The first cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were reported in December 2019. On March 11, 2020, the WHO declared coronavirus disease 2019 (COVID-19) a pandemic (1). By the end of 2021, COVID-19 has caused 5.4 million deaths worldwide, impacting severely on health systems and triggering a global economic and social crisis. On November 24, 2021, Europe is once again the epicenter of the COVID-19 pandemic (2), with 75% of fatal cases occurring in people aged 65 years and above, and hospital admission rates more than doubling in 1 week, according to the latest data (2). The reasons behind this increase are mainly insufficient vaccination coverage and relaxation of public health and social measures (2). Vaccination has been shown to be 70–95% effective against COVID-19 after two doses and against COVID-19-related hospital admissions up to 6 months after being fully vaccinated (3–5) and is considered one of the most cost-effective interventions to preserve healthcare resources and system efficiency (6). Yet, vaccination coverage within Europe is still suboptimal (2). As of November 24, 2021, Italy has administered 95,571,957 doses of COVID-19 vaccines, with an 84.5% coverage of fully vaccinated population over 12 years old, and 87.3% with at least one dose (7). Four different vaccines (Cominarty, Spikevax, Vaxzevria, and Janssen) have been administered since December 27, 2020. Up until September 26, 2021, 71.2% of administered doses were Cominarty, 14.5% were Vaxzevria, 12.5% were Spikevax, and 1.8% were Janssen (8). Since September 27, 2021, the booster dose, administered right after the date of vaccination only of Cominarty and Spikevax, as well as the second dose of Janssen, was initially indicated only for people aged over 80 years, as well as residents and staff of nursing homes and healthcare facilities. It was subsequently extended to all subjects vaccinated with a single dose of Janssen vaccine from at least 6 months, regardless of age, and has now been extended to the whole over-18 population, provided a minimum of 5 months have passed since the completion of the primary course with two doses (9–11). Despite these efforts and the establishment of a COVID-19 Green Pass, which allows access to public events, transportations, and nursing homes only to vaccinated people or people tested for SARS-CoV-2 (12), trends of hospital admissions due to COVID-19 are rising, particularly among the non-vaccinated who amount to 8 million people. Indeed, as of November 24, 2021, data provided by the Italian National Health Institute (ISS) show an increased risk of hospital admission and death for the non-vaccinated population in all age groups, with new cases primarily caused by the B.1.617.2 (Delta) variant of SARS-CoV-2 (13). In the light of this situation, the Italian Ministry of Health (MoH) instituted a reinforced COVID-19 Green Pass that allowed only people who are fully vaccinated or recovered from COVID-19 to access shows, sporting events, indoor bars and restaurants, parties and discos, public ceremonies for the period December 6, 2021 to January 15, 2022 in the Italian white zones, and from November 29, 2021 to the end of the state of emergency in the yellow and orange zones (14). Moreover, mandatory vaccination has been extended to new categories (e.g., school and police personnel) and the validity of the COVID-19 Green Pass has been reduced from 12 to 9 months (14). Using the official data from ISS for the period October 24-November 24, 2021, on vaccination status, new positives, hospitalisations in general wards and intensive care units, this brief report aims to: (i) to assess the risks of hospital admission for different age groups ≥12 years of age, and by vaccination status; (ii) to calculate the costs of vaccine refusal during the observation period. The costs of excess cases due to vaccine refusal were calculated only for hospitalization. Neither the direct and indirect costs of non-hospitalized cases nor the cost of deaths, which however we believe to be significant, were factored into the calculation.

COVID-19 Vaccination Coverage in Italy: How Many Hospitalisations and Related Costs Could Have Been Saved If We Were All Vaccinated? / Zamagni, Giulia; Armocida, Benedetta; Abbafati, Cristiana; Ronfani, Luca; Monasta, Lorenzo. - In: FRONTIERS IN PUBLIC HEALTH. - ISSN 2296-2565. - 10:(2022). [10.3389/fpubh.2022.825416]

COVID-19 Vaccination Coverage in Italy: How Many Hospitalisations and Related Costs Could Have Been Saved If We Were All Vaccinated?

