Vaccinations at home: a new strategy to contain vaccine hesitancy? The experience of ASL Napoli 1 Centro, Italy
Keywords:
Home vaccination, mandatory vaccinations coverage, vaccine hesitancy, convenience, deprived socio- economic contextsAbstract
Vaccination coverage are generally geographically variable, even within large cities; furthermore, across target population are embedded difficult-to-reach clusters. To address this issue and improve coverage of mandatory vaccinations, a study group explored bringing vaccination at home as an interventional strategy.
In a pilot experience, parents of unvaccinated and under vaccinated children of the 2020 birth cohort living in Naples, Italy were contacted by telephone to offer home administration of vaccinations. A specifically trained team arranged vaccinations visits at home. Coverage rates were evaluated at baseline and one month after the intervention strategy. A significant positive increase in hexavalent vaccine (+1.43%) and measles-mumps-rubella (+1.85%) coverage was registered despite the short duration of the pilot program. Home vaccination turned out to be a medical resource consuming but feasible and successful strategy to increase mandatory vaccinations coverage among the most difficult-to-reach and fragile segments of the pediatric population.
References
1. Bozzola E, Spina G, Russo R, Bozzola M, Corsello G, Villani A. Mandatory vaccinations in European countries, undocumented information, false news and the impact on vaccination uptake: the position of the Italian pediatric society. Ital J Pediatr. 2018 Jun 14;44(1):67. doi:10.1186/s13052-018-0504-y. PMID: 29898770; PMCID: PMC6001041.
2. Hamilton JL. Recognizing Vaccine-Preventable Diseases and Managing Outbreaks. Prim Care. 2020 Sep;47(3):467-81. doi:10.1016/j.pop.2020.05.003. Epub 2020 May 22. PMID: 32718444.
3. Lafnitzegger A, Gaviria-Agudelo C. Vaccine Hesitancy in Pediatrics. Adv Pediatr. 2022 Aug;69(1):163-76. doi:10.1016/j.yapd.2022.03.011. Epub 2022 Jun 20. PMID: 35985708.
4. Cataldi JR, O’Leary ST. Parental vaccine hesitancy: scope, causes, and potential responses. Curr Opin Infect Dis. 2021 Oct;34(5):519-26. doi:10.1097/QCO.0000000000000774. PMID: 34524202.
5. MacDonald NE; Sage Working Group on Vaccine Hesitancy. Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015 Aug 14;33(34):4161-4. doi:10.1016/j.vaccine.2015.04.036. Epub 2015 Apr 17. PMID: 25896383.
6. Kestenbaum LA, Feemster KA. Identifying and addressing vaccine hesitancy. Pediatr Ann. 2015 Apr;44(4):e71-5. doi:10.3928/00904481-20150410-07. PMID: 25875982; PMCID: PMC4475845.
7. Gabis LV, Attia OL, Goldman M, Barak N, Tefera P, Shefer S, et al. The myth of vaccination and autism spectrum. Eur J Paediatr Neurol. 2022 Jan;36:151-8. doi:10.1016/j.ejpn.2021.12.011. Epub 2021 Dec 22. PMID: 34996019; PMCID: PMC8694782.
8. Bertoncello C, Ferro A, Fonzo M, Zanovello S, Napoletano G, Russo F, et al. Socioeconomic Determinants in Vaccine Hesitancy and Vaccine Refusal in Italy. Vaccines (Basel). 2020 Jun 5;8(2). doi:10.3390/vaccines8020276. PMID: 32516936; PMCID: PMC7349972.
9. Di Pietro A, Visalli G, Antonuccio GM, Facciolà A. Today’s vaccination policies in Italy: The National Plan for Vaccine Prevention 2017-2019 and the Law 119/2017 on the mandatory vaccinations. Ann Ig. 2019 Mar-Apr;31(2 Suppl 1):54-64. doi:10.7416/ai.2019.2277. PMID: 30994164.
10. Croci R, Rossi D, Colucci ME, Odone A, Signorelli C. Trends in childhood vaccinations coverage in Lombardy Region after the National Vaccine Prevention Plan (2017-19) and the new law on mandatory vaccinations. Acta Biomed. 2020 Apr 10;91(3-S):71-6. doi:10.23750/abm.v91i3-S.9458. PMID: 32275270; PMCID: PMC7975904.
11. Casula M, Toth F. The 2017 Italian reform on mandatory childhood vaccinations: Analysis of the policy process and early implementation. Health Policy. 2021 Jan;125(1):7-11. doi:10.1016/j.healthpol.2020.11.004. Epub 2020 Nov 7. PMID: 33257094.
12. Signorelli C, Odone A, Cella P, Iannazzo S. Childhood vaccine coverage in Italy after the new law on mandatory immunization. Ann Ig. 2018 Jul-Aug;30(4 Suppl 1):1-10. doi:10.7416/ai.2018.2227. PMID: 30062373.
13. Truong J, Bakshi S, Wasim A, Ahmad M, Majid U. What factors promote vaccine hesitancy or acceptance during pandemics? A systematic review and thematic analysis.
14. Health Promot Int. 2022 Feb 17;37(1). doi:10.1093/heapro/daab105. PMID: 34244738.
15. Carias C, Pawaskar M, Nyaku M, Conway JH, Roberts CS, Finelli L, et al. Potential impact of COVID-19 pandemic on vaccination coverage in children: A case study of measles-containing vaccine administration in the United States (US). Vaccine. 2021 Feb 22;39(8):1201-4. doi:10.1016/j.vaccine.2020.11.074. Epub 2020 Dec 9. PMID: 33334618; PMCID: PMC7723783.
16. Sabbatucci M, Odone A, Signorelli C, Siddu A, Silenzi A, Maraglino FP, et al. Childhood Immunisation Coverage during the COVID-19 Epidemic in Italy. Vaccines (Basel). 2022 Jan 14;10(1). doi:10.3390/vaccines10010120. PMID: 35062781; PMCID: PMC8782029.
17. Postema AS, Breiman RF; National Vaccine Advisory Committee. Adult immunization programs in nontraditional settings: quality standards and guidance for program evaluation. MMWR Recomm Rep. 2000 Mar 24;49(RR-1):1-13. PMID: 15580726.
18. Hofstetter AM, Schaffer S. Childhood and Adolescent Vaccination in Alternative Settings. Acad Pediatr. 2021 May-Jun;21(4S):S50-S6. doi:10.1016/j.acap.2021.02.001. PMID: 33958093.
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