Background:Breast cancer represents the most common form of neoplasm in women, with an estimated 685,000 deaths annually. In this regard, screening programmes represent one of the most effective intervention tools in the field of cancer prevention. The aim of this study is to analyse and describe the key performance indicators of the screening programmes in Lombardy from 2016 to 2022. Study design:Descriptive temporal analysis study. Methods:The data pertaining to the screening campaign were subjected to analysis, with the results broken down according to the following criteria: individual province, age group eligible for screening, and campaign year. For each campaign, the data pertaining to the population subjected to screening, as well as the data concerning the rate of cancers identified during the campaign, were subjected to analysis. Results:For the three age groups, a substantial overlap in call and campaign adherence rates can be observed, with stable values between 2016 and 2019, followed by a significant decline in the 2020 campaign associated with the impact of the pandemic on prevention activities, including cancer screening campaigns. The data for 2021 and 2022 indicate a reversal of the decline in adherence and call rates, particularly in the 45-49 age group, which exhibited an increase of approximately 300% in the call rate between 2021 and 2020. Moreover, the categorization of the provinces into urban, mountainous and rural provinces demonstrates an overlap in the admission rates between the three areas in the different years. Conclusions:Despite the existence of mammography screening campaigns for more than 20 years, adherence rates in the Lombardy region remain below the targets set out in Europe's Beating Cancer Plan. In this regard, the observed variations, particularly during the period of the pandemic and in the subsequent post-pandemic period, provide an opportunity to rethink the organization of screening campaigns in order to increase adherence and effectiveness.

Background: Antimicrobial resistance represents one of the most significant future health challenges in terms of both clinical and economic impacts on healthcare systems. The reason behind this issue is the misuse of antibiotics for the treatment of non-bacterial pathologies. The objective of this study is to investigate the factors underlying antibiotic prescription in pediatricians in the Lombardy region. Methods: The study was conducted by means of a 32-item questionnaire that investigated both pediatricians’ knowledge of antimicrobial resistance and the factors determining the choice to prescribe antibiotic therapy. Results: A total of 253 pediatricians participated in the survey. Most participants (71.6%) reported as highly relevant the need for a national plan against AMR. However, approximately half of the respondents declared the phenomenon of AMR as uncommon in pediatric settings. Among the identified associated factors, diagnostic uncertainty was associated with a stronger fear of legal repercussions and the influence of parental pressure when prescribing antibiotics. Conclusions: The inability to diagnose the bacterial origin of an infection might be the primary driver of prescribing choices, rather than other non-clinical factors, such as parental demands or a fear of lawsuits.

Background: COVID-19 vaccination is the most significant step toward the long-term mitigation of SARS-CoV-2-related complication, avoiding disease and death and decreasing virus spread. This study aimed to evaluate, in a real-world setting, booster dose effectiveness to reduce COVID-19 risk considering the amount of time after the end of the two-dose vaccination cycle. A sub-analysis was conducted to adjust the booster dose effect for occupational and demographic factors. Methods: About 16,000 COVID-19-vaccinated HCWs of three University Hospital Networks in Milan (HN1/HN2/HN3) were included in the study. Data were collected by Occupational Health Physicians of the HNs within specific computerized databases. Results: In univariable analysis, booster dose administration displayed a slightly higher risk of infection with respect to not receiving it, OR = 1.18, with 95% confidence interval (C.I) [0.99, 1.41]. When the model was adjusted with the modulating effect of time from the completion of the vaccination cycle on booster dose administration, the latter resulted in strong protective effect against infection, OR = 0.43, 95% CI [0.26, 0.74]. However, considering the modifying influence of time from the vaccination cycle’s completion, the administration of booster doses appeared to have a protective effect against infection. In HN1, students and resident physicians displayed lower odds of infection with respect to physicians. Lastly, a non-linear effect of age was reported. Conclusions: Our findings suggest that the correct timing in vaccine scheduling and administration is critical to vaccine effectiveness. These findings, applicable to all vaccinations, should help in setting up more effective vaccination strategies.

