IMPROVING VACCINE COVERAGE FOR NON-COMPULSORY VACCINES

Key words: Immunization, Immunization schedule, Pertussis, Measles

In Italy, vaccinations for diphtheria, tetanus, poliomyelitis, and hepatitis B are compulsory by law for all newborns and are funded by the National Health System. The national vaccination coverage for each of these diseases is over 90%. By contrast, pertussis, measles and Hib vaccines are not compulsory and whether or not they are offered free-of-charge is left to the discretion of the individual regional health authorities. Until the mid-1990s, national pertussis and measles vaccination coverage was less than 60%. The fact that the National Health System did not directly provide these vaccines has been identified as one of the major causes of failure to vaccinate. In 1995, the Ministry of Health began to strongly advise the regional health authorities to actively offer non-compulsory vaccinations free-ofcharge. Since then, 19 of the 21 regional health authorities have made efforts to ensure that pertussis and measles vaccinations are provided free-of-charge. Nevertheless, there exist great differences in vaccination schedules and strategies. For the 1996 birth cohort, pertussis vaccination coverage was 88%, yet coverage for measles has remained low (56%). To successfully control vaccine-preventable diseases, it is crucial to conduct coordinated efforts, including the routine active offering of vaccines free-of-charge and the monitoring of vaccination coverage in all birth cohorts.