Special Issue "Measure to Improve Vaccination Coverage In at Risk Categories: Pregnant Women, Healthcare Workers and Patients with Chronic Diseases"

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Clinical Immunology".

Deadline for manuscript submissions: 31 December 2021.

Special Issue Editors

Dr. Cristina Genovese
E-Mail Website
Guest Editor
Department of Biomedical Sciences and Morphological and Functional Images (BIOMORF), University of Messina, 98124 Messina, Italy
Interests: communicable diseases and vaccination strategies; risk communication; non-communicable disease; public health; HCAIs
Prof. Squeri Raffaele
E-Mail Website
Guest Editor
Department of Biomedical Sciences, Dental Sciences and Morpho-functional images, University of Messina, 98125 Messina, Italy
Interests: vaccination coverage; vaccination strategies; healthcare-associated infections; hospital hygiene; flu
Dr. Claudio Costantino
E-Mail Website
Guest Editor
Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties “G. D’Alessandro” – Hygiene section, University of Palermo, Palermo, Italy
Interests: vaccination strategies; health communication; counselling; smoking habit; nutrition; food hygiene; influenza
Special Issues, Collections and Topics in MDPI journals
Prof. Anna Odone
E-Mail Website
Guest Editor
Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia PV, Italy
Interests: public health; epidemiology; prevention; vaccines; immunisation policies; Information and Communication technology, digital health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent years, a phenomenon known as "vaccine hesitancy" has spread throughout the world, even among healthcare workers, determining a reduction in vaccination coverage, although vaccination is widely considered to be an efficacious and cost-effective health technology.

Although some data about vaccination coverage are not systematically available for some at-risk categories, i.e., pregnant women, healthcare workers and patients with chronic diseases, the international literature shows a poor adhesion.

Manuscripts reporting on vaccines administered to pregnant women, at-risk patients (with chronic diseases such as, i.e., HIV or kidney failure, or other risk factors) and healthcare workers and on strategies adopted to promote vaccination adherence by these categories are welcomed for this Special Issue.

This Special Issue encourages the submission of original articles, systematic reviews, meta-analyses, short communications, and other types of articles that describe measures and strategies to improve vaccination coverage in these categories that could be adapted in other settings and countries.

Dr. Cristina Genovese
Prof. Squeri Raffaele
Dr. Claudio Costantino
Prof. Anna Odone
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • vaccination coverage
  • improvement
  • at-risk populations
  • pregnancy
  • healthcare workers

Published Papers (6 papers)

