Quadrivalent Live-Attenuated Influenza Vaccine in Milan preschools: an Italian experience of school-located flu vaccination within the 2022-2023 season.
Humans
Italy
Influenza Vaccines
/ administration & dosage
Child, Preschool
Influenza, Human
/ prevention & control
Male
Female
Vaccines, Attenuated
/ administration & dosage
Child
School Health Services
Vaccination Coverage
/ statistics & numerical data
Immunization Programs
Vaccination
/ statistics & numerical data
Surveys and Questionnaires
Seasons
Children
Flu vaccination
Influenza
Quadrivalent Live Attenuated Influenza Vaccine (qLAIV)
School-located vaccination program
Widespread immunization
Journal
Italian journal of pediatrics
ISSN: 1824-7288
Titre abrégé: Ital J Pediatr
Pays: England
ID NLM: 101510759
Informations de publication
Date de publication:
13 May 2024
13 May 2024
Historique:
received:
07
01
2024
accepted:
07
04
2024
medline:
14
5
2024
pubmed:
14
5
2024
entrez:
13
5
2024
Statut:
epublish
Résumé
In Italy, since the 2020-2021 flu season, the flu vaccine recommendation was extended to all children aged 6 months to 6 years and quadrivalent Live-Attenuated Influenza Vaccine (qLAIV) was introduced. Since school-aged children are important carriers of annual influenza epidemics, a school-based influenza vaccination program may potentially increase vaccine uptake. Recent studies, conducted in the UK and the US, show that school-based vaccination can reach higher percentage of paediatric vaccination coverage compared to children vaccinated in other settings. During 2022-2023 flu season in 9 preschools located in Milan healthcare personnel vaccinated children with qLAIV at the end of a school day. A Google Form questionnaire was administered to preschoolers' parents of all preschools within the Municipality of Milan. In the preschools engaged in the vaccination program, 233 out of 1939 children were vaccinated (12%). Among these, 61 (26.2%) had never been vaccinated for influenza before. Vaccination coverage was 11.5% for Italian children and 14.3% for children coming from an immigrant background. We collected 3659 questionnaire responses, divided according to study participation status (371 from preschools that participated in the vaccination program and 3288 from other preschools in Milan). 57% of the families who answered to the questionnaire vaccinated their children for flu. qLAIV accounted for 85.6% of vaccinations. We observed a statistically significant difference in the percentage of vaccinated children between those attending a school participating in the project (67.9%) and children attending other schools (56%) (p < 0.001). Vaccination was administered by family pediatricians (48.9%), in vaccination centers (34.8%), in vaccine hubs (11.3%), in schools (2.6%), by private pediatricians (1.6%) and in other settings (0.7%). Focusing on the responses from families whose children attend schools participating in the vaccination program, 21.8% stated that the vaccination was provided in school. According to our experience, in Italy, at the moment, only the cooperation between health providers and alternative settings, including schools, may expand flu vaccination coverage. In particular, schools are to be considered a place to inform and reach out to families, useful to increase vaccination coverage.
Sections du résumé
BACKGROUND
BACKGROUND
In Italy, since the 2020-2021 flu season, the flu vaccine recommendation was extended to all children aged 6 months to 6 years and quadrivalent Live-Attenuated Influenza Vaccine (qLAIV) was introduced. Since school-aged children are important carriers of annual influenza epidemics, a school-based influenza vaccination program may potentially increase vaccine uptake. Recent studies, conducted in the UK and the US, show that school-based vaccination can reach higher percentage of paediatric vaccination coverage compared to children vaccinated in other settings.
METHODS
METHODS
During 2022-2023 flu season in 9 preschools located in Milan healthcare personnel vaccinated children with qLAIV at the end of a school day. A Google Form questionnaire was administered to preschoolers' parents of all preschools within the Municipality of Milan.
RESULTS
RESULTS
In the preschools engaged in the vaccination program, 233 out of 1939 children were vaccinated (12%). Among these, 61 (26.2%) had never been vaccinated for influenza before. Vaccination coverage was 11.5% for Italian children and 14.3% for children coming from an immigrant background. We collected 3659 questionnaire responses, divided according to study participation status (371 from preschools that participated in the vaccination program and 3288 from other preschools in Milan). 57% of the families who answered to the questionnaire vaccinated their children for flu. qLAIV accounted for 85.6% of vaccinations. We observed a statistically significant difference in the percentage of vaccinated children between those attending a school participating in the project (67.9%) and children attending other schools (56%) (p < 0.001). Vaccination was administered by family pediatricians (48.9%), in vaccination centers (34.8%), in vaccine hubs (11.3%), in schools (2.6%), by private pediatricians (1.6%) and in other settings (0.7%). Focusing on the responses from families whose children attend schools participating in the vaccination program, 21.8% stated that the vaccination was provided in school.
CONCLUSION
CONCLUSIONS
According to our experience, in Italy, at the moment, only the cooperation between health providers and alternative settings, including schools, may expand flu vaccination coverage. In particular, schools are to be considered a place to inform and reach out to families, useful to increase vaccination coverage.
