Immunity status against tetanus in young migrants: a seroprevalence study
Keywords:
tetanus, migrants, serological survey, seroprevalence, immunity, WHO regionAbstract
Background and aim of the work: Thanks to the highly effective vaccine, tetanus became sporadic in high-income countries with well-established primary childhood immunization programs, but it is common in low-income countries. The migrants, leaving countries with poor immunization programs or where vaccinations have been interrupted, may represent a new risk group for tetanus in host countries. A seroprevalence study was conducted to estimate the immunological status against tetanus in young migrants without vaccination documentation. Methods: After a careful assessment by vaccination services of the Local Health Authority, all migrants recently arrived in Italy were included in the serosurvey. Titers of anti-tetanus toxoid were measured using a commercial ELISA kit. Subjects were stratified by age and by WHO region. Antibody titers <0.10 IU/ml were considered to be seronegative, between 0.10 and 1.00 IU/ml as intermediate protection, and >1.00 IU/ml high protection. Results: From January 2004 to December 2019, 2,326 blood samples were collected. Mean age was 13.9 years with no differences between WHO regions. The percentage of the subjects without protective antibodies was 22.3%, with an intermediate level was 45.2%, with high titer was 32.5%. Among migrant coming from African and Eastern Mediterranean WHO regions, the highest percentages of seronegative titers and, at the same time, the low percentages of high protective levels were found. Titers decreased with age. Conclusions: The significant proportion of seronegative migrants and the decrease of protective titers increasing age, confirm the importance of the evaluation of the immunological status to employ the appropriate vaccination strategy.
References
1. World Health Organization - WHO. Tetanus. Available from: https://www.who.int/immunization/diseases/tetanus/en/ (last accessed on 05 February 2020)
2. Centers for Disease Control and Prevention - CDC. Epidemiology and Prevention of Vaccine-Preventable Diseases. The Pink Book: Course Textbook - 13th Edition (2015). Chapter 21: Tetanus. Available from: https://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html (last accessed on 05 February 2020)
3. Fine P.E.M. Herd Immunity: History, Theory, Practice. Epidemiologic Reviews 1993; 15(2): 265–302.
4. Thwaites CL, Loan H.T. Eradication of tetanus. Br Med Bull. 2015; 116:68–77.
5. Lam M.Y, Thwaites C.L. Tetanus. Lancet 2019; 393:1657-1668.
6. World Health Organization – WHO. Vaccine‐Preventable Diseases: Monitoring System. 2019. Available from: http://apps.who.int/immunization_monitoring/globalsummary (last accessed on 05 February 2020)
7. Behrens H, Ochmann S, Dadonaite B, Roser M. Tetanus. Available from: https://ourworldindata.org/tetanus (last accessed on 05 February 2020)
8. Valentino M, Rapisarda V. Tetanus in a central Italian region: scope for more effective prevention among unvaccinated agricultural workers. Occup Med (Lond) 2001; 51:114–117.
9. Pedalino B, Cotter B, Ciofi degli Atti M, Mandolini D, Parroccini S, Salmaso S. Epidemiology of tetanus in Italy in years 1971-2000. Euro surveill 2002; 7:103-110.
10. Filia A, Bella A, von Hunolsteinb C, Pinto A, Alfarone G, Declicha S et al. Tetanus in Italy 2001–2010: A continuing threat in older adults. Vaccine 2014; 32:639– 644.
11. Weinberger B. Adult vaccination against tetanus and diphtheria: the European perspective. Clin Exp Immunol. 2017; 187:93-99.
12. Brabin L, Fazio-Tirrozzo G, Shahid S, Agbaje O, Maxwel1 S, Broadhead R et al. Tetanus antibody levels among adolescent girls in developing countries. Transaction of the Royal Society of Tropical Medicine and Hygiene 2000; 94:455-459.
13. Ounnavong P, Chanthavilay P, Khampanisong P, Reinharz D, Muller CP, Black AP. Seroprevalence of anti-tetanus antibodies in mothers and cord blood and associated factors in health-care settings in Lao People's Democratic Republic. Vaccine 2020; 38(5):1234-1240.
