Abstract:
Background: In European after pandemic period for SARS Covid 2019-2023 we are encountered serious complications and mortality data associated with infectious diseases increase with age. Vaccination against influenza and Covid (annually) are recommended for children and specific risk groups. In international lecture, we are many article that discuss about vaccine co-administration in adults1 thanks to these indications. While they was approved in Italy, Calabria region, the first region to get the co-administration in children by first to second year of life2. In Italy, since June 2025 to now, we are combined hexavalent vaccine: Tetanus, Pertussis, Diphtheria, and acellular vaccine with Haemophilus influenzae type B, Poliomyelitis, Hepatitis B plus Meningococcal B, Pneumococcus and Rotavirus. Not more meningococcal C but Meningococcal ACWY and MMRV (measles, mumps, rubella and varicella or chickenpox) are recommended for healthy children at 1 years old and with recall at 5 years old.
Lombardy region data: Vaccines like hexavalent, pneumococcus and meningococcus B are recommended in the same day at 61 days of life, at 4 and 10 months for children, because the coverage rates remain high after 4 months accesses and became suboptimal after 1 years of age. With actual co-administration the Lombardy region would improve vaccine uptake and timely immunization, this is a good routine practice in children. We review key data on co-administration of four vaccines in children to reassure healthcare providers about its safety and advantages.
Now co-administration are well established in children in Lombardy region with maximum 3 injections in the legs for first and second appointment and 1 oral dose for prevent Rotavirus. Minimum 2 injections in the legs for third appointment at 10 month with 1 for legs and more 1 injections also in the arm for the last dose MMRV, after happy birthday. It is less common in IUGR for intrauterine growth restriction or SGA for small for gestational age in severe condition in which the babies fails. Only in these cases, we maintain the old vaccination schedule with 7 doses between 2-15 months.
Statistical Data: with Anova we have analysis babies birth in the 2023-2024 with vaccine finished in 2024-2025 for the first group versus concluded in 2025-2026 for the second group.
Data Bergamo Analysis: Local data analysis has allowed us to highlight with statistical charts the significance of reducing vaccination sessions from 7-8 to 4-5. As can be seen from the data in the graphs shown here with a significance of p<0.05 for the data from the province of Bergamo. And with a significance of p<0.001 for the sample data of 6 months from ASS Bergamo Ovest.
In conclusions: We confirm these results of previous author in bibliography to promote it into Italian national scale and European Unit. Thanks to these “new -baby schedules”, we finished in time the babies schedule and we have been able to organize for immigrate, adolescent and travel vaccine. These news data are always in co-administration because we have a well-established positive benefit-risk profile, it’s an efficient and cost-saving strategy to improve coverage.
Recommending bodies also in schedule babies may consider revising vaccination schedules to reduce the number of visits. Healthcare providers could more often recommend and practice vaccine co-administration; this would not risk patient safety and health, would improve protection against vaccine-preventable diseases, would help comply with national vaccination calendars in a range of 12-13 months in the mean.
We note an increase of facultative vaccination consequently to oblige vaccination in the baby, in the best moment in which he needs more of protection, with an evident reduce of date and distress for baby and parents (reduced work permission). So we can underline the positive outcome for Public Health Organization in sanitary Lombardy region and administrative planning in 4-5 babies' regular vaccination sessions.
Keywords: Healthcare provider; concomitant immunization; primary care; simultaneous vaccine uptake.
