Gripa poate provoca leziuni severe, inclusiv declansarea infarctului miocardic si pneumoniei ¹²³⁴

Organizatia Mondiala a Sanatatii recomanda intensificarea campaniei de vaccinare antigripala ⃰

MOTIVE PENTRU A PRIORITIZA VACCINAREA ANTIGRIPALA PENTRU POPULATIA LA RISC

Protectie impotriva complicatiilor severe

Protejarea populatiilor vulnerabile (inclusiv persoanele in varsta, persoanele cu multiple comorbiditati si imunodeprimate) de potentialele complicatii severe ale gripei ar trebui sa fie o prioritate pentru a salva vieti si pentru a sprijini sustenabilitatea sistemelor de sanatate.

· In UE, se estimeaza ca vaccinarea impotriva gripei sezoniere previne pana la 65.600 de spitalizari, 37.200 de decese si 844.700 de zile de munca pierdute in fiecare an⁵.

· Pana la 1 din 3 adulti in varsta spitalizati cu gripa dezvolta pneumonie⁶. Recuperarea in cazul pneumoniei este de obicei de 10 zile⁷, dar pentru un adult in varsta cu comorbiditati poate dura pana la 6-12 saptamani⁸.

· Grupurile la risc (cei cu boli cronice cardiace sau pulmonare, boli metabolice sau renale, sau imunodeficiente, precum si cei peste 65 de ani) au cu 51% mai multe sanse de a vizita un medic de familie si de 3 ori mai multe sanse de internare din cauza gripei, in comparatie cu cei cu putini sau fara factori de risc, in urma infectiei cu gripa sezoniera⁹.

Prevenirea bolilor netransmisibile

Gripa poate fi factor declansator pentru infarctul miocardic si exacerbarea diabetului. Vaccinarea antigripala poate proteja de aceste complicatii, reducand astfel povara asupra pacientilor individuali si a sistemelor de sanatate.

· Vaccinarea antigripala a demonstrat o eficacitate de 15-45% in prevenirea infarctului miocardic, similar cu masurile de rutina de prevenire a infarctului miocardic, cum ar fi renuntarea la fumat (32-43%), administrarea de statine (19-30%) si terapia antihipertensiva (17-25%)¹².

· Prezenta unei afectiuni cronice creste riscul de spitalizare din cauza gripei de doua ori ¹³.

· 1 din 10 varstnici spitalizati din cauza gripei se confrunta cu pierderea independentei¹⁴, 15% confruntandu-se cu o dizabilitate catastrofala ce implica o pierdere a independentei in mai mult de doua activitati de baza in autoingrijire ¹⁵.

Posibila crestere a numarului de infectii gripale

Expertii in sanatate publica si epidemiologie au atras atentia asupra unei posibile cresteri a numarului de infectii gripale dupa COVID-19. Cu sistemele de sanatate si economiile tarilor inca sub presiune, este vital pentru cat mai multi adulti vulnerabili sa fie protejati impotriva gripei si a consecintelor sale grave.

· Potrivit OMS, vaccinarea de rutina impotriva gripei sezoniere este vitala pentru a asigura pregatirea impotriva unor noi pandemii provocate de boli infectioase, aspect esential pentru consolidarea securitatii sanatatii globale¹⁰.

· Medicii epidemiologi sunt ingrijorati ca circulatia scazuta a virusului gripal, ca urmare a restrictiilor impuse in timpul pandemiei de COVID-19, ar fi putut duce la o pierdere a imunitatii care ar putea face lumea mai susceptibila la un focar de infectie. Fostul sef al programului de Gripa si alte virusuri respiratorii din cadrul Centrului European pentru Prevenirea si Controlul Bolilor (ECDC), Pasi Penttinen, a declarat ca riscul in acest an este ca gripa sa persiste mai mult decat in mod normal¹¹.

„Dovada protectiei dincolo de gripa ar trebui sa fie o noua cerinta standard de reglementare pentru vaccinurile gripale. Protejarea categoriilor de populatie vulnerabile de complicatiile gripei va duce la rezultate mai bune in materie de sanatate, eliminand costul spitalizarilor si al cheltuielilor medicale atat pentru indivizi, cat si pentru sistemul de sanatate. Totodata, va contribui la protejarea sanatatii publice si va permite oamenilor sa traiasca o viata implinita.”