Abbafati, Cristiana
Writing – Review & Editing
;
2022

Abstract

The first cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were reported in December 2019. On March 11, 2020, the WHO declared coronavirus disease 2019 (COVID-19) a pandemic (1). By the end of 2021, COVID-19 has caused 5.4 million deaths worldwide, impacting severely on health systems and triggering a global economic and social crisis. On November 24, 2021, Europe is once again the epicenter of the COVID-19 pandemic (2), with 75% of fatal cases occurring in people aged 65 years and above, and hospital admission rates more than doubling in 1 week, according to the latest data (2). The reasons behind this increase are mainly insufficient vaccination coverage and relaxation of public health and social measures (2). Vaccination has been shown to be 70–95% effective against COVID-19 after two doses and against COVID-19-related hospital admissions up to 6 months after being fully vaccinated (3–5) and is considered one of the most cost-effective interventions to preserve healthcare resources and system efficiency (6). Yet, vaccination coverage within Europe is still suboptimal (2). As of November 24, 2021, Italy has administered 95,571,957 doses of COVID-19 vaccines, with an 84.5% coverage of fully vaccinated population over 12 years old, and 87.3% with at least one dose (7). Four different vaccines (Cominarty, Spikevax, Vaxzevria, and Janssen) have been administered since December 27, 2020. Up until September 26, 2021, 71.2% of administered doses were Cominarty, 14.5% were Vaxzevria, 12.5% were Spikevax, and 1.8% were Janssen (8). Since September 27, 2021, the booster dose, administered right after the date of vaccination only of Cominarty and Spikevax, as well as the second dose of Janssen, was initially indicated only for people aged over 80 years, as well as residents and staff of nursing homes and healthcare facilities. It was subsequently extended to all subjects vaccinated with a single dose of Janssen vaccine from at least 6 months, regardless of age, and has now been extended to the whole over-18 population, provided a minimum of 5 months have passed since the completion of the primary course with two doses (9–11). Despite these efforts and the establishment of a COVID-19 Green Pass, which allows access to public events, transportations, and nursing homes only to vaccinated people or people tested for SARS-CoV-2 (12), trends of hospital admissions due to COVID-19 are rising, particularly among the non-vaccinated who amount to 8 million people. Indeed, as of November 24, 2021, data provided by the Italian National Health Institute (ISS) show an increased risk of hospital admission and death for the non-vaccinated population in all age groups, with new cases primarily caused by the B.1.617.2 (Delta) variant of SARS-CoV-2 (13). In the light of this situation, the Italian Ministry of Health (MoH) instituted a reinforced COVID-19 Green Pass that allowed only people who are fully vaccinated or recovered from COVID-19 to access shows, sporting events, indoor bars and restaurants, parties and discos, public ceremonies for the period December 6, 2021 to January 15, 2022 in the Italian white zones, and from November 29, 2021 to the end of the state of emergency in the yellow and orange zones (14). Moreover, mandatory vaccination has been extended to new categories (e.g., school and police personnel) and the validity of the COVID-19 Green Pass has been reduced from 12 to 9 months (14). Using the official data from ISS for the period October 24-November 24, 2021, on vaccination status, new positives, hospitalisations in general wards and intensive care units, this brief report aims to: (i) to assess the risks of hospital admission for different age groups ≥12 years of age, and by vaccination status; (ii) to calculate the costs of vaccine refusal during the observation period. The costs of excess cases due to vaccine refusal were calculated only for hospitalization. Neither the direct and indirect costs of non-hospitalized cases nor the cost of deaths, which however we believe to be significant, were factored into the calculation.
2022
Covid 19, vaccination, hospitalisations, related costs
01 Pubblicazione su rivista::01a Articolo in rivista
COVID-19 Vaccination Coverage in Italy: How Many Hospitalisations and Related Costs Could Have Been Saved If We Were All Vaccinated? / Zamagni, Giulia; Armocida, Benedetta; Abbafati, Cristiana; Ronfani, Luca; Monasta, Lorenzo. - In: FRONTIERS IN PUBLIC HEALTH. - ISSN 2296-2565. - 10:(2022). [10.3389/fpubh.2022.825416]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1614619
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