Pneumococcal vaccine uptake among high-risk adults and children in Italy: results from the OBVIOUS project survey.
Immunization
Pneumococcal vaccine
Vaccine uptake
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
07 Mar 2024
07 Mar 2024
Historique:
received:
13
09
2023
accepted:
26
02
2024
medline:
8
3
2024
pubmed:
8
3
2024
entrez:
8
3
2024
Statut:
epublish
Résumé
Streptococcus pneumoniae infections, including Invasive Pneumococcal Diseases (IPDs), pose a substantial public health challenge, causing significant morbidity and mortality, especially among children and older adults. Vaccination campaigns have played a vital role in reducing pneumococcal-related deaths. However, obstacles related to accessibility and awareness might impede optimal vaccine adoption. This study aims to provide comprehensive data on pneumococcal vaccine coverage and attitudes within at-risk groups in Italy, with the goal of informing public health strategies and addressing vaccination barriers. Between April 11 and May 29, 2022, a questionnaire investigating vaccine uptake and attitudes toward several vaccinations was administered to 10,000 Italian adults, chosen through population-based sampling. Respondents who were targets of the campaign according to the 2017-2019 National Vaccination Plan, accessed questions regarding pneumococcal vaccination. Data on uptake, awareness of having the right to free vaccination, opinion on vaccine safety, concern with pneumococcal disease, and ease of access to vaccination services were summarized and presented based on statistical regions. Multinomial logistic regression analysis was used to explore factors influencing vaccine uptake. Out of 2357 eligible adult respondents (42.6% women; mean age: 58.1 ± 15.7), 39.5% received pneumococcal vaccination. Uptake differed among at-risk groups: respondents aged ≥65 (33.7%), with lung disease (48.4%), cardiovascular disease (46.6%), and diabetes (53.7%). Predictors of not being vaccinated and unwilling to included female gender, residing in rural areas, lower education, low concern about pneumococcal disease, vaccine safety concerns, and associations with vaccine-opposed acquaintances. Health access issues predicted willingness to be vaccinated despite non-vaccination. Pneumopathy, heart disease, diabetes, and living in Northeastern or Central Italy were linked to higher uptake. Among the 1064 parents of eligible children, uptake was 79.1%. Parental unawareness of children's free vaccination eligibility was a predictor of non-vaccination. Vaccine safety concerns correlated with reluctance to vaccinate children, while perceived healthcare access challenges were associated with wanting but not having received vaccination. Pneumococcal vaccination uptake within prioritized groups and children in Italy remains inadequate. Scarce awareness of vaccine availability and obstacles in accessing vaccinations emerge as principal barriers influencing this scenario.
Sections du résumé
BACKGROUND
BACKGROUND
Streptococcus pneumoniae infections, including Invasive Pneumococcal Diseases (IPDs), pose a substantial public health challenge, causing significant morbidity and mortality, especially among children and older adults. Vaccination campaigns have played a vital role in reducing pneumococcal-related deaths. However, obstacles related to accessibility and awareness might impede optimal vaccine adoption. This study aims to provide comprehensive data on pneumococcal vaccine coverage and attitudes within at-risk groups in Italy, with the goal of informing public health strategies and addressing vaccination barriers.
METHODS
METHODS
Between April 11 and May 29, 2022, a questionnaire investigating vaccine uptake and attitudes toward several vaccinations was administered to 10,000 Italian adults, chosen through population-based sampling. Respondents who were targets of the campaign according to the 2017-2019 National Vaccination Plan, accessed questions regarding pneumococcal vaccination. Data on uptake, awareness of having the right to free vaccination, opinion on vaccine safety, concern with pneumococcal disease, and ease of access to vaccination services were summarized and presented based on statistical regions. Multinomial logistic regression analysis was used to explore factors influencing vaccine uptake.
