Childhood vaccination coverage in Italy: results of a seven region survey

In Italy few data exist on vaccination coverage and timeliness. We therefore carried out cluster surveys on 12-23-month-olds in nine Italian cities and regions using standard Expanded Programme on Immunization methodology. The study areas accounted for 40% of all live births in Italy in 1991. Coverage levels for the third dose of diphtheria and tetanus toxoids and for oral poliovirus vaccine, which are mandatory, exceeded 90% in all but one area. However, less than two-thirds of the children had completed the primary vaccine series by their first birthday. The commonest reason for failure to complete the series in time was that the child had been sick and was not brought for vaccination. For the two optional vaccines (pertussis and measles) coverage was much poorer, ranging from 8% to 71% for pertussis and from 9% to 53% for measles. The commonest reason given by the mothers for pertussis non-vaccination was that they had been advised against it, while for measles the commonest reasons were that the child was sick and that they had been advised against it. These findings suggest that although coverage for the mandatory vaccines is high, coverage for pertussis and measles is very low. Additional education of physicians and mothers is needed concerning the true contraindications for vaccination. Also, in the absence of legislation making pertussis and measles vaccines mandatory, greater efforts are needed to convince physicians and the public about the benefits of their use.