Invasive Meningococcal Disease in Italy: from the analysis of national data to an evidence-based vaccination strategy.

Igidbashian, Sarah; Bertizzolo, Lorenzo; Tognetto, Alessia; Azzari, Chiara; Bonanni, Paolo; Castiglia, Paolo; Conversano, Michele; Esposito, Susanna; Gabutti, Giovanni; Icardi, Giancarlo; Lopalco, Pier Luigi; Vitale, Francesco; Parisi, Salvatore; Lisi, Giovanni Checcucci

doi:10.15167/2421-4248/jpmh2020.61.2.1589

Cited by 9 publications

(10 citation statements)

References 41 publications

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“…There was also an increased proportion of IMD cases caused by serogroup Y (Germany and Canada) [ 33 , 34 ] and serogroup B and Y (Italy) [ 32 ]. Studies in Australia have also suggested that following the introduction of childhood vaccination against serogroup C, the proportion of notified cases in those aged > 65 years increased [ 35 ], whilst studies in the European Union (EU)/European Economic Area (EEA) [ 36 ] and Italy [ 37 ] also suggested that cases in older adults have increased. Taken together, this would suggest a need to utilise multivalent vaccines and increase vaccine coverage beyond paediatric age groups to counteract these trends.…”

Section: Introductionmentioning

confidence: 99%

Invasive meningococcal disease in older adults in North America and Europe: is this the time for action? A review of the literature

Guedes

Bertrand-Gerentes

Evans³

et al. 2022

BMC Public Health

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Background Neisseria meningitidis is an encapsulated Gram-negative diplococcus that asymptomatically colonises the upper respiratory tract in up to 25% of the population (mainly adolescents and young adults). Invasive meningococcal disease (IMD) caused by Neisseria meningitidis imposes a substantial public health burden,. The case fatality rate (CFR) of IMD remains high. IMD epidemiology varies markedly by region and over time, and there appears to be a shift in the epidemiology towards older adults. The objective of our review was to assess the published data on the epidemiology of IMD in older adults (those aged ≥ 55 years)in North America and Europe. Such information would assist decision-makers at national and international levels in developing future public health programmes for managing IMD. Methods A comprehensive literature review was undertaken on 11 August 2020 across three databases: EMBASE, Medline and BIOSIS. Papers were included if they met the following criteria: full paper written in the English language; included patients aged ≥ 56 years; were published between 1/1/2009 11/9/2020 and included patients with either suspected or confirmed IMD or infection with N. meningitidis in North America or Europe. Case studies/reports/series were eligible for inclusion if they included persons in the age range of interest. Animal studies and letters to editors were excluded. In addition, the websites of international and national organisations and societies were also checked for relevant information. Results There were 5,364 citations identified in total, of which 76 publications were included in this review. We identified that older adults with IMD were mainly affected by serogroups W and Y, which are generally not the predominant strains in circulation in most countries. Older adults had the highest CFRs, probably linked to underlying comorbidities and more atypical presentations hindering appropriate timely management. In addition, there was some evidence of a shift in the incidence of IMD from younger to older adults. Conclusions The use of meningococcal vaccines that include coverage against serogroups W and Y in immunization programs for older adults needs to be evaluated to inform health authorities’ decisions of the relative benefits of vaccination and the utility of expanding national immunization programmes to this age group.

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Section: Introductionmentioning

confidence: 99%

Invasive meningococcal disease in older adults in North America and Europe: is this the time for action? A review of the literature

Guedes

Bertrand-Gerentes

Evans³

et al. 2022

BMC Public Health

View full text Add to dashboard Cite

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“… 35 These regimens are applied immediately in the presence of clinical suspicion pending laboratory confirmation of the diagnosis. 35 Fortunately, the number of confirmed diagnoses of meningitis in Italy is low, 36 but prescriptions take place for all suspected cases and, in Italy, resistance to third-generation cephalosporins in the bacterial species under surveillance is among the highest in Europe. 37…”

Section: Discussionmentioning

confidence: 99%

“… 50–53 Risk for bacterial and fungal infections has been detected in overcrowded ICUs admitting critically-ill COVID-19 patients mechanically ventilated, and where secondary infections were found in 50.0% of deceased COVID-19 patients. 36 , 50 In addition, concerns were expressed that enormous work pressure on HCPs might relax adherence to hospitals’ antimicrobial stewardship policies. 54 On the other hand, the disruption of routine medical care could potentially lead to an overall reduction of antibiotics administration.…”

