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Mandatory vaccinations: the italian experience - Slideset by Professor Esposito

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Every year 2.5 million lives are saved by vaccines. In this slideset Professor Susanna Esposito gives an overview on the vaccine coverage in Italy, including the latest laws on mandatory and recommended vaccines.

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Mandatory vaccinations: the italian experience - Slideset by Professor Esposito

  1. 1. MANDATORY VACCINATIONS: THE ITALIAN EXPERIENCE Susanna Esposito Pediatric Clinic, University of Perugia, Perugia, Italy
  2. 2. 2 How many lives are saved by vaccines? 2.5 million per year 7,000 per day 300 per hour 5 per minute WHO – 2011-2020
  3. 3. Vaccination has a major beneficial impact1 1. Plotkin SL & Plotkin SA. Chapter 1 in Plotkin SA et al. Vaccines. 6th Edition, Elsevier Saunders, 2012; 2. WHO, 2003. Influenza. http://www.who.int/mediacentre/factsheets/2003/fs211/en/ (accessed October 2016); 3. Andre FE et al. Bull World Health Organ 2008;86:81–106; 4. Ehreth J. Vaccine 2003;21:4105–4117 –With the exception of safe water, no other modality, not even antibiotics, has had such a major effect on mortality reduction1 Economic growth3 Mortality, morbidity, global financial burden2–4 Illustrative figure based on Plotkin SL & Plotkin SA. 2012; WHO, 2003; Andre FE et al. 2008; Ehreth J. 2003
  4. 4. Vaccine coverage trends by 24 months of age in Italy, 2000-2015
  5. 5. N. of cases of measles and vaccine coverage by 24 months per year, Italy 1970-2016* *preliminary data
  6. 6. 92,25 79,42 85,59 82,37 92,18 92,54 93,80 89,65 94,16 91,25 83,60 76,63 93,4898,47 92,02 91,74 n/a 94,63 84,41 86,78 79,43 88,10 82,62 83,12 88,28 87,82 76,64 86,50 n/a 62,20 42,72 77,7586,33 66,21 60,17 n/a 74,15 77,78 81,73 61,31 Men C Pneumococcus 87,10 80,69 Vaccine coverage for MenC and Pneumococcus
  7. 7. Main news in the Lifetime Immunization Schedule, 2017 • Introduction of dTp/IPV in the adolescence • Universal MenB in infancy • MenACYW to all adolescents • Universal anti-varicella vaccination among children, with MMRV (or MRR+V) • HPV to 12 years old females and males • Universal Rotavirus vaccination • PCV13/PPV23 ≥65 years and at risk inividuals of any age • Zoster in at least one cohort of elderly and at risk individuals
  8. 8. In Italy, vaccines account for a small proportion of the all pharmaceutical costs 8
  9. 9. Hurdles to the introduction of new vaccines in the schedule • Increase workload for vaccination centres • Involvement of pediatricians and GPs • Reorganization of the vaccination framework • Possible parents’ reactions to increased number of vaccine administrations • Sustainability of high levels of vaccine coverage for both mandatory and recommended vaccines
  10. 10. 10 • anti-polio • anti-diphtheria • anti-tetanus • anti-hepatitis B • anti-pertussis • anti Haemophilus influenzae type b • anti-measles • anti-rubella • anti-mumps 19 May 2017: 10 mandatory vaccines because of reduction of vaccine coverage licenza CC-BY-NC-SA 3.0 IT
  11. 11. 11 … Anti-vax movements
  12. 12. 12 Italian Minister of Health and experts opinion published in >200 articles
  13. 13. 13 News on vaccines appeared in >250 TV and Radio
  14. 14. Vaccini, Salvini: dieci sono inutili. No ad espulsione bimbi - Rai News www.rainews.it/.../Vaccini-Salvini-dieci-sono-inutili-no-ad-espulsione-bimbi- 2096827... 22 giu 2018 - Il ministro dell'Interno: "Troppi vaccini fanno male. Priorità è che i bimbi non vengano espulsi dalle classi" anche se non vaccinati. Hai visitato questa pagina 2 volte. Ultima visita: 21/06/18 Vaccini, la ministra Grillo vuole “l'obbligo flessibile” - Wired https://www.wired.it › Lifestyle › Vaccini, la ministra Grillo vuole “l’obbligo flessibile” 9 ago 2018 - La ministra della Salute Giulia Grillo ritorna sulle critiche che le sono state rivolte sui vaccini dall'Associazione nazionale dei presidi, unita nel .. Grillo: nuovo Ddl sui vaccini per superare il vecchio - Tecnica della ... https://www.tecnicadellascuola.it › Attualità 11 set 2018 - La ministra della Salute, Giulia Grillo, ritorna sui vaccini per superare l'insufficiente impostazione del decreto Lorenzin, che ha prodotto una
  15. 15. Discontinuation/interruption of vaccination programmes results in increased disease incidence1 1. Gangarosa EJ et al. Lancet 1998;351:356–361; 2. Carlsson RM & Gustafsson L. Ten year report – pertussis surveillance in Sweden. Swedish Institute for Infectious Disease Control 2008. https://www.folkhalsomyndigheten.se/pagefiles/14930/pertussis-surveillance%20in-sweden-ten-year-report.pdf (accessed October 2016) DTP, diphtheria, tetanus and pertussis; DTaP, diphtheria, tetanus and acellular pertussis Sweden: No DTP coverage Norway: 92% DTP coverage 1974 1978 1982 1986 1990 1994 Year Incidenceofpertussis per100,000 individuals DTP vaccine withdrawn in Sweden 0 50 100 150 200 1986 1990 1994 1998 2002 DTaP-vaccination introduced Totalnumberofpertussiscases Year 0 500 1000 1500 2000 In Sweden, reintroduction of pertussis vaccination using acellular vaccines in 1996 resulted in a major drop in pertussis cases2 In Sweden, following withdrawal of the whole-cell DTP vaccine in 1979, incidence of pertussis increased considerably compared with Norway1 Adapted from Gangarosa EJ et al. 1998, copyright permission from Elsevier Adapted from Carlsson RM & Gustafsson L. 2008 2006
  16. 16. Thanks

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