At the 58th congress of the Sir-Italian Society of Rheumatology there was much talk of prevention and the importance of vaccines, especially as a tool to combat highly prevalent diseases, morbidity and mortality, in particular in elderly or frail subjects with chronic diseases , such as rheumatology, or high-risk hospitalization. “Rheumatic diseases are diseases in which the development of infection is very frequent – explained Andrea Doria, Head of Rheumatology at the Padua hospital – which are among the leading causes of death in these patients; the rheumatologist must try to prevent them and vaccination is one of the most effective ways of preventing an infection “. The point on the new tools available for the protection of these patients was made during the symposium” The innovations in vaccination of the rheumatological patient beyond Covid “, created with the educational contribution of GlaxoSmithKline. The National Vaccine Prevention Plan 2017-2019, constitutes the reference document in which the reduction or elimination of the burden of preventable infectious diseases is recognized as a public health priority The PNPV, in addition to presenting the new National Calendar of vaccinations offered free of charge to the population by age group, contains chapters dedicated to vaccination interventions intended for particular categories at risk (by pathology, by occupational exposure, by occasional events) and identifies some priority areas for action. “There are classic vaccinations c like the flu or pneumococcal vaccines – continued Doria – but many other vaccinations are now required by doctors and the last one is Covid 19 recommended for all immunocompromised patients. Then also that against Herpes Zoster which is one of the most frequent infections among patients treated with some types of drugs widely used in rheumatology; then there are many other recommended vaccinations such as hepatitis B or meningococcal vaccination. ”And Herpes Zoster is one of the most risky and disabling diseases for frail patients. More commonly known as shingles, herpes zoster is the reactivation of the chickenpox virus that affects nerve structures. The virus after causing chickenpox can remain inactive in the nervous tissue for many years and then suddenly awaken. This usually leads to painful chickenpox-like rashes most frequently on only one side of the chest or abdomen, but can spread to other parts of the body as well. About 1 in 3 adults are at risk in their lifetime. The incidence and severity increase with age, with an increase after the age of 50, reaching 1 in 2 individuals over the age of 85. “We are going through a demographic transition, – explained Paolo Castiglia, coordinator of the vaccine center of the Aou di Sassari, Department of hygiene – thanks also to the successes in prevention and therapy, the population is aging, and therefore the risk conditions for infectious diseases are changing, for which the vaccinations that have been designed for the population frail children today are increasingly moving towards the adult population, so although the incidence remains predominant in childhood, the burden of pathology deriving from the elderly population is greater “. effective and safe through the vaccine. Vaccination has been available in Italy for several years and is included in the new National Prevention Plan vaccination included in the essential levels of assistance (Lea). It is free and recommended for people 65 years of age or individuals at risk, even if younger. To defend against this disease, a new weapon is now available: the new adjuvanted recombinant vaccine which in some regions is already available for fragile patients, such as rheumatology. “It is a new recombinant vaccine – continued Castiglia – and therefore does not have the limits that the vaccine available up to now live attenuated both for efficacy, but above all because it could not be indicated for the immunocompromised. Today we have a new weapon against Herpes Zoster for both immunocompromised and immunosenescents, therefore the elderly “. Many regions are taking action to make this novelty available to their citizens:” The Veneto Region – recalled Doria – has just published the news in the Official Gazette, the vaccine is available and can be used free of charge in all patients both in those over 50 and in immunocompromised people between 18 and 50. From this point of view, the Veneto Region is marking the road ”, he concluded.