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IMMUNIZATION
Salmaso S, Rota MC, Ciofi Degli Atti ML, Tozzi AE, Kreidl P. Infant
immunization coverage in Italy: estimates by simultaneous EPI cluster surveys of
regions. ICONA Study Group. Bull World Health Organ 77(10). 843-51. 1999.
In 1998, a series of regional cluster surveys (the ICONA
Study) was conducted simultaneously in 19 out of the 20 regions in Italy to
estimate the mandatory immunization coverage of children aged 12-24 months with
oral poliovirus (OPV), diphtheria-tetanus (DT) and viral hepatitis B (HBV)
vaccines, as well as optional immunization coverage with pertussis, measles and
Haemophilus influenzae b (Hib) vaccines. The study children were born in 1996
and selected from birth registries using the Expanded Programme of Immunization
(EPI) cluster sampling technique. Interviews with parents were conducted to
determine each child's immunization status and the reasons for any missed or
delayed vaccinations. The study population comprised 4310 children aged 12-24
months. Coverage for both mandatory and optional vaccinations differed by
region. The overall coverage for mandatory vaccines (OPV, DT and HBV) exceeded
94%, but only 79% had been vaccinated in accord with the recommended schedule
(i.e. during the first year of life). Immunization coverage for pertussis
increased from 40% (1993 survey) to 88%, but measles coverage (56%) remained
inadequate for controlling the disease; Hib coverage was 20%. These results
confirm that in Italy the coverage of only mandatory immunizations is
satisfactory. Pertussis immunization coverage has improved dramatically since
the introduction of acellular vaccines. A greater effort to educate parents and
physicians is still needed to improve the coverage of optional vaccinations in
all regions.
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