influenza vaccination: why we must speak hours
We declare our readiness to participate in the discussion on the potential opportunity to extend the indications for influenza vaccination if demonstrated its benefit on the basis of robust scientific studies, which consider the outcomes specified by the Ministry and they are explicitly free from conflicts of interest. However, we believe that this discussion should be a collaborative support by the scientific societies with respect to a central decision-making body responsible for vaccination policies. In this body must still rely on recognizing the 'authority and decision-making power.
Deprecated strongly that, as a number of years is taking place in Italy, he tries to force a change in vaccination policies expressed in non-scientific premises and not institutional positions differing from those ministries are not always supported by clear evidence and free from conflicts.
We reiterate along with useful Ministry of the importance of personal protective measures to reduce transmission of influenza viruses. Highly recommended hand washing (in the absence of water, use of alcohol gel), the good respiratory hygiene, cover nose and mouth when sneezing or coughing, handling tissues, promote the voluntary isolation home of persons with febrile respiratory illness, especially in the initial phase and the use of masks by persons with flu symptoms, if present in healthcare settings.
We agree with the choice to emphasize the role of ministerial first estimate attributed to the choice of washing hands, a practice recognized by the World Health Organization (WHO) as a the most effective in controlling the spread of infections, not just influenza, even in hospitals.
vaccination for healthy children aged between 6 months and 24 months (or up to 5 years) is instead an issue currently under discussion by the international scientific community. The data available so far do not allow you to share a positive evaluation for the purpose of achieving a significant reduction of risk of death, hospitalization, serious illness , despite the Health American, Canadian and some European Union countries have chosen to vaccinate these children. Risk of death, hospitalization and serious illness are the outcomes of vaccination that must be demonstrated to justify its offer active and free to the entire population of healthy children: this is what the Ministry says, and we fully agree with this statement. In the absence of evidence of effectiveness with respect to these outcomes, as in past years influenza vaccination has been offered in an active and free only to children older than 6 months with severe chronic illnesses.
Given the weakness evidence of effectiveness in relation to the outcomes listed ACP intends to engage in the next flu season in an ad hoc study, independent and free from any conditioning, hoping for a massive participation of Italian paediatricians.
We are aware that the evidence is weak even for those at risk and specific evaluation studies would be useful for them, these people must be judged satisfactory but also the achievement of outcomes as less important than the simple saving of a few days disease since those days of illness may, for example, coincide with the start of a cycle of chemotherapy or may intervene in a period of severe immune impairment. In a word, we believe that, in agreement with the Department, you should find it useful to their vaccination in the absence of contrary evidence.
Rosario Horse
Head of Secretariat of Infectious Diseases Prevention
Paolo Siani
ACP President
The Board ACP:
Carlo Corchia, Stefano Gorini, Chiara Guidoni, Thomas Montini, Mario Narducci, Joseph Spring, Mary F. Syracuse, Enrico Valletta, Luciana Nicoli
Articoli di Medico e Bambino sulla vaccinazione antinfluenzale 2010-2011
MCPrevenzione e controllo dell'influenza: raccomandazioni per la stagione 2010-2011
Medico e Bambino 2010;29(8):504-7
Cavallo R
Influenza 2010-2011: le raccomandazioni del Ministero della Salute.
Medico e Bambino 2010;29(8) :483-84
http://www.medicoebambino.com/?id=1008_483.pdf
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