“Work on updating paediatricians, communicating with parents and shortening the supply chain”. It is the recipe for the prevention of serious infectious diseases, such as meningitis B, proposed by Giorgio Conforti, former contact person for Vaccinology training of the Italian Federation of Pediatric Doctors (Fimp) and scientific director of the 'Together for vaccinations' conference. We have the vaccines, let's do the vaccinations scheduled for tomorrow, January 27, in La Spezia. Since September, Liguria itself has been offering vaccinations against meningitis B in its regional vaccination calendar, even in adolescents, actively and free of charge.
Meningitis B mainly affects children under 4 years of age and adolescents, around 15-20 years of age. “Based on the latest ministry data referring to 2022 – explains Conforti – it is responsible for around seventy cases a year. It mainly affects children under 4 years of age and, in particular, under the age of one when the vaccination cycle which requires 3 doses within the year has not started or has not been completed. In fact, the first inoculation is scheduled from the 61st day of life, the second 2 months after the first and the third 6 months after the second”. The pediatrician is clear on the importance of vaccination: “Meningitis is an often unpredictable and rapidly evolution – he underlines – From the appearance of symptoms to hospitalization, only 24-48 hours can pass, but the rapid progression makes effective intervention difficult. The disease in fact has a mortality rate of 10% and the appearance of handicaps, even serious ones, affects the 20% of cases. Little is said about it – reflects the family pediatrician – but the consequences include deafness, low vision, limping, learning disorders and even limb amputation. Furthermore, the consequences can also be remote from the disease”.
The vaccine against meningococcal B “is not mandatory and this classification makes it seem like it is a series B vaccine – observes Conforti -. Precisely for this reason, like Fimp, we work on updating paediatricians at national and regional level. If the update is fundamental, the second step is communication with parents: in the degree course they don't train us on how to interface with fathers and mothers. The third element is organization. The evidence shows that, if the pediatrician vaccinates, coverage increases” If the specialist's argument in the clinic is that “serious disease is avoided, the adverse effects are those of other vaccines and it ends with 'I have it in the fridge' – explains the pediatrician – the supply chain is shortened because it avoids having to make another appointment and a further step which, by extending the time, in fact leads to a lowering of coverage. These are international data”.
A clear confirmation of this statement is in the number of vaccinated adolescents, which is a sort of “middle ground – continues Conforti – because pediatric assistance is up to 14-16 years of age and in the transition to general practitioner one can miss these appointments.” The booster shot of anti-meningococcal B among 14-18 year olds is important even if a child has been vaccinated as a child because “the antibodies – states the pediatrician – run out in 7 years and therefore the second peak is not covered, which it is between 15-20 years. For this reason – he reiterates – vaccination is indicated, not only in those who have never been vaccinated, but also in those who have already received the 3 doses as a child”.
However, it must be considered that “the Ministry of Health – comments Conforti – has not included anti-meningococcal B in the Lea (Essential levels of assistance, ed.): it has given a general indication, but has not financed it, therefore the Regions are moving, in no particular order, to guarantee active and free vaccination even from 14 to 18 years old. Currently – he continues – it is planned in almost all the regions of the South – Sicily Puglia Calabria – but also in Liguria, Emilia Romagna and Abruzzo. Others are being added.”
A novelty is expected within the next 2 years for type B meningitis. “Currently in the Lea there is already a vaccine against 4 strains of meningococcus (ACWY) – adds Conforti – Recently in America the pentavalent (ABCWY) has been approved which it also contains, in a single injection, the B strain. When there is the pentavalent it will be possible to make the vaccination offer homogeneous even for the pediatrician, with fewer injections, fewer appointments and lower costs”. Among the expected innovations there is also the immunization of newborns against the respiratory syncytial virus (RSV), responsible for bronchiolitis, the main cause of hospitalization under one year of age. “From October, antibodies against RSV will be inoculated in newborns. It is not a vaccine, because the antibodies are directly supplied, which last a year – he concludes – but this is the time in which it is most necessary to avoid infection in children”.
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