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Domnich A, Ferrari A, Ogliastro M, Orsi A, Icardi G. Web search volume as a near-real-time complementary surveillance tool of tick-borne encephalitis (TBE) in Italy. Ticks Tick Borne Dis 2024; 15:102332. [PMID: 38484539 DOI: 10.1016/j.ttbdis.2024.102332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/04/2024] [Accepted: 03/08/2024] [Indexed: 03/24/2024]
Abstract
The Internet is an important gateway for accessing health-related information, and data generated through web queries have been increasingly used as a complementary source for monitoring and forecasting of infectious diseases and they may partially address the issue of underreporting. In this study, we assessed whether tick-borne encephalitis (TBE)-related Internet search volume may be useful as a complementary tool for TBE surveillance in Italy. Monthly Google Trends (GT) data for TBE-related information were extracted for the period between January 2017 and September 2022, corresponding to the available time series of TBE notifications in Italy. Time series modeling was performed by applying seasonal autoregressive integrated moving average (SARIMA) models with or without GT data. The search terms relative to tick bites reflected best the observed temporal distribution of TBE cases, showing a correlation coefficient of 0.81 (95 % CI: 0.71-0.88). Particularly, both the reported number of TBE cases and GT searches occurred mainly during the summer. The peak of disease notifications coincided with that of Google searches in 4 of 6 years. Once calibrated, SARIMA models with or without GT data were applied to a validation set. Retrospective forecast made by the model with GT data was associated with a lower prediction error and accurately predicted the peak timing. By contrast, the traditional SARIMA model underestimated the actual number of TBE notifications by 65 %. Timeliness, easy availability, low cost and transparency make monitoring of the TBE-related Internet search queries a promising addition to the traditional methods of TBE surveillance in Italy.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Allegra Ferrari
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy
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Domnich A, Orsi A, Ogliastro M, Ferrari A, Bruzzone B, Panatto D, Icardi G. Influenza-like illness surveillance may underestimate the incidence of respiratory syncytial virus in adult outpatients. Int J Infect Dis 2024; 141:106968. [PMID: 38368926 DOI: 10.1016/j.ijid.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/13/2024] [Accepted: 02/13/2024] [Indexed: 02/20/2024] Open
Abstract
OBJECTIVES Although respiratory syncytial virus (RSV) is a leading cause of acute respiratory infections (ARIs), it is unclear which of the case definitions that prompt swab collection predicts RSV best. We aimed to profile RSV-positive adults and to identify possible RSV case definitions. METHODS This individual-based pooled analysis was based on influenza-like illness (ILI) surveillance conducted among Italian outpatient adults. All samples were tested for influenza, RSV and other respiratory viruses. RESULTS RSV was detected in 5.2% of the 1240 ILI adults tested. The prevalence of fever/feverishness was significantly lower (83.3%) in individuals positive for RSV and those negative for both viruses (79.4%) than in influenza-positive subjects (96.2%). Conversely, 98.3% of RSV-positive adults reported cough. Compared with subjects who tested negative, the adjusted relative risk ratio of cough in RSV-positive subjects was much higher than in influenza-positive subjects (6.89 vs 2.79). Using ARI with cough as the RSV case definition increased specificity. CONCLUSION As fever/feverishness is more common among influenza than RSV cases, ILI-based surveillance may underestimate RSV incidence in adult outpatients. While broad ARI definitions are useful for routine RSV surveillance, their low specificity may hamper vaccine effectiveness studies. The use of further ARI qualifiers like cough increases specificity.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy; Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Matilde Ogliastro
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Allegra Ferrari
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy; Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy; Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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Youhanna J, Tran V, Hyer R, Domnich A. Immunogenicity of Enhanced Influenza Vaccines Against Mismatched Influenza Strains in Older Adults: A Review of Randomized Controlled Trials. Influenza Other Respir Viruses 2024; 18:e13286. [PMID: 38594827 PMCID: PMC11004266 DOI: 10.1111/irv.13286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 04/11/2024] Open
Abstract
Antigenic drift is a major driver of viral evolution and a primary reason why influenza vaccines must be reformulated annually. Mismatch between vaccine and circulating viral strains negatively affects vaccine effectiveness and often contributes to higher rates of influenza-related hospitalizations and deaths, particularly in years dominated by A(H3N2). Several countries recommend enhanced influenza vaccines for older adults, who are at the highest risk of severe influenza complications and mortality. The immunogenicity of enhanced vaccines against heterologous A(H3N2) strains has been examined in nine studies to date. In six studies, an enhanced, licensed MF59-adjuvanted trivalent inactivated influenza vaccine (aIIV3) consistently increased heterologous antibody titers relative to standard influenza vaccine, with evidence of a broad heterologous immune response across multiple genetic clades. In one study, licensed high-dose trivalent inactivated influenza vaccine (HD-IIV3) also induced higher heterologous antibody titers than standard influenza vaccine. In a study comparing a higher dose licensed quadrivalent recombinant influenza vaccine (RIV4) with HD-IIV3 and aIIV3, no significant differences in antibody titers against a heterologous strain were observed, although seroconversion rates were higher with RIV4 versus comparators. With the unmet medical need for improved influenza vaccines, the paucity of studies especially with enhanced vaccines covering mismatched strains highlights a need for further investigation of cross-protection in older adults.
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Affiliation(s)
| | - Vy Tran
- CSL Seqirus LtdSummitNew JerseyUSA
| | - Randall Hyer
- Baruch S. Blumberg InstituteDoylestownPennsylvaniaUSA
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De Pace V, Bruzzone B, Ricucci V, Domnich A, Guarona G, Garzillo G, Qosja R, Ciccarese G, Di Biagio A, Orsi A, Icardi G. Molecular Diagnosis of Human Monkeypox Virus during 2022-23 Outbreak: Preliminary Evaluation of Novel Real-Time Qualitative PCR Assays. Microorganisms 2024; 12:664. [PMID: 38674608 DOI: 10.3390/microorganisms12040664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 03/11/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024] Open
Abstract
In 2022-23, the human monkeypox virus (MPXV) caused a global outbreak in several non-endemic countries. Here, we evaluated the diagnostic performance of four real-time qualitative PCR assays for the laboratory diagnosis of mpox (monkeypox) monkeypox disease. From July to August 2022, 27 positive and 10 negative specimens (lesion, crust and exudate swabs) were tested in the laboratory of the Hygiene Unit of the San Martino Hospital (Genoa, Italy) by using home-made real-time PCR to detect MPXV generic G2R_G DNA. According to the manufacturer's instructions, we also retrospectively analyzed these specimens using RealCycler MONK-UX/-GX (Progenie Molecular), STANDARD M10 MPX/OPX (SD Biosensor), Novaplex MPXV (Seegene Inc.) and RealStar Orthopoxvirus PCR Kit 1.0 (Altona Diagnostics) assays, recognized as research-use-only tests. The diagnostic accuracy and sensitivity of these assays ranged from 97.3% (95% CI: 86.2-99.5%) to 100% (95% CI: 90.6-100%) and 96.3% (95% CI: 81.72-99.34%) to 100% (95% CI: 72.2-100%), respectively. The RealCycler MONK-UX and STANDARD M10 MPX/OPX did not detect one positive sample with a cycle threshold of 36. The overall specificity was 100% (95% CI: 72.2-100%), and Cohen's Kappa values ranged from 1 (95% CI: 0.67-1) to 0.93 (95% CI: 0.61-1). As they are highly accurate, reliable and user-friendly, these tests should be recommended for the routine or rapid laboratory discrimination of mpox from other rash illnesses.
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Affiliation(s)
- Vanessa De Pace
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Laboratorio di Riferimento Regionale per le Emergenze di Sanità Pubblica (LaRESP), 16132 Genoa, Italy
| | - Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Laboratorio di Riferimento Regionale per le Emergenze di Sanità Pubblica (LaRESP), 16132 Genoa, Italy
| | - Valentina Ricucci
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Laboratorio di Riferimento Regionale per le Emergenze di Sanità Pubblica (LaRESP), 16132 Genoa, Italy
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Laboratorio di Riferimento Regionale per le Emergenze di Sanità Pubblica (LaRESP), 16132 Genoa, Italy
| | - Giulia Guarona
- Laboratorio di Riferimento Regionale per le Emergenze di Sanità Pubblica (LaRESP), 16132 Genoa, Italy
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
| | - Giada Garzillo
- Laboratorio di Riferimento Regionale per le Emergenze di Sanità Pubblica (LaRESP), 16132 Genoa, Italy
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
| | - Rexhina Qosja
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Laboratorio di Riferimento Regionale per le Emergenze di Sanità Pubblica (LaRESP), 16132 Genoa, Italy
| | - Giulia Ciccarese
- Dermatology Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
| | - Antonio Di Biagio
- Infectious Disease Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Laboratorio di Riferimento Regionale per le Emergenze di Sanità Pubblica (LaRESP), 16132 Genoa, Italy
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Laboratorio di Riferimento Regionale per le Emergenze di Sanità Pubblica (LaRESP), 16132 Genoa, Italy
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
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Lapi F, Marconi E, Domnich A, Cricelli I, Rossi A, Grattagliano I, Icardi G, Cricelli C. A Vulnerability Index to Assess the Risk of SARS-CoV-2-Related Hospitalization/Death: Urgent Need for an Update after Diffusion of Anti-COVID Vaccines. Infect Dis Rep 2024; 16:260-268. [PMID: 38525768 PMCID: PMC10961815 DOI: 10.3390/idr16020021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/11/2024] [Accepted: 03/12/2024] [Indexed: 03/26/2024] Open
Abstract
Background: There are algorithms to predict the risk of SARS-CoV-2-related complications. Given the spread of anti-COVID vaccination, which sensibly modified the burden of risk of the infection, these tools need to be re-calibrated. Therefore, we updated our vulnerability index, namely, the Health Search (HS)-CoVulnerabiltyIndex (VI)d (HS-CoVId), to predict the risk of SARS-CoV-2-related hospitalization/death in the primary care setting. Methods: We formed a cohort of individuals aged ≥15 years and diagnosed with COVID-19 between 1 January and 31 December 2021 in the HSD. The date of COVID-19 diagnosis was the study index date. These patients were eligible if they had received an anti-COVID vaccine at least 15 days before the index date. Patients were followed up from the index date until one of the following events, whichever came first: COVID-19-related hospitalization/death (event date), end of registration with their GPs, and end of the study period (31 December 2022). To calculate the incidence rate of COVID-19-related hospitalization/death, a patient-specific score was derived through linear combination of the coefficients stemming from a multivariate Cox regression model. Its prediction performance was evaluated by obtaining explained variation, discrimination, and calibration measures. Results: We identified 2192 patients who had received an anti-COVID vaccine from 1 January to 31 December 2021. With this cohort, we re-calibrated the HS-CoVId by calculating optimism-corrected pseudo-R2, AUC, and calibration slope. The final model reported a good predictive performance by explaining 58% (95% CI: 48-71%) of variation in the occurrence of hospitalizations/deaths, the AUC was 83 (95% CI: 77-93%), and the calibration slope did not reject the equivalence hypothesis (p-value = 0.904). Conclusions: Two versions of HS-CoVId need to be differentially adopted to assess the risk of COVID-19-related complications among vaccinated and unvaccinated subjects. Therefore, this functionality should be operationalized in related patient- and population-based informatic tools intended for general practitioners.
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Affiliation(s)
- Francesco Lapi
- Health Search, Italian College of General Practitioners and Primary Care, 50142 Florence, Italy
| | - Ettore Marconi
- Health Search, Italian College of General Practitioners and Primary Care, 50142 Florence, Italy
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.D.); (G.I.)
| | | | - Alessandro Rossi
- Italian College of General Practitioners and Primary Care, 50142 Florence, Italy; (A.R.); (I.G.); (C.C.)
| | - Ignazio Grattagliano
- Italian College of General Practitioners and Primary Care, 50142 Florence, Italy; (A.R.); (I.G.); (C.C.)
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.D.); (G.I.)
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
| | - Claudio Cricelli
- Italian College of General Practitioners and Primary Care, 50142 Florence, Italy; (A.R.); (I.G.); (C.C.)
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Domnich A, Calabrò GE. Epidemiology and burden of respiratory syncytial virus in Italian adults: A systematic review and meta-analysis. PLoS One 2024; 19:e0297608. [PMID: 38442123 PMCID: PMC10914269 DOI: 10.1371/journal.pone.0297608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/17/2024] [Indexed: 03/07/2024] Open
Abstract
OBJECTIVE Respiratory syncytial virus (RSV) is a common respiratory pathogen not only in children, but also in adults. In view of a recent authorization of adult RSV vaccines in Italy, our research question was to quantify the epidemiology and burden of RSV in Italian adults. METHODS Observational studies on the epidemiology and clinical burden of laboratory-confirmed or record-coded RSV infection in Italian adults of any age were eligible. Studies with no separate data for Italian adults, modeling and other secondary publications were excluded. A literature search was performed in MEDLINE, Biological Abstracts, Global Health, Scopus and Web of Science on 22 November 2023. Critical appraisal was performed by means of a Joanna Briggs Institute checklist. Random-effects (RE) meta-analysis was performed to obtain pooled estimates and the observed heterogeneity was investigated by subgroup and meta-regression analyses. The protocol was prospectively registered (doi.org/10.17504/protocols.io.5qpvo32odv4o/v1). RESULTS Thirty-five studies were identified, most of which had at least one possible quality concern. RSV seasonal attack rates ranged from 0.8 ‰ in community-dwelling older adults to 10.9% in hematological outpatients. In the RE model, 4.5% (95% CI: 3.2-5.9%) of respiratory samples tested positive for RSV. This positivity prevalence was higher in older adults (4.4%) than in working-age adults (3.5%) and in outpatient (4.9%) than inpatient (2.9%) settings. According to the meta-regression, study location and sample size were also significant predictors of RSV detection frequency. The pooled estimate of in-hospital mortality was as high as 7.2% (95% CI: 4.7-10.3%). Data on other indicators of the diseases burden, such as complication and hospitalization rates, were unavailable. CONCLUSION RSV poses a measurable burden on Italian adults, especially those of older age and with some co-morbidities. However, several data on the natural history of RSV disease are missing and should be established by future large-scale studies.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Giovanna Elisa Calabrò
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
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Lapi F, Domnich A, Marconi E, Rossi A, Grattagliano I, Cricelli C. Examining the effectiveness and duration of adjuvanted vs. non-adjuvanted influenza vaccines in protecting older adults against symptomatic SARS-CoV-2 infection. Br J Clin Pharmacol 2024; 90:600-605. [PMID: 37876110 DOI: 10.1111/bcp.15940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/24/2023] [Accepted: 10/16/2023] [Indexed: 10/26/2023] Open
Abstract
Annual influenza vaccination is one of the main public health measures able to drastically reduce the burden of this infectious disease. Some evidence suggests 'trained immunity' triggered by influenza vaccine might reduce the risk of SARS-CoV-2 infection. Adjuvanted influenza vaccines are known to induce a broader cross-reactive immunity. No studies investigated the effect of adjuvanted vs. non-adjuvanted influenza vaccines on the risk of symptomatic SARS-CoV-2 infection. A case-control analysis nested in a cohort of subjects aged ≥65 years and immunized with adjuvanted or non-adjuvanted influenza vaccines was conducted. Although no statistically significant (OR = 0.87; P = .082) difference between the two vaccine types was observed for the 9-month follow-up period, a 17% (OR = 0.83; P = .042) reduction in the odds of COVID-19 was observed for adjuvanted vaccines with a 6-month follow-up. Further evidence is needed, but these results might have implications given the complexity of the upcoming winter seasons, in which the co-occurrence of influenza, SARS-CoV-2 and other respiratory infections (e.g., syncytial virus) might be unpredictable.
