Knowledge, attitudes and adherence towards influenza and other vaccinations among healthcare workers at the University Hospital of Palermo, Italy, during the first COVID-19 pandemic season (2020/2021).

Background: Increasing adherence to influenza vaccination among healthcare workers is a public health priority, stated that actually remains far below than international recommendations. During the 2020/2021 pandemic season, COVID-19 vaccines were not yet available until the end of December 2020, and influenza vaccines were the only one available to protect against seasonal respiratory diseases. The main objective of the present study was to assess knowledge, attitudes and adherence to influenza and other vaccinations recommended by the National Immunization Plan 2017-2021 for healthcare workers. Methods: Enrollment lasted from October and December 2020 at the vaccination unit of the University Hospital of Palermo. Data were collected through an anonymous and self-administered questionnaire, divided into 5 sections and 31 items. Results: Among 734 healthcare professionals that completed the survey, a significantly higher adherence to influenza vaccination was observed among healthcare workers that were more prone to receive COVID-19 vaccination (OR=4.02; 95% CI: 1.63-9.91). Moreover, higher influenza vaccination rates were observed among healthcare professionals that received influenza vaccination during previous 2019/2020 season (OR=15.3; 95% CI: 5.17-45.1) and that were favorable to the possible impact on increasing adherence of influenza mandatory vaccination (OR=4.88; 95% CI: 2.43-9.80). Conclusions: Propensity of healthcare workers to undergo vaccinations recommended in the National Immunization Plan increased during the first pandemic season. At the end of the vaccination season, flu vaccination coverage reached highest rates ever at the University Hospital of Palermo (around 60%), remaining anyway below the recommended minimum value of 75%. During next seasonal flu vaccination campaigns, it becomes essential to promote communication and information strategies to increase flu vaccination among healthcare workers, also focusing on co-administration with the anti-COVID-19 booster/seasonal doses.

COVID-19 VACCINE: A SURVEY ON HESITANCY IN PATIENTS WITH CELIAC DISEASE

Background and aim: COVID-19 vaccination campaign represents the most relevant way to overcome the pandemic. COVID-19 vac-cines have been developed at the fastest known pace yet;such a fast production has led to concerns among general population wor-ldwide about safety and efficacy of COVID-19 vaccines. Specifically, patients affected by chronic illnesses, such as Celiac Disease (CeD), may have greater apprehension. The immune status of CeD patients has been studied in literature, however the actual risk of infections is not clear, depending on various factors such as suboptimal nutri-tional status. Information on vaccine hesitancy plays a pivotal role in the development of an efficient vaccine campaign. In our study, we aimed at evaluating COVID-19 vaccine hesitancy among CeD patients, its reasons and determinants. Materials and methods: An anonymous validated questionnaire formulated on the EUSurvey web platform was sent to a mailing list of CeD patients followed at our “Celiac Center” of Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico of Milan. The questions focused on socio-demographic data, disease-related and lifestyle data, attitude to vaccinations in general and predisposition to the COVID-19 vaccine. Hesitancy was defined by a negative answer to the question “Would You accept to get vaccinated tomorrow against COVID-19?”. Among the hesitant, COVID-19 vaccine refusing patients were defined as those who answered negatively to the fol-lowing question: “Would You eventually accept it in the future when more data is available?”. We evaluated the reasons and the factors associated (determinants) to hesitancy, by calculating Adjusted Odds Ratio (AdjOR) with 95% confidence intervals (CI). Results: The questionnaire was sent to 346 patients with a response rate of 29.8% (103). Among the respondents, 25.2% of patients were hesitant, with a total refusal rate of 4.8%. The main reason was the fear of adverse events (68.2%). Among the hesitant patients, 23% declared that their opinion was influenced by CeD. A positive atti-tude towards general vaccinations, a perceived good knowledge about COVID-19 and related vaccines and the adherence to GFD were determinants significantly associated to vaccine willingness (respective AdjOR of 16.48, 95% C.I. 3.34–81.31;6.50, 95% C.I. 1.44–29.22;12.71, 95% C.I. 1.82–88.58).(figure presented) Conclusions: Most CeD patients would accept COVID-19 vaccines. Data on the reasons and the determinants of vaccine hesitancy plays a pivotal role in the development of an efficient vaccine campaign

DETERMINANTS OF COVID-19 VACCINE HESITANCY IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE (IBD): RESULTS OF A NATIONAL SURVEY OF THE ITALIAN IBD PATIENTS’ ASSOCIATION (AMICI ONLUS)

