Vaccination for adults, a new prevention plan is ready in Lombardy

With a new regional vaccine prevention plan validated by the Ministry of Health and adhering to the national guidelines set out in the 2020-2025 plan, the Lombardy Region is capitalizing on the Covid-19 pandemic. Pending a resolution of the council, the regulatory process provides that there is now a public debate, before reaching the resolution of the Regional Council. Danilo Cereda, hygienist and member of the Welfare Directorate General of the Lombardy Region, spoke about it during a webinar organized by HappyAgeing – Italian Alliance for Active Aging, together with the Lombard Academy of Public Health. Theme at the center of the debate, the “Adult-elderly immunization strategies: what can we learn from the Covid-19 experience?”. “The Lombard system has strengths: first of all, the evidence-based approach that guides vaccination policy decisions. A plant already present before the pandemic, as happened in 2018 when the quadrivalent flu shot was chosen – highlighted Cereda -. With Covid the dispensers have changed, while the basic vaccination center has been joined by other paths, involving general practitioners, family pediatricians, pharmacies “. An offer that from now on must be integrated and managed in an organic way, supported by the strengthening of the single vaccination register, with which to “compare the coverage for the different pathologies, especially in adults”. The objective of increasing coverage, according to the reference standards defined by the new prevention plan, requires the activation of various tools, including a new software that allows the healthcare professional to manage the co-administration of the flu with the anti Covid vaccination. Since the inclusion in the Lea, the essential levels of assistance, vaccinations for adults and the elderly, which took place with the 2017-2019 National Prevention Plan, pneumococcus, herpes zoster and flu have been at the center of vaccination policies, alongside the recalls decades against diphtheria, tetanus and pertussis. “Training is fundamental, not only for citizens, but also for primary care doctors, in order to facilitate adherence to coverage, which can also be increased thanks to co-administration”, said Luigi Vezzosi, specialist in Hygiene and preventive medicine at the University of Parma and manager in Ats Valpadana. “The introduction of a new vaccine against shingles makes it possible to include immunosuppressed and immunocompromised patients, starting as early as 18 years of age. The Lombardy Region has recently found 200 thousand doses: the cohort of recipients has a population of over 65 that exceeds 115 thousand people, flanked by 450 thousand diabetics and 150 thousand patients with BPCO. At the moment, part of the requirement is covered with the new vaccine, so there will be coexistence with the previous live attenuated one. We are waiting – Vezzosi specified – for a regional note that gives addresses to Ats and Asst for the use of the new vaccine: being a different technology it could also be used by general practitioners, but we await official indications “. The data as of 23 September count in Lombardy over 14 million 700 thousand administrations of the anti-Covid vaccine, with coverage of 90.44% on the doses delivered and for the target of over 70s, coverage is reported to be greater than 90%. And on the flu front, the data relating to the 2020-2021 vaccination campaign has seen a substantial increase, going from a percentage of just under 50% in the previous season to 60.5%. It was the general practitioners who made 75% of the administrations, confirming how central proximity medicine is for proximity to the patient. To favor the process, the decision to supply the territories thanks to the support of the pharmacies and the choice to allow the co-administration of the anti-pneumococcal also. There is no lack of points of fragility, a question more of a system than a strictly regional one, as highlighted by Anna Odone, Professor of Hygiene at the University of Pavia, who analyzed the main tools of technological innovation, also in light of the National Recovery and Resilience Plan , which also includes innovation in health. At the center, proximity networks, telemedicine and the digitization of the national health system. If Covid-19 “has accelerated the planning and implementation of innovative vaccine delivery models for adults and the elderly, we are still struggling with a widely improvable vaccine registry, heterogeneous throughout the national territory and similarly also at European “, highlighted Odone, who thus illustrated the results of a study conducted by the University of Pavia with the San Raffaele Institute of Milan on the art of technological innovation in terms of vaccines in EU countries. Raising awareness among the population, informing correctly, inserting vaccination into the treatment path, supporting the active call, are therefore some central points to be pursued in the Lombardy prevention plan. “We hope that vaccination hubs are no longer needed”, concluded Carlo Signorelli, professor of Hygiene at the Vita-Salute San Raffaele University and secretary of the Lombard Academy of Public Health. “We must treasure that experience to be efficient in other vaccinations, which will have to return to the bed of routine services”.