Search

Available data highlights the significant impact of the COVID-19 pandemic on global vaccination trends. Despite this, comprehensive evaluations of these changes at the European level are still scarce. This study examines coverage for diphtheria, tetanus, and pertussis (DTP) and measles-containing vaccines (MCV) in the WHO European Region from 2000 to 2022. Vaccination coverage data, defined as the percentage of surviving infants who received the first and third doses of DTP (DTP1 and DTP3) and the first and second doses of MCV (MCV1 and MCV2), were extracted from UNICEF databases. Joinpoint regression analysis was employed to identify joinpoints in the time series and to estimate Annual Percent Changes (APCs) and Average Annual Percent Changes (AAPCs) over predefined timeframes. The coverages for DTP1 and MCV1 exhibit a similar trend, overall characterized by four joinpoints, one of which is in 2019. In contrast, the coverage for DTP3 does not show a significant temporal trend and lacks joinpoints, while the vaccination coverage for MCV2 shows a steadily increasing trend, with three identified joinpoints. A comparative analysis with the pre-pandemic period reveals a significant increase in the number of countries characterized by a decreasing trend during the pandemic period for all considered vaccination coverages, as indicated by the negative AAPC values. These results highlight the effect of the pandemic on childhood vaccination coverage. Compared to a mere descriptive analysis, the temporal analysis of trends using joinpoint regression provides significant opportunities to identify variations in vaccination coverages and pinpoint areas for intervention in future vaccination strategies.

Although previous studies showed that warmer temperatures may be associated with increased antimicrobial resistance (AMR) rates, unmeasured factors may explain the observed relationship. We conducted a ten-year ecological analysis to evaluate whether temperature change was associated with AMR across 30 European countries, considering predictors that can determine a geographical gradient. Using four data sources, we created a dataset of: annual temperature change (FAOSTAT database); AMR proportions for ten pathogen-antibiotic combinations (ECDC atlas); consumption of antibiotics for systemic use in the community (ESAC-Net database); population density, gross domestic product (GDP) per capita, and governance indicators (World Bank DataBank). Data were obtained for each country and year (2010-2019) and analyzed through multivariable models. We found evidence of a positive linear association between temperature change and AMR proportion across all countries, years, pathogens, and antibiotics (β = 0.140; 95%CI = 0.039; 0.241; p = 0.007), adjusting for the effect of covariates. However, when GDP per capita and the governance index were included in the multivariable model, temperature change was no longer associated with AMR. Instead, the main predictors were antibiotic consumption (β = 0.506; 95%CI = 0.366; 0.646; p < 0.001), population density (β = 0.143; 95%CI = 0.116; 0.170; p < 0.001), and the governance index (β = -1.043; 95%CI = -1.207; -0.879; p < 0.001). Ensuring the appropriate use of antibiotics and improving governance efficiency are the most effective ways of counteracting AMR. It is necessary to conduct further experimental studies and obtain more detailed data to investigate whether climate change affects AMR.

Inadequate gestational weight gain (GWG) affects a growing number of pregnancies, influencing intrauterine environment and long-term health. Uncovering molecular mechanisms associated with GWG could be helpful to develop public health strategies for tackling this issue. Here, our study aimed to understand the relationship of DNA telomere length with weigh gain during pregnancy, using data and samples from the ongoing prospective "Mamma & Bambino" study (Catania, Italy). GWG was calculated according to the Institute of Medicine (IOM) guidelines. Relative telomere length was assessed by real-time quantitative polymerase chain reaction in 252 samples of maternal leucocyte DNA (mlDNA) and 150 samples of cell-free DNA (cfDNA) from amniotic fluid. We observed that relative telomere length of mlDNA seemed to weakly increase with GWG. In contrast, telomere length of cfDNA exhibited a U-shaped relationship with GWG. Women with adequate GWG showed longer telomere length than those who gained weight inadequately. Accordingly, the logistic regression model confirmed the association between telomere length of cfDNA and adequate GWG, after adjusting for potential confounders. Our findings suggest an early effect of GWG on telomere length of cfDNA, which could represent a molecular mechanism underpinning the effects of maternal behaviours on foetal well-being.

According to the evidence demonstrating vaccines' safety and effectiveness in anticipation of and during pregnancy, several countries have established immunization programs during the periconceptional period. Here, we evaluated vaccination status among 220 mother-child pairs, using data from the 'Mamma & Bambino' cohort. The self-reported data were evaluated at delivery, and with planned follow-ups at 1-2 years after delivery. In general, we noted that the vaccination status among the women was heterogeneous, ranging from 8.3% (vaccine against Human Papillomavirus, HPV) to 65.6% (vaccine against Diphtheria Tetanus and Pertussis, DTaP). Excluding the women who contracted the diseases in the past, the main ground for refusal was the lack of information. We also demonstrated that increasing age was associated with higher odds of not being vaccinated against Measles-Mumps-Rubella (MMR; OR = 1.12; 95% CI = 1.04-1.21; p = 0.004), HPV (OR = 1.20; 95% CI = 1.08-1.33; p = 0.001) and DTaP (OR =1.09; 95% CI = 1.01-1.18; p = 0.040). As expected, we showed that the proportion of newborns vaccinated with the Hexavalent and Pneumococcal vaccines was high (99.5% and 98.6%, respectively), while the vaccination coverage against MMRV did not reach the auspicated threshold (84.1%). Overall, these results underlined the need for the improvement of women's knowledge about the recommendations for vaccination, especially during pregnancy.