AN OVERVIEW; ROLES OF FAMILY PHYSICIANS IN SMALLPOX DISEASE PREVENTION IN PRIMARY CARE CENTRES

Abstract

Individuals lacking known exposure to the smallpox virus may nevertheless face a significant risk of contracting smallpox, contingent upon the severity of the outbreak and the efficacy of the public health response. Individuals will be identified by public health officials and should be evaluated for relative contraindications to smallpox immunization. In 2022, monkeypox (Mpox) was designated a public health emergency. The European Medicines Agency has approved Imvanex/Jynneos, a smallpox vaccine, for protection against pox. According to the European Centre for Disease Prevention and Control, all healthcare workers (HCWs) are deemed at risk; nevertheless, in Italy, immunization was exclusively provided to laboratory personnel. This study seeks to examine smallpox vaccination coverage (VC) that offers protection against Mpox among healthcare workers (HCWs) in an Italian university hospital and to evaluate HCWs' opinions regarding the potential for Mpox vaccination. Vaccine hesitancy diminishes adult immunization rates and has been identified by the WHO as a significant health issue. Primary care physicians (PCP) are instrumental in immunization by providing vaccine counseling to their patients. This review aims to evaluate the knowledge, beliefs, attitudes, and barriers related to personal vaccination and the prevention of smallpox infection among patients, as well as recommendations for primary care physicians. Methods: The MEDLINE/PubMed, EMBASE, and Cochrane Library databases were utilized to search for and identify pertinent studies based on their titles and abstracts.  Given that basic healthcare facilities are pivotal in smallpox transmission during the initial stages of an epidemic, various mathematical models advocate for pre-event smallpox immunization of healthcare workers (HCWs). The determining factor for healthcare worker voluntary immunization is the risk of disease exposure compared to the risk of adverse vaccine effects. To enhance preparedness and response, smallpox immunization is advised for individuals appointed by public health authorities to investigate and monitor first smallpox cases that may need direct patient interaction.