Editor’s note: This article was updated to reflected changes to Italy’s law on compulsory vaccination. An earlier draft of the legislation provided for 12 vaccines to become mandatory. This was reduced to 10 during a debate in parliament.
Italy is one of several European countries experiencing measles outbreaks – jeopardising a continent-wide effort to eliminate the disease.
In Italy, the number of two-year-olds vaccinated against measles has dropped from more than 90% to below 80%. This is well short of the World Health Organization’s recommended coverage of 95% or more. Almost three times as many measles cases have been recorded in Italy to date, compared to all of 2016.
Whether mandatory vaccination is the best way to reach vaccine uptake targets remains a debate – some countries are measles-free without introducing compulsory measures. Other countries, such as Australia, have incentivised vaccination by linking it to social welfare payments. Several US states have introduced mandates, with opt-out clauses for medical (and, sometimes, philosophical) exemptions.
The Italian government, concerned by falling vaccine uptake rates and an apparent increase in antivaccine sentiment, has decided to take a firm position by introducing compulsory vaccination for measles and 9 other diseases.
‘We are sending a very strong message to the public,’ said Health Minister Beatrice Lorenzin, adding that the ‘vaccine emergency is driven by fake news’ which has spread misinformation about vaccine safety.
Vaccini:Emergenza generata dalle fake news https://t.co/KefQrqwEQp
— Beatrice Lorenzin (@BeaLorenzin) May 12, 2017
This was echoed by Prime Minister Paolo Gentiloni who blamed a decrease in vaccinations on the ‘spread of anti-scientific theories’.
Vaccines against the following diseases are mandatory for Italian schoolchildren: polio, diphtheria, tetanus, hepatitis B, haemophilus influenzae B, measles, mumps, rubella, whooping cough, and chickenpox.
Some of these vaccines are given in combination. For example, the MMR jab protects against measles, mumps and rubella.
Italy: big on prevention
The Italian government has been proactive in its support for preventative health measures, including vaccination. Its new immunisation schedule takes a life-course approach to immunisation and is widely supported by scientific societies in Italy.
While many public health campaigners welcome the latest move to make several vaccines mandatory, some have questioned whether the health system is ready to meet the surge in demand that this may generate. Others worry that the move will backfire.
While there is strong consensus in the public health community about the importance of vaccination, it is not yet clear whether making vaccines compulsory is the best way to achieve high uptake rates.
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