Dr. Adrian Marinescu | Director Medical, Institutul National de Boli Infectioase „Prof. Dr. Matei Bals”

Referinte

⃰ WHO surveillance update #420 (30/5/22): https://cdn.who.int/media/docs/defaultsource/influenza/influenzaupdates/2022/2022_05_30_surveillance_update_420.pdf?sfvrsn=f5cee736_1&download=true

¹ Warren-Gash C, et al. Eur respir J. 2018 Mar 29;51(3):1701794

² Andrew MK et al. J Am Geriatr Soc. 2021 Mar;69(3):696-703

³ Samson et al. J Diabetes Sci Technol. 2019 Nov 20:1932296819883340

⁴ Kubale J, et al. Clin Infect Dis. 2021 Dec 6;73(11):e4288-e4295

⁵ Sanofi, Global Influenza Corporate Narrative. (2020). Data on file; Preaud E., Durand L., Macabeo B., Farkas N., Sloesen B., Palache A., Shupo F., Samson S.I., & Vaccines Europe influenza working group. (2014). Annual public health and economic benefits of seasonal influenza vaccination: a European estimate. BMC public health, 14, 813. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4141103/

⁶ Sanofi, Global Efluelda Fluzone HD Payer Value Proposition. February 2022. Data on file; Garg, S., Jain, S., Dawood, FS., Jhung M., Pérez A., et al. (2015). Pneumonia among adults hospitalized with laboratory-confirmed seasonal influenza virus infection—United States, 2005–2008. Garg, Shikha et al. “Pneumonia among adults hospitalized with laboratory-confirmed seasonal influenza virus infection-United States, 2005-2008.” BMC infectious diseases. 15: 369.

Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4550040/

⁷ Sanofi, Global Efluelda Fluzone HD Payer Value Proposition. February 2022. Data on file; Wootton, DG., Dickinson, L., Pertinez, H., Court, J., Eneje, O., Keogan, L., Macfarlane, L., Wilks, S., Gallagher, J., Woodhead, M., Gordon, SB. and Diggle, PJ. (2017). A longitudinal modelling study estimates acute symptoms of community acquired pneumonia recover to baseline by 10 days. The European Respiratory Journal, 49(6). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5898948/

⁸ Sanofi, Global Efluelda Fluzone HD Payer Value Proposition. February 2022. Data on file; El Solh, AA., Aquilina, AT., Gunen, H. & Ramadan, F. (2004). Radiographic Resolution of Community-Acquired Bacterial Pneumonia in the Elderly. Journal of the American Geriatrics Society, 52(2), pp.224–229.

Available at: https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-5415.2004.52059.x?sid=nlm%3Apubmed

⁹ Sanofi, Global Influenza Corporate Narrative. (2020). Data on file; Baguelin, M., Camacho, A., Flasche, S., Edmunds, W.J. (2015). Extending the elderly- and risk- group programme of vaccination against seasonal influenza in England and Wales; a cost-effectiveness study. BMC Med. 13: 236. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604076/

¹⁰ Sanofi, Global Influenza Corporate Narrative. (2020). Data on file; World Health Organization (WHO). (2019a). Global influenza strategy 2019-2030. Retrieved from http://apps.who.int/iris/bitstream/handle/10665/311184/9789241515320-eng.pdf?sequence=18

¹¹ Neville S and Bruce-Lockhart (2022). Health experts brace for flu surge after Covid curbs supress infections. Financial Times, 13 February 2022. Available at: https://www.ft.com/content/a693237b-554c-47d6-9e00-a01da2cee559

¹² Sanofi, Global Influenza Corporate Narrative. (2020). Data on file; MacIntyre C. R., Mahimbo A., Moa A. M., & Barnes M. (2016). Influenza vaccine as a coronary intervention for prevention of myocardial infarction. Heart, 102(24), 1953-1956. Available at: https://heart.bmj.com/content/102/24/1953.long

¹³ Sanofi, Global Influenza Corporate Narrative. (2020). Data on file ; Mertz, D., Kim, T.H., Johnstone, J., Lam, P.P., Science, M., Kuster, S.P., Fadel, S.A., Tran, D., Fernandez, E., Bhatnagar, N., & Loeb, M. (2013). Populations at risk for severe or complicated influenza illness: systematic review and meta- analysis. BMJ. Aug 2013; 347: f5061. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805492/

¹⁴ Sanofi, Global Influenza Corporate Narrative. (2020). Data on file; Andrew M.K., MacDonald S., Ye L., Ambrose A., Boivin G., Diaz-Mitoma F., et al. (2016) Impact of frailty on influenza vaccine effectiveness and clinical outcomes: Experience from the Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS) Network 2011/12 Season Canadian Immunization Conference, Ottowa, Ontario, Canada, Retrieved from: https://academic.oup.com/ofid/article/3/suppl_1/710/2637095

¹⁵ McElhaney JE., Verschoor CP., Andrew MK., et al. (2020). The immune response to influenza in older humans: beyond immune senescence. Immunity and Ageing, 17(10). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204009/