Background: Vaccination is a highly effective tool for controlling infectious diseases, particularly in populations at high risk of contagion due to clinical conditions or occupational exposure, such as healthcare workers. The purpose of this study is to present the open day event that marked the beginning of the influenza and anti-COVID-19 vaccination campaign in the Lombardy region and to describe the experience of an Istituto di Ricovero e Cura a Carattere Scientifico in Milan. Methods: During the vaccination open day, eligible individuals received free vaccinations for influenza, COVID-19, pneumococcal disease, and shingles, as provided by the Lombardy Agenzia per la Tutela della Salute. In celebration of the centenary of the Università degli Studi di Milano, the Fondazione Ca’Granda Ospedale Policlinico, a contracted hospital of the university, created a special electronic diary for a total of 150 individuals, equally divided between children aged 2–6, pregnant women, and university staff. Results: At the regional level, a total of 6634 influenza vaccines, 2055 anti-COVID-19 vaccines, 108 anti-pneumococcal vaccines, and 37 anti-zoster vaccines were administered. A total of 3134 (47.3%) influenza vaccines, 1151 (56%) anti-COVID-19 vaccines, and 77 (62%) anti-pneumococcal vaccines, were given to individuals aged 60–79. No differences were observed between the total number of male and female vaccinees (1017 and 1038, respectively), who received the anti-COVID-19 vaccine. At the Policlinico Foundation, out of 150 available booking slots, 154 vaccines were administered, including 117 influenza vaccines. Conclusions: The establishment of vaccine open days is a beneficial way to increase vaccine compliance. Co-administration of little-known vaccinations outside of healthcare settings could also be a useful tool.

Introduction. Vaccinations represent an extremely effective tool for the prevention of certain infectious diseases - such as influenza and COVID-19 -, particularly for those categories at risk due to both their frail condition or professional exposure, such as healthcare workers. The aim of this study is to describe the course of the anti -influenza and anti-COVID-19 vaccination campaign at two Research Hospitals in Milan, Italy. Study design. Multicentre, cross-sectional study. Methods. For the 2023-24 vaccination campaign, the two facilities opted for two different approaches. At the Hospital A, two different strategies for vaccinating healthcare workers were implemented: a fixed -site vaccination clinic and two mobile vaccination groups run by Public Health residents of the University of Milan. At the Hospital B, on the other hand, a single fixed -site outpatient clinic run by Public Health residents of the University of Milan was used. On the occasion of the campaign, a survey was also carried out using anonymous online questionnaires to investigate healthcare workers attitudes towards vaccination. Results. A total of 1,937 healthcare workers were vaccinated: 756 were immunized against influenza only, 99 against COVID-19 only, and 1,082 against both. The results show a substantial difference in vaccination adherence among medical and nursing staff compared to other professional categories. In particular, the category with the highest vaccination adhesion turned out to be that of medical doctors with 55.7% adhesion while, on the contrary, the category with the lowest adhesion turned out to be that of auxiliary personnel characterized by 7.4% adhesion. At the same time, the comparison between the two hospital facilities showed a double adherence rate by the staff of Hospital A as regards both the flu vaccine (40.6% and 20.1%) and the anti-COVID-19 vaccine (26.4% and 12.3%). Finally, the survey showed that the attitude towards influenza vaccination is lower among auxiliary staff in terms of both knowledge and vaccination attitude. Conclusions. The results of the study show a vaccination adherence in line with that of previous years, although lower than the values recommended by the principal national and international Organizations. The analysis of the differences between the two facilities and the surveys carried out will allow for the implementation of targeted interventions to increase adherence in future campaigns.

BACKGROUND AND AIM:Nowadays Health Technology Assessment (HTA) is becoming more important in the hospital management, until the conception of Hospital Based HTA (HB-HTA), considered as a tool of HTA that is a multidisciplinary process to determine the value of a health technology in health sector. The aims of this study are the investigation of the current state of the art and of the diffusion of the HTA culture in hospitals (HB-HTA) also the analysis of the thinking of healthcare professionals regarding the usefulness of HTA.METHODS:The study was performed through the administration of two questionnaires respectively to hospitals' HealthCare Workers (HCW) to assess the HTA's knowledge and to hospitals' HCW that have submitted a new technologies or devices' request to Direction between 2017 and 2019.RESULTS:Considering 988 questionnaires send to HCW only 416 (42.1%) answer were collected, with a higher attention towards HTA made by physicians (148; 35,6%). It's fundamental to observe that despite a mean response rate all the population shows interest for the HB-HTA concept as an instrument to help the hospital management. About the 23 questionnaires to HCW that have made request show a higher attention and knowledge to HTA.CONCLUSIONS:In conclusion, in the current welfare landscape and for the future developments that will ensue from it, especially in the Italian context due to the increase of healthcare funds provided by the NRRP (National Recovery and Resilience Plan), the adoption of the HB-HTA method will represent a strategic lever to support clinical and organizational decision-making processes governance.

