“We are in the middle of the anti-flu campaign and unfortunately there is a lot of ground to make up. In fact, looking at the example of flu vaccination in the elderly, if in the 2020-21 season the highest percentage of coverage was recorded compared to the previous 10 flu campaigns (65.3%), already in 2021-22 the coverage dropped to 58.1%, to reach up to 56.7% in the 2022-23 season. Practically between 2020 and 2023, influenza vaccination coverage for the elderly fell by around 9 percentage points, with a distance of around 20 points from the minimum coverage target of 75% set by the World Health Organisation”. In the meantime, the State and the Regions, on 2 August 2023, approved the Agreement on the “National Vaccination Prevention Plan (Pnpv) 2023-2025” and on the “National Vaccination Calendar”. A tool which, if in its intentions aspires to strengthen vaccination campaigns, in reality, with respect to its ability to concretely impact the state of things, upon closer analysis, appears to be “a blunt weapon”. Tonino Aceti, president of Salutequità, is convinced of this and in an editorial published on Alleati per la Salute (www.alleatiperlasalute.it), the medical-scientific information portal created by Novartis, takes stock of the state of the art of the Pnpv 2023-25 .
In the text – writes Aceti – we find around 14 important actions expressed in the conditional, relating to issues which, to guarantee effective change, would require more prescriptive and immediately binding provisions for everyone. This is the case, for example, of the transition to a “proactive logic of a patient-centered vaccination process”, for which the plan provides only that “it would be useful (rather than “it is necessary”) for the specialist network designed to follow the subjects at risk can actively promote (rather than “guarantee/promote”) vaccinations, both at hospital and local level”. Another example of “weak indication” by the Plan is that on communication in the vaccination field to build the trust of the population. On this too, the Plan envisages a series of actions that “should” (rather than “must”) be undertaken at all levels (national, regional and local) in a coherent and, possibly, concerted manner”.
“There is also a “resource issue” that has held sway in the dialectic between the Ministry of Health, Mef and the Regions for about 8 months, still not resolved – underlines Aceti – which risks concretely influencing the work of the Regions with respect to full implementation of the National Plan, of the new vaccination calendar and therefore of the rights to be guaranteed to all citizens. The approved State-Regions Agreement, in fact, while on the one hand does not provide for any increase in resources in light of the expansion of the vaccination offer and actions necessary to ensure vaccination coverage for all those at risk, despite the desire expressed in the 2023 Policy Act of the Ministry of Health to invest strategic resources also in the National Vaccine Prevention Plan, on the other hand it introduces the activation of a ” monitoring of expenditure, functional to ensuring the Government’s subsequent political evaluations, in any case in order to ensure the adequacy of the resources available and to evaluate the possibility of finding additional resources in the event of any increased costs”.
The Plan provides for a distinct vaccination calendar, therefore intended to be easily updated and able to keep up with future epidemiological scenarios, scientific evidence and innovations in the biomedical field. However, this innovation risks remaining on paper – Aceti writes in his editorial – for at least two reasons: the uncertainty of the resources for the correct financing of the Plan and the slowness with which the NHS updates its LEAs. In fact, if the LEAs are not constantly reviewed and updated, it will not be possible to include the updates foreseen by the vaccination calendar in the LEAs themselves and therefore it will be impossible for the citizen to benefit from all the vaccinations foreseen by the calendar. A substantial and serious problem explicitly reported also within the PPNV.
In order to make the vaccination offer sustainable, fair and homogeneous, as well as to guarantee quality services with the utmost professional competence, the Plan expressly recalls as indispensable the need to define the organizational and personnel standards of the local health authorities’ prevention departments. A fundamental measure to move from the metric of “staff that each Region can afford” to that of “staff that is needed” to best guarantee specific service standards. Despite the particular relevance of the measure, the path still seems to be on the high seas – concludes Aceti – Likewise, no substantial progress has yet been communicated, for example, with respect to the start of the path of professional autonomy in the vaccination field, including for nurses.
The complete article is available on: https://www.alleatiperlasalute.it/piu-lungo/larma-spuntata-del-piano-nazionale-prevenzione-vaccinale-2023-2025
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