Azienda Ligure Sanitaria della Regione Liguria (A.Li.Sa.), Liguria Region, Italy.
Policlinic San Martino Hospital, Genoa, Italy.
Biomed Res Int. 2019 Jul 4;2019:6764154. doi: 10.1155/2019/6764154. eCollection 2019.
The study aimed to assess the impact of HPV immunization campaigns organizational aspects, the characteristics of immunization program (vaccination targets and type of offer), and communicative strategies adopted by four Italian administrative regions on vaccination coverage observed. From November 2017 to March 2018, regional and Local Health Units (LHUs) representatives were invited to complete an online survey including 54 questions evaluating vaccination invite systems, access systems to vaccination centres, reminder and recall systems, and adverse events surveillance. An overall descriptive analysis was conducted. Since observed vaccine coverage (VC) obtained in females (2002-2004 birth cohorts) was lower than objectives fixed by the Italian Ministry of Health, variables were assessed using the national VC mean obtained in the 2003 girls birth cohort as outcome. Twenty-six LHUs belonging to 4 Northern and Southern Italian regions participated in the study. Organizational aspects significantly related to VC lower than the national mean were access to vaccine centres without appointment and parents' reservation as appointment planning system. Recall systems for both the first and the second dose, including the appointment in the invitation letter, the availability of regional immunization registry, and education of healthcare workers on universal HPV immunization strategies, instead, were related to higher VC. As regards preadolescent immunization strategies, both VC obtained in girls and boys were far from the Ministerial goals. Only 20% of LHUs introduced multicohort female strategies while all LHUs adopted copayment targeting both men and women. Immunizations strategies targeting subjects at risk were implemented only in half of participating LHUs. VC observed in participating LHUs are largely lower than the national objectives in all anti-HPV vaccine targets. Both organizational and educational strategies have to be implemented to improve the VC goals.
本研究旨在评估 HPV 免疫接种运动的组织方面、免疫计划的特征（接种目标和提供类型）以及四个意大利行政区采用的沟通策略对观察到的疫苗接种覆盖率的影响。2017 年 11 月至 2018 年 3 月，邀请地区和地方卫生单位（LHUs）的代表填写一份在线调查问卷，其中包括 54 个问题，评估接种邀请系统、接种中心的准入系统、提醒和召回系统以及不良事件监测。进行了总体描述性分析。由于观察到的女性疫苗接种覆盖率（VC）（2002-2004 年出生队列）低于意大利卫生部设定的目标，因此使用全国范围内在 2003 年女孩出生队列中获得的 VC 平均值来评估变量。来自意大利北部和南部四个地区的 26 个 LHUs 参加了这项研究。与 VC 低于全国平均水平相关的组织方面是无预约和父母预约作为预约规划系统进入疫苗接种中心。第一剂和第二剂的召回系统，包括邀请信中的预约、区域性免疫登记册的可用性以及医疗保健工作者对普遍 HPV 免疫接种策略的教育，相反，与更高的 VC 相关。至于青春期前的免疫接种策略，女孩和男孩的 VC 都远未达到部长级目标。只有 20%的 LHUs 引入了多队列女性策略，而所有 LHUs 都采用了针对男女双方的共付费用策略。仅在一半的参与 LHUs 中实施了针对高危人群的免疫接种策略。在所有抗 HPV 疫苗目标中，参与 LHUs 的 VC 都远低于全国目标。必须实施组织和教育策略来提高 VC 目标。