RESULTS
RESULTS
Out of 2357 eligible adult respondents (42.6% women; mean age: 58.1 ± 15.7), 39.5% received pneumococcal vaccination. Uptake differed among at-risk groups: respondents aged ≥65 (33.7%), with lung disease (48.4%), cardiovascular disease (46.6%), and diabetes (53.7%). Predictors of not being vaccinated and unwilling to included female gender, residing in rural areas, lower education, low concern about pneumococcal disease, vaccine safety concerns, and associations with vaccine-opposed acquaintances. Health access issues predicted willingness to be vaccinated despite non-vaccination. Pneumopathy, heart disease, diabetes, and living in Northeastern or Central Italy were linked to higher uptake. Among the 1064 parents of eligible children, uptake was 79.1%. Parental unawareness of children's free vaccination eligibility was a predictor of non-vaccination. Vaccine safety concerns correlated with reluctance to vaccinate children, while perceived healthcare access challenges were associated with wanting but not having received vaccination.
CONCLUSIONS
CONCLUSIONS
Pneumococcal vaccination uptake within prioritized groups and children in Italy remains inadequate. Scarce awareness of vaccine availability and obstacles in accessing vaccinations emerge as principal barriers influencing this scenario.
Identifiants
pubmed: 38454392
doi: 10.1186/s12889-024-18216-3
pii: 10.1186/s12889-024-18216-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
736Investigateurs
Angelo Capodici
(A)
Michele Conversano
(M)
Claudio Costantino
(C)
Mirko Degli Esposti
(MD)
Zeno Di Valerio
(Z)
Maria Pia Fantini
(MP)
Davide Gori
(D)
Andrea Grignolio
(A)
Giusy La Fauci
(G)
Heidi Larson
(H)
Julie Leask
(J)
Jacopo Lenzi
(J)
Marco Montalti
(M)
Anna Odone
(A)
Daniel Remondini
(D)
Francesca Scognamiglio
(F)
Aurelia Salussolia
(A)
Giorgia Soldà
(G)
Federico Toth
(F)
Francesco Vitale
(F)
Informations de copyright
© 2024. The Author(s).
Références
Musher DM. Infections caused by Streptococcus pneumoniae: clinical Spectrum, pathogenesis, immunity, and treatment. Clin Infect Dis. 1992;14(4):801–9. https://www.jstor.org/stable/4456413 . Accessed 02 July 2023.
doi: 10.1093/clinids/14.4.801
pubmed: 1576274
GBD 2019 Results. Seattle, WA: Institute for Health Metrics and Evaluation (IHME). 2020. https://vizhub.healthdata.org/gbd-results/ . Accessed 02 July 2023 .
Istituto Superiore di Sanità. Rapporto ISS Sorveglianza RIS-3/2022 - Sorveglianza nazionale delle malattie batteriche invasive. 2022. https://www.iss.it/documents/20126/6703853/RIS-3_2022.pdf/6163051a-8f97-1b6b-4d9c-be2079b02eac?t=1674037787174 . Accessed 02 July 2023 .
World Health Organization. Introduction of PCV (Pneumococcal conjugate vaccine). 2021. http://immunizationdata.who.int/pages/vaccine-intro-by-antigen/pneumo_conj.html?ISO_3_CODE=&YEAR=&CODE=High%20income . Accessed 02 July 2023 .
World Health Organization. Introduction of PPV (Pneumococcal polysaccharide vaccine). 2021. http://immunizationdata.who.int/pages/vaccine-intro-by-antigen/pneumo_ps.html?ISO_3_CODE=&YEAR=&CODE=High%20income . Accessed 02 July 2023 .
Musher DM, Anderson R, Feldman C. The remarkable history of pneumococcal vaccination: an ongoing challenge. Pneumonia. 2022;14(1):5. https://doi.org/10.1186/s41479-022-00097-y .
doi: 10.1186/s41479-022-00097-y
pubmed: 36153636
pmcid: 9509586
European Centre for Disease Prevention and Control. Surveillance report - Invasive pneumococcal disease - Annual Epidemiological Report for 2018. 2020. https://www.ecdc.europa.eu/sites/default/files/documents/AER_for_2018_IPD.pdf . Accessed 02 July 2023 .
