Organize a campaign of mass vaccination to be carried out in emergency situations, such as the current ones, planning it however adopting a long-term vision. This guarantees speed, efficiency and flexibility as well as a ready-to-use tool for probable future vaccination campaigns. How to act and what factors to consider to avoid improvisations and mistakes are explained by the experts of Italian Society of Hygiene, Preventive Medicine and Public Health SItI which, in collaboration with the Italian Observatory of Prevention and the “Smith Kline” Foundation, have drawn up a Decalogue on the subject. A full-bodied document of 46 pages between strategic and operational indications regarding the logistical-organizational phase, relating to the entire supply chain from the acquisition, storage and distribution of vaccines, and the final phase of administration to the population, the one that SITES call it “the last mile”.
“Vaccinations must speed up,” says the doctor Antonio Ferro, President of the Italian Society of Hygiene “and each dose must be used to the fullest. There Italian Society of Hygiene has made available a handbook that examines the entire organizational chain. The path must be simplified: from access to organizational structures to informed consent, up to the vaccination itself. We are ready to perform thousands of doses in the next few days. THE Departments of Prevention they are the directors of this operation ”.
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As regards the problems relating to the distribution of the vaccine to regional centers, the Decalogue states that it is essential “to guarantee a regional and local chain of command with defined and explicit responsibilities” but also “coordination with specific know-how in the field of hygiene, public health, primary care, civil protection management, health emergencies, complex distribution and logistic processes to guarantee a systematic interaction with the actors (health and non-health) of the vaccination campaign in the area “.
Furthermore, both in this first distribution phase and in the subsequent vaccination phases, the hygienists emphasize the need for a clear real-time monitoring system of the functioning of each single node of the network: “the availability of disaggregated and updated data and indicators is needed. real time monitoring, also comparative, on the progress of the vaccination campaign at local / regional / national level, accessible to all stakeholders “.
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In addition, real-time data must also be available on adherence to the vaccination campaign, the effectiveness of the administration process and adverse events. Pharmacovigilance done well and soon is as crucial as good communication is for citizenship’s adherence to the campaign itself, as stated in the document: “There is no doubt that in a situation where millions of doses will be administered in a short time, there is a high risk that symptoms, signs and negative events related to existing diseases, or whose frequency is unchanged compared to the past, can be easily linked to a recent dose of vaccine. The lack of ability to verify the existence or non-existence of a cause-effect relationship between vaccination and adverse event could unnecessarily compromise the confidence of the population not only in anti-vaccines. COVID-19, but against vaccines in general, which could cause serious damage to public health ”.
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To solve the problems of the third phase, that of the organization of administrations, for days now at the center of the news, the experts provide not only an analysis of the strengths and weaknesses of the various models that can be adopted, from the hospital, to the drive- in and so on, but also operational checklists and underline the need to adequately train the personnel called to vaccinate to better implement the entire process.
Finally, it should not be forgotten that the vaccination coverage of children, adolescents and adults is decreasing in many Italian regions for a number of concomitant reasons. It is worth recalling what was underlinedWHO European Region in a recent guideline, issued on March 20, 2020: “Any interruption of immunization services, even for short periods, determines an accumulation of susceptibles, and a higher probability of epidemics of vaccine-preventable diseases. Such outbreaks may lead to preventable disease-related deaths and an increased burden on health systems already worn down by the response to the pandemic. COVID-19”.
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The document will be updated and integrated in relation to the evolution of the pandemic, knowledge on SARS-CoV-2, the availability and characteristics of new vaccines in addition to those already approved and the dissemination of good practices implemented in the field and discussion on the issue with institutions, scientific societies and technical-professional associations.
Long form
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