ABSTRACT
Background The debate on vaccination strategies has been periodically involving researchers, policymakers, and also the population. Interest waves have occurred both after a revival of childhood infectious diseases in 2016-2017, due to low vaccine coverages, and during the recent Coronavirus outbreak. This study aimed at overviewing vaccination strategies (and corresponding vaccine coverages) for childhood vaccinations and SARS-CoV-2. Methods Measles was chosen as a childhood vaccination indicator. Policy data were retrieved from health institutions (either European or national/regional) and, for COVID-19, also from press agencies and newspaper websites. Vaccine coverage data were retrieved from the World Bank, World Health Organisation, and UNICEF databases (for childhood vaccines), and from the “Our World in Data” platform for SARS-CoV-2. A qualitative comparison was performed between the two contexts. Results Unlike childhood vaccinations, few countries (and only Austria in Europe) imposed generalised COVID-19 mandates, most countries preferring targeted mandates for higher-risk groups. Many countries confirmed their traditional voluntary vaccination approach also for COVID-19, while countries historically relying on compulsory vaccination strategies, such as Slovenia and Hungary, surprisingly opted for voluntary SARS-CoV-2 vaccination, with unsatisfactory results. However, no tangible crude association was generally found between vaccination policies and achieved coverages, although factors such as cultural background, education, and religion appeared to influence the impact of vaccination policies. Conclusions The COVID-19 experience has enriched pre-existent vaccination strategy debates by adding interesting elements concerning attitudes toward vaccines in a novel context. Reading the available results in the frame of vaccine hesitancy determinants can help to understand the relationship between policies and actual coverages. Key messages Few countries have imposed generalised mandates for COVID-19, while many preferred targeted obligations for high-risk groups and some countries surprisingly opted for a voluntary approach. Accurately considering social and cultural determinants allows understanding the chance of success of vaccination strategies, ahead of fostering the right policymaking approach for each population.
ABSTRACT
BACKGROUND: On March 11, 2020, the World Health Organization characterized the novel coronavirus disease 2019 (COVID-19) outbreak as a pandemic. The first cases in Italy were reported on January 30, 2020, and the outbreak quickly escalated. On March 19, 2020, deaths in Italy surpassed those in China. The Italian government implemented progressively restrictive measures leading to a nationwide lockdown on March 8, 2020. This study aimed to assess the impact of mitigation measures implemented in Italy on the spread of COVID-19. METHODS: Publicly available data were used to evaluate changes in the growth curve of the number of patients hospitalized in intensive care (IC) at three time intervals between February 19, 2020, and April 9, 2020, after the implementation of progressive measures: (1) containment and travel restrictions, (2) lockdown of the epicenter of the outbreak, and (3) school closures and nationwide lockdown. The models that showed the highest reliability according to the Akaike information criterion and based on data from the three time intervals were projected to assess how the epidemic would have evolved if no other measure had been implemented. RESULTS: The most reliable models were (1) exponential, (2) quadratic, and (3) cubic (R2 = 0.99, >0.99, and > 0.99 respectively), indicating a progressive decrease in the growth of the curve. CONCLUSION: This study suggests the measures were effective in flattening the epidemic curve and bought valuable time, allowing for the number of IC beds to be nearly doubled before the national health system reached maximum capacity.