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Ferrari C, Somma G, Gentili S, Manili G, Mauro G, Treglia M, Trabucco Aurilio M, Magrini A, Coppeta L. Rubella Vaccine Uptake among Women of Childbearing Age in Healthcare Settings. Healthcare (Basel) 2023; 11:2992. [PMID: 37998484 PMCID: PMC10671143 DOI: 10.3390/healthcare11222992] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Rubella is a contagious viral infection that occurs most often in children and young adults. Rubella is the leading vaccine-preventable cause of birth defects. Rubella infection in pregnant women may cause fetal death or congenital defects known as congenital rubella syndrome. There is no specific treatment for rubella, but the disease is preventable by vaccination with an efficacy of over 95%. Vaccination coverage is still below the recommended levels and many cases have occurred worldwide. The COVID-19 pandemic has had a negative impact on the immunization programs and the quality of disease surveillance worldwide. Operators of the healthcare setting are at increased risk of infection due to their work duties and should receive preventive vaccination or serologic protection to work in a healthcare setting. AIMS To evaluate the serological evidence of rubella IgG antibodies in female healthcare operators of childbearing age, to assess the risk of a breakthrough infection and the need for an additional dose of vaccine. METHODS We collected age and antibody titers from 449 young female operators aged <50 years who underwent the periodic surveillance at the Occupational Medicine Unit of the Policlinico Tor Vergata, Rome, from January to July 2022. Subjects were considered immune if the anti-rubella IgG titer was >11.00 IU/mL. RESULTS The rate of serologically unprotected subjects was 9.13% (41/449). The mean age of protected subjects was 26.93 years, while the mean age of unprotected subjects was 28.24 years. Age did not correlate with mean titer on statistical analysis (p = 0.10). The acceptance rate among unprotected operators was 31.7%. A positive attitude towards vaccination was found in 11/28 (39.3%) of the unvaccinated subjects, while a negative tendency was found in 2/28 (7.1%) of these subjects; most of the unvaccinated operators 15/28 (53.6%) prefer to postpone the administration of the vaccine. When compared with a similar population from the pre-pandemic period, the actual proportion of immune female subjects was not significantly different from that found in 2019 (90.87% vs. 90.3%). CONCLUSIONS Protection against rubella was suboptimal among female healthcare workers of childbearing age. Acceptance of the rubella vaccine among these operators was low. Most of those who were hesitant intended to postpone the vaccination, while a minority had negative attitudes toward vaccination. A policy of mandatory vaccination policy should overcome the reluctance of operators.
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Affiliation(s)
- Cristiana Ferrari
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giuseppina Somma
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Sandro Gentili
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Gianmarco Manili
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Gaetano Mauro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Michele Treglia
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Marco Trabucco Aurilio
- Office of Medical Forensic Coordination, Italian National Social Security Institute (INPS), 00144 Rome, Italy
| | - Andrea Magrini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
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Coppeta L, Ferrari C, Verno G, Somma G, Trabucco Aurilio M, Di Giampaolo L, Treglia M, Magrini A, Pietroiusti A, Rizza S. Protective Anti-HBs Antibodies and Response to a Booster Dose in Medical Students Vaccinated at Childhood. Vaccines (Basel) 2023; 11:1326. [PMID: 37631894 PMCID: PMC10460060 DOI: 10.3390/vaccines11081326] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 08/28/2023] Open
Abstract
The immune system in humans is regulated by the circadian rhythm. Published studies have reported that the time of vaccination is associated with the immune response to vaccine for some pathogens. Our study aimed to evaluate the association between time of dose administration of challenge HBV vaccine and seroconversion for anti-HBs in medical students vaccinated at birth who were found to be unprotected at pre-training screening. Humoral protection for HBV was assessed in 885 medical students vaccinated during childhood. In total, 359 (41.0%) of them showed anti-HBs titer < 10 UI/mL and received a challenge dose of HBV vaccine followed by post-vaccination screening 30-60 days later. The challenge dose elicited a protective immune response (anti-HBs IgG titer > 10 UI/mL) in 295 (83.8%) individuals. Seroconversion was significantly associated with female gender and time of vaccination after controlling for age group and nationality at logistic regression analysis. Students who received the booster dose in the morning had a higher response rate than those who received the vaccine in the afternoon (OR 1.93; 95% C.I. 1.047-3.56: p < 0.05). This finding suggests that morning administration of the HBV booster may result in a better immune response in susceptible individuals.
