Abstract

The COVID-19 pandemic has affected national healthcare systems worldwide, with around 282 million cumulative confirmed cases reported in over 220 countries and territories as of the end of 2021. The Italian National Health System was heavily affected, with detrimental impacts on preventive service delivery. Routine vaccination services were disrupted across the country during the first months of the pandemic, and both access to and demand for vaccines have decreased during the pandemic. In many cases, parents preferred to postpone scheduled appointments for routine paediatric vaccinations because of stay-at-home orders or fear of COVID-19 infection when accessing care. The objective of the current study was to assess the routine childhood vaccine coverage (VC) rates during the COVID-19 epidemic in Italy. We compared 2020 and 2019 VC by age group and vaccine type. The Italian Ministry of Health collected anonymised and aggregated immunisation national data through the local health authorities (LHAs). Results were considered statistically significant at a two-tailed p-value ≤ 0.05. VC rates for mandatory vaccinations decreased in 2020 compared to 2019 (range of VC rate decrease: −1% to −2.7%), while chicken pox increased (+2.2%) in 7-year-old children. Recommended vaccinations were moderately affected (range of VC rate decrease in 2020 vs. 2019: −1.4% to −8.5%), with the exception of anti-HPV in males, Men ACWY, and anti-rotavirus vaccination (VC increase 2020 vs. 2019: +1.8%, +4.7% and +9.4%, respectively). In the COVID-19 era, the implementation of coherent, transparent, and effective communication campaigns and educational programs on safe childhood vaccinations, together with the increase in the number of healthcare staff employed, is essential to support strategies to reinforce vaccination confidence and behaviour, thus avoiding health threats due to VPD during and beyond COVID-19 times.

Highlights

  • Health Organisation (WHO) published interim guidelines [3,4] warning about the risk of vaccine-preventable disease (VPD) outbreaks, which could cause further pressure on health services

  • We evaluated the first two timepoints (24 months and 7 years of age) only, as the fourth dose has a massive range of possible administration that would not indicate the impact of the COVID-19 epidemic on the vaccine coverage (VC) rates achieved in 2020

  • We reported the number of vaccinated children and the eligible paediatric population registered in Italy for each VPD and year of administration

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Summary

Introduction

The SARS-CoV-2 infection has spread widely at the global level in 2020, causing disruption of routine vaccination activities in most countries [1,2]. International health authorities revealed a decreased demand for vaccination because of physical and social distancing requirements or community reluctance due to the fear of contagion. Health Organisation (WHO) published interim guidelines [3,4] warning about the risk of vaccine-preventable disease (VPD) outbreaks, which could cause further pressure on health services. The COVID-19 pandemic had a critical impact on Italy’s population and national health system. After the first case detected in Lombardy Region on 21 February

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