Search

Italy (in pilot regions) and Germany (nationwide) were the first European countries to introduce universal varicella vaccination (UVV) programs. A systematic review was performed to assess varicella epidemiology before UVV programs and the impact of 1-dose and 2-dose UVV programs in Italy and Germany. Italy implemented 1- or 2-dose UVV programs successively in eight pilot regions between 2003 and 2011 and nationwide in 2017. Germany implemented 1- and 2-dose UVV programs in 2004 and 2009, respectively. While Italy had two nationwide surveillance systems in place for varicella in the pre-vaccination era, in Germany, a mandatory notification system for varicella was only introduced in the New Federal States 2 years before the 1-dose UVV implementation. Substantial reductions in moderate/severe varicella and varicella-related hospitalization incidence occurred during the 1-dose era. Further reductions were reported in Italy and Germany after the recommendation of a second dose in a long or short schedule, respectively. Different benefit-risk evaluations of a tetravalent varicella-containing vaccine (MMRV) used as a first dose led to different recommendations (MMRV versus MMR+V) in these countries. Vaccination strategies in both countries tailored to country-specific needs and goals led to a reduction in varicella-related health care hospitalization costs. [ABSTRACT FROM AUTHOR]

Background: Effective linkage to specialist care following screening is crucial for secondary prevention of chronic viral hepatitis-related consequences. Methods: To explore the frequency of referral of patients to secondary care from the health services involved in screening and to gather information on the services responsible for the provision of post-test counselling and contact tracing, four online surveys were conducted among general practitioners (GP), and experts working in sexual health services (SHS), antenatal care (ANC) and specialist secondary care in Germany, Hungary, Italy, The Netherlands, Spain and the UK. Results: Overall, 60% of GPs report referring all patients to specialist care. Although 67% of specialists commonly receive patients referred by GPs, specialists in Germany rarely or never receive patients from ANC or from centres testing injecting drug users; and specialists in the Netherlands, Hungary and Germany rarely receive patients from SHS. Gastroenterologists/hepatologists are the professionals mainly responsible for the provision of counselling following a positive diagnosis of viral hepatitis according to two-thirds of specialists, 14% of SHS providers and 11% of ANC providers. Almost half of ANC providers (45%) stated that gynaecologists are the professionals responsible for the provision of counselling to positive pregnant women; among SHS providers, only 14% identified SHS as the services responsible. Conclusion: Our findings suggest the existence of complex/ineffective referral practices or that opportunities to screen risk groups are missed. Recommendations clarifying the services responsible at each step of the referral pathway are needed in order to increase the success of screening programmes. [ABSTRACT FROM AUTHOR]

Introduction Vaccination is the best way to prevent hepatitis B infection and its consequences. The aim of the present study is to analyze the current vaccination practices within various population subgroups who are offered screening for hepatitis B, when found negative, in Germany, Hungary, Italy, the Netherlands, Spain and the UK. Methods Online surveys were conducted in the six countries. In total, 1181 experts from six different health professions were invited to participate. Descriptive analyses of data were performed. Results Less than half of the respondents in the Netherlands, only about 1/4 in Germany and none in Hungary reported that the vaccine is commonly offered to people who inject drugs. Less than half of the respondents in Germany reported vaccinating sex workers or HIV positive patients against hepatitis B as common practice. None in Hungary stated that vaccinating sex workers is common practice, and only according to a minority (17%) HIV patients are commonly vaccinated. 1/4 to 1/3 of respondents in Germany, the Netherlands, Italy, Hungary and the UK, indicated that HCV positive patients are only sporadically immunized. Only in Spain almost half of the respondents reported that migrants from hepatitis B endemic areas who are screened negative are commonly vaccinated. Widespread uncertainty about vaccination practices for asylum seekers was reported. Conclusions By showing the gaps between current practices and policies in place, our findings can help to increase the success of future vaccination programmes. Implementation of training for health care professional, e.g. introducing vaccinology and vaccination policy courses in the medical and paramedical curriculum, could contribute to a more homogenous application of the recommendations regarding immunization against hepatitis B. Our results show, nonetheless, that the universal vaccination approach, coupled with targeted programmes for immigrants, represents the only way to make the elimination of hepatitis B a foreseeable, realistic objective. [ABSTRACT FROM AUTHOR]