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Affiliation(s)
- Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
- Faculty of Medicine, University “Nostra Signora del Buon Consiglio”, Tirana 1000, Albania;
| | - Cristiana Ferrari
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Greta Verno
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Giuseppina Somma
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Marco Trabucco Aurilio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy;
| | - Luca Di Giampaolo
- Department of Occupational Medicine, University of Chieti “G. D’Annunzio”, 66100 Chieti, Italy;
| | - Michele Treglia
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Andrea Magrini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Antonio Pietroiusti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Stefano Rizza
- Faculty of Medicine, University “Nostra Signora del Buon Consiglio”, Tirana 1000, Albania;
- Department of System Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
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Coppeta L, Ferrari C, Somma G, Giovinazzo V, Buonomo E, Trabucco Aurilio M, Treglia M, Magrini A. Serological Evaluation for Measles among Italian and Foreign Medical Students in a University Hospital in Rome. Vaccines (Basel) 2023; 11:1256. [PMID: 37515071 PMCID: PMC10384754 DOI: 10.3390/vaccines11071256] [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: 06/23/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Measles infection in the hospital setting is a major issue. Despite the availability of an effective vaccine, measles outbreaks continue to occur in some European countries. We aimed to evaluate the immunological status of medical students attending the Tor Vergata Polyclinic (PTV). METHODS Measles antibodies titers were assessed by venipuncture on a sample of 2717 medical students who underwent annual health surveillance visits from January 2021 to March 2023. Subjects showing serum IgG values above 1.0 S/CO were considered serologically protected. Personal data, country of origin, and main demographic characteristic were also collected. RESULTS 66.7% (1467 Italian and 346 foreign) of medical students showed protective IgG antibodies levels. Female students were serologically immune more frequently than males (68.6% vs. 63.3%; p < 0.01 at Chi2). The mean antibody titer was 1.72 S/CO, significantly higher in females than males (1.67 vs. 1.75, respectively; p < 0.05), and significantly related to age (p < 0.01). Albanian students, who were the largest foreign population in our study, showed a low serological protection rate (40/90: 44.4%). CONCLUSIONS The proportion of serologically non-immune students is high, raising concerns about the possible risk of hospital transmission. Substantial differences in the rate of immunity have been found between subjects coming from different parts of Europe and the world. Pre-training assessment of all medical students and vaccination of susceptible individuals is highly recommended, particularly for those from low immunization rate countries.
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Affiliation(s)
- Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
- Faculty of Medicine, University "Our Lady of Good Counsel", 1000 Tirana, Albania
| | - Cristiana Ferrari
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giuseppina Somma
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Viola Giovinazzo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Ersilia Buonomo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
- Faculty of Medicine, University "Our Lady of Good Counsel", 1000 Tirana, Albania
| | - Marco Trabucco Aurilio
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100 Campobasso, Italy
| | - Michele Treglia
- Forensics Department, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Andrea Magrini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
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Trabucco Aurilio M, Mennini FS, Ferrari C, Somma G, Di Giampaolo L, Bolcato M, De-Giorgio F, Muscatello R, Magrini A, Coppeta L. Main Predictors of COVID-19 Vaccination Uptake among Italian Healthcare Workers in Relation to Variable Degrees of Hesitancy: Result from a Cross-Sectional Online Survey. Trop Med Infect Dis 2022; 7:419. [PMID: 36548674 PMCID: PMC9780995 DOI: 10.3390/tropicalmed7120419] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/26/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Background: Hesitancy remains one of the major hurdles to vaccination, regardless of the fact that vaccines are indisputable preventive measures against many infectious diseases. Nevertheless, vaccine hesitancy or refusal is a growing phenomenon in the general population as well as among healthcare workers (HCWs). Many different factors can contribute to hesitancy to COVID-19 vaccination in the HCWs population, including socio-demographic characteristics (female gender, low socio-economical status, lower age), individual beliefs regarding vaccine efficacy and safety, as well as other factors (occupation, knowledge about COVID-19, etc.). Understanding the determinants of accepting or refusing the COVID-19 vaccination is crucial to plan specific interventions in order to increase the rate of vaccine coverage among health care workers. Methods: We conducted a cross-sectional online survey on HCWs in seventeen Italian regions, between 30 June and 4 July 2021, in order to collect information about potential factors related to vaccine acceptance and hesitancy. Results: We found an overall vaccine uptake rate of 96.4% in our sample. Acceptance was significantly related to job task, with physicians showing the highest rate of uptake compared to other occupations. At univariate analysis, the HCWs population’s vaccine hesitancy was significantly positively associated with fear of vaccination side effects (p < 0.01), and negatively related to confidence in the safety and efficacy of the vaccine (p < 0.01). Through multivariate analysis, we found that only the fear of possible vaccination side effects (OR: 4.631, p < 0.01) and the confidence in vaccine safety and effectiveness (OR: 0.35 p < 0.05) remained significantly associated with hesitancy. Conclusion: Action to improve operator confidence in the efficacy and safety of the vaccine should improve the acceptance rate among operators.