14. World Health Organization - WHO. Maternal and Neonatal Tetanus Elimination (MNTE). Available from: https://www.who.int/immunization/diseases/MNTE_initiative/en/ (last accessed on 05 February 2020)
15. World Health Organization - WHO. Validation of maternal and neonatal tetanus elimination in the Democratic Republic of the Congo.Weekly Epidemiological Record (WER) 2019; 94 (44): 505–512. Available from http://www.who.int/wer (last accessed on 05 February 2020)
16. UNICEF. Maternal and newborn health. Available from: https://www.unicef.org/health/maternal-and-newborn-health (last accessed on 05 February 2020)
17. European Centre for Disease Prevention and Control. Tetanus. Annual epidemiological report for 2017. Stockholm: ECDC;2019. Available from: https://www.ecdc.europa.eu/en/publications-data/tetanus-annual-epidemiological-report-2017 (last accessed on 05 February 2020)
18. Piano Nazionale Prevenzione Vaccinale 2017-19. Available from:
http://www.salute.gov.it/imgs/C_17_pubblicazioni_2571_allegato.pdf (last accessed on 05 February 2020)
19. XXVIII Rapporto Immigrazione 2018-2019 Caritas e Migrantes. Non si tratta solo di Migranti.
Available from: https://www.migrantes.it/wp-content/uploads/sites/50/2019/09/XXVIII-Rapporto-Immigrazione-2018-2019-Sintesi.pdf (last accessed on 05 February 2020)
20. Giambi C, Del Manso M, Marchetti G, Olsson K, Ali K.A, Declich S. Immunisation of migrants
in EU/EEA countries: Policies and practices. Vaccine 2019; 37:5439–5451.
21. LEGGE 6 marzo 1998, n. 40 art. 32. Disciplina dell'immigrazione e norme sulla condizione
dello straniero. Gazzetta Ufficiale n. 59 del 12 marzo 1998 - Supplemento Ordinario n. 40
Available from: https://www.camera.it/parlam/leggi/98040l.htm (last accessed on 05 February 2020)
22. Ministero della Salute. Assistenza sanitaria italiani all'estero e stranieri in Italia. Available from:
http://www.salute.gov.it/portale/temi/p2_4.jsp?lingua=italiano&area=Assistenza%20sanitaria (last accessed on 05 February 2020)
23. Vitale F, Bonanni P. La profilassi vaccinale nella popolazione immigrata adulta: priorità e proposta di calendario. Italian Journal of Public Health 2011; 8 (3):S34-S38.
24. Ferro A, Chiamenti G. La prevenzione nel bambino immigrato. Italian Journal of Public Health 2011; 8(3):S39-S47.
25. Mipatrini, D, Stefanelli, P, Severoni, S, Rezza G. Vaccinations in migrants and refugees: A
challenge for European health systems. A systematic review of current scientific evidence. Pathog. Glob. Health 2017; 111:59–68.
26. Hui C, Dunn J, Morton R, Staub L.P, Tran A, Hargreaves S et al. Interventions to Improve Vaccination Uptake and Cost Effectiveness of Vaccination Strategies in Newly Arrived Migrants in the EU/EEA: A Systematic Review. Int. J. Environ. Res. Public Health 2018; 15:2065-2077.
27. World Health Organization - WHO Immunological Basis for Immunization Series Module 3: Tetanus Update 2018. Available from:
https://www.who.int/immunization/documents/ISBN9789241513616/en/ (last accessed on 05 February 2020)
28. World Health Organization – WHO. Tetanus vaccines: WHO position paper. February 2017. Weekly Epidemiological Record (WER) 2017; 92(6): 53–76. Available from: http://www.who.int/wer (last accessed on 05 February 2020)
29. Global Vaccine Action Plan 2019 Regional reports on progress towards GVAP-RVAP goals. Available from: https://www.who.int/immunization/sage/meetings/2019/october/4_3450-OMS-IVB-GVAP2019-SecretariatReport-20190906-v3-rev.pdf (last accessed on 05 February 2020)
30. World Health Organization – WHO. National Passive Surveillance. Tetanus. Available from:
https://www.who.int/immunization/monitoring_surveillance/burden/vpd/surveillance_type/passive/tetanus/en (last accessed on 05 February 2020)
31. WHO-UNICEF. Progress and Challenges with Achieving Universal Immunization Coverage. Available from: https://www.who.int/immunization/monitoring_surveillance/who-immuniz.pdf (last accessed on 05 February 2020)
32. Rapisarda V, Bracci M, Nunnari G, Ferrante M, Ledda C. Tetanus immunity in construction workers in Italy . Occupational Medicine 2014; 64: 217-219.
