For allergic people, the ad hoc vaccine can be a lifesaver, but out of 6 million allergic Italians who could benefit from it – out of a total of 12 million – only 2% opt for the administration, also due to the lack of reimbursement in various regions. A ‘paradox’, say allergists, which exposes people to high risks and causes a significant cost for the NHS. For this reason, on the occasion of the congress of the Italian Society of Allergology, Asthma and Clinical Immunology (Siaaic) in Bologna, specialists ask that the health problem of allergies, today “trivialized”, become a priority on the political agenda.
In Italy, specific immunotherapy, i.e. the vaccine, therefore remains a chimera for millions of patients, although international guidelines indicate it as the best therapy for one allergy sufferer in two, both for respiratory allergies and for those to insect bites. . It is in fact the only treatment capable of stopping the escalation of inflammatory symptoms that leads to asthma, a condition which in our country, in the most serious cases, causes almost 300 victims every year.
Today the use of the vaccine is strongly limited above all by costs, because in most regions (practically the entire central and southern part) this treatment is entirely borne by the patients, with a cost of 500/600 euros per year. The lack of knowledge of allergic diseases and the lack of an adequate care network also weigh heavily. Yet the spread of allergies is continually increasing.
The numbers of respiratory allergies
According to the WHO, approximately 350 million people in the world suffer from respiratory allergies. There are more than 1,000 deaths per day from asthma globally, around 300 per year in Italy, many of which could be avoided if patients were treated effectively. The prediction is that by 2050 almost half of the population will suffer from some form of allergy, thanks to climate change and pollution. In our country approximately 10% of under 14s suffer from asthma and 80% of these are allergic. The direct costs of asthma represent 1-2% of Italian healthcare spending.
The usefulness of vaccines
Specific allergen immunotherapy, i.e. the vaccine, is “a desensitizing therapy that can really change the course of the disease – he explains Mario Di Gioacchino, president of Siaaic -. It consists of progressively increasing doses of the allergen to which the patient is sensitized. In this way, an active immune tolerance develops, with the production of protective antibodies towards the allergen itself.
This effect is maintained for many years after discontinuation of treatment which lasts 3-4 years.”
Few vaccinations: the reasons
However, there are many reasons that limit the use of vaccines. “Certainly the problem of costs, in the Regions in which this treatment is entirely borne by the patients, represents a strong limitation – declares Di Gioacchino -. There is a patchy situation due to the lack of legislation that regulates reimbursement in a uniform. The decision whether to provide vaccines and to what extent depends on the individual Regions, with an unacceptable discrepancy in the treatment of a chronic disease whose treatment should instead be included in the Lea”.
The requests of scientific societies
Furthermore, although allergic diseases now affect 20% of the population and are constantly increasing, resulting in a large healthcare burden, “allergy care is greatly reduced everywhere”, underlines the expert.
The scientific societies in the sector therefore ask that allergies find a place on the government agenda: “We hope that Mission 6 of the Pnrr reserves particular attention to the role of the specialist in Allergology, considering a serious lack that the figure of the allergist is never included among the professionals called to provide assistance in the homes of the community”, underlines the Siaaic president. “We then urge the inclusion of vaccines among the treatments authorized by Aifa as the only therapy capable of modifying the natural history of allergies and – he concludes – the implementation of a national network for the monitoring of allergenic pollen and fungal spores”.