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Affiliation(s)
- Marco Trabucco Aurilio
- Department of Medicine and Health Sciences “V.Tiberio”, University of Molise, 86100 Campobasso, Italy
- Office of Medical Forensic Coordination, Italian National Social Security Institute (INPS), 00144 Rome, Italy
| | - Francesco Saverio Mennini
- Economic Evaluation and HTA (EEHTA CEIS), Department of Economics and Finance, Faculty of Economics, University of Rome “Tor Vergata”, Via Columbia 2, 00133 Rome, Italy
| | - Cristiana Ferrari
- Department of Occupational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Giuseppina Somma
- Department of Occupational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Luca Di Giampaolo
- Department of Medicine and Science of Ageing, Specialization School of Allergy and Clinical Immunology, G. D’Annunzio University Chieti-Pescara, 66100 Chieti, Italy
| | - Matteo Bolcato
- Department of Neuroscience, University of Padua, 35121 Padua, Italy
| | - Fabio De-Giorgio
- Department of Healthcare Surveillance and Bioethics, Section of Legal Medicine, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Fondazione Policlinico Universitario IRCCS A. Gemelli, 00168 Rome, Italy
| | - Roberto Muscatello
- Office of Medical Forensic Coordination, Italian National Social Security Institute (INPS), 00144 Rome, Italy
| | - Andrea Magrini
- Department of Occupational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Luca Coppeta
- Department of Occupational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
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Trabucco Aurilio M, Maiorino MI, Mennini FS, Scappaticcio L, Longo M, Nardone C, Coppeta L, Gazzillo S, Migliorini R, Bellastella G, Giugliano D, Esposito K. Applications for social security benefits related to diabetes in the working age in Italy between 2009 and 2019: a nationwide retrospective cohort study. BMJ Open 2022; 12:e057825. [PMID: 35613811 PMCID: PMC9174764 DOI: 10.1136/bmjopen-2021-057825] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The aim of this study is to estimate the average number of claims for social security benefits from workers with diabetes-related disability. DESIGN Nationwide retrospective cohort study. SETTING The database of the Italian Social Security Institute (INPS) was used to analyse the trends and the breakdown of all claims for social security benefit with diabetes as primary diagnosis from 2009 to 2019. PARTICIPANTS We selected all the applications with the 250.xx International Classification of Diseases, Ninth Revision-CM diagnosis code from 2009 to 2019. PRIMARY AND SECONDARY OUTCOME MEASURES The ratio between accepted or rejected claims for both ordinary incapacity benefit (OIB) and disability pension (DP) and total submitted claims over a 10-year period was computed. RESULTS From 2009 to 2019, 40 800 applications for social security benefits were filed with diabetes as the principal diagnosis, with an annual increase of 30% per year. Throughout the study decade, there was a higher rate of rejected (67.2%) than accepted (32.8%) applications. Among the accepted requests, most of them (30.7%) were recognised as OIB and the remaining 2.1% were recognised as DP. When related to the total number of claims presented per year, there was a 8.8% decrease of rejected applications, associated with a 20.6% increase of overall acceptance rate. In terms of time trends, the overall rise of submitted requests from 2009 to 2019 resulted in an increase in both rejected (+18%) and accepted (+61% for OIB, +11% for DP) applications. The higher rate of accepted requests was for workers aged 51-60 years, with 52% of admitted applications. CONCLUSIONS Between 2009 and 2019, the number of applications for social security benefits due to diabetes in Italy increased significantly, and so did the number of applications approved, mainly represented by the OIBs.
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Affiliation(s)
- Marco Trabucco Aurilio
- Office of Medical Forensic Coordination, Italian National Social Security Institute (INPS), Rome, Italy
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Maria Ida Maiorino
- Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Metabolic Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Saverio Mennini
- CEIS-Economic Evaluation and HTA (EEHTA), Faculty of Economics, University of Rome Tor Vergata, Rome, Italy
- Department of Accounting and Finance, Kingston University, Kingston, UK
| | - Lorenzo Scappaticcio
- Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Metabolic Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Miriam Longo
- Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Metabolic Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Claudia Nardone
- CEIS-Economic Evaluation and HTA (EEHTA), Faculty of Economics, University of Rome Tor Vergata, Rome, Italy
| | - Luca Coppeta
- Department of Occupational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Simone Gazzillo
- CEIS-Economic Evaluation and HTA (EEHTA), Faculty of Economics, University of Rome Tor Vergata, Rome, Italy
| | - Raffaele Migliorini
- Office of Medical Forensic Coordination, Italian National Social Security Institute (INPS), Rome, Italy
| | - Giuseppe Bellastella
- Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Metabolic Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Dario Giugliano
- Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Metabolic Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Katherine Esposito
- Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Metabolic Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
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Trabucco Aurilio M, Mennini FS, Nardone C, Piccioni A, Bolcato M, Russo V, Sciannamea V, Migliorini R, Coppeta L, Magrini A. Health and Economic Impact of Atrial Fibrillation of Workers in Italy: Social Security Benefits. Int J Environ Res Public Health 2022; 19:ijerph19031883. [PMID: 35162904 PMCID: PMC8834668 DOI: 10.3390/ijerph19031883] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/04/2022] [Accepted: 02/06/2022] [Indexed: 11/16/2022]
Abstract
Background: The aim of this research was to analyze trends in social security applications in Italy as a result of the onset of atrial fibrillation, analyzing data pertaining to the classification of professions and assessing the economic impact on the social security system. Methods: We analyzed all applications for invalidity allowances and invalidity pensions throughout Italy over a 10-year period from 01.01.2009 to 31.12.2019, giving specific attention to all reports indicating atrial fibrillation as the principal diagnosis (Cod. ICD-9-CM 427.31). We then extracted the relative expenditure data for said benefits. The results of all analyses have been collated in tables. Results: Over the period in question, a total of 3468 applications for assistance were filed throughout Italy indicating a diagnosis of atrial fibrillation, of which 58% were rejected, 41% qualified for an invalidity allowance, and only 1.1% qualified for a pension. On average, every year, 1100 workers received social security benefits as a result of a diagnosis of atrial fibrillation, which equates to an average annual expenditure of EUR 10 million. A comparison of the data from the first observation year (2009) with data from the last (2019) shows a rising trend in the number of beneficiaries and consequently in expenses. Conclusions: The social security assistance provided by the Italian government by means of the National Institute of Social Security is fundamental to social cohesion and to those who are either permanently disabled from working or those with a significantly diminished earning capacity. This assistance is associated with a significant financial cost, which requires careful monitoring.
