Learning from the Past to Improve the Future—Vaccine Hesitancy Determinants in the Italian Population: A Systematic Review

Abstract

WHO identifies vaccine hesitancy (VH) as one of the ten threats to global health. The authors bring to the international scientific community an Italian episode that offers the opportunity to renew the discussion on the extent of the VH matter. The purpose of this systematic review is to analyze the factors determining vaccine hesitancy in the Italian population, to understand its roots, and suggest potential strategies to mitigate it. A systematic review of the literature according to the PRISMA guidelines was carried out using the SCOPUS and Medline (via PubMed) databases, using the following strategy: (COVID-19 vaccines) AND (vaccination hesitancy) AND (Italy). After the selection process, 36 articles were included in this systematic review. The most frequently detected factors associated with VH in the Italian population can be grouped as vaccine-related factors, socio-cultural factors, and demographic factors. Currently, we are facing a gap between the population and science, governments, and institutions. To heal this breach, it is necessary to strengthen the trust of the population through the implementation of health communication and public education strategies, while scientific literacy must continue to support families and individuals in discerning evidence from opinions to recognize the real risks and balance them with the benefits.

Exploring COVID-19 Vaccination Willingness in Italy: A Focus on Resident Foreigners and Italians Using Data from PASSI and PASSI d’Argento Surveillance Systems

“…A larger sample size might yield significant results. Similar findings concerning distrust in institutions, the government, public health authorities, and in the information received were reported in various studies on the willingness to get vaccinated [ 40 , 41 , 42 , 43 , 44 , 51 , 52 ].…”

“…A multivariate analysis revealed that sociodemographic factors influenced vaccination propensity; notably, there was a (female) gender-related refusal of the COVID-19 vaccination among the foreign resident group, unlike the Italian group. No significant association was reported in scientific literature between gender and migrants’ willingness to get vaccinated [ 40 , 41 , 42 ], while two systematic reviews reported that the female gender is a determinant for hesitancy in the Italian population [ 43 , 44 ].…”

“…A monthly random sample was extracted from the resident lists in each LHU, stratified by sex and age group (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49), and 50-69 for PASSI; 65-74, 75−84, and ≥85 years of age for PASSI d'Argento) according to the population proportion in each stratum. The LHU data were merged, weighted (each record received a probability weight equivalent to the inverse of the sampling fraction within each LHU stratum), and analysed to obtain estimates at the national level.…”

COVID-19 Vaccination Actual Uptake and Potential Inequalities Due to Socio-Demographic Characteristics: A Population-Based Study in the Umbria Region, Italy

“…The relationship between sex, age and uptake of vaccination can be discussed in the light of current knowledge on the factors influencing vaccine hesitancy. In fact, two systematic reviews on COVID-19 vaccination hesitancy in the Italian population reported a higher hesitancy in females and younger people [ 18 , 30 ]. These results were also confirmed by studies performed outside Italy and their systematic reviews [ 31 , 32 ].…”

Challenges to Implementing a Vaccine for Coccidioidomycosis

“…A novel coccidioidal vaccine will require a specific plan to educate the public about its benefits and potential risks. This will require a multipronged approach directed at education from trusted sources, examination of social and cultural values, and retooling of health-related media platforms to combat misinformation [ 79 ]. In addition, the populations initially targeted for vaccination should be those who are most at risk and would most benefit from vaccination.…”