The Impact of Mandatory Vaccination Law in Italy on MMR Coverage Rates in Two of the Largest Italian Regions (Emilia-Romagna and Sicily): An Effective Strategy to Contrast Vaccine Hesitancy

Abstract

Background: Vaccine hesitancy has increased worldwide, leading to reduction in vaccination coverage rates. In particular, reduction in the coverage for the trivalent Measles-Mumps-Rubella vaccine has led to an increase of measles cases. The aim of this study is to analyze the coverage rates for the MMR vaccine in the Emilia-Romagna Region (RER) and Sicily Region (SR) between 2009 and 2018, and to correlate any significant change to index events which could have modified the trend of vaccination rates. Methods: Official aggregate data on vaccination coverage at 24 months provided by the RER and the SR were analyzed through trend analysis and related to important index events. Results: The two regions showed similar results; both achieved the lowest coverage rates in 2015 and both showed an increase in the rates after the introduction of mandatory vaccinations for access to schools. In 2018, both reached the starting point before the decrease. Conclusions: Our results confirm the effectiveness of legislative coercive measures in favor of vaccination. A potential decrease in the coverage rates may be observed as a result of an attenuation of the positive effects of coercive measures over time. It is thus necessary to combine these measures together with information campaigns and political initiatives at different levels (i.e., national, regional).

The long-term success of mandatory vaccination laws at implementing the first vaccination campaign in 19thcentury rural Finland

“…Our results show an abrupt increase in the vaccination coverage at the start of the vaccination law. Similarly, short-term studies in contemporary societies observed immediate increases in vaccination coverage after the introduction of the vaccination laws (16,56) and our study suggested that the observed increases will persist on a longer term. In our study the increase in vaccination coverage associated with the start of the vaccination law could be due to a law-abiding decrease in vaccine hesitancy or alternatively due to a sudden improvement in vaccine access or delivery.…”

Análise das unidades de vacinação públicas do município de Aracaju-Se

“…18 É de extrema importância que as equipes da imunização trabalhem com base em conhecimentos que tornem suas ações mais eficientes, já que, alguns especialistas na área identificaram falta desde a supervisão, educação, capacitação, além da inexistência de normas consistentes envolvendo todos os processos de transporte de vacinas. (19) Para minimizar os efeitos deletérios das taxas de vacinação subótimas 10 , várias estratégias são utilizadas para garantir que a população receba a vacinação em tempo oportuno, como a vacinação extramuro, a de rotina, de bloqueio, as campanhas, a disponibilidade de horários noturnos em algumas unidades de saúde, a busca ativa de faltosos, o controle rigoroso dos cartões controles e a educação em saúde. Fato este, um pouco distante da realidade do município avaliado em que de 50% a 70% dos locais avaliados algumas dessas atividades supracitadas não se constituía como uma atividade rotineira e isso corrobora com outros estudos.…”

Vaccination and Vaccine Effectiveness: A Commentary of Special Issue Editors

“…Mascia et al demonstrated in a multicenter survey that Italian adolescents share information and knowledge on vaccination especially through social networks [ 17 ]. Furthermore, from a comparison between two of the most populous (Emilia Romagna and Sicily) Italian regions, it emerged that the legislative coercive measures applied in Italy at the end of 2017 had a favorable impact on MMRV vaccination coverage rates among children [ 18 ].…”