33. Riccò M, Vezzosi L, Cella C, Pecoraro M, Novembre G, Moreo A et al. Tetanus vaccination status in construction workers: results from an institutional surveillance campaign. Acta Biomed. 2019; 90(2): 269-278.
34. Riccò M, Cattani S, Veronesi L, Colucci ME. Knowledge, attitudes, beliefs and practices of construction workers towards tetanus vaccine in Northern Italy. Ind Health. 2016; 54:554–564.
35. Van der Wal MF, Diepenmaat AC, Pel JM, Hirasing RA. Vaccination rates in a multicultural population. Arch Dis Child. 2005;90(1): 36-40.
36. Affanni P, Veronesi L, Rizziero S, Bizzoco S, Bracchi MT, Tanzi ML. Status of immunity against poliomyelitis: a study among European and extra-European young immigrants living in Parma. Acta Biomed 2005; 76:157-163.
37. Veronesi L, Virdis R, Bizzoco S, Colucci ME, Affanni P, Paganuzzi F et.al. Vaccination status and prevalence of enteric viruses in internationally adopted children. The case of Parma, Italy.
Acta Biomed. 2011; 82(3):208-13
38. Veronesi L, Affanni P, Verrotti di Pianella C, Colucci ME, Tanzi ML. Immunity status against poliomyelitis in childbearing women in a province of northern Italy. A cross-sectional analysis. Ann IG. 2003; 25(5):427-433.
39. Böhmer MM, Walter D, Krause G, Müters S, Gösswald A, Wichmann O. Determinants of tetanus and seasonal influenza vaccine uptake in adults living in Germany. Hum Vaccin.2011; 7(12):1317-25.
40. Toikkanen SE, Baillot A, Dreesman J, Mertens, E. Seroprevalence of antibodies against Measles, Rubella and Varicella among asylum seekers arriving in Lower Saxony, Germany, November 2014–October 2015. Int. J. Environ. Res. Public Health 2016; 13: E650.
41. Freidl G.S, Tostmann A, Curvers M, Ruijs W.L.M, Smits G, Schepp R et al. Immunity against measles, mumps, rubella, varicella, diphtheria, tetanus, polio, hepatitis A and hepatitis B among adult asylum seekers in The Netherlands, 2016. Vaccine 2018; 36:1664–1672.
42. Rizzo C, Bella A, Alfonsi V, Puzelli S, Palmieri AP, Chironna M et al. Influenza vaccine effectiveness in Italy: Age, subtype-specific and vaccine type estimates 2014/15 season. Vaccine. 2016;34(27):3102-3108.
43. Nakken C.S, Skovdal M, Nellums L.B, Friedland J.S.; Hargreaves, S.; Norredam, M. Vaccination status and needs of asylum-seeking children in Denmark: A retrospective data analysis. Public Health 2018; 158:110–116.
44. Ianiro G, Recanatini C, D'Errico M.M, Monini M, Pagani, E, Moroder L et al. Uncommon G9P[4] group A rotavirus strains causing dehydrating diarrhea in young children in Italy. Infection, Genetics and Evolution 2018; 64:57-64.
45. Chiapponi C, Ebranati E, Pariani E, Faccini S, Luppi A, Baioni L et al. Genetic analysis of human and swine influenza A viruses isolated in Northern Italy during 2010-2015. Zoonoses Public Health. 2018;65(1):114-123.
46. Veronesi L, Colucci ME, Capobianco E, Bracchi MT, Zoni R, Palandri L et al. Immunity status against poliomyelitis in young migrants: a seroprevalence study. Acta Biomed. 2019; 90(9-S): 28-34.
47. Stefanelli P, Bellino S, Fiore S, Fontana S, Amato C, Buttinelli G, Ansaldi F et al. Hospital discharges-based search of acute flaccid paralysis cases 2007-2016 in Italy and comparison with the National Surveillance System for monitoring the risk of polio reintroduction. BMC Public Health 2019; 19:1532.
48. Bellino S, Bella A, Puzelli S, Di Martino A, Facchini M, Punzo O et al. Moderate influenza vaccine effectiveness against A(H1N1)pdm09 virus, and low effectiveness against A(H3N2) subtype, 2018/19 season in Italy. Expert Rev Vaccines. 2019;18(11):1201-1209.
