Monitoring regional-level vaccination coverage rates in Lombardy Region (Northern Italy)

Abstract

Abstract Background Lombardy is Italy's most affluent and most populated region, with the highest national per capita GDP, and over 10 million residents - more than 16 out of 27 EU countries. In 2017, two measures were approved against vaccine hesitancy, i.e. the National Plan for Vaccine Prevention (2017-2019) and Law no. 119 on mandatory vaccinations. Aim of the study is to monitor Lombardy regional-level vaccine coverage trends and to assess the new legislative framework's overall impact. Methods We analysed and critically interpreted Lombardy regional-level vaccination coverage (2000-2018 for childhood vaccinations; birth cohorts 1997-2005 for HPV; flu seasons 1999-2000/2018-2019 for influenza). All data were extracted from the Italian Ministry of Health website. We carried out descriptive trend analysis for measles and polio-containing vaccines in 24 month-old-children, Human Papilloma Virus vaccine in 12-year-old females, and influenza vaccine in seniors over 65 years. Regional data were compared with the corresponding Italian national averages. Results Childhood vaccinations: Lombardy and Italy have never met the 95% target for measles-containing vaccines (average coverage 2000-2018: Lombardy 91,79%, Italy 86,94%). Polio-containing vaccines have always remained above the 95% threshold, with a drop in 2015-2017. In 2018 they increased back to safety levels (Lombardy 95,31%, Italy 95,09%). HPV: coverage has always kept below WHO/SAGE intermediate 80% goal (average coverage, birth cohorts 1997-2005: Lombardy 75,58%, Italy 72,73%). Influenza: mean coverage has been alarmingly inadequate (Lombardy 54,09%, Italy 57,98%) compared to WHO-recommended minimum of 75%. Conclusions Except for influenza, coverage in Lombardy is slightly higher than the Italian average. Exploring Lombardy's response to the national legislation could guide policymakers in developing tailored vaccination strategies. Key messages Overall, vaccination coverage in Lombardy is slightly higher than the Italian average. In 2017, law n.119 on mandatory vaccinations came into force, acting as a powerful tool for coverage increase.