Knowledge and attitudes of parents after the implementation of mandatory vaccination in kindergartens of Palermo, Italy

Knowledge and attitudes of parents after the implementation of mandatory vaccination in kindergartens of Palermo, Italy

Authors

  • Vincenzo Restivo a:1:{s:5:"en_US";s:21:"University of Palermo";}
  • Sara Palmeri Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo
  • Stefania Bono Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo
  • Francesca Caracci Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo
  • Giusy Russo Fiorino Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo
  • Angelo Foresta Department of Medical Prevention, Local Health Unit of Palermo
  • Valerio Gaglio Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo
  • Giorgio Graziano Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo
  • Valentina Marchese Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo
  • Marialuisa Maniglia Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo
  • Claudia Sannasardo Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo
  • Laura Saporito Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo
  • Francesco Scarpitta Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo
  • Carlotta Vella Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo
  • Gianmarco Ventura Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo
  • Maria Silvia Mangano Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo
  • Francesco Vitale Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo
  • Alessandra Casuccio Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo
  • Claudio Costantino Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo

Keywords:

Mandatory vaccination; vaccine adherence; parent age; MMRV vaccine; hexavalent vaccine; Health Belief Model; Health Literacy; Safety; Accessibility; Sicily.

Abstract

Background and aim of the work: Even though vaccination is easy to access in Europe, it has been facing several outbreaks caused by vaccine preventable diseases. Trying to balance the right to health of the community with individual self-determination, in Italy was mandate vaccination for ten vaccine preventable diseases in 2017. The project “Sportello Vaccinale” provided a counseling service to parents in kindergarten of Palermo. The main objective of the study was to investigate knowledge and compliance on vaccination by children’s parents after the implementation of mandatory vaccination. Methods: A cross sectional study was conducted among parents accessing to the “Sportello Vaccinale” using a questionnaire.  The questionnaire consisted of 34 items divided into three sections: socio-demographic data; knowledge and attitude on mandatory vaccination using Health Belief Model (HBM); Health Literacy (HL) level. Results: A total of 95 questionnaires were garnered in the kindergartens from respondents with a mean age of 36 (±SD=6) years. The respondents who delayed hexavalent or Measles, Mumps, Rubella and Varicella (MMRV) vaccinations were 8 (8%) and the more frequent cause was fear of adverse reaction (87%). The sample had more often high level of health literacy (37%), and 55% had higher HBM score. The factor significantly associated with higher HBM score was the age of respondents (OR= 1.14, p=0.006) after controlling for other variables. Conclusions: Consent to vaccination practice was widely represented, but the results of the study highlighted the need for parents to have more information and more time devoted to the practice of vaccination counseling. Implementing counseling activities at school or at the vaccination service, could support an aware decision process of the parents on vaccination topic.