49. Ianiro G, Micolano R, Di Bartolo I, Scavia G, Monini M, RotaNet-Italy Study Group. Group A rotavirus surveillance before vaccine introduction in Italy, September 2014 to August 2017. Euro Surveill. 2019(15).
50. Moura S, Martins MR. Determinants of tetanus vaccination among adult immigrants findings from the Portuguese National Health Survey 2014. Int J Res Public Health 2019; 16:1619-1628.
51. Colucci ME, Veronesi L, Bracchi MT, Zoni R, Caruso L, Capobianco E et al. On field vaccine effectiveness in three periods of 2018/2019 influenza season in Emilia-Romagna Region. Acta Biomed. 2019; 90(9-S):21-27.
52. Puzelli S, Di Martino A, Facchini M, Fabiani C, Calzoletti L, Di Mario G et al. Co-circulation of the two influenza B lineages during 13 consecutive influenza surveillance seasons in Italy, 2004-2017. BMC Infect Dis. 2019;19(1):990.
53. Affanni P, Colucci ME, Bracchi MT, Capobianco E, Zoni R, Caruso L et al. Virological Surveillance of Influenza in the eight epidemic seasons after the 2009 pandemic in Emilia-Romagna (Northern Italy). Acta Biomed. 2019; 90(9-S):35-44.
54. Colucci ME, Cantarelli A, Caruso L, Bracchi MT, Capobianco e et al. Influenza vaccine effectiveness in children: the eight seasons post-pandemic study with trivalent inactivated vaccine. Acta Biomed. 2020; X(X):X-X.
55. Palandri L, Morgado M, Colucci ME, Affanni P, Zoni R, Mezzetta S et al. Reorganization of
Active Surveillance of Acute Flaccid Paralysis (AFP) in Emilia-Romagna, Italy: a two-step Public
Health intervention. Acta Biomed. 2020; X(X):X-X.
56. Tchidjou HK, Gargiullo L, Vescio F, Giampaolo R, Nicolosi L, Finocchi A et al. Immunization
status of internationally adopted children in Rome, Italy. Nigerian Journal of Clinical Practice 2015; 18 (3):307-311.
57. Signorelli C, Odone A, Cella P, Iannazzo S, D’Ancona F, Guerra R. Infant immunization coverage in Italy (2000-2016). Ann Ist Super Sanità 2017;53(3):231-237.
58. Ministero della Salute. Vaccinazioni dell'età pediatrica e dell'adolescente - Coperture vaccinali Available from: http://www.salute.gov.it/portale/documentazione/p6_2_8_3_1.jsp?lingua=italiano&id=20 (last accessed on 05 February 2020)
59. Paxton GA, Rice J, Davie G, Carapetis JR, Skull SA. East African immigrant children in Australia have poor immunisation coverage. J Paediatr Child Health. 2011;47(12):888-892.
2. Centers for Disease Control and Prevention - CDC. Epidemiology and Prevention of Vaccine-Preventable Diseases. The Pink Book: Course Textbook - 13th Edition (2015). Chapter 21: Tetanus. Available from: https://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html (last accessed on 05 February 2020)
3. Fine P.E.M. Herd Immunity: History, Theory, Practice. Epidemiologic Reviews 1993; 15(2): 265–302.
4. Thwaites CL, Loan H.T. Eradication of tetanus. Br Med Bull. 2015; 116:68–77.
5. Lam M.Y, Thwaites C.L. Tetanus. Lancet 2019; 393:1657-1668.
6. World Health Organization – WHO. Vaccine‐Preventable Diseases: Monitoring System. 2019. Available from: http://apps.who.int/immunization_monitoring/globalsummary (last accessed on 05 February 2020)
7. Behrens H, Ochmann S, Dadonaite B, Roser M. Tetanus. Available from: https://ourworldindata.org/tetanus (last accessed on 05 February 2020)
8. Valentino M, Rapisarda V. Tetanus in a central Italian region: scope for more effective prevention among unvaccinated agricultural workers. Occup Med (Lond) 2001; 51:114–117.
9. Pedalino B, Cotter B, Ciofi degli Atti M, Mandolini D, Parroccini S, Salmaso S. Epidemiology of tetanus in Italy in years 1971-2000. Euro surveill 2002; 7:103-110.
