Signorelli C, Odone A, Cella P, Iannazzo S
Department of Medicine and Surgery, University of Parma, Parma, Italy - School of Medicine, University Vita-Salute San Raffaele, Milan, Italy.
School of Medicine, University Vita-Salute San Raffaele, Milan, Italy.
Ann Ig. 2018 Jul-Aug;30(4 Supple 1):1-10. doi: 10.7416/ai.2018.2227.
The Italian National Immunization Prevention Plan (PNPV) identifies vaccines actively offered free of charge to target populations within the National Health Service. Despite this, childhood immunization coverage has been declining in Italy in recent years. As a response, the Italian Parliament in July 2017 approved law n. 119 extending mandatory childhood vaccines from four to ten, this stimulating a lively debate at both the scientific and policy level.
We analysed and critically interpreted 2000-2017 Italian national childhood immunization coverage trends, by different vaccine, target population, birth cohort and by Region. In particular, in order to preliminarily assess the impact of the new law, we computed percentage changes in 2016-2017 vaccine coverage for both mandatory and recommended vaccine programs. Data were provided by the Directorate General of Health Prevention of the Italian Ministry of Health.
In 2017 national-level vaccine coverage at 24 months of age was 94.5% for Polio and 91.7% for Measles, this representing, respectively 1.2% and 4.4% increase, as compared to 2016. Conjugate Pneumococcal and Meningococcal C vaccines coverage increased, respectively, by +2.5% and +2.4% between 2016 and 2017. National-level polio vaccine coverage remained above the 95% PNPV coverage target between 2000 and 2013 and has remained below since then. In particular, it has had been steadily declining between 2011 and 2016 (-2.8%). Measles coverage remained well below the 95% coverage target for the entire study period. In recent times, it declined by 4.8% between 2011 and 2015 with the lowest coverage rate reported for year 2015 (85.3%). There is high heterogeneity in coverage within Regions for both mandatory and recommended vaccines.
Preliminary data show that childhood immunization coverage increased since the approval of the new law on mandatory vaccination. Nonetheless, as additional data are accumulating and will make it possible to further assess the impact of the new law, strengthened efforts are needed in Italy to promote informed and proactive vaccine uptake.
意大利国家免疫预防计划（PNPV）确定了在国家医疗服务体系内免费向目标人群积极提供的疫苗。尽管如此，近年来意大利儿童免疫接种覆盖率一直在下降。作为回应，意大利议会于2017年7月批准了第119号法律，将儿童强制疫苗从4种增加到10种，这在科学和政策层面引发了热烈的辩论。
我们分析并批判性地解读了2000 - 2017年意大利全国儿童免疫接种覆盖率趋势，按不同疫苗、目标人群、出生队列和地区进行分析。特别是，为了初步评估新法律的影响，我们计算了2016 - 2017年强制和推荐疫苗计划的疫苗覆盖率变化百分比。数据由意大利卫生部卫生预防总局提供。
2017年，24月龄儿童的脊髓灰质炎疫苗全国覆盖率为94.5%，麻疹疫苗覆盖率为91.7%，与2016年相比，分别增长了1.2%和4.4%。2016年至2017年期间，结合型肺炎球菌疫苗和C群脑膜炎球菌疫苗覆盖率分别增长了2.5%和2.4%。2000年至2013年期间，全国脊髓灰质炎疫苗覆盖率一直高于PNPV覆盖率目标的95%，此后一直低于该目标。特别是，2011年至2016年期间覆盖率一直在稳步下降（-2.8%）。在整个研究期间，麻疹疫苗覆盖率远低于95%的覆盖率目标。近年来，2011年至2015年期间下降了4.8%，2015年的覆盖率最低（85.3%）。无论是强制疫苗还是推荐疫苗，各地区的覆盖率都存在很大差异。
初步数据显示，自强制疫苗接种新法律批准以来，儿童免疫接种覆盖率有所提高。尽管如此，随着更多数据的积累，将有可能进一步评估新法律的影响，意大利需要加大力度促进明智和积极主动地接种疫苗。
