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In recent days, the regional government of Lombardy, led by the center-right, has received much criticism for the management of stocks of influenza vaccine, considered a very important tool to avoid congestion in the regional health system, especially during a pandemic.
In essence, for months the Ministry of Health has recommended that the regions anticipate the administration of the vaccine – not mandatory, but recommended for the elderly – and extend free coverage for people over 65 years of age to those who have it. more than 60. At the moment, however, Lombardy has not bought enough doses to cover all potentially vaccinable people in this population group: according to the most recent estimates of the Corriere della Sera It has around 1.86 million doses, which would not even be enough to vaccinate the goal set until last year, that is, people over 65 years of age, which in the region are 2.2 million.
The regional government and in particular the Councilor for Welfare Giulio Gallera, already highly criticized for the management of the first months of the pandemic, have rejected any criticism and explained that the difficulties are a consequence of national problems. But the situation in Lombardy has been described as problematic by both health experts and local family doctors, with several critics pointing out that other regions have managed to equip themselves in time to comply with ministerial guidelines. In Lombardy, however, even today, regional authorities do not know when the influenza vaccination campaign will start, nor can they inform family doctors (i.e. the main channel, in addition to vaccination centers, with which they Lombard citizens are vaccinated).
Each year, vaccination campaigns against influenza protect the lives of millions of people, but they require a considerable productive and logistical effort, which is generally managed by pharmaceutical companies and health systems without particular problems. The ongoing pandemic, however, has complicated their activities, also due to a greater demand for vaccines following the indications received from the ministry (which also invited people who work in contact with the most vulnerable subjects, such as operators) to be vaccinated. RSA).
“We have all known for a long time that this year was important,” he said. Fan page the president of the Milan Physicians Order, Carlo Roberto Rossi, according to whom the flu vaccine will be essential to “reduce fevers and flu that can paralyze the health machinery”: in essence, to limit the risks of an incorrect diagnosis in the case of symptoms that do not allow to determine immediately if it is flu or COVID-19.
However, to date Lombardy has only found a part of the necessary vaccine doses. According to Corriere della Sera It has bought about 1.86 million for adults and 430,000 for children from six months to six years, another category for which the vaccine is available for free. These figures are compatible with the estimates made at the end of September by the GIMBE Foundation on the availability of vaccines in the regions. The GIMBE foundation, however, estimates that there are 2.88 million vaccinable adults in Lombardy: a figure much lower than the available doses.
The problem seems to arise from the Regional Agency for Innovation and Purchasing (ARIA), the body that for the regional government is in charge of obtaining vaccines from pharmaceutical companies or intermediaries. Newspapers report that ARIA has had difficulty purchasing the necessary vaccine doses since the spring. The procedure works by tender: ARIA establishes how many doses it wants and how much it wants to pay for them, and interested companies join in offering better conditions or proposing counter-offers.
It’s already the first call, says the Corriere della Sera, it was a half failure: it was launched on February 26 but only one company appeared, the British Glaxosmithkline, which among other things asked for a price higher than what ARIA was willing to spend: 5.9 euros per dose, against 4.5 euros per dose that marks the notice. One of the problems with the eight subsequent calls, of which only four were successful, appears to be the too low price set by ARIA: Messenger Service he speculates it was an “attempt to save” that failed.
Already from the third call – launched almost three months after the first, at the end of June – ARIA decided to increase the price of each single dose, going to 5.9 euros; but even that race was left deserted. Instead, during the summer ARIA collected the vaccines that are now available in four successful tenders, but the problem was repeated in the ninth call held at the end of August, announced because the doses were not yet sufficient: the price set by ARIA has been more than doubled compared to the first call – it has reached 10 euros per dose – but no company has met the necessary criteria. On September 30, the day after the ninth call, ARIA launched another with the same criteria as the ninth: 1.5 million doses were requested at 10 euros each. The result of the call is not yet known, but the Corriere della Sera says that by now ARIA has found about a third of the desired doses, that is 500 thousand. If the call were to end in this way, the Lombardy region would have enough doses to vaccinate only those over 65.
The flu vaccine is distributed according to a very precise hierarchy: first it is made available to the most vulnerable people, such as cancer patients and pregnant women, then to the elderly, and only then is it distributed to all who request it.
The problem in Lombardy, however, is that if you do not find the necessary doses, you run the risk of not reaching the new goal set by the ministry, that is, people between 60 and 64 years old (in Lombardy there are around 600 thousand) . The Director General of the Lombardy Welfare sector, Marco Trivelli, had also clearly explained this in an internal circular issued in August and published by Daily occurrence: “The offer for people over 60-64 years old will be evaluated after the offer for people over 65 years old is exhausted with an evaluation even during the current campaign in relation to the doses of vaccine available.”
The result of the delays is that the vaccination campaign will probably only start in several weeks, despite the fact that family doctors have already received lists of their vaccinable patients and are therefore potentially ready, with a considerable delay in compared to regions that have already found the doses. necessary of the vaccine or are very close to doing so like Lazio, Calabria, Puglia and Campania.
It is not clear if Lombardy’s vaccination campaign will start anyway: the regional government could rely on the fact that only a part of the vaccinated people will agree to do so; According to a recent survey by the University of Milan, only 60 percent of Italians over the age of 55 intend to get vaccinated and vaccinate people in the highest-risk groups until supplies run out.
Gallera, meanwhile, in a recent interview with Newspaper He said that the vaccination campaign will begin in mid-October – but at the moment there is no indication that it really happens – and that “the plan is ready”, while in a Facebook post published two days ago he rejected the criticism. by the mayor of Milan Beppe Sala, elected by the center-left, without providing any relevant information.
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