The role of pharmacies in the implementation of vaccination cover- age in Italy. Insights from the preliminary data of the Lombardy Region.

Introduction: The administration of vaccines in pharmacies was not allowed in Italy until 2021. During the COVID-19 pandemic, legislative innovations were introduced that now allow qualified pharmacists to administer anti-flu and anti-COVID-19 vaccines after completing specific training. Methods: The article provides an overview of legislation concerning vaccinations in Italian pharmacies, followed by a description of the vaccinations carried out by pharmacies participating in the regional vaccination campaign from 2021 to 2023. The study relies on data extracted from the Lombardy Region's database on vaccine administration in pharmacies. Furthermore, innovative vaccination practices from the Marche Region were also taken into consideration. Study Design: Observational Study. Results: Lombardy became the Italian pioneer region in extensively incorporating pharmacy-based vaccinations, starting in 2021. This initiative reached its zenith with 46% of anti-COVID vaccines and 17% of flu vaccines administered within the first six weeks of the autumn 2023 campaign. Pharmacies played a crucial role in meeting the targets outlined in the Italian National Vaccine Prevention Plan for 2023-25. As part of an experimental program, the Marche Region has further expanded pharmacy-based vaccinations, now including anti-zoster and anti-pneumococcus vaccines for the 2023-24 campaign. Conclusions: The promising outcomes observed in Lombardy and the ongoing experimental efforts in the Marche are encouraging steps toward achieving vaccination coverage targets, albeit still falling below the objectives set by the National Vaccination Plan for 2023-25. The widespread presence of pharmacies throughout the territory makes them well-suited as support structures for vaccination campaigns, especially in reaching the adult, the elderly, and the vulnerable populations.

The contribution of the private healthcare sector during the COVID-19 pandemic: the experience of the Lombardy Region in Northern Italy.

Introduction: In Lombardy, the first European region hit by the COVID-19 pandemic, for decades the regional public healthcare service has followed a mixed delivery model with extensive involvement of private accredited providers. The study aimed at examining the role of the private sector in delivering healthcare services (diagnosis, hospitalization, and vaccination) during the pandemic. Study design: Healthcare system study. Methods: We analysed regional healthcare data referring to the period from March 2020 onwards to assess the availability of acute care and intensive care hospital beds, SARS-CoV-2 tests, and COVID-19 vaccinations. We specifically examined healthcare offered by private accredited providers within the region. Results: Of the 12,306 converted beds for COVID-19 treatment, 4,975 (40%) were in accredited private hospitals. Intensive care beds increased by 95%, reaching 1,755, with 484 (28%) in accredited private hospitals. Since the pandemic onset, 28.9 million (62%) of SARS-CoV-2 tests were conducted by private accredited facilities including pharmacies. Private sector actively contributed to the COVID-19 vaccination campaign administering over 2.6 million doses in 2021, enhancing vaccination capacity to its peak. Conclusions: The longstanding relationship between the public and private sectors within the Lombardy regional healthcare service facilitated a rapid increase in hospital bed capacity, the upscaling of SARS-CoV-2 testing capacity, and the achievement of vaccination goals to address the COVID-19 emergency. Therefore, alongside a robust and adequately funded public healthcare service, the private sector serves as an asset to enhance the resilience of healthcare systems, in line with WHO indications.