Improved Temporal Trends of Vaccination Coverage Rates in Childhood after the Mandatory Vaccination Act, Italy 2014–2019

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.

Mandate or Not Mandate: Knowledge, Attitudes, and Practices of Italian Occupational Physicians towards SARS-CoV-2 Immunization at the Beginning of Vaccination Campaign

“…A statutory mandate for SARS-CoV-2/COVID-19 vaccines has been advocated as an instrument to rapidly improve immunization rates, particularly among certain occupational groups [ 22 , 23 ], but it remains an ambiguous asset. Even though extensive vaccination mandates were instrumental and effective in improving vaccination rates for those in pediatric ages [ 24 ], it should be stressed that, before the start of the global vaccination campaigns, around 70% of the Western general population was somewhat favorable to get vaccinated as soon as possible [ 2 , 25 , 26 ]. In other words, under favorable conditions, a legal duty to get vaccinated to achieve herd immunity, might not be necessary [ 27 ].…”

Vaccine Hesitancy and Trust in the Scientific Community in Italy: Comparative Analysis from Two Recent Surveys

“…Authors suggested that vaccine mandates for children may have resulted in public attention and discussion that, to some extent, also boosted the adherence to recommended vaccinations that are offered actively at the vaccination point of care during the immunization session. They also stated that, in addition to mandates, education programs encouraging responsible behavior and enhancing vaccine literacy should also be taken into account [ 29 ].…”

Evolving measles status and immunization policy development in six European countries

“…Mandatory immunization has shown benefits in improving pediatric vaccine uptake in Italy; with first MMR dose at 24 months of age increasing from 87.3% in 2016 to 94.5% in 2019 and the corresponding second dose at 6 years increasing from 82.2% to 87.6%. 128 , 129 Although impact data for Germany are not available, this measure is considered in generally favorable terms by German physicians. 105 However, such mandates also provide a focus for public distrust and anti-vaccination sentiments, and for political and social reasons may seem unfeasible in some countries.…”