{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:56:44Z","timestamp":1789729004626,"version":"4.0.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>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 \u22120.24% for varicella to \u22122.39% 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.<\/jats:p>","DOI":"10.1093\/eurpub\/ckaf107","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T11:47:10Z","timestamp":1752061630000},"page":"781-787","source":"Crossref","is-referenced-by-count":4,"title":["Trends in pediatric vaccination coverage in Italy from 2000 to 2023"],"prefix":"10.1093","volume":"35","author":[{"given":"Leonardo","family":"Villani","sequence":"first","affiliation":[{"name":"Department of Life Sciences and Public Health, Section of Hygiene, Universit\u00e0 Cattolica del Sacro Cuore , Rome,","place":["Italy"]},{"name":"UniCamillus \u2014 Saint Camillus International University of Health and Medical Sciences, Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco Andrea","family":"Causio","sequence":"additional","affiliation":[{"name":"Department of Life Sciences and Public Health, Section of Hygiene, Universit\u00e0 Cattolica del Sacro Cuore , Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosimo","family":"Savoia","sequence":"additional","affiliation":[{"name":"Department of Life Sciences and Public Health, Section of Hygiene, Universit\u00e0 Cattolica del Sacro Cuore , Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Pastorino","sequence":"additional","affiliation":[{"name":"Department of Life Sciences and Public Health, Section of Hygiene, Universit\u00e0 Cattolica del Sacro Cuore , Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5655-688X","authenticated-orcid":false,"given":"Walter","family":"Ricciardi","sequence":"additional","affiliation":[{"name":"Department of Life Sciences and Public Health, Section of Hygiene, Universit\u00e0 Cattolica del Sacro Cuore , Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Boccia","sequence":"additional","affiliation":[{"name":"Department of Life Sciences and Public Health, Section of Hygiene, Universit\u00e0 Cattolica del Sacro Cuore , Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4346-1494","authenticated-orcid":false,"given":"Chiara","family":"de Waure","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Perugia , Perugia,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"2025073115054934800_ckaf107-B1","author":"World Health Organization (WHO)"},{"key":"2025073115054934800_ckaf107-B2","doi-asserted-by":"crossref","first-page":"2307","DOI":"10.1016\/S0140-6736(24)00850-X","article-title":"Contribution of vaccination to improved survival and health: modelling 50 years of the expanded programme on immunization","volume":"403","author":"Shattock","year":"2024","journal-title":"Lancet"},{"key":"2025073115054934800_ckaf107-B3","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.vaccine.2018.11.056","article-title":"Cost-effectiveness of adult vaccinations: a systematic review","volume":"37","author":"Leidner","year":"2019","journal-title":"Vaccine"},{"key":"2025073115054934800_ckaf107-B4","doi-asserted-by":"crossref","first-page":"27041","DOI":"10.3402\/jmahp.v3.27041","article-title":"Vaccination: the cornerstone of an efficient healthcare system","volume":"3","author":"R\u00e9my","year":"2015","journal-title":"J Mark Access Health Policy"},{"key":"2025073115054934800_ckaf107-B5","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1586\/14760584.2015.964212","article-title":"Vaccine hesitancy, vaccine refusal and the anti-vaccine movement: influence, impact and implications","volume":"14","author":"Dub\u00e9","year":"2015","journal-title":"Expert Rev Vaccines"},{"key":"2025073115054934800_ckaf107-B6","doi-asserted-by":"crossref","first-page":"4161","DOI":"10.1016\/j.vaccine.2015.04.036","article-title":"Vaccine hesitancy: definition, scope and determinants","volume":"33","author":"MacDonald","year":"2015","journal-title":"Vaccine"},{"key":"2025073115054934800_ckaf107-B7","doi-asserted-by":"crossref","first-page":"4212","DOI":"10.1016\/j.vaccine.2015.04.042","article-title":"Health communication and vaccine hesitancy","volume":"33","author":"Goldstein","year":"2015","journal-title":"Vaccine"},{"key":"2025073115054934800_ckaf107-B8","volume-title":"Vaccination in Acute Humanitarian Emergencies: A Framework for Decision Making","author":"World Health Organization (WHO)","year":"2017"},{"key":"2025073115054934800_ckaf107-B9","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1016\/j.vaccine.2020.10.024","article-title":"Maintain and increase vaccination coverage in children, adolescents, adults and elderly people: let\u2019s avoid adding epidemics to the pandemic: appeal from the board of the vaccination calendar for life in Italy: maintain and increase coverage also by re-organizing vaccination services and reassuring the population","volume":"39","author":"Bonanni","year":"2021","journal-title":"Vaccine"},{"key":"2025073115054934800_ckaf107-B10","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.3390\/vaccines12111296","article-title":"Childhood mandatory vaccinations: current situation in European countries and changes occurred from 2014 to 2024","volume":"12","author":"Farina","year":"2024","journal-title":"Vaccines (Basel)"},{"key":"2025073115054934800_ckaf107-B11","author":"Ministero della Salute","year":"2017"},{"key":"2025073115054934800_ckaf107-B12","author":"Ministero della salute","year":"2025"},{"key":"2025073115054934800_ckaf107-B13","doi-asserted-by":"crossref","first-page":"e02515","DOI":"10.1016\/j.heliyon.2019.e02515","article-title":"The utility of joinpoint regression for estimating population parameters given changes in population structure","volume":"5","author":"Gillis","year":"2019","journal-title":"Heliyon"},{"key":"2025073115054934800_ckaf107-B14","article-title":"Trend in mandatory immunisation coverage: linear and joinpoint regression approach, Serbia, 2000 to 2017","volume":"26","author":"Veljkovic","journal-title":"Euro Surveill"},{"key":"2025073115054934800_ckaf107-B15","author":"National Cancer Institute"},{"key":"2025073115054934800_ckaf107-B16","doi-asserted-by":"crossref","first-page":"16","DOI":"10.3390\/vaccines13010016","article-title":"Vaccinating in different settings: best practices from Italian regions","volume":"13","author":"Signorelli","year":"2025","journal-title":"Vaccines (Basel)"},{"key":"2025073115054934800_ckaf107-B17","first-page":"569","article-title":"Vaccine hesitancy in South Tyrol: a narrative review of insights and strategies for public health improvement","volume":"36","author":"Wiedermann","year":"2024","journal-title":"Ann Ig"},{"key":"2025073115054934800_ckaf107-B18","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1080\/20477724.2019.1705021","article-title":"Mandatory vaccination for infants and children: the Italian experience","volume":"113","author":"Rezza","year":"2019","journal-title":"Pathog Glob Health"},{"key":"2025073115054934800_ckaf107-B19","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1080\/14760584.2021.1912603","article-title":"Current understandings of the impact of mandatory vaccination laws in Europe","volume":"20","author":"Odone","year":"2021","journal-title":"Expert Rev Vaccines"},{"key":"2025073115054934800_ckaf107-B20","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.jpeds.2021.01.021","article-title":"Global ethical considerations regarding mandatory vaccination in children","volume":"231","author":"Savulescu","year":"2021","journal-title":"J Pediatr"},{"key":"2025073115054934800_ckaf107-B21","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1186\/s13052-018-0504-y","article-title":"Mandatory vaccinations in European countries, undocumented information, false news and the impact on vaccination uptake: the position of the Italian pediatric society","volume":"44","author":"Bozzola","year":"2018","journal-title":"Ital J Pediatr"},{"key":"2025073115054934800_ckaf107-B22","article-title":"The impact of mandatory vaccination law in Italy on MMR coverage rates in two of the largest Italian regions (Emilia-Romagna and Sicily): an effective strategy to contrast vaccine hesitancy","volume":"8","author":"Gori","journal-title":"Vaccines (Basel)"},{"key":"2025073115054934800_ckaf107-B23","article-title":"Effectiveness of mandatory and incentive-based routine childhood immunization programs in Europe: a systematic review of the literature","volume":"9","author":"Kuznetsova","journal-title":"Vaccines (Basel)"},{"key":"2025073115054934800_ckaf107-B24","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1093\/aje\/kwac048","article-title":"The long-term success of mandatory vaccination laws after implementing the first vaccination campaign in 19th century rural Finland","volume":"191","author":"Ukonaho","year":"2022","journal-title":"Am