[The active offering of measles, rubella and mumps vaccine in new mothers: the experience of health facilities in one of the Local Health Unit of Rome, Lazio, Italy]. / Offerta attiva della vaccinazione Morbillo, Parotite e Rosolia nelle donne in occasione della prima vaccinazione del figlio: l'esperienza della ex ASL Roma C.

Rubella is a contagious disease that can be very serious, especially in unvaccinated pregnant women. The best way to be protected is getting vaccinated: MMR vaccine is very effective at protecting people against measles, mumps, and rubella, and preventing the complications caused by these diseases. According to PASSI 2012-2015 (the Italian behavioral risk factor surveillance system) in the territory of ex ASL Roma C only 56% of women between 18 and 49 years were immunized against rubella, thanks to vaccination (34%) or past infection detected by rubeotest (22%); 2% was susceptible and 42% of respondents did not know their immune status against rubella. The Italian National Plan for the Elimination of Measles and Congenital Rubella (PNEMoRc) 2010-15 had the aim to reduce the prevalence of rubella susceptibility in young women (<5%), to reduce the prevalence of congenital rubella and to increase MMR vaccination coverage. This plan suggested to promote actions to spread correct information about MMR vaccine in the general population and healthcare workers and to offer this vaccine to susceptible women during every appropriate contact with the Family planning clinics. In order to ensure and monitor these recommendations, a recovery procedure for MMR vaccine was activated in 2015 for women who contacted the health facilities for their first child vaccination. A form was developed in order to collect information about women's immune status against rubella and measles. According to this tool all women who stated they had never been vaccinated for rubella or MMR and/or did not remember vaccination and/or had never had a rubeotest were considered susceptible to rubella. Women susceptible to rubella were invited to undergo vaccination. Data collected during one year activity were recorded and analyzed with Epinfo 7.0 software. We collected 1801 correctly filled forms; 88.6% (1595) of women were evaluated immune to rubella and 11.4% susceptible. The prevalence of susceptibility seems to be influenced by age, from 16% in the youngest age group to 9% in the >35 years. Among 206 women susceptible to rubella: 38% were vaccinated, 31% preferred to wait, 11% refused vaccination and for 20% data is missing. The protocol of MMR vaccine recovery was effective, and allowed to reach a good number of women who had a contact with the health facilities and we hope this number to be bigger, adding a part of those women who preferred to wait. However, data of a year activity indicate that vaccine recovery initiatives should be proposed and implemented, in consideration of the proportion of rubella susceptibility in women who were recently pregnant.

[The evaluation of susceptibility to rubella in women of childbearing age; the experience of the Asl Roma C]. / La valutazione della suscettibilità alla rosolia nelle donne in età fertile: l'esperienza della ASL ROMA C.

The new Plan for Elimination of Measles and Congenital Rubella 2010-15 recommends the local health unit (ASL) to analyze the immunization coverage data available in the adult population cohorts, in order to identify susceptible people. The aim of this paper is to estimate the susceptibility to rubella in resident women of childbearing age, through integration of all ASL data sources, in order to implement the most appropriate vaccination strategy for susceptible women. In ASL Roma C, the "PASSI" surveillance system estimates a 53% prevalence of childbearing age women immune to rubella; as many as 43 % is not aware of her immune status and 4% is certainly susceptible because of reporting a negative result "rubeotest" (years 2008-10). The data extracted from the database of the ASL Roma C laboratory (year 2010) estimate a prevalence of approximately 20% of susceptibility among women who spontaneously perform a rubeotest at the hospital laboratory for any reason (control or pregnancy). Childbearing age women susceptible to rubella, residing in the territory of our ASL, are definitely more than 5%, ranging from 4% estimated by the "PASSI" surveillance system to 20% detected by hospital laboratory.