The NAVIDAD multicentre project: attitudes towards compulsory vaccination in Italy

Background: Vaccine hesitancy is a considerable issue in European Countries and leads to low coverage rates. After a long public debate, in July 2017, Italy turned the Vaccination Plan mandatory to be admitted in schools. to assess vaccine hesitancy and identify possible predictor of vaccine hesitancy. Methods: The NAVIDAD study was conducted among September 2016 and May 2017 in 15 Italian cities. For this project a 63 items questionnaire was administered to 1820 pregnant woman. This paper assessed interviewer’s opinion on mandatory vaccines and how it is influenced by socio-economic framing, will- ingness to vaccinate the newborn, information sources and confidence in the Italian National Healthcare Service (NHS). Results: Most women of the sample (81.6%) declared to be in favour of mandatory vaccinations, 13.8% were against them and 4.5% did not answer to the question. Information sources play a key role in determining the opinion on restoration of mandatory vaccine, in particular women who got information from anti- vaccination movements websites are less likely to accept it (OR: 0.35, 95%CI: 0.21-0.58, p<0.001). Women who had confidence in healthcare professional information agreed more on mandatory vaccination than the other (OR: 2.66, 95%CI:1.62-4.36, p < 0.001), who perceive that healthcare professionals have economic interest in child immunization and who declared that healthcare providers inform only on vaccinations benefits not on risks were less likely to agree on compulsory vaccination (OR: 0.66, CI 95%: 0.46-0.96, p = 0,03;OR: 0.66, CI 95%: 0.46-0.95, p = 0.03). Conclusions: Information sources and confidence towards health profes- sionals are the main determinants of acceptance of mandatory vaccine restoration. In order to increase the acceptability of the restoration and reduce vaccine hesitancy, these aspects need to be strengthened.