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Research

Communication
COVID-19 Vaccine Acceptance among Liver Transplant Recipients
Vaccines 2021, 9(11), 1314; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9111314 - 11 Nov 2021
Viewed by 456
Abstract
(1) Background: COVID-19 vaccination hesitancy is a threat for fragile patients. We aimed to evaluate COVID-19 vaccination hesitancy and its reasons in a population of liver transplant (LT) recipients. (2) Methods: In February 2021, a questionnaire on COVID-19 vaccines was sent to LT [...] Read more.
(1) Background: COVID-19 vaccination hesitancy is a threat for fragile patients. We aimed to evaluate COVID-19 vaccination hesitancy and its reasons in a population of liver transplant (LT) recipients. (2) Methods: In February 2021, a questionnaire on COVID-19 vaccines was sent to LT patients followed at our liver transplant outpatient clinic in Milan, Italy. Sociodemographic and clinical characteristics were recorded. Patients were defined as willing, hesitant, or refusing and their reasons were investigated. Associations between baseline characteristics and willingness were evaluated. Since March 2021, when the COVID-19 vaccines became available for LT candidates and recipients in Italy, the entire cohort of LT recipients was contacted by phone and called for vaccination, and the rate of refusals recorded. (3) Results: The web-based survey was sent to 583 patients, of whom 190 responded (response rate of 32.6%). Among the respondents to the specific question about hesitancy (184), 157 (85.3%) were willing to be vaccinated against COVID-19, while 27 (14.7%) were hesitant. Among the hesitant, three were totally refusing, for a refusal rate of 1.6%. Thirteen hesitant patients (48.1%) answered that their COVID-19 vaccination hesitancy was influenced by being a transplant recipient. The fear of adverse effects was the main reason for refusal (81.5%). Of the 711 LT patients followed at our center, 668 got fully vaccinated, while 43 (6.1%) of them refused the scheduled vaccination. (4) Conclusions: Most patients accepted COVID-19 vaccines, although 6.1% refused the vaccine. Since it is crucial to achieve adequate vaccination of LT patients, it is very important to identify the reasons influencing COVID-19 vaccination hesitancy so that appropriate and targeted communication strategies can be established and specific vaccination campaigns further implemented. Full article
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Article
Descriptive Observational Study of Tdap Vaccination Adhesion in Pregnant Women in the Florentine Area (Tuscany, Italy) in 2019 and 2020
Vaccines 2021, 9(9), 955; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9090955 - 26 Aug 2021
Viewed by 491
Abstract
Background: Tdap (Tetanus-Diphtheria-acellular Pertussis) vaccination is nowadays a worldwide-recommended practice to immunize pregnant women. The vaccine administration at the third trimester of pregnancy (as recommended by the WHO) would ensure antibody protection to both the mother and the newborn and has contributed [...] Read more.
Background: Tdap (Tetanus-Diphtheria-acellular Pertussis) vaccination is nowadays a worldwide-recommended practice to immunize pregnant women. The vaccine administration at the third trimester of pregnancy (as recommended by the WHO) would ensure antibody protection to both the mother and the newborn and has contributed to the significant drop of pertussis cases in infants. The aim of this observational study was to describe for the first time the socio-demographic characteristics and determinants of Tdap vaccination adhesion of pregnant women in the Florentine area. Methods: Information about parents’ vaccination status, their citizenship, employment type and mothers’ previous pregnancies and/or abortions were collected at the time of birth through the assistance birth certificates (CedAP) both for the years 2019 and 2020. This archive and the regional SISPC (Collective Prevention Healthcare Information System) linked using an anonymous unique personal identifier to retrieve the mother’s vaccination status. Results: We found an overall Tdap vaccination adhesion of 43% in 2019 and 47.3% in 2020. Several socio-demographic parameters would determine an increased vaccination adhesion, including parents’ geographical origin, mothers’ age and educational background, as well as the number of previous deliveries, abortions or voluntary termination of pregnancy. Conclusions: Since not much data are available on this topic in Italy, this study may constitute the baseline information for Tdap vaccination adhesion in pregnant women in the Florentine area (Italy). Thus, future successful vaccination strategies may be designed accordingly. Full article
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Article
Type 1 Diabetes Patients’ Practice, Knowledge and Attitudes towards Influenza Immunization
Vaccines 2021, 9(7), 707; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9070707 - 29 Jun 2021
Viewed by 515
Abstract
Diabetic patients are at higher risk of developing infectious diseases and severe complications, compared to the general population. Almost no data is available in the literature on influenza immunization in people with type 1 diabetes mellitus (T1DM). As part of a broader project [...] Read more.
Diabetic patients are at higher risk of developing infectious diseases and severe complications, compared to the general population. Almost no data is available in the literature on influenza immunization in people with type 1 diabetes mellitus (T1DM). As part of a broader project on immunization in diabetic patients, we conducted a cross-sectional study to: (i) report on seasonal influenza coverage rates in T1DM patients, (ii) explore knowledge, attitudes, and practices (KAPs) towards seasonal influenza in this population, and (iii) identify factors associated with vaccine uptake, including the role of family doctors and diabetologists. A survey was administered to 251 T1DM patients attending the Diabetes Clinic at San Raffaele Research Hospital in Milan, Italy and individual-level coverage data were retrieved from immunization registries. Self-reported seasonal influenza immunization coverage was 36%, which decreased to 21.7% when considering regional immunization registries, far below coverage target of 75%. More than a third (36.2%) of T1DM patients were classified as pro-vaccine, 30.7% as hesitant, 17.9% as uninformed, and 15.1% as anti-vaccine. Diabetologists resulted to be the most trusted source of information on vaccines’ benefits and risks (85.3%) and should be more actively involved in preventive interventions. Our study highlights the importance of developing tailored vaccination campaigns for people with diabetes, including hospital-based programs involving diabetes specialists. Full article
