Modern vaccination paradigms for respiratory diseases: from pediatric programs to adult reimbursement experience in Romania

Romania has transitioned to a “life-course immunization” approach, extending protection from the pediatric seg­ment to adults. This shift is supported by new legislative mecha­nisms that allow for the reimbursement of vac­cines that prevent respiratory diseases. The pillars of pre­ven­tion include: the pediatric program, through BCG vac­ci­na­tion and the hexavalent and pneumococcal schedules ad­mi­nis­tered at 2, 4 and 11 months, along with adult protection, through the use of the PCV20 conjugate pneumococcal vac­cine (single dose), technologically adapted influenza vac­cines (including high-dose for the elderly), and the dTpa boos­ter every 10 years. Among innovations, we mention the availa­bi­lity of vaccination against the respiratory syncytial vi­rus (RSV) for adults over 60 and pregnant women (for in­fant protection). The success depends on multidisciplinary col­la­bo­ra­tion, strict adherence to the cold chain (2-8°C) and the mandatory reporting in the National Electronic Vac­ci­na­tion Registry (RENV). Although barriers such as vaccine hesi­tancy exist, these new policies aim to reduce the burden on hospitals by preventing infectious exacerbations.