On the eve of the departure of the vaccination campaigns (there are Regions that begin on Tuesday like Emilia Romagna, others like Piedmont that begin on October 26), there are many unknowns about the flu vaccine: will there be enough? With the anti Covid measures, will doctors be able to organize themselves? Will coverage increase, which last year stopped at 55%?
After the criticism of the Gimbe Foundation which has predicted a shortage in some Regions, the criticisms of the consultant of the Minister Roberto Speranza Walter Ricciardi to the Regions, and the alarms of the doctors, it is clear that the flu vaccine will be the most important test of our own health in the critical period in which contagions start to rise again. Yesterday the topic was addressed in a meeting dedicated to Covid which took place in Catania. The coordinator of the Health Commission of the Conference of the Regions and Piedmont Health Councilor Luigi Icardi argued with the government: “In March we asked the government to run a national competition, but it has not been done. Now we must also organize ourselves to provide the doses. to pharmacies. There will be a control room for the management of influenza vaccines that will guarantee fair distribution, he added: Abruzzo and Sardinia have asked us for doses and they will have them “.
On the eve of departure, the investigation on purchases could not be missing. Yesterday afternoon the news that the Milan Public Prosecutor’s Office opened a fact-finding investigation (for now there are no suspects and title of crime) on the purchase of influenza vaccines in Lombardy (2 million doses ordered) at a price higher than the market price.
Who is eligible for the free vaccine?
Covid, has convinced that it was time to accelerate and expand the number of those who have the right to get the vaccine for free. The chimera would be to reach a coverage of 95% but the 75% target is more realistic and still difficult to achieve, given that last year the coverage only reached 55%. Until now, the vaccine was free from the age of 65 and for people who fall into the categories at risk of complications. For the 2020-2021 season the gratuity has also been extended to those in the 60-64 range. Precisely because the risk is that the symptoms of the flu can be confused with those of Covid, the vaccine is also strongly recommended for children in the 0-6 range. Doctors and nurses are under special observation: there is no obligation but health professionals, and with them all those who exercise social and health professions especially in contact with the elderly, are warmly invited to get the vaccine.
The categories at risk
All those who run a greater risk of suffering complications or hospitalizations. The complete list includes all women who are pregnant and in the “postpartum” period at the beginning of the epidemic season; individuals aged 60 or over; children and adolescents on long-term treatment with acetylsalicylic acid, at risk of Reye’s syndrome if they have a flu infection; individuals of any age admitted to long-term care facilities; blood donors; personnel who are in contact with animals that could be a source of infection with non-human influenza viruses; subjects assigned to public services of primary collective interest, and family members and contacts of subjects at high risk of complications. The latter group includes those suffering from: chronic diseases affecting the respiratory system (including severe asthma, bronchopulmonary dysplasia, cystic fibrosis and chronic obstructive bronchopathy – COPD) • diseases of the cardiovascular system, including congenital and acquired heart disease
• diabetes mellitus and other metabolic diseases (including obese people with a body mass index greater than 30
• chronic renal / adrenal insufficiency
• diseases of the hematopoietic organs and hemoglobinopathies
• tumors and undergoing chemotherapy treatment
• congenital or acquired diseases resulting in deficient production of antibodies, drug-induced immunosuppression or HIV
• chronic inflammatory diseases and intensional malabsorption syndromes
• pathologies for which major surgical interventions are planned
• diseases associated with an increased risk of aspiration of respiratory secretions (such as neuromuscular diseases)
• chronic liver diseases
Is the vaccine mandatory?
No. Lazio tried, which in April made an ordinance that made the ordinance mandatory for the over 65s and health professionals, but the TAR blocked it.
When to get vaccinated?
In recent times the debate on the hypothesis of anticipating vaccination has opened up. However, some Regions such as Piedmont have believed that leaving much ahead of time could be a mistake, considering that one would risk seeing the effect diminish at the peak of the influence that usually arrives between January and February. Aifa, the Italian Medicines Agency, reminds that the protection induced by the vaccine begins about two weeks after vaccination and lasts for a period of six / eight months and then decreases.
Where to get vaccinated
In the offices of family doctors and pediatricians, in health facilities or in vaccination and prevention clinics and, in some cases, also by occupational doctors. Covid rules complicate the organization a lot. In the event that family doctors have difficulties because they have little staff, some Regions have prepared to activate drive-in where citizens can turn to avoid gatherings or too long times. Many professionals this year have decided to set some days, after hours, dedicated to vaccination. It also goes in alphabetical order. The pharmacist associations have posed the problem: to speed up the vaccine it could be done directly in the pharmacy. However, the Scientific Technical Committee clarified that vaccination should only be done in the presence of a doctor.
The drug puzzle
In recent years, those who were not entitled to the free vaccine but wanted to get vaccinated to avoid complications could buy the dose of the vaccine at the pharmacy and go to their doctor. This year, however, foreseeing the growth in requests, the Regions have bought up and bought a much higher quantity of doses. The result is that the vaccine for individuals is not available in pharmacies for now and this happens precisely in the year in which many, even outside the age groups to which the vaccine is offered free of charge, want to do the influenza and pneumococcal vaccination. The doses, is the promise, will arrive because it is difficult for the orders of the Regions to be exhausted. Instead, it is very likely that they are in insufficient quantity. The price varies according to the pharmaceutical companies that produce it, but should not exceed 25 euros. In any case, the ministry has made it known that the advanced doses will be distributed free of charge. Piedmontese councilor Luigi Icardi, coordinator in the Conference of the Regions, clarified the percentages: “We will give 1.25% of the supply of the Regions to pharmacies, but it is insufficient and we will have to increase the quota. I think it will be possible to cover the need “.
How many doses have been ordered
Seventeen and a half million doses ordered this year, about 7 million more than those used last year, when 10 million free vaccines were administered, with a coverage of 55%, now considered completely inadequate with Covid which circulates with symptoms comparable to those of the flu. Almost all the Regions have thus decided to double the orders. In Italy there are 15.5 million over 60s, the age group where the highest percentage of chronic diseases is concentrated. Lazio is one of the regions that has ordered the most doses, 2.2 million. Lombardy would have wanted 3.2 million and has 2.2 million. Piedmont asked for 1 million doses. The first batches of doses are arriving everywhere. A delivery in stages that will continue in November.