References

1. World Healh Organization. Report of the SAGE Working Group on Vaccine Hesitancy. 2014. Available online: https://www.who.int/immunization/sage/meetings/2014/october/1_Report_WORKING_GROUP_vaccine_hesitancy_final.pdf (accessed 12 January 2019).
2. MacDonald NE, Desai S, Gerstein B. Working with vaccine-hesitant parents: An update. Paediatr Child Health. 2018;23(8):561-562. doi: 10.1093/pch/pxy144.
3. WHO. Measles – European Region Disease outbreak news - update 6 May 2019. Available online: https://www.who.int/csr/don/06-may-2019-measles-euro/en/ (accessed 13th of January 2020.
4. Rechel B, Richardson E, McKee M. The organization and delivery of vaccination services in the European Union. European Observatory on Health Systems and Policies, 2018. Available online: http://www.euro.who.int/__data/assets/pdf_file/0008/386684/vaccination-report-eng.pdf?ua=1 (accessed .
5. Ministero della Salute. Piano Nazionale Prevenzione Vaccinale PNPV 2017-2019. 2017. Available online: http://www.salute.gov.it/imgs/C_17_pubblicazioni_2571_allegato.pdf(accessed 12 January 2020).
6. Istituto Superiore di Sanità. Morbillo & Rosolia News. Rapporto N°37 - Gennaio 2018. Available online: http://www.salute.gov.it/portale/temi/documenti/morbillo/Bollettino_morbillo_37-2018.pdf (accessed 12 Jan 2020).
7. Istituto Superiore di Sanità. Morbillo & Rosolia News. Rapporto N°48 - Gennaio 2019. Available online: https://www.epicentro.iss.it/morbillo/bollettino/RM_News_2018_48%20def.pdf (accessed 12 Jan 2020).
8. Ministero della Salute. Vaccinali dell'età pediatrica e dell'adolescente - Coperture vaccinali. 2019. Available online: http://www.salute.gov.it/imgs/C_17_tavole_20_allegati_iitemAllegati_0_fileAllegati_itemFile_7_file.pdf (accessed 12 Jan 2020).
9. Presidente della Repubblica. Legge 31 luglio 2017 , n. 119, 2017. Available online:http://www.trovanorme.salute.gov.it/norme/dettaglioAtto?id=60201 (accessed 12 Jan 2020).
10. Rezza G. Mandatory vaccination for infants and children: the Italian experience. Pathog Glob Health. 2019:1-6.
11. Signorelli C. Forty years (1978-2018) of vaccination policies in Italy. Acta Biomed. 2019;90(1):127-133. doi: 10.23750/abm.v90i1.7900.
12. Janz NK, Becker MH. The Health Belief Model: a decade later. Health Educ Q. 1984 Spring;11(1):1-47.
13. Rudd RE. Health Literacy: Insights and Issues. Stud Health Technol Inform. 2017;240:60-78.
14. Rawson KA, Gunstad J, Hughes J et al. . The METER: a brief, self-administered measure of health literacy. J Gen Intern Med. 2010 Jan;25(1):67-71.
15. Biasio LR, Corbellini G, D'Alessandro D. An Italian validation of "meter", an easy-to-use Health Literacy (hl) screener. Ann Ig. 2017;29(3):171-178.
16. Gidengil C, Chen C, Parker AM, Nowak S, Matthews L. Beliefs around childhood vaccines in the United States: A systematic review. Vaccine. 2019;37(45):6793-6802.
17. Larson HJ, de Figueiredo A, Xiahong Z et al. The State of Vaccine Confidence 2016: Global Insights Through a 67-Country Survey. EBioMedicine. 2016;12:295-301.
18. Salmon DA, Dudley MZ, Glanz JM, Omer SB. Vaccine hesitancy: Causes, consequences, and a call to action.Vaccine. 2015;33 Suppl 4:D66-71. .
19. Kaufman J, Ryan R, Walsh L et al. Face-to-face interventions for informing or educating parents about early childhood vaccination. Cochrane Database Syst Rev. 2018;5:CD010038.
20. Tabacchi G, Costantino C, Cracchiolo M, et al. Information sources and knowledge on vaccination in a population from southern Italy: The ESCULAPIO project. Hum Vaccin Immunother. 2017;13(2):339-345. doi: 10.1080/21645515.2017.1264733. .
21. Restivo V, Napoli G, Marsala MG, et al. Factors associated with poor adherence to MMR vaccination in parents who follow vaccination schedule. Hum Vaccin Immunother. 2015;11(1):140-5. doi: 10.4161/hv.
22. Restivo V, Vizzini G, Mularoni A, Di Benedetto C, Gioè SM, Vitale F. Determinants of influenza vaccination among solid organ transplant recipients attending Sicilian reference center. Hum Vaccin Immunother. 2017;13(2):346-350. doi: 10.1080/21645515.2017.1.
23. Crenna S, Osculati A, Visonà SD. Vaccination policy in Italy: An update. J Public Health Res. 2018;7(3):1523. .
24. Signorelli C, Odone A, Conversano M, Bonanni P. Deaths after Fluad flu vaccine and the epidemic of panic in Italy. BMJ. 2015;350:h116. .
25. Restivo V, Cernigliaro A, Palmeri S, Sinatra I, Costantino C, Casuccio A. The Socio-Economic Health Deprivation Index and its association with mortality and attitudes towards influenza vaccination among the elderly in Palermo, Sicily. J Prev Med Hyg. 2019.
26. Barclay TR, Hinkin CH, Castellon SA. Age-associated predictors of medication adherence in HIV-positive adults: health beliefs, self-efficacy, and neurocognitive status. Health Psychol. 2007 ;26(1):40-9.
27. Zhou M, Qu S, Zhao L, Campy KS, Wang S. Parental perceptions of human papillomavirus vaccination in central China: the moderating role of socioeconomic factors. Hum Vaccin Immunother. 2019;15(7-8):1688-1696. .
28. Restivo V, Orsi A, Ciampini S, et al. How should vaccination services be planned, organized, and managed? Results from a survey on the Italian vaccination services. Ann Ig. 2019;31(2 Supple 1):45-53. doi: 1.
29. Restivo V, Costantino C, Mammina C, Vitale F. Influenza like Illness among Medical Residents Anticipates Influenza Diffusion in General Population: Data from a National Survey among Italian Medical Residents. PLoS One. 2016;11(12):e0168546. doi: 10.1371/j.
30. Amit Aharon A, Nehama H, Rishpon S, Baron-Epel O. Parents with high levels of communicative and critical health literacy are less likely to vaccinate their children. Patient Educ Couns. 2017 Apr;100(4):768-775.
31. Biasio LR. Vaccine hesitancy and health literacy. Hum Vaccin Immunother. 2017;13(3):701-702.
32. Cernigliaro A, Palmeri S, Casuccio A, Scondotto S, Restivo V; In Primis Working Group. Association of the Individual and Context Inequalities on the Breastfeeding: A Study from the Sicily Region. Int J Environ Res Public Health. 2019;16(19). pii: E3514. d.
33. Lorini C, Santomauro F, Donzellini M. Health literacy and vaccination: A systematic review. Hum Vaccin Immunother. 2018;14(2):478-488. .
34. Restivo V, Costantino C, Giorgianni G, et al. . Case-control study on intestinal intussusception: implications for anti-rotavirus vaccination. Expert Rev Vaccines. 2018;17(12):1135-1141. doi: 10.1080/14760584.2018.1546122.

Downloads

Published

10-04-2020

How to Cite

1.
Restivo V, Palmeri S, Bono S, et al. Knowledge and attitudes of parents after the implementation of mandatory vaccination in kindergartens of Palermo, Italy. Acta Biomed. 2020;91(3-S):41-47. doi:10.23750/abm.v91i3-S.9415