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Affiliation(s)
- Francesco Lapi
- Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Ettore Marconi
- Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy
| | - Alessandro Rossi
- Italian College of General Practitioners and Primary Care, Florence, Italy
| | | | - Claudio Cricelli
- Italian College of General Practitioners and Primary Care, Florence, Italy
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Domnich A, Orsi A, Signori A, Chironna M, Manini I, Napoli C, Rizzo C, Panatto D, Icardi G. Waning intra-season vaccine effectiveness against influenza A(H3N2) underlines the need for more durable protection. Expert Rev Vaccines 2024; 23:380-388. [PMID: 38494919 DOI: 10.1080/14760584.2024.2331073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/12/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND The question of whether influenza vaccine effectiveness (VE) wanes over the winter season is still open and some contradictory findings have been reported. This study investigated the possible decline in protection provided by the available influenza vaccines. RESEARCH DESIGN AND METHODS An individual-level pooled analysis of six test-negative case-control studies conducted in Italy between the 2018/2019 and 2022/2023 seasons was performed. Multivariable logistic regression analyses were performed to estimate weekly change in the odds of testing positive for influenza 14 days after vaccination. RESULTS Of 6490 patients included, 1633 tested positive for influenza. Each week that had elapsed since vaccination was associated with an increase in the odds of testing positive for any influenza (4.9%; 95% CI: 2.0-8.0%) and for A(H3N2) (6.5%; 95% CI: 2.9-10.3%). This decline in VE was, however, significant only in children and older adults. A similar increase in the odds of testing positive was seen when the dataset was restricted to vaccinees only. Conversely, VE waning was less evident for A(H1N1)pdm09 or B strains. CONCLUSIONS Significant waning of VE, especially against influenza A(H3N2), may be one of the factors associated with suboptimal end-of-season VE. Next-generation vaccines should provide more durable protection against A(H3N2).
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Alessio Signori
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Maria Chironna
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Ilaria Manini
- Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | | | - Caterina Rizzo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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Domnich A, Orsi A, Ogliastro M, Trombetta CS, Scarpaleggia M, Ceccaroli C, Amadio C, Raffo A, Berisso L, Yakubovich A, Zappa G, Amicizia D, Panatto D, Icardi G. Exploring missed opportunities for influenza vaccination and influenza vaccine co-administration patterns among Italian older adults: a retrospective cohort study. Eur J Public Health 2023; 33:1183-1187. [PMID: 37632235 PMCID: PMC10710345 DOI: 10.1093/eurpub/ckad155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Missed opportunities constitute a main driver of suboptimal seasonal influenza vaccination (SIV) coverage in older adults. Vaccine co-administration is a way to reduce these missed opportunities. In this study, we quantified missed opportunities for SIV, identified some of their socio-structural correlates and documented SIV co-administration patterns. METHODS In this registry-based retrospective cohort study, we verified the SIV status of all subjects aged ≥65 years who received at least one dose of coronavirus disease 2019 (COVID-19), pneumococcal or herpes zoster vaccines during the 2022/23 influenza season. The frequency of concomitant same-day administration of SIV with other target vaccines was also assessed. RESULTS Among 41 112, 5482 and 3432 older adults who received ≥1 dose of COVID-19, pneumococcal and herpes zoster vaccines, missed opportunities for SIV accounted for 23.3%, 5.0% and 13.2%, respectively. Younger, male and foreign-born individuals were generally more prone to missing SIV. The co-administration of SIV with other recommended vaccines was relatively low, being 11.0%, 53.1% and 17.1% in COVID-19, pneumococcal and herpes zoster cohorts, respectively. CONCLUSIONS A sizeable proportion of older adults who received other recommended vaccines during the last influenza season did not receive SIV. This share of missed opportunities, which are subject to some social inequalities, may be addressed by increasing vaccine co-administration rates and implementing tailored health promotion interventions.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital—IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital—IRCCS for Oncology and Neurosciences, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Matilde Ogliastro
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | | | | | | | | | - Anna Raffo
- Local Health Unit 3 (ASL3), Genoa, Italy
| | | | | | | | - Daniela Amicizia
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
- Regional Health Agency of Liguria (ALiSa), Genoa, Italy
| | - Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital—IRCCS for Oncology and Neurosciences, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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Pestarino L, Domnich A, Orsi A, Bianchi F, Cannavino E, Brasesco PC, Russo G, Valbonesi S, Vallini G, Ogliastro M, Icardi G. Rollout of the 2022/2023 Seasonal Influenza Vaccination and Correlates of the Use of Enhanced Vaccines among Italian Adults. Vaccines (Basel) 2023; 11:1748. [PMID: 38140153 PMCID: PMC10747154 DOI: 10.3390/vaccines11121748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
In Italy, several types of seasonal influenza vaccines (SIVs) are available for older adults, but for the 2022/2023 season there were no guidelines on their specific use. This cross-sectional study assessed the frequency and determinants of the use of enhanced (adjuvanted and high-dose) SIVs in Italian older adults, as compared to standard-dose non-adjuvanted formulations. Of 1702 vaccines administered to a representative outpatient sample of adults aged ≥ 60 years and residing in Genoa, 69.5% were enhanced SIVs. Older age (adjusted odds ratio (aOR) for each 1-year increase 1.10; p < 0.001), and the presence of cardiovascular disease (aOR 1.40; p = 0.011) and diabetes (aOR 1.62; p = 0.005) were associated with the use of enhanced vaccines. Compared with the adjuvanted SIV, subjects immunized with the high-dose vaccine were older (aOR for each 1-year increase 1.05; p < 0.001) and had higher prevalence of respiratory diseases (aOR 1.85; p = 0.052). Moreover, usage of the enhanced SIVs was driven by the period of immunization campaign, place of vaccination and physician. Despite their superior immunogenicity and effectiveness, the adoption of enhanced SIVs in Italy is suboptimal, and should be increased. Enhanced formulations are mostly used in the oldest, and in subjects with some co-morbidities.
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Affiliation(s)
- Luca Pestarino
- Private General Practice, 16122 Genoa, Italy; (L.P.); (F.B.); (E.C.); (P.C.B.); (G.R.); (S.V.)
- Medicoop Liguria, 16122 Genoa, Italy;
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.I.)
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), 16132 Genoa, Italy
| | - Federico Bianchi
- Private General Practice, 16122 Genoa, Italy; (L.P.); (F.B.); (E.C.); (P.C.B.); (G.R.); (S.V.)
| | - Elisa Cannavino
- Private General Practice, 16122 Genoa, Italy; (L.P.); (F.B.); (E.C.); (P.C.B.); (G.R.); (S.V.)
| | - Pier Claudio Brasesco
- Private General Practice, 16122 Genoa, Italy; (L.P.); (F.B.); (E.C.); (P.C.B.); (G.R.); (S.V.)
- Medicoop Liguria, 16122 Genoa, Italy;
| | - Gianluca Russo
- Private General Practice, 16122 Genoa, Italy; (L.P.); (F.B.); (E.C.); (P.C.B.); (G.R.); (S.V.)
- Medicoop Liguria, 16122 Genoa, Italy;
| | - Simone Valbonesi
- Private General Practice, 16122 Genoa, Italy; (L.P.); (F.B.); (E.C.); (P.C.B.); (G.R.); (S.V.)
- Medicoop Liguria, 16122 Genoa, Italy;
| | | | - Matilde Ogliastro
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), 16132 Genoa, Italy
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11
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Fedele G, Schiavoni I, Trentini F, Leone P, Olivetta E, Fallucca A, Fiore S, Di Martino A, Abrignani S, Baldo V, Baldovin T, Bandera A, Clerici P, De Paschale M, Diaco F, Domnich A, Fortunato F, Giberti I, Gori A, Grifantini R, Lazzarotto T, Lodi V, Mastroianni CM, Prato R, Restivo V, Vitale F, Brusaferro S, Merler S, Palamara AT, Stefanelli P. A 12-month follow-up of the immune response to SARS-CoV-2 primary vaccination: evidence from a real-world study. Front Immunol 2023; 14:1272119. [PMID: 38077369 PMCID: PMC10698351 DOI: 10.3389/fimmu.2023.1272119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/01/2023] [Indexed: 12/18/2023] Open
Abstract
A real-world population-based longitudinal study, aimed at determining the magnitude and duration of immunity induced by different types of vaccines against COVID-19, started in 2021 by enrolling a cohort of 2,497 individuals at time of their first vaccination. The study cohort included both healthy adults aged ≤65 years and elderly subjects aged >65 years with two or more co-morbidities. Here, patterns of anti-SARS-CoV-2 humoral and cell-mediated specific immune response, assessed on 1,182 remaining subjects, at 6 (T6) and 12 months (T12) after the first vaccine dose, are described. At T12 median anti-Spike IgG antibody levels were increased compared to T6. The determinants of increased anti-Spike IgG were the receipt of a third vaccine dose between T6 and T12 and being positive for anti-Nucleocapside IgG at T12, a marker of recent infection, while age had no significant effect. The capacity of T12 sera to neutralize in vitro the ancestral B strain and the Omicron BA.5 variant was assessed in a subgroup of vaccinated subjects. A correlation between anti-S IgG levels and sera neutralizing capacity was identified and higher neutralizing capacity was evident in healthy adults compared to frail elderly subjects and in those who were positive for anti-Nucleocapside IgG at T12. Remarkably, one third of T12 sera from anti-Nucleocapside IgG negative older individuals were unable to neutralize the BA.5 variant strain. Finally, the evaluation of T-cell mediated immunity showed that most analysed subjects, independently from age and comorbidity, displayed Spike-specific responses with a high degree of polyfunctionality, especially in the CD8 compartment. In conclusion, vaccinated subjects had high levels of circulating antibodies against SARS-CoV-2 Spike protein 12 months after the primary vaccination, which increased as compared to T6. The enhancing effect could be attributable to the administration of a third vaccine dose but also to the occurrence of breakthrough infection. Older individuals, especially those who were anti-Nucleocapside IgG negative, displayed an impaired capacity to neutralize the BA.5 variant strain. Spike specific T-cell responses, able to sustain immunity and maintain the ability to fight the infection, were present in most of older and younger subjects assayed at T12.
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Affiliation(s)
- Giorgio Fedele
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Ilaria Schiavoni
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Filippo Trentini
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
- Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy
| | - Pasqualina Leone
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Eleonora Olivetta
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Alessandra Fallucca
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Stefano Fiore
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Angela Di Martino
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Sergio Abrignani
- INGM, Istituto Nazionale Genetica Molecolare “Romeo ed Enrica Invernizzi”, Milan, Italy
- Department of Clinical Sciences & Community Health, University of Milan, Milan, Italy
| | - Vincenzo Baldo
- Laboratory of Hygiene and Applied Microbiology, Hygiene and Public Health Unit, Department of Cardiac Thoracic and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Tatjana Baldovin
- Laboratory of Hygiene and Applied Microbiology, Hygiene and Public Health Unit, Department of Cardiac Thoracic and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Alessandra Bandera
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milano, Milan, Italy
| | - Pierangelo Clerici
- Microbiology Unit, Azienda Socio Sanitaria Territoriale (ASST) Ovest Milanese, Milan, Italy
| | - Massimo De Paschale
- Microbiology Unit, Azienda Socio Sanitaria Territoriale (ASST) Ovest Milanese, Milan, Italy
| | - Fabiana Diaco
- Department of Molecular Medicine, AOU Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Alexander Domnich
- IRCCS Ospedale Policlinico San Martino Genova, and Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Francesca Fortunato
- Hygiene Unit, Policlinico Riuniti Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Irene Giberti
- IRCCS Ospedale Policlinico San Martino Genova, and Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Andrea Gori
- Microbiology Unit, Azienda Socio Sanitaria Territoriale (ASST) Ovest Milanese, Milan, Italy
- II Division of Infectious Diseases, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Renata Grifantini
- INGM, Istituto Nazionale Genetica Molecolare “Romeo ed Enrica Invernizzi”, Milan, Italy
| | - Tiziana Lazzarotto
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Section of Microbiology, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Vittorio Lodi
- Occupational Health Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Claudio Maria Mastroianni
- Department of Public Health and Infectious Disease, AOU Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Rosa Prato
- IRCCS Ospedale Policlinico San Martino Genova, and Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Vincenzo Restivo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Francesco Vitale
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | | | - Stefano Merler
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | | | - Paola Stefanelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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Domnich A, Grassi R, Fallani E, Costantini G, Panatto D, Ogliastro M, Salvatore M, Cambiaggi M, Vasco A, Orsi A, Icardi G. Increasing Influenza Vaccination Uptake by Sending Reminders: A Representative Cross-Sectional Study on the Preferences of Italian Adults. Vaccines (Basel) 2023; 11:1601. [PMID: 37897002 PMCID: PMC10610822 DOI: 10.3390/vaccines11101601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/10/2023] [Accepted: 10/14/2023] [Indexed: 10/29/2023] Open
Abstract
Evidence from countries that achieved a high seasonal influenza vaccination (SIV) coverage suggests that reminders to get vaccinated may increase SIV uptake. The goal of this study was to explore the experience and attitudes of Italian adults toward an active invitation to receive SIV, triggered by different sources and delivered via different communication channels, and to assess the projected benefits of this strategy. A cross-sectional survey on a representative sample of Italian adults was conducted by using computer-assisted web interviewing. Responses from 2513 subjects were analyzed. A total of 52.2% of individuals previously received invitations to undergo SIV and compared with people who did not receive any reminder were three times more likely (68.2% vs. 22.2%) to be vaccinated in the last season. Compared with other sources, reminders sent by general practitioners (GPs) were perceived as the most attractive. As for communication channels, most participants preferred text/instant messaging (24.6%) or email (27.2%), suggesting an acceleration in the Italian digital transformation triggered by the COVID-19 pandemic. Conversely, traditional postal letters or phone calls were preferred by only 17.0% and 8.6% of respondents, respectively. Reminders sent by GPs via text/instant messages or email are a valuable option for increasing SIV uptake among Italian adults.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.I.)
| | | | - Elettra Fallani
- CSL Seqirus, 53035 Monteriggioni, Italy; (E.F.); (M.S.); (M.C.); (A.V.)
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
| | | | - Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (D.P.); (M.O.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), 16132 Genoa, Italy
| | - Matilde Ogliastro
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (D.P.); (M.O.)
| | - Marco Salvatore
- CSL Seqirus, 53035 Monteriggioni, Italy; (E.F.); (M.S.); (M.C.); (A.V.)
| | - Maura Cambiaggi
- CSL Seqirus, 53035 Monteriggioni, Italy; (E.F.); (M.S.); (M.C.); (A.V.)
| | - Alessandro Vasco
- CSL Seqirus, 53035 Monteriggioni, Italy; (E.F.); (M.S.); (M.C.); (A.V.)