U.S. Food and Drug Administration. PNEUMOVAX 23 - Pneumococcal Vaccine, Polyvalent | FDA. 2021. https://www.fda.gov/vaccines-blood-biologics/pneumovax-23-pneumococcal-vaccine-polyvalent . Accessed 02 July 2023 .
European Medicines Agency. Prevenar: pneumococcal polysaccharide conjugate vaccine. Amsterdam: European Medicines Agency; 2009. https://www.ema.europa.eu/en/medicines/human/EPAR/prevenar . Accessed 02 July 2023 .
European Medicines Agency. Prevenar 13: pneumococcal polysaccharide conjugate vaccine (13-valent, adsorbed). Amsterdam: European Medicines Agency; 2021. https://www.ema.europa.eu/en/medicines/human/EPAR/prevenar-13 . Accessed 02 July 2023 .
European Medicines Agency. Vaxneuvance: pneumococcal polysaccharide conjugate vaccine (15-valent, adsorbed). Amsterdam: European Medicines Agency; 2021. https://www.ema.europa.eu/en/medicines/human/EPAR/vaxneuvance . Accessed 02 July 2023 .
European Medicines Agency. Apexxnar: pneumococcal polysaccharide conjugate vaccine (20-valent, adsorbed). Amsterdam: European Medicines Agency; 2023. https://www.ema.europa.eu/en/medicines/human/EPAR/apexxnar . Accessed 02 July 2023 .
Falkenhorst G, Remschmidt C, Harder T, Hummers-Pradier E, Wichmann O, Bogdan C. Effectiveness of the 23-Valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal disease in the elderly: systematic review and Meta-analysis. PLoS One. 2017;12(1):e0169368. https://doi.org/10.1371/journal.pone.0169368 .
doi: 10.1371/journal.pone.0169368
pubmed: 28061505
pmcid: 5218810
Harboe ZB, Dalby T, Weinberger DM, Benfield T, Mølbak K, Slotved HC, et al. Impact of 13-Valent pneumococcal conjugate vaccination in invasive pneumococcal disease incidence and mortality. Clin Infect Dis. 2014;59(8):1066–73. https://doi.org/10.1093/cid/ciu524 .
doi: 10.1093/cid/ciu524
pubmed: 25034421
Pilishvili T, Lexau C, Farley MM, Hadler J, Harrison LH, Bennett NM, et al. Sustained reductions in invasive pneumococcal disease in the era of conjugate vaccine. J Infect Dis. 2010;201(1):32–41. https://doi.org/10.1086/648593 .
doi: 10.1086/648593
pubmed: 19947881
Ministero della Salute. Piano Nazionale Vaccini 2017–2019. https://www.epicentro.iss.it/vaccini/PianoNazionaleVaccini . Accessed 02 July 2023.
World Health Organization. Wkly Epidemiol Rec, 2021, 96, 20. https://www.who.int/publications/i/item/who-wer9720-209-224 . Accessed 02 July 2023.
World Health Organization. Behavioural and social drivers of vaccination: tools and practical guidance for achieving high uptake. World health Organization; 2022. https://doi.org/10.5281/zenodo.5548679 .
doi: 10.5281/zenodo.5548679
Gori D, Capodici A, La Fauci G, et al. COVID-19 vaccine refusal and delay among adults in Italy: evidence from the OBVIOUS project, a National Survey in Italy. Vaccines. 2023;11(4):839. https://doi.org/10.3390/vaccines11040839 .
doi: 10.3390/vaccines11040839
pubmed: 37112751
pmcid: 10141216
Istituto Nazionale di Statistica. I tempi della vita quotidiana-lavoro, conciliazione, parità di genere e benessere soggettivo. 2023. https://www.istat.it/it/archivio/230102 . Accessed 02 July 2023 .
CREA Sanità. Osservatorio Strategie Vaccinali: 1° Rapporto Annuale. 2023. https://www.creasanita.it/wp-content/uploads/2023/03/Osservatorio-Strategie-Vaccinali-1-Rapporto-Annuale-.pdf . Accessed 02 July 2023 .
