The introduction of mandatory vaccinations in Italy: impact assessment and development of a support strategy for health workers

Background. In order to counteract the fall in immunization coverage observed in Italy during the past years, the Italian Government has approved a law decree (then converted in Law 119/2017), obliging all preschool pupils (aged 0-6) to be immunized against 10 vaccine-preventable diseases to be admitted to state-run nurseries and kindergardens. Objectives. The project aims to assess the impact of the mandatory vaccinations policy on the various actors involved in its implementation (vaccination centres, schools, parents) and to formulate a strategy to support health workers working in family care centres for the dissemination of correct information on vaccinations to parents. In particolar, the specific objectives will be: to assess the impact of the policy on parents’ attitudes regarding vaccinations; to evaluate the capacity of health staff working in local vaccination centres to respond to the increased demand for vaccines; to assess the capacity of school staff to control the vaccination status of their pupils; to develop a traning and communication strategy to be implemented in family care centres to support vaccinations’ acceptance among parents. Preliminary results. Preliminary data on vaccination coverage in 2017 show that the new law seems to be working: one-third of the previously unvaccinated children born in 2011-15 have now been immunized, and polio and measles vaccine uptake has increased by 1% and 2.9%, respectively. No data are available yet on the impact on parental attitudes on vaccination nor on barriers to the policy implementation at the local level. A survey on the midwives working in family centres of Rome Province is ongoing to assess their knowledge and attitudes on vaccinations, in order to develop tailored tranining and communication strategies. Conclusions and perspectives. The existence of a gap between what was planned and what occurs as a result of a policy is common, but little research is conducted on this topic. The project will provide useful elements for assessing the actual impact of the mandatory vaccinations policy’s implementation in Italy, with the ultimate objective of contributing to the development of health policy guidelines for the provision of vaccination services.