Covid-19, only 13% of fragile patients vaccinated

According to data collected by the ECDC (European Center for Disease Prevention and Control), Italy is among the European countries with the lowest vaccination coverage for Covid-19 among the people most at risk. In 2023, just over two million doses in total were administered: even assuming that they were all intended for the elderly and frail patients, coverage only reached around 13% – a value very far from the recommended threshold of 75%. “Although today fortunately the impact on the general population is less than in the past, the Covid-19 disease is still a serious problem for fragile people – he underlined Health Roberta Siliquini, president of the Italian Society of Hygiene, Preventive Medicine and Public Health (Sites) – In 2023 it was responsible for approximately 10 thousand deaths and 82 thousand hospital admissions, the majority in elderly subjects or with other frail conditions and not correctly vaccinated”. The shared document Siti-Simit (Italian Society of Infectious and Tropical Diseases) was born from the need to improve vaccination coverage in view of next autumn. “Proposals for urgent actions for the next Covid-19 vaccination campaign in Italy”to stimulate institutions and other stakeholders to take the necessary measures: from awareness messages aimed at the greater involvement and preparation of healthcare workers, up to the timely supply of multiple different vaccines to respond to different needs in the area.

The errors of the latest vaccination campaign

“Unfortunately, last year’s vaccination campaign for Covid-19 had very poor results – confirms Siliquini – What we need to do now is understand what didn’t work and make the necessary adjustments: only in this way will it be possible to truly protect fragile patients”. According to experts, the responsibilities for the failure of the 2023 campaign are many and at many levels. There were, for example, problems with vaccination hesitancy probably linked to communication errors which meant that the perception of risk was lowered to such an extent that even the most fragile people did not consider it necessary to vaccinate against Covid-19. The organization of the campaign was also not the best, according to Siliquini: “With a certain regional variability, on average we started late and the vaccine doses arrived further late. In practice, general practitioners’ clinics, which are the first site people turn to for seasonal vaccinations, had doses of the flu vaccine available between October and November but not those for Covid-19. Thus the possibility of co-administration in frail people – a practice which is strongly recommended – has disappeared and after the anti-flu vaccine many of those who would have benefited from it did not return to the clinic a second time to recover the anti-Covid vaccination” . Another problem encountered by experts is that in 2023 the supply of vaccines against Covid-19 remained essentially linked to a single type of product, while expanding the choice to the three options currently available (two mRNA vaccines and one protein) could help resolve situations linked to difficulties in managing the vaccines themselves or to particular patient needs.

The “5 urgent actions” to achieve 75% coverage

For Siti and Simit, the goal for next season is to reach 75% coverage for Covid-19, the same value desired for anti-flu coverage. Five urgent actions have been identified: the first is to define at a national level the targets, times and methods of carrying out the next COVID-19 vaccination campaign by May. Training, information and communication activities are then fundamental: “In our opinion, for the next vaccination campaign, messages will be needed specifically addressed to those who risk the most serious consequences of the Sars-Cov-2 infection, to avoid the perception of the risk is diluted again – specifies Siliquini – We also believe that it is necessary to involve other scientific societies more to increase the information and preparation of health workers, so that they are more effective in raising awareness of the categories at risk in order to increase adherence. Furthermore, it will be appropriate to modify the vaccination calendar included in the National Prevention Plan by adding vaccination against Covid-19, so as to make the offer explicit for the elderly and frail. Institutions are also invited to do their part, in particular by promptly procuring doses (from general practitioners, local and hospital vaccination clinics, pharmacies, RSA) for all three vaccines available in an equitable manner: their different characteristics, in fact, can offer solutions to problems of handling (some products are not supplied single-dose, or must be stored at -80°C, factors which affect availability in medical practices in the area) but also allow rational use in terms of appropriateness, to provide the most suitable vaccine for each individual patient.

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