Pancreatic cancer (PC) represents the 6th cause of cancer death. Although the aetiology of PC is not completely understood, numerous risk factors have been identified in association with this cancer, among them diet. However, little is known about the association between the Mediterranean Diet (MedDiet) and the risk of PC. For this reason, we conducted a systematic review with meta-analysis according to the PRISMA guidelines, searching on three databases (PubMed/MEDLINE, Scopus, and EMBASE). The protocol was registered in PROSPERO. Both fixed and random effect models were performed. The Effect size was reported as a hazard ratio (HR) with a 95% Confidence Interval (CI). A total of eight articles were included. The methodological quality of the included meta-analyses was high. Our results show that a higher adherence to the MedDiet is associated with a lower risk of PC [HR:0.82 (0.76–0.88) p < 0.001, based on 1,301,320 subjects]. The results were also confirmed in sensitivity and subgroups analyses (avoidance of potential overlapping effects, type of tools used to assess dietary intake and the diagnosis of PC, prevalence and incidence of PC risk, country where the studies took place, sex, and cancer site). Promoting a higher adherence to the MedDiet could be an effective approach to reduce the risk of PC.

Liver InternationalVolume 43, Issue 4 p. 945-946 LETTER TO THE EDITOR 2022 open day in the University of Milan: An opportunity for HCV screening Giovanni Aldinio, Giovanni Aldinio Division of Gastroenterology and Hepatology, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, ItalySearch for more papers by this authorRoberta D'Ambrosio, Corresponding Author Roberta D'Ambrosio [email protected] orcid.org/0000-0003-0019-1153 Division of Gastroenterology and Hepatology, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy Correspondence Roberta D'Ambrosio, Division of Gastroenterology and Hepatology, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy. Email: [email protected]Search for more papers by this authorPier M. Perrone, Pier M. Perrone Quality Department, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, ItalySearch for more papers by this authorSilvana Castaldi, Silvana Castaldi Quality Department, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy Department of Biomedical Sciences for Health University of Milan, Milan, ItalySearch for more papers by this author Giovanni Aldinio, Giovanni Aldinio Division of Gastroenterology and Hepatology, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, ItalySearch for more papers by this authorRoberta D'Ambrosio, Corresponding Author Roberta D'Ambrosio [email protected] orcid.org/0000-0003-0019-1153 Division of Gastroenterology and Hepatology, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy Correspondence Roberta D'Ambrosio, Division of Gastroenterology and Hepatology, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy. Email: [email protected]Search for more papers by this authorPier M. Perrone, Pier M. Perrone Quality Department, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, ItalySearch for more papers by this authorSilvana Castaldi, Silvana Castaldi Quality Department, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy Department of Biomedical Sciences for Health University of Milan, Milan, ItalySearch for more papers by this author First published: 30 January 2023 https://doi.org/10.1111/liv.15505Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. REFERENCES 1Beltrami M, Pagani G, Conti F, et al. HCV point of care screening in people tested for SARS-COV-2 in a social-housing neighbourhood of Milan, Italy. Liver Int. 2023; 43: 251- 255. 2Hepatitis C n.d. Accessed February 3, 2023. https://www.who.int/news-room/fact-sheets/detail/hepatitis-c 3 Gazzetta Ufficiale n.d. Accessed February 3, 2023. https://www.gazzettaufficiale.it/eli/id/2021/07/08/21A04075/sg 4Giacomelli A, Pagani G, Conti F, Bassoli C, Galli M. Detecting HCV infection by means of mass population SARS-CoV-2 screening: a pilot experience in northern Italy. J Hepatol. 2021; 75: 484- 486. 5D'Ambrosio R, Rizzardini G, Puoti M, et al. Implementation of HCV screening in the 1969-1989 birth-cohort undergoing COVID-19 vaccination. Liver Int. 2022; 42: 1012- 1016. Volume43, Issue4April 2023Pages 945-946 ReferencesRelatedInformation

