Factors influencing vaccine uptake in Italy.

In Italy, vaccination of children is regulated by a dual system, that is a certain number of compulsory immunisations, and a number of other facultative vaccinations. This has resulted in a different coverage against infections under the two regimens. While the percentage of immunised children against polio, diphtheria, tetanus and hepatitis B is around 95%, until recently the average coverage with facultative vaccinations was no >50%. Coverage against pertussis has dramatically increased in recent times thanks to the advent of acellular and combined vaccines. Regional programmes that aim to increase coverage against measles, mumps and rubella are presently underway. In order to verify the attitude of mothers towards vaccination, a questionnaire-based study was proposed to women taking their children to vaccination services for mandatory immunisation. The preliminary results on 300 questionnaires show a generally favourable attitude towards vaccines of 80% of mothers. Only 7% of them would not immunise at all their children if vaccinations were not mandatory. Measles and mumps vaccines are considered important by 92% of mothers. However, a high number of both parents and paediatricians still give disproportionate importance to mild intercurrent diseases as a reason to differ immunisation. In the middle-long term, it is likely that Italy will shift to a system of recommended immunisations without compulsion. Before this happens, wide and in-depth campaigns on the benefits of vaccination need to be planned and implemented by central and local health authorities, in order to avoid the risk of a dramatic drop of coverage.