10. Filia A, Bella A, von Hunolsteinb C, Pinto A, Alfarone G, Declicha S et al. Tetanus in Italy 2001–2010: A continuing threat in older adults. Vaccine 2014; 32:639– 644.
11. Weinberger B. Adult vaccination against tetanus and diphtheria: the European perspective. Clin Exp Immunol. 2017; 187:93-99.
12. Brabin L, Fazio-Tirrozzo G, Shahid S, Agbaje O, Maxwel1 S, Broadhead R et al. Tetanus antibody levels among adolescent girls in developing countries. Transaction of the Royal Society of Tropical Medicine and Hygiene 2000; 94:455-459.
13. Ounnavong P, Chanthavilay P, Khampanisong P, Reinharz D, Muller CP, Black AP. Seroprevalence of anti-tetanus antibodies in mothers and cord blood and associated factors in health-care settings in Lao People's Democratic Republic. Vaccine 2020; 38(5):1234-1240.
14. World Health Organization - WHO. Maternal and Neonatal Tetanus Elimination (MNTE). Available from: https://www.who.int/immunization/diseases/MNTE_initiative/en/ (last accessed on 05 February 2020)
15. World Health Organization - WHO. Validation of maternal and neonatal tetanus elimination in the Democratic Republic of the Congo.Weekly Epidemiological Record (WER) 2019; 94 (44): 505–512. Available from http://www.who.int/wer (last accessed on 05 February 2020)
16. UNICEF. Maternal and newborn health. Available from: https://www.unicef.org/health/maternal-and-newborn-health (last accessed on 05 February 2020)
17. European Centre for Disease Prevention and Control. Tetanus. Annual epidemiological report for 2017. Stockholm: ECDC;2019. Available from: https://www.ecdc.europa.eu/en/publications-data/tetanus-annual-epidemiological-report-2017 (last accessed on 05 February 2020)
18. Piano Nazionale Prevenzione Vaccinale 2017-19. Available from:
http://www.salute.gov.it/imgs/C_17_pubblicazioni_2571_allegato.pdf (last accessed on 05 February 2020)
19. XXVIII Rapporto Immigrazione 2018-2019 Caritas e Migrantes. Non si tratta solo di Migranti.
Available from: https://www.migrantes.it/wp-content/uploads/sites/50/2019/09/XXVIII-Rapporto-Immigrazione-2018-2019-Sintesi.pdf (last accessed on 05 February 2020)
20. Giambi C, Del Manso M, Marchetti G, Olsson K, Ali K.A, Declich S. Immunisation of migrants
in EU/EEA countries: Policies and practices. Vaccine 2019; 37:5439–5451.
21. LEGGE 6 marzo 1998, n. 40 art. 32. Disciplina dell'immigrazione e norme sulla condizione
dello straniero. Gazzetta Ufficiale n. 59 del 12 marzo 1998 - Supplemento Ordinario n. 40
Available from: https://www.camera.it/parlam/leggi/98040l.htm (last accessed on 05 February 2020)
22. Ministero della Salute. Assistenza sanitaria italiani all'estero e stranieri in Italia. Available from:
http://www.salute.gov.it/portale/temi/p2_4.jsp?lingua=italiano&area=Assistenza%20sanitaria (last accessed on 05 February 2020)
23. Vitale F, Bonanni P. La profilassi vaccinale nella popolazione immigrata adulta: priorità e proposta di calendario. Italian Journal of Public Health 2011; 8 (3):S34-S38.
24. Ferro A, Chiamenti G. La prevenzione nel bambino immigrato. Italian Journal of Public Health 2011; 8(3):S39-S47.
25. Mipatrini, D, Stefanelli, P, Severoni, S, Rezza G. Vaccinations in migrants and refugees: A
challenge for European health systems. A systematic review of current scientific evidence. Pathog. Glob. Health 2017; 111:59–68.
26. Hui C, Dunn J, Morton R, Staub L.P, Tran A, Hargreaves S et al. Interventions to Improve Vaccination Uptake and Cost Effectiveness of Vaccination Strategies in Newly Arrived Migrants in the EU/EEA: A Systematic Review. Int. J. Environ. Res. Public Health 2018; 15:2065-2077.
