A pilot experience of a clinic for the evaluation of contraindications to vaccine administration: results from the first year of activities in Puglia, Italy
More details
Hide details
Public Health Post-Graduate School, University of Bari Aldo Moro, Italy
Public Health Post-Graduate School
University of Bari Aldo Moro, Italy
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A2009
Background and Objectives:
Since August 2021, Italian law provided limitations for subjects without SARS-CoV-2 vaccination, prohibiting attendance of restaurants, gyms, workplaces, and use of public transportation. Subjects with contraindications to vaccination needed certification by authorized physicians. Bari Policlinico General Hospital, in Puglia, has been providing a service for the evaluation of possible causes of contraindication, such as medical conditions and past adverse events following immunization.

This is a retrospective observational study. Patients evaluated from August 18, 2021, to August 13, 2022, were included. Subjects were interviewed about their medical history, and clinical documentation was reviewed.

168 patients were evaluated before anti-SARS-CoV-2 vaccination, with an average age of 46.5 ± 16.2 years (7-82). The male-to-female ratio was 64/104. 71 patients (42.3%) asked for evaluation after suffering from adverse events following previous vaccine administrations, 80 (47.6%) had previous medical conditions, and 9 (5.3%) reported both circumstances. Eight subjects (4.8%) underwent evaluation due to pregnancy. After anamnesis, 149 subjects (88.7%) were found to be affected by at least one medical condition; most conditions were classifiable as either cardiovascular (30.9%), allergies (30.2%) or endocrine/metabolic (28.2%). 41 patients required further specialistic evaluation; most evaluations were requested to allergologists (58,5%). Only 40 evaluations resulted in the release of a vaccination exemption, 39 of which were due to transitory conditions. 42.5% of all exemptions were due to a temporary clinical condition; 32.5% were due to ongoing therapy; 8 cases (20.0%) were related to a complicated pregnancy; in 2 cases (5.0%) the certificate was issued for hypersensitivity to vaccine components. 83 patients (49.4%) did receive at least one vaccine dose after evaluation. 84 (50.0%) still refused vaccination, and another (0.6%) is currently exempt from vaccination.

The pre-vaccination evaluation service helped strengthening the patients’ trust towards vaccination and physicians and promotes the patients’ empowerment and awareness.