Vaccines, Conversano (HappyAgeing): "Prevention for the elderly should involve doctors and pharmacists"

The presentation of the position paper, 'Towards a new model of vaccination prevention in the elderly. Operational proposals for a model based on evidence, sustainability and organizational capacity', "the result of a broad collaboration with the scientific component of HappyAgeing - Italian Alliance for Active Aging, and with the social component, with the involvement of pensioners' unions, was the occasion for a useful comfort also to find the best formula for collaboration between general practitioners and pharmacists, respecting roles and skills, but with a single objective: to increase vaccination coverage and protect the health of citizens". This is how Michele Conversano, president of the Technical Scientific Committee of HappyAgeing, comments on the contents of the event, which took place today in Rome, on the occasion of the National Assembly on the Prevention of Infectious Diseases in the Elderly at the Istituto Enciclopedia Italiana Treccani, to Adnkronos Salute.

"The document - explains Conversano - is the result of a work process that included 2 workshops held in collaboration with the Interregional Prevention Coordination (CIP), therefore with the active participation of all Italian regions involved in prevention issues, in particular vaccination. The position paper - he clarifies - systematically addresses the problems that today lead us to still have low vaccination coverage in adults and the elderly, despite the fact that today we have safe, effective and essential vaccines. We are talking about the vaccine against influenza, the one against Covid, the anti-pneumococcal vaccine, the one against Herpes Zoster (shingles), the ten-yearly booster of Tetanus and Pertussis - diseases that unfortunately still cause deaths among the elderly - and finally the new vaccine against respiratory syncytial virus (RSV). Despite the availability of these tools, coverage is still too low and with strong inhomogeneities between one region and another".

The position paper has identified 3 critical areas, which correspond to the 3 chapters of the document, and "for each one we have proposed shared solutions - explains the expert - On the economic-financial aspect", the hope is "to consider vaccines as an investment. We must stop considering vaccination as a cost - underlines Conversano - All international studies now show that for every euro invested in vaccinations, we recover from 19 to 35 in terms of avoided health costs: hospitalizations, treatments, hospitalizations. And this without even considering the indirect social costs: if an elderly person gets sick, the daughter or family member has to take time off work to care for them, and so on. The concrete proposal is to remove the expense for vaccinations from the current health expenditure chapter and move it to investments. A position also shared by the Ministry of Health who have already proposed a similar solution for innovative oncology drugs".

On the scientific side, the proposal is for a continuous update of the vaccination calendar. "The National Vaccination Prevention Plan 2023-2025 provides for an annual update of the calendar to promptly incorporate scientific and technological innovations. We cannot afford to wait 3 years to introduce a new vaccine when science makes it available to us today", observes the president of the CTS of HappyAgeing. The last area of ​​intervention concerns the organizational aspect, with the improvement of supply models. "This is perhaps the most critical point - highlights Conversano - Even the vaccines already available in our refrigerators we are not always able to administer as we should. There are virtuous regions, such as Veneto, which thanks to active call models achieve 70% coverage for vaccines such as the anti-pneumococcal or against Herpes Zoster. In other regions, however, we are far behind".

In this context, another important issue is that of the places and professionals involved in vaccination. "There has been a lot of talk, for example, about the role of pharmacies - he specifies - The positive experience of the anti-Covid vaccination has shown that it is a viable path. In Lombardy and Marche, for example, the expansion of the vaccination offer in pharmacies is already being tested for other vaccines. Today, the Prevention department - the expert underlines - knows the names of diabetic patients, but for privacy reasons it cannot call them directly to invite them to get vaccinated. The general practitioner and pharmacies, however, have direct contact with these patients. It could be very useful if the pharmacist, in addition to dispensing the anti-diabetic drug, could also propose the vaccination, considering that diabetics are fragile subjects and therefore particularly at risk of infectious complications".

The active involvement of the pharmacist "will depend on the regional organization - reflects Conversano - For example, in the Marche Region they are already experimenting with the direct administration in pharmacies of vaccines such as the anti-pneumococcal and shingles vaccines, in addition to the one against Covid. I myself participated in the training of the pharmacists involved. The important thing is not so much who administers the vaccine, but that the vaccination is done, in conditions of safety and appropriateness. The direction - he warns - must remain in the hands of public health. There is no opposition between family doctors and pharmacists, on the contrary, it was reiterated during the event by the representatives of the Simg, Italian Society of General Medicine. The way - he concludes - is that of collaboration to achieve prevention objectives".