Immunization through vaccination is a milestone achievement that has made a tremendous contribution to public health. Historically, immunization programs aimed firstly to protect children, who were disproportionally affected by infectious diseases. However, vaccine-preventable diseases can have significant impacts on adult mortality, health, and quality of life. Despite this, adult vaccinations have historically been overlooked in favor of other health priorities, because their benefits to society were not well recognized. As the general population is aging, the issue of vaccination in older adults is gaining importance. In high-income countries, recommendations for the routine vaccination of older adults have been gradually introduced. The Italian National Immunization Plan is considered to be among the most advanced adult vaccination plans in Europe. However, available data indicate there is low adherence to vaccination recommendations in Italy. The COVID-19 pandemic has exposed the damage that can be caused by an infectious disease, especially among adults and individuals with comorbidities. The aim of this “Manifesto”, therefore, is to provide an overview of the existing evidence on the value of adult vaccination, in the Italian context, with a call to action to healthcare providers and health authorities.

Background/Objectives The economic impact of respiratory syncytial virus (RSV) in Italy is not well defined. This analysis assessed the economic outcomes of RSV-hospitalized patients aged ≥ 60 years in Italy. Methods: Healthcare resource utilization and direct healthcare costs during the first RSV hospitalization and 12-month follow-up were collected from Italian administrative databases. A propensity-score-matched (PSM) analysis was performed between patients hospitalized for RSV and those hospitalized for any cause (without an RSV diagnosis). Results: Among 201 patients, an average of 1.95 hospitalizations, 19.38 prescriptions, and 7.11 outpatient services were reported during the first RSV hospitalization and the following 12 months. The mean direct healthcare costs were EUR 11,599 (related to hospitalization [79%], prescriptions [16%], and outpatient services [5%]). Following PSM analyses, direct healthcare costs were 15% higher for RSV-hospitalized patients versus those hospitalized for any cause (EUR 9369 versus EUR 8173; p < 0.05), driven by differences in hospitalizations (EUR 7477 versus EUR 6327; p < 0.05) and intensive care unit admissions (EUR 818 versus EUR 178; p = 0.001). Conclusions: Despite a limited sample size, this study reports a substantial economic burden associated with RSV-hospitalized patients aged ≥ 60 years in Italy. The results provide important evidence to inform preventative RSV strategies to reduce the economic burden on the Italian National Health Service.

Respiratory syncytial virus (RSV) causes respiratory infections across all ages, with an increasingly recognized burden in older adults, particularly those with comorbidities. Despite the recent licensure of RSV vaccines, awareness of RSV and other respiratory disease vaccinations remains limited. We conducted a literature review and a web-based survey to explore the awareness of RSV and respiratory disease vaccinations among Italian healthcare professionals (HCPs) and patients. This survey (N = 540) was conducted between April and May 2023 by the Italian Society of Pneumology and the Italian Association of Hospital Pulmonologists. HCPs consider RSV a major concern and understand the importance of vaccination. However, HCPs have limited familiarity with RSV, which may contribute to sub-optimal vaccination adherence. Patients are concerned about RSV, but their awareness is lower than for other respiratory infections. As trusted sources of information, HCPs could enhance education and support patient care with an integrated approach, from prevention to treatment.