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意大利的疫苗接种覆盖率及2012 - 2014年国家免疫预防计划评估

Vaccine coverage in Italy and assessment of the 2012-2014 National Immunization Prevention Plan.

作者信息

Bonanni Paolo, Ferro Antonio, Guerra Raniero, Iannazzo Stefania, Odone Anna, Pompa Maria Grazia, Rizzuto Elvira, Signorelli Carlo

机构信息

Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI).

Direzione generale della prevenzione sanitaria, Ministero della salute, Roma, Italy.

出版信息

Epidemiol Prev. 2015 Jul-Aug;39(4 Suppl 1):146-58.

Abstract

BACKGROUND

In 2012, the ItalianMinistry of Health issued the National Immunization Prevention Plan (Piano Nazionale Prevenzione Vaccinale, or PNPV 2012-2014), with the aim of harmonizing immunization strategies across the country and ensuring equitable access to infectious disease prevention to all citizens. The Plan defines the immunization standards all regions should comply with.

OBJECTIVE AND METHODS

As new evidence has accumulated in the field of immunization, and the new National Immunization Prevention Plan is about to be launched, the aim of the current study is to: i. present immunization coverage data (2000-2014) for 14 vaccines included in the PNPV to be offered to the general population, ii. assess to what extent the PNPV coverage targets and objectives have been met, and iii. report on how the PNPV was transposed into regional immunization programs. Data are also available for the eight regions that piloted varicella immunization.

RESULTS

The 2012-2014 PNPV first introduced a "lifecourse" approach to vaccination at the institutional level, and has been a milestone for prevention in the Italian health policy agenda. However, infant vaccine coverage rates have been decreasing over the last years, as has influenza immunization in the elderly. HPV vaccine coverage has been increasing for all birth cohorts, but is still far below the targets set in the Plan. Promising preliminary data show that pneumococcal and meningococcal C conjugate vaccines were well introduced in regional immunization schedules.

CONCLUSION

The 2012-2014 PNPV objectives have only been partially met, due to several factors, in particular increase in vaccine hesitancy. Strengthened efforts are needed to promote immunization. The new National Immunization Prevention Plan should introduce new vaccines and extend immunization programs to other target populations on the basis of the most recent scientific evidence available. It is of crucial importance that interventions of proven efficacy be planned and implemented to contrast the growing phenomenon of vaccine hesitancy and ultimately increase immunization uptake.

摘要

背景

2012年,意大利卫生部发布了《国家免疫预防计划》(Piano Nazionale Prevenzione Vaccinale,简称PNPV 2012 - 2014),旨在协调全国的免疫策略,确保所有公民都能公平地获得传染病预防服务。该计划明确了所有地区应遵循的免疫标准。

目的与方法

随着免疫领域新证据的不断积累,新的《国家免疫预防计划》即将推出,本研究的目的是:i. 呈现PNPV中包含的14种面向普通人群的疫苗在2000 - 2014年的免疫覆盖率数据;ii. 评估PNPV的覆盖目标和指标达成的程度;iii. 报告PNPV如何转化为地区免疫计划。同时也有针对试行水痘免疫的8个地区的数据。

结果

2012 - 2014年的PNPV首次在机构层面引入了“全生命周期”的疫苗接种方法,是意大利卫生政策议程中预防工作的一个里程碑。然而,过去几年婴儿疫苗接种率一直在下降,老年人的流感疫苗接种率也是如此。人乳头瘤病毒(HPV)疫苗在所有出生队列中的接种率一直在上升,但仍远低于计划设定的目标。有前景的初步数据表明,肺炎球菌和C群脑膜炎球菌结合疫苗已很好地纳入地区免疫计划。

结论

由于多种因素,特别是疫苗犹豫现象的增加,2012 - 2014年PNPV的目标仅部分实现。需要加大力度推广免疫接种。新的《国家免疫预防计划》应根据最新的科学证据引入新疫苗,并将免疫计划扩展到其他目标人群。规划和实施已证实有效的干预措施以应对日益增长的疫苗犹豫现象并最终提高免疫接种率至关重要。

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