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (D.P.); (M.O.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), 16132 Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (D.P.); (M.O.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), 16132 Genoa, Italy
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13
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Domnich A, Orsi A, Ricucci V, De Pace V, Massaro E, Ogliastro M, Bruzzone B, Icardi G. Real-world performance of SARS-CoV-2 rapid antigen testing through the Alpha-, Delta- and Omicron-dominant waves of the COVID-19 pandemic. Int J Infect Dis 2023; 135:18-20. [PMID: 37536389 DOI: 10.1016/j.ijid.2023.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 08/05/2023] Open
Abstract
OBJECTIVES Compared with reverse transcription polymerase chain reaction (RT-PCR), rapid antigen detection tests (RADTs) for SARS-CoV-2 diagnostics are faster, less expensive, but also less accurate. Performance of RADTs is context-specific and depends on disease prevalence. In this real-world study, we assessed impact of RADTs in an inpatient setting through the entire COVID-19 emergency phase. METHODS In this matched retrospective study, data on RT-PCR and RADT laboratory diagnoses of SARS-CoV-2 made between February 2020 and May 2023 in a large hospital were analyzed. To be included in the study, samples used for both RT-PCR and RADT had to be collected on the same day. RESULTS Of 278,867 RT-PCR tests available, 13,321 same-day RADTs could be matched to RT-PCR. Over the entire period, RADT sensitivity and specificity were 76.4% and 99.4%, respectively. With the observed positivity rate of 9.4%, positive and negative predictive values were 92.7% and 97.6%, respectively. Compared with the periods dominated by the Alpha and Delta variants of concern, RADT accuracy was slightly lower during the Omicron phase. CONCLUSION This real-world experience demonstrates that despite suboptimal sensitivity and some variation by predominant variants of concern and positivity prevalence, the use of RADTs is useful in hospital settings. Public health implications were discussed.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Valentina Ricucci
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Vanessa De Pace
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Elvira Massaro
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Matilde Ogliastro
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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Domnich A, Orsi A, Panatto D, Ogliastro M, Barca A, Bert F, Cereda D, Chironna M, Costantino C, Fiacchini D, Pariani E, Rizzo C, Volpe E, Icardi G. Population-level benefits of increasing influenza vaccination uptake among Italian older adults: results from a granular panel model. Front Public Health 2023; 11:1224175. [PMID: 37601177 PMCID: PMC10435743 DOI: 10.3389/fpubh.2023.1224175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Background The impact of seasonal influenza vaccination (SIV) on mortality is still controversial; some studies have claimed that increasing vaccination coverage rates is beneficial, while others have found no significant association. This study aimed to construct a granular longitudinal dataset of local VCRs and assess their effect on pneumonia- and influenza-related (P&I) mortality among Italian adults aged ≥ 65 years. Methods NUTS-3 (nomenclature of territorial units for statistics) level data on SIV coverage were collected via a survey of local data holders. Fixed- and random-effects panel regression modeling, when adjusted for potential confounders, was performed to assess the association between local SIV coverage rates and P&I mortality in older adults. Results A total of 1,144 local VCRs from 2003 to 2019 were ascertained. In the fully adjusted fixed-effects model, each 1% increase in vaccination coverage was associated (P < 0.001) with a 0.6% (95% CI: 0.3-0.9%) average over-time decrease in P&I mortality. With an annual average of 9,293 P&I deaths in Italy, this model suggested that 56 deaths could have been avoided each year by increasing SIV coverage by 1%. The random-effects model produced similar results. The base-case results were robust in a sensitivity analysis. Conclusion Over the last two decades, Italian jurisdictions with higher SIV uptake had, on average, fewer P&I deaths among older adults. Local policy-makers should implement effective strategies to increase SIV coverage in the Italian senior population.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Matilde Ogliastro
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Alessandra Barca
- Directorate for Health and Social Policy, Lazio Region, Rome, Italy
| | - Fabrizio Bert
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Hygiene and Infection Control Unit, ASL TO3, Turin, Italy
| | - Danilo Cereda
- Directorate General for Health, Lombardy Region, Milan, Italy
| | - Maria Chironna
- Department of Interdisciplinary Medicine, University of Bari, Aldo Moro Policlinico, Bari, Italy
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D'Alessandro, ” University of Palermo, Palermo, Italy
| | | | - Elena Pariani
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Caterina Rizzo
- Department of Translational Research on New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Enrico Volpe
- Directorate for Health and Social Policy, Lazio Region, Rome, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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Domnich A, Amicizia D, Lai PL, Ogliastro M, Piedrahita-Tovar M, Orsi A, Icardi G, Panatto D. Three seasons of enhanced safety surveillance of a cell culture-based quadrivalent influenza vaccine. Hum Vaccin Immunother 2023; 19:2261689. [PMID: 37787067 PMCID: PMC10549188 DOI: 10.1080/21645515.2023.2261689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/19/2023] [Indexed: 10/04/2023] Open
Abstract
The objective of this paper is to summarize annual enhanced safety surveillance activity across three seasons (2019/20-2021/22) for cell culture-based quadrivalent influenza vaccine (QIVc; Flucelvax® Tetra) in all age groups. This activity was conducted in primary care setting in Genoa (Italy) during the seasons 2019/20, 2020/21 and 2021/22. All adverse events registered within the first seven days following immunization were analyzed by season, type, age group and seriousness. Over three seasons, 3,603 QIVc exposures were recorded within the enhanced passive safety surveillance activity. No safety signals were identified. The overall reporting rates of individual case safety reports for the seasons 2019/20, 2020/21 and 2021/22 were 1.75%, 0.48% and 0.40%, respectively. The average number of adverse events per individual case safety report was similar (range 3.3-3.8 adverse events per case report) across the three seasons. Most adverse events were reactogenic in nature. The rate of adverse events was similarly low in all age groups. Enhanced passive safety surveillance activity is a feasible approach for the post-marketing monitoring of seasonal influenza vaccines. Within its limitations, results of this study support the favorable safety profile of QIVc. These safety data could further bolster public trust in influenza vaccines with the goal to increase vaccination uptake in all target groups.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Daniela Amicizia
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Piero Luigi Lai
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Matilde Ogliastro
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | | | - Andrea Orsi
- Hygiene Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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16
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Domnich A, Orsi A, Ogliastro M, Trombetta CS, Scarpaleggia M, Stefanelli F, Panatto D, Bruzzone B, Icardi G. Influenza vaccine effectiveness in preventing hospital encounters for laboratory-confirmed infection among Italian adults, 2022/23 season. Vaccine 2023:S0264-410X(23)00775-2. [PMID: 37385889 DOI: 10.1016/j.vaccine.2023.06.072] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 07/01/2023]
Abstract
The effectiveness of seasonal influenza vaccination (SIV) varies from year to year. Interim estimates of vaccine effectiveness (VE) in outpatient settings have suggested that the 2022/23 northern hemisphere SIV was 54 % effective. The main goal of this study was to measure the 2022/23 SIV VE among Italian adults in a hospital setting. The study adopted a retrospective test-negative case-control design and was conducted in a large tertiary hospital (Genoa, Italy) between October 2022 and April 2023. Adult (≥18 years) patients accessing the hospital's Emergency Department for symptoms ascribable to an acute respiratory infection, for which a reverse-transcription real-time polymerase chain reaction test for the detection of influenza virus was prescribed, were potentially eligible. Of 33,692 referrals assessed, 487 patients were included in the study. A total of 13 % of patients were positive for influenza, most of which (63 %) belonged to the A(H3N2) subtype. SIV VE was 57 % (95 % CI: 11-81 %), 53 % (95 % CI: 2-80 %) and 38 % (95 % CI: -34-74 %) against any influenza, influenza A and A(H3N2), respectively. Although no cases caused by A(H1N1)pdm09 and B strains were observed among vaccinated individuals, VE estimates against the latter were imprecise, owing to their low detection rates. In conclusion, the 2022/23 SIV was moderately effective against hospital encounters for laboratory-confirmed influenza.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy; Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Matilde Ogliastro
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | | | | | - Federica Stefanelli
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy; Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy; Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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17
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Domnich A, Milano G, Capitani E, Camarri A, Bova G, Capecchi PL, Montomoli E, Manini I. Lower frequency of SARS-CoV-2-associated severe respiratory infections among adults vaccinated against the 2021/22 season influenza. Respir Med Res 2023; 83:100979. [PMID: 36565562 PMCID: PMC9694353 DOI: 10.1016/j.resmer.2022.100979] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/21/2022] [Accepted: 11/17/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital – IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Giovanna Milano
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Elena Capitani
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Andrea Camarri
- Emergency and Transplants Department, University Hospital of Siena, Siena, Italy
| | - Giovanni Bova
- Emergency and Transplants Department, University Hospital of Siena, Siena, Italy
| | - Pier Leopoldo Capecchi
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy,VisMederi S.r.l., Siena, Italy,Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Ilaria Manini
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy,Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy,Corresponding author at. Department of Molecular and Developmental Medicine, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy
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18
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Amicizia D, Domnich A, Lai PL, Orsi A, Icardi G, Tkach-Motulyak O, Panatto D. Enhanced passive safety surveillance of the MF59-adjuvanted quadrivalent influenza vaccine in the elderly during the 2021/22 influenza season. Hum Vaccin Immunother 2023; 19:2190279. [PMID: 36919537 PMCID: PMC10072113 DOI: 10.1080/21645515.2023.2190279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
In accordance with European directives, each year the enhanced safety surveillance (ESS) of seasonal influenza vaccines should be conducted in order to detect any potential increase in reactogenicity when the vaccine composition is updated or a new formulation becomes available. The objective of this passive ESS (EPSS) was to assess the frequency of spontaneously reported adverse events (AEs) following vaccination with the 2021/22 formulation of the MF59-adjuvanted quadrivalent influenza vaccine (aQIV) among older adults in Italy through the collection of data within a short time period (start of seasonal influenza vaccination) in order to monitor the reactogenicity of aQIV early in the season. All AEs reported within seven days following vaccination were analyzed by type and seriousness. In all, 1,059 vaccination cards were distributed to individuals aged ≥65 years. Only one, non-serious, spontaneous individual case safety report was submitted, yielding an overall rate of 0.9 per 1,000 doses administered. This report consisted of a reactogenic AE of pyrexia. The EPSS confirmed that the reactogenicity profile of aQIV was consistent with the known safety profile of the previous trivalent formulation. These optimal safety data could bolster public confidence in influenza vaccination and help to improve vaccination coverage.
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Affiliation(s)
- Daniela Amicizia
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Piero Luigi Lai
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Andrea Orsi
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy.,Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Giancarlo Icardi
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy.,Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | | | - Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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19
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Panatto D, Domnich A, Lai PL, Ogliastro M, Bruzzone B, Galli C, Stefanelli F, Pariani E, Orsi A, Icardi G. Epidemiology and molecular characteristics of respiratory syncytial virus (RSV) among italian community-dwelling adults, 2021/22 season. BMC Infect Dis 2023; 23:134. [PMID: 36882698 PMCID: PMC9990006 DOI: 10.1186/s12879-023-08100-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/20/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a leading cause of acute respiratory infections worldwide. While historically RSV research has been focused on children, data on RSV infection in adults are limited. The goal of this study was to establish the prevalence of RSV in community-dwelling Italian adults and analyze its genetic variability during the 2021/22 winter season. METHODS In this cross-sectional study, a random sample of naso-/oropharyngeal specimens from symptomatic adults seeking for SARS-CoV-2 molecular testing between December 2021 and March 2022 were tested for RSV and other respiratory pathogens by means of reverse-transcription polymerase chain reaction. RSV-positive samples were further molecularly characterized by sequence analysis. RESULTS Of 1,213 samples tested, 1.6% (95% CI: 0.9-2.4%) were positive for RSV and subgroups A (44.4%) and B (55.6%) were identified in similar proportions. The epidemic peak occurred in December 2021, when the RSV prevalence was as high as 4.6% (95% CI: 2.2-8.3%). The prevalence of RSV detection was similar (p = 0.64) to that of influenza virus (1.9%). All RSV A and B strains belonged to the ON1 and BA genotypes, respectively. Most (72.2%) RSV-positive samples were also positive for other pathogens being SARS-CoV-2, Streptococcus pneumoniae and rhinovirus the most frequent. RSV load was significantly higher among mono-detections than co-detections. CONCLUSION During the 2021/22 winter season, characterized by the predominant circulation of SARS-CoV-2 and some non-pharmaceutical containment measures still in place, a substantial proportion of Italian adults tested positive for genetically diversified strains of both RSV subtypes. In view of the upcoming registration of vaccines, establishment of the National RSV surveillance system is urgently needed.
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Affiliation(s)
- Donatella Panatto
- Department of Health Sciences, University of Genoa, Via A. Pastore, 1, 16132, Genoa, Italy. .,Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy.
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Piero Luigi Lai
- Department of Health Sciences, University of Genoa, Via A. Pastore, 1, 16132, Genoa, Italy
| | - Matilde Ogliastro
- Department of Health Sciences, University of Genoa, Via A. Pastore, 1, 16132, Genoa, Italy
| | - Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Federica Stefanelli
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Andrea Orsi
- Department of Health Sciences, University of Genoa, Via A. Pastore, 1, 16132, Genoa, Italy.,Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy.,Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Via A. Pastore, 1, 16132, Genoa, Italy.,Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy.,Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
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20
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Domnich A, Bruzzone B, Trombetta CS, De Pace V, Ricucci V, Varesano S, Garzillo G, Ogliastro M, Orsi A, Icardi G. Rapid differential diagnosis of SARS-CoV-2, influenza A/B and respiratory syncytial viruses: Validation of a novel RT-PCR assay. J Clin Virol 2023; 161:105402. [PMID: 36805601 DOI: 10.1016/j.jcv.2023.105402] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/06/2023] [Accepted: 02/12/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Influenza and respiratory syncytial (RSV) viruses are expected to co-circulate with SARS-CoV-2 in the upcoming seasons and clinical differential diagnosis between them is difficult. Laboratory-based RT-PCR is a gold standard diagnostic method for influenza, RSV and SARS-CoV-2. The objective of this study was to estimate the diagnostic performance of a novel point-of-care RT-PCR assay STANDARD M10 Flu/RSV/SARS-CoV-2 (SD Biosensor) in a large number of clinical specimens with diversified (co)-infection patterns and viral loads. METHODS This was a retrospective study, in which all samples were tested in both STANDARD M10 Flu/RSV/SARS-CoV-2 index and Allplex SARS-CoV-2/Respiratory Panel 1 (Seegene) reference kits. Samples with discordant results were further processed in a third resolver test (Resp-4-Plex, Abbott). RESULTS A total of 1,019 naso-/oropharyngeal samples (50.3% positive for at least one virus) were processed in both STANDARD M10 Flu/RSV/SARS-CoV-2 and Allplex assays and the overall between-assay agreement was as high as 94.6%. Positive percent agreement of the STANDARD M10 Flu/RSV/SARS-CoV-2 was 100%, 96.6%, 97.3% and 99.4% for influenza A, B, RSV and SARS-CoV-2, respectively. The corresponding negative percent agreement was 99.7%. 100%, 100% and 98.4%, respectively. The expected positive and negative predictive values for all viruses were constantly above 96% in a reasonable range of disease prevalence. CONCLUSIONS STANDARD M10 Flu/RSV/SARS-CoV-2 is a reliable RT-PCR assay able to detect influenza A, influenza B, RSV and SARS-CoV-2 in one hour or less, fostering a rapid differential diagnosis of common respiratory viruses.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | | | - Vanessa De Pace
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Valentina Ricucci
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Serena Varesano
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Giada Garzillo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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21
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Orsi A, Domnich A, Mosca S, Ogliastro M, Sticchi L, Prato R, Fortunato F, Martinelli D, Tramuto F, Costantino C, Restivo V, Baldo V, Baldovin T, Begier E, Theilacker C, Montuori EA, Beavon R, Gessner B, Icardi G. Prevalence of Pneumococcal Serotypes in Community-Acquired Pneumonia among Older Adults in Italy: A Multicenter Cohort Study. Microorganisms 2022; 11:microorganisms11010070. [PMID: 36677362 PMCID: PMC9864441 DOI: 10.3390/microorganisms11010070] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/22/2022] [Accepted: 12/24/2022] [Indexed: 12/28/2022] Open
Abstract
Pneumococcal community-acquired pneumonia (CAP) is a leading cause of mortality. Following the introduction of pneumococcal conjugate vaccines (PCVs) in children, a decrease in the burden of the disease was reported. In parallel, an increase in non-vaccine serotypes was also noted. The objective of this study was to assess the current serotype-specific epidemiology of pneumococci among Italian older adults hospitalized for CAP. A prospective study was conducted between 2017 and 2020 in four Italian regions. Subjects aged ≥65 years hospitalized with confirmed CAP were tested for pneumococci using both pneumococcal urinary antigen and serotype-specific urine antigen tests able to identify all 24 serotypes included in the available vaccines. Of the 1155 CAP cases, 13.1% were positive for pneumococci. The most prevalent serotypes were 3 (2.0%), 8 (1.7%), 22F (0.8 %) and 11A (0.7%). These serotypes are all included in the newly licensed PCV20. The serotypes included in PCV13, PCV15 and PCV20 contributed to 3.3%, 4.4% and 7.5% of the CAP cases, respectively. In the context of a low PCV13 coverage among older adults and a high PCV coverage in children, a substantial proportion of CAP is caused by PCV13 serotypes. Higher valency PCV15 and PCV20 may provide additional benefits for the prevention of CAP in vaccinated older adults.
