Insights and expectations of healthcare professionals on the implementation of the updated pediatric regional immunization Calendar in Calabria, Italy

Abstract

The Regional Immunization Calendar in Calabria, a region of Italy, was updated in 2022, introducing optional co-administration of three injectable vaccines, with one oral vaccine, at 3 and 5 months old, and three injectable vaccines at 13–14 months old. In this project, the opinions and expectations of healthcare professionals (HCPs) in Calabria were investigated, with respect to the updated recommended practices. An 11-question survey was developed, which addressed concepts and topics related to immunization calendar implementation. Focus group discussions were also organized to provide further insight on the survey findings. A total of 132 HCPs completed the survey (86 public health providers [PHs] and 46 family pediatricians [FPs]). Overall, ≥50% of respondents agreed that vaccine co-administration would be advantageous for public health by reducing the number of vaccination sessions required. Most PHs and FPs agreed that dissemination of available safety data on vaccine co-administration is a necessary action to facilitate effective implementation of the strategy into clinical practice. The importance of safety data related to vaccine co-administration was supported further by discussions held in PH and FP focus groups. Overall, these findings demonstrate support from HCPs in Calabria for vaccine co-administration, and highlight key activities needed for successful uptake.

Available evidence on the co-administration of the four-component meningococcal B vaccine (4CMenB) with three vaccines at the same visit among pediatric individuals

“… 39 The feasibility of full co-administration of pediatric vaccines, as recommended by the NVPP 2023–2025, 14 was documented in the Local Health Unit of Reggio Calabria at an Italian Continued Medical Education seminar in April 2023. 40 Following the introduction of the option for full co-administration in the Calabria Immunization Calendar in April 2022, 15 the proportion of patients who had chosen for their child to receive full co-administration increased from 37.33% in May 2022 to 86.17% in March 2023. 40 Despite this, two surveys carried out among HCPs in Italy highlighted that the lack of information on vaccine co-administration provided in relevant data sheets is perceived as a key barrier to implementation, 15 , 16 although this may have been overcome by the subsequent updated NVPP 2023–2025 recommendations.…”

“… 2 A survey conducted in Calabria, Italy, in 2022, reported that the majority of healthcare professionals (HCPs) supported vaccine co-administration as an effective strategy to improve immunization calendars, as it can provide a range of benefits to healthcare systems and patients. 15 However, concerns were raised regarding the lack of readily available information on the safety of concomitant administration of multiple vaccines in pediatric populations, which could limit the implementation of coadministration strategies. 15 In particular, HCPs noted that limited safety data on co-administration of vaccines was often perceived as a key barrier, limiting its use in clinical practice.…”

“… 15 However, concerns were raised regarding the lack of readily available information on the safety of concomitant administration of multiple vaccines in pediatric populations, which could limit the implementation of coadministration strategies. 15 In particular, HCPs noted that limited safety data on co-administration of vaccines was often perceived as a key barrier, limiting its use in clinical practice. 15 Similar findings were also reported in 2022, in a survey carried out among Public Health Nurses.…”

“… 15 In particular, HCPs noted that limited safety data on co-administration of vaccines was often perceived as a key barrier, limiting its use in clinical practice. 15 Similar findings were also reported in 2022, in a survey carried out among Public Health Nurses. 16 An earlier study among HCPs had also reported hesitancy toward 4CMenB co-administration, owing to a lack of explicit guidance and information on the co-administration of pediatric vaccines.…”

“…Given the importance of available information on the safety of vaccine co-administration, highlighted in surveys of HCPs, 15 , 16 the objective of this narrative review was to assess the available literature reporting on the safety profile of co-administering 4CMenB with three vaccines (pneumococcal conjugate vaccine [PCV], hexavalent, and RV vaccines) at the same visit in pediatric populations aged 0–24 months.…”