Il vaccino pneumococcico 13-valente per la prevenzione delle infezioni da S. pneumoniae in età adulta: una valutazione di HTA

[Autom. eng. transl.] In line with the growing importance given to prevention, in developed countries it is now increasingly felt the need to develop effective strategies for adequate vaccination prophylaxis of the adult population, as well as pediatric populations, also considering the current variations in demographic trends . Among the vaccinations of particular interest for the adult / elderly population, the anti-pneumococcal one certainly plays a role of primary importance. In relation to the disease burden associated with S. Pneumoniae infections, a reflection on the need to extend the vaccination target to the entire population over 50 appears therefore appropriate. The FDA has recently approved the use of PCV13 for the active immunization for the prevention of pneumonia and invasive diseases even in adults aged ≥50 years. In Italy SItI recommends the administration of pneumococcal vaccination to subjects of any age at risk of contracting the disease due to the presence of pathologies or predisposing conditions; also advises the use, in subjects at risk aged between 59 months and 50 years, of an initial dose of PCV13 followed at least 2 months after the administration of 23-valent polysaccharide vaccine, underlining the advisability of an administration sequential of the two different types of vaccine, to obtain a better immunological response. A key role in the promotion of health, through the implementation of vaccination plans in non-pediatric age, is carried out by the GP, which, appropriately trained, should: - identify the candidates to be vaccinated and actively promote vaccination; - promote vaccination counseling; - administer the influenza vaccine and, during the same campaign, evaluate the appropriate co-administration of other indicated vaccines; - develop a reminder and recall system designed to easily identify and recall the selected population; - develop a vaccination register of its clients. With regard to surveillance and monitoring systems, in Europe there is currently great heterogeneity, both in the methods of ascertaining cases and in the type of information collected; a European IPD surveillance system would therefore be desirable to facilitate comparison of disease incidence rates across countries. An example of a well-structured surveillance system is the German CAPNETZ, which has created an organized system in a horizontal network that integrates the different components of medical research and a vertical network that supports cooperation between general practitioners, hospitals and universities. In addition to disease surveillance systems, there is also, in the various countries, an information flow relating to vaccines which allows the calculation of vaccination coverage through the availability of data on the target population and vaccination status. As regards surveillance of adverse vaccination events, the obligation to report is the responsibility of each health care provider whose patients receive clinical-anamnestic pictures compatible with a vaccine reaction. Another aspect to be taken into consideration in the vaccination process is the acquisition, even if only verbal, of the informed consent, which must be collected ensuring the full understanding of the information by the vaccination candidate and declaring the maximum availability to possible further investigations. In order also to increase the adhesion to the vaccination, it is necessary to undertake strategies that foresee actions of empowerment, consisting in training programs and education of the citizen, which should be adequately informed of the individual and collective benefits guaranteed by the vaccination practice in order to develop a culture of prevention. Indeed, a progra