Regarding the Cultural Association of Paediatricians influenza vaccination is considered necessary to follow the official recommendations released by the Ministry of Health for the 2010-11 season.
We declare our readiness to participate in the discussion on the potential opportunity to extend the indications for influenza vaccination if demonstrated its benefit on the basis of robust scientific studies, which consider the outcomes specified by the Ministry and they are explicitly free of conflicts of interest. However, we believe that this discussion should be a collaborative support by the scientific societies with respect to a central decision-making body responsible for policies vaccine. In this body must still rely on recognizing the 'authority and decision-making power.
Deprecated strongly that, as a number of years is taking place in Italy, he tries to force the change in vaccination policies expressed in non-scientific premises and not institutional positions differing from those ministries are not always supported by clear evidence and clear conflict.
useful We reiterate the importance and the Ministry of personal protective measures to reduce transmission of influenza viruses. Highly recommended hand washing (in the absence of water, use of alcohol gel) the good respiratory hygiene, cover nose and mouth when sneezing or coughing, handling tissues, promote voluntary home isolation of persons with febrile respiratory illness, especially in the initial phase and the use of masks by of people with flu symptoms, if present in healthcare settings.
We agree with the choice to emphasize the role of ministerial budget grade attributed to the washing of hands, a practice recognized by the World Health Organization (WHO) as a the most effective in controlling the spread infection, not only influenza, even in hospitals.
vaccination for healthy children aged between 6 months and 24 months (or up to 5 years) is instead an issue currently under discussion by the international scientific community.
The data available so far do not allow you to share a positive evaluation for the purpose of achieving a significant reduction of risk of death, hospitalization, serious illness , despite the American health care, Canadian and some European Union countries have chosen to vaccinate these children.
risk of death, hospitalization and serious illness are the outcomes of influenza vaccination that must be demonstrated to justify its offer active and free to the entire population of healthy children: this is what the Ministry says, and we fully agree with this statement.
In the absence of evidence of effectiveness with respect to these outcomes, as in past years influenza vaccination has been offered in an active and free only to children older than 6 months with severe chronic diseases (see Table . 1).
Given the weakness of the evidence of effectiveness in relation to outcomes given the ACP intends to engage in the next flu season in an ad hoc study, independent and free from any conditioning, auspicando una massiccia partecipazione dei pediatri italiani.
Siamo consapevoli che le evidenze sono deboli anche per i soggetti a rischio e sarebbero utili specifici studi di valutazione anche per loro; per queste persone si deve però giudicare soddisfacente anche il raggiungimento di outcomes meno importanti come il semplice risparmio di qualche giorno di malattia dato che quei giorni di malattia potrebbero, per esempio, coincidere con l'inizio di un ciclo di chemioterapia o potrebbero intervenire in una fase di grave compromissione immunitaria. In una parola riteniamo che, in accordo col Ministero, si debba ritenere utile la loro vaccinazione in mancanza di evidenze contrarie.
Rosario Horse
Head of Secretariat of Infectious Diseases Prevention
Paolo Siani
ACP President
The Board ACP:
Corchia Carlo, Stefano Gorini, Chiara Guidoni, Thomas Montini, Mario Narducci, Joseph Spring, Mary F. Syracuse, Enrico Valletta, Luciana Nicoli
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