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Affiliation(s)
- Andrea Orsi
- Dipartimento di Scienze della Salute (DiSSal), University of Genoa, 16132 Genoa, Italy
- Hygiene Unit, Ospedale Policlinico San Martino IRCCS Genoa, 16132 Genoa, Italy
- Correspondence:
| | - Alexander Domnich
- Hygiene Unit, Ospedale Policlinico San Martino IRCCS Genoa, 16132 Genoa, Italy
| | - Stefano Mosca
- Dipartimento di Scienze della Salute (DiSSal), University of Genoa, 16132 Genoa, Italy
| | - Matilde Ogliastro
- Dipartimento di Scienze della Salute (DiSSal), University of Genoa, 16132 Genoa, Italy
| | - Laura Sticchi
- Dipartimento di Scienze della Salute (DiSSal), University of Genoa, 16132 Genoa, Italy
- Hygiene Unit, Ospedale Policlinico San Martino IRCCS Genoa, 16132 Genoa, Italy
| | - Rosa Prato
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Francesca Fortunato
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Domenico Martinelli
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Fabio Tramuto
- Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica d’Eccellenza (PROSAMI) “G. D’Alessandro”—Sezione di Igiene—University of Palermo, 90127 Palermo, Italy
| | - Claudio Costantino
- Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica d’Eccellenza (PROSAMI) “G. D’Alessandro”—Sezione di Igiene—University of Palermo, 90127 Palermo, Italy
| | - Vincenzo Restivo
- Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica d’Eccellenza (PROSAMI) “G. D’Alessandro”—Sezione di Igiene—University of Palermo, 90127 Palermo, Italy
| | - Vincenzo Baldo
- Dipartimento di Scienze Cardio-Toraco-Vascolari e Sanità Pubblica, University of Padua, 35100 Padua, Italy
| | - Tatjana Baldovin
- Dipartimento di Scienze Cardio-Toraco-Vascolari e Sanità Pubblica, University of Padua, 35100 Padua, Italy
| | | | | | | | - Rohini Beavon
- Global Vaccines, Pfizer Inc., Collegeville, PA 19426, USA
| | | | - Giancarlo Icardi
- Dipartimento di Scienze della Salute (DiSSal), University of Genoa, 16132 Genoa, Italy
- Hygiene Unit, Ospedale Policlinico San Martino IRCCS Genoa, 16132 Genoa, Italy
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22
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Calabrò GE, Boccalini S, Bechini A, Panatto D, Domnich A, Lai PL, Amicizia D, Rizzo C, Pugliese A, DI Pietro ML, Zanella B, Parente F, Trombetta CS, Saraceno G, Sottile S, Abreha FM, Giacchetta I, Properzi S, Santolini G, D'Ambrosio F, Maida A, Scardigno A, LA Gatta E, Petrella L, Bonanni P, DE Waure C. [Health Technology Assessment: a value-based tool for the evaluation of healthcare technologies. Reassessment of the cell-culture-derived quadrivalent influenza vaccine: Flucelvax Tetra ® 2.0]. J Prev Med Hyg 2022; 63:E1-E140. [PMID: 37034835 PMCID: PMC10079375 DOI: 10.15167/2421-4248/jpmh2022.63.4s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Affiliation(s)
- Giovanna Elisa Calabrò
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
- VIHTALI (Value In Health Technology and Academy for Leadership & Innovation), Spin-off dell'Università Cattolica del Sacro Cuore, Roma, Italia
| | - Sara Boccalini
- Dipartimento di Scienze della Salute, Università degli di Studi di Firenze, Firenze, Italia
| | - Angela Bechini
- Dipartimento di Scienze della Salute, Università degli di Studi di Firenze, Firenze, Italia
| | - Donatella Panatto
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
- Centro Interuniversitario di Ricerca sull'Influenza e le altre Infezioni Trasmissibili (CIRI-IT), Genova, Italia
| | | | - Piero Luigi Lai
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
- Centro Interuniversitario di Ricerca sull'Influenza e le altre Infezioni Trasmissibili (CIRI-IT), Genova, Italia
| | - Daniela Amicizia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
- Centro Interuniversitario di Ricerca sull'Influenza e le altre Infezioni Trasmissibili (CIRI-IT), Genova, Italia
| | - Caterina Rizzo
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, Università degli Studi di Pisa, Pisa, Italia
| | - Andrea Pugliese
- Dipartimento di Matematica, Università di Trento, Trento, Italia
| | - Maria Luisa DI Pietro
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Beatrice Zanella
- Dipartimento di Scienze della Salute, Università degli di Studi di Firenze, Firenze, Italia
| | - Flavio Parente
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | | | | | - Sara Sottile
- Dipartimento di Matematica, Università di Trento, Trento, Italia
| | - Fasika Molla Abreha
- Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Irene Giacchetta
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - Sara Properzi
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - Giulia Santolini
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - Floriana D'Ambrosio
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Ada Maida
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Anna Scardigno
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Emanuele LA Gatta
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Luigi Petrella
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Paolo Bonanni
- Dipartimento di Scienze della Salute, Università degli di Studi di Firenze, Firenze, Italia
| | - Chiara DE Waure
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
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23
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Domnich A, Panatto D, Pariani E, Napoli C, Chironna M, Manini I, Rizzo C, Orsi A, Icardi G. Relative effectiveness of the adjuvanted vs non-adjuvanted seasonal influenza vaccines against severe laboratory-confirmed influenza among hospitalized Italian older adults. Int J Infect Dis 2022; 125:164-169. [PMID: 36332902 DOI: 10.1016/j.ijid.2022.10.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/17/2022] [Accepted: 10/27/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES In this study, we aimed to investigate the relative vaccine effectiveness (rVE) of the MF59-adjuvanted trivalent (aTIV) and non-adjuvanted quadrivalent (QIVe) egg-based standard-dose vaccines against severe laboratory-confirmed influenza. METHODS This test-negative case-control study was conducted in a hospital setting during four recent Italian influenza seasons (from 2018/19 to 2021/22). The clinical outcome was severe acute respiratory infection (SARI) with laboratory confirmation diagnosed among subjects aged ≥65 years. rVE of aTIV versus QIVe was estimated through propensity score matching followed by logistic regression. RESULTS The influenza virus circulated to a significant extent only during the 2018/19 and 2019/20 seasons. The final population included 512 vaccinated older adults, of which 83 were cases and 429 were test-negative controls. aTIV and QIVe users differed substantially from the point of view of several baseline characteristics. The propensity score adjusted rVE of aTIV vs QIVe was 59.2% (95% CI: 14.6%, 80.5%), 54.7% (95% CI: -28.7%, 84.0%) and 56.9% (95% CI: -7.8%, 82.8%) against any influenza, A(H1N1)pdm09 and A(H3N2), respectively. CONCLUSION aTIV was more effective than QIVe in preventing laboratory-confirmed SARI. The benefits of aTIV may be obscured by confounding indication.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Donatella Panatto
- Department of Health Sciences, University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Elena Pariani
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Maria Chironna
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Ilaria Manini
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy; Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Caterina Rizzo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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Lapi F, Domnich A, Marconi E, Rossi A, Cricelli C. Adjuvanted versus non-adjuvanted standard-dose influenza vaccines in preventing all-cause hospitalizations in the elderly: a cohort study with nested case-control analyses over 18 influenza seasons. Expert Rev Vaccines 2022; 21:1647-1653. [PMID: 35984048 DOI: 10.1080/14760584.2022.2115362] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The higher effectiveness of adjuvanted trivalent influenza vaccine (aTIV) versus non-adjuvanted (na) formulations in preventing all-cause hospitalization has been demonstrated for a single influenza season and in institutionalized elderly only. This study evaluated the relative vaccine effectiveness for aTIV vs. non-adjuvanted trivalent (naTIV) and/or quadrivalent (naQIV) influenza vaccines in preventing all-cause hospitalizations across 18 influenza seasons in primary care. RESEARCH DESIGN AND METHODS Using Health Search Database, a nested case-control analysis was conducted in a cohort of older adults being vaccinated with aTIV or naTIV/naQIV. Conditional logistic regression was adopted to estimate the odds ratio (OR) of all-cause hospitalizations occurred during the epidemic period. RESULTS Of 58,252 patients vaccinated with aTIV and naTIV/naQIV for the first time, 2,504 cases of all-cause hospitalization (3.46 per 1,000 person-weeks) during the 18 influenza seasons were identified. Compared with naTIV/naQIV, aTIV was associated with a 12% reduced the odds of all-cause hospitalizations (OR 0.88; 95% CI: 0.80-0.98). CONCLUSIONS In an 18-season cohort of older adults, aTIV reduced the risk of all-cause hospitalizations when compared with naTIV/naQIV. Our findings confirm additional benefits for adjuvanted influenza vaccines in older adults.
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Affiliation(s)
- Francesco Lapi
- Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Ettore Marconi
- Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy
| | - Alessandro Rossi
- Italian College of General Practitioners and Primary Care, Florence, Italy
| | - Claudio Cricelli
- Italian College of General Practitioners and Primary Care, Florence, Italy
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Domnich A, de Waure C. Comparative effectiveness of adjuvanted versus high-dose seasonal influenza vaccines for older adults: A systematic review and meta-analysis. Int J Infect Dis 2022; 122:855-863. [PMID: 35878803 DOI: 10.1016/j.ijid.2022.07.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/18/2022] [Accepted: 07/18/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES MF59-adjuvanted standard-dose and non-adjuvanted high-dose seasonal influenza vaccines have been developed to protect older adults at high risk of severe complications. The aim of this study was to summarize the available evidence on the comparative efficacy/effectiveness of these two vaccines. METHODS A systematic literature review (CRD42022313021) of experimental and observational studies was conducted according to the PRISMA guidelines. When possible, the extracted effect sizes were pooled in random-effects meta-analyses. RESULTS Ten studies were identified. Of these, no head-to-head randomized controlled trials were identified. All available studies had retrospective cohort design and large sample sizes, were conducted in the United States between 2016/17 and 2019/20 seasons and were at moderate risk of bias. Relative effectiveness estimates were limited to non-laboratory-confirmed clinical endpoints, such as medical encounters including hospitalizations. While most pooled relative effectiveness estimates were close to null, few statistically significant pooled effect sizes were small in magnitude, moved in opposite directions and depended on both the study sponsor and specificity of influenza-related outcomes. CONCLUSIONS At current, MF59-adjuvanted standard-dose and non-adjuvanted high-dose vaccines appear to have similar effectiveness in preventing seasonal influenza in older adults and no conclusive recommendations on the preference of one vaccine over another could be drawn.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Chiara de Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Giberti I, Costa E, Domnich A, Ricucci V, De Pace V, Garzillo G, Guarona G, Icardi G. High Diagnostic Accuracy of a Novel Lateral Flow Assay for the Point-of-Care Detection of SARS-CoV-2. Biomedicines 2022; 10:biomedicines10071558. [PMID: 35884863 PMCID: PMC9312898 DOI: 10.3390/biomedicines10071558] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 12/27/2022] Open
Abstract
Highly accurate lateral flow immunochromatographic tests (LFTs) are an important public health tool to tackle the ongoing COVID-19 pandemic. The aim of this study was to assess the comparative diagnostic performance of the novel ND COVID-19 LFT under real-world conditions. A total of 400 nasopharyngeal swab specimens with a wide range of viral loads were tested in both reverse-transcription polymerase chain reaction and ND LFT. The overall sensitivity and specificity were 85% (95% CI: 76.7−90.7%) and 100% (95% CI: 98.7−100%), respectively. There was a clear association between the false-negative rate and sample viral load: the sensitivity parameters for specimens with cycle threshold values of <25 (>3.95 × 106 copies/mL) and ≥30 (≤1.29 × 105 copies/mL) were 100% and 50%, respectively. The performance was maximized in testing samples with viral loads ≥1.29 × 105 copies/mL. These findings suggest that the ND LFT is sufficiently accurate and useful for mass population screening programs, especially in high-prevalence and resource-constrained settings or during periods when the epidemic curve is rising. Other public health implications were also discussed.
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Affiliation(s)
- Irene Giberti
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (I.G.); (E.C.); (G.G.); (G.I.)
| | - Elisabetta Costa
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (I.G.); (E.C.); (G.G.); (G.I.)
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (V.R.); (V.D.P.); (G.G.)
- Correspondence:
| | - Valentina Ricucci
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (V.R.); (V.D.P.); (G.G.)
| | - Vanessa De Pace
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (V.R.); (V.D.P.); (G.G.)
| | - Giada Garzillo
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (I.G.); (E.C.); (G.G.); (G.I.)
| | - Giulia Guarona
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (V.R.); (V.D.P.); (G.G.)
| | - Giancarlo Icardi
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (I.G.); (E.C.); (G.G.); (G.I.)
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (V.R.); (V.D.P.); (G.G.)
