Multidisciplinary Hospital-Territory Vaccine Center: a Model for Achieving the Herpes Zoster Vaccine Coverage

Vaccinations are a safe and effective means of protecting populations against specific infectious diseases and are recommended at all ages. The implementation of Vaccine Services also goes through the introduction of new modes of delivery, with pathways increasingly suitable to promote and implement the prevention campaign. The Hospital represents the place par excellence where categories of at-risk individuals are intercepted for whom adequate vaccine protection is a priority. A Hospital Vaccine Center (CVO), therefore, could effectively select patients/users in both a programmed and an opportunity and initiative medicine perspective, putting in place the national and regional indications that would like to integrate the vaccine offer with the clinical care pathways of at-risk categories that belong to different disciplines. In line with these provisions of the Ministry of Health and the Lazio Region, the CVO is also proposed as a referral structure for the immunization of patients with high clinical complexity in order to achieve optimization, personalization and compliance with the vaccine program of individuals at higher risk, who, due to underlying diseases or ongoing treatments, need monitoring of the antibody response and have an indication to be vaccinated in a protected environment.

In concert with a forward-looking vision of "Hospital as a Vaccine Care and Prevention Center," the optimal vaccination pathway should be built in collaboration with the territorial reality, becoming a strategic-cultural continuum of promoting vaccination both as individual protection of frail adults and as a solidaristic choice in the interest of the entire community. So, our project is proposed as an organizational synergy between the I.R.C.C.S. Policlinico Universitario A. Gemelli and ASL Roma 1 (relying on the agreement stipulated between ASL Roma 1 and Policlinico Gemelli Foundation, regarding the supply of vaccines), thus ensuring cultural confrontation between hygienists and specialists involved in the care of frailty, constituting a scientific training network of professionals dedicated to counseling and for the drafting of vaccine protocols dedicated to the various conditions of interest.

The Strategic Advisory Group of Experts (SAGE) of the World Health Organization (WHO) defines "vaccine hesitation" as a delay in acceptance or refusal of vaccination despite vaccine availability. In any case, it appears mandated to put in place all interventions aimed at raising awareness of the benefits of vaccination, counteracting misinformation, fears, and reticence. The strategic value of the "Hospital Vaccine Center" model-pilot is inherent in offering the best and most appropriate immunological prophylaxis, being able to seize the right time (with respect to clinical-diagnostic and therapeutic-surgical follow-ups), place and time most effective for both the user and the specialist, managing patient care, promoting technological and scientific innovativeness, collecting and generating data (immunogenicity, efficacy, safety, compliance) and integrated "vaccine therapy-prevention" operational protocols, all in a real-world setting in specific fragile populations. All this is done by leveraging the specialist-patient fiduciary relationship and facilitating the vaccine culture pathway that sees vaccine delivery integrated with patient care activities.

The purpose of this study Single-center prospective longitudinal observational cohort study is to verify patients' compliance with the proposed vaccination, the effectiveness of counseling carried out by a multidisciplinary team in the hospital setting.

Primary endpoint of the study is to verify patients' compliance to the vaccination proposal, in terms of the number of patients vaccinated compared to the total number of subjects eligible for vaccination and afferent to the participating OUs.