Early childhood vaccination coverage and timeliness by macro-area of origin in children born to foreign women residing in Italy

OBJECTIVES

Country of origin might affect vaccine uptake in children born to immigrants. We aimed to evaluate differences in childhood vaccination coverage (VC) and timeliness by macro-area of origin of foreign mothers residing in Italy.

STUDY DESIGN

Multicentre retrospective birth cohorts.

METHODS

We analysed data of 23,287 children born in 2009-2014 to foreign women in the cities of Rome, Turin and Treviso. We retrieved data through record-linkage of the population, vaccination and birth registries. We estimated VCs at different ages for vaccines against tetanus, measles and meningococcal group-C, using the Kaplan-Meier method. Factors associated with vaccine uptake were evaluated using multilevel Poisson models.

RESULTS

Estimates of VC at any age and for all antigens were significantly lower in children born to women from Asia and higher in children born to women from Africa, as compared to other macro-areas. Similar differences by area of origin were observed for timeliness; independently of mother's sociodemographic characteristics and neonatal outcomes, the probability of delay vaccination after 2 years of age for each antigen was highest in children born to women from Asia. The risk of missed vaccination for all antigens was significantly higher in children born to younger and unemployed women.

CONCLUSIONS

Factors related to area of origin (e.g., cultural habits, language skills) are likely to affect parents' decision to vaccinate their children. These factors, as well as sociodemographic characteristics, should be adequately investigated and addressed to increase vaccine uptake in foreign children, especially those born to Asian women.

Flu vaccination among health workers in Italy: results from the nationwide surveillance PASSI 2015-18

Background

Influenza causes a significant health and socio-economic burden every year. Healthcare workers (HCWs) are at higher risk of exposure to respiratory pathogens than general population, including seasonal influenza virus, with potential threats to their health and patients' safety. We aimed to estimate the adherence to flu vaccination of health workers in 2015-2018 seasons in Italy.

Methods

We analyzed data collected between 2015 and 2018 from the Italian Behavioral Risk Factor Surveillance System (PASSI). PASSI collects data on health behaviors in the adults (18-64 years) through telephonic administration of standardized questionnaires to a representative sample of Italian population. The answers related to flu vaccination refer to the vaccination campaign preceding the interview

Results

Preliminary data show that overall 11.9% (CI 10.3% - 13.7%) of HCWs reported to have been vaccinated vs 7.2% (CI 6.9% - 7.5%) of the total population sample. Physicians showed a higher overall adherence compared to other healthcare professionals (22.4% [CI 18% - 27.5%] vs 9% [CI 7.4% - 10.9%], respectively). Differences of adherence were found also across age groups: 18.3% [CI 15% - 22.2%] of respondents between 50-64 years reported to have received a vaccination compared to 10% (CI 7.9% - 12.5%) and 4.3% (CI 2.8% - 6.4%) of 35-49 years and 18-34 years age groups, respectively. The annual influenza vaccination coverage for people working in healthcare has increased over the years (9.8% in 2015 vs 14.1% in 2018).

Conclusions

Although coverage rates are increasing over time, adherence to influenza vaccination is still too low, especially among younger HCWs and non-medical HCWs. Strategic actions, such as local and national programs to increase self-awareness of being an at-high-risk category for contracting and transmitting infections and/or mandatory vaccination, should be adopted to sharply achieve an optimal coverage rate for HCWs.

Key messages

Adherence to seasonal influenza vaccination is still very low among Italian HCWs. A participatory attitude towards vaccination for HCWs should be pursued. Monitoring and reporting process should be improved to provide further detailed evidence for adopting targeted programs.

Profiling biopsychosocial health of cancer-diagnosed elderly in Italy by Passi d’Argento, 2016-2017

Background

PASSI d'Argento (PdA) is an Italian population-based surveillance system, coordinated by the Istituto Superiore di Sanità (ISS) and carried out by the Local Health Units (LHUs). PdA monitors wide-ranged health related-behaviours in the elderly (65+) living in Italy as per the three pillars of the “Active Healthy Ageing” framework: Health, Participation, Security.

Methods

The PdA sample is randomly selected from the LHU lists, stratified by sex and age. 22,811 records have been collected in 2016-2017 on a representative sample of residents aged over65, not being hospitalised, in long-term care, in a nursing home or prison.

Results

3,019 respondents resulted cancer-diagnosed elderly (CDE) reporting cancer diagnosis or confirmation, leukaemia and lymphomas included (annual average prevalence of 12.8%, Confidence Intervals 95%: 12.1-13.4%; one million and 729 thousand people). CDE refer: poorer health conditions (22%) than Chronic Elderly Patients (CEP; 18%) and Healthy Elderly (HE; 5%), sight impairment (12%), hearing loss (15%) and chewing problems (14%). CDE (10%) and CEP (11%) are more prone to fall than HE do (6%). Disability accounts for 21% in CDE and CEP vs. 12% in HE. A multivariate analysis confirms a compromised psychophysical health profile in CDE vs. HE, and vs. CEP. CDE behave still unhealthily, are insufficiently advised by health professionals, do not comply with the seasonal flu vaccination [Health]. CDE face increased risk for isolation or cognitive decline: they experience lower social connectedness (17%) than CEP (20%) and HE (28%) [Participation], and perceive higher neighbourhood insecurity (19%) than how CEP (17%) and HE (13%) do [Security].

Conclusions

PdA data on the poor biopsychosocial health profile of CDE highlight to what extent healthy behaviours and prevention can ameliorate their quality of life PdA calls for global action strategies in Italy, which aim at taking complete charge of CDE and also CEP.

Key messages

In Italy, elderly cancer survivors show poor biopsychosocial health profile and overall quality of life. By modifying behaviours, elderly suffering from any cancer or chronic disease can age healthily.

Quantitative analysis of trace elements in human clear cell carcinoma of the kidney by energy-dispersive X-ray fluorescence

In a case-control study, 20 cases of renal cell carcinoma (RCC) were analyzed by energy-dispersive X-ray fluorescence in order to establish the concentration of Fe, Cu, Zn and Cd. Patients with RCC were examined and compared with 7 controls from selected autopsies. A significant decrease in Cd and Zn concentration was found in the neoplastic tissue in all cases. In contrast, no significant decrease in Cu concentration was detected in our cases.