Childhood Immunization Coverage Before, During and After the COVID-19 Pandemic in Italy
<b>Background/Objectives:</b> Maintaining high childhood vaccination coverage is essential to prevent outbreaks of vaccine-preventable diseases. In Italy, Law No. 119/2017 introduced mandatory childhood immunizations, leading to significant improvements. However, the COVID-19 pandemic di...
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MDPI AG
2025-06-01
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| Online Access: | https://www.mdpi.com/2076-393X/13/7/683 |
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| author | Flavia Pennisi Andrea Silenzi Alessia Mammone Andrea Siddu Anna Odone Michela Sabbatucci Riccardo Orioli Anna Carole D’Amelio Francesco Maraglino Giovanni Rezza Carlo Signorelli |
| author_facet | Flavia Pennisi Andrea Silenzi Alessia Mammone Andrea Siddu Anna Odone Michela Sabbatucci Riccardo Orioli Anna Carole D’Amelio Francesco Maraglino Giovanni Rezza Carlo Signorelli |
| author_sort | Flavia Pennisi |
| collection | DOAJ |
| description | <b>Background/Objectives:</b> Maintaining high childhood vaccination coverage is essential to prevent outbreaks of vaccine-preventable diseases. In Italy, Law No. 119/2017 introduced mandatory childhood immunizations, leading to significant improvements. However, the COVID-19 pandemic disrupted routine services, potentially jeopardizing these gains. This study aimed to evaluate national and regional trends in vaccine coverage across three phases: post-mandate (2015–2016 vs. 2017–2019), pandemic (2017–2019 vs. 2020–2021), and post-pandemic recovery (2020–2021 vs. 2022–2023). <b>Methods:</b> National and regional administrative data on vaccination coverage at 24 months of age were obtained from the Italian Ministry of Health. Temporal trends were analyzed using Joinpoint regression to estimate annual percent changes (APCs), and absolute changes in coverage (Δ) were calculated across defined periods. Pearson correlation coefficients were used to assess associations between baseline coverage and subsequent changes. <b>Results:</b> After the 2017 mandate, coverage increased significantly for varicella (APC = +28.6%), MenB (+22.6%), and measles (+3.4%). Regionally, varicella coverage rose by up to +58.4% in Emilia-Romagna and measles by +11.1% in Campania. During the pandemic, coverage declined for polio (−2.4% in the South) and measles (−6.2% in Abruzzo), while MenB increased in regions with lower initial uptake (r = −0.918, <i>p</i> < 0.001). Post-pandemic, coverage rebounded, with varicella improving by +20.1% in central regions and measles by +13.9% in Abruzzo. A strong inverse correlation between baseline coverage and improvement was observed for varicella across all periods (r from −0.877 to −0.915). <b>Conclusions:</b> Mandatory vaccination policies led to substantial coverage improvements, and despite the disruption caused by the pandemic, recovery trends were observed for most vaccines. The consistent association between low baseline coverage and stronger gains highlights the resilience of the system, but also the ongoing need for regionally tailored strategies to reduce geographic disparities and ensure equitable immunization across Italy. |
| format | Article |
| id | doaj-art-692cf547f9494513bbf36c3e894435c4 |
| institution | Kabale University |
| issn | 2076-393X |
| language | English |
| publishDate | 2025-06-01 |
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| series | Vaccines |
| spelling | doaj-art-692cf547f9494513bbf36c3e894435c42025-08-20T03:56:46ZengMDPI AGVaccines2076-393X2025-06-0113768310.3390/vaccines13070683Childhood Immunization Coverage Before, During and After the COVID-19 Pandemic in ItalyFlavia Pennisi0Andrea Silenzi1Alessia Mammone2Andrea Siddu3Anna Odone4Michela Sabbatucci5Riccardo Orioli6Anna Carole D’Amelio7Francesco Maraglino8Giovanni Rezza9Carlo Signorelli10National PhD Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, ItalyCenter for Research and Studies on Leadership in Medicine, Università Cattolica del Sacro Cuore, 00168 Rome, ItalyGeneral Directorate of Health Prevention, Ministry of Health, 00153 