Keywords
Vaccine coverage
Anti-flu vaccine
Abstract
Introduction. Adherence to vaccination program for Influenza virus is an important issue of Public Health in presence of many no-vaccine tendencies. The media event of some deaths after MF59 adjuvanted vaccine administration has characterized the season 2014/15 vaccination program in Italy. Aim of the study is vaccination adherence assessment of the current season with regards to local health units (LHU) responsibleâs perceptions in Lazio Region (IT).
Methods. LHU responsibleâs perceptions were collected from an informal questionnaire that was send via email to the all 12 LHU responsibles. The questionnaire was built with 4 questions concerning the impression about the vaccination adherence of elderly people in the current season. Data from questionnaire was compared with the official coverage rate obtained by the Regional Authority. Severe adverse events were collected by 1 LHU.
Results. Â All the 12 LHU responsibles answered to our questionnaire: 7/12 (50%) predicted a coverage rate of at least 50%; 3/12 (25%) referred a coverage rate around 40-45%; 2/12 (17%) predicted a reduction of 5-10% less than the previous season. Indeed, a mean 49.1% vaccination coverage in the elderly has been reported by the regional authority highlighting a reduction of 10% less than the 2013/14 season coverage. No severe adverse events were observed.
Discussion. In our survey an important effect of media event on anti-flu vaccination program adherence has been evidenced, with a failure in communication and joint management of Public Health Institutions in Italy about efficacy and safety information of flu vaccine. Â
References
Harper SA, Bradley JS, Englund JA, et al. Expert Panel of the Infectious Diseases
Society of America. Seasonal influenza in adults and children - diagnosis, treatment,
chemoprophylaxis, and institutional outbreak management: clinical practice guidelines of
the Infectious Diseases Society of America. Clin Infect Dis 2009;48(8):1003-1032.
Available from: http://cid.oxfordjournals.org/lookup/doi/10.1086/598513 doi:
1086/598513. [Google Scholar]
Thompson WW, Shay DK, Weintraub E, Brammer L, Bridges CB, Cox NJ, et al.
Influenza-associated hospitalizations in the United States.. JAMA 2004
Sep;292(11):1333-1340. Available from:
http://ClinicalTrials.gov/search/term=15367555%20%5BPUBMED-IDS%5D PubMed PMID: 15367555.
doi: 10.1001/jama.292.11.1333. [Google Scholar]
Prevention, f.D.C.a. (Centers) . Study Shows Flu Vaccination Prevents Hospitalizations
in Older Adults. Proceedings of . . Available from:
http://www.cdc.gov/flu/spotlights/flu-vaccination-older-adults.htm [Google Scholar]
Thompson WW, Shay DK, Weintraub E, Brammer L, Cox N, Anderson LJ, et al. Mortality
associated with influenza and respiratory syncytial virus in the United States.. JAMA 2003
Jan;289(2):179-186. Available from:
http://ClinicalTrials.gov/search/term=12517228%20%5BPUBMED-IDS%5D PubMed PMID: 12517228.
doi: 10.1001/jama.289.2.179. [Google Scholar]
World Health Organization (WHO) . Influenza (Seasonal). Proceedings of . . Available
from: http://www.who.int/mediacentre/factsheets/fs211/en/ [Google Scholar]
Epicentro , author. Influenza. Available at:
http://www.epicentro.iss.it/problemi/influenza/influenza.asp Accessed 02/07/2015.
Agenzia Italiana del Farmaco (AIFA) . Vaccino FLUAD. L'AIFA fa il punto della
situazione. Proceedings of . . Available from:
http://www.agenziafarmaco.gov.it/it/content/vaccino-fluad-laifa-fa-il-punto-della-
situazione-0 [Google Scholar]
Nicholson KG. Clinical features of influenza.. Semin Respir Infect 1992;7(1):26-37.
Available from: https://www.nlm.nih.gov/medlineplus/flu.html PubMed PMID: 1609165. [Google
Scholar]
European Centre for Disease Prevention and Control (ECDC) . . Proceedings of . .
PubMed PMID: 17868585. [Google Scholar]
Ho Y, Wang J, Wang J, Wu U, Chang C, Wu H, et al. Prognostic factors for fatal adult
influenza pneumonia. J Infect 2009;58(6):439-445. Available from:
https://www.nlm.nih.gov/medlineplus/flu.html PubMed PMID: 19386366. doi:
1016/j.jinf.2009.03.007. [Google Scholar]
Writing Committee of the WHO Consultation on Clinical Aspects of Pandemic [H1N1] 2009
Influenza , author . Clinical aspects of pandemic 2009 influenza A [H1N1] virus infection.
N Engl J Med 2010;362:1708. [Google Scholar]
Fiore AE, Fry A, Shay D, et al. Centers for Disease Control and Prevention [CDC],
author Antiviral agents for the treatment and chemoprophylaxis of influenza -
recommendations of the Advisory Committee on Immunization Practices [ACIP] MMWR Recomm
Rep. 2011;60:1–24.