Zens KD, Schmutz C, Schwenkglenks M, et al. Pneumococcal vaccination coverage and uptake among adults in Switzerland: a Nationwide cross-sectional study of vaccination records. Front Public Health. 2020;8:571602. https://doi.org/10.3389/fpubh.2020.571602 .
doi: 10.3389/fpubh.2020.571602
Delelis-Fanien AS, Lasserre A, Pulcini C, et al. Vaccine coverage against influenza and pneumococcal infections in patients aged 65 and over: a survey on 299 outpatients [in French]. Med Mal Infect. 2008;38(11):589–94. https://doi.org/10.1016/j.medmal.2008.08.007 .
doi: 10.1016/j.medmal.2008.08.007
Papazoglou D, Kotsiou OS, Papadimitriou EK, et al. Cross-sectional study on the prevalence of influenza and pneumococcal vaccination and its association with health conditions and risk factors among hospitalized multimorbid older patients. BMC Public Health. 2019;19(1):1243. https://doi.org/10.1186/s12889-019-7568-x .
doi: 10.1186/s12889-019-7568-x
Matthews PC, Berenzon SK, Valadez JJ, et al. Pneumococcal vaccine coverage among individuals aged 18 to 64 years old with underlying medical conditions in the UK: a retrospective database analysis. BMC Public Health. 2019;19(1):1692. https://doi.org/10.1186/s12889-019-8055-z .
doi: 10.1186/s12889-019-8055-z
Ochoa-Gondar O, Vila-Corcoles A, Rodriguez-Blanco T, et al. Antipneumococcal vaccination in Catalonian adults: vaccine coverages and adequacy to distinct guideline recommendations. BMC Public Health. 2011;11:422. https://doi.org/10.1186/1471-2458-11-422 .
doi: 10.1186/1471-2458-11-422
Martinelli D, Fortunato F, Tafuri S, et al. Burden of hospitalizations for pneumococcal pneumonia in the Apulia region of Italy, 2006–2008: analysis of administrative databases and estimation of the vaccine effectiveness in the elderly population. Hum Vaccin. 2010;6(11):895–900. https://doi.org/10.4161/hv.6.11.13132 .
doi: 10.4161/hv.6.11.13132
Bellino S, Puro V, Fusco FM, et al. Influenza and pneumococcal immunization in Italian healthcare workers: a cross-sectional study on knowledge, attitudes and behaviors. Hum Vaccin Immunother. 2019;15(12):2874–81. https://doi.org/10.1080/21645515.2019.1661754 .
doi: 10.1080/21645515.2019.1661754
WHO Regional Office for Europe. Pneumococcal vaccination coverage. 2023. https://gateway.euro.who.int/en/indicators/epw_29-pneumococcal-vaccination-coverage/visualizations/#id=36870&tab=table . Accessed 02 July 2023 .
Bianchi FP, Stefanizzi P, Cuscianna E, Riformato G, Di Lorenzo A, Giordano P, et al. COVID-19 vaccination hesitancy among Italian parents: a systematic review and meta-analysis. Hum Vaccin Immunother. 2023;19(1):2171185.
doi: 10.1080/21645515.2023.2171185
pubmed: 36698309
pmcid: 10012888
Berical AC, Harris D, Dela Cruz CS, Possick JD. Pneumococcal vaccination strategies. An update and perspective. Ann Am Thorac Soc. 2016;13(6):933–44. https://doi.org/10.1513/AnnalsATS.201511-778FR .
doi: 10.1513/AnnalsATS.201511-778FR
pubmed: 27088424
pmcid: 5461988
Linares J, Ardanuy C, Pallares R, Fenoll A. Changes in antimicrobial resistance, serotypes and genotypes in Streptococcus pneumoniae over a 30-year period. Clin Microbiol Infect. 2010;16(5):402–10. https://doi.org/10.1111/j.1469-0691.2010.03182.x .
doi: 10.1111/j.1469-0691.2010.03182.x
pubmed: 20132251