Rome, ItalyHealth Promotion and Prevention, Regional Directorate for Health and Social-Health Integration, Lazio Region, 00193 Rome, ItalyDepartment of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, ItalyGeneral Directorate of Health Prevention, Ministry of Health, 00153 Rome, ItalyGeneral Directorate of Health Prevention, Ministry of Health, 00153 Rome, ItalySchool of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, ItalyGeneral Directorate of Health Prevention, Ministry of Health, 00153 Rome, ItalySchool of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, ItalySchool of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy<b>Background/Objectives:</b> Maintaining high childhood vaccination coverage is essential to prevent outbreaks of vaccine-preventable diseases. In Italy, Law No. 119/2017 introduced mandatory childhood immunizations, leading to significant improvements. However, the COVID-19 pandemic disrupted routine services, potentially jeopardizing these gains. This study aimed to evaluate national and regional trends in vaccine coverage across three phases: post-mandate (2015–2016 vs. 2017–2019), pandemic (2017–2019 vs. 2020–2021), and post-pandemic recovery (2020–2021 vs. 2022–2023). <b>Methods:</b> National and regional administrative data on vaccination coverage at 24 months of age were obtained from the Italian Ministry of Health. Temporal trends were analyzed using Joinpoint regression to estimate annual percent changes (APCs), and absolute changes in coverage (Δ) were calculated across defined periods. Pearson correlation coefficients were used to assess associations between baseline coverage and subsequent changes. <b>Results:</b> After the 2017 mandate, coverage increased significantly for varicella (APC = +28.6%), MenB (+22.6%), and measles (+3.4%). Regionally, varicella coverage rose by up to +58.4% in Emilia-Romagna and measles by +11.1% in Campania. During the pandemic, coverage declined for polio (−2.4% in the South) and measles (−6.2% in Abruzzo), while MenB increased in regions with lower initial uptake (r = −0.918, <i>p</i> < 0.001). Post-pandemic, coverage rebounded, with varicella improving by +20.1% in central regions and measles by +13.9% in Abruzzo. A strong inverse correlation between baseline coverage and improvement was observed for varicella across all periods (r from −0.877 to −0.915). <b>Conclusions:</b> Mandatory vaccination policies led to substantial coverage improvements, and despite the disruption caused by the pandemic, recovery trends were observed for most vaccines. The consistent association between low baseline coverage and stronger gains highlights the resilience of the system, but also the ongoing need for regionally tailored strategies to reduce geographic disparities and ensure equitable immunization across Italy.https://www.mdpi.com/2076-393X/13/7/683vaccinesmandatory vaccinationvaccination coverageCOVID-19 pandemicvaccination strategies |
| spellingShingle | Flavia Pennisi Andrea Silenzi Alessia Mammone Andrea Siddu Anna Odone Michela Sabbatucci Riccardo Orioli Anna Carole D’Amelio Francesco Maraglino Giovanni Rezza Carlo Signorelli Childhood Immunization Coverage Before, During and After the COVID-19 Pandemic in Italy Vaccines vaccines mandatory vaccination vaccination coverage COVID-19 pandemic vaccination strategies |
| title | Childhood Immunization Coverage Before, During and After the COVID-19 Pandemic in Italy |
| title_full | Childhood Immunization Coverage Before, During and After the COVID-19 Pandemic in Italy |
| title_fullStr | Childhood Immunization Coverage Before, During and After the COVID-19 Pandemic in Italy |
| title_full_unstemmed | Childhood Immunization Coverage Before, During and After the COVID-19 Pandemic in Italy |
| title_short | Childhood Immunization Coverage Before, During and After the COVID-19 Pandemic in Italy |
| title_sort | childhood immunization coverage before during and after the covid 19 pandemic in italy |
| topic | vaccines mandatory vaccination vaccination coverage COVID-19 pandemic vaccination strategies |
| url | https://www.mdpi.com/2076-393X/13/7/683 |
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