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Panatto D, Orsi A, Bruzzone B, Ricucci V, Fedele G, Reiner G, Giarratana N, Domnich A, Icardi G. Efficacy of the Sentinox Spray in Reducing Viral Load in Mild COVID-19 and Its Virucidal Activity against Other Respiratory Viruses: Results of a Randomized Controlled Trial and an In Vitro Study. Viruses 2022; 14:v14051033. [PMID: 35632774 PMCID: PMC9144724 DOI: 10.3390/v14051033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 01/25/2023] Open
Abstract
Sentinox (STX) is an acid-oxidizing solution containing hypochlorous acid in spray whose virucidal activity against SARS-CoV-2 has been demonstrated. In this paper, results of a randomized controlled trial (RCT) on the efficacy of STX in reducing viral load in mild COVID-19 patients (NCT04909996) and a complementary in vitro study on its activity against different respiratory viruses are reported. In the RCT, 57 patients were randomized (1:1:1) to receive STX three (STX-3) or five (STX-5) times/day plus standard therapy or standard therapy only (controls). Compared with controls, the log10 load reduction in groups STX-3 and STX-5 was 1.02 (p = 0.14) and 0.18 (p = 0.80), respectively. These results were likely driven by outliers with extreme baseline viral loads. When considering subjects with baseline cycle threshold values of 20–30, STX-3 showed a significant (p = 0.016) 2.01 log10 reduction. The proportion of subjects that turned negative by the end of treatment (day 5) was significantly higher in the STX-3 group than in controls, suggesting a shorter virus clearance time. STX was safe and well-tolerated. In the in vitro study, ≥99.9% reduction in titers against common respiratory viruses was observed. STX is a safe device with large virucidal spectrum and may reduce viral loads in mild COVID-19 patients.
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Affiliation(s)
- Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (D.P.); (A.O.); (G.I.)
| | - Andrea Orsi
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (D.P.); (A.O.); (G.I.)
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (B.B.); (V.R.)
| | - Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (B.B.); (V.R.)
| | - Valentina Ricucci
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (B.B.); (V.R.)
| | | | - Giorgio Reiner
- APR Applied Pharma Research SA, via Corti 5, CH-6828 Balerna, Switzerland; (G.R.); (N.G.)
| | - Nadia Giarratana
- APR Applied Pharma Research SA, via Corti 5, CH-6828 Balerna, Switzerland; (G.R.); (N.G.)
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (B.B.); (V.R.)
- Correspondence:
| | - Giancarlo Icardi
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (D.P.); (A.O.); (G.I.)
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (B.B.); (V.R.)
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Domnich A, Orsi A, Trombetta CS, Costa E, Guarona G, Lucente M, Ricucci V, Bruzzone B, Icardi G. Comparative Diagnostic Accuracy of the STANDARD M10 Assay for the Molecular Diagnosis of SARS-CoV-2 in the Point-of-Care and Critical Care Settings. J Clin Med 2022; 11:2465. [PMID: 35566591 PMCID: PMC9105343 DOI: 10.3390/jcm11092465] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 02/06/2023] Open
Abstract
Accurate and rapid molecular diagnosis of COVID-19 is a crucial step to tackle the ongoing pandemic. The primary objective of this study was to estimate the real-world performance of the novel RT-PCR STANDARD M10 SARS-CoV-2 assay in a large number of nasopharyngeal (NP) specimens eluted in universal transport medium. The secondary objective was to evaluate the compatibility of this kit in testing NP samples eluted in an inactivated transport medium (essential for point-of-care testing) and lower respiratory tract (LRT) specimens, which are commonly collected in critical care. A total of 591 samples were analyzed. Compared with the standard extraction-based RT-PCR Allplex 2019-nCoV (time-to-result of 270 min), the sensitivities of the STANDARD M10 were 100% (95% CI: 98.1-100%), 95.5% (95% CI: 91.7-97.6%), and 99.5% (95% CI: 97.2-99.9%) for ≥1 gene, the ORF1ab gene, and the E gene, respectively, while the specificity was 100% (95% CI: 98.7-100%). The diagnostic accuracy was 100% in testing both NP samples eluted in an inactivated transport medium and LRT specimens. STANDARD M10 reliably detects SARS-CoV-2 in 60 min, may be used as a POC tool, and is suitable for testing LRT specimens in the critical care setting.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.G.); (M.L.); (V.R.); (B.B.); (G.I.)
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.G.); (M.L.); (V.R.); (B.B.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (C.-S.T.); (E.C.)
| | - Carlo-Simone Trombetta
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (C.-S.T.); (E.C.)
| | - Elisabetta Costa
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (C.-S.T.); (E.C.)
| | - Giulia Guarona
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.G.); (M.L.); (V.R.); (B.B.); (G.I.)
| | - Miriana Lucente
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.G.); (M.L.); (V.R.); (B.B.); (G.I.)
| | - Valentina Ricucci
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.G.); (M.L.); (V.R.); (B.B.); (G.I.)
| | - Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.G.); (M.L.); (V.R.); (B.B.); (G.I.)
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.G.); (M.L.); (V.R.); (B.B.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (C.-S.T.); (E.C.)
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Domnich A, Orsi A, Sticchi L, Panatto D, Dini G, Ferrari A, Ogliastro M, Boccotti S, De Pace V, Ricucci V, Bruzzone B, Durando P, Icardi G. Effect of the 2020/21 season influenza vaccine on SARS-CoV-2 infection in a cohort of Italian healthcare workers. Vaccine 2022; 40:1755-1760. [PMID: 35153098 PMCID: PMC8829680 DOI: 10.1016/j.vaccine.2022.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/08/2022] [Accepted: 02/02/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Healthcare workers (HCWs) are a priority group for seasonal influenza vaccination (SIV). The 2020/21 SIV campaign was conducted during the second wave of the COVID-19 pandemic. Vaccines, including SIV, may exert non-specific protective effects on other infectious diseases which may be ascribable to the concept of trained immunity. The aim of this study was to explore the association between 2020/21 SIV and SARS-CoV-2 positivity in a cohort of Italian HCWs. METHODS In this observational study, a cohort of HCWs employed by a large (ca 5000 employees) referral tertiary acute-care university hospital was followed up retrospectively until the start of the COVID-19 vaccination campaign. The independent variable of interest was the 2020/21 SIV uptake. Both egg-based and cell culture-derived quadrivalent SIVs were available. The study outcome was the incidence of new SARS-CoV-2 infections, as determined by RT-PCR. Multivariable Cox regression was applied in order to discern the association of interest. RESULTS The final cohort consisted of 2561 HCWs who underwent ≥1 RT-PCR test and accounted for a total of 94,445 person-days of observation. SIV uptake was 35.6%. During the study period, a total of 290 new SARS-CoV-2 infections occurred. The incidence of new SARS-CoV-2 was 1.62 (95% CI: 1.22-2.10) and 3.91 (95% CI: 3.43-4.45) per 1000 person-days in vaccinated and non-vaccinated HCWs, respectively, with an adjusted non-proportional hazard ratio of 0.37 (95% CI: 0.22-0.62). E-values suggested that unmeasured confounding was unlikely to explain the association. CONCLUSIONS A lower risk of SARS-CoV-2 infection was observed among SIV recipients.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy.
| | - Laura Sticchi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy.
| | - Donatella Panatto
- Department of Health Sciences, University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy.
| | - Guglielmo Dini
- Department of Health Sciences, University of Genoa, Genoa, Italy; Occupational Medicine Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Allegra Ferrari
- Department of Health Sciences, University of Genoa, Genoa, Italy.
| | | | - Simona Boccotti
- Department of Health Sciences, University of Genoa, Genoa, Italy.
| | - Vanessa De Pace
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Valentina Ricucci
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Paolo Durando
- Department of Health Sciences, University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy; Occupational Medicine Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy.
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Domnich A, Orsi A, Trombetta CS, Guarona G, Panatto D, Icardi G. COVID-19 and Seasonal Influenza Vaccination: Cross-Protection, Co-Administration, Combination Vaccines, and Hesitancy. Pharmaceuticals (Basel) 2022; 15:ph15030322. [PMID: 35337120 PMCID: PMC8952219 DOI: 10.3390/ph15030322] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/06/2022] [Accepted: 03/07/2022] [Indexed: 12/26/2022] Open
Abstract
SARS-CoV-2 and influenza are the main respiratory viruses for which effective vaccines are currently available. Strategies in which COVID-19 and influenza vaccines are administered simultaneously or combined into a single preparation are advantageous and may increase vaccination uptake. Here, we comprehensively review the available evidence on COVID-19/influenza vaccine co-administration and combination vaccine candidates from the standpoints of safety, immunogenicity, efficacy, policy and public acceptance. While several observational studies have shown that the trained immunity induced by influenza vaccines can protect against some COVID-19-related endpoints, it is not yet understood whether co-administration or combination vaccines can exert additive effects on relevant outcomes. In randomized controlled trials, co-administration has proved safe, with a reactogenicity profile similar to that of either vaccine administered alone. From the immunogenicity standpoint, the immune response towards four influenza strains and the SARS-CoV-2 spike protein in co-administration groups is generally non-inferior to that seen in groups receiving either vaccine alone. Several public health authorities have advocated co-administration. Different combination vaccine candidates are in (pre)-clinical development. The hesitancy towards vaccine co-administration or combination vaccines is a multifaceted phenomenon and may be higher than the acceptance of either vaccine administered separately. Public health implications are discussed.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.G.); (G.I.)
- Correspondence:
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.G.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (C.-S.T.); (D.P.)
| | - Carlo-Simone Trombetta
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (C.-S.T.); (D.P.)
| | - Giulia Guarona
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.G.); (G.I.)
| | - Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (C.-S.T.); (D.P.)
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.G.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (C.-S.T.); (D.P.)
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De Pace V, Bruzzone B, Orsi A, Ricucci V, Domnich A, Guarona G, Randazzo N, Stefanelli F, Battolla E, Dusi PA, Lillo F, Icardi G. Comparative Analysis of Five Multiplex RT-PCR Assays in the Screening of SARS-CoV-2 Variants. Microorganisms 2022; 10:microorganisms10020306. [PMID: 35208761 PMCID: PMC8876857 DOI: 10.3390/microorganisms10020306] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/18/2022] [Accepted: 01/26/2022] [Indexed: 11/16/2022] Open
Abstract
The rapid and presumptive detection of SARS-CoV-2 variants may be performed using multiplex RT-PCR assays. The aim of this study was to evaluate the diagnostic performance of five qualitative RT-PCR tests as compared with next-generation sequencing (NGS). We retrospectively examined a multi-variant panel (n = 72) of SARS-CoV-2-positive nasopharyngeal swabs categorized as variants of concern (Alpha, Beta, Gamma and Delta), variants under monitoring (Iota and Kappa) and wild-type strains circulating in Liguria (Italy) from January to August 2021. First, NGS libraries of study samples were prepared and mapped to the reference genome. Then, specimens were screened for the detection of L452R, W152C, K417T, K417N, E484Q, E484K and N501Y mutations using the SARS-CoV-2 Variants II Assay Allplex, UltraGene Assay SARS-CoV-2 452R & 484K & 484Q Mutations V1, COVID-19 Ultra Variant Catcher, SARS-CoV-2 Extended ELITe MGB and Simplexa SARS-CoV-2 Variants Direct. The overall accuracy of these assays ranged from 96.9% to 100%. Specificity and sensitivity were 100% and 96–100%, respectively. We highly recommend the use of these assays as second-level tests in the routine workflow of SARS-CoV-2 laboratory diagnostics, as they are accurate, user friendly, low cost, may identify specific mutations in about 2–3 h and, therefore, optimize the surveillance of SARS-CoV-2 variants.
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Affiliation(s)
- Vanessa De Pace
- Hygiene Unit, Ospedale Policlinico San Martino—IRCCS, 16132 Genoa, Italy; (B.B.); (V.R.); (A.D.); (N.R.); (F.S.)
- Correspondence: ; Tel.: +39-3341145967
| | - Bianca Bruzzone
- Hygiene Unit, Ospedale Policlinico San Martino—IRCCS, 16132 Genoa, Italy; (B.B.); (V.R.); (A.D.); (N.R.); (F.S.)
| | - Andrea Orsi
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (A.O.); (G.G.); (G.I.)
| | - Valentina Ricucci
- Hygiene Unit, Ospedale Policlinico San Martino—IRCCS, 16132 Genoa, Italy; (B.B.); (V.R.); (A.D.); (N.R.); (F.S.)
| | - Alexander Domnich
- Hygiene Unit, Ospedale Policlinico San Martino—IRCCS, 16132 Genoa, Italy; (B.B.); (V.R.); (A.D.); (N.R.); (F.S.)
| | - Giulia Guarona
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (A.O.); (G.G.); (G.I.)
| | - Nadia Randazzo
- Hygiene Unit, Ospedale Policlinico San Martino—IRCCS, 16132 Genoa, Italy; (B.B.); (V.R.); (A.D.); (N.R.); (F.S.)
| | - Federica Stefanelli
- Hygiene Unit, Ospedale Policlinico San Martino—IRCCS, 16132 Genoa, Italy; (B.B.); (V.R.); (A.D.); (N.R.); (F.S.)
| | - Enrico Battolla
- Division of Clinical Pathology, Azienda Sanitaria Locale n°5, 19121 La Spezia, Italy;
| | - Pier Andrea Dusi
- Microbiology Department, Sanremo Hospital, 18038 Imperia, Italy;
| | - Flavia Lillo
- Laboratory of Clinical Pathology, ASL2 Savonese, 17100 Savona, Italy;
| | - Giancarlo Icardi
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (A.O.); (G.G.); (G.I.)
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Domnich A, Grassi R, Fallani E, Ciccone R, Bruzzone B, Panatto D, Ferrari A, Salvatore M, Cambiaggi M, Vasco A, Orsi A, Icardi G. Acceptance of COVID-19 and Influenza Vaccine Co-Administration: Insights from a Representative Italian Survey. J Pers Med 2022; 12:jpm12020139. [PMID: 35207628 PMCID: PMC8878648 DOI: 10.3390/jpm12020139] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 12/18/2022] Open
Abstract
Co-administration of coronavirus disease 2019 (COVID-19) and seasonal influenza vaccines has several advantages, has been advocated by various public health authorities and should be seen as an opportunity to increase the uptake of both vaccines. The objective of this survey was to quantify the acceptance of concomitant COVID-19/influenza vaccination and to identify its correlates in a representative sample of Italian adults. Of 2463 participants, a total of 22.9% were favorable to vaccine co-administration, while 16.6% declared their firm unwillingness to receive both vaccines simultaneously. The remaining 60.5% of subjects could be dubbed hesitant to some degree. Compliance with the primary COVID-19 vaccination schedule (adjusted proportional odds ratio (aOR) = 7.78), previous influenza vaccination (aOR = 1.89) and trust in public health institutions (aOR = 1.22) were the main determinants of positive attitudes toward vaccine co-administration. Other significant correlates included age, sex, perceived disease severity and vaccination risk–benefit, being offered a more personalized influenza vaccine and recent seeking for influenza-related information. In Italy, hesitancy toward COVID-19/influenza vaccine co-administration is common and appears to be higher than hesitancy toward either vaccine administered alone. This pattern is multifaceted and requires specific and tailored strategies, with public health institutions playing the central role.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (B.B.); (A.O.); (G.I.)