Identifiants
pubmed: 38741102
doi: 10.1186/s13052-024-01649-2
pii: 10.1186/s13052-024-01649-2
doi:
Substances chimiques
Influenza Vaccines
0
Vaccines, Attenuated
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
97Informations de copyright
© 2024. The Author(s).
Références
Istituto Superiore di Sanità (ISS) - EpiCentro. Influenza – Aspetti epidemiologici. Available at the website: https://www.epicentro.iss.it/influenza/epidemiologia-italia . Accessed 1 Sept 2023.
Ministero della Salute - Istituto Superiore di Sanità (ISS). Vaccinazione antinfluenzale: 2019–2020 - Coperture Vaccinali per 100 abitanti. Available at the website: https://www.salute.gov.it/imgs/C_17_tavole_19_5_0_file.pdf . Accessed 1 Sept 2023 .
Ministero della Salute. Prevenzione e controllo influenza: raccomandazioni per la stagione 2020–2021. Vol. 1. 2020
Ministero della Salute - Istituto Superiore di Sanità (ISS). Vaccinazione antinfluenzale: 2020–2021 - Coperture Vaccinali per 100 abitanti. 2021. Available at the website: https://www.salute.gov.it/imgs/C_17_tavole_19_1_21_file.pdf . Accessed 1 Sept 2023.
Ministero della Salute - Istituto Superiore di Sanità (ISS). Vaccinazione antinfluenzale: 2022–2023 -Coperture Vaccinali per 100 abitanti. Available a the website: https://www.salute.gov.it/portale/documentazione/p6_2_8_3_1.jsp?lingua=italiano&id=19 . Accessed 1 Sept 2023.
Regione Lombardia - Giunta Direzione Generale Welfare. Prevenzione e controllo dell’influenza: raccomandazioni per la stagione 2020–2021: indicazioni in merito alla campagna antinfluenzale in Regione Lombardia. Milano: Gov. UK; 2019. Protocollo G1.2019.0028685 del 13/08/2019. Available at the website: https://www.regione.lombardia.it/wps/wcm/connect/0f3c1600-818c-42ce-892b-94a625795400/nota2019_28685_circolare+antinfluenzale.pdf?MOD=AJPERES&CACHEID=ROOTWORKSPACE-0f3c1600-818c-42ce-892b-94a625795400-mTaLjL1 . Accessed 1 Sept 2023.
EMA. RCP Fluenz Tetra. Available at the website: https://www.ema.europa.eu/en/documents/product-information/fluenz-tetra-epar1 product-information_it.pdf . Accessed 1 Sept 2023.
Simpson CR, Lone NI, Kavanagh K, Englishby T, Robertson C, McMenamin J, Wissman BV, Vasileiou E, Butler CC, Ritchie LD, Gunson R, Schwarze J, Sheikh A. Vaccine effectiveness of live attenuated and trivalent inactivated influenza vaccination in 2010/11 to 2015/16: the SIVE II record linkage study. Health Technol Assess. 2020;24(67):1–66. https://doi.org/10.3310/hta24670.PMID:33256892;PMCID:PMC7750866 .
doi: 10.3310/hta24670.PMID:33256892;PMCID:PMC7750866
pubmed: 33256892
pmcid: 7750866
MedImmune. Fluenz® intranasal live attenuated influenza vaccine: EU summary of product characteristics. Available at the website: http://www.ema.europa.eu/docs/%0Aen_GB/document_library/EPARProduct_Information/%0Ahuman/001101/WC500103709.pdf . Last Accessed 1 Sept 2023.
McNaughton R, Lynn E, Osborne V, Coughtrie A, Layton D, Shakir S. Safety of Intranasal Quadrivalent Live Attenuated Influenza Vaccine (QLAIV) in Children and Adolescents: A Pilot Prospective Cohort Study in England. Drug Saf. 2016;39(4):323–33.
doi: 10.1007/s40264-015-0384-7
pubmed: 26798051
pmcid: 4796333
Gasparini C, Acunzo M, Biuso A, Roncaglia S, Migliavacca F, Borriello CR, Bertolini C, Allen MR, Orenti A, Boracchi P, Zuccotti GV. Nasal spray live attenuated influenza vaccine: the first experience in Italy in children and adolescents during the 2020–21 season. Ital J Pediatr. 2021;47(1):225. https://doi.org/10.1186/s13052-021-01172-8. PMID:34774062;PMCID:PMC8590342.
doi: 10.1186/s13052-021-01172-8.
pubmed: 34774062
pmcid: 8590342
Pebody RG, Green HK, Andrews N, Zhao H, Boddington N, Bawa Z, Durnall H, Singh N, Sunderland A, Letley L, Ellis J, Elliot AJ, Donati M, Smith GE, de Lusignan S, Zambon M. Uptake and impact of a new live attenuated influenza vaccine programme in England: early results of a pilot in primary school-age children, 2013/14 influenza season. Euro Surveill. 2014;19(22):20823. https://doi.org/10.2807/1560-7917.es2014.19.22.20823 . (PMID: 24925457).
doi: 10.2807/1560-7917.es2014.19.22.20823
pubmed: 24925457
Wissmann BV. UK (Scotland) childhood influenza vaccination programme – experience from seasons 2013/14 and 2014/15; 2015. Available from: http://www.vacunas.org/images/stories/recursos/profesionales/material_educativo/2015/Presentacion_Beatrix_Wissmann.pdf . Accessed 1 Sept 2023.
