Which vaccines are mandatory in Italy?

Editorial Board

Editorial Board

May 26th, 2017

Editorial Board
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‘The Italian government has made vaccines against 12 diseases compulsory for children enrolling in state-run schools. The parents of children not vaccinated by six years of age will be fined. ’

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.

Italy’s choice

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 11 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.

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, meningitis B, meningitis C, 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.

Beyond Italy, the debate about mandatory vaccination continues among vaccine advocates, with some contending that health professionals have a duty to be vaccinated so as to protect their patients.

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.

What do you think?