Aspetti organizzativi e nuove sfide connesse alla vaccinazione antinfluenzale nella popolazione over 65 in Valutazione di Health Technology Assessment (HTA) del vaccino antinfluenzale adiuvato nella popolazione anziana italiana

[Autom. eng. transl.] From an organizational point of view, one of the most important challenges concerns the achievement of vaccination coverage. Despite the ministerial recommendations and the minimum target coverage of 75% and optimal 95%, the vaccination coverage of the elderly population persist at rather low levels with interregional differences reaching 20 percentage points. Vaccination is free of charge in the population over 65 and in categories at risk and / or of particular social value. The methods of distribution and administration of the vaccine vary from region to region. In order to reach the recommended coverage, it would be advisable to define new strategic-organizational measures that involve the entire healthcare program, from the decision maker to the general practitioner, a fundamental figure in linking the patient's health needs with the need to ensure adequate system of surveillance and protection of public health. The strategies to be pursued include: (i) the creation of regional lists based on the pathology exemption codes to facilitate the identification of the population to be subjected to an active call; (ii) the promotion of vaccination in the hospital, through the involvement of medical specialists; (iii) lowering the age of recommendation for annual vaccination, now set by the National Vaccine Prevention Plan (PNPV) 2017–2019 at 65 years. This possibility had already been prefigured in 2013 in an analysis document produced by the Italian Society of Hygiene, Preventive Medicine and Public Health and taken up in the latest version of the Calendar for Life, written by four companies and medical-scientific associations involved in the field of vaccination prevention (Italian Society of Hygiene, Italian Society of Perinatal Medicine, Italian Federation of General Practitioners and the Italian Federation of Pediatric Doctors). Even the same PNPV 2017–2019, published in the Official Journal at the end of January 2017, aligns with this aspect by establishing “the final goal over time of extending the recommendation of vaccination to all subjects over the age of 50”.