Epidemiol Prev. 2025 Jul-Aug;49(4):291-298. doi: 10.19191/EP25.4.A848.068.
ABSTRACT
OBJECTIVES: to review pneumococcal vaccination recommendations in at-risk adults and people aged 65 years or over across the Italian Regions.
DESIGN: mapping review of available online resources, both at regional and local health unit level, on pneumococcal vaccination programmes by age and risk group.
SETTING AND PARTICIPANTS: the review included institutional websites of regional and local health authorities, freely accessible to the public via generic search engines, containing information on pneumococcal vaccination in frail people.
MAIN OUTCOME MEASURES: the following information was collected and classified: • populations targeted by the immunization programme; • type of recommended vaccine (conjugate and/or polysaccharide); • adopted vaccination schedule; • mode of patient contact; • involved health professional; • availability of vaccination registry; • availability of vaccination coverage data; • presence of online awareness campaigns.
RESULTS: a total of 24 institutional websites, representative of all Italian Regions, were included in the review. More than 90% of the recommendations collected were published between 2023 and 2024. In 75% of the analyzed documents, the Regions offer pneumococcal vaccination to the cohort aged 65 years; in 46% of the documents, the offer is extended to all persons aged 65 years and over. In 96% of the resources, the vaccination programme includes at-risk adults, and 75% of these give details of the diseases for which vaccination is recommended. In seven resources, it is reported that Regions recommend a single dose of the 20-valent pneumococcal conjugate vaccine, in the others the use of the pneumococcal conjugate vaccine (PCV) followed by the 23-valent pneumococcal polysaccharide vaccine (PPSV23) is indicated, with different schedules. In at-risk adults, 83% of the documents recommend the sequential schedule with PCV followed by PPSV23, with time schedules defined in 63% of cases. The mode of patient contact is reported in 7 web resources, 4 of which include sending an invitation letter at 65 years of age. Vaccination center health professionals (16/24) and general practitioners (15/24) are the healthcare providers most involved in promoting and administering vaccination. In 71% of the resources, the regional health authorities were reported to have promoted targeted communication campaigns. Data on PCV coverage by age were available for 6 Regions, but not by risk group.
CONCLUSIONS: the findings of this study highlight significant heterogeneity in the offer of pneumococcal vaccination to at-risk adults and people aged 65 years and older among Italian Regions. Greater efforts are needed to standardize and harmonize vaccination policies and to coordinate vaccination communication. The integration of immunization registries with high-risk patient clinical data will allow the systematic identification of vaccine candidates and facilitate the monitoring of vaccination coverage.
PMID:41399888 | DOI:10.19191/EP25.4.A848.068
