.); (S.M.)
| | - Stefania Mariani
- Health Surveillance Service, University Hospital of Modena, 41125 Modena, Italy; (L.C.); (D.G.); (C.D.); (S.M.)
| | - Francesca Larese Filon
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Luca Cegolon
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Corrado Negro
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Federico Ronchese
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Francesca Rui
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Paola De Michieli
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Nicola Murgia
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Marco Dell’Omo
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Giacomo Muzi
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Tiziana Fiordi
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Angela Gambelunghe
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Ilenia Folletti
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Dana Mates
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Violeta Claudia Calota
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Andra Neamtu
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Ovidiu Perseca
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Catalin Alexandru Staicu
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Angelica Voinoiu
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Eleonóra Fabiánová
- Occupational Health Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia;
| | - Jana Bérešová
- Epidemiology Health Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia;
| | - Zora Kľocová Adamčáková
- Health Promotion Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia;
| | - Roman Nedela
- Health Informatics Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia;
| | - Anna Lesňáková
- Infectology Clinic, Central Military Hospital, 03426 Ružomberok, Slovakia;
| | - Jana Holčíková
- Occupational Medicine Clinic, University Hospital, 83105 Bratislava, Slovakia;
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA
| | - Mahsa Abedini
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
| | - Giorgia Ditano
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
| | - Shuffield Seyram Asafo
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
| | - Giovanni Visci
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
| | - Francesco Saverio Violante
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
- IRCCS, Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
| | - Carlotta Zunarelli
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
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Bianchi FP, Stefanizzi P, Di Gioia MC, Brescia N, Lattanzio S, Tafuri S. COVID-19 vaccination hesitancy in pregnant and breastfeeding women and strategies to increase vaccination compliance: a systematic review and meta-analysis. Expert Rev Vaccines 2022; 21:1443-1454. [PMID: 35818804 DOI: 10.1080/14760584.2022.2100766] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Pregnant and breastfeeding women are at an increased risk of severe illness from COVID-19. Despite this, low vaccination coverages are reported in this population sub-group. AREAS COVERED The purpose of this study is to estimate the proportion of pregnant and breastfeeding women expressing hesitation to the COVID-19 vaccine worldwide. Forty-six studies were included in the meta-analysis and systematic review, selected from scientific articles available in the MEDLINE/PubMed, Google Scholar, and Scopus databases between January 1, 2020 and February 6, 2022. The vaccine hesitation rate among pregnant and breastfeeding women was 48.4% (95%CI= 43.4-53.4%). In a sub analysis by study period, it was 40.0% (95%CI=31.6-46.6%) considering surveys administered in 2020, 58.0% (95%CI=48.9-66.9%) considering surveys administered in the first semester of 2021, and 38.1% (95%CI=25.9-51.2%) considering surveys administered in the second semester of 2021. The main reasons for vaccine hesitation were lack of information about vaccination, opinion that the vaccine is unsafe, and fear of adverse events. EXPERT OPINION Available evidence in the literature has shown that fighting vaccine resistance is harsh and too slow as a process, considering the rapidity and unpredictability of a pandemic. Health education should be provided in order to improve the willingness of the community, especially for those with lower levels of education.
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Affiliation(s)
| | | | | | - Nazario Brescia
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari
| | - Sabrina Lattanzio
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari
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Bianchi FP, Stefanizzi P, Brescia N, Lattanzio S, Martinelli A, Tafuri S. COVID-19 vaccination hesitancy in Italian healthcare workers: a systematic review and meta-analysis. Expert Rev Vaccines 2022; 21:1289-1300. [PMID: 35757890 DOI: 10.1080/14760584.2022.2093723] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION As for other vaccines, vaccination hesitancy may be a determining factor in the success (or otherwise) of the COVID-19 immunization campaign in healthcare workers (HCWs). AREAS COVERED To estimate the proportion of HCWs in Italy who expressed COVID-19 vaccine hesitancy, we conducted a systematic review of the relevant literature and a meta-analysis. Determinants of vaccine compliance and options suggested by these studies to address vaccine hesitancy among HCWs were also analyzed. Seventeen studies were included in the meta-analysis and systematic review, selected from scientific articles available in the MEDLINE/PubMed, Google Scholar and Scopus databases between January 1, 2020 and January 25, 2022. The vaccine hesitancy rate among HCWs was 13.1% (95%CI: 6.9-20.9%). The vaccine hesitancy rate among HCWs investigated before and during the vaccination campaign was 18.2% (95%CI=12.8-24.2%) and 8.9% (95%CI=3.4-16.6%), respectively. That main reasons for vaccine hesitation were lack of information about vaccination, opinion that the vaccine is unsafe, and fear of adverse events. EXPERT OPINION Despite strategies to achieve a greater willingness to immunize in this category, mandatory vaccination appears to be one of the most important measures that can guarantee the protection of HCWs and the patients they care for.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Nazario Brescia
