Attitudes of healthcare personnel towards vaccinations before and during the covid-19 pandemic

Vaccines constitute highly effective tools for controlling and eliminating vaccine-preventable diseases (VPDs) and are assessed to avert between two to three million deaths per year globally. Healthcare personnel (HCP) constitute a priority group for several vaccinations. However, studies indicate significant rates of vaccine hesitancy among them and, therefore, of acceptance of vaccination recommendations. This cross-sectional study was conducted in a university hospital in Southern Italy to assess the knowledge and attitudes of HCP about VPDs before and during the COVID-19 pandemic, estimate their intention to get vaccinated against COVID-19, and search for determinants that may influence their choice. A self-administered questionnaire was used. HCP improved their knowledge about VPDs and were more favorable to vaccinations in September\u2013December 2020 compared to January\u2013December 2019. Overall, 75% of respondents would get a COVID-19 vaccine. Our findings indicate a potential role of the ongoing COVID-19 pandemic on Italian HCP\u2019s knowledge and attitudes towards vaccines

Vaccination of health-care workers against influenza: Our obligation to protect patients

Nosocomial influenza poses a threat for specific groups of patients and is associated not only with the disruption of health-care services but also excess costs. Although vaccination of health-care workers (HCWs) has been recommended for almost three decades and constitutes the most convenient and effective means to prevent nosocomial transmission, vaccine uptake within this group remains unacceptably low worldwide. In regard to the pandemic influenza A H1N1, HCWs constitute a priority group for immunization. Nevertheless, low vaccination rates have been documented regarding the influenza pandemic and associated with the onset of nosocomial cases and outbreaks. HCWs, health-care institutions, and public health bodies have the moral obligation to protect vulnerable patients and therefore weigh the benefits of mandatory vaccination. Key effective interventions, such as the education of HCWs concerning the benefits and safety of influenza vaccination, the reinforcement of on-site, free of charge vaccinations, and the use of mobile vaccination teams in conjunction with incentives, should be widely implemented. © 2011 Blackwell Publishing Ltd

Vaccination of pregnant women against influenza: what is the optimal timing?

Pregnant women and young infants are at increased risk for severe influenza and its complications. Influenza vaccination during pregnancy is increasingly implemented as a strategy aiming to protect the pregnant woman, the fetus and the young infant. In clinical practice, the achievement of satisfactory protection for the pregnant woman without compromising the protection of her infant during the first months of life remains a challenge. Determinants that are implicated in the optimal timing of influenza vaccination in pregnancy include influenza season, trimester of pregnancy, maternal host factors and infant factors. This article addresses influenza vaccination in pregnancy and presents recent published evidence on issues that affect the optimization of the timing of maternal vaccination. © 2021 Taylor & Francis Group, LLC

Nosocomial pertussis in neonatal units

Pertussis remains a public health concern in many countries despite high vaccination coverage rates. Nosocomial outbreaks of pertussis continue to occur in neonatal units. Neonates and young infants admitted to neonatal intensive care units constitute a pool of susceptible high-risk patients given their prematurity, inadequate immune response and the fact that they are too young to have completed their primary vaccination series against pertussis. This article reviews nosocomial pertussis in neonates and infants, focusing on the role of healthcare workers (HCWs). Outbreaks in neonatal units are often traced to HCWs and are associated with serious morbidity or even a fatal outcome among susceptible young infants. A high index of suspicion is required for early recognition and isolation of patients admitted with suspected or proven pertussis, as well as for HCWs with a compatible clinical syndrome, regardless of vaccination status. Contact investigation is also essential in order to guide administration of post-exposure prophylaxis. Recommendations for a booster vaccination for HCWs are in place in several countries; however, the need of HCWs for lifelong immunity against pertussis cannot be fulfilled by the current vaccine. © 2013 The Healthcare Infection Society

