Missed Opportunities of Flu Vaccination in Italian Target Categories: Insights from the Online EPICOVID 19 Survey.

Andrea Giacomelli,Fulvio Adorni,Mauro Di Bari,Caterina Trevisan,Aleksandra Sojic,Massimo Galli,Fabrizio Bianchi,Raffaele Antonelli Incalzi,Claudio Pedone,Marianna Noale,Stefania Maggi,Federica Prinelli,Claudio Mastroianni,Gabriele Pagani,Marcello Tavio,Massimo Andreoni

doi:10.3390/vaccines8040669

Abstract

We aimed to assess the reported rate of flu vaccination in the 2019/2020 season for respondents to the Italian nationwide online EPICOVID 19 survey. A national convenience sample of volunteers aged 18 or older was assessed between 13 April and 2 June 2020. Flu vaccine rates were calculated for all classes of age. The association between the independent variables and the flu vaccine was assessed by applying a multivariable binary logistic regression model. Of the 198,822 respondents, 41,818 (21.0%) reported having received a flu vaccination shot during the last influenza season. In particular, 15,009 (53.4%) subjects aged 65 years or older received a flu vaccination shot. Being 65 years aged or older (Adjusted Odds Ratios (aOR) 3.06, 95% Confidence Interval (CI) 2.92–3.20) and having a high education level (aOR 1.34. 95%CI 1.28–1.41) were independently associated to flu vaccination. Heart and lung diseases were the morbidities associated with the higher odds of being vaccinated (aOR 1.97 (95%CI 1.86–2.09) and aOR 1.92 (95%CI 1.84–2.01), respectively). Nursing home residents aged ≥ 65 years showed lower odds of being vaccinated (aOR 0.39 (95%CI 0.28–0.54)). Our data indicate the need for an urgent public heath effort to fill the gap of missed vaccination opportunities reported in the past flu seasons.

Highlights

Influenza is an acute viral infection of the respiratory tract, whose clinical manifestations range from mild upper respiratory tract symptoms to life-threating complications requiring hospitalization.It is estimated that every year flu can cause worldwide high morbidity and mortality epidemics with approximately 3 to 5 million cases and between 250,000 and 500,000 deaths [1]
Between April and June 2020, 198,822 participants filled the online EPICOVID 19 survey and 41,818 (21.0%) reported having received a flu vaccination shot during the last influenza season (2019/2020)
We were able to identify predictors of flu vaccine uptake and highlight significant gaps in vaccination coverage in key populations such as in those residing in nursing homes and in those reporting specific medical conditions

Summary

Introduction

It is estimated that every year flu can cause worldwide high morbidity and mortality epidemics with approximately 3 to 5 million cases and between 250,000 and 500,000 deaths [1]. Influenza viruses circulating during fall and winter seasons cause epidemic outbreaks with an important burden of morbidity and a remarkable mortality rate. In Italy, the cost for the national healthcare system has been estimated at an average of USD 1.4 billion for each season between. The new pandemic caused by Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2). SARS-CoV-2 infection causes a severe respiratory syndrome which could lead to intensive care assistance and to death [4,5]. The dramatic impact of the SARS-CoV-2 pandemic on the Italian national healthcare system led the national authorities to impose a national lockdown from March 9 to May

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