by Luciano Fassari
The new document is ready which outlines the vaccination strategies for the coming years and also draws on what has been experienced with the Covid emergency. Among the novelties is the new vaccination calendar and new indications for the reorganization of local services which, under the direction of the ASL prevention departments, will have to rely on the network made up of family doctors, paediatricians and pharmacies, also expanding the staff responsible for vaccinations. THE NATIONAL VACCINE PLAN
25 GEN –
Maintain polio-free status, achieve and maintain elimination of measles and rubella, and strengthen prevention of cervical cancer and other HPV-related diseases. But not only that, it is necessary to achieve and maintain target vaccination coverage by structuring networks and implementing vaccination prevention pathways. Furthermore, it will be essential to promote vaccination interventions in population groups at high risk for pathology, favoring an approach centered on the needs of the citizen/patient and at the same time it is necessary to reduce inequalities and provide for actions for population groups that are difficult to reach and/or with low vaccination coverage.
And again: complete the computerization of the regional vaccination registers and put the national vaccination register up and running, improve the surveillance of vaccine-preventable diseases, strengthen communication in the field of vaccination and promote the culture of vaccination and training in vacciniology among health professionals .
These are the goals of the new National Vaccine Prevention Plan 2023-2025 of which Health newspaper anticipates the document that will have to pass in the State-Regions Conference. But beyond the objectives, the Plan also focuses strongly on the reorganization of vaccination services also in light of the Covid experience which has highlighted a lack of homogeneity between procedures, logistics, coverage and the vaccination offer in each region and Pa.
For this reason, one of the main innovations introduced with the new PNPV is the preparation of the vaccination calendar as a “separate document and, therefore, easily updated based on future epidemiological scenarios, scientific evidence and innovations in the biomedical field. The New Calendar, in addition to presenting the vaccination offer actively and free of charge foreseen by age group, contains the vaccinations recommended for particular risk categories (by medical condition, occupational exposure, occasional events, social and economic vulnerabilities)” .
However, the Plan also focuses on the approach to the prevention of infectious diseases which must “be coordinated and multidisciplinary and that the immunization services should work coherently with each other and in synergy with other health service bodies”.
“Think, for example, – we read – of the delicate issue of adverse events to vaccination, real or presumed, and the need for an integrated approach for their adequate management, both for the safety of the population (where the risk is plausible) , and to avoid exploitation (in the absence of causal correlation) which would end up endangering collective security”.
“Furthermore – the Plan points out -, new infectious emergencies, such as the SARS-CoV-2 pandemic, have shown how the vaccination system must be able to respond to new needs not only with solidity, but also with flexibility, integrating into the systems of preparation and emergency response and in those of overall population management. The scenario in which the new PNPV was conceived is, therefore, characterized by the presence of critical issues, which represent the open challenges for Public Health in the vaccination field. The Plan, in acknowledging the elements that make up the complex ambit of vaccination strategies and policies, seeks to provide answers and propose effective and flexible solutions, in the awareness of the impossibility of predicting future developments in terms of technological innovation, development of new vaccines and emerging diseases or re-emerges”.
Reorganization of services by creating a Hub&Spoke network
The Plan reaffirms the directing role of the Prevention Departments among all the actors involved at a regional/company level in vaccination in the planning, coordination and monitoring phases of all vaccination campaigns. “The Prevention Departments – the document highlights -, through the Vaccination Services and the professionals who work there (hygienists, health assistants, nurses, etc.), have ensured the country ordinary and extraordinary vaccination campaigns in recent decades. This activity was carried out autonomously in the area of competence by the Local Health Authorities (ASL) with internal organization and dedicated partnerships. Historically there has been a common synergy with GPs and PLS, even more consolidated in the context of the vaccination campaign for the COVID-19 emergency and expanded with the involvement of further players and the identification of new delivery contexts such as pharmacies” .
“Fundamental players – recalls the document – in the vaccination promotion networks are, as mentioned above, the GPs and the PLS. GPs play an important role in the promotion and delivery of vaccinations for adults, with particular reference to the subject who is fragile due to pathology, behavioural/occupational factors or vulnerable due to socio-economic condition, especially if this is not included or is not been adequately reached by the active call. Similarly, the PLS is the reference figure in the first years of life for the protection of the health of the newborn and child, playing a central role in promoting vaccination for its client and the vaccination confidence of his parents and the family nucleus . The modalities of involvement of GPs/PLS can be defined by specific agreements at regional and company level”.
The COVID-19 experience has also brought to full maturity the involvement of pharmacists and pharmacies in the vaccination prevention network. It is necessary that vaccination clinics guarantee the supply of quality services with the utmost professional competence and for this reason it is essential that organizational standards are defined which can reduce possible inequalities in supply at a territorial and regional level. In particular, it is desirable to apply a “hub and spoke” type model that ensures capillarity of vaccination points with an expansion of the staff responsible for vaccinations, with simplification of access to vaccination sessions and with a procedural approach to guarantee the offer of vaccinations”.
The objectives of the PNPV 2023-2025 are:
- Maintain polio-free status
- Achieve and maintain elimination of measles and rubella
- Strengthen the prevention of cervical cancer and other HPV-related diseases
- Achieve and maintain target vaccination coverage by structuring networks and implementing vaccination prevention pathways
- Promote vaccination interventions in population groups at high risk for pathology, favoring an approach centered on the needs of the citizen/patient
- Reduce inequalities and provide actions for population groups that are difficult to reach and/or with low vaccination coverage
- Complete the computerization of the regional vaccination registers and implement the national vaccination register
- Improve surveillance of vaccine-preventable diseases
- Strengthen communication in the vaccination field
- Promote the culture of vaccinations and formation in vacciniology among health professionals.
The New Vaccination Calendar
Vaccination coverage objectives
January 25, 2023
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