- Correspondence:
| | | | - Elettra Fallani
- Seqirus S.R.L., 53035 Monteriggioni, Italy; (E.F.); (M.S.); (M.C.); (A.V.)
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
| | | | - Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (B.B.); (A.O.); (G.I.)
| | - Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (D.P.); (A.F.)
| | - Allegra Ferrari
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (D.P.); (A.F.)
| | - Marco Salvatore
- Seqirus S.R.L., 53035 Monteriggioni, Italy; (E.F.); (M.S.); (M.C.); (A.V.)
| | - Maura Cambiaggi
- Seqirus S.R.L., 53035 Monteriggioni, Italy; (E.F.); (M.S.); (M.C.); (A.V.)
| | - Alessandro Vasco
- Seqirus S.R.L., 53035 Monteriggioni, Italy; (E.F.); (M.S.); (M.C.); (A.V.)
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (B.B.); (A.O.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (D.P.); (A.F.)
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (B.B.); (A.O.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (D.P.); (A.F.)
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Lapi F, Domnich A, Marconi E, Rossi A, Grattagliano I, Lagolio E, Medea G, Sessa A, Cricelli I, Icardi G, Cricelli C. Predicting the risk of severe COVID-19 outcomes in primary care: development and validation of a vulnerability index for equitable allocation of effective vaccines. Expert Rev Vaccines 2021; 21:377-384. [PMID: 34913796 DOI: 10.1080/14760584.2022.2019582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND General practitioners (GPs) need a valid, user-friendly tool to identify patients most vulnerable to COVID-19, especially in the hypothesis of a booster vaccine dose. The aim of this study was to develop and validate a GP-friendly prognostic index able to forecast severe COVID-19 outcomes in primary care. Indeed, no such prognostic score is as yet available in Italy. RESEARCH DESIGN AND METHODS In this retrospective cohort study, a representative sample of 47,868 Italian adults were followed up for 129,000 person-months. The study outcome was COVID-19-related hospitalization and/or death. Candidate predictors were chosen on the basis of systematic evidence and current recommendations. The model was calibrated by using Cox regression. Both internal and external validations were performed. RESULTS Age, sex and several clinical characteristics were significantly associated with severe outcomes. The final multivariable model explained 60% (95%CI 58-63%) of variance for COVID-19-related hospitalizations and/or deaths. The area under the receiver-operator curve (AUC) was 84% (95% CI: 83-85%). On applying the index to an external cohort, the AUC was 94% (95% CI: 93-95%). CONCLUSIONS This index is a reliable prognostic tool that can help GPs to prioritize their patients for preventive and therapeutic interventions.
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Affiliation(s)
- Francesco Lapi
- Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - Irccs for Oncology and Neurosciences, Genoa, Italy
| | - Ettore Marconi
- Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy
| | - Alessandro Rossi
- Italian College of General Practitioners and Primary Care, Florence, Italy
| | | | - Erik Lagolio
- Italian College of General Practitioners and Primary Care, Florence, Italy
| | - Gerardo Medea
- Italian College of General Practitioners and Primary Care, Florence, Italy
| | - Aurelio Sessa
- Italian College of General Practitioners and Primary Care, Florence, Italy
| | - Iacopo Cricelli
- Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital - Irccs for Oncology and Neurosciences, Genoa, Italy.,Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Claudio Cricelli
- Italian College of General Practitioners and Primary Care, Florence, Italy
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Fallani E, Orsi A, Signori A, Icardi G, Domnich A. An exploratory study to assess patterns of influenza- and pneumonia-related mortality among the Italian elderly. Hum Vaccin Immunother 2021; 17:5514-5521. [PMID: 34965179 PMCID: PMC8916782 DOI: 10.1080/21645515.2021.2005381] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Older adults are at disproportionately high risk of severe influenza-related outcomes and represent the main target of the annual influenza vaccination. The protective effect of seasonal influenza vaccination on the observed mortality indicators is controversial. In this ecological study, spatiotemporal patterns of pneumonia- and influenza-related mortality registered in the Italian elderly over seven (2011–2017) consecutive seasons were explored and the epidemiological association between the observed local pneumonia- and influenza-related mortality and influenza vaccination campaign features were modeled by using both fixed- and random-effects panel regression models. The descriptive spatiotemporal analysis showed a clear North–South gradient, where northern regions tended to report more pneumonia- and influenza-related deaths. After adjustment for potential confounders, it was found that each 1% increase in influenza vaccination coverage rate would be associated (P < .001) with a 1.6–1.9% decrease in pneumonia- and influenza-related mortality. Moreover, each 1% increase in the use of MF59®-adjuvanted trivalent influenza vaccine would be associated (P < .05) with a further 0.4% decrease in pneumonia- and influenza-related mortality. This study supports the increase in annual influenza vaccination in Italy and suggests that a higher level of use of the adjuvanted influenza vaccine in the elderly may be beneficial.
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Affiliation(s)
- Elettra Fallani
- Seqirus S.R.L., Monteriggioni, Italy.,Department of Life Sciences, University of Siena, Siena, Italy
| | - Andrea Orsi
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Alessio Signori
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Giancarlo Icardi
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
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Domnich A, Orsi A, Panatto D, De Pace V, Ricucci V, Caligiuri P, Guarona G, Chessa V, Ferone D, Boccotti S, Bruzzone B, Icardi G. Comparative Diagnostic Performance of a Novel Reverse Transcription Loop-Mediated Isothermal Amplification (RT-LAMP) Kit for the Rapid Detection of SARS-CoV-2. Pathogens 2021; 10:1629. [PMID: 34959584 PMCID: PMC8706056 DOI: 10.3390/pathogens10121629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/09/2021] [Accepted: 12/14/2021] [Indexed: 11/30/2022] Open
Abstract
Although the reverse transcription-polymerase chain reaction (RT-PCR) is considered a standard-of-care assay for the laboratory diagnosis of SARS-CoV-2, several limitations of this method have been described. Reverse transcription loop-mediated isothermal amplification (RT-LAMP) is an alternative molecular assay and is potentially able to overcome some intrinsic shortcomings of RT-PCR. In this study, we evaluated the diagnostic performance of the novel HG COVID-19 RT-LAMP assay. In this retrospective analysis, a total of 400 routinely collected leftover nasopharyngeal samples with a known RT-PCR result were tested by means of the HG COVID-19 RT-LAMP assay. The overall sensitivity and specificity values of HG COVID-19 RT-LAMP versus RT-PCR were 97.0% (95% CI: 93.6-98.9%) and 98.5% (95% CI: 95.7-99.7%), respectively. Inter-assay agreement was almost perfect (κ = 0.96). Concordance was perfect in samples with high viral loads (cycle threshold < 30). The average time to a positive result on RT-LAMP was 17 min. HG COVID-19 RT-LAMP is a reliable molecular diagnostic kit for detecting SARS-CoV-2, and its performance is comparable to that of RT-PCR. Shorter turnaround times and the possibility of performing molecular diagnostics in the point-of-care setting make it a valuable option for facilities without sophisticated laboratory equipment.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (V.D.P.); (V.R.); (P.C.); (G.G.); (V.C.); (S.B.); (B.B.); (G.I.)
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (V.D.P.); (V.R.); (P.C.); (G.G.); (V.C.); (S.B.); (B.B.); (G.I.)
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy;
| | - Donatella Panatto
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy;
| | - Vanessa De Pace
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (V.D.P.); (V.R.); (P.C.); (G.G.); (V.C.); (S.B.); (B.B.); (G.I.)
| | - Valentina Ricucci
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (V.D.P.); (V.R.); (P.C.); (G.G.); (V.C.); (S.B.); (B.B.); (G.I.)
| | - Patrizia Caligiuri
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (V.D.P.); (V.R.); (P.C.); (G.G.); (V.C.); (S.B.); (B.B.); (G.I.)
| | - Giulia Guarona
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (V.D.P.); (V.R.); (P.C.); (G.G.); (V.C.); (S.B.); (B.B.); (G.I.)
| | - Valerio Chessa
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (V.D.P.); (V.R.); (P.C.); (G.G.); (V.C.); (S.B.); (B.B.); (G.I.)
| | - Diego Ferone
- Department of Internal Medicine and Medical Specialties, University of Genoa, 16132 Genoa, Italy;
- Endocrinology Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
| | - Simona Boccotti
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (V.D.P.); (V.R.); (P.C.); (G.G.); (V.C.); (S.B.); (B.B.); (G.I.)
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy;
| | - Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (V.D.P.); (V.R.); (P.C.); (G.G.); (V.C.); (S.B.); (B.B.); (G.I.)
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (V.D.P.); (V.R.); (P.C.); (G.G.); (V.C.); (S.B.); (B.B.); (G.I.)
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy;
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Garbarino S, Domnich A, Costa E, Giberti I, Mosca S, Belfiore C, Ciprani F, Icardi G. Seroprevalence of SARS-CoV-2 in a Large Cohort of Italian Police Officers. Int J Environ Res Public Health 2021; 18:12201. [PMID: 34831958 PMCID: PMC8619349 DOI: 10.3390/ijerph182212201] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 12/30/2022]
Abstract
Certain professional categories are at a high occupational exposure to COVID-19. The aim of this survey was to quantify the seroprevalence of SARS-CoV-2 among police officers in Italy and identify its correlates. In this cross-sectional study, a nationally representative sample of State police employees was tested for IgG and IgM before the start of the National vaccination campaign. A total of 10,535 subjects (approximately 10% of the total workforce) participated in the study. The overall seroprevalence was 4.8% (95% CI: 4.4-5.3%). However, seropositivity was unevenly distributed across the country with a clear (p < 0.001) North-South gradient. In particular, the seroprevalence was 5.6 times higher in northern regions than in southern regions (9.0% vs. 1.6%). Most (71.2%) seropositive subjects reported having no recent symptoms potentially attributable to SARS-CoV-2 infection. Previous dysosmia, dysgeusia, and influenza-like illness symptoms were positive predictors of being seropositive. However, the prognostic value of dysosmia depended (p < 0.05) on both sex and prior influenza-like illness. The baseline seroprevalence of SARS-CoV-2 in police employees is considerable. A significant risk of occupational exposure, frequent asymptomatic cases and the progressive waning of neutralizing antibodies suggest that the police workers should be considered among the job categories prioritized for the booster COVID-19 vaccine dose.
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Affiliation(s)
- Sergio Garbarino
- Italy State Police Health Service Department, Ministry of Interior, 00198 Rome, Italy; (C.B.); (F.C.)
- Post-Graduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.D.); (G.I.)
| | - Elisabetta Costa
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (E.C.); (I.G.); (S.M.)
| | - Irene Giberti
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (E.C.); (I.G.); (S.M.)
| | - Stefano Mosca
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (E.C.); (I.G.); (S.M.)
| | - Cristiano Belfiore
- Italy State Police Health Service Department, Ministry of Interior, 00198 Rome, Italy; (C.B.); (F.C.)
| | - Fabrizio Ciprani
- Italy State Police Health Service Department, Ministry of Interior, 00198 Rome, Italy; (C.B.); (F.C.)
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.D.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (E.C.); (I.G.); (S.M.)
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Rahmani A, Dini G, Orsi A, Sticchi L, Bruzzone B, Montecucco A, Pellegrini L, Manca A, Domnich A, Battistini A, Kusznir Vitturi B, Zacconi S, Debarbieri N, Icardi G, Durando P. Reactogenicity of BNT162b2 mRNA COVID-19 Vaccine in a Young Working Age Population: A Survey among Medical School Residents, within a Mass Vaccination Campaign, in a Regional Reference Teaching Hospital in Italy. Vaccines (Basel) 2021; 9:1269. [PMID: 34835199 PMCID: PMC8625320 DOI: 10.3390/vaccines9111269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/28/2021] [Accepted: 10/30/2021] [Indexed: 11/17/2022] Open
Abstract
Vaccinations are a key prevention measure in fighting the COVID-19 pandemic. The BNT162b2 mRNA vaccine (BioNTech/Pfizer), the first to receive authorization, was widely used in the mass vaccination campaign in Italy. Healthcare workers were identified as a priority group for vaccination, but few studies have assessed its reactogenicity among the young working age population. An online survey was conducted to investigate the adverse reactions occurring in the 7 days following the first and second vaccination doses amongst resident doctors of the University of Genoa, employed at the IRCCS Ospedale Policlinico San Martino of Genoa, between 11 January and 16 March 2021. A total of 512 resident physicians were invited to participate in the study (female = 53.2%; mean age = 28.9 years), of whom 296 (female = 53.4%, mean age = 28.9 years) and 275 (female = 55.3%, mean age = 29.1 years) completed the survey after their first and second vaccination doses, respectively. In the 7 days following the first dose, most common adverse reactions were local pain (96.3%), fatigue (42.6%), headache (33.8%), arthromyalgia (28.0%), and 5.1% reported fever, while following the second dose, participants reported local pain (93.5%), fatigue (74.9%), headache (57.5%), arthromyalgia (58.2%), and fever (30.9%), with a higher prevalence among females. Systemic (but not local) reactions increased following the second vaccination, reaching severe intensity in 9.8% of participants and causing three or more events of moderate intensity in 23.7% of participants. Adverse reactions preventing regular daily activities could cause absenteeism among workers. These results can be useful to inform populations of young individuals, set expectations, and improve adherence to vaccination campaigns.
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Affiliation(s)
- Alborz Rahmani
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (A.R.); (G.D.); (A.O.); (L.S.); (A.M.); (L.P.); (B.K.V.); (S.Z.); (G.I.)
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (A.M.); (N.D.)
| | - Guglielmo Dini
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (A.R.); (G.D.); (A.O.); (L.S.); (A.M.); (L.P.); (B.K.V.); (S.Z.); (G.I.)
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (A.M.); (N.D.)
| | - Andrea Orsi
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (A.R.); (G.D.); (A.O.); (L.S.); (A.M.); (L.P.); (B.K.V.); (S.Z.); (G.I.)
- Hygiene Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (B.B.); (A.D.); (A.B.)
| | - Laura Sticchi
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (A.R.); (G.D.); (A.O.); (L.S.); (A.M.); (L.P.); (B.K.V.); (S.Z.); (G.I.)
- Hygiene Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (B.B.); (A.D.); (A.B.)
| | - Bianca Bruzzone
- Hygiene Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (B.B.); (A.D.); (A.B.)
| | - Alfredo Montecucco
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (A.R.); (G.D.); (A.O.); (L.S.); (A.M.); (L.P.); (B.K.V.); (S.Z.); (G.I.)
| | - Luca Pellegrini
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (A.R.); (G.D.); (A.O.); (L.S.); (A.M.); (L.P.); (B.K.V.); (S.Z.); (G.I.)
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (A.M.); (N.D.)
| | - Alessia Manca
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (A.M.); (N.D.)
| | - Alexander Domnich
- Hygiene Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (B.B.); (A.D.); (A.B.)
| | - Angela Battistini
- Hygiene Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (B.B.); (A.D.); (A.B.)
| | - Bruno Kusznir Vitturi
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (A.R.); (G.D.); (A.O.); (L.S.); (A.M.); (L.P.); (B.K.V.); (S.Z.); (G.I.)
| | - Sonia Zacconi
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (A.R.); (G.D.); (A.O.); (L.S.); (A.M.); (L.P.); (B.K.V.); (S.Z.); (G.I.)
| | - Nicoletta Debarbieri
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (A.M.); (N.D.)
| | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (A.R.); (G.D.); (A.O.); (L.S.); (A.M.); (L.P.); (B.K.V.); (S.Z.); (G.I.)
