The WHO declared the novel coronavirus disease a pandemic, with severe consequences for health and global economic activity and Italy is one of the hardest hit countries. This study aims to assess the socio-economic burden of COVID-19 pandemic in Italy through the estimation of Disability-Adjusted Life Years (DALYs) and productivity loss. The observational study was based on data from official governmental sources collected since the inception of epidemic until 28 April 2020. DALYs for a disease combines the years of life lost due to premature mortality in the population and the years lost due to disability of the disease. In addition to DALYs, temporary productivity loss due to absenteeism from work and permanent productivity loss due to premature mortality were estimated using the Human Capital Approach. The total DALYs amount to 2.01 per 1000 persons. The total permanent productivity loss was around EUR 300 million while the temporary productivity loss was around EUR 100 million. This evaluation does not consider other economic aspects related to lockdown, quarantine of contacts, healthcare direct costs etc. The burden of disease methodology is functional metric for steering choices of health policy and allowing the government to be accountable for the utilization of resources.

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Objective: This study compares the incidence of new-onset symptoms within 24 hours after enhanced magnetic resonance imaging (eMRI) with intravenous administration of gadodiamide or gadoterate meglumine compared with a control group undergoing unenhanced MRI (uMRI). Materials and Methods: A prospective cohort study (n = 1088 patients) was designed to assess the incidence of symptoms within 24 hours after administration of gadodiamide or gadoterate meglumine. The participants underwent a structured questionnaire by phone call before and 24 hours after the MRI scan to check for symptoms that were not present before the scan. The questionnaire included a list of active questions aimed to test the prevalence of symptoms that have been proposed in the debated definition of gadolinium deposition disease (GDD) and that we recorded in this study as GDD-like. In particular, the following symptoms and signs were tested: central torso pain, arm or leg pain, bone pain, headache, skin redness (any site of the body), fatigue, and mental confusion.Fisher exact test was used to test differences between groups with significance threshold set at P < 0.05. Results: Within the 24 hours after the MRI scan, 8.3% of patients reported at least one new-onset symptom in the uMRI group versus 17.4% in the gadodiamide eMRI versus 17.8% in the gadoterate meglumine eMRI group. The difference between the eMRI and the uMRI group was statistically significant (P < 0.001 for gadodiamide and P < 0.001 for gadoterate meglumine). There was not a different incidence of symptoms between the gadodiamide and the gadoterate meglumine eMRI groups. For gadodiamide, fatigue (P < 0.05) and dizziness (P < 0.05) were symptoms significantly more frequent than uMRI group; for gadoterate meglumine, fatigue (P < 0.01), mental confusion (P < 0.01), and diarrhea (P < 0.01) were significantly more frequent than uMRI group. Conclusions: We found that the onset of new symptoms within 24 hours after exposure to gadolinium-based contrast agent was more frequent than after uMRI. Among GDD-like symptoms, fatigue and mental confusion were the most frequent symptoms reported after eMRI. The other GDD-like symptoms were not overreported after eMRI versus uMRI. Thus, these results are questioning the term GDD.

Vaccination rates in Italy fell until 2015 because of unfounded safety concerns. Public education and a 2017 law on mandatory vaccination have boosted rates since then. The aim of our study is to explore how trust in the scientific community and attitudes towards vaccines have changed in the period of 2017–2019 in Italy. Data were extracted from the Italian section of the 2017 and 2019 editions of the European Social Survey (ESS). We compared the two surveys highlighting changes in public opinion on vaccines. A descriptive analysis of the socio-cultural variables according to the answers provided to key questions on the harmfulness of vaccines was conducted. Differences between percentages were tested by using the χ2 test. The association between the opinion about the harmfulness of vaccines and trust in the scientific community was analyzed through a logistic regression model. Compared to ESS8, ESS9 showed an increase in the percentage of respondents disagreeing with the harmfulness of vaccines. Trust in the scientific community raised in the period from 2017 to 2019 (59% vs. 69.6%). Higher education was significantly associated with disagreement regarding the harmfulness of vaccines (odds ratio (OR) = 2.41; 95% confidence interval (95%CI) 1.75–3.31), the strongest predictor was trust in the scientific community (OR = 10.47; 95% CI 7.55–14.52). In Italy, trust in the scientific community and in vaccinations has grown significantly in recent years, indicating a paradigm shift in public opinion compared to the past. Central actions and effective public communication strategies might reduce vaccine hesitancy and could be essential to garner public trust.

Vaccinations generate health, economic and social benefits in both vaccinated and unvaccinated populations. The aim of this study was to conduct a cost–benefit analysis to estimate the costs and benefits associated with the COVID-19 vaccination campaign for health workers in Fondazione Policlinico Universitario Agostino Gemelli IRCCS (FPG). The analysis included 5152 healthcare workers who voluntarily received the Pfizer–BioNTech COVID-19 vaccine, divided into physicians, nurses and other health workers. Data about vaccine cost, administration and materials were derived from administrative databases of the FPG from 28 December 2020 to 31 March 2021. The costs associated with the COVID-19 vaccination campaign amounted to EUR 2,221,768, while the benefits equaled EUR 10,345,847. The benefit-to-cost ratio resulted in EUR 4.66, while the societal return on investment showed a ratio of EUR 3.66. The COVID-19 vaccination campaign for health workers in FPG has high social returns and it strengthens the need to inform and update decision-making about the economic and social benefits associated with a vaccination campaign. Health economic evaluations on vaccines should always be considered by decision-makers when considering the inclusion of a new vaccine into the national program.