Section: Discussionmentioning

confidence: 99%

Survey among Italian experts on existing vaccines’ role in limiting antibiotic resistance

Marchetti

Prato

Viale

2021

Human Vaccines & Immunotherapeutics

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Antimicrobial resistance (AMR) is a major public health problem threatening to reverse the progress made against infectious diseases. The rapid increase of AMR exposes Italian hospitals at increased risk of untreatable infections. Vaccinations can potentially limit AMR by reducing the number of infected cases in need of antibiotics. We conducted a survey among Italian vaccine experts to record their opinion regarding the role of vaccinations against antibiotic resistance (ABR). Among 80 invited experts, 51 answered all questions. Most respondents were experts in hygiene and preventive medicine (56.9%) and aged >50 years (72.6%). ABR was a priority concern in the daily professional activity of 82.4% of respondents. Overall, 47.1% of respondents believed that all vaccinations included in the vaccination calendar played a role against ABR: 92.2% for pertussis vaccination followed by 88.2%, 74.5%, and 70.6% for meningococcus, measles, and varicella vaccinations, respectively. Almost all respondents agreed that the role of vaccinations against ABR should be clearly expressed in the national vaccination guidelines (96.1%) and Scientific Societies should take an explicit position on the issue (92.2%). These results show that Italian experts have recognized the vaccinations' potential role in limiting ABR and guidelines from the appropriate scientific and governmental authorities are needed.

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“…In these cases too, the high level of outrage leads to a demand for mass vaccination by the public, as soon as there is even a single episode, only to see the same public quickly lose their perception of the risk soon afterwards. This can be seen, for example, in the meningococcal vaccination coverage in adolescence recorded in Italy, which, despite its availability, continues to be very low, thereby confirming the poor compliance among the reference target [ 21 ]. This shows that, as with immunological memory with regard to SARS-CoV-2, the memory of scientific data also tends to decline over time due to emotional factors.…”

Section: Introductionmentioning

confidence: 99%

Knowledge and Behaviours towards Immunisation Programmes: Vaccine Hesitancy during the COVID-19 Pandemic Era

Dettori

Arghittu

Castiglia

2022

IJERPH

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Assessing knowledge, attitudes and behaviours towards vaccination is a key strategy when implementing national and international immunisation programmes aimed at improving compliance among the population and thereby increasing vaccination coverage. While vaccination’s role as a powerful life-saving weapon in the fight against infectious diseases has been further highlighted following the introduction of the Coronavirus Disease 2019 (COVID-19) vaccine, there is still a discrepancy between the scientific evidence on the effectiveness of vaccines and the perception of the risk attributed to them. Known as “Vaccine Hesitancy” (VH), this phenomenon is the delay in acceptance or refusal of vaccines, despite the availability of services. VH can be found in at least 15% of the worldwide population, and even professional groups tasked with promoting vaccination as a primary prevention measure, e.g., healthcare workers (HCWs), sometimes have doubts regarding vaccination. Since 2014, this Public Health problem has been increasing in 90% of countries worldwide, to the extent that in 2019 it was listed as one of the ten greatest threats to global health by the World Health Organization (WHO). VH has also affected COVID-19 vaccination, hampering the achievement of desired vaccination coverage. Monitoring this trend by studying people’s behaviour and attitudes could be a useful tool to aid Public Health, in orienting vaccination policies and designing new health education and continuous training interventions, aimed at both the general public and accountable cohorts, such as HCWs.

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Invasive Meningococcal Disease in Italy: from the analysis of national data to an evidence-based vaccination strategy.

Cited by 9 publications

References 41 publications

Invasive meningococcal disease in older adults in North America and Europe: is this the time for action? A review of the literature

Invasive meningococcal disease in older adults in North America and Europe: is this the time for action? A review of the literature

Survey among Italian experts on existing vaccines’ role in limiting antibiotic resistance

Knowledge and Behaviours towards Immunisation Programmes: Vaccine Hesitancy during the COVID-19 Pandemic Era

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