Parental vaccine hesitancy in Italy – Results from a national survey. Issue 6 (1st February 2018)

• Record Type: Journal Article
• Authors: Giambi, Cristina; Fabiani, Massimo; D'Ancona, Fortunato; Ferrara, Lorenza; Fiacchini, Daniel; Gallo, Tolinda; Martinelli, Domenico; Pascucci, Maria Grazia; Prato, Rosa; Filia, Antonietta; Bella, Antonino; Del Manso, Martina; Rizzo, Caterina; Rota, Maria Cristina
• Is Part Of: Vaccine. Volume 36:Issue 6(2018)
• Page Start: 779
• Page End: 787
• Publication Date: 2018-02-01
• Subjects: Vaccine hesitancy -- Vaccines and immunisation -- Attitude -- Beliefs -- Refusal -- Parental; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2017.12.074
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: About 15% of Italian parents hesitate to vaccinate their children. Safety concerns are the main reported reason for refusing or interrupting vaccination. Negative or discordant advice from health professionals is associated with hesitancy. Paediatricians are the main source of information on vaccinations for hesitant parents. Multiple interventions are necessary to increase trust in vaccinations. Abstract: In Italy, in 2016, we conducted a cross-sectional survey to estimate vaccine hesitancy and investigate its determinants among parents of children aged 16–36 months. Data on parental attitudes and beliefs about vaccinations were collected through a questionnaire administered online or self-administered at pediatricians' offices and nurseries. Parents were classified as pro-vaccine, vaccine-hesitant or anti-vaccine, according to self-reported tetanus and measles vaccination status of their child. Multivariable logistic regression was used to investigate factors associated with hesitancy. A total of 3130 questionnaires were analysed: 83.7% of parents were pro-vaccine, 15.6% vaccine-hesitant and 0.7% anti-vaccine. Safety concerns are the main reported reason for refusing (38.1%) or interrupting (42.4%) vaccination. Anti-vaccine and hesitant parents are significantly more afraid than pro-vaccine parents of short-term (85.7 and 79.7% vs 60.4%) and long-term (95.2 and 72.3% vs 43.7%) vaccine adverse reactions. Most pro-vaccine and hesitant parents agree about the benefits of vaccinations. Family pediatricians are considered a reliable source of information by most pro-vaccine and hesitant parents (96.9 and 83.3% respectively), against 45% of anti-vaccine parents. The main factors associated with hesitancy were found to be: not having received from a paediatrician a recommendation to fully vaccinate their child [adjusted odds ratio (AOR): 3.21, 95% CI: 2.14–4.79], having received discordant opinions on vaccinations (AOR: 1.64, 95% CI: 1.11–2.43), having met parents of children who experienced serious adverse reactions (AOR: 1.49, 95% CI: 1.03–2.15), and mainly using non-traditional medical treatments (AOR: 2.05, 95% CI: 1.31–3.19). Vaccine safety is perceived as a concern by all parents, although more so by hesitant and anti-vaccine parents. Similarly to pro-vaccine parents, hesitant parents consider vaccination an important prevention tool and trust their family pediatricians, suggesting that they could benefit from appropriate communication interventions. Training health professionals and providing homogenous information about vaccinations, in line with national recommendations, are crucial for responding to their concerns.