2023-12-06 15:03:03
by Maria Giovanna Faiella
Is it still necessary to get vaccinated? Do vaccines protect against circulating variants? Any adverse effects: what to do. ECDC study on the role of booster in preventing hospitalizations and deaths. Ministry of Health circular on the updated protein vaccine soon available in Italy
Covid today: how to prevent the disease? still dangerous and for whom? What are the symptoms? Does the vaccine protect against circulating variants? Is it necessary to carry out a recall? To whom is it recommended and why? Can children do it? What about pregnant women? Are there any contraindications? What to do in case of any adverse effects?
Below are the answers to these and other questions, based on a recent study conducted by the European Center for Disease Prevention and Control (ECDC), and the indications given by the Ministry of Health in the Circular of 27 September 2023 Indications and recommendations for the 2023/2024 autumn/winter vaccination campaign against COVID-19 and subsequent additions and expert advice.
The disease, how it is transmitted
Covid-19, acronym for COronaVIrus Disease 19, an acute respiratory disease caused by a virus called SARS-CoV-2, which belongs to the coronavirus family. Over the last three years, hundreds of variants of this virus have been identified around the world. Currently, as noted by the Istituto Superiore di Sanit, in our country there is co-circulation of various Omicron recombinant viral strains attributable to XBB and the EG.5 (Eris) variant is confirmed as prevalent.
Based on current evidence, the virus spreads through close contact with infected people, through mouth and nose secretions (saliva, respiratory secretions or droplets) and indirectly, through contaminated objects or surfaces.
How to protect yourself
To reduce the risk of infection, some precautions are recommended (valid, in general, to prevent the transmission of respiratory infections), such as:
– wear the mask correctly if you come into contact with other people, especially if they are at risk;
– wash your hands regularly and frequently with soap and water (or with alcohol-based cleaning solutions), especially after coughing and sneezing, or after using public transport or public places;
– ensure good ventilation of closed environments, including homes and offices;
– avoid hugs and handshakes;
– maintain a distance of at least one meter from other people;
– sneeze and cough into a paper tissue, avoiding contact of your hands with respiratory secretions, then throw it away and wash your hands;
– avoid touching your eyes, nose and mouth with unwashed hands;
– avoid crowded environments.
What to do if you test positive
With the circular from the Ministry of Health of 11 August 2023 the indications on measures to prevent the transmission of coronavirus have been updated, therefore:
– people testing positive for a molecular or antigen diagnostic test are no longer obliged to remain in isolation, but it is recommended to observe the precautions listed above, they must also:
– avoid contact with fragile, immunosuppressed people, pregnant women, and also from going to hospitals or RSAs;
– inform the people with whom you were in contact in the days immediately preceding the diagnosis, especially if elderly, frail or immunosuppressed people;
– contact your doctor if you are frail or immunosuppressed, if the symptoms do not resolve after 3 days or if your clinical condition worsens.
Warning: if you are symptomatic you must stay at home until the symptoms stop.
More frequent symptoms
People who contract the infection today, with the viral strains in circulation, mainly present upper respiratory tract disorders, but the symptoms vary according to the severity of the disease: they range from being asymptomatic to the presence of the most common symptoms (many similar to those of the flu) such as fever, cough, sore throat, headache, congestion or runny nose, feeling of fatigue, muscle and joint pain; until the onset – in the most serious cases – of pneumonia, respiratory failure, sepsis, septic shock, potentially fatal.
The loss of taste and smell is less widespread than the previous variants.
Why it is important to do the recall, the Ecdc study
Vaccines are available against Covid-19, offered free of charge to the population, in order to prevent serious forms of the disease, hospitalizations and even deaths.
A recent confirmation of the importance of booster doses in preventing hospitalizations and deaths study conducted by ECDC in six European countries. The results demonstrate that, in the level of protection against hospitalization and death from COVID-19, the time since the last dose was more important than the total number of doses administered.
The booster doses, in fact, restored protection shortly after administration, while protection decreased over the course of 24 weeks after vaccination. Hence ECDC’s conclusions: provide additional boosters periodically to maintain protection, especially in elderly people aged 80 and over.
New updated vaccines
Anti-Covid vaccine formulations adapted to the new variants of the SARS-CoV-2 virus have recently been authorized by the competent authorities – in Europe EMA-European Medicines Agency, in Italy Aifa -Italian Medicines Agency – on the basis of the most recent scientific evidence and documents relating to anti-Covid vaccination issued, among others, by the World Health Organization and ECDC.
For some months now, the National Health Service has started a national anti-Covid 19 vaccination campaign with the use of new vaccines adapted to Omicron XBB.1.5.
In the first phase of the campaign, the Comirnaty Omicron XBB 1.5 mRNA vaccine was used, available in different age-specific formulations.