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Affiliation(s)
- Marco Trabucco Aurilio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy;
| | - Francesco Saverio Mennini
- CEIS EEHTA, DEF Department, Faculty of Economics, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.S.M.); (C.N.)
| | - Claudia Nardone
- CEIS EEHTA, DEF Department, Faculty of Economics, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.S.M.); (C.N.)
| | - Andrea Piccioni
- Emergency Medicine Department, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, 00168 Rome, Italy;
| | - Matteo Bolcato
- Legal Medicine, University of Padua, 35121 Padua, Italy
- Correspondence:
| | - Vincenzo Russo
- Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli” Monaldi Hospital, 80131 Naples, Italy;
| | - Valerio Sciannamea
- Ufficio di Coordinamento Medico Legale, Istituto Nazionale Previdenza Sociale (INPS), 00144 Rome, Italy; (V.S.); (R.M.)
| | - Raffaele Migliorini
- Ufficio di Coordinamento Medico Legale, Istituto Nazionale Previdenza Sociale (INPS), 00144 Rome, Italy; (V.S.); (R.M.)
| | - Luca Coppeta
- Department of Occupational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (L.C.); (A.M.)
| | - Andrea Magrini
- Department of Occupational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (L.C.); (A.M.)
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Coppeta L, Ferrari C, Somma G, Mazza A, D’Ancona U, Marcuccilli F, Grelli S, Aurilio MT, Pietroiusti A, Magrini A, Rizza S. Reduced Titers of Circulating Anti-SARS-CoV-2 Antibodies and Risk of COVID-19 Infection in Healthcare Workers during the Nine Months after Immunization with the BNT162b2 mRNA Vaccine. Vaccines (Basel) 2022; 10:vaccines10020141. [PMID: 35214600 PMCID: PMC8879462 DOI: 10.3390/vaccines10020141] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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: 12/22/2021] [Revised: 01/12/2022] [Accepted: 01/16/2022] [Indexed: 11/20/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has had a tremendous impact on health services; hundreds of thousands of healthcare workers (HCWs) have died from coronavirus disease 2019 (COVID-19). The introduction of the BNT162b2 mRNA vaccine in Italy provided recipients with significant protection against COVID-19 within one to two weeks after the administration of the second of the two recommended doses. While the vaccine induces a robust T cell response, the protective role of factors and pathways other than those related to memory B cell responses to specific SARS-CoV-2 antigens remains unclear. This retrospective study aimed to evaluate the determinants of serological protection in a group of vaccinated HCWs (n = 793) by evaluating circulating levels of antiviral spike receptor-binding domain (S-RBD) antibodies during the nine-month period following vaccination. We found that 99.5% of the HCWs who received the two doses of the BNT162b2 vaccine developed protective antibodies that were maintained at detectable levels for as long as 250 days after the second dose of the vaccine. Multivariate analysis was performed on anti-S-RBD titers in a subgroup of participants (n = 173) that were evaluated twice during this period. The results of this analysis reveal that the antibody titer observed at the second time point was significantly related to the magnitude of the primary response, the time that had elapsed between the first and the second evaluation, and a previous history of SARS-CoV-2 infection. Of importance is the finding that despite waning antibody titers following vaccination, none of the study participants contracted severe COVID-19 during the observational period.
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Affiliation(s)
- Luca Coppeta
- Department of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (C.F.); (G.S.); (A.M.); (U.D.); (A.M.)
| | - Cristiana Ferrari
- Department of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (C.F.); (G.S.); (A.M.); (U.D.); (A.M.)
| | - Giuseppina Somma
- Department of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (C.F.); (G.S.); (A.M.); (U.D.); (A.M.)
| | - Andrea Mazza
- Department of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (C.F.); (G.S.); (A.M.); (U.D.); (A.M.)
| | - Umberto D’Ancona
- Department of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (C.F.); (G.S.); (A.M.); (U.D.); (A.M.)
| | - Fabbio Marcuccilli
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (F.M.); (S.G.)
| | - Sandro Grelli
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (F.M.); (S.G.)
| | - Marco Trabucco Aurilio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy;
| | - Antonio Pietroiusti
- Departmental Faculty of Medicine, University Unicamillus, 00131 Rome, Italy;
| | - Andrea Magrini
- Department of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (C.F.); (G.S.); (A.M.); (U.D.); (A.M.)
| | - Stefano Rizza
- Department of System Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy
- Correspondence: ; Tel.: +39-0620908330
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Coppeta L, Ferrari C, Mazza A, Trabucco Aurilio M, Rizza S. Factors Associated with Pre-Vaccination SARS-CoV-2 Infection Risk among Hospital Nurses Facing COVID-19 Outbreak. Int J Environ Res Public Health 2021; 18:ijerph182413053. [PMID: 34948662 PMCID: PMC8701284 DOI: 10.3390/ijerph182413053] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 10/15/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 01/09/2023]
Abstract
The objective of this work was to evaluate the magnitude of COVID-19 spread and the related risk factors among hospital nurses employed in a COVID hospital in Rome, before the beginning of the vaccination programmes commenced in 2021. Participants periodically underwent (every 15–30 days) nasopharyngeal swab and/or blood sample for SARS-CoV-2 IgG examination. From 1 March 2020 to 31 December 2020, we found 162 cases of COVID-19 infection (n = 143 nasopharyngeal swab and n = 19 IgG-positive) in a total of 918 hospital nurses (17.6%). Most SARS-CoV-2-infected hospital nurses were night shift workers (NSWs), smokers, with higher BMI and lower mean age than that of individuals who tested negative. After adjusting for covariates, age (OR = 0.923, 95% C.I. 0.895–0.952), night shift work (OR = 2.056, 95% C.I. 1.320–2.300), smoking status (OR = 1.603, 95% C.I. 1.080–2.378) and working in high-risk settings (OR = 1.607, 95% C.I. 1.036–2.593) were significantly associated with SARS-CoV-2 hospital infection, whereas BMI was not significantly related. In conclusion, we found a high prevalence of SARS-CoV-2 infection among hospital nurses at a Rome COVID hospital in the pre-vaccination period. Smoking, young age, night shift work and high-risk hospital settings are relevant risk factors for hospital SARS-CoV-2 infection; therefore, a close health surveillance should be necessary among hospital nurses exposed to SARS-CoV-2.