Background and aim: Vaccine hesitancy, the delay in acceptance or refusal of vaccination despite its availability, threatens the control of infectious diseases. COVID-19 vaccination has been recommended by national and international organizations in patients with Inflammatory Bowel Diseases (IBD). The aim of the study was to evaluate COVID-19 vaccine hesitancy in a population of Italian patients with IBD. Materials and methods: In February 2021 an online questionnaire focused on COVID-19 vaccine was proposed to a representative sample of Italian IBD patients. Socio-demographic characteristics, IBD features, lifestyle, perception of COVID-19, general attitude towards vaccinations and to COVID-19 vaccines were investigated. Patients were divided into willing, hesitant and refusive towards COVID-19 vaccine. The hesitation reasons were investigated. The associations between baseline characteristics and willingness (determinants) were evaluated by calculating crude and adjusted Odds Ratio (AdjOR) with 95% confidence intervals (CI). Results: A total of 1252 surveys were collected. 1005 (80.3%), 222 (18.1%) and 33 (2.63%) patients were defined as willing, hesitant and refusive, respectively. The baseline characteristics are shown below. Concerns for vaccine adverse effects constituted the main reason for refusal (73.4%) (Figure). 49.1% of hesitant patients reported that presence of IBD exerted an influence on their answer. Among the patients willing to be vaccinated whenever possible, 78.2% (786) thought that their IBD represented a valid motivation to access vaccination with priority. Willingness to COVID-19 vaccine was significantly associated with adherence to previous vaccinations (AdjOR 17.6;95% CI: 11.4-27.2), male gender (1.68 95%;CI: 1.16-2.43), graduation degree (1.48;95%;CI: 1.03-2.13), perceived higher risk of COVID-19 becaues of IBD (1.47;95% CI: 1.05-2.08), alcohol intake (1.69;95% CI: 1.16-2.45). Conversely, the hesitancy was significantly associated with complementary and alternative medicine use (0.58;95% CI: 0.36-0.92). 54.5% of patients were under the impression to have a higher risk of COVID-19 and 31.8% to have a more severe course due to their IBD. (figure presented) Conclusions: Most IBD patients would accept COVID-19 vaccines, although one in five was hesitant, primarily due to fear of adverse events. Knowledge of determinants and reasons for COVID-19 vaccination acceptance or refusal could be key in developing targeted communication strategies to fight vaccine hesitancy, also in the future for general vaccinations.

Willingness to receive covid-19 vaccination in costumers accessing community pharmacies in the province of Palermo, Italy

In Italy, vaccination against COVID-19 began on December 27, 2020. To date, 13,713,224 people in Italy are fully vaccinated, which accounts for 25.3 % of the general population, and 44.8% received at least one vaccination dose. The present study aim to investigate willingness to receive COVID-19 vaccination in costumers accessing a sample of community pharmacies in the Province of Palermo, Italy. A self-administered and anonymous questionnaire was carried out among costumers older than 18 years old between December 2020 and March 2021. Three hundred and sixty-three subjects were enrolled in the study, 259 (71.3%) expressed their willingness to receive COVID-19 vaccination. The main determinants associated with vaccination acceptance resulted “trust in safety and effectiveness of vaccinations” and the absence of any previous negative vaccination experience. Unfavourable information on COVID-19 vaccination obtained through internet/media/social media and lack of confidence in COVID-19 vaccines and in the Italian national healthcare system are the main determinants associated with vaccine refusal. Male gender, younger age classes and influenza vaccination acceptance due to the impact of COVID pandemic were significantly associated with willingness to be vaccinated against COVID-19. In order to promote COVID-19 vaccination campaign accurate, informative and communicative campaign dedicated to subjects that are more hesitant regarding COVID-19 vaccination (e.g. female sex, adults, people that usually do not adhere to influenza vaccination campaign) should be implemented. © EuroMediterranean Biomedical Journal 2021.

SARS-CoV-2 pandemic in the mediterranean area: Epidemiology and perspectives

In December 2019, a disease caused by a novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was identified in Wuhan, Hubei Province, China. In March 2020, the World Health Organization declared the pandemic due to SARS-CoV-2. At the end of May 2020, SARS-CoV-2 confirmed cases and deaths due to novel Coronavirus disease (COVID-19) were about 6.5 million and 380,000, worldwide. In this commentary the authors argue on the impact of SARS-CoV-2 pandemic in different epidemiological settings within the Mediterranean area, discussing any possible association with higher or lower virus spread according to climatic factors, pollutants, characteristics of general population, and organization of health care services. © EuroMediterranean Biomedical Journal 2020 - SARS-CoV-2/COVID 19 Special Issue.