A few days after the closing of the ninth national congress of the Italian Society of Pediatric Primary Care (Sicupp), held from 9 to 11 June in Catania, the balance is positive. The panels in the program suggested comparisons and updates on the problems that the pediatric specialist has to face in the different stages of the child’s growth. Many preventive interventions, including vaccinations.
“The pandemic has greatly affected the organizational plan to reduce access to vaccination centers, along with the population’s fear of leaving their homes. Therefore, many families have not vaccinated their children, which has postponed them to more appropriate times. However, proliferation is often not possible to recover ”. He states that Gaetano Bottaro, free choice pediatrician in Catania and among the organizers of the Congress. Among the first vaccines to be hit was the one against rotavirus, which according to the WHO is responsible for the most serious form of viral gastroenteritis in children under the age of five, and against which the region of Sicily introduced universal vaccination in 2013, the first in Italy. Recommended for all children from the sixth week of life, administration should be completed within 24 weeks. “
I already recommended it when it was still paid – remembers Bottaro -. Since the introduction, we have witnessed the collapse of severe diarrhea, which also led to the hospitalization of children under six months, and which can be difficult to deal with even in the hospital ”.
Vaccination prevention must now restore the impact of anti-infective measures on services, which prompted the “vaccination offices to regulate access upon booking. Therefore, the influx decreased and now it is necessary to implement recall programs from the region. We pediatricians continue to do vaccination training, but it will not be enough without a project to restore the spread. ”
A speech that also applies to meningitisespecially group B, which – again according to Bottaro – “has as its criticality the various recalls, with a four-dose scheme, which makes it more challenging to achieve coverage. Among other things, it is not performed with other vaccines, unlike what happens in the UK, where it is possible to administer it with the hexavalent, and then the short-term effects, ie the fever peak, which may be higher and the prolonged muscle pain at the injection site, for families trigger resistance, as we are talking about recommended but not mandatory vaccines.However we are talking about protecting children from dangerous diseases“I personally recommend to my patients all the vaccines provided for in the regional and national plan”.
And about meningitis, Bottaro emphasizes that “although it does not involve epidemics, the bacterium is always present in the territory, just think that 10 percent of the pediatric population carries both meningococci and pneumococci in the nose. The disease does not always develop in every moment of life, but it is a danger that should not be underestimated, above all for the health of the individual. The warning is primarily for the prepubertal and adolescent age, which is difficult to achieve in terms of vaccination recovery. And yet, the difficult replacement of retired pediatricians has its weight given that “many children have been redirected to family physicians who, however, do not have the same culture of preventing and promoting vaccination,” Bottaro emphasizes.
“We should force our institutions so we can vaccinate at the pediatrician’s office: there is already a national agreement that allows it, in many regions it is already happening, but in Sicily we have not yet succeeded in getting it. Our health balance plan includes ten stages, which follow all stages of the child’s development and which overlap with the correct timing of the first doses and reminders, starting from the first months up to 12 years – concludes the pediatrician active in the province of Catania -. If that were already the case, we would have done it another weapon to respond to the vaccination delay“.
emphasizes in disappointing data for papillomavirus, but also non-recoverable rotavirus covers Also there Dr. Milena Lo Giudice, one of the speakers at Sicupp’s National Congress and family pediatrician in Palermo. “We are talking about a virus that affects children in the very first months of life and which can cause a number of manifestations that can also lead to hospitalization or even resuscitation. Prior to the introduction of the vaccine, there were eleven deaths a year in Italy: we are at risk of relapse if we do not activate recovery projects “. The active and free offer collides with the difficulties that Sicilians have had in accessing vaccination centers. “Palermo had closed them all, except one, for a few months, then the entrance was regulated by booking. therefore, the problem is not in the regional calendar. Being able to vaccinate in the family pediatrician’s doctor’s office would be the turning point, but the bureaucratic obstacles that need to be overcome are not few ”.
If rotavirus again, according to Lo Giudice’s experience, precludes the perception of not being a serious disease, meningitis warns parents more. “However the pandemic has pushed the number of young people away continues the pediatrician,. We are talking about a recall for meningococcus B and for ACWY strains. These are non-compulsory vaccinations, so if the families are not well informed and guided, we will see that there is a decrease in attention. Initiatives such as open days, which some centers, such as in Palermo, activate, are useful corrective measures “.
The invitation to colleagues, especially young professionals, is from listen to the parents’ fears“Which we respond to by providing as much information as possible and making the data understandable – emphasizes Lo Giudice – therefore I invite pediatricians to study, to get to know the subject thoroughly to respond to families’ fears with solid knowledge. It happened. “to me that someone feared the meningitis vaccine because they were convinced that the bacterium was inside and that it was the real cause of the disease. These doubts need answers and to do that you need to study well”. The emphasis also stems from the awareness that even in the Covid emergency “there have been no wax pediatricians either. If we want them to become referees for vaccinations for children, we need to focus a lot on training. When one thinks of the trainees, the education in vaccinology needs to be improved. Although it is good for colleagues to follow refresher courses, and then give clear indications to families “.