Harris C, Cottrell S, Perry M, Meaden R, Davey R, Elliott M, Cushen R, Jones G, Youlden H, Meredith N, Jones R, Thomas S, Akbari A, Lyons RA, Johnson C. A pilot intervention to improve uptake and equality of childhood influenza vaccination in an area of Wales, through the introduction of a mixed delivery model including nursery school immunisation sessions. Vaccine. 2023;41(18):2990–5.
doi: 10.1016/j.vaccine.2023.03.075
pubmed: 37037705
Kassianos G, MacDonald P, Aloysius I, Reynolds A. Implementation of the United Kingdom’s childhood influenza national vaccination programme: A review of clinical impact and lessons learned over six influenza seasons. Vaccine. 2020;38(36):5747–58. https://doi.org/10.1016/j.vaccine.2020.06.065 . (Epub 2020 Jul 21 PMID: 32703747).
doi: 10.1016/j.vaccine.2020.06.065
pubmed: 32703747
Public Health England. Surveillance of influenza and other respiratory viruses in the UK: Winter 2018 to 2019; 2019. Available at the website: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/807472/Surveillance_of_influenza_and_other_respiratory_viruses_in_the_UK_2018_to_2019-FINAL.pdf . Accessed 1 Sept 2023.
Szilagyi PG, Schaffer S, Rand CM, Goldstein NPN, Hightower AD, Younge M, Eagan A, Blumkin A, Albertin CS, DiBitetto K, Concannon C, Vincelli P, Yoo BK, Humiston SG. Impact of elementary school-located influenza vaccinations: A stepped wedge trial across a community. Vaccine. 2018;36(20):2861–9. https://doi.org/10.1016/j.vaccine.2018.03.047 . (Epub 2018 Apr 17 PMID: 29678459).
doi: 10.1016/j.vaccine.2018.03.047
pubmed: 29678459
Szilagyi PG, Schaffer S, Rand CM, Goldstein NPN, Vincelli P, Hightower AD, Younge M, Eagan A, Blumkin A, Albertin CS, DiBitetto K, Yoo BK, Humiston SG. School-located Influenza Vaccinations for Adolescents: A Randomized Controlled Trial. J Adolesc Health. 2018;62(2):157–63. https://doi.org/10.1016/j.jadohealth.2017.09.021 . (Epub 2017 Dec 13 PMID: 29248390).
doi: 10.1016/j.jadohealth.2017.09.021
pubmed: 29248390
Yoo BK, Schaffer SJ, Humiston SG, Rand CM, Goldstein NPN, Albertin CS, Concannon C, Szilagyi PG. Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children. BMC Health Serv Res. 2019;19(1):407. https://doi.org/10.1186/s12913-019-4228-5 . PMID:31234842;PMCID:PMC6591987.
doi: 10.1186/s12913-019-4228-5
pubmed: 31234842
pmcid: 6591987
Amendola A, Borghi E, Bianchi S, Gori M, Fappani C, Barcellini L, Forlanini F, Garancini N, Nava C, Mari A, Sala A, Gasparini C, Ottaviano E, Colzani D, Biganzoli EM, Tanzi E, Zuccotti GV. Preschool-located influenza vaccination and influenza-like illness surveillance: an Italian pilot experience. Ital J Pediatr. 2023;49(1):91. https://doi.org/10.1186/s13052-023-01481-0 .
doi: 10.1186/s13052-023-01481-0
pubmed: 37480047
pmcid: 10362647
Kansagra SM, Papadouka V, Geevarughese A, Hansen MA, Konty KJ, Zucker JR. Reaching children never previously vaccinated for influenza through a school-located vaccination program. Am J Public Health. 2014;104(1):e45–9. https://doi.org/10.2105/AJPH.2013.301671 . Epub 2013 Nov 14. PMID: 24228652; PMCID: PMC3910058.
Daley MF, Clarke CL, Glanz JM, Xu S, Hambidge SJ, Donahue JG, Nordin JD, Klein NP, Jacobsen SJ, Naleway AL, et al. The Safety of Live Attenuated Influenza Vaccine in Children and Adolescents 2 through 17 Years of Age: A Vaccine Safety Datalink Study. Pharmacoepidemiol Drug Saf. 2018;27:59–68. https://doi.org/10.1002/pds.4349 .
doi: 10.1002/pds.4349
pubmed: 29148124
Ministero Della Salute - Prevenzione e Controllo Dell’influenza: Raccomandazioni per La Stagione 2023–2024 - Accessed 21 Apr 2023.