Crenna Stefano, Osculati Antonio, Visonà Silvia D
Section of Legal Medicine and Forensic Science, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy.
J Public Health Res. 2018 Dec 20;7(3):1523. doi: 10.4081/jphr.2018.1523.
The effective control of vaccine-preventable diseases generally requires indefinite maintenance of extremely high rates of timely vaccination. Therefore, vaccine hesitancy is of paramount importance and needs to be addressed. In Italy, regulations about vaccinations are controversial and, to some extent, inconsistent. Even though the childhood vaccinations are mandatory by law (Italian Law n. 891/1939, n. 292/1963, n.51/1966 and n. 165/1991), the limited deterrent effectiveness of the sanctioning system, and the changes introduced by the Italian Constitutional Law n. 3/2001 (devolution of almost all the competences and responsibilities in health matters to the Regions and the Autonomous Provinces), were the fertile ground in which new vaccine policies were generated and developed, radically different from the existing ones: many Regions, based on what was decided in 2005 - on an experimental basis - by the State-Regions Conference, decided to abolish the vaccination obligation and/or to stop the imposition of administrative sanctions on non-compliant parents. In addition, since then, there is a worrying tendency to decline vaccinations due to the parents' mistrust in pharmaceutical companies and health policies. Therefore, recently, the Italian government decided to deploy an emergency ordinance (Italian Decree Law n. 73/2017). In this article, the authors are going to illustrate the current situation in Italy concerning vaccination policy, from a legislative and social point of view.
有效控制疫苗可预防疾病通常需要长期维持极高的及时接种率。因此,疫苗犹豫至关重要,需要加以解决。在意大利,有关疫苗接种的法规存在争议,且在一定程度上不一致。尽管儿童疫苗接种在法律上是强制性的(意大利第891/1939号、第292/1963号、第51/1966号和第165/1991号法律),但制裁制度的威慑效力有限,以及意大利第3/2001号宪法法律(将几乎所有卫生事务的权限和责任下放给各地区和自治省)所带来的变化,为新疫苗政策的产生和发展创造了条件,这些政策与现有政策截然不同:许多地区根据2005年国家-地区会议在实验基础上做出的决定,决定废除疫苗接种义务和/或停止对不遵守规定的父母实施行政制裁。此外,从那时起,由于父母对制药公司和卫生政策的不信任,疫苗接种率出现了令人担忧的下降趋势。因此,最近意大利政府决定颁布一项紧急法令(意大利第73/2017号法令)。在本文中,作者将从立法和社会角度阐述意大利目前疫苗接种政策的现状。