- Hygiene Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (B.B.); (A.D.); (A.B.)
| | - Paolo Durando
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (A.R.); (G.D.); (A.O.); (L.S.); (A.M.); (L.P.); (B.K.V.); (S.Z.); (G.I.)
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (A.M.); (N.D.)
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Giacchetta I, Primieri C, Cavalieri R, Domnich A, de Waure C. The burden of seasonal influenza in Italy: A systematic review of influenza-related complications, hospitalizations, and mortality. Influenza Other Respir Viruses 2021; 16:351-365. [PMID: 34704361 PMCID: PMC8818820 DOI: 10.1111/irv.12925] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 09/28/2021] [Indexed: 12/13/2022] Open
Abstract
Reliable country‐specific data on influenza burden play a crucial role in informing prevention and control measures. Our purpose was to provide a comprehensive summary of the available evidence on the burden of seasonal influenza in Italy. We performed a systematic literature review of articles published until July 31, 2020. PubMed, Embase, and Web of Science were searched using terms related to burden, influenza, and Italian population. We included studies investigating seasonal influenza‐related complications, hospitalizations, and/or mortality. Sixteen studies were included: eight (50%) analyzed influenza‐related complications, eight (50%) hospitalizations, and seven (43.8%) influenza‐related deaths. Only three studies (19.7%) concerned pediatric age. The synthesis of results showed that patients with chronic conditions have an increased risk for complications up to almost three times as compared with healthy people. Hospitalizations due to influenza can occur in as much as 5% of infected people depending on the study setting. Excess deaths rates were over sixfold higher in the elderly as compared with the rest of population. Although there are still gaps in existing data, there is evidence of the significant burden that influenza places each year especially on high‐risk groups. These data should be used to inform public health decision‐making.
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Affiliation(s)
- Irene Giacchetta
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Chiara Primieri
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Riccardo Cavalieri
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Chiara de Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Giacchetta I, Primieri C, Cavalieri R, Domnich A, de Waure C. The burden of seasonal influenza-associated complications in Italy: a systematic review. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Influenza is the infectious disease with the highest impact on population health in the European Union in terms of disability-adjusted life years. Reliable country-specific influenza-associated burden estimates play a crucial role in informing prevention and control measures to minimize the health and economic burden of the disease. Our purpose was to provide a comprehensive summary of available scientific literature on the burden of seasonal influenza on the Italian population.
Methods
We performed a systematic literature review of articles published until 31 July 2020. PubMed, Embase and Web of Science were searched. The search strategy included a combination of search terms related to burden, influenza and Italian population. We included studies investigating seasonal influenza-related complications and/or mortality in Italy. A meta-analysis of data was not pre-planned because of the expected heterogeneity in study populations and outcomes.
Results
A total of 16 studies were included in the qualitative synthesis, out of an original yield of 9,268 articles. Ten (62.5%) and 8 (50%) studies analyzed influenza-related complications and hospitalizations, respectively, while 8 (50%) assessed influenza-related deaths. Only 3 studies (19.7%) concerned pediatric age. The synthesis of results showed that patients with chronic conditions might have an increased risk for complications up to almost 3 times as compared to healthy people. Hospitalization due to influenza can occur from less than 1% to more than 5% according to the study setting (general practice or emergency room). Excess deaths rates were estimated to be over 6-fold higher for the elderly than for the rest of population.
Conclusions
Although there are still gaps in existing data, there is evidence of the significant burden that influenza places each year especially on high-risk groups. Summaries of the available data may inform decision-making in regard to vaccine strategies and public health policies.
Key messages
Existing data show evidence of significant burden of influenza on Italian population, especially on high-risk groups. Summaries of country-specific influenza-related burden are crucial in informing vaccine strategies.
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Affiliation(s)
- I Giacchetta
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - C Primieri
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - R Cavalieri
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - A Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - C de Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Domnich A, Grassi R, Fallani E, Spurio A, Bruzzone B, Panatto D, Marozzi B, Cambiaggi M, Vasco A, Orsi A, Icardi G. Changes in Attitudes and Beliefs Concerning Vaccination and Influenza Vaccines between the First and Second COVID-19 Pandemic Waves: A Longitudinal Study. Vaccines (Basel) 2021; 9:1016. [PMID: 34579253 PMCID: PMC8470379 DOI: 10.3390/vaccines9091016] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/07/2021] [Accepted: 09/10/2021] [Indexed: 12/01/2022] Open
Abstract
Perceptions of the risks of vaccine-preventable diseases and preventive behaviors change over time. The ongoing COVID-19 pandemic may have modified laypeople's attitudes towards routine vaccinations. In this longitudinal study, we aimed to assess changes in attitudes and beliefs concerning (influenza) vaccines between the first and second COVID-19 pandemic waves. A total of 1979 participants completed both 2020 and 2021 surveys. After one year, more interviewees agreed that vaccines were fundamental and should be mandatory (77.3% vs. 75.0%). Analogously, willingness to undergo influenza vaccination increased (p < 0.001) from 44.1% to 48.6%. This increase was seen in subjects aged ≥35 years. Previous influenza vaccinations, receipt of a COVID-19 vaccine, positive attitudes towards (influenza) vaccination, male sex, and older age were the main correlates of willingness to receive the 2021/22 influenza vaccine. Totals of 12.6% and 11.8% had no intention to receive the next seasonal influenza and COVID-19 vaccines, respectively. Most respondents favored a hypothetical combined influenza/COVID-19 vaccine (73.7%) or influenza and COVID-19 vaccine co-administration (67.5%). In Italy, influenza and COVID-19 vaccination hesitancy and refusal are common. Effective public health strategies to pursue higher uptake of both vaccines are urgently needed.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (B.B.); (A.O.); (G.I.)
| | | | - Elettra Fallani
- Seqirus S.R.L., 53035 Monteriggioni, Italy; (E.F.); (M.C.); (A.V.)
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
| | - Alida Spurio
- SWG S.p.A., 34133 Trieste, Italy; (R.G.); (A.S.)
| | - Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (B.B.); (A.O.); (G.I.)
| | - Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
| | - Barbara Marozzi
- Faculty of Medicine and Surgery, University of Genoa, 16126 Genoa, Italy;
| | - Maura Cambiaggi
- Seqirus S.R.L., 53035 Monteriggioni, Italy; (E.F.); (M.C.); (A.V.)
| | - Alessandro Vasco
- Seqirus S.R.L., 53035 Monteriggioni, Italy; (E.F.); (M.C.); (A.V.)
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (B.B.); (A.O.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (B.B.); (A.O.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
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Domnich A, De Pace V, Pennati BM, Caligiuri P, Varesano S, Bruzzone B, Orsi A. Evaluation of extraction-free RT-qPCR methods for SARS-CoV-2 diagnostics. Arch Virol 2021; 166:2825-2828. [PMID: 34302551 PMCID: PMC8302966 DOI: 10.1007/s00705-021-05165-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/20/2021] [Indexed: 01/13/2023]
Abstract
Extraction-based real-time reverse transcription quantitative polymerase chain reaction (RT-qPCR) is currently the "gold standard" in SARS-CoV-2 diagnostics. However, some extraction-free RT-qPCR techniques have recently been developed. In this study, we compared the sensitivity of traditional extraction-based, heated extraction-free, and unheated extraction-free RT-qPCR methods for SARS-CoV-2 detection in nasopharyngeal swabs from symptomatic individuals. The unheated extraction-free method showed perfect agreement with the standard extraction-based RT-qPCR. By contrast, the heat-treated technique was associated with an 8.2% false negativity rate. Unheated extraction-free RT-qPCR for the molecular diagnosis of SARS-CoV-2 is a valuable alternative to the traditional extraction-based methods and may accelerate turnaround times by about two hours.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Vanessa De Pace
- Hygiene Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Beatrice M Pennati
- Department of Health Sciences (DISSAL), University of Genoa, Via Pastore 1, 16132, Genoa, Italy
| | - Patrizia Caligiuri
- Hygiene Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
| | - Serena Varesano
- Hygiene Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Largo Rosanna Benzi 10, 16132, Genoa, Italy.,Department of Health Sciences (DISSAL), University of Genoa, Via Pastore 1, 16132, Genoa, Italy
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Orsi A, Domnich A, Pace VD, Ricucci V, Caligiuri P, Bottiglieri L, Vagge R, Cavalleri MA, Orlandini F, Bruzzone B, Icardi G. Outbreak of SARS-CoV-2 Lineage 20I/501Y.V1 in a Nursing Home Underlines the Crucial Role of Vaccination in Both Residents and Staff. Vaccines (Basel) 2021; 9:591. [PMID: 34199663 PMCID: PMC8228066 DOI: 10.3390/vaccines9060591] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/30/2021] [Accepted: 05/31/2021] [Indexed: 12/13/2022] Open
Abstract
Elderly residents in nursing homes are at very high risk of life-threatening COVID-19-related outcomes. In this report, an epidemiological and serological investigation of a SARS-CoV-2 outbreak in an Italian nursing home is described. Among the residents, all but one (19/20) were regularly vaccinated against SARS-CoV-2. In mid-February 2021, a non-vaccinated staff member of the nursing home was diagnosed with the SARS-CoV-2 infection. Following the outbreak investigation, a total of 70% (14/20) of residents aged 77-100 years were found positive. The phylogenetic analysis showed that the outbreak was caused by the SARS-CoV-2 variant of concern 202012/01 (the so-called "UK variant"). However, all but one positive subjects (13/14) were fully asymptomatic. The only symptomatic patient was a vaccinated 86-year-old female with a highly compromised health background and deceased approximately two weeks later. The subsequent serological investigation showed that the deceased patient was the only vaccinated subject that did not develop the anti-spike protein antibody response, therefore being likely a vaccine non-responder. Although the available mRNA SARS-CoV-2 vaccine was not able to prevent several asymptomatic infections, it was able to avert most symptomatic disease cases caused by the SARS-CoV-2 variant of concern 202012/01 in nursing home residents.
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Affiliation(s)
- Andrea Orsi
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (A.O.); (G.I.)
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (V.D.P.); (V.R.); (P.C.); (B.B.)
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (V.D.P.); (V.R.); (P.C.); (B.B.)
| | - Vanessa De Pace
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (V.D.P.); (V.R.); (P.C.); (B.B.)
| | - Valentina Ricucci
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (V.D.P.); (V.R.); (P.C.); (B.B.)
| | - Patrizia Caligiuri
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (V.D.P.); (V.R.); (P.C.); (B.B.)
| | - Livio Bottiglieri
- Laboratory Medicine, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy;
| | - Rosanna Vagge
- Local Health Unit 4, 16043 Chiavari, Italy; (R.V.); (M.A.C.); (F.O.)
| | | | | | - Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (V.D.P.); (V.R.); (P.C.); (B.B.)
| | - Giancarlo Icardi
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (A.O.); (G.I.)
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (V.D.P.); (V.R.); (P.C.); (B.B.)
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Bruzzone B, De Pace V, Caligiuri P, Ricucci V, Guarona G, Pennati BM, Boccotti S, Orsi A, Domnich A, Da Rin G, Icardi G. Comparative diagnostic performance of rapid antigen detection tests for COVID-19 in a hospital setting. Int J Infect Dis 2021; 107:215-218. [PMID: 33930540 PMCID: PMC8078031 DOI: 10.1016/j.ijid.2021.04.072] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The availability of accurate and rapid diagnostic tools for COVID-19 is essential for tackling the ongoing pandemic. Our study aimed to quantify the performance of available antigen-detecting rapid diagnostic tests (Ag-RDTs) in a real-world hospital setting. METHODS In this retrospective analysis, the diagnostic performance of 7 Ag-RDTs was compared with real-time reverse transcription quantitative polymerase chain reaction assay in terms of sensitivity, specificity and expected predictive values. RESULTS A total of 321 matched Ag-RDTreal-time reverse transcription quantitative polymerase chain reaction samples were analyzed retrospectively. The overall sensitivity and specificity of the Ag-RDTs was 78.7% and 100%, respectively. However, a wide range of sensitivity estimates by brand (66.0%-93.8%) and cycle threshold (Ct) cut-off values (Ct <25: 96.2%; Ct 30-35: 31.1%) was observed. The optimal Ct cut-off value that maximized sensitivity was 29. CONCLUSIONS The routine use of Ag-RDTs may be convenient in moderate-to-high intensity settings when high volumes of specimens are tested every day. However, the diagnostic performance of the commercially available tests may differ substantially.
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Affiliation(s)
- Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Vanessa De Pace
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Patrizia Caligiuri
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Valentina Ricucci
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Giulia Guarona
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | | | - Simona Boccotti
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Giorgio Da Rin
- Laboratory Medicine, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy
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Lazzeri G, Panatto D, Domnich A, Arata L, Pammolli A, Simi R, Giacchi MV, Amicizia D, Gasparini R. Clustering of health-related behaviors among early and mid-adolescents in Tuscany: results from a representative cross-sectional study. J Public Health (Oxf) 2018; 40:e25-e33. [PMID: 27908972 PMCID: PMC5896622 DOI: 10.1093/pubmed/fdw134] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/19/2016] [Accepted: 11/09/2016] [Indexed: 12/19/2022] Open
Abstract
Background A huge amount of literature suggests that adolescents' health-related behaviors tend to occur in clusters, and the understanding of such behavioral clustering may have direct implications for the effective tailoring of health-promotion interventions. Despite the usefulness of analyzing clustering, Italian data on this topic are scant. This study aimed to evaluate the clustering patterns of health-related behaviors. Methods The present study is based on data from the Health Behaviors in School-aged Children (HBSC) study conducted in Tuscany in 2010, which involved 3291 11-, 13- and 15-year olds. To aggregate students' data on 22 health-related behaviors, factor analysis and subsequent cluster analysis were performed. Results Factor analysis revealed eight factors, which were dubbed in accordance with their main traits: 'Alcohol drinking', 'Smoking', 'Physical activity', 'Screen time', 'Signs & symptoms', 'Healthy eating', 'Violence' and 'Sweet tooth'. These factors explained 67% of variance and underwent cluster analysis. A six-cluster κ-means solution was established with a 93.8% level of classification validity. The between-cluster differences in both mean age and gender distribution were highly statistically significant. Conclusions Health-compromising behaviors are common among Tuscan teens and occur in distinct clusters. These results may be used by schools, health-promotion authorities and other stakeholders to design and implement tailored preventive interventions in Tuscany.
