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Low influenza vaccination coverage in subjects with liver cirrhosis. An alert waiting for winter season 2020-2021 during the COVID-19 pandemic.

  • Stroffolini, Tommaso1
  • Lombardi, Anna2
  • Ciancio, Alessia3
  • Niro, Grazia A4
  • Colloredo, Guido5
  • Marignani, Massimo6
  • Vinci, Maria7
  • Morisco, Filomena8
  • Babudieri, Sergio9
  • Ferrigno, Luigina10
  • Sagnelli, Evangelista11
  • 1 Department of Tropical and Infectious Diseases, Policlinico Umberto I, Roma, Italy. , (Italy)
  • 2 Liver Unit, Cardarelli Hospital, Naples, Italy. , (Italy)
  • 3 Department of Gastroenterology, Ospedale Molinette, Torino, Italy. , (Italy)
  • 4 Gastroenterology Unit, Fondazione Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy. , (Italy)
  • 5 Internal Medicine Unit, Policlinico S. Pietro, Bergamo, Italy. , (Italy)
  • 6 Department of Digestive and Liver Diseases, S. Andrea Hospital and School of Medicine, Rome, Italy. , (Italy)
  • 7 Department of Gastroenterology, Ospedale Niguarda, Milano, Italy. , (Italy)
  • 8 Department of Clinical Medicine and Surgery, Gastroenterology and Hepatology Unit, University of Naples Federico II, Naples, Italy. , (Italy)
  • 9 Dipartimento di Scienze Mediche, Chirurgiche e Sperimentali, Clinic of Infectious Diseases, University of Sassari, Sassari, Italy. , (Italy)
  • 10 National Health Institute, National Center for Global Health, Rome, Italy. , (Italy)
  • 11 Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Clinic of Infectious Diseases, University of Naples, Naples, Italy. , (Italy)
Published Article
Journal of Medical Virology
Wiley (John Wiley & Sons)
Publication Date
Dec 28, 2020
DOI: 10.1002/jmv.26763
PMID: 33368427


We have evaluated flu vaccine coverage and variables associated with the lack of vaccination in cirrhotic subjects with particular attention to the cirrhosis etiology. Cirrhotic subjects consecutively referring to eight Italian centers were prospectively enrolled for a 6-month period in 2019. Subjects were asked if they had received a flu vaccine in the last 12 months. Multiple logistic regression analysis was performed to identify independent predictors of lack of vaccination. A total of 818 cases were recruited. The overall vaccine coverage was 39.6% (26.9% in those younger than 65 years and 51.9% in those older than 64 years; p < 0.001). Age < 65 years (odds ratio [OR] = 2.38; 95% confidence interval [CI] = 1.68-3.36), alcoholic etiology (OR = 2.40; 95% CI = 1.49-3.85), birth abroad (OR = 2.7; 95% CI = 1.10-6.61), and residence in South/Sardinia island (OR = 1.66; 95% CI = 1.14-2.42) all resulted independent predictors of the likelihood of lack of vaccination. The lack of information regarding the vaccine as the reason for no vaccination was reported by 71.4% of foreigners and by 34.7% of natives (p < 0.001). In conclusion, much work still should be done to improve coverage among groups at higher risk of lack of vaccination identified in this survey. The ongoing SARS-CoV-2 pandemic may represent one more alert for improving seasonal flu vaccine coverage to avoid further stress to the National Health System. © 2020 Wiley Periodicals LLC.

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