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Affiliation(s)
- Luca Coppeta
- Department of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (C.F.); (A.M.)
| | - Cristiana Ferrari
- Department of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (C.F.); (A.M.)
| | - Andrea Mazza
- Department of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (C.F.); (A.M.)
| | - Marco Trabucco Aurilio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy;
| | - Stefano Rizza
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- Correspondence:
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Coppeta L, Somma G, Ferrari C, Mazza A, Rizza S, Trabucco Aurilio M, Perrone S, Magrini A, Pietroiusti A. Persistence of Anti-S Titre among Healthcare Workers Vaccinated with BNT162b2 mRNA COVID-19. Vaccines (Basel) 2021; 9:vaccines9090947. [PMID: 34579184 PMCID: PMC8472926 DOI: 10.3390/vaccines9090947] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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] [Received: 06/24/2021] [Revised: 08/16/2021] [Accepted: 08/23/2021] [Indexed: 01/28/2023] Open
Abstract
The COVID-19 pandemic has led to health, social and economic consequences for public health systems. As a result, the development of safe and effective vaccines, in order to contain the infection quickly became a priority. The first vaccine approved by the Italian Agency for Drugs Authorization (AIFA) was the BNT162b2 mRNA vaccine, developed by BioNTech and Pfizer (Comirnaty). Comirnaty contains a molecule called messenger RNA (mRNA), which is a nucleoside-modified RNA that encodes the SARS-CoV-2 spike glycoprotein. Even if data from phase I suggest that vaccine induced antibodies can persist for up to six months following the second shot of BNT vaccine, data regarding the real duration of immunological protection are lacking. In this study, we aimed to evaluate the duration of serological protection by detecting the presence of anti-S-RBD (receptor-binding domain) antibodies for SARS-CoV-2 among a large group of healthcare workers (HCWs) three months after vaccination. 99% of HCWs had a detectable titre of anti-S SARS-CoV-2 antibodies 90 days after the second vaccine shot. Elderly operators showed significantly lower levels of protective antibodies when compared to the younger ones, thus they could become unprotected earlier than other operators.
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Affiliation(s)
- Luca Coppeta
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (L.C.); (G.S.); (A.M.); (S.P.); (A.M.); (A.P.)
| | - Giuseppina Somma
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (L.C.); (G.S.); (A.M.); (S.P.); (A.M.); (A.P.)
| | - Cristiana Ferrari
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (L.C.); (G.S.); (A.M.); (S.P.); (A.M.); (A.P.)
- Correspondence:
| | - Andrea Mazza
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (L.C.); (G.S.); (A.M.); (S.P.); (A.M.); (A.P.)
| | - Stefano Rizza
- Department of Traslational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy;
| | - Marco Trabucco Aurilio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy;
| | - Stefano Perrone
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (L.C.); (G.S.); (A.M.); (S.P.); (A.M.); (A.P.)
| | - Andrea Magrini
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (L.C.); (G.S.); (A.M.); (S.P.); (A.M.); (A.P.)
| | - Antonio Pietroiusti
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (L.C.); (G.S.); (A.M.); (S.P.); (A.M.); (A.P.)
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10
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Ferrari C, Trabucco Aurilio M, Mazza A, Pietroiusti A, Magrini A, Balbi O, Bolcato M, Coppeta L. Evaluation of Immunity for Mumps among Vaccinated Medical Students. Vaccines (Basel) 2021; 9:vaccines9060599. [PMID: 34199971 PMCID: PMC8226533 DOI: 10.3390/vaccines9060599] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 11/16/2022] Open
Abstract
Healthcare workers are considered at higher risk for mumps infection than the general population. Since 2017, the national immunization plan recommended the administration of a dose of measles–mumps–rubella (MMR) vaccine to the healthcare operators who are unable to demonstrate a complete vaccination history or that are seronegative for at least one of the three agents. Regarding mumps infection, based on actual concerns regarding the loss of protection over the years after vaccination, the Advisory Committee on Immunization Practices (ACIP) recommended to administer a third dose of vaccine to operators previously vaccinated with two doses of MMR vaccine who belong to a group at increased risk of mumps infection in the event of an epidemic. This guideline, however, is not currently followed in Italy, resulting in a potential risk for vaccinated operators to become unprotected from mumps over the years. The aim of our study is to evaluate the persistence of a protective antibody level for mumps among medical students vaccinated during infancy or adolescence, at the start of their hospital internship. We retrospectively evaluated mumps-specific IgG levels in a group of medical students, in the period from 1 January to 31 December 2020. We evaluated the persistence of the detectable level of mumps-specific antibodies in relation to their vaccinal status, gender and time elapsed from vaccination. We found that 17.4% (65 subjects) of our sample were seronegative for mumps. The univariate analysis showed a significant difference in serological protection between male and female gender (77.0% vs. 86.2%; p < 0.05 with chi2 test) and between age classes (86.5% vs. 76.4%; p < 0.05 for subjects aged 18–23 years and over 23 years, respectively). Female gender was significantly related to higher serological protection even after adjusting for age classes and number of vaccine doses administered in a multivariate analysis model. Our study shows a substantial percentage of subjects lacking a protective mumps titer among medical students who were vaccinated in childhood. Given the higher risk of infection among those subjects, routine pre-employment screening should be performed among those operators regardless of their vaccination history and a third dose of MMR should be offered to unprotected students.