Background: Blood transfusion can be considered as a life-saving treatment and is a primary health management topic. This study aims to assess the appropriateness of blood transfusion performed in a large tertiary hospital in Italy. Methods: a multispecialist team composed oof hematologists, public health experts and pediatricians analyzed blood transfusions performed between 2018 and 2022 in the pediatric wards comparing the appropriateness with the available NHS guidelines available. Patients’ characteristics, clinical features and blood component’s data were collected and analyzed. Results: considering 147 blood transfusions performed in 2018–2022, only eight (5.4%) were performed according to guidelines, while 98 (66.7%) were driven by clinicians’ expertise, especially for anemia in genetic syndromes (30) (20.5%) and autoimmune diseases (20) (13.6%). Thirty-nine (26.5%) transfusions could be considered as inappropriate, while two (1.4%) blood packs were never been transfused after being requested. Conclusions: This analysis is one of the first performed to assess the appropriateness of blood component transfusions comparing their compliance to NHS guidelines. The importance of this analysis can be explained first by the clinical point of view and second by the economic one.

Background and aim: The pandemic caused by SARS-COV-2 has increased Semi-Intensive Care Unit (SICU) admission, causing an increase in healthcare-associated infection (HAI). Mostly HAI reveals the same risk factors, but fewer studies have analyzed the possibility of multiple coinfections in these patients. The study aimed was to identify patterns of co-presence of different species describing at the same time the association between such patterns and patient demographics and, finally, comparing the patterns between the two cohorts of COVID-19 patients admitted at Policlinico during the first wave and the second one). Methods: All the patients admitted to SICUs during two COVID-19 waves, from March to June 2020 months and from October to December 2020, were screened following the local infection control surveillance program; whoever manifested fever has undergone on microbiological culture to detect bacterial species. Statistical analysis was performed to observe the existence of microbiological patterns through DBSCAN method. Results: 246 patients were investigated and 83 patients were considered in our study because they presented infection symptoms with a mean age of 67 years and 33.7% of female patients. During the first and second waves were found respectively 10 and 8 bacterial clusters with no difference regarding the most frequent species. Conclusions: The results show the importance of an analysis which considers the risk factors for the possibility of co- and superinfection (such as age and gender) to structure a good prognostic tool to predict which patients will encounter severe coinfections during hospitalization (www.actabiomedica.it)

Background: While the effectiveness of tetanus-diphtheria-pertussis childhood immunization programs is unquestionable, the actual need for a periodic boosting vaccination in adults is controversial. In Italy, the Ministry of Health recommends a Tdap booster vaccination every 10 years. The aim of this study is to assess the real-world adherence of Italian regional healthcare services to national recommendations and to evaluate two alternative strategies. Methods: Annual Tdap vaccine requirements by the 21 Italian regions were retrieved from related tender announcements, and regional and national vaccination coverage rates (VCRs) were estimated for three scenarios, namely the currently recommended 10-year booster vaccination, a single booster shot at age 50 and at age 65. Results: In Scenario 1, no region reached a VCR > 30%, and the national VCR was 10.6%; in Scenario 2, five regions achieved the optimal vaccination coverage of ≥95%, but the vast majority continued to have inadequate VCRs, with a national VCR of 54.4%; in Scenario 3, five regions reached VCRs exceeding 100%, with VCRs from other regions significantly improving and a national VCR of 74.8%. Conclusions: A substantial lack of adherence by Italian regional healthcare services to current national recommendations on tetanus-diphtheria-pertussis adult vaccination was shown. Scenario 3 is the most feasible, i.e., a single booster shot at age 65, possibly administrable along with other already-recommended, age-specific vaccines.

