Vaccines and Covid: the missing words. What Italy can do to avoid following the dangerous American path.

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In the United States, the CDC's ACIP Committee has introduced a significant change to the COVID-19 vaccination strategy : vaccination is no longer recommended for everyone, nor for priority groups, but is now entrusted solely to a "shared clinical decision" between citizens and healthcare professionals. This approach, at least on paper, takes into account the individual risk-benefit ratio, but in reality risks dangerously reducing public awareness of a disease that, while less aggressive than in the initial stages of the pandemic, continues to severely impact the most vulnerable. Shifting the decision-making burden entirely onto patients and physicians, without a clear public recommendation, could weaken the perception of the vaccine's importance and fuel misinformation. The greatest risk is that this choice will also be used as a model in Italy, where other models, especially American ones, are too often imported late and poorly. Meanwhile, while strategies are being discussed, the essential thing is missing: organization.

Just days before the start of the flu vaccination campaign (October 1st in many regions), the Ministry of Health has yet to publish an official circular on the COVID-19 vaccination campaign. The regions have no operational or logistical information: the delivery times for the updated doses are unknown, nor whether they will be available in time. A paradox: back in August, the regions had already communicated their needs for September, October, and November, but that request has not been followed by any concrete response. AIFA has not yet authorized the new vaccines, the doses have not been distributed, and, in effect, the campaigns cannot begin. Yet, many regions are ready to begin COVID-19 vaccinations in parallel with the flu vaccinations, to facilitate their citizens and increase uptake. Prompt and authoritative intervention from the Ministry is needed: the flu season is imminent, and every day of delay reduces protection for the most vulnerable groups.

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