Vaccine coverage in Italy and assessment of the 2012-2014 National Immunization Prevention Plan.
BACKGROUND
In 2012, the ItalianMinistry of Health issued the National Immunization Prevention Plan (Piano Nazionale Prevenzione Vaccinale, or PNPV 2012-2014), with the aim of harmonizing immunization strategies across the country and ensuring equitable access to infectious disease prevention to all citizens. The Plan defines the immunization standards all regions should comply with.


OBJECTIVE
As new evidence has accumulated in the field of immunization, and the new National Immunization Prevention Plan is about to be launched, the aim of the current study is to: i. present immunization coverage data (2000-2014) for 14 vaccines included in the PNPV to be offered to the general population, ii. assess to what extent the PNPV coverage targets and objectives have been met, and iii. report on how the PNPV was transposed into regional immunization programs. Data are also available for the eight regions that piloted varicella immunization.


RESULTS
The 2012-2014 PNPV first introduced a "lifecourse" approach to vaccination at the institutional level, and has been a milestone for prevention in the Italian health policy agenda. However, infant vaccine coverage rates have been decreasing over the last years, as has influenza immunization in the elderly. HPV vaccine coverage has been increasing for all birth cohorts, but is still far below the targets set in the Plan. Promising preliminary data show that pneumococcal and meningococcal C conjugate vaccines were well introduced in regional immunization schedules.


CONCLUSIONS
The 2012-2014 PNPV objectives have only been partially met, due to several factors, in particular increase in vaccine hesitancy. Strengthened efforts are needed to promote immunization. The new National Immunization Prevention Plan should introduce new vaccines and extend immunization programs to other target populations on the basis of the most recent scientific evidence available. It is of crucial importance that interventions of proven efficacy be planned and implemented to contrast the growing phenomenon of vaccine hesitancy and ultimately increase immunization uptake.
Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI).
Paolo
P
Bonanni
Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI).
Antonio
A
Ferro
Direzione generale della prevenzione sanitaria, Ministero della salute, Roma, Italy.
Raniero
R
Guerra
Direzione generale della prevenzione sanitaria, Ministero della salute, Roma, Italy.
Stefania
S
Iannazzo
Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI). anna.odone@mail.harvard.edu.
Anna
A
Odone
Direzione generale della prevenzione sanitaria, Ministero della salute, Roma, Italy.
Maria Grazia
MG
Pompa
Direzione generale della prevenzione sanitaria, Ministero della salute, Roma, Italy.
Elvira
E
Rizzuto
Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI).
Carlo
C
Signorelli
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D006801:Humans; D017589:Immunization Programs / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D007115:Immunization Schedule; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D008875:Middle Aged; D009313:National Health Programs; D015397:Program Evaluation; D014611:Vaccination / Q000592:standards / Q000706:statistics & numerical data*; D000072758:Vaccination Refusal / Q000639:trends*; D055815:Young Adult