Vaccinome landscape in nearly 620,000 patients with diabetes.

INTRODUCTION: Type 1 (T1D) and type 2 diabetes (T2D) are associated with an elevated incidence of infectious diseases and a higher risk of infections-related hospitalization and death. In this study, we delineated the "vaccinome" landscape obtained with a large immunization schedule offered by the Regional Government of Lombardy in a cohort of 618,396 patients with diabetes (T1D and T2D). METHODS: Between September 2021 and September 2022, immunization coverage for influenza, meningococcus, pneumococcus, and herpes zoster was obtained from the public computerized registry of the healthcare system of Lombardy Region (Italy) in 618,396 patients with diabetes and in 9,534,087 subjects without diabetes. Type of diabetes, age, mortality, and hospitalizations were retrospectively analyzed in vaccinated and unvaccinated patients. RESULTS: Among patients with diabetes (T1D and T2D), 44.6% received the influenza vaccine, 10.9% the pneumococcal vaccine, 2.5% the anti-meningococcus vaccine and 0.7% the anti-zoster vaccine. Patients with diabetes immunized for influenza, zoster and meningococcus showed a 2-fold overall reduction in mortality risk and a decrease in hospitalizations. A 3-fold lower risk of mortality and a decrease in hospitalizations for both cardiac and pulmonary causes were also observed after influenza, zoster, and meningococcus immunization in older patients with diabetes. CONCLUSIONS: Immunization coverage is still far from the recommended targets in patients with diabetes. Despite this, influenza vaccination protected nearly 3,800 per 100,000 patients with diabetes from risk of death. The overall impressive decrease in mortality and hospitalizations observed in vaccinated patients strengthens the need for scaling up the "vaccinome" landscape in patients with diabetes.

HB-HTA focus in a tertiary hospitals' network in Northern Italy: A three-years experience analysis.

BACKGROUND AND AIM: Nowadays Health Technology Assessment (HTA) is becoming more important in the hospital management, until the conception of Hospital Based HTA (HB-HTA), considered as a tool of HTA that is a multidisciplinary process to determine the value of a health technology in health sector. The aims of this study are the investigation of the current state of the art and of the diffusion of the HTA culture in hospitals (HB-HTA) also the analysis of the thinking of healthcare professionals regarding the usefulness of HTA. METHODS: The study was performed through the administration of two questionnaires respectively to hospitals' HealthCare Workers (HCW) to assess the HTA's knowledge and to hospitals' HCW that have submitted a new technologies or devices' request to Direction between 2017 and 2019. RESULTS: Considering 988 questionnaires send to HCW only 416 (42.1%) answer were collected, with a higher attention towards HTA made by physicians (148; 35,6%). It's fundamental to observe that despite a mean response rate all the population shows interest for the HB-HTA concept as an instrument to help the hospital management. About the 23 questionnaires to HCW that have made request show a higher attention and knowledge to HTA. CONCLUSIONS: In conclusion, in the current welfare landscape and for the future developments that will ensue from it, especially in the Italian context due to the increase of healthcare funds provided by the NRRP (National Recovery and Resilience Plan), the adoption of the HB-HTA method will represent a strategic lever to support clinical and organizational decision-making processes governance.

COVID-19 and Influenza Vaccination Campaign in a Research and University Hospital in Milan, Italy.

BACKGROUND: Healthcare workers (HCWs) are a historical key target of influenza vaccination programs. For the 2021-2022 season, WHO considered the coadministration of a flu and a COVID-19 vaccine as acceptable and recommended it to allow for higher uptake of both vaccines. The aim of this study was to investigate demographic and occupational features of vaccinated HCWs, reasons behind flu vaccine acceptance and a possible effect of the coadministration of a COVID-19 vaccine, in order to potentially draw general conclusions on HCWs' attitude towards flu vaccination and inform further strategies for consistent improvement of vaccine acceptance. METHODS: a promotional and educational campaign, a gaming strategy, and vaccination delivery through both a large central hub and on-site ambulatories, were the implemented strategies. In the central hub, the flu/COVID-19 vaccine coadministration was offered. Statistical descriptive analysis, multiple correspondence analysis (MCA) and logistic regression models were performed. RESULTS: 2381 HCWs received the flu vaccine, prompting a vaccination coverage rate (VCR) of 52.0% versus 43.1% in the 2020-2021 campaign. Furthermore, 50.6% vaccinated HCWs belonged to the 18-39 years-old age group. The most expressed reasons for vaccine uptake were "Vaccination is the most effective strategy of prevention" (n = 1928, 81.0%), "As HCW it's my duty to get vaccinated to protect my patients" (n = 766, 32.2%), and the group of COVID-19-related reasons (n = 586, 24.6%). In addition, 23.3% HCWs received the flu vaccine in the current campaign but not in the previous one (newly vaccinated) and the flu/COVID-19 vaccine coadministration was more frequent in this group. A total of 51.0% HCWs were hesitant towards the coadministration, while residents and nurses showed the highest propensity to receive it. CONCLUSIONS: in the second year of the COVID-19 pandemic, the Fondazione's influenza VCR continued to increase, with the greatest participation among HCWs aged 18-39 years. A potential propelling role of the COVID-19 vaccine coadministration was highlighted.