How will the “other” vaccine go this year, the flu

Experts and institutions are calling for more vaccinations than in previous years, and to do so soon. But general practitioners have identified several problems

While i vaccines under development against Covid-19 undergo a setback, the organization of the distribution of the flu vaccine for next season. Because, as the experts and the Ministry of Health have repeated from many quarters, this year more than ever it will be useful flu vaccination, to help diagnose and lighten the burden on health facilities. It is recommended to do it especially for the risk categories: and to do it early, anticipating the traditional calendar: from mid-October to early October, says Aifa. Yet it is not certain that everything can begin as recommended.

On the management of anti-flu campaign in fact, still today – a few days from the presumed starting date of vaccinations – open questions remain. They will succeed i general practitioners, who have always managed most of the vaccinations, to respond to the increased demand? And how? Will pharmacies have enough vaccines to meet the demands of categories not considered at risk but who still want to get vaccinated? There are many questions still open.

Who should be vaccinated?

However, what concerns general practitioners above all at the moment, points out a Wired Silvestro Scotti, secretary of the Italian Federation of family doctors (Fimmg), is the failure to plan the management of the vaccination campaign in an emergency situation. It has been asked several times whether in the face of the increased number of eligible to receive the vaccine for free, – but more generally, in the face of the expected increase in vaccination demand – general practitioners will be able to respond quickly. “The ability or not to respond does not depend on doctors, but on healthcare companies “- says Scotti – “The health authorities have not entered into negotiations on how to deal with the next vaccination campaign, both in ordinary and exceptional regimes. Today it is very urgent that these negotiations with companies are opened, to identify organizational models in the area and on the basis of this organize needs “. For example, Scotti continues, there could be days dedicated to vaccinations, or extra moments dedicated to procedures. And also on the basis of this extraordinary regime the needs should be planned: “Starting with those of the individual protection devices, whose expenses and management of the resulting waste must not fall on general practitioners, obliged to participate in vaccination campaigns “.

There is no doubt that it is the competence of the doctor to vaccinate. The proposal to involve pharmacists is out of the question for family doctors, as well as per National Federation of Medical Orders (Fnomceo): “We are not against it because we think that pharmacists are unable to give injections, but because the vaccine history, necessary for the administration of the vaccine, is a medical procedure, and the pharmacist is unable to do it” – Scotti comments – “It is not enough that the person has had the vaccine in the previous year: you need to know the patient’s history. We could think of administering the vaccine in pharmacies if we had adequate spaces and medical staff available to do so, but increasing the delivery centers also risks increasing waste ”.

Start early

The invitation to open the vaccination season it is another of the still unclear management aspects. This is the message that reached the citizens – get vaccinated, and do it soon – who are likely to go to their doctors to request it, but the risk is that they will then be faced with delays. “As far as we know, the vaccination season will begin like the other years, after the second half of October”, Scotti comments. “The tenders for the procurement of vaccines will not allow their delivery until mid-October, and we must consider that the distribution of vaccines takes time: once they arrive in the collection centers of the regions, they are delivered to the local health authorities, and then to the districts and finally to doctors. We currently have no indication to believe that these timelines are being shortened with an urgent deployment procedure plan. All this – goes on Scotti, who for a long time points his finger about the fact that we are already late to be able to do everything that is asked – it risks creating confusion and expectations among citizens and delays. We will start as soon as possible ”.

Pharmacies without vaccines?

Furthermore, only a few days ago Federation of the orders of Italian pharmacists (Foti), feared the risk of a shortage of vaccines at pharmacies, in the face of the increased demand for doses this year by the national health system, which should go to 18 million, asking for a discussion table with the ministry. There was a comparison, with the result that the ministry would have asked the State-Regions Conference for one “Remodeling of the quotas of influenza vaccines acquired by the Regions, in order to satisfy the request of citizens through pharmacies who, although not among the subjects entitled to vaccination by the NHS, will still want to get vaccinated”, one reads note Fofi.

A vaccine for everyone?

But on the question of doses the discussion is much broader. Only in the past few hours the deputy minister of health Pierpaolo Sileri he declared that “The flu vaccine will be there for everyone”. Yet those 18 million, albeit an increase compared to previous years, may not even be enough, confides Scotti. “The age range for which vaccination is recommended has been lowered to 60 years, to this we must add all the categories at risk: are we sure to cover all those who need it and those entitled to it?” 18 million, a little less, is equivalent to approximately the over 60 population in Italy (from Istat data), to which must be added all the cases of people under 60 with chronic diseases, such as people with cancer, diabetes, respiratory diseases, insufficiencies kidney diseases, inflammatory diseases, family and contacts of subjects at risk of complications, and again categories for which is offered free of charge, such as medical personnel, police forces, firefighters, breeders, blood donors and registered, such as children. “We have increased the doses available to the Health Service by about 40% “ – Scotti resumes – “But we still run the risk of not having vaccines for all those entitled to and of making the family doctor responsible for allocating the doses available to people with equal rights”.

And to also leave citizens who want to provide by paying out of their own pockets without the possibility of having the vaccine. It therefore appears certain that the vaccine will not be there for all, understood as anyone who wants to get vaccinated, regardless of belonging to the category of over 60 or with pathology at risk. “In this regard, the hypothesis of verifying, even with a more advanced supply, the availability of excess vaccination doses, perhaps by a centralized body such as the Civil Protection and not by the Regions, possibly to be distributed on the basis of the characteristics of the population and on the basis of the needs of the regions that have planned less and are more in difficulty “, concludes Scotti.

<![CDATA[]]>