Preschool-located influenza vaccination and influenza-like illness surveillance: an Italian pilot experience

• Published in: Italian journal of pediatrics Vol. 49; no. 1; p. 91
• Main Authors: Amendola, Antonella, Borghi, Elisa, Bianchi, Silvia, Gori, Maria, Fappani, Clara, Barcellini, Lucia, Forlanini, Federica, Garancini, Nicolò, Nava, Chiara, Mari, Alessandra, Sala, Anna, Gasparini, Chiara, Ottaviano, Emerenziana, Colzani, Daniela, Biganzoli, Elia Mario, Tanzi, Elisabetta, Zuccotti, Gian Vincenzo
• Format: Journal Article
• Language: English
• Published: England BioMed Central 21.07.2023; BMC
• Subjects: Absenteeism; Children; Collaboration; Consent; COVID-19; COVID-19 vaccines; Differential diagnosis; Disease transmission; Epidemics; Health care; Health equity; Health surveillance; Immunization; Influenza; Influenza A; Intranasal administration; Live-attenuated influenza vaccination; Pandemics; Parents & parenting; Pediatrics; Pilot projects; Prevention programs; Public health; Saliva; Sampling; School-located vaccination; Schools; Seasons; Self-sampling; Severe acute respiratory syndrome coronavirus 2; Socioeconomic factors; Italy; Self-sampling; School-located vaccination; Health equity; Children; Saliva; Live-attenuated influenza vaccination
• ISSN: 1824-7288; 1720-8424; 1824-7288
• DOI: 10.1186/s13052-023-01481-0

We describe the first school-located influenza vaccination campaign with quadrivalent live-attenuated influenza vaccine (LAIV) among pre-school children in Italy, coupled with an innovative school-centred influenza-like illnesses (ILIs) surveillance using a self-sampling non-invasive saliva collection method. The pilot study was proposed during the 2021/2022 influenza season to fifteen pre-schools in the Milan municipality. LAIV was offered directly in school to all healthy children without contraindications. ILI differential diagnosis was conducted by real-time RT-PCR for influenza A/B and SARS-CoV-2. Five pre-schools were involved in the pilot project and overall, 135 families (31.2%) participated in the study, adhering to both surveillance and vaccination; 59% of families had an immigrant background. No pupil experienced adverse reactions after vaccination. Nineteen saliva samples were collected from sixteen children (11.8%). Six samples (31.6%) tested positive for SARS-CoV-2; none was positive for influenza A/B. The participation in the immunisation campaign was good, considering possible absences due to COVID-19 pandemic, and the intranasal administration was well tolerated and helped to overcome parental hesitancy. Saliva sampling represented a useful tool to reduce children's stress and increase parents' compliance. The high participation of families with an immigrant background suggests that school-based interventions can represent an effective strategy to overcome socioeconomic and cultural barriers.