BACKGROUND:Preventing and reducing nosocomial infections is a public health goal. Concern about healthcare-associated fungal infections has increased in recent years due to the emergence and spread of new pathogens, increasing antifungal resistance and outbreaks in hospital settings. AIM:To investigate the presence of medically relevant fungal species on environmental surfaces in 12 intensive care units of eight hospitals in Milan, Italy. METHODS:Environmental samplings, using contact plates on surfaces near bed stations and medical workstations, were conducted between November 2019 and January 2020. Fungi isolated were identified, and some were tested in vitro for antifungal susceptibility. FINDINGS:In total, 401 environmental samples were collected from 61 bed stations and 17 medical workstations. Positive samples were found in all hospitals except one, with positivity rates ranging from 4% to 24.2%. Filamentous fungi were found mainly on infusion pumps (23.2%) and patient tables (21.2%), whereas yeasts were found mainly on computers (25%) and floors (10.9%). Fungi were isolated from 12% of total samples. Filamentous fungi, mainly Aspergillus fumigatus, grew in 70.8% of positive samples, and yeasts grew in 27.1%, mainly Candida parapsilosis (42.8%) and Candida glabrata (28.6%). Fungi were detected near patients' beds and on surfaces at workstations, indicating potential for environment-to-patient, patient-to-patient and healthcare worker-to-patient transmission. CONCLUSIONS:Surveillance in hospital settings through environmental sampling may be an important component of fungal infection prevention.

Background: During the COVID-19 pandemic, more than ever, optimal influenza vaccination coverage among healthcare workers (HCWs) is crucial to avoid absenteeism and disruption of health services, as well as in-hospital influenza outbreaks. The aim of this study is to analyze the 2020 influenza vaccination campaign, comparing it with the previous year’s in a research and teaching hospital in Northern Italy. Methods: adopting an approach based on combined strategies, three interventions were deployed: a promotional and educational campaign, vaccination delivery through both ad hoc and on-site ambulatories, and a gaming strategy. Personal data and professional categories were collected and analyzed using univariate logistic regression. Vaccinated HCWs were asked to fill in a questionnaire to describe their reasons for vaccination adherence. Results: the vaccination coverage rate (VCR) was 43.1%, compared to 21.5% in 2019. The highest increase was registered among administrative staff (308.3%), while physicians represent the most vaccinated category (n = 600). Moreover, residents (prevalence ratio (PR): 1.12; 95% CI 1.04–1.20), as well as intensive care (PR: 1.44; 95% CI: 1.24–1.69) and newborn workers (PR: 1.41; 95% CI: 1.20–1.65) were, respectively, the categories most frequently vaccinated for the first time. Conclusion: the significant increase in vaccination coverage rate confirms the suitability of the combined strategy of delivering the flu vaccination campaign and represents a first step towards reaching WHO recommended vaccination rates.

Background: Health care workers (HCWs) are at high risk of contracting an infection by SARS CoV-2 and thus they are a priority for vaccination. We hereby aim to investigate whether the risk of severe and moderate systemic symptoms (MSS) after vaccination is higher in HCWs with a history of previous COVID-19. Methods: An online questionnaire was offered to the cohort all HCWs undergoing anti-SARS CoV-2 mRNA BNT162b2 vaccination between January 4th and February 9th 2021 in two large tertiary hospitals (ASST Santi Paolo and Carlo) in Milan, Italy. Previous SARS-CoV-2 infection/COVID-19 was recorded. Local and systemic symptoms after each of the two doses were reported. MSS were those either interfering with daily activities or resulting in time off-work. Factors associated to MSS were identified by logistic regression. Findings: 3,078 HCW were included. Previous SARS-CoV-2 infection/COVID-19 occurred in 396 subjects (12.9%). 59.6% suffered from >= 1 local or systemic symptom after the first and 73.4% after the second dose. MSS occurred in 6.3% of cases (14.4% with previous vs 5.1% with no COVID-19 p <0.001) and in 28.3% (24.5% in COVID-19 vs 28.3% no COVID, p = 0.074) after the first and second dose, respectively. Subjects already experiencing COVID-19 had an independent 3-fold higher risk of MSS after the first and a 30% lower risk after the second dose. No severe adverse events were reported. Interpretation: Our data confirm in a real-world setting, the lack of severe adverse events and the short duration of reactogenicity in already infected HCWs. Possible differences in immune reactivity are drivers of MSS among this group of HCWs, as well as among females and younger individuals. (C) 2021 The Authors. Published by Elsevier Ltd.