J Epidemiol"},{"key":"2025073115054934800_ckaf107-B25","doi-asserted-by":"crossref","first-page":"E524","DOI":"10.9778\/cmajo.20180191","article-title":"Impact of school vaccination mandates on pediatric vaccination coverage: a systematic review","volume":"7","author":"Greyson","year":"2019","journal-title":"CMAJ Open"},{"key":"2025073115054934800_ckaf107-B26","article-title":"Effect of the mandatory vaccination law on measles and rubella incidence and vaccination coverage in Italy (2013\u20132019)","volume":"18","author":"Sindoni","journal-title":"Hum Vaccin Immunother"},{"key":"2025073115054934800_ckaf107-B27","author":"Folkhalsomyndigheten","year":"2015"},{"key":"2025073115054934800_ckaf107-B28","first-page":"CD010038","article-title":"Face-to-face interventions for informing or educating parents about early childhood vaccination","volume":"5","author":"Kaufman","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"2025073115054934800_ckaf107-B29","doi-asserted-by":"crossref","first-page":"4191","DOI":"10.1016\/j.vaccine.2015.04.041","article-title":"Strategies intended to address vaccine hesitancy: review of published reviews","volume":"33","author":"Dub\u00e9","year":"2015","journal-title":"Vaccine"},{"key":"2025073115054934800_ckaf107-B30","author":"World Health Organization","year":"2020"},{"key":"2025073115054934800_ckaf107-B31","author":"World Health Organization","year":"2023"},{"key":"2025073115054934800_ckaf107-B32","article-title":"The impact of the COVID-19 pandemic on vaccination uptake in the United States and strategies to recover and improve vaccination rates: a review","volume":"19","author":"Cunniff","journal-title":"Hum Vaccin Immunother"},{"key":"2025073115054934800_ckaf107-B33","author":"European Centre for Disease Prevention and Control","year":"2024"},{"key":"2025073115054934800_ckaf107-B34","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/s13052-021-01023-6","article-title":"Pediatric routine vaccinations in the COVID 19 lockdown period: the survey of the Italian Pediatric Society","volume":"47","author":"Russo","year":"2021","journal-title":"Ital J Pediatr"},{"key":"2025073115054934800_ckaf107-B35","article-title":"Childhood immunisation coverage during the COVID-19 epidemic in Italy","volume":"10","author":"Sabbatucci","journal-title":"Vaccines (Basel)"},{"key":"2025073115054934800_ckaf107-B36","article-title":"A missed opportunity? Exploring changes in influenza vaccination coverage during the COVID-19 pandemic: data from 12 countries worldwide","volume":"19","author":"Del Riccio","journal-title":"Influenza Other Respir Viruses"},{"key":"2025073115054934800_ckaf107-B37","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s13052-022-01271-0","article-title":"Influenza vaccination coverage in pediatric population in Italy: an analysis of recent trends","volume":"48","author":"D'Ambrosio","year":"2022","journal-title":"Ital J Pediatr"},{"key":"2025073115054934800_ckaf107-B38","doi-asserted-by":"crossref","first-page":"256","DOI":"10.5501\/wjv.v12.i5.256","article-title":"Routine pediatric vaccinations during the COVID-19 pandemic: a review of the global impact","volume":"12","author":"Locke","year":"2023","journal-title":"World J Virol"},{"key":"2025073115054934800_ckaf107-B39","doi-asserted-by":"crossref","first-page":"4151","DOI":"10.1016\/j.vaccine.2023.05.034","article-title":"Estimating global changes in routine childhood vaccination coverage during the COVID-19 pandemic, 2020\u20132021","volume":"41","author":"Ghaznavi","year":"2023","journal-title":"Vaccine"}],"container-title":["European Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurpub\/article-pdf\/35\/4\/781\/63705293\/ckaf107.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurpub\/article-pdf\/35\/4\/781\/63705293\/ckaf107.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T19:05:53Z","timestamp":1753988753000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurpub\/article\/35\/4\/781\/8193947"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,8]]},"references-count":39,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,7,8]]},"published-print":{"date-parts":[[2025,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/eurpub\/ckaf107","relation":{},"ISSN":["1101-1262","1464-360X"],"issn-type":[{"value":"1101-1262","type":"print"},{"value":"1464-360X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,8]]},"published":{"date-parts":[[2025,7,8]]}}}