Article
The Gender Impact Assessment among Healthcare Workers in the SARS-CoV-2 Vaccination—An Analysis of Serological Response and Side Effects
Vaccines 2021, 9(5), 522; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9050522 - 18 May 2021
Cited by 13 | Viewed by 1058
Abstract
Healthcare professionals are considered to be at high risk of exposure and spread of SARS-CoV-2, and have therefore been considered a priority group in COVID-19 vaccination campaign strategies. However, it must be assumed that the immune response is influenced by numerous factors, including [...] Read more.
Healthcare professionals are considered to be at high risk of exposure and spread of SARS-CoV-2, and have therefore been considered a priority group in COVID-19 vaccination campaign strategies. However, it must be assumed that the immune response is influenced by numerous factors, including sex and gender. The analysis of these factors is an impact element for stratifying the population and targeting the vaccination strategy. Therefore, a large cohort of healthcare workers participating in the Italian vaccination campaign against SARS-CoV-2 has been studied to establish the impact of sex and gender on vaccination coverage using the Gender Impact Assessment approach. This study shows a significant difference in the antibody titers among different age and sex groups, with a clear decreasing trend in antibody titers in the older age groups. Overall, the serological values were significantly higher in females; the reported side effects are more frequent in females than in males. Therefore, disaggregated data point out how the evaluation of gender factors could be essential in COVID-19 vaccination strategies. On this biomedical and social basis, suggestions are provided to improve the SARS-CoV-2 vaccination campaign in healthcare professionals. Still, they could be adapted to other categories and contexts. Full article
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Article
COVID-19 Vaccine: A Survey of Hesitancy in Patients with Celiac Disease
Vaccines 2021, 9(5), 511; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9050511 - 16 May 2021
Cited by 7 | Viewed by 1721
Abstract
(1) Background: COVID-19 vaccination campaigns offer the best hope of controlling the pandemic. However, the fast production of COVID-19 vaccines has caused concern among the general public regarding their safety and efficacy. In particular, patients with chronic illnesses, such as celiac disease (CD), [...] Read more.
(1) Background: COVID-19 vaccination campaigns offer the best hope of controlling the pandemic. However, the fast production of COVID-19 vaccines has caused concern among the general public regarding their safety and efficacy. In particular, patients with chronic illnesses, such as celiac disease (CD), may be more fearful. Information on vaccine hesitancy plays a pivotal role in the development of an efficient vaccination campaign. In our study, we aimed to evaluate COVID-19 vaccine hesitancy among Italian CD patients. (2) Methods: an anonymous questionnaire was sent to CD patients followed at our tertiary referral center for CD in Milan, Italy. Patients were defined as willing, hesitant and refusing. We evaluated the reasons for hesitancy/refusal and the possible determinants, calculating crude and adjusted odds ratios [AdjORs] with 95% confidence intervals [CIs]. (3) Results: the questionnaire was sent to 346 patients with a response rate of 29.8%. Twenty-six (25.2%) of the 103 respondents were hesitant, with a total refusal rate of 4.8%. The main reason was fear of adverse events related to vaccination (68.2%). Among hesitant patients, 23% declared that their opinion was influenced by their CD. The determinants positively influencing willingness to be vaccinated against COVID-19 were adherence to a GFD, perception of good knowledge about COVID-19 and its vaccines, and a positive attitude to previous vaccines (AdjOR 12.71, 95% CI 1.82–88.58, AdjOR 6.50, 95% CI 1.44–29.22, AdjOR 0.70, 95% CI 0.11–4.34, respectively). (4) Conclusions: CD patients should be vaccinated against COVID-19 and a specific campaign to address the determinants of hesitancy should be developed. Full article
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Article
Attitudes and Perception of Healthcare Workers Concerning Influenza Vaccination during the 2019/2020 Season: A Survey of Sicilian University Hospitals
Vaccines 2020, 8(4), 686; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines8040686 - 16 Nov 2020
Cited by 6 | Viewed by 906
Abstract
Influenza is an infectious disease with a high impact on the population in terms of morbidity and mortality, but despite International and European guidelines, vaccination coverage rates among healthcare workers (HCWs) remain very low. The aim of the present study was to evaluate [...] Read more.
Influenza is an infectious disease with a high impact on the population in terms of morbidity and mortality, but despite International and European guidelines, vaccination coverage rates among healthcare workers (HCWs) remain very low. The aim of the present study was to evaluate influenza vaccination adherence in the three Sicilian University Hospitals of Catania, Messina, and Palermo and to understand the attitudes and perceptions of vaccinated healthcare workers and the main reasons for vaccination refusal. A cross-sectional survey through a self-administered questionnaire was conducted during the 2019/2020 influenza season. Overall, 2356 vaccinated healthcare workers answered the questionnaire. The main reason reported for influenza vaccination adherence during the 2019/2020 season was to protect patients. Higher self-perceived risk of contracting influenza and a positive attitude to recommending vaccination to patients were significantly associated with influenza vaccination adherence during the last five seasons via multivariable analysis. Fear of an adverse reaction was the main reason for influenza vaccine refusal. In accordance with these findings, Public Health institutions should develop and tailor formative and informative campaigns to reduce principal barriers to the immunization process and promote influenza vaccination adherence among HCWs. Full article
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