McElhaney JE, Dutz JP. Better influenza vaccines for older people: what will it take.
J Infect Dis 2008;198(5):632-634. Available from:
http://jid.oxfordjournals.org/lookup/doi/10.1086/590435 doi: 10.1086/590435. [Google
Scholar]
Goodwin K, Viboud C, Simonsen L. Antibody response to influenza vaccination in the
elderly: a quantitative review.. Vaccine 2005 Sep;24(8):1159-1169. Available from:
https://www.nlm.nih.gov/medlineplus/immunization.html PubMed PMID: 16213065. doi:
1016/j.vaccine.2005.08.105. [Google Scholar]
Centers for Disease Control and Prevention (CDC) , author . Prevention and control of
seasonal influenza with vaccines. Recommendations of the Advisory Committee on
Immunization Practices - United States, 2013-2014. MMWR Recomm Rep 2013;62(RR-07):1-43.
Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6207a1.htm PubMed PMID:
[Google Scholar]
Ministero della Salute. Dipartimento della prevenzione e dell'innovazione. Prevenzione
e controllo dell'Influenza: raccomandazioni per la stagione 2014/2015. Available at:
http://www.trovanorme.salute.gov.it/norme/renderNormsanPdf;jsessionid=1uXoYPAYNa59k+
MzXMCu6g__.sgc3-prdsal?anno=0&codLeg=49871&parte=1%20&serie= Accessed 02/07/2015.
Agenzia Italiana del Farmaco (AIFA) , author. AIFA dispone il divieto di utilizzo per
due lotti del vaccino antinfluenzale FLUAD. Available at:
http://www.agenziafarmaco.gov.it/it/content/aifadispone-il-divieto-di-utilizzo-due-lotti-
del-vaccino-antinfluenzale-fluad-0 Accessed 02/07/2015.
Conferenza delle Regioni e delle Province autonome. Vaccini: Regione Lazio,
sospensione totale FLUAD. Available at:
http://www.regioni.it/dalleregioni/2014/11/28/vaccini-regione-laziosospensione-totale-
fluad-379080/ Accessed 02/07/2015.
Regione Lazio. Direzione regionale salute e integrazione socio sanitaria area politica
del farmaco. Ritiro cautelativo vaccino antinfluenzale FLUAD. Available at:
http://www.aslromab.it/campagna_promozione_salute_roma/docs/FLUR2014-2015/
Nota_Prot__n__664796_28nov14.pdf Accessed 02/07/2015.
European Medicines Agency (EMA) , author. No evidence that FLUAD vaccine caused deaths
in Italy. Available at:
http://www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/2014/12/
news_detail_002228.jsp&mid=WC0b01ac058004d5c1 Accessed 02/07/2015.
Agenzia Italiana del Farmaco (AIFA) , author. Vaccino FLUAD: negative le prime analisi
ISS su lotti bloccati dall'AIFA. Available at:
http://www.agenziafarmaco.gov.it/it/content/vaccino-fluad-negative-prime-analisi-iss-su-
lotti-bloccatidall%E2%80%99aifa Accessed 02/07/2015.
Istituto Superiore di Sanità (ISS). Vaccino FLUAD: Favorevole esito finale analisi
ISS. AIFA annuncia sblocco Lotti. Available at:
http://www.iss.it/pres/?lang=1&id=1482&tipo=6 Accessed 02/07/2015.
Regione Lazio. Decreto del Commissario ad Acta. Prolungamento del periodo di
svolgimento e disapplicazione della penalizzazione inerente la non utilizzazione dei
vaccini da parte del medico partecipante. Available at:
http://www.regione.lazio.it/binary/rl_sanita/tbl_normativa/
DCA_U00042_03_02_2015_Campagna_di_vaccinazione_antinfluenza_Prolungamento_del_periodo_di_s
volgimento.pdf Accessed 02/07/2015.
VaccinarSì. Il valore di vaccinarsi. Available at:
http://www.vaccinarsi.org/il-valore-di-vaccinarsi.html Accessed 02/07/2015.
Ministero della Salute. Piano Nazionale Prevenzione Vaccinale 2012/2014. Available at:
http://www.salute.gov.it/imgs/c_17_pubblicazioni_1721_allegato.pdf Accessed 02/07/2015.
Ministero della Salute. Vaccinazione antinfluenzale: coperture vaccinali. Available
at: http://www.salute.gov.it/imgs/C_17_pagineAree_679_listaFile_itemName_6_file.pdf
Accessed 02/07/2015.
World Health Organization (WHO) , author. Global manual on surveillance of adverse
events following immunization. Available at:
http://www.who.int/vaccine_safety/publications/aefi_surveillance/en/ Accessed 02/07/2015.
Signorelli C, Odone A, Conversano M, et al. Deaths after Fluad flu vaccine and the
epidemic of panic in Italy. BMJ 2015;350. [Google Scholar]