Post-COVID syndrome: An insight on its pathogenesis

Post-COVID syndrome is increasingly recognized as a new clinical entity in the context of SARS-CoV-2 infection. Symptoms persisting for more than three weeks after the diagnosis of COVID-19 characterize the post-COVID syndrome. Its incidence ranges from 10% to 35%, however, rates as high as 85% have been reported among patients with a history of hospitalization. Currently, there is no consensus on the classification of post-COVID syndrome. We reviewed the published information on post-COVID syndrome, putting emphasis on its pathogenesis. The pathogenesis of post-COVID syndrome is multi-factorial and more than one mechanism may be implicated in several clinical manifestations. Prolonged inflammation has a key role in its pathogenesis and may account for some neurological complications, cognitive dysfunction, and several other symptoms. A multisystem inflammatory syndrome in adults (MIS-A) of all ages has been also described recently, similarly to multisystem inflammatory syndrome in children (MIS-C). The post-infectious inflammatory pathogenetic mechanism of MIS-A is supported by the fact that its diagnosis is established through serology in up to one third of cases. Other pathogenetic mechanisms that are implicated in post-COVID syndrome include immune-mediated vascular dysfunction, thromboembolism, and nervous system dysfunction. Although the current data are indicating that the overwhelming majority of patients with post-COVID syndrome have a good prognosis, registries to actively follow them are needed in order to define the full clinical spectrum and its long-term outcome. A consensus-based classification of post-COVID syndrome is essential to guide clinical, diagnostic, and therapeutic management. Further research is also imperative to elucidate the pathogenesis of post-COVID syndrome. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

Antimicrobial resistance and the current refugee crisis

In the past few years, Europe has experienced an enormous influx of refugees and migrants owing to the ongoing civil war in Syria as well as conflicts, violence and instability in other Asian and African countries. Available data suggest that refugees carry a significant burden of multidrug-resistant (MDR) organisms, which is attributed to the rising antimicrobial resistance (AMR) rates in their countries of origin, both in healthcare settings and in the community. Transmission of MDR pathogens among refugees is facilitated by the collapsed housing, hygiene and healthcare infrastructures in several communities as well as poor hygiene conditions during their trip to destination countries. These findings highlight the fact that refugees may serve as vehicles of AMR mechanisms from their countries of origin along the immigration route. Following risk assessment, routine microbiological screening for MDR organism carriage of refugees and migrants as well as effective infection control measures should be considered upon admission. This will on the one hand address the possibility of dissemination of novel AMR mechanisms in non- or low-endemic countries and on the other will ensure safety for all patients. © 2017 International Society for Chemotherapy of Infection and Cance

Paediatric malaria in Greece in the era of global population mobility

We reviewed the medical records of children admitted because of malaria to four tertiary-care hospitals in Greece during 1972-2002. A total of 21 cases were found, including 20 (95.2%) diagnosed during 2003-2012. Sixteen (76.2%) children had been in a malaria-endemic country within a median of 50 days before the onset of their symptoms. Main causes of travel were immigration to Greece and to visit friends and relatives (VFRs). A considerable epidemiological shift of paediatric malaria occurred in Greece during the past decade, which is attributed almost exclusively to the increase of immigrants and travellers VFRs. © 2013 Elsevier Ltd. All rights reserved

Vaccination of healthcare personnel: Time to rethink the current situation in Europe

Vaccination of healthcare personnel (HCP) is a key measure for their protection but mainly for the protection of the susceptible patients from healthcare-associated transmission of vaccine-preventable diseases. Studies indicate that there are significant immunity gaps as well as suboptimal vaccination uptake rates among HCP across Europe. Despite the fact that all European countries have vaccination policies for HCP, there are significant variations among them in terms of recommended vaccines and implementation frameworks (recommended or mandatory). In an environment of increasing vaccine hesitancy, Italy has one of the highest rates of skepticism related to safety and effectiveness of vaccines. It is also one of the first European countries to address this issue in a comprehensive way, implementing mandatory vaccination policies for several vaccinations included in the routine vaccination program, but also for HCPs as a requirement for employment. © 2019 Future Medicine Ltd

Herpes zoster after vaccination with one dose varicella vaccine to a 4-year-old child

Clinical observations from the international literature report that herpes zoster occurs after varicella vaccination in immunocompetent children. We present the case of a four-year-old immunocompetent girl who developed herpes zoster after she had received one dose of varicella-zoster virus live attenuated vaccine at the age of 15 months. Continued surveillance for herpes zoster among vaccinated persons is important to evaluate the varicella vaccination program and to detect any changes in the epidemiology of herpes zoster. Vaccinated children appear to have a lower risk of herpes zoster than people who were infected naturally with varicella zoster virus (chickenpox). © 2019, EDIMES Edizioni Medico Scientifiche. All rights reserved