Knowledge, attitudes and behaviors of the Italian population towards Neisseria meningitidis, Streptococcus pneumoniae and HPV diseases and vaccinations: A cross-sectional multicentre study

Invasive Meningococcal Disease and Meningococcal Serogroup B Vaccination in Adults and Their Offspring: Knowledge, Attitudes, and Practices in Italy (2019)

“…Eventually, the male gender, living in a municipality >15,000 inhabitants, reporting a favorable attitude on meningococcus B vaccine, having been vaccinated against serogroup B, and/or serogroup C, and having previously vaccinated their offspring against serogroup C meningococcus were characterized as positive effectors. Personal antecedents with meningococcal vaccines (both in the respondents and their offspring) are not only the most significant effectors but are highly consistent with the underlying health belief model (HBM) [ 29 , 59 ]. Even though it was originally developed in the 1950s, HBM is still widely applied in health behavior research [ 60 , 61 , 62 ].…”

“…As a consequence, we reasonably collected a substantial share of individuals who were particularly willing to contribute to our study because of a series of factors, including and not limited to their better literacy or younger age, an increased attitude to sharing personal information through Internet access, greater knowledge and/or interest about the assessed topic, and a stronger will to contribute to health-care-related research because of their healthcare background [ 81 ]. Not coincidentally, we clearly oversampled individuals of the female gender (78.1%), a feature that was still shared by previous Italian studies on meningococcal vaccines [ 29 , 71 ], and that is often reported in KAP surveys on healthcare topics [ 59 , 89 , 90 , 91 , 92 , 93 ].…”

“…In comparison to other Italian reports, we specifically did not inquire whether respondents had any knowledge of MenB [ 71 ], but similarly to the report by de Waure et al [ 29 ] on MenC, we assessed the vaccination status of offspring. In this regard, it is of some interest to stress how the share of respondents having reportedly vaccinated their children was strikingly different, i.e., 68.8% in the aforementioned study compared to 38.7% in our study (chi square 78.51, p < 0.001).…”

“…In fact, not only is Italy usually acknowledged as geographically quite heterogenous in terms of health literacy [ 25 , 79 , 80 ], but also our sampling strategy could explain such heterogeneity. In both studies, sampled individuals included either people aged ≥18 years accessing the department of prevention of the local health authorities of Genoa, Savona, Roma, and Viterbo (two different regions, Liguria and Latium) [ 29 ] or parents of children from primary and middle schools from Naples and Salerno (region of Campania) [ 71 ]. As a consequence, our study not only reports on quite different areas (North-Western provinces of Emilia Romagna Region), but also on different individuals, either in terms of literacy, town size, or easiness to access the vaccination programs (which in Italy are region-based).…”

“…More precisely, Italian Medicines Agency (AIFA) has authorized the use of a quadrivalent recombinant vaccine developed through “reverse vaccinology” (i.e., preparation of the vaccine starting from the identification of genes encoding antigenic proteins), or 4CMenB, among infants >2 months since 2014, and a bivalent recombinant vaccine (MenB-FHbp) in children >10 years of age since 2017 [ 23 ]. Despite considerable efforts, vaccination rates for MenB have remained suboptimal due to a series of factors, ranging from the heterogeneity in the vaccination policies in terms of official recommendations and the actual costs of the vaccine [ 19 , 27 , 28 , 29 ], limited effectiveness of the sanctioning system, low-risk perception of infectious diseases, confidence in the availability of antimicrobial therapies, scientific misinformation, and the re-emergence of anti-vaccination movements [ 25 , 30 , 31 ]. More precisely, while all children born after 2015 were offered MenB vaccine totally at no cost to their parents, parents of individuals born before 2015 and not affected by risk factors for IMD may be requested to partially or even totally contribute to the costs of the vaccine [ 19 ].…”