Peer-reviewed article
Catch-Up Vaccination Intervention and Study of Infant Vaccine Hesitancy in Health District in Palermo (Italy).
Alessandra Fallucca, Roberto Levita, Giuseppe Vella, Angela Sutera, Domenico Mirabile et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001A vaccination catch-up intervention was implemented in Palermo, Italy, targeting children born in 2022-2023 where immunisation coverage was below safe thresholds. Working with primary care pediatricians and organising active outreach sessions increased vaccination coverage by 10-12 percentage points. A questionnaire study found that parents' perception of disease risk and expectations of vaccination benefits were linked to willingness to vaccinate, while information from internet and media was associated with refusal.
Key points
- Initial vaccination coverage for polio and measles was 77.29% and 77.62% respectively, below the 95% safety threshold
- The catch-up intervention increased coverage by approximately 10-12 percentage points in both birth cohorts
- Perception of infectious disease risk was strongly associated with vaccination acceptance (OR: 7.91)
- Expectations of positive vaccination outcomes were significantly associated with acceptance (OR: 8.62)
- Internet and media as information sources were associated with vaccination refusal (OR: 0.47 and 0.13 respectively)
Limitations
The study relied on self-reported questionnaire data from parents, which may introduce recall and social desirability bias. The before-after design without a control group cannot definitively attribute the coverage increase solely to the intervention, as other factors may have contributed.
Abstract
BACKGROUND: Despite the introduction in 2017 of mandatory vaccination for the hexavalent and the measles-mumps-rubella-varicella vaccines, childhood vaccination coverage in Sicily (Italy) remains below the recommended and safety threshold of 95%. A catch-up vaccination intervention was implemented for the pediatric population of the 2022-2023 birth cohorts residing in a health district of Palermo (Bagheria) where in 2024, 24-month coverage for polio and measles was 77.29% and 77.62%, respectively. METHODS: A cross-sectional study with a before-after component was conducted between June 2025 and December 2025, with the aim of evaluating the increase in vaccination coverage. A questionnaire was administered to the parents of non-compliant children to investigate the determinants of infant vaccine hesitancy. RESULTS: Collaboration with primary care pediatricians and the organization of active call sessions and extra vaccination sessions resulted in an increase in vaccination coverage of approximately 10-12 percentage points in both birth cohorts. The investigation of the determinants of vaccination adherence showed some significant associations: "perception of infectious disease risk" (OR: 7.91; p = 0.009) and "expectations of a positive outcome from vaccination" (OR: 8.62; p = 0.003). Vaccine information sources such as the internet and media were associated with refusal of catch-up vaccination (OR: 0.47, p < 0.001; and OR: 0.13, p = 0.026, respectively). CONCLUSIONS: Despite methodological limitations, such as the self-reported nature of the survey data, the study demonstrated the usefulness of local strategies aimed at vaccination catch-up, representing a valuable example of local public health practice and effectively contributing to improved vaccination coverage in the pediatric population.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Catch-up vaccination intervention involving collaboration with primary care pediatricians, active call sessions to parents, and organisation of extra vaccination sessions
- Population
- Children from 2022-2023 birth cohorts in Bagheria health district, Palermo, Italy, whose parents were initially non-compliant with vaccination schedules
Key finding
Vaccination coverage increased by approximately 10-12 percentage points following the intervention