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The development of a vaccine, particularly one that can help against the recent pandemic, is a topic that has recently attracted public opinion. More than ninety vaccines are currently being developed against Sars-Cov2 by universities and companies around the world. They are protein-based vaccines, viral vector vaccines, DNA or RNA vaccines and inactivated or attenuated viral vaccines. The development of a vaccine starts from the identification and characterization of the microorganism that causes the disease. The second step is the preclinical phase. Then, there is the phase of clinical experimentation, which allows to study the posology, efficacy and safety of the vaccine, on an increasingly larger sample. In the European Union, vaccines are authorized through two procedures (EU and national) based on the quality, safety and efficacy requirements defined by the European and international guidelines. Timing of realization, authorization and marketing of new vaccines can be shortened in cases of particular need, through an accelerated evaluation known as "Priority Medicines". In this period, it is crucial not to neglect current vaccinations. In fact, during the pandemic period, many countries postponed vaccination campaigns against many vaccine-preventable diseases, causing a marked decrease in routine immunizations in childhood.

Objective: Despite the many advances obtained thanks to vaccination, in recent years it has been a marked drop in vaccination coverage. In fact, data show the failure in reaching the 95% of coverage, equal to the safety threshold for almost all vaccinations. This is due to the phenomenon of vaccine hesitancy. Aim of this study is to describe knowledge, attitudes and perceptions respect to childhood vaccinations in a sample of parents of patients of a Free Choice Pediatrician (PLS) in the territory of Salerno Local Healthcare Service, (ASL) to assess what might be the educational needs of parents to decrease the hesitation., Methods: A quantitative observational descriptive and phenomenological study was conducted, recruiting parents belonging to a PLS in ASL Salerno, through a questionnaire constructed ad hoc., Results: Parents are not always favorable to vaccination and for some vaccine they fear a bond with a pharmaceutical business. All have vaccinated their children but not for all available vaccinations. DISCUSSION AND CONCLUSIONS . Through the educational means of the PLS doubts about vaccinations are minor and the sample of children is vaccinated, although parents appear not totally supportive and considers vaccinations as a warranty by the ASL. The sample has shown a discrepancy between the health workers about the need to vaccinate or not. Hence the need to train the health care professional before and make him responsible and then inform, through a dedicated path, who should receive the vaccine.

The Italian National Vaccine Prevention Plan (PNPV) of 2017-19 and subsequent mandatory vaccination law (Law 119/2017) both occurred in the context of a progressive decrease in vaccine coverage levels in Italy and led to important policy changes, including the introduction of new vaccine recommendations and increasing the number of mandatory vaccinations in childhood from four to ten. A survey on a sample of 446 Italian health care workers (HCW) was carried out in order to assess their opinions on policy changes introduced by the PNPV and by the mandatory vaccination law. The convenience sample was selected among participants in a training course on vaccination counselling. The large majority of participants expressed overall satisfaction about the policy changes introduced by the PNPV but some highlighted pitfalls related to its implementation. Moreover, the majority of HCW believe that vaccination coverage for both recommended and mandatory vaccinations has increased thanks to Law 119/2017, therefore expressing a positive attitude towards the enforcement of vaccine mandates.

The National Vaccine Prevention Plan considers the recommendations for immune prophylaxis in all ages of life. However, compulsory vaccination introduced in 2017 focused the attention on improving global vaccination coverage in infants and children, giving less attention to adult/elderly vaccinations. The immunization of this population is necessary considering the change in the age structure of the population, whose average life expectancy is increasing. Aim of this work was the organization of continuing education courses about anti-Pneumococcus, anti-Herpes-Zoster and anti-Papillomavirus vaccinations to offer an update of knowledge and to discuss the attitudes of health professionals in vaccination centers of the Local Health Units in Rome.

Objectives: Gender medicine is a multi-faceted field of investigation integrating various aspects of psycho-social and biological sciences but it mainly deals with the impact of the gender on human physiology, pathophysiology, and clinical features of diseases. In Italy, the Decree Law 81/2008 recently introduced the gender issue in the risk assessment at the workplaces., Methods: This review briefly describes our current knowledge on gender medicine and on the Italian legislation in risk management. Public or private scientific institutions should be the first to pay attention to the safety of their workers, who are simultaneously subjected to biological, chemical and physical agents. The Istituto Superiore di Sanità (ISS) is beginning a project funded by INAIL, to monitor the hepatitis B, measles, rubella, mumps, pertussis, chickenpox, tetanus vaccines immune coverage in health care workers in Italy., Results: The analysis of the collected data will be disaggregated for men and women and statistically analyzed with respect to the time intervals from vaccination., Conclusions: The results could provide useful elements to implement prevention and health surveillance programs in occupational medicine., Competing Interests: The authors of this article have no conflict of interests to disclose., (Copyright© by Aracne Editrice, Roma, Italy.)

