COVID-19: parental vaccine hesitancy and misinformation in Italy

According to the Strategic Advisory Group of Experts on Immunization (SAGE), vaccine hesitancy can be defined as the “delayed acceptance or refusal of vaccination despite the availability of vaccination services” (MacDonald, 2015) and it is one of the top 10 global health threats (WHO, 2019). From January 2021, the Italian Government implemented a vaccination program aiming at vaccinating most of the population (Bloom et al., 2020). It is important to point out that, following a general decrease in adherence to vaccination programs in Italy, in July 2017 the Parliament issued an ad-hoc decree law (n.119/2017), introducing compulsory vaccinations for infants and recommending their exclusion from nursery schools if not vaccinated. A controversy ensued, as a no-vax movement emerged to oppose to the new law and dispute its compliance with the Italian Constitution. The movement continued to develop during the COVID-19 pandemic, and anti-vax groups proliferated, particularly in the northern regions of the country (Moscardino et al., 2022). A crucial factor influencing vaccine hesitancy is the dissemination of false, misleading information, such as the proliferation of anti-Vax groups on social media (Johnson et al., 2020). A recent study found that belief in misinformation was associated with lower intention to be vaccinated against COVID-19 across 40 countries (Singh et al., Santirocchi et al., 2022). The present study investigates the factors influencing parents' hesitation to vaccinate their children against COVID-19. It aims to: 1) examine whether there are differences in the willingness to vaccinate children of different ages; 2) assess the role of exposure to fake news as a variable that could reduce the willingness to vaccinate one's children and receive the fourth dose. Method: A questionnaire assessing disinformation and vaccine availability towards children was prepared using Google Forms and disseminated to parents through different social media. All data were collected between 5th February and 5th June 2022 and is from an empirical study. We collected 100 participants. Results: We performed a one-way ANOVA with “child age” (18-15, 14-12, 11-5) as the independent variable and “availability” as the dependent variable. The results showed a significant difference between the three groups [F(2,97)=15.38, p<0.01]. Post hoc analysis revealed that the parents of the 15-18 group showed significantly lower availability compared to parents of the 12-14 group and of the 5-11 group. A negative correlation [r(98)=-0.35, p<0.001] emerged between belief of misinformation and availability to vaccinate children, showing that higher levels of misinformation are associated to higher hesitancy. Conclusions: High rates of parental hesitancy towards adolescents could be driven by a combination of low perception of infection susceptibility and higher protective behaviours aiming at exerting control (Musa et al., 2021). Furthermore, the results of our study highlight the danger of the “infodemic” the population is experiencing. In a historical period characterized by the fight against COVID-19, it is evident how fake news can undermine the population's choices on vaccines. We therefore consider it useful that strategies are developed to counteract misinformation and provide the appropriate means for the population to recognize them.