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Sabrina Lattanzio
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Andrea Martinelli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
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Bianchi FP, Stefanizzi P, Trerotoli P, Tafuri S. Sex and age as determinants of the seroprevalence of anti-measles IgG among European healthcare workers: A systematic review and meta-analysis. Vaccine 2022; 40:3127-3141. [PMID: 35491343 DOI: 10.1016/j.vaccine.2022.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/14/2022] [Accepted: 04/04/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The international literature shows good evidence of a significant rate of measles susceptibility among healthcare workers (HCWs). As such, they are an important public health issue. METHODS We conducted a systematic review and meta-analysis to estimate the prevalence of susceptible HCWs in EU/EEA countries and in the UK and to explore the characteristics (sex and age differences) and management of those found to be susceptible. RESULTS Nineteen studies were included in the meta-analysis. The prevalence of measles-susceptible HCWs was 13.3% (95 %CI: 10.0-17.0%). In a comparison of serosusceptible female vs. male HCWs, the RR was 0.92 (95 %CI = 0.83-1.03), and in a comparison of age classes (born after vs. before 1980) the RR was 2.78 (95 %CI = 2.20-3.50). The most recent studies proposed the mandatory vaccination of HCWs. DISCUSSION According to our meta-analysis, the prevalence of serosusceptible European HCWs is 13%; HCWs born in the post-vaccination era seem to be at higher risk. Healthcare professionals susceptible to measles are a serious epidemiological concern. Greater efforts should therefore be made to identify those who have yet to be vaccinated and actively encourage their vaccination.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - Paolo Trerotoli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy.
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Milano E, Ricciardi A, Casciaro R, Pallara E, De Vita E, Bavaro DF, Larocca AMV, Stefanizzi P, Tafuri S, Saracino A. Immunogenicity and safety of the BNT162b2 COVID-19 mRNA vaccine in PLWH: A monocentric study in Bari, Italy. J Med Virol 2022; 94:2230-2236. [PMID: 35106771 PMCID: PMC9015486 DOI: 10.1002/jmv.27629] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/21/2022] [Accepted: 01/22/2022] [Indexed: 11/06/2022]
Abstract
In March, people living with HIV infection (PLWH) were included in the risk category of fragile people for severe COVID-19 receiving priority access to vaccination with BNT162b2 vaccine. The aim of the study was to evaluate the immunogenicity and safety of the two doses regimen. The antibodies titer for severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) was evaluated after 21 days since the first administration (Time 1), 1 (Time 2), and 3 (Time 3) months post-vaccination. Information regarding virological and immunological conditions at baseline, previous SARS-CoV-2 state of infection, other immunodeficiencies, current antiretroviral therapy (ART), comorbidities, and severe adverse events (SAE) to vaccination was collected. Six hundred and ninety-seven patients were tested for quantitative anti-spike antibodies at Time 1, 577 patients had a second detection at Time 2, and 491 patients had the third detection. Baseline characteristics of the study population are reported in Table 1. At the time of vaccine administration, all patients were on ART (except one long-term nonprogressor); 632 (90.7%) patients had undetectable HIV-RNA; 12 (1.7%) patients were immunosuppressed due to chemotherapy or other immunosuppressive drugs; 345 (49.5%) patients had at least one COVID-19 related comorbidity and 155 (22.2%) had two or more comorbidities. No SAEs were reported. Final serological results are available for 694 patients after the first dose, 577 and 491 after the second and third ones, respectively; positive titer (values ≥ 50 AU/ml) was demonstrated in 653 (94.1%), 576 (99.8%), 484 (98.6%) patients, respectively. Only one patient was a nonresponder after completing vaccination, who was a newly diagnosed one for HIV infection. All vaccinations were well tolerated, with no SAEs. BNT162b2 mRNA vaccine was immunogenic and safe in PLWH.
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Affiliation(s)
- Eugenio Milano
- Clinic of Infectious DiseasesUniversity of BariBariItaly
| | | | | | | | - Elda De Vita
- Clinic of Infectious DiseasesUniversity of BariBariItaly
| | | | | | - Pasquale Stefanizzi
- Department of Biomedical Science, Human Oncology‐Hygiene SectionUniversity of BariBariItaly
| | - Silvio Tafuri
- Department of Biomedical Science, Human Oncology‐Hygiene SectionUniversity of BariBariItaly
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