Influenza vaccination coverages in Italy from 1999/00 to 2023/24: A joinpoint regression analysis

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-06-18 DOI:10.1016/j.jiph.2025.102875

Andrea Zaino , Michele Bonacquisti , Luigi Russo , Tiziana Sabetta , Alessandro Solipaca , Walter Ricciardi , Stefania Boccia , Leonardo Villani

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引用次数: 0

Abstract

Background

Influenza is a contagious respiratory viral infection with significant health and economic impacts, causing millions of cases and hundreds of thousands of deaths annually worldwide. In Italy, annual epidemics affect approximately 8 % of the population. Vaccination remains the most effective prevention strategy, yet coverage in Italy is low and consistently below the WHO-recommended threshold of 75 % in elderly. This study aims to analyze trends in influenza vaccination coverage in Italy from 1999/2000 to 2023/2024 through joinpoint regression analysis.

Methods

Data on influenza vaccination coverage were obtained from the Italian Ministry of Health, covering the general population and specific age groups. The analysis included data from the 1999/2000 season to the 2023/2024 season. Joinpoint regression was used to identify significant changes in coverage trends over time, calculating Annual Percentage Change (APC) and Average Annual Percent Change (AAPC).

Results

Coverages vary between and within age groups over the study period. The pediatric population showed the lowest values, never exceeding 10 % except for the COVID-19 pandemic years. Similar trends, albeit with higher coverage, were observed in the adult population. In the elderly population, the WHO target of 75 % was never reached, obtaining the highest value of 68.3 % in 2005/2006. Trends show increasing AAPC coverages for all groups except 15–17 years. During the pandemic, increases in coverages are observed in all age groups, but these decline towards pre-pandemic values during the following seasons.

Conclusions

Our study shows that vaccination coverage in Italy falls below target thresholds, particularly in high-risk age groups, with a significant decreasing trend observed in the years following the pandemic across almost all age groups. Despite the proven efficacy and safety of the vaccine, hesitancy has gained momentum in Italy, resulting in persistently low coverage rates. Our findings highlight the need for a multifaceted approach, including expanding free vaccination programs, implementing school-based initiatives, strengthening healthcare worker engagement, and enhancing public awareness campaigns. A coordinated national effort, led by the Ministry of Health, is essential to achieving higher coverage rates and reducing the burden of influenza.

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意大利1999/00年至2023/24年流感疫苗接种覆盖率：联合点回归分析

流感是一种传染性呼吸道病毒感染，对健康和经济造成重大影响，每年在全世界造成数百万病例和数十万死亡。在意大利，每年的流行病影响到大约8 %的人口。疫苗接种仍然是最有效的预防策略，但意大利的覆盖率很低，并且一直低于世卫组织建议的老年人75% %的阈值。本研究旨在通过联点回归分析，分析意大利1999/2000年至2023/2024年流感疫苗接种覆盖率的趋势。方法流感疫苗接种覆盖率数据来自意大利卫生部，涵盖普通人群和特定年龄组。该分析包括1999/2000赛季到2023/2024赛季的数据。通过计算年百分比变化（APC）和平均年百分比变化（AAPC），使用连接点回归来识别覆盖趋势随时间的显著变化。结果：在研究期间，不同年龄组和不同年龄组的覆盖率有所不同。儿童人群的数值最低，除了COVID-19大流行年外，从未超过10% %。在成年人口中也观察到类似的趋势，尽管覆盖率更高。在老年人群中，世卫组织制定的75% %的目标从未实现，2005/2006年达到最高值68.3% %。趋势显示，除15-17岁年龄组外，所有年龄组的AAPC覆盖率都在增加。在大流行期间，所有年龄组的覆盖率都有所增加，但在接下来的季节，覆盖率下降到大流行前的水平。我们的研究表明，意大利的疫苗接种覆盖率低于目标阈值，特别是在高危年龄组，在大流行后的几年中，几乎所有年龄组的疫苗接种覆盖率都有显著下降趋势。尽管疫苗的有效性和安全性已得到证实，但在意大利，犹豫不决的情绪日益高涨，导致疫苗覆盖率持续较低。我们的研究结果强调需要采取多方面的方法，包括扩大免费疫苗接种计划，实施以学校为基础的倡议，加强卫生保健工作者的参与，以及加强公众意识运动。由卫生部领导的协调一致的国家努力对于实现更高的覆盖率和减轻流感负担至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.