Italian survey on public health professionals’ attitudes and beliefs towards mandatory vaccination: a pilot study

Introduction In response to the low rate of vaccination coverage and the concerns around vaccine hesitancy and refusal, in 2017 Italy introduced ten mandatory vaccinations for preschool and school-age children. The debate over mandatory vaccination is still on and involves citizens as well as politicians and health professionals. Within this context, we designed a survey to assess Italian public health professionals’ attitudes and beliefs towards mandatory vaccination. Materials and methods The survey was piloted on a sample of 73 public health professionals belonging to the Italian Society of Hygiene (SItI). The on-line questionnaire consists of five sections: socio-demographic information; political and health system attitudes; personal and professional experience with vaccinations; attitudes and beliefs towards mandatory vaccination; perception of the epidemiologic, social and economic impact of mandatory vaccination. Results Fifty-two people completed the questionnaire, a response rate of 71%. They are mostly medical doctors (86 %) working in Universities (56%) or Prevention departments (21%) and directly involved in vaccinations (71%). The vast majority of respondents is in favor of the Italian mandatory vaccine Law (85%) and 65% believes that it should not be removed. Moreover, 83% or respondents is against the recent Government's proposal of introducing a “flexible” obligation. Among the alternative strategies to mandatory vaccinations, the favorite are vaccination promotion and information campaigns for the general population and organizational interventions to strengthen vaccination services. Nevertheless, 67% of respondents consider their implementation to be very difficult. Concerning the epidemiologic impact of mandatory vaccination, the majority or respondents agree that mandatory vaccination is able to increase vaccination coverage and reduce morbidity from vaccine-preventable infectious diseases. Concerning the social impact, the majority of respondents believes that mandatory vaccination encourages hesitant parents to vaccinate their children but exacerbate the quarrel with no vax movements. Finally, regarding the economic impact, the majority of respondents agree that mandatory vaccination will overall save health and social costs for the National Health System. Conclusions The pilot study showed positive attitudes and believes towards mandatory vaccination among Italian public health professionals. Moreover, it confirmed the usability of the questionnaire and provided important input for the main survey, which will be soon circulated to all the members of the SItI.