HAVE THE IMMUNIZATION COVERAGE TARGETS AMONG INFANTS BEEN AFFECTED BY THE INTRODUCTION OF ADDITIONAL VACCINES IN ITALY?

Background In the last decade, Italy’s National Immunization Plan has progressively included many new vaccines. Before the recent overall decreasing trend in vaccination coverage (VC) became a public health issue, some experts argued that adding new vaccinations in the childhood routine immunization schedule could hamper the attainment of coverage target goals [1]. In this work, we aimed at assessing if the introduction of universal pneumococcal conjugate vaccination (PCV7, followed by PCV13) and varicella vaccination has worsened intake of DTaP-HBV-IPV-Hib vaccine and measles-mumps-rubella vaccine. Methods We compared vaccination coverage levels [2] between the periods 2000-2007 and 2008-2012 in the eight regions that implemented PCV since 2006 (group A: Apulia, Basilicata, Emilia Romagna, Liguria, Province of Trento, Sicily, Valle d'Aosta, Veneto) versus the remaining 13 regions that introduced PCV between 2007 and 2012 (group B: Abruzzo, Calabria, Campania, Friuli – Venezia Giulia, Lazio, Lombardy, Marche, Molise, Province of Bolzano, Piedmont, Sardinia, Tuscany, Umbria) and in the eight regions that introduced varicella vaccine before 2012 (group C: Apulia, Basilicata, Calabria, Friuli – Venezia Giulia, Sardinia, Sicily, Tuscany, Veneto) versus the remaining 13 regions (group D: Abruzzo, Campania, Emilia Romagna, Lazio, Liguria, Lombardy, Marche, Molise, Province of Bolzano, Province of Trento, Piedmont, Umbria, Valle d'Aosta) [3]. Results Between the 2000-2007 and 2008-2012 periods, the following vaccination coverage levels in the four groups of Italian regions were estimated: Ø DT-DTaP: 97% and 96.6% in group A versus 95.8% and 96.2% in group B (Fig. 1a) Ø IPV: 97.3% and 96.6% in group A versus 95.9% (both periods) in group B (Fig. 1b) Ø HBV: 96.1% and 96.2% in group A versus 95.3% and 95.7% in group B (Fig. 1c) Ø Hib: from 86.4% to 96% in group A versus 86.5% to 94.7% in group B (Fig. 1d) Ø M-MMR-MMRV: from 84.7% to 90% in group A versus 82.6% to 89.9% in group B (Fig. 1e) and from 85.4% to 90.7% in group C versus 82.1% to 89.5% in group D (Fig. 2). Conclusions In Italy, those regions that piloted additional vaccinations (PCV and varicella) showed higher uptake rates and an overall smaller decreasing trend in coverage for DTPa-HBV-IPV-Hib vaccine and measles-mumps-rubella vaccine.