Trends in pediatric vaccination coverage in Italy from 2000 to 2023

Vaccination represents one of the most effective public health interventions. However, a decrease in pediatric vaccination coverage has been observed in Italy, with an increase in vaccine-preventable infectious diseases. To counter this phenomenon, the Italian government approved a compulsory vaccination law in 2017, increasing the number of mandatory vaccinations from four to 10. This study analyzes the trends of vaccination coverages in Italy from 2000 to 2023, with a focus on the impact of the law. Vaccination coverage data were obtained from the Italian Ministry of Health, sorted by antigen. A linear regression and joinpoint regression analysis was performed for each antigen to identify a significant or non-significant change (increase or decrease) in the trend. Vaccination coverages declined steadily until 2015, but with the introduction of the law 119/2017, there was an increase for all antigens, ranging from 1.05% for tetanus to 5.30% for rubella. During the years of the COVID-19 pandemic, a decline in coverage was observed for all antigens, with values ranging from -0.24% for varicella to -2.39% for rubella. Implementing vaccine mandates seem to be useful for increasing vaccination coverages. Likewise, this study showed the negative impact of the COVID-19 pandemic on primary healthcare services, such as vaccination, contributing to a decline in coverage. Health systems should measure vaccination coverages and monitor changes and variations to be resilient toward external stressors and be proactive in tackling crises.