2023-05-23 13:13:00
These days in some Italian cities – such as Perugia, Terni, Turin, Ostia, Cosenza and Regio Calabria – a Meningitis B awareness campaignpromoted by Gskwhich sees the creation, in some city streets, of information floor carpets, adhesive carpets that stick to the asphalt and invite you to learn about the preventable risks of meningitis, even through a QR code. In fact, the meningococcal vaccine B whose administration is recommended from the 2nd to the 3rd month, the vaccination calendar indicates it at 15 days from the hexavalent, pneumococcus and rotavirus. Coverage is still low but in the regions where it is administered free of charge by the pediatrician, very few give up prophylaxis.
“Today’s parents get informed on the web, these information campaigns create curiosity and trigger interest and requests for clarifications – he says Gianni Di Stefano, Umbria regional secretary of the National Federation of Pediatricians (Fimp) – Even if the percentage of infections is not very high, meningitis B is a pathology that can give very important neurological outcomes, such as hemiplegia (paralysis of one half of the body), and epilepsy, or skin necrosis that may require amputation limbs and, in the most serious cases, even lead to death”.
Often, at the first visit, “parents ask when to get the vaccinations done, but it’s better to plan ahead – continues Di Stefano – Before the visit in the second month of life, when the first administrations are scheduled, I fix the visit and ask the parents if they have received the communication from the vaccination center and, starting from the letter, I explain the various issues. In fact, it happens that, for example, before getting the vaccine, the doctor or nurse asks if they have discussed it with the pediatrician: this way doubts creep in the parents that make vaccination postponed. Vaccination centers offer anti-meningococcal B after 6 and 7 months, but this practice should be avoided to ensure adequate coverage in infants and children to protect against the disease before the first year of life, given that the higher incidence of infection it is from 0-2 years and after 12 years”.
In Umbria, the coverage for anti-meningococcus B, as of 2021, the latest data available “is 56%: below the 60% which is the national average – observes Di Stefano -. It is a very low value and far from 90-95% which guarantees that the bacterium does not circulate. Furthermore, the figure is down compared to the pre-covid period, when it was 58%”. On the new vaccinations “we are working on raising awareness – he adds – but the problem is the recovery of that approximately 50% jumped from 2019 to 2021. There is also a shortage of healthcare personnel which probably does not allow for the recovery of the administrations left behind in cause of Covid: vaccination can also be done after 0-2 months, coverage lasts for decades “.
The issue that most worries new parents is “an excess of vaccination. They believe that the child’s immune system is being bombarded, but it is something that has no scientific foundation – underlines Di Stefano -. The immune system is not bombarded by vaccinations, but stimulated to work against the single antigen. Children are bombarded with viruses and bacteria every day. It is not justifiable, it has no basis to think that a vaccine causes problems with the immune system. The stimulation of the vaccine is infinitesimal compared to what a child’s immunity faces during the day”.
A practically total adherence percentage to the vaccination of all vaccines, including that for meningococcus B, can be obtained by offering them to be administered in the pediatric clinic and free of charge. The experience of Franco Aurelio, pediatrician in charge of the Vaccini Fimp area of the province of Cosenza. “I don’t have major difficulties. There are very few who are not vaccinated – he says – Since 2015, the coverage of my clients is around 96-97%. I am completing the cohort between 11 and 16 years old, but it will be closed soon. The court remains among those born before 2015 between the ages of 8 and 11, who will be vaccinated as they reach 11 years of age”. The reason for this subdivision is due to the fact that, after various “meetings with the Calabria region – explains Aurelio – we have included in the vaccination calendar the free distribution of the anti-meningococcal B, also free for 11-18 year olds, while it was already free for infants ”. A similar situation is also found in Tuscany and Lazio.
The relationship of trust with the pediatrician and the practicality of free administration are crucial issues, for Aurelio, in favoring adherence to prophylaxis. “Parents ask if the vaccine is safe, if it causes complications – he remarks – but once they are reassured that it prevents a very serious disease such as fulminant meningitis, adhesion is practically total”.
With thirty years of experience in vaccinations, “I believe that a big problem is the discrepancy in access: each region does as it sees fit – observes Aurelio – When we had co-payment, however low, there was not the same level of accession visa after free and with your doctor”. Of course, this also entails a greater workload for the pediatrician, which is why the inclusion of a clinic nurse would be desirable. “In a commissioned region like Calabria – reflects Aurelio – we have difficulties, but the presence of a nurse is not so much for the administration of the vaccine, but for the whole administrative bureaucratic question which takes a long time”.
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