From autumn the flu will hit hard, but only one in two elderly people gets vaccinated

The flu could come back to hit hard after last year's record with over 16 million Italians ending up in bed. The warnings of a season at risk, especially for the elderly, come from the other side of the planet, that is, from the southern hemisphere, where in Australia in the middle of the winter season there is a boom in cases and growing numbers that have put hospitals in serious difficulty where - with infections up by 70% and hospitalisations up by 50% in a fortnight - beds are scarce. A picture, infectivologists warn, that in all likelihood could soon be replicated in Italy as early as the autumn: in fact, a mix of influenza viruses is on the way, including the B strain, for which there is less coverage. Hence the call by experts to get vaccinated in view of a season that promises to be 'heavy', to avert the most serious consequences, given that influenza in the most intense seasons reaches 8-10 thousand deaths and thousands of hospitalisations, to which are added those for Covid.

The problem is that for some years now in Italy there has been a real flight from the vaccine. And this phenomenon also concerns the most vulnerable - the over-65s - since by now practically only one out of every two elderly people is vaccinated against influenza, with a decline that has been constant for some years now: in the last 2024-2025 vaccination campaign - as reported to Il Sole 24 Ore by the Ministry of Health - the over-65s who immunised themselves against influenza fell to a meagre 52.5%, compared to 53.3% the year before and 56.7% in 2022-2023. Numbers are steadily decreasing and far from the 65.3% achieved at the height of the pandemic - in 2020-21 - and still far from the minimum target of 75% indicated by the WHO for this vaccination (the ideal would be 95%). On the other hand, vaccinations in the general population rose slightly to 19.6% (it was 18.9% the year before).

But why this flight? It is due to a mix of causes: certainly vaccination fatigue after the pandemic - vaccinations against SarsCoV2 are now practically zero - mixed with the prejudices that hold sway over vaccines, as demonstrated by the recent controversy over the commission of experts (Nitag) later revoked by Health Minister Orazio Schillaci, and the delays in the recent past of the Regions in getting the network of pharmacies and doctors' offices to immunise off the ground. The latter is a risk that the Ministry of Health no longer wants to take, and last July it issued a circular with the indications for the next vaccination campaign: it will start in early October, with the ambitious goal of reaching at least 75% of the elderly and frail. The vaccine will be offered free of charge to the over 60s, children, the chronically ill, pregnant women, and health workers, but also, 'after covering priorities', to anyone who requests it.

"We expect the first cases of influenza in early October with the co-circulation of various influenza viruses together with the respiratory syncytial virus and the SarsCoV2 virus. As is happening in Australia, in addition to the A H1N1 strain, the B Victoria flu strain will also be circulating this year, to which there is less coverage and which could therefore lead to more infections. Both influenza strains are however included in the flu vaccine. This is why, especially for frail individuals, immunisation is important to reduce the heaviest effects of infection," warns Fabrizio Pregliasco, director of the School of Specialisation in Hygiene and Preventive Medicine at the University of Milan. "As we know, vaccination is the most effective form of prevention against influenza and its complications, which mainly affect the most vulnerable segments of the population such as the over 60s or pregnant women. With our circular we have recommended that the Regions strengthen the involvement of family doctors and paediatricians, hospital and healthcare professionals, and the Associations of the sick, citizens and the elderly on the importance of vaccination in people with risk conditions," emphasises Maria Rosaria Campitiello head of the Prevention Department of the Ministry of Health, who signed the circular, which also provides specific paths "to ensure the vaccination offer in in-patient and long-term care facilities or residential facilities for the elderly", also continuing "the experiences of active involvement of pharmacies".