Hospital-Territory Vaccination Center: pilot study on a multidisciplinary model for administration of recombinant zoster vaccine in fragile patients
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Universita' Cattolica del Sacro Cuore, Italy
Università Cattolica del Sacro Cuore, Italy
ASL Roma 1, Italy
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1999
Background and Objectives: The literature indicates that target populations eligible for vaccinations are not comprehensively reached by out-of-hospital health services, particularly frail people with immunization deficits. The aim of this study was to evaluate the effectiveness of a model of shared management between hospital (IRCCS Fondazione Policlinico Universitario A. Gemelli) and out-of-hospital health services (ASL Roma 1) of fragile patients with an indication for herpes zoster (HZ) vaccination, based on counseling carried out by a multidisciplinary team in the hospital setting. Methods: From June 2022 to November 2022, patients with congenital and/or acquired immunodepression, who were treated at the IRCCS Fondazione Policlinico Universitario A. Gemelli in the Units of Hematology, Geriatrics, Infectious Diseases, Rheumatology were selected and offered vaccination with the recombinant Zoster vaccine. At the time of enrollment, all patients completed the Vaccination Attitudes Examination (VAX-I) scale, for the purpose of assessing vaccine hesitancy. Patients received multidisciplinary counseling focusing on HZ and contrasting vaccine hesitancy. Multiple linear regression was used to analyze the impact of demographic and clinical characteristics on the VAX-I items. Results: Thirty-five fragile patients were included. Mean vaccine hesitancy score was 2.3±1.0. A significant correlation between vaccine hesitancy and the age group of 45 to 64 years was demonstrated (p=0.0001). Patients with ages between 45 and 64 years had significantly higher score of “mistrust of vaccine benefits”, “worries about unforeseen future effects”, “concerns about commercial profiteering” and “preference for natural immunity”. After counseling, all patients adhered to the vaccination with two doses of a recombinant zoster vaccine. No serious adverse events or breakthrough HZ infections were observed during a median follow-up of 62 days (IQR=23). Conclusions: Although vaccine hesitancy in some age groups is high, hospital-based multidisciplinary counseling achieved full HZ vaccination compliance.