Gender appears to be a strong predictor of online health information-seeking behaviour (OHISB), which is related to Digital Health Literacy (DHL). Gender differences in OHISB have been studied in different countries with different results, but no studies have investigated gender-specific OHISB among University students during the COVID-19 pandemic. We sought to investigate any gender differences in OHISB in the period between the first and second waves of the pandemic in Italian university students. A questionnaire developed by the global COVID-HL network, including existing and adapted validated scales and self-developed scales, was administered to 2996 University students in Florence. Gender differences were tested using the χ² test or the Mann–Whitney U test. Male students reported a higher score in DHL than females (p < 0.001). However, female students seek COVID-19 information more often on different sources (for themselves and other people), on various topics, consider various aspects of information quality to be “very important’’ (p < 0.05) and are more likely to be “often dissatisfied’’ or ”partly satisfied’’ with information (p < 0.001). Our study confirmed gender as an important dimension to explain students’ OHISB differences, which could help institutions promote gender-specific education programmes and provide gender-oriented health information.

Background: Vaccination is a key measure in influenza control, yet global coverage rates remain low, although previous research reported an increase in influenza vaccination coverage rates (VCR) after the onset of the COVID‐19 pandemic. This study aims to assess whether these changes were sustained over time by analyzing VCR trends from 2012 to 2023 in the countries included in the FluCov project.Methods: Data on influenza VCR from 2012 to 2023 for different age and risk groups were extracted from national health organizations and international sources for countries included in the FluCov project. For coverage rates in the older adults, segmented regression models were used to test if 2020 marked a significant change in VCR trends. Moreover, polynomial regression models were fitted for each country with VCR in the period 2012 to 2020 to predict coverage rates for 2021 to 2023 and to compare these to the actual coverage rates for 2021 to 2023.Results: For the elderly, we retrieved influenza VCR data for 12 countries. In 2020, VCR among elderly increased in 10 countries, but the increase was statistically significant in Spain and England only. Moreover, all countries except Spain reverted to levels within the confidence intervals of trends modeled using pre‐2020 data.Conclusions: Although influenza VCR increased in 2020, these changes were statistically significant in only two out of 12 countries, and no consistent, sustained increase was observed afterward, except in Spain. The findings suggest the need for continuous monitoring of VCR and the implementation of strategies to promote and maintain high vaccination coverage rates.

The exchange of knowledge and best practices in adult immunization are essential to improve vaccination strategies across the European region. Italy has made groundbreaking progress in the field, being one of the first countries to propose a life-course vaccination schedule, broadening the traditional focus on childhood immunization to include adults. All vaccines included in Italy's vaccination schedule are free of charge. Moreover, the country's National Immunization Plan sets clear coverage targets, immunization priorities, and actions to reduce disparities. However, the fragmentation of its National Health System following the constitutional reform of 2001 has led to an increased complexity and regional inequalities regarding immunization. Other challenges the country faces include growing vaccine hesitancy, data gaps and underserved populations. This review describes Italy's adult immunization system, from policy to implementation. The successes, challenges and lessons learned were shared during the first Adult Immunization Board country meeting in Italy, where local experts, healthcare providers, public health representatives, and policymakers engaged in collaborative discussions and shared insights through case studies and presentations (December 2023). These insights are reviewed and discussed in this manuscript.

Identifying determinants of COVID-19 vaccine uptake is essential for developing effective strategies for promoting vaccination. This longitudinal study aimed to explore predictors of actual COVID-19 vaccine uptake in workers involved in essential services during the first lockdown period in the Prato Province (Italy). All essential workers were invited and surveyed before COVID-19 vaccine approval (96.5% participation rate). Participants were followed up to evaluate their actual COVID-19 vaccination uptake using the vaccination register. Multinomial models were performed to assess predictors of delayed vaccination or non-vaccination. A total of 691 participants were included, of whom 21.7% had delayed the vaccination and 4.4% were unvaccinated. Participants with a sufficient level of health literacy were 50.2% in the vaccinated-on-time group and 32.3% in the unvaccinated group. The multinomial model predictors of delayed vaccination were work type (OR = 0.51), age between 50 and 59 years (OR = 1.82), and influenza vaccination uptake in the last season (OR = 2.51). Predictors of being unvaccinated were work type (OR = 0.33) and attitudes related to attributing less importance to COVID-19 preventive measures (OR = 0.47). Findings showed distinct predictors for COVID-19 vaccination delay and for being unvaccinated. Being unvaccinated seems to be associated with a general skepticism toward prevention measures.

Cancer screening is a cornerstone of effective cancer prevention. The 2022 European Council Recommendation on cancer screening encourages risk-based approaches, including risk stratification, when appropriate, to improve the balance of screening benefits, harms, and resource use. To address conceptual heterogeneity and fragmented guidance across cancer sites and countries, the EUCanScreen Joint Action convened a multidisciplinary working group from 22 European countries to develop a shared conceptual framework for risk-stratified cancer screening, as a specific operational approach. We conducted a scoping review to identify definitions, key outcomes, benefits and harms, and ethical considerations relevant to risk-stratified screening. The findings informed a structured brainstorming session and a two-round Delphi survey among EUCanScreen participants. A consultation phase and plenary discussion were used to finalize the framework in May 2025. The core elements defining risk-stratified screening are (1) the availability of validated information to estimate individual risk (i.e., the different probability of disease or its natural history), (2) the definition of stratification criteria (i.e., risk thresholds defining groups with similar risk that can be managed similarly), and (3) the presence of evidence-based stratum-specific management protocols. The framework clarifies how risk stratification can be applied across the screening pathway, from eligibility and screening intensity to referral and follow-up. Crosscutting organizational and ethical, legal, and social considerations were identified, including data governance, privacy and data protection, management of genetic information, psychological impacts, equity and access, and training and communication needs. Conclusions This collaborative, consensus-based framework identifies essential elements and crosscutting issues for designing, implementing, monitoring, and evaluating risk-stratified cancer screening. The rationale of risk-stratified screening is to modulate screening intensity in both directions, intensifying it for those at higher risk and reducing it for those at lower risk.