Italian Physicians’ Opinions on Rotavirus Vaccine Implementation

Abstract

Rotavirus (RV) infection is the main cause of severe acute gastroenteritis (GE) in the pediatric population and has a major impact in both developing and industrialized countries. The reduction of severe RVGE cases, followed by death or hospitalization, is considered the main benefit of RV vaccination, even though its implementation often faces obstacles. In Italy, the recently approved National Immunization Plan aims to overcome the differences among regions, offering a universal free RV vaccination. The aim of the study was to evaluate the opinions on benefit and acceptability of RV vaccination related to the perception of the burden of RV disease. Data were collected from 108 physicians in 2015 by a questionnaire consisting of 12 questions; some answers were compared with those obtained with a similar tool in 2011. The majority of respondents (76.2%) was convinced of the benefit of the vaccine and 57.4% recommended it routinely, but more than half indicated a <25% adherence to RV vaccination among their patients. As the main reasons of vaccine refusal, skepticism about the vaccine (60.4%) and its cost (34.1%) were indicated. Our data confirm that more information and counselling are needed to increase RV vaccine coverage.

Factors Affecting the Implementation Process of Pertussis [Tdap] Immunization in Pregnant Women in an Italian Region: A Qualitative Study

“…These findings confirm those obtained by Signorelli et al, who studied the introduction of meningococcal serogroup B vaccine in Italian regional immunization schedules: they found that the lack of health education and communication activities and the economic sustainability in a context of deprived resources are main barriers to the implementation process (23). Moreover, the results of Mita et al, who studied rotavirus vaccine implementation after the approval of the PNPV, are consistent with our findings (24). Some of our respondents suggested that the ANC booklet should be updated with information about immunizations needed in the antenatal period, and this had also been suggested in other studies (12).…”

Group A rotavirus surveillance before vaccine introduction in Italy, September 2014 to August 2017

“…Both Rotarix and Rotateq are available on the market and their administration is not mandatory. In addition, a debate about the benefits of anti-RVA vaccination is still ongoing among physicians [19]. For these reasons, the anti-RVA vaccination coverage in Italy is still low (8%) and not homogeneous among the different Italian regions (range: 0–40%), which have autonomy in the decision about non-mandatory vaccinations and started the programmes at different times [20].…”

Rotavirus vaccine administration patterns in Italy: potential impact on vaccine coverage, compliance and adherence

“…In a survey conducted in Italy in 2015 among family pediatricians, 76.2% of respondents declared that they were convinced on the value of RV vaccination and 57.4% of them stated that they recommended it in their daily practice; however the adherence to RV vaccination was estimated to be <25% due, in the greatest part (60.4%), to poor confidence in the vaccine. 6 In a more recent web-based survey, more than 85.8% of one thousand family pediatricians spontaneously declared that they would recommend RV vaccination in the future, however more than 40% of them feared that a recommended but not compulsory vaccination might exert a negative impact on family acceptance. 7 On the other side, although surveys carried out among Italian parents documented significant parental distress due to rotavirus gastroenteritis (RVGE) hospitalization (93.6% reporting high/medium stress), many parents were still unwilling to immunize their babies for RV due to a lack of knowledge of the rotavirus burden of disease and the possibility of preventing RVGE by vaccination.…”