Long time persistence of antibodies against Mumps in fully MMR immunized young adults: an Italian retrospective cohort study

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Resources for assessing parents’ vaccine hesitancy: a systematic review of the literature

Vaccine hesitancy (VH) is a complex and country-specific issue, responsible for the decreasing vaccination rate and subsequent spread of vaccine-preventable diseases. In literature, several questionnaires were developed to assess VH. The aim of this systematic review was to evaluate the published questionnaires assessing parental VH. The search was conducted in PubMed/Medline, Web of Science and The Cochrane Library, in December 2017, following the PRISMA guidelines. The search strategy included 4 types of keywords: parents, vaccine hesitancy/acceptance, immunization and survey. Only English and Italian original papers were included. 17 reviewers independently screened titles and abstracts. Only the included articles were downloaded in full and, after a second screening, data were extracted and recorded in an ad hoc spreadsheet. A total of 5,139 articles were retrieved, after duplicates elimination 3,508 papers were screened. After a screening selection, 334 studies were included in the analysis. Most studies were cross-sectional (92.8%), followed by case-control (4.8%) and cohort studies (2.4%). The population interviewed was mainly parents, without any further details (73.1%); mothers were the only parent surveyed in approximately 20% of the studies, while only 1 study involved selectively the fathers. The sample size ranged from 7 to 59,897. Only 38% of the included studies reported both the number and type of items used. Regarding the type, more than half consisted of closed questions, followed by Likert scales, while open-ended questions were used in 14.8% of the surveys. Frequently, the survey was conducted using a self-reported questionnaire or interview. The questionnaires were mostly administered on paper, while online forms were used in 20.1% of the cases. However, 80.2% of the questionnaires were not attached to the paper. HPV vaccine was the most frequently investigated (39.2%), followed by influenza (13.5%) and measles (10.8%). While 22.4% of the articles referred to paediatrics vaccinations in general. Data about the immunization behaviours were reported in 294 studies: the subjects involved showed a behaviour defined as “acceptance” in 129 studies (38.6%), as “hesitancy/scepticism/doubt” in 145 studies (43.1%) and as “refusal” in 22 studies (6.6%). This information was not reported in 12% of the studies. VH is still a public health challenge, as confirmed by the high number of studies and questionnaires retrieved. This study offers a deeper perspec- tive on the available questionnaires, helping to identify the best one in terms of aim and study setting.     &nbsp

Long term immunogenicity of anti-measles vaccine: a study among students of a South Italy University

Long term immunogenicity is an important issue in the evaluation of vaccination strategies. According to international guidelines, long term immunogenicity of anti-measles vaccine is not well studied. In this perspective, we experimented a management strategy for subject yet immunized and seronegativ

Vaccination coverage in patients affected by chronic diseases: A 2014 cross-sectional study among subjects hospitalized at Bari Policlinico General Hospital. Am J Infect Control

Subjects affected by at least 1 chronic disease are the target of influenza vaccination strategies because they are at high risk of influenza complications or death. The aim of this cross-sectional study is to evaluate flu and pneumococcal vaccination coverage (VC) in a sample of patients hospitalized at Bari Policlinico General Hospital (South Italy). According to national public health guidelines, these patients should have been vaccinated at hospital discharge by general practitioners. There were 540 patients involved in the study, and the average age was of 46.9 ± 13.4 years (range, 0-64 years). We assessed the vaccination status of 412 of 540 (76.3%) patients. The overall VC was 22.8% (94/412) for influenza and 7.2% (30/412) for pneumococcal vaccine. Doctor recommendation has a pivotal importance in vaccine acceptance, and recent experiences seem to show a high efficacy of the vaccination offer during hospitalization. This model could be helpful to improve influenza and pneumococcal vaccination offers to patient with underlying chronic conditions. © 2018 Association for Professionals in Infection Control and Epidemiology, Inc

Influenza vaccination coverage among splenectomized patients: an Italian study on the role of active recall in the vaccination compliance

Patients with anatomical or functional hypo-/a-splenia have a 10- to 50-fold higher risk of developing severe infectious diseases than does the general population. Thus, it is recommended to adhere to a specific vaccination schedule, including receiving influenza vaccine. During 2014, Bari Policlinico General Hospital approved a specific protocol to ensure that vaccines are actively offered to all splenectomized patients during their hospitalizations. The aim of this study is to evaluate the efficacy of this active recall protocol for performing influenza vaccination in the years following splenectomy among patients still involved in a specific vaccination program carried out by the hospital’s Hygiene department. From May 2014 to October 2016, 96 patients were involved in the vaccination program of the Hygiene department. In November 2017, 46/96 (48%) of patients received a specific invitation by phone to receive the annual influenza vaccine (intervention group), while 50/96 (52%) did not receive any such invitation (control group). At the end of the 2017 influenza season, 73/96 (76%; 95%CI = 66–84%) of patients reported having received the influenza vaccine; no differences were observed in the extent of vaccine coverage between the groups (intervention group = 80% vs. control group = 72%; p = 0.33). Older age, more recent splenectomy, hemo-lymphopathy and receiving the previous years’ doses of influenza vaccine are associated with receiving influenza vaccination during the 2017 season. These data indicate how effective communication at the time of the vaccine counseling results in good adherence to the vaccination program even after several years. Indeed, vaccination should be an opportunity not only limited to the administration of the vaccine but also for providing patient care

