Tetanus Vaccination Status and Vaccine Hesitancy in Amateur Basketball Players (Italy, 2020).

Matteo Riccò,Simona Peruzzi

doi:10.3390/vaccines10010131

Abstract

Basketball is among the third most popular team sport in Italy. Albeit not usually perceived as being at high risk for tetanus, the Italian legal framework (Law No. 292 of 1963; Presidential Decree 1301/1965) requires tetanus vaccination (TeV) even for amateur practice. Even though some previous reports have suggested a relatively low adherence towards vaccination practice among basketball player, corresponding knowledge, attitudes and practices towards TeV remain largely unknown. Our study specifically investigated such topics in a total of 270 amateur basketball players participating into an internet-based survey by completing a structured questionnaire. Of them, 73.0% had a proper vaccination status, but a third of respondents (33.3%) exhibited some degree of vaccine hesitancy. The average understanding of TeV and tetanus (79.8% with a potential range 0–100) as well as the risk perception for natural infection (63.9% ± 26.6) were quite good. Even though unmotivated fears towards TeV were more scarcely reported (14.0% ± 15.4), they still represented the main reasons for having missed vaccination shots (63.0%). Knowledge status and risk perception for natural infection and TeV were well correlated (R = 0.22 and R = −0.64, respectively). Appropriate TeV status was more likely in respondents not exhibiting vaccine hesitancy (Odds Ratio (OR) 0.114, 95% Confidence Interval (95%CI) 0.059–0.225). In turn, vaccine hesitancy was more frequently reported among individuals of male gender (OR 3.148, 95%CI 1.072–9.244), while better formal education (OR 0.065, 95%CI 0.013–0.319) and working in healthcare settings (OR 0.042, 95%CI 0.007–0.265) were characterized as negative effectors. Vaccinations in athletes represent an often overlooked issue, with a considerable lack of available evidence. The results stress the opportunity for appropriate TeV screening programs among amateur athletes and the potential relevance of interventions aimed at raising the perceived significance of TeV in order to cope with a significant share of vaccine-hesitant athletes.

Highlights

Tetanus is a severe and potentially deadly disease caused by a neurotoxin produced by the spore-forming anaerobic bacteria Clostridium tetani [1,2]
Our study suggests that Italian amateur basketball players (BPs) exhibit vaccination rates that substantially exceed usual estimates for the general population
Despite the extensive acceptance of tetanus vaccination (TeV), up to a third of respondents exhibited a certain degree of vaccine hesitancy, which was mainly associated with non-modifiable factors such as gender, level of formal education, and occupational background from healthcare settings

Summary

Introduction

Tetanus is a severe and potentially deadly disease caused by a neurotoxin produced by the spore-forming anaerobic bacteria Clostridium tetani [1,2]. Since the early 1960s, a specific legal framework (Law No 292/63) identified tetanus vaccination (TeV) as compulsory for all people born after 1968 as well as for workers engaged in activities considered to be at risk for interaction with tetanus toxin (e.g., construction, farming, waste collection and animal husbandry) [5,6,7,8]. In order to cope with such unsatisfying vaccination rates as well as with the re-emergence of anti-vaccination movements [13,14,15], the National Vaccination Prevention Plan 2017–2019 (NVPP) has strongly encouraged the active decennial offer of TeV either as diphtheria toxoid (Td) formulate or tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) in all adults, exploiting all interaction with subjects at higher risk for inappropriate vaccination status, including periodic sport medicine checkups [13,15,16]

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