Background: Health care workers (HCW) are at high risk of get infected by SARS CoV-2 and thus they are a priority for vaccination. We hereby aim to investigate whether the risk of severe and moderate systemic symptoms (MSS) after vaccination is higher in HCWs with a history of previous COVID-19. Methods: An online questionnaire was offered to all HCW undergoing anti-SARS CoV-2 mRNA BNT162b2 vaccine. Previous SARS-CoV-2 infection/COVID-19 was recorded. Local and systemic symptoms after each of the two doses were reported. MSS were those either interfering with daily activities or resulting in time off-work. Factors associated to MSS were identified by logistic regression.Findings: 3,078 HCW were included. Previous SARS-CoV-2 infection/COVID-19 occurred in 396 subjects (12·9%). 59·6% suffered from >=1 local or systemic symptom after the first and 73·4% after the second dose. MSS occurred in 6·3% of cases (14·4% with previous vs 5·1% with no COVID-19 p<.001) and in 28·3% (24·5% in COVID-19 vs 28·3% no COVID, p=0·074) after the first and second dose. Subjects already experiencing COVID-19 had an independent 3-fold higher risk of MSS after the first and a 30% lower risk after the second dose. Females and younger subjects were at higher risk. No serious adverse events were reported. Interpretation: Possible differences in immune reactivity are drivers of MSS among females, younger and previously infected HCWs. Vaccination strategies according to previous COVID-19 along with data on the longevity of immune response need to be further investigated. Funding: NoneDeclaration of Interests: None of the authors have any conflicts of interest to disclose.Ethics Approval Statement: The protocol was approved by the Ethic Committee Area 1, Milan.

BACKGROUND AND AIM:Seasonal influenza exerts a deep and multi-level impact on population and public health systems. Among at risk groups, healthcare workers (HCWs) represent a crucial one due to the threat of absenteeism and consequent disruption of healthcare services (and economic losses). Also in this group vaccine hesitancy is a well known issue, therefore innovative and 360-degree strategies are urgently needed to overcome the problem.METHODS:in the 2020-21 influenza vaccination campaign in a research and teaching hospital in Milan, Italy, the working group implemented three different strategies: the offer of vaccination through both an ad hoc ambulatory and several itinerant (on site) vaccinating teams, a promotional and educational communication campaign, a gaming strategy Results: vaccinated employees nearly doubled (2103 vs 1153 in 2019-20 flu vaccination campaign), reaching a comprehensive vaccination coverage rate (VCR) of 43,1%. A highly significant increase in the 40-59 age group was registered. While physicians and nursing staff confirmed to be the most represented categories among vaccinated subjects, administrative and auxiliary staffs performed the greatest increase compared to the previous campaign. The on site vaccination was clearly preferred than the ad hoc one (1693 HCWs, 80,5% vs 410, 19,5%). Vaccinated for the first time registered a significant increase (40,2% vs 36,2% in 2019-20 campaign).CONCLUSIONS:such meaningful results confirm the effectiveness of the strategies implemented in the present campaign, suggesting their possible application in the debated COVID19-third-dose vaccination campaign.

Background: Despite recommendations, the influenza vaccination coverage rate in healthcare workers (HCWs) in Italy is far from the recommended target. The aim of the study is to analyze the influenza vaccination campaign performed in 2019 in a research and teaching hospital in Milan. Methods: The vaccination strategy included an ad hoc ambulatory, as in the previous years, and an onsite ambulatory, introduced for the first time. Personal data and professional categories were collected and analyzed using univariate logistic regression. HCWs who refused the vaccination were asked to fill in a questionnaire to explain their reasons for dissent. Results: The achieved vaccination coverage rate (VCR) for HCWs was 21.5 %, compared to 17.1% in 2018. The lowest VCR was registered among nurses (11.9%), while physicians had the highest VCR (40.7%). Prevalence ratios show that some professional categories were more frequently vaccinated for the first time than attending physicians (reference category); those with statistically significant confidence intervals were nurses (PR: 2.42; 95% CI: 1.78–3.28), residents (PR: 1.85; 95% CI: 1.36–2.53), and auxiliary staff (PR: 2.33; 95% CI: 1.45–3.74). Conclusions: An onsite vaccination strategy failed in providing a remarkable increase in VCR in 2019, but it is important to point out that the campaign was influenced by several logistic problems.