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      Rubella Seroprevalence Boost in the Pediatric and Adolescent Population of Florence (Italy) as a Preventive Strategy for Congenital Rubella Syndrome (CRS)

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          Abstract

          Background: Despite the availability of an effective vaccine since the 1970s, rubella disease and, importantly, congenital rubella syndrome (CRS) remain a public health concern. The aim of this study was to analyze the rubella seroprevalence in the children population of the province of Florence and compare the obtained results to a previous survey conducted in 2005–2006. Methods: A qualitative measurement of anti-rubella antibodies was performed on 165 sera using the enzyme-linked immunosorbent Assay (ELISA). The anamnestic and vaccination status was also collected. Results: Our study highlighted a very high rubella seroprevalence (85–100%) in our enrolled population. In the vaccinated group (153/165), 98.7% of them were positive to rubella antibodies. Conclusions: Our study showed the highest seroprevalence rate reached in the province of Florence for rubella in the last 15 years, thanks to the several successful vaccination campaigns promoted in the Tuscany region. Our findings in pediatric and adolescent subjects are a key factor in preventing CRS in adult life, specifically in childbearing women. Thus, the set goal will be to keep the awareness about the vaccination for this preventable disease high.

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          Rubella.

          Rubella remains an important pathogen worldwide, with roughly 100,000 cases of congenital rubella syndrome estimated to occur every year. Rubella-containing vaccine is highly effective and safe and, as a result, endemic rubella transmission has been interrupted in the Americas since 2009. Incomplete rubella vaccination programmes result in continued disease transmission, as evidenced by recent large outbreaks in Japan and elsewhere. In this Seminar, we provide present results regarding rubella control, elimination, and eradication policies, and a brief review of new laboratory diagnostics. Additionally, we provide novel information about rubella-containing vaccine immunogenetics and review the emerging evidence of interindividual variability in humoral and cell-mediated innate and adaptive immune responses to rubella-containing vaccine and their association with haplotypes and single-nucleotide polymorphisms across the human genome.
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            Addressing the anti-vaccination movement and the role of HCWs.

            Over the last two decades, growing numbers of parents in the industrialized world are choosing not to have their children vaccinated. Trying to explain why this is occurring, public health commentators refer to the activities of an anti-vaccination movement. The aim of this paper is to review the literature about the anti-vaccination movements and to highlight the knowledge and the skills needed for HCWs to fight against their ideas. The main theoretical structures of anti-vaccination ideology in the 19th and 20th centuries are: vaccines cause idiopathic illness; opponents against vaccines accused vaccine partisans to be afraid of the "search after truth," they fear unveiling errors; the vaccination law not only insults every subject of the realm, but also it insults every human being; vaccine immunity is temporary; an alternative healthy lifestyle, personal hygiene and diet stop diseases. Proponents against vaccination now have additional means to communicate their positions to the general public, the Internet in particular. Doctors and HCWs constantly have to face parents and patients who search information about vaccination. A lot of these people have previously found data about vaccinations from a lot of sources, such as papers, media or in websites and in these sources most contents come from anti-vaccine movements. For these reasons doctors and HCWs need to have updated knowledge about the vaccinations and to know the contents proposed by vaccine sceptics. Educating the general public cannot be fully effective unless there is a corresponding provision, enthusiasm and commitment by trained HCWs.
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              Congenital cataract following German measles in the mother

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                Author and article information

                Journal
                Vaccines (Basel)
                Vaccines (Basel)
                vaccines
                Vaccines
                MDPI
                2076-393X
                12 October 2020
                December 2020
                : 8
                : 4
                : 599
                Affiliations
                [1 ]Department of Health Sciences, University of Florence, 50134 Florence, Italy; beatrice.zanella@ 123456unifi.it (B.Z.); sara.boccalini@ 123456unifi.it (S.B.); benedetta.bonito@ 123456unifi.it (B.B); emilia.tiscione@ 123456unifi.it (E.T.); paolo.bonanni@ 123456unifi.it (P.B.)
                [2 ]Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; marco.delriccio@ 123456unifi.it (M.D.R.); federico.manzi@ 123456unifi.it (F.M.); alessandra.ninci@ 123456unifi.it (W.D.G.)
                [3 ]Meyer Children’s Hospital, 50139 Florence, Italy; francesco.puggelli@ 123456meyer.it
                [4 ]AUSL Toscana Centro, 50122 Florence, Italy; giovanna.mereu@ 123456uslcentro.toscana.it
                Author notes
                [* ]Correspondence: angela.bechini@ 123456unifi.it ; Tel.: +39-055-2751081
                [†]

                Working Group DHS: Jacopo Bianchi, Ilaria Biondi, Martina Chellini, Maddalena Innocenti, Federico Manzi, Alessandra Ninci, Diana Paolini, Gino Sartor.

                [‡]

                Working Group AOUMeyer: Francesco Puggelli, Paola Barbacci, Antonino Sala, Francesca Bellini, Roberto Schiatti, Sonia Muricci.

                [§]

                Working Group AUSLTC: Lorenzo Baggiani, Monica Della Fonte, Giorgio Garofalo, Giovanna Mereu, Simonetta Baretti, Maria Grazia Santini.

                Author information
                https://orcid.org/0000-0001-6718-1932
                https://orcid.org/0000-0002-9695-7549
                https://orcid.org/0000-0002-6116-8777
                https://orcid.org/0000-0002-2742-0297
                https://orcid.org/0000-0002-6013-8779
                Article
                vaccines-08-00599
                10.3390/vaccines8040599
                7712445
                33053851
                916066e9-8528-4fc7-8943-e47ddae41164
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 16 September 2020
                : 09 October 2020
                Categories
                Article

                rubella,crs,vaccination coverage,pediatric,adolescent,seroprevalence,italy,florence,mmrv vaccination,elimination

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