Vaccines are among the scientific topics that draw most interest in the public sphere. The discussion, however, can produce polarization, eventually becoming a controversy between "supporters of science" and "antiscience people". The aggressiveness of some anti-vaxxers, and their resistance to scientific evidence, can induce the belief that the confrontation is worthless, because many think that the top-down approach is the only one that can be used. The premise of this approach is that the gap of information is the main barrier between the scientific community and the society. However, from the '80s to date, studies have shown the fallacy of some assumptions of the so-called "deficit model", including the claim that the communication of science can be reduced only to dissemination and popularization of scientific facts. Studies and experiences, even in public health communications about vaccines, have highlighted the relevance of public engagement, social context, values systems, "lay knowledge" and the complexity of the relationship between science and society, fostering the emergence of new communication models. In the "knowledge society" we need effective communication to all, because people make use of scientific facts when they are involved in decisions on many public issues. Therefore, an evidence-based assessment of each communication approach and an evaluation of the effectiveness of methods in different contexts are required.

In 1986 the Ottawa Charter underlined the importance of advocacy in health. This article analyzes the role of advocacy in Public Health making the case of immunization, whose coverage rates are decreasing in many countries. An effective advocacy action could counteract the growing phenomenon of the vaccine hesitancy within both the general population and an increasing share of healthcare providers as well as contrast antivax movements' action. We identify who are the advocates focusing on Italy and on the crucial role of scientific societies which share the responsibility of making the latest scientific evidence and most effective infectious diseases' control strategies available to health policy makers. The Italian Society of Hygiene (SItI) has been actively engaged for several years in a number of initiatives of advocacy communication and vaccines including research, training, media exposure and a dedicated website portal (vaccinarSì).

Vaccines play the main role in primary prevention in Public Health as they allow the control of many infectious diseases progression, reducing complications, morbidity and mortality. Pharmaceutical industry has spread worldwide the production and distribution of vaccines; moreover, research and new technological approaches inside industry make possible new formulations and preparations with an increasing safety. In spite of these positive aspects, lack of confidence in the utility of vaccination as well as in the real role of the pharmaceutical industry has grown in importance in recent decades. Aim of the study was to analyze these issues, with regards to cost and timing of vaccine production, and complex vaccine planning, related to efficacy, safety and tolerability assessment. Relationship between pharmaceutical industry and Public Health was finally considered; in particular, the role of Public Health as mediator between the pharmaceutical industry and the general population.

The EU and Italian institutions have recently reiterated their commitment to harmonize and implement vaccination policies as a fundamental strategy for public health. Nonetheless, vaccines are losing public confidence. False myths related to vaccine adverse reactions and commercial interests, combined with the recent judgements of the Court and the "Fluad® episode", are fuelling vaccine hesitancy. In such a context, a lively debate is ongoing in Italian scientific community. Aim of this contribution is to recall the available solid scientific evidence demonstrating that vaccines are among the most effective prevention tools ever invented and recall the economic data that support the cost-effectiveness of the immunisation. As every other medicine, vaccines are registered after large and solid clinical trials have been conducted. Immunization schedules are proposed by experts in the field of clinical medicine, epidemiology and public health on the basis of the available scientific evidence, and then implemented by policy makers also taking into consideration resources allocation and financial sustainability. The false myth that vaccines are offered because of economic interests is to be dispelled;moreover, researchers, policy makers, scientific societies and the healthcare community at large should renew commitment to invest in health education and communication on vaccines, always disclosing potential conflicts of interests.

Conventional forms of administration of nonabsorbable drugs and peptides often rely on parenteral injection, because the intestinal epithelium represents a major barrier to the oral absorption of these therapeutical agents into the systemic circulation. Recently, a number of innovative drug-delivery approaches have been developed, including drug entrapment within small vesicles or the passage of the therapeutic molecules through the space between adjacent intestinal cells. This article reviews some of the most promising techniques currently available for oral delivery and their possible practical applications for the delivery of vaccines and drugs for the treatment of clinical conditions that require frequent, chronic parenteral administration.

Oral vaccination of 19 human adult volunteers with a killed trivalent E. coli vaccine induced an antibody response detectable either in sera and feces. Production of specific IgA immunoglobulins in the intestine was also observed. Antibody titres reached the highest levels 5-10 days after vaccination and were still detectable in the majority of volunteers about 2 months later.