Vaccination coverage in patients affected by chronic diseases: A 2014 cross-sectional study among subjects hospitalized at Bari Policlinico General Hospital

Subjects affected by at least 1 chronic disease are the target of influenza vaccination strategies because they are at high risk of influenza complications or death. The aim of this cross-sectional study is to evaluate flu and pneumococcal vaccination coverage (VC) in a sample of patients hospitalized at Bari Policlinico General Hospital (South Italy). According to national public health guidelines, these patients should have been vaccinated at hospital discharge by general practitioners. There were 540 patients involved in the study, and the average age was of 46.9 ± 13.4 years (range, 0-64 years). We assessed the vaccination status of 412 of 540 (76.3%) patients. The overall VC was 22.8% (94/412) for influenza and 7.2% (30/412) for pneumococcal vaccine. Doctor recommendation has a pivotal importance in vaccine acceptance, and recent experiences seem to show a high efficacy of the vaccination offer during hospitalization. This model could be helpful to improve influenza and pneumococcal vaccination offers to patient with underlying chronic conditions

Long-term immunogenicity after measles vaccine vs. wild infection: an Italian retrospective cohort study

The persistence of specific IgG after measles infection and after measles vaccination has not been sufficiently investigated. Current evidence suggests that immunity after the disease is life-long, whereas the response after two doses of measles-containing vaccine declines within 10–15 years. This study evaluated the proportion of individuals with detectable anti-measles IgG in two groups, those vaccinated with two doses of anti-MMR vaccine and those with a self-reported history of measles infection. Among the 611 students and residents who were tested, 94 (15%) had no detectable protective anti-measles IgG. This proportion was higher among vaccinated individuals (20%; GMT = 92.2) than among those with a self-reported history of measles (6%; GMT = 213.3; p < .0001). After one or two MMR vaccine booster doses, the overall seroconversion rate was 92%. An important proportion of people immunized for measles did not have a protective IgG titer in the years after vaccination, but among those who had a natural infection the rate was three-fold lower. This finding should be considered in the pre-elimination phase, given the resurgence of measles cases among individuals who after being vaccinated lost their circulating IgG after several years, especially if they failed to receive a natural booster

Influenza vaccination in healthcare workers: An evaluation of an on-site vaccination strategy to increase vaccination uptake in HCWs of a South Italy Hospital

Despite the international recommendation and specific programs, and although the vaccination of Healthcare workers (HCWs) is considered the main measure to prevent nosocomial influenza, vaccination coverage (VC) among HCWs remains low. One of the most important barriers to vaccination uptake is the time required to attend a vaccination clinic. Centers for Disease Control and Prevention (CDC) recommends on-site influenza vaccination as a proven and cost-effective strategy that increases productivity, reduces overall absenteeism and prevents direct healthcare costs. In order to increase vaccine compliance in the HCWs, the Hygiene and the Occupational Medicine departments of Bari Policlinico General University-Hospital, in the 2017/18 influenza season, promoted an on-site vaccination program in 8 Operative Units (OUs). We investigated the influenza VC among HCWs of Bari Policlinico (n=3,397), comparing VC after implementation of the on-site strategy by the Hygiene department during the 2017/18 influenza season to VC in 2016/17 season. For 2017/18 season, we also compared VC in OUs target of on-site strategy with data from in 8 "control" Units (choose by simple random sampling) not included in the on-site offer. In the 2016/17 influenza season, 295/3,397 HCWs were vaccinated (VC: 8.7%) while in the 2017/18 season 482 HCWs (VC: 14.2%) received the vaccination. In OUs target of on-site vaccination, 71 HCWs (VC: 10.0%) were vaccinated in the 2016/17 season and 126 (18.0%) in the 2017/18 season, of which 101/126 (80.2%) were vaccinated in an on-site clinic. VC in OUs target of on-site vaccination increased between 2016/17 and 2017/18 seasons of 16.8±10.4% (range: 5.5-37.1), while the coverage in OUs of the control group increased of 1.6±2.2% (range: -1.7-4.5), with a significant difference (p&lt;0.05). Our study suggests that the offer of on-site vaccination during the 2017/18 season led to an increase of VC in HCWs compared to the classical vaccination clinic approach. The determinants of adhesion and not-adhesion must be analyzed in dept, to experiment, in the future, new good clinical practices to increase the vaccination coverage in HCWs

Immunity to rubella: an Italian retrospective cohort study

International guidelines recommend that healthcare workers (HCWs) have presumptive evidence of immunity to rubella and that susceptible HCWs and doubt cases receive two doses of the MMR vaccine. However, a small percentage of the fully immunized will remain unprotected against wild viruses. Moreover, protective levels of antibodies induced by the vaccine have been shown to decline over time, but a formal recommendation regarding the testing of immunized HCWs for the persistence of IgG against rubella is lacking

Health Sciences students’ immunization behavior: differences among Italian universities

The aim of this study was to evaluate the knowledge and attitude of Health Sciences students towards vaccinations, investigating the differences that may exist in different Italian Universitie