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Affiliation(s)
- Giacomo Lazzeri
- Department of Molecular and Developmental Medicine, CREPS, University of Siena, 53100 Siena,Italy
| | - Donatella Panatto
- Department of Health Sciences, University of Genoa, 16126 Genoa, Italy
| | - Alexander Domnich
- Department of Health Sciences, University of Genoa, 16126 Genoa, Italy
| | - Lucia Arata
- Department of Health Sciences, University of Genoa, 16126 Genoa, Italy
| | - Andrea Pammolli
- Department of Molecular and Developmental Medicine, CREPS, University of Siena, 53100 Siena,Italy
| | - Rita Simi
- Department of Molecular and Developmental Medicine, CREPS, University of Siena, 53100 Siena,Italy
| | - Mariano Vincenzo Giacchi
- Department of Molecular and Developmental Medicine, CREPS, University of Siena, 53100 Siena,Italy
| | - Daniela Amicizia
- Department of Health Sciences, University of Genoa, 16126 Genoa, Italy
| | - Roberto Gasparini
- Department of Health Sciences, University of Genoa, 16126 Genoa, Italy
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Amicizia D, Domnich A, Arata L, Zoli D, Zotti CM, Cacello E, Gualano MR, Gasparini R, Panatto D. The role of age-sex interaction in the development of post-herpetic neuralgia. Hum Vaccin Immunother 2017; 13:376-378. [PMID: 28215122 PMCID: PMC5328223 DOI: 10.1080/21645515.2017.1264799] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Post-herpetic neuralgia is the most frequent complication of herpes zoster and affects up to 30% of patients. Increased age is a well-recognized risk factor, while the role of gender is highly uncertain. Little research has been performed into a possible combined effect of age and sex in post-herpetic neuralgia. The objective of the study was to study the role of age and sex and their combined effect in the development of post-herpetic neuralgia. This retrospective study enrolled adult subjects with at least one episode of herpes zoster in the previous 10 y. A questionnaire on the patient's socio-demographic, anamnestic and clinical characteristics was administered by general practitioners. Multivariable logistic regression was used to detect relationships between post-herpetic neuralgia and age, sex and their interaction. Fifty-nine of 272 patients reported post-herpetic neuralgia: a prevalence of 21.7%. Subjects with post-herpetic neuralgia (mean age 70.9 years) were significantly older (P = .001) than those without (64.2 years), the standardised mean difference being 0.5; no significant between-sex association was revealed (P = .96). A fully adjusted multivariable logistic analysis, however, revealed a highly significant (P = .007) age-sex interaction, with an odds ratio of 0.92; this also showed that older males were more likely to report post-herpetic neuralgia than younger males, while no obvious age-associated pattern was observed among females. We discerned a significant age-by-sex interaction in the development of post-herpetic neuralgia, which suggests that the effect of age on the development of this condition may differ between men and women.
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Affiliation(s)
- Daniela Amicizia
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Alexander Domnich
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Lucia Arata
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Daniela Zoli
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | | | - Elena Cacello
- b Department of Public Health , University of Turin , Turin , Italy
| | | | - Roberto Gasparini
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Donatella Panatto
- a Department of Health Sciences , University of Genoa , Genoa , Italy
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Panatto D, Domnich A, Gasparini R, Bonanni P, Icardi G, Amicizia D, Arata L, Carozzo S, Signori A, Bechini A, Boccalini S. An eHealth Project on Invasive Pneumococcal Disease: Comprehensive Evaluation of a Promotional Campaign. J Med Internet Res 2016; 18:e316. [PMID: 27913372 PMCID: PMC5161781 DOI: 10.2196/jmir.6205] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 10/10/2016] [Accepted: 10/12/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The recently launched Pneumo Rischio eHealth project, which consists of an app, a website, and social networking activity, is aimed at increasing public awareness of invasive pneumococcal disease (IPD). The launch of this project was prompted by the inadequate awareness of IPD among both laypeople and health care workers, the heavy socioeconomic burden of IPD, and the far from optimal vaccination coverage in Italy, despite the availability of safe and effective vaccines. OBJECTIVE The objectives of our study were to analyze trends in Pneumo Rischio usage before and after a promotional campaign, to characterize its end users, and to assess its user-rated quality. METHODS At 7 months after launching Pneumo Rischio, we established a 4-month marketing campaign to promote the project. This intervention used various approaches and channels, including both traditional and digital marketing strategies. To highlight usage trends, we used different techniques of time series analysis and modeling, including a modified Mann-Kendall test, change-point detection, and segmented negative binomial regression of interrupted time series. Users were characterized in terms of demographics and IPD risk categories. Customer-rated quality was evaluated by means of a standardized tool in a sample of app users. RESULTS Over 1 year, the app was accessed by 9295 users and the website was accessed by 143,993 users, while the project's Facebook page had 1216 fans. The promotional intervention was highly effective in increasing the daily number of users. In particular, the Mann-Kendall trend test revealed a significant (P ≤.01) increasing trend in both app and website users, while change-point detection analysis showed that the first significant change corresponded to the start of the promotional campaign. Regression analysis showed a significant immediate effect of the intervention, with a mean increase in daily numbers of users of 1562% (95% CI 456%-4870%) for the app and 620% (95% CI 176%-1777%) for the website. Similarly, the postintervention daily trend in the number of users was positive, with a relative increase of 0.9% (95% CI 0.0%-1.8%) for the app and 1.4% (95% CI 0.7%-2.1%) for the website. Demographics differed between app and website users and Facebook fans. A total of 69.15% (10,793/15,608) of users could be defined as being at risk of IPD, while 4729 users expressed intentions to ask their doctor for further information on IPD. The mean app quality score assigned by end users was approximately 79.5% (397/500). CONCLUSIONS Despite its specific topic, Pneumo Rischio was accessed by a considerable number of users, who ranked it as a high-quality project. In order to reach their target populations, however, such projects should be promoted.
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Affiliation(s)
| | | | | | - Paolo Bonanni
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Daniela Amicizia
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Lucia Arata
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Stefano Carozzo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Alessio Signori
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Angela Bechini
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, Florence, Italy
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Domnich A, Arata L, Amicizia D, Signori A, Gasparini R, Panatto D. Assessing spatial inequalities in accessing community pharmacies: a mixed geographically weighted approach. Geospat Health 2016; 11:457. [PMID: 27903052 DOI: 10.4081/gh.2016.457] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/29/2016] [Accepted: 05/23/2016] [Indexed: 06/06/2023]
Abstract
Geographical accessibility is an important determinant for the utilisation of community pharmacies. The present study explored patterns of spatial accessibility with respect to pharmacies in Liguria, Italy, a region with particular geographical and demographic features. Municipal density of pharmacies was proxied as the number of pharmacies per capita and per km2, and spatial autocorrelation analysis was performed to identify spatial clusters. Both non-spatial and spatial models were constructed to predict the study outcome. Spatial autocorrelation analysis showed a highly significant clustered pattern in the density of pharmacies per capita (I=0.082) and per km2 (I=0.295). Potentially under-supplied areas were mostly located in the mountainous hinterland. Ordinary least-squares (OLS) regressions established a significant positive relationship between the density of pharmacies and income among municipalities located at high altitudes, while no such association was observed in lower-lying areas. However, residuals of the OLS models were spatially auto-correlated. The best-fitting mixed geographically weighted regression (GWR) models outperformed the corresponding OLS models. Pharmacies per capita were best predicted by two local predictors (altitude and proportion of immigrants) and two global ones (proportion of elderly residents and income), while the local terms population, mean altitude and rural status and the global term income functioned as independent variables predicting pharmacies per km2. The density of pharmacies in Liguria was found to be associated with both socio-economic and landscape factors. Mapping of mixed GWR results would be helpful to policy-makers.
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Domnich A, Arata L, Amicizia D, Signori A, Patrick B, Stoyanov S, Hides L, Gasparini R, Panatto D. Development and validation of the Italian version of the Mobile Application Rating Scale and its generalisability to apps targeting primary prevention. BMC Med Inform Decis Mak 2016; 16:83. [PMID: 27387434 PMCID: PMC4936279 DOI: 10.1186/s12911-016-0323-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 06/17/2016] [Indexed: 12/04/2022] Open
Abstract
Background A growing body of literature affirms the usefulness of mobile technologies, including mobile applications (apps), in the primary prevention field. The quality of health apps, which today number in the thousands, is a crucial parameter, as it may affect health-related decision-making and outcomes among app end-users. The mobile application rating scale (MARS) has recently been developed to evaluate the quality of such apps, and has shown good psychometric properties. Since there is no standardised tool for assessing the apps available in Italian app stores, the present study developed and validated an Italian version of MARS in apps targeting primary prevention. Methods The original 23-item version of the MARS assesses mobile app quality in four objective quality dimensions (engagement, functionality, aesthetics, information) and one subjective dimension. Validation of this tool involved several steps; the universalist approach to achieving equivalence was adopted. Following two backward translations, a reconciled Italian version of MARS was produced and compared with the original scale. On the basis of sample size estimation, 48 apps from three major app stores were downloaded; the first 5 were used for piloting, while the remaining 43 were used in the main study in order to assess the psychometric properties of the scale. The apps were assessed by two raters, each working independently. The psychometric properties of the final version of the scale was assessed including the inter-rater reliability, internal consistency, convergent, divergent and concurrent validities. Results The intralingual equivalence of the Italian version of the MARS was confirmed by the authors of the original scale. A total of 43 apps targeting primary prevention were tested. The MARS displayed acceptable psychometric properties. The MARS total score showed an excellent level of both inter-rater agreement (intra-class correlation coefficient of .96) and internal consistency (Cronbach’s α of .90 and .91 for the two raters, respectively). Other types of validity, including convergent, divergent, discriminative, known-groups and scalability, were also established. Conclusions The Italian version of MARS is a valid and reliable tool for assessing the health-related primary prevention apps available in Italian app stores. Electronic supplementary material The online version of this article (doi:10.1186/s12911-016-0323-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Lucia Arata
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Daniela Amicizia
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Alessio Signori
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Bernard Patrick
- School of Medical and Pharmaceutical Sciences, University of Genoa, Genoa, Italy
| | - Stoyan Stoyanov
- Institute of Health & Biomedical Innovation, School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia.,The Young and Well Cooperative Research Centre, Abbotsford, Australia
| | - Leanne Hides
- Institute of Health & Biomedical Innovation, School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia.,The Young and Well Cooperative Research Centre, Abbotsford, Australia
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Panatto D, Domnich A, Gasparini R, Bonanni P, Icardi G, Amicizia D, Arata L, Bragazzi NL, Signori A, Landa P, Bechini A, Boccalini S. Development and preliminary data on the use of a mobile app specifically designed to increase community awareness of invasive pneumococcal disease and its prevention. Hum Vaccin Immunother 2016; 12:1080-4. [PMID: 26795065 PMCID: PMC4962929 DOI: 10.1080/21645515.2015.1114196] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Given the growing use and great potential of mobile apps, this project aimed to develop and implement a user-friendly app to increase laypeople's knowledge and awareness of invasive pneumococcal disease (IPD). Despite the heavy burden of IPD, the documented low awareness of IPD among both laypeople and healthcare professionals and far from optimal pneumococcal vaccination coverage, no app specifically targeting IPD has been developed so far. The app was designed to be maximally functional and conceived in accordance with user-centered design. Its content, layout and usability were discussed and formally tested during several workshops that involved the principal stakeholders, including experts in IPD and information technology and potential end-users. Following several workshops, it was decided that, in order to make the app more interactive, its core should be a personal “checker” of the risk of contracting IPD and a user-friendly risk-communication strategy. The checker was populated with risk factors identified through both Italian and international official guidelines. Formal evaluation of the app revealed its good readability and usability properties. A sister web site with the same content was created to achieve higher population exposure. Seven months after being launched in a price- and registration-free modality, the app, named “Pneumo Rischio,” averaged 20.9 new users/day and 1.3 sessions/user. The first in-field results suggest that “Pneumo Rischio” is a promising tool for increasing the population's awareness of IPD and its prevention through a user-friendly risk checker.
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Affiliation(s)
- Donatella Panatto
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Alexander Domnich
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Roberto Gasparini
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Paolo Bonanni
- b Department of Health Sciences , University of Florence , Florence , Italy
| | - Giancarlo Icardi
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Daniela Amicizia
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Lucia Arata
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | | | - Alessio Signori
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Paolo Landa
- c Department of Economics , University of Genoa , Genoa , Italy
| | - Angela Bechini
- b Department of Health Sciences , University of Florence , Florence , Italy
| | - Sara Boccalini
- b Department of Health Sciences , University of Florence , Florence , Italy
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Domnich A, Panatto D, Arbuzova EK, Signori A, Avio U, Gasparini R, Amicizia D. Immunogenicity against Far Eastern and Siberian subtypes of tick-borne encephalitis (TBE) virus elicited by the currently available vaccines based on the European subtype: systematic review and meta-analysis. Hum Vaccin Immunother 2015; 10:2819-33. [PMID: 25483679 PMCID: PMC5443051 DOI: 10.4161/hv.29984] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Tick-borne encephalitis (TBE) virus, which is usually divided into European, Far Eastern and Siberian subtypes, is a serious public health problem in several European and Asian countries. Vaccination is the most effective measure to prevent TBE; cross-subtype protection elicited by the TBE vaccines is biologically plausible since all TBE virus subtypes are closely related. This manuscript systematically explores available data on the cross-subtype immunogenicity elicited by the currently available Western vaccines based on the European subtype. Completed immunization course of 3 doses of both Western vaccines determined very high seroconversion/seropositivity rates against both Far Eastern and Siberian subtypes among previously flavivirus-naïve subjects. All but one study found no statistically significant difference in titers of neutralizing antibodies against strains belonging to homologous and heterologous subtypes. Pooled analysis of randomized controlled trials on head-to-head comparison of immunogenicity of Western and Russian TBE vaccines did not reveal differences in seroconversion rates against Far Eastern isolates in either hemagglutination inhibition (risk ratio = 0.98, p = 0.83) or enzyme-linked immunosorbent (risk ratio = 0.95, p = 0.44) assays after 2 vaccine doses. This suggests that, in regions where a heterogeneous TBE virus population circulates, vaccines based on the European subtype may be used alongside vaccines based on the Far Eastern subtype. Studies on the field effectiveness of TBE vaccines and investigation of vaccination failures, especially in countries where different subtypes co-circulate, will further elucidate TBE vaccination-induced cross-subtype protection.
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Key Words
- C, capside
- CEE, Central European encephalitis
- CI, confidence interval
- E, envelope
- ELISA, enzyme-linked immunosorbent assay
- European subtype
- FSME, Frühsommer-Meningoenzephalitis [German] (tick-borne encephalitis)
- Far Eastern subtype
- GMT, geometric mean titer
- HI, hemagglutination inhibition
- IFA, indirect immunofluorescence
- IPVE, Institute of Poliomyelitis and Viral Encephalitis
- IgG, Immunoglobulin G
- M, membrane
- NR, not reported
- NS, non-structural
- NT, neutralization test
- RCT, randomized controlled trial
- RNA, ribonucleic acid
- RR, risk ratio
- RSSE, Russian spring summer encephalitis virus
- SCR, seroconversion rate
- SD, standard deviation
- SMD, standardized mean difference
- SPR, seropositivity rate
- Siberian subtype
- TBE
- TBE, tick-borne encephalitis
- TBEV, tick-borne encephalitis virus
- TBEV-Eu, European subtype of TBEV
- TBEV-FE, Far Eastern subtype of TBEV
- TBEV-Sib, Siberian subtype of TBEV
- VIEU, Vienna unit
- WHO, World Health Organization
- cross-protection
- cross-subtype immunogenicity
- d, day
- prM, pre-membrane
- tick-borne encephalitis
- vaccines
- we: week
- y, year
- μNT, microneutralization test
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Affiliation(s)
- Alexander Domnich
- a Department of Health Sciences ; University of Genoa ; Genoa , Italy
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