Healthcare workers, immunization and safety issues: reflections from Italy.

We have read with interest the article by Quach et al, recently published in your authoritative journal. Many health care and public health organizations have introduced measures to encourage flu immunization coverage of health care workers (HCW), and some of them are implementing strategies in order to provide an adequate monitoring benchmarking. To the light of the importance of HCW in infectious disease control, we would like lo lake the opportunity to highlight the role of immuniza¬tion, in different communicable disease, because we think that the efforts directed lo flu should be combined to those directed to the prevention of others vaccine preventable disease. In this context, we could make the example of measles as one of the most transmittable diseases, which had undergone an apparent underestimation, and has been recently the cause of outbreaks in health care institutions in Europe. In fact, it is not surprising that HCW are at higher risk than the general population for becoming infected with different infectious diseases; however, it should be not neglected that transmission occurs within medical facilities because of HCW. Nevertheless, attitudes and practices of HCWs in Europe appear at times erratic: the misconception that measles is not a serious threat to health persists, not only among the parents of young children, but also among health care providers. Despite the public health efforts in sustaining the coverage for MPR vaccination, and refusing any link between MPR vaccine and autism, we must report the recent sentence made by an Italian court that MPR vaccine had caused autism in a boy, which has erroneously contributed to the claims of those refusing immunization. These events are even more important when vaccines are declined in regions where potentially preventable disease are emerging, or re-emerging because of climatic changes, such as in Italy. In conclusion. we think that the importance of appropriateness of vaccination coverage should be addressed to the light of the WHO eradication goal of measles, and it is very unlikely that this will be achieved by 2015. Our efforts in improving HCW knowledge, attitude, and behavior should be ameliorated if we want to achieve a goal that has been missed in the past and seems so difficult to achieve in the near future.