In the next few days, the protein vaccine updated to the Omicron variants will also be available in Italy after the authorization by Ema and Aifa of the adapted formulation of the adjuvanted recombinant vaccine Nuvaxovid (Omicron XBB.1.5), as explained in the recent circular from the Ministry of Healthsigned by the director of Prevention Francesco Vaia.
Furthermore, in the ministerial circular, which confirms the indications and recommendations on the 2023-2024 anti-Covid vaccination campaign, it is specified that Nuvaxovid XBB 1.5 can be used as an alternative to the Comirnaty et.
Recall (annual), when it should be done The recall is normally valid for 12 months.
In order to maximize protection for autumn/winter 2023-2024, the booster dose is recommended 6 months after the last dose of the anti-Covid vaccine received or the last infection (date of the positive diagnostic test).
Even for those who have never been vaccinated, a single dose is expected.
On the website of the Italian Medicines Agency you can consult the relevant leaflets with the characteristics of the products (click Who for Comirnaty Omicron XBB.1.5; click Who per Nuvaxovid XBB 1.5).
To whom is the vaccine (and booster) recommended?
Based on ministerial indications, the booster dose of the updated vaccine (or the first dose for those who have never had it) is offered as a priority to these categories:
– guests of RSAs and long-term care facilities;
– people aged 60 and over;
– women who are pregnant or postpartum or breastfeeding;
– health and socio-health workers;
– people with severe disabilities (pursuant to law 104 of 1992, art. 3 paragraph 3);
– people aged between 6 months and 59 years, with high fragility motivated by pre-existing pathologies that increase the risk of a serious form of Covid-19, such as: chronic respiratory diseases, cardiovascular diseases, cerebrovascular diseases, oncological diseases (under treatment, for example, with immunosuppressive drugs), diabetes, some neurological and neurodegenerative diseases, obesity, immunosuppressed patients due to congenital or acquired pathologies, transplant recipients or under treatment with immunosuppressive drugs (complete list in the Ministerial Circular: click Who).
Why get vaccinated
Why is it recommended to have the anti-Covid vaccination for these groups of people? The virus can become dangerous if vulnerable people such as the elderly and chronically ill people at risk of serious illness become infected. The usefulness of the vaccine should prevail over fear, recalls Dr. Claudio Cricelli, past president of the Italian Society of General Medicine and Primary Care (Simmg).
Adds the national secretary of the Italian Society of Infectious and Tropical Diseases (Simit) Marco Falcone, full professor of infectious diseases at the University of Pisa and director of infectious diseases at the Pisan University Hospital: The new vaccines are updated compared to the Omicron variants and the available data – as reported by ECDC and EMA – suggest that they also protect against circulating strains, including the currently most widespread variant “Eris” (EG.5.1). Getting vaccinated as soon as possible is strongly recommended for elderly and frail people, for example cancer patients, hematology patients, patients with chronic respiratory or cardiac diseases, because they are among those who are most at risk if they fall ill with Covid. For example, – says Falcone – if a cancer patient becomes ill he will have to suspend chemotherapy, therefore his basic condition worsens; or if, for example, a person with pulmonary emphysema becomes infected and gets pneumonia, he or she must be hospitalized, or even in intensive care.
Non-exhaustive list, ask your doctor for advice
As specified in the ministerial circular, the list of pathologies that give priority to vaccination may not be exhaustive, therefore the doctor, who knows the patient’s clinical history, will be able to evaluate (taking into account the benefit/risk ratio) the cases in which there is a risk that SARS-CoV-2 infection could aggravate underlying diseases, or cause severe forms of Covid.
Vaccination is also recommended for family members, cohabitants and caregivers of people with serious frailties.
Upon request, and subject to availability of doses, those who do not fall into the risk categories can also be vaccinated.
Priority
The vaccination, while remaining recommended for all groups of people indicated and also available for those who do not fall into the identified categories, is administered as a priority to:
– people aged 80 or over;
– guests of long-term care facilities;
– people with high fragility, in particular individuals with marked impairment of the immune system;
– health and social care workers.
In the same vaccination session, the co-administration of the new anti-Covid vaccine with other vaccines such as the flu vaccine is possible, without prejudice to any specific indications for use or clinical evaluations.
Any side effects, what to do
The ministerial circular reiterates that suspected adverse reactions to vaccines (and drugs in general) can be reported both by healthcare professionals but also by every citizen through the methods provided on the website of the Italian Medicines Agency where the form can be downloaded from fill in (by clicking Who
).
In the latest Aifa Report on the Surveillance of anti-Covid-19 vaccines 27/12/2020 – 26/12/2022 (available Who) please note that the majority of adverse events reported are classified as non-serious (approximately 81.3%; among the most reported: fever, headache, muscle/joint pain, chills, gastro-intestinal disorders, vaso- vagal, tiredness, local reaction or pain at the injection site) and to a lesser extent as serious (18.7%: in most cases characterized by flu-like symptoms while adverse events of special interest are very rare).
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December 6, 2023 (modified December 6, 2023 | 2:06 pm)
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