Abstract
Maintaining high vaccine coverage (VC) for pediatric vaccinations is crucial to ensure herd immunity, reducing the risk of vaccine-preventable diseases (VPD). The Italian vaccination Law (n. 119/2017) reinforced mandates for polio, diphtheria, tetanus, and hepatitis B, extending the mandate to pertussis, Haemophilus influenzae type b, chickenpox, measles, mumps, and rubella, for children up to 16 years of age. We analyzed the national temporal trends of childhood immunization rates from 2014 to 2019 to evaluate the impact of the mandatory reinforcement law set in 2017 as a sustainable public health strategy in Italy. In a 3-year period, 9 of the 10 compulsory vaccinations reached the threshold of 95% and VC for chicken pox increased up to 90.5%, significantly. During the same period, the recommended vaccinations (against meningococcus B and C, pneumococcus, and rotavirus) also recorded a significant increase in VC trends. In conclusion, although the reinforcement of compulsory vaccination generated a wide public debate that was amplified by traditional and social media, the 3-year evaluation highlights positive results.
Highlights
In Italy, selected childhood vaccinations have been mandatory by law nationally since1888 (Law of the Kingdom of Italy 22 December 1888 for smallpox, Law n. 891/1939 for diphtheria, Law n. 292/1963 for tetanus, Law n. 51/1966 for polio and Law n. 165/1991 for hepatitis B)
We calculated the vaccine coverage (VC) rates by dividing the absolute number of the vaccinations administered to children per each age group (24 months or 6 years of age) and Regions and Autonomous Provinces (R/AP) by the number of the resident population with the same age according to data obtained from the Italian R/AP
2016 vs. 2014, polio at 24 months: −1.38%, at 6 years: −3.44%), while measles VC rates fluctuated at the 24 month-time point and markedly decreased at the 6-year time point
Summary
In Italy, selected childhood vaccinations have been mandatory by law nationally since1888 (Law of the Kingdom of Italy 22 December 1888 for smallpox, Law n. 891/1939 for diphtheria, Law n. 292/1963 for tetanus, Law n. 51/1966 for polio and Law n. 165/1991 for hepatitis B). In Italy, selected childhood vaccinations have been mandatory by law nationally since. The mandates included vaccines against diphtheria, hepatitis B, polio, and tetanus, which were already compulsory, adding vaccines against Haemophilus influenzae type b and pertussis (included in the hexavalent vaccine), chickenpox, measles, mumps, and rubella (administered through combined monovalent plus trivalent vaccine or through tetravalent vaccines). These vaccinations are actively offered throughout the country and are free of charge for infants between 3 and 24 months of age and for children around 5–6 years of age. The compulsory model for the trivalent vaccination against measles, mumps, and rubella is subject to revision every three years, based on epidemiological data and on VC levels achieved
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