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Affiliation(s)
- Cristiana Ferrari
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (C.F.); (A.M.); (A.P.); (A.M.); (O.B.); (L.C.)
| | - Marco Trabucco Aurilio
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy;
| | - Andrea Mazza
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (C.F.); (A.M.); (A.P.); (A.M.); (O.B.); (L.C.)
| | - Antonio Pietroiusti
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (C.F.); (A.M.); (A.P.); (A.M.); (O.B.); (L.C.)
| | - Andrea Magrini
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (C.F.); (A.M.); (A.P.); (A.M.); (O.B.); (L.C.)
| | - Ottavia Balbi
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (C.F.); (A.M.); (A.P.); (A.M.); (O.B.); (L.C.)
| | - Matteo Bolcato
- Legal Medicine, University of Padua, Via Falloppio 50, 35121 Padova, Italy
- Correspondence:
| | - Luca Coppeta
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (C.F.); (A.M.); (A.P.); (A.M.); (O.B.); (L.C.)
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11
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Trabucco Aurilio M, Mennini FS, Gazzillo S, Massini L, Bolcato M, Feola A, Ferrari C, Coppeta L. Intention to Be Vaccinated for COVID-19 among Italian Nurses during the Pandemic. Vaccines (Basel) 2021; 9:vaccines9050500. [PMID: 34066068 PMCID: PMC8151959 DOI: 10.3390/vaccines9050500] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/27/2021] [Accepted: 05/05/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND While the COVID-19 pandemic has spread globally, health systems are overwhelmed by both direct and indirect mortality from other treatable conditions. COVID-19 vaccination was crucial to preventing and eliminating the disease, so vaccine development for COVID-19 was fast-tracked worldwide. Despite the fact that vaccination is commonly recognized as the most effective approach, according to the World Health Organization (WHO), vaccine hesitancy is a global health issue. METHODS We conducted a cross-sectional online survey of nurses in four different regions in Italy between 20 and 28 December 2020 to obtain data on the acceptance of the upcoming COVID-19 vaccination in order to plan specific interventions to increase the rate of vaccine coverage. RESULTS A total of 531 out of the 5000 nurses invited completed the online questionnaire. Most of the nurses enrolled in the study (73.4%) were female. Among the nurses, 91.5% intended to accept vaccination, whereas 2.3% were opposed and 6.2% were undecided. Female sex and confidence in vaccine efficacy represent the main predictors of vaccine intention among the study population using a logistic regression model, while other factors including vaccine safety concerns (side effects) were non-significant. CONCLUSIONS Despite the availability of a safe and effective vaccine, intention to be vaccinated was suboptimal among nurses in our sample. We also found a significant number of people undecided as to whether to accept the vaccine. Contrary to expectations, concerns about the safety of the vaccine were not found to affect the acceptance rate; nurses' perception of vaccine efficacy and female sex were the main influencing factors on attitudes toward vaccination in our sample. Since the success of the COVID-19 immunization plan depends on the uptake rate, these findings are of great interest for public health policies. Interventions aimed at increasing employee awareness of vaccination efficacy should be promoted among nurses in order to increase the number of vaccinated people.
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Affiliation(s)
- Marco Trabucco Aurilio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (M.T.A.); (L.M.)
| | - Francesco Saverio Mennini
- EEHTA-CEIS, DEF Department, Faculty of Economics, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.S.M.); (S.G.)
- Institute for Leadership and Management in Health, Kingston University, London KT1 2EE, UK
| | - Simone Gazzillo
- EEHTA-CEIS, DEF Department, Faculty of Economics, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.S.M.); (S.G.)
| | - Laura Massini
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (M.T.A.); (L.M.)
| | - Matteo Bolcato
- Legal Medicine, University of Padua, Via G. Falloppio 50, 35121 Padua, Italy
- Correspondence: ; Tel.: +39-049-9941096
| | - Alessandro Feola
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via Luciano Armanni 5, 80138 Naples, Italy;
| | - Cristiana Ferrari
- Department of Occupational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (C.F.); (L.C.)
| | - Luca Coppeta
- Department of Occupational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (C.F.); (L.C.)
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Bolcato M, Trabucco Aurilio M, Di Mizio G, Piccioni A, Feola A, Bonsignore A, Tettamanti C, Ciliberti R, Rodriguez D, Aprile A. The Difficult Balance between Ensuring the Right of Nursing Home Residents to Communication and Their Safety. Int J Environ Res Public Health 2021; 18:ijerph18052484. [PMID: 33802378 PMCID: PMC7967622 DOI: 10.3390/ijerph18052484] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 01/09/2021] [Revised: 02/10/2021] [Accepted: 02/26/2021] [Indexed: 12/22/2022]
Abstract
The COVID-19 epidemic has had a profound impact on healthcare systems worldwide. The number of infections in nursing homes for the elderly particularly is significantly high, with a high mortality rate as a result. In order to contain infection risks for both residents and employees of such facilities, the Italian government passed emergency legislation during the initial stages of the pandemic to restrict outside visitor access. On 30 November 2020, the Italian President of the Council of Ministers issued a new decree recognizing the social and emotional value of visits to patients from family and friends. In addition, it indicated prevention measures for the purposes of containing the infection risk within nursing homes for the elderly. This article comments on these new legislative provisions from the medicolegal perspective, providing indications that can be used in clinical practice.
