Gasparini R, Amicizia D, Lai P L, Panatto D
Department of Health Sciences, University of Genoa, Italy.
J Prev Med Hyg. 2016;57(1):E1-4.
Influenza is a serious public health problem, since seasonal epidemics affect approximately 5-10% of the population and thus give rise to a heavy social and healthcare burden. The heavy burden of disease is due to several factors, one of which is the biological features of the pathogen. Indeed influenza viruses display high mutation rates and undergo frequent genetic reassortment. Minor variations cause seasonal epidemics and major variations, which result from the hybridization of viruses typical of different animal species, can lead to pandemics. Vaccination remains the most efficacious means of mitigating the harmful healthcare and social effects of influenza. Influenza vaccines have evolved over time in order to offer broader protection against circulating strains. Trivalent vaccines containing two A viruses and one B virus are currently available. However, given the co-circulation of both B virus lineages (B/Yamagata and B/Victoria), quadrivalent vaccines have recently been developed. The new quadrivalent vaccines constitute a great advance, in that they can offer broader strain coverage. Despite the availability of effective and safe influenza vaccines, the Italian public's trust in vaccination has declined and, in the last few years, influenza vaccination coverage rates have decreased both among the elderly and among at-risk adults. It is therefore necessary that users, in their own interests, regain trust in this important means of disease prevention. In order to mitigate the damage wreaked by influenza, it seems important to: (i) improve clinical-epidemiological and virological surveillance of the disease; (ii) promote the development of new efficacious vaccines, as has recently been done through the introduction of the quadrivalent vaccine; (iii) extend free vaccination to the entire population, as in the US and Canada; (iv) ensure that general healthcare professionals are properly informed and always updated with regard to vaccination; (v) promote public campaigns to raise the population's awareness of the importance of vaccination; (vi) inform politicians and other decision-makers of scientific results in the field of vaccination; (vii) fight the antivaccination lobbies with every available weapon.
流感是一个严重的公共卫生问题，因为季节性流行影响约5%-10%的人口，从而产生沉重的社会和医疗负担。疾病负担沉重归因于几个因素，其中之一是病原体的生物学特性。事实上，流感病毒显示出高突变率并频繁发生基因重配。微小变异导致季节性流行，而由不同动物物种特有的病毒杂交产生的重大变异可导致大流行。接种疫苗仍然是减轻流感对医疗和社会有害影响的最有效手段。随着时间的推移，流感疫苗不断发展，以便对流行毒株提供更广泛的保护。目前有含两种甲型病毒和一种乙型病毒的三价疫苗。然而，鉴于两种乙型病毒谱系（B/山形和B/维多利亚）共同流行，最近已研发出四价疫苗。新的四价疫苗是一大进步，因为它们能提供更广泛的毒株覆盖范围。尽管有有效且安全的流感疫苗，但意大利公众对疫苗接种的信任度下降，在过去几年中，老年人和高危成年人中的流感疫苗接种覆盖率均有所下降。因此，为了自身利益，使用者有必要重新信任这一重要的疾病预防手段。为了减轻流感造成的损害，以下几点似乎很重要：(i) 改善对该疾病的临床流行病学和病毒学监测；(ii) 促进新型有效疫苗的研发，如最近通过引入四价疫苗所做的那样；(iii) 像美国和加拿大那样将免费疫苗接种扩大到全体人口；(iv) 确保普通医疗保健专业人员得到关于疫苗接种的适当信息并始终了解最新情况；(v) 开展公众宣传活动，提高民众对疫苗接种重要性的认识；(vi) 向政治家和其他决策者通报疫苗接种领域的科学成果；(vii) 用一切可用的手段对抗反疫苗游说团体。