27. World Health Organization - WHO Immunological Basis for Immunization Series Module 3: Tetanus Update 2018. Available from:
https://www.who.int/immunization/documents/ISBN9789241513616/en/ (last accessed on 05 February 2020)
28. World Health Organization – WHO. Tetanus vaccines: WHO position paper. February 2017. Weekly Epidemiological Record (WER) 2017; 92(6): 53–76. Available from: http://www.who.int/wer (last accessed on 05 February 2020)
29. Global Vaccine Action Plan 2019 Regional reports on progress towards GVAP-RVAP goals. Available from: https://www.who.int/immunization/sage/meetings/2019/october/4_3450-OMS-IVB-GVAP2019-SecretariatReport-20190906-v3-rev.pdf (last accessed on 05 February 2020)
30. World Health Organization – WHO. National Passive Surveillance. Tetanus. Available from:
https://www.who.int/immunization/monitoring_surveillance/burden/vpd/surveillance_type/passive/tetanus/en (last accessed on 05 February 2020)
31. WHO-UNICEF. Progress and Challenges with Achieving Universal Immunization Coverage. Available from: https://www.who.int/immunization/monitoring_surveillance/who-immuniz.pdf (last accessed on 05 February 2020)
32. Rapisarda V, Bracci M, Nunnari G, Ferrante M, Ledda C. Tetanus immunity in construction workers in Italy . Occupational Medicine 2014; 64: 217-219.
33. Riccò M, Vezzosi L, Cella C, Pecoraro M, Novembre G, Moreo A et al. Tetanus vaccination status in construction workers: results from an institutional surveillance campaign. Acta Biomed. 2019; 90(2): 269-278.
34. Riccò M, Cattani S, Veronesi L, Colucci ME. Knowledge, attitudes, beliefs and practices of construction workers towards tetanus vaccine in Northern Italy. Ind Health. 2016; 54:554–564.
35. Van der Wal MF, Diepenmaat AC, Pel JM, Hirasing RA. Vaccination rates in a multicultural population. Arch Dis Child. 2005;90(1): 36-40.
36. Affanni P, Veronesi L, Rizziero S, Bizzoco S, Bracchi MT, Tanzi ML. Status of immunity against poliomyelitis: a study among European and extra-European young immigrants living in Parma. Acta Biomed 2005; 76:157-163.
37. Veronesi L, Virdis R, Bizzoco S, Colucci ME, Affanni P, Paganuzzi F et.al. Vaccination status and prevalence of enteric viruses in internationally adopted children. The case of Parma, Italy.
Acta Biomed. 2011; 82(3):208-13
38. Veronesi L, Affanni P, Verrotti di Pianella C, Colucci ME, Tanzi ML. Immunity status against poliomyelitis in childbearing women in a province of northern Italy. A cross-sectional analysis. Ann IG. 2003; 25(5):427-433.
39. Böhmer MM, Walter D, Krause G, Müters S, Gösswald A, Wichmann O. Determinants of tetanus and seasonal influenza vaccine uptake in adults living in Germany. Hum Vaccin.2011; 7(12):1317-25.
40. Toikkanen SE, Baillot A, Dreesman J, Mertens, E. Seroprevalence of antibodies against Measles, Rubella and Varicella among asylum seekers arriving in Lower Saxony, Germany, November 2014–October 2015. Int. J. Environ. Res. Public Health 2016; 13: E650.
41. Freidl G.S, Tostmann A, Curvers M, Ruijs W.L.M, Smits G, Schepp R et al. Immunity against measles, mumps, rubella, varicella, diphtheria, tetanus, polio, hepatitis A and hepatitis B among adult asylum seekers in The Netherlands, 2016. Vaccine 2018; 36:1664–1672.
42. Rizzo C, Bella A, Alfonsi V, Puzelli S, Palmieri AP, Chironna M et al. Influenza vaccine effectiveness in Italy: Age, subtype-specific and vaccine type estimates 2014/15 season. Vaccine. 2016;34(27):3102-3108.
43. Nakken C.S, Skovdal M, Nellums L.B, Friedland J.S.; Hargreaves, S.; Norredam, M. Vaccination status and needs of asylum-seeking children in Denmark: A retrospective data analysis. Public Health 2018; 158:110–116.
44. Ianiro G, Recanatini C, D'Errico M.M, Monini M, Pagani, E, Moroder L et al. Uncommon G9P[4] group A rotavirus strains causing dehydrating diarrhea in young children in Italy. Infection, Genetics and Evolution 2018; 64:57-64.