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Affiliation(s)
- Matteo Bolcato
- Legal Medicine, Department of Molecular Medicine, University of Padua, via G. Falloppio 50, 35121 Padua, Italy; (D.R.); (A.A.)
- Correspondence: (M.B.); (M.T.A.); Tel.: +39-0499941096 (M.B.); +39-081-778-316 (M.T.A.)
| | - Marco Trabucco Aurilio
- Department of Medicine and Health Sciences “V. Tiberio,” University of Molise, 86100 Campobasso, Italy
- Correspondence: (M.B.); (M.T.A.); Tel.: +39-0499941096 (M.B.); +39-081-778-316 (M.T.A.)
| | - Giulio Di Mizio
- Forensic Medicine, Department of Law, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy;
| | - Andrea Piccioni
- Department of Emergency Medicine, Gemelli, IRCCS (Scientific Institute for Hospitalization and Treatment), Catholic University of Rome-Teaching Hospital Foundation A, 00168 Rome, Italy;
| | - Alessandro Feola
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, via Luciano Armanni 5, 80138 Naples, Italy;
| | - Alessandro Bonsignore
- Department of Health Sciences, Section of Legal and Forensic Medicine, University of Genova, 16126 Genova, Italy; (A.B.); (C.T.)
| | - Camilla Tettamanti
- Department of Health Sciences, Section of Legal and Forensic Medicine, University of Genova, 16126 Genova, Italy; (A.B.); (C.T.)
| | - Rosagemma Ciliberti
- Department of Health Sciences, Section of History of Medicine and Bioethics, University of Genova, 16126 Genova, Italy;
| | - Daniele Rodriguez
- Legal Medicine, Department of Molecular Medicine, University of Padua, via G. Falloppio 50, 35121 Padua, Italy; (D.R.); (A.A.)
| | - Anna Aprile
- Legal Medicine, Department of Molecular Medicine, University of Padua, via G. Falloppio 50, 35121 Padua, Italy; (D.R.); (A.A.)
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Mennini FS, Marcellusi A, Gazzillo S, Nardone C, Sciattella P, Migliorini R, Trabucco Aurilio M, Amore M, Brugnoli R. Economic Impact of Schizophrenia from a Hospital and Social Security System Perspective in Italy. Clin Drug Investig 2021; 41:183-191. [PMID: 33559103 DOI: 10.1007/s40261-020-00991-7] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Schizophrenia is one of the mental disorders with the highest economic and social costs, with an important burden on patients, caregivers, and society. OBJECTIVE The objective of this study was to estimate the direct and social security costs of schizophrenia in Italy. As far as direct costs are concerned, those related to hospitalizations and pharmaceutical expenditure have been analyzed, while disability benefits (DBs) and incapacity pensions (IPs) have been considered for the social security costs. METHODS In order to provide annual economic burden of schizophrenia using the real-world data, we analyzed the main regional and national databases related to hospitalizations and pharmaceuticals. Hospitalizations have been analyzed considering the Hospital Information System, which collects all the information regarding hospital discharges from all public and private hospitals (psychiatric wards or residential facilities have not been considered). Hospitalizations with a discharge date between 2009 and 2016, and with a primary or secondary diagnosis of schizophrenia (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 295.xx) were selected. Hospital costs have been estimated considering the national tariffs associated with each selected hospitalization. In addition, using the same inclusion criteria, the average DBs (for workers with reduced working capacity) and IPs (for workers without working capacity) provided each year have been analyzed from the social security benefit applications database. The estimate of pharmaceutical expenditure was prepared based on the OsMed 2018 Report (Italian Medicines Agency, latest issue 18 July 2019). A one-way deterministic sensitivity analysis was conducted to examine the robustness of the results. RESULTS In Italy from 2009 to 2016, schizophrenia had an important economic impact from a social perspective. On average, 13,800 patients were hospitalized, with an average of 2.98 hospitalizations per patient. From a National Health Service (NHS) perspective and with specific reference to hospitalizations, the annual economic burden was €101.4 million, with an average cost per patient of €7338. On the other hand, pharmaceutical expenditure amounts to over €147 million each year, while residential, semi-residential, and specialist facilities amount to approximately €1 billion. Again, schizophrenia led to approximately 15,000 recipients of social security benefits (DBs and IPs) yearly from 2009 to 2015, with an average annual expenditure of €160.1 million (average cost per patient = €10,675). CONCLUSIONS Our study estimates an economic burden of schizophrenia of €1250 million per year in direct costs, of which 20% is related to hospitalizations and pharmaceutical expenditure. With regard to social security benefits, an average annual expenditure of €160.1 million was calculated (average cost per patient = €10,675).
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Affiliation(s)
- Francesco Saverio Mennini
- Economic Evaluation and HTA (EEHTA), CEIS, Facoltà di Economia, Università di Roma "Tor Vergata", Via Columbia 2, 00133, Rome, Italy.
- Department of Accounting Finance and Informatics, Kingston University, London, UK.
| | - Andrea Marcellusi
- Economic Evaluation and HTA (EEHTA), CEIS, Facoltà di Economia, Università di Roma "Tor Vergata", Via Columbia 2, 00133, Rome, Italy.
