Italy started 2017 with a public health crisis. With vaccination coverage rates at a minimum, measles broke out in the country, which has since recorded 7,500 chaos and a dozen deaths. It was a serious warning of what could happen to other diseases if the growing influence of the anti-vaccine movement was not reversed. The regional parliament of the Veneto, for example, passed a law in 2007 that abolished the obligation to immunize children against four diseases (tetanus, diphtheria, polio and hepatitis B). A compulsory nature that was already relative in the absence of measures that forced parents to really vaccinate their children.
The Italian government responded to the challenge with an unprecedented measure in Europe: to extend the compulsory nature to 10 vaccines and, this time, to apply a package of measures to ensure that children were immunized, with fines for those parents who refuse.
The Italian case has sparked interest throughout Europe, as evidenced by the Escaide 2018 conference, organized by the European Center for Disease Control and Prevention (ECDC) in Malta last November. Domenico Martinelli, researcher in Hygiene and Public Health of the University of Foggia, presented there a detailed work of the difficulties and the results obtained with the measure.
Question. Was the situation so bad at the beginning of 2017?
Answer. Very dangerous. The vaccine coverage rate against measles at seven years of age was 82%, when the goal is 95%. Many vaccines had dropped five, six or seven points in a few years. Measles was a warning of what could happen to other diseases.
P. What did the Government do?
R. A law that declared that summer required 10 vaccines and designed a plan to comply with it.
P.With what measures?
R. First, it was necessary to identify, with the help of schools and vaccination services, children who were not immunized. For this it was necessary to have a computerized registry, which in several regions did not exist.
Q. And once identified?
R. First two parents were sent letters inviting them to vaccinate their children. If they still did not do so, a third sending would call them to a meeting to discuss and discuss the reasons why they did not do so. Then they were left with a time of reflection, but they were given a deadline to decide it.
P. And if they refused?
R. The law provides for a fine, the amount of which is decided by the regions. They are a few hundred euros.
P. And it worked?
R. Fairly good. According to the vaccine and the cohort, there are rates that have grown five and six points. But you have to keep working.
P. Who is convinced by these measures?
R. The policy has been effective with families who have doubts or hesitant positions. It is true that the antivaccina nucleus continues to reject them, but it is a small group, from 1% to 3% of the population, that does not operate in the rational plane. The danger is when your messages make others doubt. The law has proven useful in isolating the most skeptical.
P. The current government has launched messages against vaccines ...
R. There is a 5 Star Movement sector that has been ambiguous. But the law is still in force.
P. Do you think that this law is applicable to other countries?
R. Depends on the context. Italy applied a drastic measure, with its costs but which has proved useful, in a very specific situation. But Spain has high rates and confidence in the health system. So, you have other ways to keep rates at 95% without having to apply a law like this. In a way, it can be considered a last resort.