Department Biomedical Sciences for Health, Postgraduate School in Public Health, University of Milan, 20136 Milan, Italy.
Quality Unit Fondazione IRCCS Ca' Granda OMP, 20122 Milan, Italy.
Int J Environ Res Public Health. 2022 Mar 29;19(7):4066. doi: 10.3390/ijerph19074066.
Background: While the effectiveness of tetanus-diphtheria-pertussis childhood immunization programs is unquestionable, the actual need for a periodic boosting vaccination in adults is controversial. In Italy, the Ministry of Health recommends a Tdap booster vaccination every 10 years. The aim of this study is to assess the real-world adherence of Italian regional healthcare services to national recommendations and to evaluate two alternative strategies. Methods: Annual Tdap vaccine requirements by the 21 Italian regions were retrieved from related tender announcements, and regional and national vaccination coverage rates (VCRs) were estimated for three scenarios, namely the currently recommended 10-year booster vaccination, a single booster shot at age 50 and at age 65. Results: In Scenario 1, no region reached a VCR > 30%, and the national VCR was 10.6%; in Scenario 2, five regions achieved the optimal vaccination coverage of ≥95%, but the vast majority continued to have inadequate VCRs, with a national VCR of 54.4%; in Scenario 3, five regions reached VCRs exceeding 100%, with VCRs from other regions significantly improving and a national VCR of 74.8%. Conclusions: A substantial lack of adherence by Italian regional healthcare services to current national recommendations on tetanus-diphtheria-pertussis adult vaccination was shown. Scenario 3 is the most feasible, i.e., a single booster shot at age 65, possibly administrable along with other already-recommended, age-specific vaccines.
虽然破伤风白喉无细胞百日咳儿童免疫计划的有效性是毋庸置疑的，但成年人定期加强接种疫苗的实际需求仍存在争议。在意大利，卫生部建议每 10 年进行一次 Tdap 加强疫苗接种。本研究旨在评估意大利各地区卫生保健服务机构对国家建议的实际遵循情况，并评估两种替代策略。方法：从相关招标公告中获取了意大利 21 个地区每年 Tdap 疫苗的需求，并根据三种情况估计了地区和国家疫苗接种覆盖率（VCR），即目前建议的 10 年加强疫苗接种、50 岁和 65 岁时的单次加强接种。结果：在方案 1 中，没有一个地区的 VCR 超过 30%，全国 VCR 为 10.6%；在方案 2 中，有五个地区达到了最佳的 95%以上的接种覆盖率，但绝大多数地区的 VCR 仍然不足，全国 VCR 为 54.4%；在方案 3 中，有五个地区的 VCR 超过 100%，其他地区的 VCR 显著提高，全国 VCR 为 74.8%。结论：意大利各地区卫生保健服务机构对当前国家破伤风白喉无细胞百日咳成人疫苗接种建议的遵循程度明显不足。方案 3 是最可行的，即 65 岁时进行单次加强接种，可能与其他已建议的、年龄特定的疫苗同时进行。