- Department of Accounting Finance and Informatics, Kingston University, London, UK.
| | - Simone Gazzillo
- Economic Evaluation and HTA (EEHTA), CEIS, Facoltà di Economia, Università di Roma "Tor Vergata", Via Columbia 2, 00133, Rome, Italy
| | - Claudia Nardone
- Economic Evaluation and HTA (EEHTA), CEIS, Facoltà di Economia, Università di Roma "Tor Vergata", Via Columbia 2, 00133, Rome, Italy
| | - Paolo Sciattella
- Economic Evaluation and HTA (EEHTA), CEIS, Facoltà di Economia, Università di Roma "Tor Vergata", Via Columbia 2, 00133, Rome, Italy
| | - Raffaele Migliorini
- Ufficio di Coordinamento Medico Legale, Istituto Nazionale Previdenza Sociale (INPS), Rome, Italy
| | - Marco Trabucco Aurilio
- Dipartimento di Medicina e Scienze della Salute, Università degli Studi del Molise, Campobasso, Italy
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Coppeta L, Somma G, Ippoliti L, Ferrari C, D’Alessandro I, Pietroiusti A, Trabucco Aurilio M. Contact Screening for Healthcare Workers Exposed to Patients with COVID-19. Int J Environ Res Public Health 2020; 17:ijerph17239082. [PMID: 33291364 PMCID: PMC7730521 DOI: 10.3390/ijerph17239082] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/24/2020] [Accepted: 12/01/2020] [Indexed: 01/12/2023]
Abstract
In China and Italy, many cases of coronavirus disease 2019 (COVID-19) have occurred among healthcare workers (HCWs). Prompt identification, isolation and contact tracing of COVID-19 cases are key elements in controlling the COVID-19 pandemic. The aim of this study was to evaluate the rate of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection among HCWs exposed to patients with COVID-19 in relation to the main determinants of exposure. To assess the risk of exposure, we performed active symptom monitoring in 1006 HCWs identified as contacts of COVID19 cases. The presence of symptoms was statistically associated with a positive nasopharyngeal swab result. Only one subject was asymptomatic at the time of positive test. These data suggest that clinical history may help in the selection of subjects to be investigated by means of reverse transcriptase-polymerase chain reaction (RT-PCR) in the case of a shortage of diagnostic resources. We found that close contact (within 2 m for 15 min or more) was not statistically related to contagion. Regarding the use of personal protective equipment (PPE), only the use of facial masks was inversely related to the chance of becoming infected (p < 0.01). In conclusion, our data show that unprotected contacts between HCWs should be considered a major route of HCW contagion, suggesting that the use of facial masks should be implemented even in settings where known patients with COVID-19 are not present.
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Affiliation(s)
- Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (G.S.); (A.P.)
- Correspondence:
| | - Giuseppina Somma
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (G.S.); (A.P.)
| | - Lorenzo Ippoliti
- School of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (L.I.); (C.F.); (I.D.)
| | - Cristiana Ferrari
- School of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (L.I.); (C.F.); (I.D.)
| | - Iacopo D’Alessandro
- School of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (L.I.); (C.F.); (I.D.)
| | - Antonio Pietroiusti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (G.S.); (A.P.)
| | - Marco Trabucco Aurilio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy;
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15
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Coppeta L, Ferrari C, Iannuzzi I, D’Alessandro I, Balbi O, Pietroiusti A, Trabucco Aurilio M. Rubella Immunity among Italian Female Healthcare Workers: A Serological Study. Int J Environ Res Public Health 2020; 17:ijerph17217992. [PMID: 33143150 PMCID: PMC7663519 DOI: 10.3390/ijerph17217992] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/22/2020] [Accepted: 10/24/2020] [Indexed: 11/24/2022]
Abstract
Rubella, also known as German measles or three-day measles, is an infectious disease caused by virus of the genus Rubivirus, which may be prevented by vaccination. The infection is potentially dangerous for non immune subjects, although 20–50% of infected subjects are asymptomatic. Healthcare workers (HCWs) have an increased potential exposure to rubella in comparison to the general population, putting them and their patients at risk of infection and its complications. In 2019, 20 cases of rubella have been reported in Italy. According to the Italian National Immunization and Prevention Plan, HCWs should provide a written certification of vaccination for rubella or serological evidence of protective antibodies. The aim of the study was to evaluate the rubella immunization status in female HCWs of the teaching hospital Policlinic Rome Tor Vergata (PTV) of childbearing age. For this purpose, we retrospectively checked the serologic values of rubella-specific IgG antibodies analyzing the clinical records of the HCWs of undergoing the occupational health surveillance program from January 1st to June1st 2020. Five hundred fourteen HCWs with a mean age of 23.19 (range 19–37, DS: 2.80) were included: 90.3% (464) showed a protective antibody titre. The mean value of the anti-rubella IgG was 49.59 IU/mL. Our study shows a non-protective anti rubella IgG titre in a substantial percentage of HCWs (9.7%). As vaccine protection decreases over the years and the risk of congenital rubella syndrome (CRS) in vaccinated subjects should not be underestimated, we suggest routine screening of the immunological status followed by the administration of a third dose of vaccine if the antibody titre becomes non-protective.
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Affiliation(s)
- Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
- Correspondence: (L.C.); (M.T.A.)
| | - Cristiana Ferrari
- School of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (C.F.); (I.I.); (I.D.); (O.B.)
| | - Ilaria Iannuzzi
- School of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (C.F.); (I.I.); (I.D.); (O.B.)
| | - Iacopo D’Alessandro
- School of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (C.F.); (I.I.); (I.D.); (O.B.)
| | - Ottavia Balbi
- School of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (C.F.); (I.I.); (I.D.); (O.B.)
| | - Antonio Pietroiusti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Marco Trabucco Aurilio
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
- Correspondence: (L.C.); (M.T.A.)
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