45. Chiapponi C, Ebranati E, Pariani E, Faccini S, Luppi A, Baioni L et al. Genetic analysis of human and swine influenza A viruses isolated in Northern Italy during 2010-2015. Zoonoses Public Health. 2018;65(1):114-123.
46. Veronesi L, Colucci ME, Capobianco E, Bracchi MT, Zoni R, Palandri L et al. Immunity status against poliomyelitis in young migrants: a seroprevalence study. Acta Biomed. 2019; 90(9-S): 28-34.
47. Stefanelli P, Bellino S, Fiore S, Fontana S, Amato C, Buttinelli G, Ansaldi F et al. Hospital discharges-based search of acute flaccid paralysis cases 2007-2016 in Italy and comparison with the National Surveillance System for monitoring the risk of polio reintroduction. BMC Public Health 2019; 19:1532.
48. Bellino S, Bella A, Puzelli S, Di Martino A, Facchini M, Punzo O et al. Moderate influenza vaccine effectiveness against A(H1N1)pdm09 virus, and low effectiveness against A(H3N2) subtype, 2018/19 season in Italy. Expert Rev Vaccines. 2019;18(11):1201-1209.
49. Ianiro G, Micolano R, Di Bartolo I, Scavia G, Monini M, RotaNet-Italy Study Group. Group A rotavirus surveillance before vaccine introduction in Italy, September 2014 to August 2017. Euro Surveill. 2019(15).
50. Moura S, Martins MR. Determinants of tetanus vaccination among adult immigrants findings from the Portuguese National Health Survey 2014. Int J Res Public Health 2019; 16:1619-1628.
51. Colucci ME, Veronesi L, Bracchi MT, Zoni R, Caruso L, Capobianco E et al. On field vaccine effectiveness in three periods of 2018/2019 influenza season in Emilia-Romagna Region. Acta Biomed. 2019; 90(9-S):21-27.
52. Puzelli S, Di Martino A, Facchini M, Fabiani C, Calzoletti L, Di Mario G et al. Co-circulation of the two influenza B lineages during 13 consecutive influenza surveillance seasons in Italy, 2004-2017. BMC Infect Dis. 2019;19(1):990.
53. Affanni P, Colucci ME, Bracchi MT, Capobianco E, Zoni R, Caruso L et al. Virological Surveillance of Influenza in the eight epidemic seasons after the 2009 pandemic in Emilia-Romagna (Northern Italy). Acta Biomed. 2019; 90(9-S):35-44.
54. Colucci ME, Cantarelli A, Caruso L, Bracchi MT, Capobianco e et al. Influenza vaccine effectiveness in children: the eight seasons post-pandemic study with trivalent inactivated vaccine. Acta Biomed. 2020; X(X):X-X.
55. Palandri L, Morgado M, Colucci ME, Affanni P, Zoni R, Mezzetta S et al. Reorganization of
Active Surveillance of Acute Flaccid Paralysis (AFP) in Emilia-Romagna, Italy: a two-step Public
Health intervention. Acta Biomed. 2020; X(X):X-X.
56. Tchidjou HK, Gargiullo L, Vescio F, Giampaolo R, Nicolosi L, Finocchi A et al. Immunization
status of internationally adopted children in Rome, Italy. Nigerian Journal of Clinical Practice 2015; 18 (3):307-311.
57. Signorelli C, Odone A, Cella P, Iannazzo S, D’Ancona F, Guerra R. Infant immunization coverage in Italy (2000-2016). Ann Ist Super Sanità 2017;53(3):231-237.
58. Ministero della Salute. Vaccinazioni dell'età pediatrica e dell'adolescente - Coperture vaccinali Available from: http://www.salute.gov.it/portale/documentazione/p6_2_8_3_1.jsp?lingua=italiano&id=20 (last accessed on 05 February 2020)
59. Paxton GA, Rice J, Davie G, Carapetis JR, Skull SA. East African immigrant children in Australia have poor immunisation coverage. J Paediatr Child Health. 2011;47(12):888-892.
Downloads
Published
10-04-2020
Issue
Section
ORIGINAL ARTICLES
License
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
How to Cite
1.
Affanni P, Colucci ME, Capobianco E, Bracchi MT, Zoni R, Viani I, et al. Immunity status against tetanus in young migrants: a seroprevalence study . Acta Biomed [Internet]. 2020 Apr. 10 [cited 2024 Jul. 3];91(3-S):77-84. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/9438
